The hyperosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitologic, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US) of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosnophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benign eosinophilic infiltrates and one of them revealed combined centrilobular necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least one of CT, US, or scintigraphy. These findings completely disappeared in 2 To 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphy. These findings completelydisappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnoses of these findings should include metastatic disease, lymphoma, leukemia. candidiasis or other opportunistic infections.
Abdomen ; Biopsy ; Bone Marrow ; Candidiasis ; Cough ; Diagnosis, Differential ; Eosinophilia ; Eosinophils ; Fever ; Hepatocytes ; Hepatomegaly ; Histamine Antagonists ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Leukemia ; Leukocytosis ; Liver ; Lymphoma ; Necrosis ; Opportunistic Infections ; Radionuclide Imaging ; Spleen ; Ultrasonography

The hyperosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitologic, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US) of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosnophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benign eosinophilic infiltrates and one of them revealed combined centrilobular necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least one of CT, US, or scintigraphy. These findings completely disappeared in 2 To 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphy. These findings completelydisappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnoses of these findings should include metastatic disease, lymphoma, leukemia. candidiasis or other opportunistic infections.
Abdomen ; Biopsy ; Bone Marrow ; Candidiasis ; Cough ; Diagnosis, Differential ; Eosinophilia ; Eosinophils ; Fever ; Hepatocytes ; Hepatomegaly ; Histamine Antagonists ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Leukemia ; Leukocytosis ; Liver ; Lymphoma ; Necrosis ; Opportunistic Infections ; Radionuclide Imaging ; Spleen ; Ultrasonography

Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.
Agrochemicals ; Alcoholism ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Korea ; Liver Diseases

OBJECTIVE: Because of the limited penetration into the central nervous system after systemic administration of numerous therapeutic compounds, intratumoral chemotherapy for brain tumors has also been used. However, the efficacy of intratumoral drug administration is restricted by the poor diffusion of drug through tumor and brain interstitium. In order to enhance the diffusion of chemotherapeutic agent and increase the cytotoxicity with minimal dose, the authors report the results of convection-enhanced delivery(CED) of chemotherapeutic agent to the malignant brain tumor as a method of enhancing cerebral drug delivery. METHODS: Authors used "CADD-Micro(R) ambulatory infusion pump" from Deltec, which can be programmed for continuous infusion. Intratumoral injection of chemotherapeutic drug using the pump was applied to eight patients with glioma and one patient with lymphoma. Surgery was done and tumor was removed as much as possible. The tip of catheter was placed in the center of tumor cavity. Adriamycin (0.16~0.32mg) was put in the reservoir which was connected to the proximal catheter and fixed in the pump device. Twenty-four hours after surgery, Adriamycin was infused. RESULTS: There was no adverse reaction of CED technique. Compared with current delivery techniques, the improvement of survival rate has been observed(5 patients: alive, 3 patients: dead, 1 patient: lost(alive to 5 mo.)). CONCLUSION: CED can be useful method for distributing therapeutic molecules in the interstitial space of tumor and can be utilized for chemotherapeutic agents, immunotoxins, and gene etc..
Brain ; Brain Neoplasms ; Catheters ; Central Nervous System ; Diffusion ; Doxorubicin ; Drug Therapy ; Glioma ; Humans ; Immunotoxins ; Lymphoma ; Survival Rate

PURPOSE: The purpose of this study was to present methods and results for the modified Phemister operation, with a suture anchor added for augmentation of the conoid ligament in cases of acute dislocation of the acromioclavicular joint. MATERIALS AND METHODS: We evaluated 14 cases of acute dislocation of the acromioclavicular joint. This included 11 cases of Rockwood type 3, and 3 cases of type 5. The mean age of patients was 45.2 years. We operated on them using an anchor for augmentation of the conoid ligament in the modified Phemister operation. The average follow-up period was 14 months and post-operative clinical analysis was conducted using the Weitzman classification, VAS Score, Constant Score and KSS Score. RESULTS: According to Weitzman scores, 13 cases were evaluated as excellent, and one case was good. They had mean joint ranges of forward elevation of 170.7degrees, lateral elevation of 166.4, external rotation of 68.2, and internal rotation to the level of T7. The mean VAS Score was 1.9, mean Constant Score 90.8, and the mean KSS Score 91. Radiologic analysis indicated that all cases had a good result. CONCLUSION: The modified Phemister operation with a suture anchor added for augmentation of the conoid ligament is very effective clinically in acute dislocations of the acromioclavicular joint.
Acromioclavicular Joint ; Dislocations ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Suture Anchors ; Sutures

PURPOSE: To obtain basic data for development of a glioblastoma-specific immunotoxin, the expression of variable cell surface receptors on a human glioblastoma xenograft model was evaluated, using NOD/SCID mice. MATERIALS AND METHODS: We developed a xenograft model in NOD/SCID mice implanted with a human glioblastoma cell line (U-87MG). Immunohistochemical studies were performed on implanted tumor nodules (n=8) using antibodies against CD71, EGFR, IGF-IRalpha, CXCR4 and IL-4Ralpha. RESULTS: Expression of IL-4Ralpha, in implanted tumornodules, was the highest of the cell surface receptors evaluated in this study. However, the endothelial cells in, and around, the tumor nodules also revealed immunopositivity against IL-4Ralpha. The immunoreactivity of IL-4Ralpha, and other surface receptors such as CD71, IGF-IRalpha and EGFR, was prominent in tumor nodules associated with tumor necrosis. CONCLUSION: IL-4Ralpha would be a possible target for the development of glioblastoma-specific immunotoxin, although there are limitations due to its endothelial expression.
Animals ; Antibodies ; Cell Line ; Endothelial Cells ; Glioblastoma* ; Heterografts* ; Humans* ; Immunotoxins ; Mice* ; Mice, SCID ; Necrosis ; Receptors, Cell Surface*

