No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

Dysgerminoma developed in a 21-year-old phenotypic female patient with 46,XY pure gonadal dysgenesis, Swyer syndrome. This patient presented with pelvic mass associated with abdominal pain and primay amenorrhea. Clinical characteristics showed a typical stigmata of gonadal dysgenesis: primary amenorrhea, sexual infantilism, a small uterus and left streak gonad. A 46,XY karyotype was made by lymphocyte culture. The patient was counseled to undergo operation, chemotherapy and hormon therapy. She underwent bilateral gonadectomy with total hysterectomy, partial omentectomy and multiple pelvic wall random biopsy. Histological examination revealed dysgenetic gonads with dysgerminoma. After surgery, the patient received chemotherapy and also was started on hormone replacement therapy. She is currently alive with no evidence of disease after 19 months from surgery.
Abdominal Pain ; Amenorrhea ; Biopsy ; Christianity ; Drug Therapy ; Dysgerminoma* ; Female ; Gonadal Dysgenesis ; Gonadal Dysgenesis, 46,XY* ; Gonads ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Karyotype ; Lymphocytes ; Sexual Infantilism ; Uterus ; Young Adult

A 33-year-old woman who was diagnosed as medullary carcinoma by fine needle aspiration of thyroid mass is presented. The smear revealed dispersed pattern and small clusters of cells without follicular or papillary structures. The nuclei were round, oval or spindle shaped and eccentrically located. The cytoplasm was abundant and showed red-stained cytoplasmic granulation and tail-like projection with indistinct border. Clumps of amorphous, light-green material were intermingled with tumor cells.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Medullary ; Child* ; Cytoplasm ; Female ; Granular Cell Tumor ; Humans ; Hypercalciuria* ; Mass Screening* ; Thigh ; Thyroid Gland

PURPOSE: It is well known that duodenal ulcer disease does not relapse if H. pylori is cleared from the gastric mucosa. Little is known about the recurrence of duodenal ulcer in children. The purpose of this study was to evaluate the effect of the eradication of H. pylori in duodenal ulcer in children upon the duodenal ulcer recurrence. METHODS: 105 patients (M : F=78 : 27) diagnosed as duodenal ulcer by endoscopy in 1987~1995 were reviewed clinically, and were parted into two groups. The two treatment groups were ranitidine/antacid (RAN/ANT) and ranitidine/amoxicillin/denol (RAN/AMX/D). The latter was for H. pylori-positive children with duodenal ulcer who were diagnosed by serology and/or antral biopsies for histology, culture, and urease testing. The recurrence rates were compared between the two groups. RESULTS: 1) 30 patients with primary duodenal ulcer underwent endoscopy for H. pylori and 27 (90.0%) of them were positive for H. pylori. 2) 27 of H. pylori-positive children received RAN/AMX/D. 23(85.2%) of them showed cure of duodenal ulcer and eradication of H. pylori. 3) The duodenal ulcer recurrence rate in RAN/ANT group was 65.3% and the rate in RAN/AMX/D was 4.3% by a year. CONCLUSIONS: There is a strong correlation between the duodenal ulceration and H. pylori infection in children, and the eradication of H. pylori in duodenal ulcer patients reduces the recurrence of the ulcer. Because of the low incidence of duodenal ulcers in children, a multicenter prospective study is required to determine the effect of treating H. pylori infetion on the long term natural history of duodenal ulcer disease.
Biopsy ; Child* ; Duodenal Ulcer* ; Endoscopy ; Gastric Mucosa ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Natural History ; Recurrence* ; Ulcer ; Urease

Subacute thyroiditis is a frequent benign thyroid disease associated with previous viral upper respiratory tract infection. Known complications of this disease are long-standing subclinical hypothyroidism, persistent anterior neck pain and rarely Graves disease. In general, thyroid abscess is an uncommon disease because of anatomic isolation of the gland and its rich system of drainage for blood and lymph. Especially, development of thyroid abscess in subacute thyroiditis is extremely rare phenomenan, but significant bad outcomes can be resulted. Its clinical BACKGROUND containes immune-suppressed state, anatomic defect, presence of underlying other thyroid disease and of non-thyroidal infectious foci. We experienced a case of subacute thyroiditis complicated with streptococcal thyroid abscess during glucocorticoid therapy. The patient was a 19-year-old female who was admitted due to anterior neck pain for 1 month. Typical subacute thyroiditis was suggested from initial laboratory findings including CBC, erythrocyte sedimentation rate, serum T3, T4, TSH levels, thyroid scan & thyroid uptake. But during oral prednisolone therapy, unexpected bacterial thyroid abscess was developed. We report this unusual case with review of literatures.
Abscess ; Blood Sedimentation ; Drainage ; Female ; Graves Disease ; Humans ; Hypothyroidism ; Neck Pain ; Prednisolone ; Respiratory Tract Infections ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis, Subacute* ; Young Adult

