In a murine model system, enhancement of the total IgA and rotavirus-specific IgA of suckling mice was measured by ELISA with the intestinal fluid following oral administration of murine rotavirus EC (EDIM-Cambridge) strain. In the EC strain-administered group, the geometric mean titers (GMT) of total IgAs were 512 and 91 at 1 and 2 week postinfection, respectively. On the other hand, the GMTs of the rotavirus-specific IgAs were 108 and 3 at the same periods, respectively. Thus increase in the total IgAs was 64 folds and that in the rotavirus-specific IgAs was 43 folds compared with the negative control group. As the maximal titers of both the total and rotavirus-specific IgAs were observed at 1 week decreasing until 2 weeks after infection, it is evident that the GMT of the total IgA implies that of rotavirus-specific IgA. In our ELISA system, whose specificity was verified by Western blot analysis, the total IgA in the administered group was determined to be 40-400 ng per 1 ml of the intestinal fluid. Therefore it is concluded that determination of the rotavirus-specific IgA in murine models can be a sensitive indication of rotavirus infection, and will be another promising tool in viral challenge experiments in vaccine development.
Administration, Oral ; Animals ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Hand ; Immunoglobulin A* ; Mice ; Mice, Inbred ICR* ; Rotavirus Infections ; Rotavirus* ; Sensitivity and Specificity

PURPOSE: To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. MATERIALS AND METHODS: The study was based on retrospective analysis of twelve cases(8 men, 4 women) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(I), typhoid fever(I), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). RESULTS: Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 reguired surgery and none showed serious complication. CONCLUSION: Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding.
Accidents, Traffic ; Aneurysm, False ; Arteries ; Diagnosis ; Drainage ; Gastrointestinal Hemorrhage* ; Hemobilia ; Hemorrhage ; Humans ; Male ; Retrospective Studies ; Stomach ; Typhoid Fever

Percutaenous transhepatic biliary drainage (PTBD) is widely used to control cholangitis, sepsis, or jaundice caused by biliary tree obstruction. The PTBD tract can be used in percutaneous biliary stone extraction in pre-or post-operative state when ERCP is failed or operation is contraindicated. We performed 16 cases of percutaneous transhepatic biliary stone removal. Locations of biliay stones are combined intrahepatic and extrahepatic in 8 cases (50%), only extrahepati in 7 cases (44%), and only intrahepatic in 1 case (6%). The number of stones was single in 6 cases and multiple in 10 cases. Over all success rate was 81% (13/16), 93% (14/15) in extrahepatic stones and 78% (7/9) in intrahepatic stones. In 5 of 6 cases, complete stone removal was impossible due to marked tortuosity of T-tube tract or peripherally located stones, complete removal of biliary stones was achieved via a new PTBD tract. No significant pre-or post-procedure complication was occured. Percutaneous removal of biliary stones via PTBD tract is an effective and safe alternative method in difficult cases in the menagement of biliary tract stones.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Drainage ; Jaundice ; Methods ; Sepsis

PURPOSE: To evaluate the cilinical results of transjugular intrahepatic portosystemicshunt(TIPS) for the control of variceal bleeding. MATERIALS AND METHODS: TIPS creation was attempted in 23 patients with endoscopically confirmed variceal bleeding. Most patients had multiple episodes of bleeding in the past and have been treated with multiple endoscopic sclerotherapies. Pre- and post-procedural hepatic and portal vein pressures were measured. After creation of TIPS patients were followed up at regular intervals. RESULTS: TIPS has been successfully accomplished in 22 of 23 patients using Wallstent(n=21 ) and Strecker stent(n=1 ). Immediate bleeding control was achieved in all patients with shunt creation. No procedure-related complication was noted. Portal vein pressure was reduced from 30.7+/-5.8 mmHg to 20.8+/-4.7 mmHg. The mean pressure gradient of portosystemic shunt dropped from 22.8+/-6.0 prior to TIPS to 12.2+/-4.1 immediately after. During the follow-up period (6-556 days, mean; 10months), seven patients died; progressive hepatic failure (n=4), variceal rebleeding(n=2), and respiratory failure(n=1). Hepatic encepha-Iopathy after TIPS was noted in 7 patients(31.8%). Variceal rebleeding occurred in 3 patients(13.6%). The remaining 15 patients have survived an average of 11 months. CONCLUSION: This results suggest that TIPS is a safe and effective method for lowering portal pressure and controlling variceal bleeding. Furthermore if these initial results are encourged by further long-term observation, TIPS could replace endoscopic and risky surgical intervention.
Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver Failure ; Portal Pressure ; Portal Vein ; Portasystemic Shunt, Surgical* ; Sclerotherapy

