A 45 year old man with a history of syncopal attacks of 3 days' duration showed complete heart block with occasional retrograde P waves following QRS complexes in the electrocardiogram. The site of A-V block seemed to be below A-V node judging from the QRS complexes when occasional capture occured. This may be a case of complete heart block progressing from right bundle branch block plus left posterior hemiblock. There was a rapid improvement of conduction with sublingual isoproterenol in a few days, EKG's showing normal A-V conduction and QRS complexes on discharge. The mechanism of the retrograde conduction in the presence of complete heart block is discussed with a review of literature.
Atrioventricular Node ; Bundle-Branch Block ; Electrocardiography ; Heart Block* ; Heart* ; Humans ; Isoproterenol ; Middle Aged

No abstract available.
Child* ; Humans ; Paraquat* ; Poisoning*

We have constructed several panels of MAbs which specifically recognize B-subunit of HCG (BHCG). Splenocytes from Balb/c mice immunized with B-subunit of HCG were fused with SP2/o-Ag14 myeloma cells by PEG method. Fifteen different hybridorna clones (individually named as mG10.127, mG10.61, mG9.5, mG9.18, rnG9.20, mG6.3, mG6.36, mG6.8, mG7.31, mG7.79, mG9.11, mG9.51.6, mG9.51.12, mH4.17, and mH4.4) were obtained by indirect ELISA screening and three to five successive cloning procedures. The distinct features of these MAbs were determined by specificity, western blot, isotyping, and isoelectrofocusing. All of the MAbs except mG9.20 and mG6.8 specifically bind to BHCG without cross- reaction with B-subunit of LH (BLH). In western blot analysis, all of the MAbs bind to non-denatured form of BHCG suggesting that the MAbs recognize conformation-dependent epitope of BHCG. This new panels of MAbs to BHCG should be useful for developing diagnostic reagent such as pregnancy, choriocarcinoma, Down's syndrome as well as for the fine quantitation of serum or urinary HCG.
Animals ; Antibodies, Monoclonal* ; Blotting, Western ; Choriocarcinoma ; Chorionic Gonadotropin* ; Clone Cells ; Cloning, Organism ; Down Syndrome ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans* ; Mass Screening ; Mice ; Pregnancy ; Sensitivity and Specificity

Achalasia is rare disorder with an estimated prevalence of 0.5~1 per 100,000 per year and secondary achalasia due to trauma is rarer. The following case report describes a patient who developed achalasia after chest trauma. This report presents a 22 year-old male with chest trauma who had hoarseness and postprandial reflux. We suggested the achalasia through video-fluoroscopic swallowing study (VFSS), and confirmed superior and recurrent laryngeal neuropathies through laryngeal electromyography (EMG). VFSS and laryngeal EMG are helpful to diagnose the achalasia due to vagus nerve injury after chest trauma.
Deglutition ; Electromyography ; Esophageal Achalasia ; Hoarseness ; Humans ; Male ; Prevalence ; Thorax ; Vagus Nerve ; Vagus Nerve Injuries

OBJECTIVES: To identify diagnostically meaningful differences between Warthin's tumor and malignant masses in the parotid gland by dynamic susceptibility contrast (DSC) MR imaging. METHODS: Eleven malignant parotid tumors and 9 Warthin's tumors were included. MR imaging was performed on all patients. Signal intensity time curves of tumors were obtained by DSC MR imaging and dynamic susceptibility contrast percentages (DSC%) were calculated. RESULTS: No significant difference was observed between malignant tumors and Warthin's tumors (P = 0.437), although DSC% values tended to be higher for Warthin's tumors. CONCLUSIONS: Warthin's tumor tended to have higher DSC% values than malignant parotid tumors, but this difference was not significantly different.
Humans ; Magnetic Resonance Imaging ; Parotid Gland ; Perfusion

