PURPOSE: For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. METHODS: The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. RESULTS: The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastro intestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum(21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. CONCLUSION: The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.
Abdomen, Acute ; Abdominal Pain* ; Diagnosis ; Duodenitis ; Duodenum ; Early Diagnosis ; Endoscopy ; Exanthema* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Nephritis ; Purpura* ; Recurrence ; Sigmoidoscopy ; Skin* ; Ulcer ; Ultrasonography

The spindle and epithelioid cell nevus, is known also as Spitz's nevus or benign juvenile melanoma. The histologic picture of the lesion often closely resembles that of a malignant melanoma, but spindle and epithelioid cell nevus hehaves benignly. Criteria for accurate histological diagnosis of this nevus now exist. However, a difficult lesion occasionally brings one to the worrisome situation even now. We experienced four cases (three children and one adult) of spindle and epithelioid cell neveus with nodular or macular skin lesions. In children (7/F, 9/F, 4/M), all of the lesion show a solitary pinkish red or light brown nodular firm masses, 0.7 cm to 1.0 cm in greatest dimension, which are located at the left posterior thigh, posterior neck and right anterior neck region, respectively. In adult (36/F), the lesion shows a light brown, erythematous macule, 0.8 cm in greatest diameter, in the skin of the back. Microscopically, both spindle and epithelioid cells are found in all the four cases, but epithelioid cells predominate in children and spindle cells predominate in adult.
Child ; Adult ; Male ; Female ; Humans

OBJECTIVE: Nitric oxide (NO) produced in ovary may contribute to follicle maturation, ovulation, oocyte maturation and luteinization. In this study, the effect of nitric oxide on the spontaneous maturation of mouse oocyte was observed. Method: The index of oocyte maturation was checked by the germinal vesicle breakdown (GVBD) and appearance of polar body (PB) under microscope in the denuded oocytes and oocyte-cumulus complexes (OCCs) from mouse ovarian follicles after 24 hours pregnant-mare serum gonadotropin treatment. RESULTS: The GVBD appeared 50 %, 1 hour and 80 %, 2 hrs after changes of oocytes from dibutyryl cAMP (dbcAMP, 0.5 mM) contained media into dbcAMP-free media. dbcAMP (0.5 mM) completely blocked the GVBD until 24 hrs but dbcGMP (5 mM) delayed the GVBD by 1 hr. Sodium nitroprusside, the NO generator, inhibited the GVBD dose-dependently at 2 hr incubation in denuded and OCCs. The appearance of GVBD was not different between control and dbcGMP or SNP in denuded oocytes and OCCs at 24 hrs incubation. The guanylate cyclase activity in denuded oocyte cytosol was not detected whereas the guanylate cyclase activity in OCCs cytosol was 1.3 nmole/min/mg protein which was increased about 3 times by SNP (100 micrometer). CONCLUSION: These results suggest that the NO in ovary may delay the spontaneous oocyte maturation in early stage by acting on the maturation signaling protein as well as guanylate cyclase.
Animals ; Bucladesine ; Cytosol ; Female ; Gonadotropins ; Guanylate Cyclase ; Lutein ; Luteinization ; Mice* ; Nitric Oxide* ; Nitroprusside ; Oocytes* ; Ovarian Follicle ; Ovary ; Ovulation ; Polar Bodies ; Staphylococcal Protein A

Color developers(CD) have been noted to produce lichen planus like eruption as well as eczematous contact dermatitis. The chemicals involved are derivatives of paraphenylenediamine or aniline, i. e., Kodak CD 2, Kodak CD 3, Agfa TSS. We report a 28-year-old male who showed a feature of lichenoid contact dermatitis after exposure to color developer. Patch test revealed positive reactions to CD2, CD3 and CD4. Skin biopsy from a patch site showed lichen planus-like tissue reaction.
Adult ; Biopsy ; Dermatitis ; Dermatitis, Contact* ; Humans ; Lichen Planus ; Lichens ; Male ; Patch Tests ; Skin

No abstract available.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Prevalence*

Fetal hydrops is often serious and associated with a high perinatal motality rate. Cardiac causes of fetal hydrops include congenital heart diseases and rhythm disturbances. An irregular fetal heart rate may indicate atrial fibrillation and atrial flutter with variable AV conduction. Fetal atrial flutter is characterized by the pressence of flutter waves which are regular sawtooth undulations in the baseline that are larger than p waves. Authors experienced a case of fetal atrial flutter with hydrops fetalis at 30 week's gestation which was confirmed by fetal M-mode echocardiogram and electrocardiography. A new born infant had shown to have atrial flutter in utero and after delivery was successfully converted to normal sinus rhythm with digoxin and quinidene.
Atrial Fibrillation ; Atrial Flutter* ; Digoxin ; Edema* ; Electrocardiography ; Female ; Heart Diseases ; Heart Rate, Fetal ; Humans ; Hydrops Fetalis* ; Infant ; Pregnancy

No abstract available.

A fracture of the femoral neck in a young adult differs from the same fracture in an older patient in the following respects; 1. A relatively uncommon injury. 2. A significant difference in the severity of trauma. 3. A less satisfactory result. At the point of view, we studied the femoral neck fcartures in 15, 20- to 50-year-old patients. The aims were to analyze why these fractures occur in young adults, and what results can be expected after internal fixation. The results were as follows; 1. Common in men (3:1). 2. 80% (12/15 cases) of the fractures were caused by severe trauma. 3. The 3 cases (20%) were associated with the other fractures. 4. The factors infuencing the clinical results and complications in our study; a. Severity of trauma. b. Degree of displacement. c. Existence of posterior comminution. d. Time interval between accident and operation. 5. The multiple pinning got the more rigid fixation and diminished the rate of fixation failure. 6. All cases were achieved good to acceptable reduction. 7. Satisfactory functional results were achieved in 93.3%. 8. The rate of avascular necrosis was 15.4% (2/13 cases). It is concluded that the most of femoral neck fractures in younger patients occur because of the significant trauma. In our study, the incidence of avascular necrosis was not greater than in order patients. Therefore, to get as good a result as possible it seems important to perform the anatomical tion and rigid internal fixation with or without bone graft.
Femoral Neck Fractures ; Femur Neck ; Humans ; Incidence ; Male ; Middle Aged ; Necrosis ; Transplants ; Young Adult

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants

For the determination of absorbed dose to water from a linear accelerator photon beams, it needs a exposure calibration factor Nx or air kerma calibration factor Nk of air ionization chamber. We used the exposure calibration factor Nx to find the absorbed dose calibration factors of water in a reference source through the TG-21 and TRS-277 protocol. TG-21 used for determine the absorbed dose in accuracy, but it required complex calculations including the chamber dependent factors. The authors obtained the absorbed dose calibration factor NdwCo-60 for reduce the complex calculations with unknown Ndw only with Nx or Nk calibration factor in a TM31010 (S/N 1055, 1057) ionization chambers. The results showed the uncertainty of calculated Ndw of IC-15 which was known the Nx and Ndw is within -0.6% in TG-21, but 1.0% in TRS-277. and TM31010 was compared the Ndw of SSDL to that of PSDL as shown the 0.4%, -2.8% uncertainty, respectively. The authors experimented with good agreement the calculated Ndw is reliable for cross check the discrepancy of the calibration factor with unknown that of TM31010 and IC-15 chamber.
Air Ionization ; Calibration ; Particle Accelerators ; Uncertainty ; Water