Factor Vll deficiency has an estimated incidence of 1/500,000 in the general population and autosomal recessive pattern of inheritance. Factor Vll deficiency is characterized by prolonged prothrombin time (PT), and normal activated partial thromboplastin time (aPTT) and bleeding time (BT). Definite diagnosis of this condition requires a specific Factor Vll assay. The clinical features are variable and do not always correlate with the Factor Vll level. We experienced a case of Factor Vll deficiency presenting as hemarthroses in a 2-years-old girl, whose chief complaint was pain, swelling of right knee joint and limping gait. The laboratory findings were prolonged PT and prominent deficiency of factor Vll. So, we report a case of Factor Vll deficiency with a brief review of the related literature.
Bleeding Time ; Diagnosis ; Female ; Gait ; Hemarthrosis* ; Humans ; Incidence ; Knee Joint ; Partial Thromboplastin Time ; Prothrombin Time ; Wills

Factor Vll deficiency has an estimated incidence of 1/500,000 in the general population and autosomal recessive pattern of inheritance. Factor Vll deficiency is characterized by prolonged prothrombin time (PT), and normal activated partial thromboplastin time (aPTT) and bleeding time (BT). Definite diagnosis of this condition requires a specific Factor Vll assay. The clinical features are variable and do not always correlate with the Factor Vll level. We experienced a case of Factor Vll deficiency presenting as hemarthroses in a 2-years-old girl, whose chief complaint was pain, swelling of right knee joint and limping gait. The laboratory findings were prolonged PT and prominent deficiency of factor Vll. So, we report a case of Factor Vll deficiency with a brief review of the related literature.
Bleeding Time ; Diagnosis ; Female ; Gait ; Hemarthrosis* ; Humans ; Incidence ; Knee Joint ; Partial Thromboplastin Time ; Prothrombin Time ; Wills

No abstract available.
Adult* ; Humans ; Intussusception* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence*

We performed this study in order to verify the heart rate decrease caused by the D2-receptor on cardiac sympathetic nerve endings and its relation to the concentration of norepinephrine in synaptic clefts. Sprague-Dawley rats were pithed and the heart rate was increased either by electrical stimulation of the cardiac accelerator nerve or by intravenous infusion of norepinephrine, tyramine, or isoproterenol. Increased heart rate by electrical stimulation of cardiac accelerator nerve was dose-dependently lowered by lisuride and its effect was blocked by pretreatment with sulpiride but not with yohimbine and SCH 23390. Also, the heart rate was decreased in a dose-dependent manner by clonidine and this effect was blocked by pretreatment with yohimbine, but not with sulpiride. For increased heart rate by infusion of norepinephrine, tyramine, or isoproterenol, the heart rate lowering effect of lisuride was more marked in the norepinephrine-and tyramine-infusion groups, in which the intrasynaptic concentration of norepinephrine was elevated, compared to the isoproterenol-infusion group, in which intrasynaptic concentration of norepinephrine was not elevated. In conclusion, there is a D2-receptor on the cardiac sympathetic nerve endings which decreases the heart rate and is different from the presynaptic alpha 2-receptor. Also, the heart rate lowering effect via stimulation of the D2-receptor by lisuride was more marked with increased concentration of norepinephrine in the synaptic cleft.
Animal ; Female ; Heart/innervation ; Heart Rate/drug effects/*physiology ; Lisuride/pharmacology ; Male ; Norepinephrine/metabolism ; Rats ; Receptors, Dopamine D2/*physiology ; Support, Non-U.S. Gov't ; Sympathetic Nervous System/metabolism ; Synapses/metabolism ; Yohimbine/pharmacology

Lithium is commonly used for the treatment of bipolar affective disorders. Lithium therapy has a narrow therapeutic window, which can lead to various neurologic, cardiovascular, and renal side effects. Dialysis is recommended for the treatment of severe lithium toxicity, but conventional hemodialysis can cause post-dialysis rebound of serum lithium level. We report a case of lithium intoxication in which continuous venovenous hemodiafiltration (CVVHDF) was successfully used in reducing toxicity. CVVHDF provides excellent lithium clearance, and prevents post-therapy lithium rebound by allowing a progressive removal of intracellular lithium. It could become a modality of choice for lithium intoxication.
Dialysis ; Hemodiafiltration* ; Lithium* ; Mood Disorders ; Renal Dialysis