Alport's syndrome is a hereditary disorder whose incidence is 1 in 10,000 in general population, and, majority are developed in childhood, so it is rare to develop in adults. This syndrome consists of hematuria, sensorineural hearing loss, and lenticonus, in classic form. However, there are many atypical forms which have not all clinical manifestations. Although most asymptomatic hematuria in adults results from IgA nephropathy(Berger's disease) or thin basement disease(benign hematuria), Alport's syndrome should be considered as a cause of hematuria. The authors experienced a case of Alport's syndrome in a 21-year-old man who showed only hematuria and proteinuria, and who was diagnosed by history, family history, audiogram, and kidney needle biopsy. So, we report this case with a review of literature.
Adult* ; Biopsy, Needle ; Hearing Loss, Sensorineural ; Hematuria ; Humans ; Immunoglobulin A ; Incidence ; Kidney ; Nephritis, Hereditary* ; Proteinuria ; Young Adult

PURPOSE: To analyze the radiologic findings of metastatic tumors of the breast. MATERIALS AND METHODS: We retrospectively analyzed the findings of mammography (n=12), ultrasonography (n=9) and CT (n=4) of 13 patients with metastatic tumors of the breast. Methods for confirmation were biopsy (n=8) and clinical follow-up (n=5). The patient's ages ranged from 24 to 63 (mean 43) years. RESULTS: Primary malignancies were contralateral breast cancer (n=3), non-Hodgkin's lymphoma (n=3), stomach cancer (n=2), uterine cervix cancer (n=1), laryngeal cancer (n=1), esophageal melanoma (n=1), malignant thymoma (n=1), and lung cancer (n=1). Patterns of metastasis from contralateral breast cancer and the stomach cancer were diffuse and infiltrative, while metastasis from other cancers was of the focal massforming type. The radiologic findings of metastasis from contralateral breast cancer (n=3) were diffuse skin thickening and increased density or echogenicity in the medial aspect of the breast, while in cases involving metastasis from stomach cancer (n=2) radiographs revealed extensive skin thickening, increased density or echogenicity, lymphedema and ipsilateral lymphadenopathy in the left breast. In cases of metastatic tumors to the breast in which focal masses were seen on mammography (n=7), marginal spiculation or microcalcification of the tumors was not present. In six such cases, ultrasonography revealed well-defined margin, posterior acoustic shadowing or an irregular thick echogenic boundary was not seen. In two patients who underwent CT scanning, well-defined masses with moderate contrast enhancement were present. CONCLUSION: Radiographs of metastatic tumors to the breast from contralateral breast cancer and stomach cancer showed diffuse infiltration. The metastatic tumors with focal masses showed oval to round, smooth-marginated, well-defined masses without spiculation or microcalcification on mammography, and a well-defined mass without posterior acoustic shadowing or irregular thick echogenic boundary on ultrasonography.
Acoustics ; Biopsy ; Breast Neoplasms ; Breast* ; Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; Lung Neoplasms ; Lymphatic Diseases ; Lymphedema ; Lymphoma, Non-Hodgkin ; Mammography ; Melanoma ; Neoplasm Metastasis ; Retrospective Studies ; Shadowing (Histology) ; Skin ; Stomach Neoplasms ; Thymoma ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Hepatitis B virus (HBV) detected in Korean patients almost belongs to genotype C, which is subdivided into subgenotype C1 (or Cs) and C2 (or Ce). It was recently reported that the risk of hepatocellular carcinoma is different between subgenotype C1 and C2. Thus, we studied the distribution of subgenotypes of HBV in Korean chronic hepatitis B (CHB) patients. METHODS: Specimens of 421 patients, who were diagnosed as CHB and underwent antiviral treatment, were used. After sequence analysis for HBV S gene, subgenotype was identified through phylogenetic analysis. Utilizing the same sequence data, the distribution of serotypes was also investigated. RESULTS: Among 421 patient specimens, genotype C was found in 419 (99.5%) and genotype B in 2 (0.5%). Among the genotype C strains, 417 strains were C2 subgenotype and 2 strains were mixed subgenotypes. However, C2 was evidently found even in the mixed sequences. Serotypes of 419 HBV with genotype C were classified as follows: adr, 385 (91.9%), adw, 22 (5.3%), ayr, 2 (0.4%) and mixed serotype, 10 (2.3%). Serotype of both HBV with genotype B was adw. CONCLUSIONS: It was found that HBV detected in Korean CHB patients under treatment almost all belong to the C2 (Ce) genotype.
Antiviral Agents/therapeutic use ; Blood Specimen Collection ; Genotype ; Hepatitis B virus/*classification/genetics ; Hepatitis B, Chronic/diagnosis/drug therapy/*virology ; Humans ; Korea ; Phylogeny ; Sequence Analysis, DNA ; Serotyping