STATEMENT OF PROBLEM: Recently, titanium has become popular as superstructure material in implant dentistry because titanium superstructure can be easily milled by means of computer-aided design and manufacture (CAD/CAM) technique. But retention form such as nail head or bead cannot be cut as a result of technical limitation of CAD/CAM milling and bond strength between titanium and porcelain is not as strong as that of conventional gold or metal alloy. PURPOSE: The objective of this study was to evaluate the shear bond strength of three different materials: heat curing resin, composite resin, porcelain which were bonded to grade II commercially pure Titanium (CP - Ti). MATERIAL AND METHODS: Thirty seven CP - Ti discs with 9 mm diameter, 10 mm height were divided into three groups and were bonded with heat curing resin (Lucitone 199), indirect composite resin (Sinfony), and porcelain (Triceram) which were mounted in a former with 7 mm diameter and 1 mm height. Samples were thermocycled for 1000 cycles at between 5 - 55 degrees C. Shear bond strength (MPa) was measured with Instron Universal Testing Machine with cross head speed of 1 mm/min. The failure pattern was observed at the fractured surface and divided into adhesive, cohesive, and combination failure. The data were analyzed by one-way ANOVA and Scheffe's multiple range test (alpha= 0.05). RESULTS: Lucitone 199 (17.82 +/- 5.13 MPa) showed the highest shear bond strength, followed by Triceram (12.97 +/- 2.11 MPa), and Sinfony (6.00 +/- 1.31 MPa). Most of the failure patterns in Lucitone 199 and Sinfony group were adhesive failure, whereas those in Triceram group were combination failure. CONCLUSION: Heat curing resin formed the strongest bond to titanium which is used as a CAD/CAM milling block. But the bond strength is still low compared with the bond utilizing mechanical interlocking and there are many adhesive failures which suggest that more studies to enhance bond strength are needed.
Acrylic Resins ; Adhesives ; Alloys ; Ceramides ; Collodion ; Computer-Aided Design ; Dental Porcelain ; Dentistry ; Head ; Hot Temperature ; Nails ; Retention (Psychology) ; Titanium

Hot bath-related deaths occur occasionally in Korea, particularly in the winter season among elderly people. The postmortem determination of the cause and manner of death is often difficult because the investigation depends predominantly on postmortem external examination. Moreover, the pathogenesis of sudden death during immersion in a hot bath tub is not easily explained. Confusion regarding the manner of death, whether accidental or natural, causes some conflicts in the compensation of life insurance. This study reviewed the literature, particularly Japanese studies about epidemiology, pathophysiology, and the disputes regarding determination of the manner of death. We concluded that the cause and manner of death are not as simple as only natural disease or drowning; there are complicated cases mixed with accidental and natural causes. Extensive epidemiological studies and thorough investigation, including full autopsy and toxicologic studies, are essential for comprehensive understanding of hot bath-related deaths in Korea.
Aged ; Asian Continental Ancestry Group ; Autopsy ; Baths ; Cause of Death ; Compensation and Redress ; Death, Sudden ; Dissent and Disputes ; Drowning ; Epidemiologic Studies ; Epidemiology ; Humans ; Immersion ; Insurance, Life ; Korea ; Seasons

Grave's disease is an autoimmune disorder and affects thyroid gland and orbit. Ocular manifestations of this disease, referred to as Grave's ophthalmopathy are caused by deposition of antithyroglobulin immune complexes into extraocular muscles and orbital fats. Consequent increase in volume of orbital contents results in exopthalmos. Severe exopthalmos results in several significant visual consequences as follows: exposure keratitis, diplopia and optic neuropathy. Orbital decompression for Grave's ophthalmopathy has traditionally been performed through either an external or a transantral approach. The advent of intranasal endoscopes allowed for the development of a transnasal approach for medial and inferior orbital wall decompression. Recently, the authors experienced a case of Grave's ophthalmopathy complicated with exposure keratitis and performed endoscopic transnasal orbital decompression, so report this case with a review of literature.
Antigen-Antibody Complex ; Decompression* ; Diplopia ; Endoscopes ; Fats ; Keratitis ; Muscles ; Optic Nerve Diseases ; Orbit* ; Thyroid Gland

Type 2 diabetes is different between Asian and non-Asian populations. Compared with their Caucasian counterparts, Asian patients with type 2 diabetes have the characteristics of lower body mass index, lower insulin secretory response, and a lower degree of insulin resistance. Furthermore, a recent study revealed that the incretin effect is not decreased in Korean patients with type 2 diabetes compared with normal glucose tolerance. The HbA1c lowering efficacy of dipeptidylpeptidase-4 inhibitors, which enhances active incretin hormones, is greater in Asian people than in non-Asian people, which could be ascribed to their lower body mass indexes. Therefore, doctors should take these differing characteristics of type 2 diabetes in Asian patients into account for customized anti-diabetes therapy.
Asian Continental Ancestry Group ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Glucose ; Humans ; Incretins ; Insulin ; Insulin Resistance