Lichen aureus is a rare disorder classified as a pigmented purpuric dermatosis. This case report is of a 46-year-old female in whom a coin sized, gold tinted, erythematous maculopapule developed on the right lower quadrant of the abdomen l0 years ago which showed characteristic histological findings of lichen aureus consisting of lymphohistiocytic infiltration in the upper dermis and extravasation of red blood cells.
Abdomen ; Dermis ; Erythrocytes ; Female ; Humans ; Lichens* ; Middle Aged ; Numismatics ; Skin Diseases

The anterior cruciate ligament(ACL) is one of the major stabilizers of knee motion. The ACL does not heal once torn, unlike many other biological tissues. Its absence can lead to severe joint instability which can lead to disruptions of secondary restraints around the knee and then progress to degenerative joint disease. Thus many authors advocate surgical intervention for a torn ACL in order to restore stability to the joint. Yet, there is still controversy as to best treatment for the ACL injuries. It is desirable to be considered for the patients age, the severity of the injury, and the future activity level of the patient to decide treatment. We analyzed thirty ACL acute injuries of twenty seven patients who had an ACL injury and treated surgically between Apr. 1986 and Dec. 1991 at St. Pauls Hospital. The results were as follows: 1. There were twenty five males and two females. The mean age was 33.4 years ranged, 15 to 52 years. 2. The anterior cruciate ligaments were torn at proximal portion in twenty two cases, at midportion and distal portion in four, respectively. 3. Two knees had isolated ACL injuries and twenty eight had combined injuries. 4. Twenty one out of twenty six cases treated with primary repair, and three out of four cases treated with reconstruction had good-excellent results.
Anterior Cruciate Ligament ; Female ; Humans ; Joint Diseases ; Joint Instability ; Joints ; Knee ; Male

No abstract available.
Constriction, Pathologic* ; Neurologic Manifestations* ; Spinal Canal*

Single coronary artery is a rare congenital anomaly occurring in approximately 0.04% of the population. This entity can be diagnosed during life only by coronary angiography. Typical angina does not occur with single coronary artery in the absence of coexisting coronary artery disease or aortic stenosis. Among 874 patients who underwent diagnostic coronary angiography at Asan Medical Center. we have experienced a case of single coronary artery with significant atherosclerotic coronary artery disease which has been managed succesfully coronary angioplasty. We report this case of single coronary artery with a review of literature.
Angioplasty ; Aortic Valve Stenosis ; Chungcheongnam-do ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Humans

Xanthogranulomatous cholecystitis(XGC) is a rare, benign, destructive, inflammatory process of the gallbladder that is believed to be a variant of chronic cholecystitis. The gross and microscopic appearances are characteristic with multiple intramural nodules composed of foamy histiocytes and inflammatory cells. Clinically, radiologically and morphologically, XGC sometimes is confused with a malignant neoplasm. In a retrospective twelve year study, 20 cases of XGC were found in 2007 gallbladders (0.99%) and we have been reviewed the characteristic features of it. In 8 patients(40%) XGC sufficiently resembled carcinoma of the gallbladder for the radiological study and surgeon. Gallstones were found in 14 cases(70%). Associated malignancy were 2 cases : one in distal CBD and one in head of pancreas but, there was no coexisted carcinoma of the gallbladder. Complete cholecystectomy was done in 12 cases(60%) and partial cholecystectomy was performed in 7 cases(35%). One underwent T-tube choledochostomy only for suspectd carcinoma of the gallbladder, which subsequently proved to be XGC. In conclusion, appearances often mimicked carcinoma of the gallbladder at laparotomy with xanthogranulomatous tissue extending to adjacent structures. So the possibility should be considered that an `inoperable tumor' of the gallbladder may be in fact XGC, a benign condition that frozen-section biopsy may confirm. If XGC was suspected at operation or confirmed at frozen-section biopsy, coincident carcinoma may still be present. Management of XGC should therefore include choloecystectomy and excision of adjacent xanthogranulomatous tissue and any fistula.
Biopsy ; Cholecystectomy ; Cholecystitis* ; Choledochostomy ; Fistula ; Gallbladder ; Gallstones ; Head ; Histiocytes ; Laparotomy ; Pancreas ; Retrospective Studies

Angiosarcoma is a rare primary malignancy occurring anywhere in the body, but most often in the skin, liver or breast. The radiological findings of angiosarcoma of the breast have rarely been reported. We encountered a case in which the condition involved a 32-year-old woman in whom mammography revealed a obscuved-marginated and lobular-shaped high-density lesion, and ultrasonography demonstrated an ovalshaped, microlobular-marginated, inhomogenous hypoechoic mass which metastasized to the whole body after surgery. We report the radiological findings of this case of angiosarcoma of the breast, and review the literature.
Adult ; Breast Neoplasms ; Breast* ; Female ; Hemangiosarcoma* ; Humans ; Liver ; Mammography ; Sarcoma ; Skin ; Ultrasonography