The sparsity of publication concerning CT findings of tuberculous arthritis prompted authors to retrospectively evaluate 12 patients with tuberculous arthritis for characteristic CT findings. In each patient, the diagnosis of tuberculous arthritis was confirmed by surgery or biopsy. The CT examinations were evaluated by two radiologists retrospectively. Involved joints were the hip joint in seven patients, the sacroiliac joint in three parients, and the shoulder and ankle joint in one patients each. CT features included subchondral bony erosion(12 patients), soft tissue mass in the joint space(nine), widenining of the joint space(eight), ipsilateral muscle atrophy(eight), thickening of the joint capsule(seven), intra-articular effusion(six), soft tissue abscess(five),and bony sclerosis(four). In seven patients with the duration of symptoms less than 1 year, thickening of joint capsule and intra-articular effusion were the predominent findings, while bony sclerosis, gross bone destruction, and soft tissue mass in joint space were seen in five patients with the duration of symptoms longer than 1 year. Our results indicate that CT is useful in the diagnosis of tuberculous arthritis by demonstrating characteristic pathologic changes of the joint space, soft tissue abnormality and bony involvement.
Ankle Joint ; Arthritis* ; Biopsy ; Diagnosis ; Hip Joint ; Humans ; Joint Capsule ; Joints ; Publications ; Retrospective Studies ; Sacroiliac Joint ; Sclerosis ; Shoulder

PURPOSE: We performed this study to determine the diagnostic significance and useful cut-off value of reticulated platelet, which can be used for discriminating the destructive thrombocytopenia from underproductive thrombocytopenia. METHODS: We evaluated 37 patients with thrombocytopenia who were admitted to the Wonju christian hospital from March to July, 1995. All patients were evaluated with bone marrow megakaryocyte count. We divided them into two groups, group 1 was consisted of underproductive thrombocytopenic patients and group 2 was consisted of destructive thrombocytopenic patients. We measured the peripheral blood reticulated platelet count by FACScan flowcytometry after thiazole orange staining. RESULTS: 1) Among 37 patients, underproductive group consisted of 21 patients and destructive group consisted of 16 patients. 2) There was no significant difference in platelet count between two groups (41.7 31.8x109/L vs. 41.0 29.1x109/L). 3) Destructive group showed higher reticulated platelet count than underproductive group (7.7 3.7% vs. 19.1 11.1% : p<0.01). 4) Ideal cut-off value of reticulated platelet count for the discrimination of two groups was 11%. Its sensitivity and specificity were 88% and 95%, respectively. CONCLUSIONS: We suggest that reticulated platelet count is closely correlated with thrombopoiesis of bone marrow. The measurement of reticulated platelet can be a simple and useful diagnostic tool to discriminate destructive thrombocytopenia from underproductive thrombocytopenia.
Blood Platelets* ; Bone Marrow ; Citrus sinensis ; Discrimination (Psychology) ; Gangwon-do ; Humans ; Megakaryocytes ; Platelet Count ; Sensitivity and Specificity ; Thrombocytopenia* ; Thrombopoiesis