High dose intravenous gammaglobuline (IVLG) therapy is effective in some of the autoimmune diseases. Although the exact mechanism of action of IVIG is uncertain, the action as a neutralizing antibody against unknown etiologic agents, the action of blocking of Fc receptors of effector cells, or the action as a antiidiotypic antibody are suggested. We report a case of 12 year old girl with systemic juvenile rheumatoid arthritis who was treated with high dose IVIG and got a remission. In August 1990 she was admitted to our hospital. because of intermittent fever, transient rash and multiple arthralgia. Under the diagnosis of systemic juvenile rheumatoid arthritis, aspirin (4.0g/day) had been given with symptom improvement. She was readmitted in October 1990 because of aspirin intoxication and acute fulminant hepatitis. She was discharged after recovery and any medicine was not prescribed. In November 1990 she was admitted because of epigastric pain, vomiting, intermittent fever, multiple arthritis, and mild hepatomegaly. Total parenteral alimentation had been given under the diagnosis of superior mesenteric artery syndrome and gold sodium thiomalate (Myochrysine, 5 and 10 mg, two weekly IM injection) was given in conjunction with prednisolone (30 mg/day) and naproxen (375 mg/day). She was admitted again in February 1991 due to the fever, coughing, rash, and hepatosplenomegaly. Pneumonia and leukopenia (2100/mm(3)) were found and gold sodium thiomalate injection was discontinued. Gammaglobulin 1 g/kg/day was given intravenously for 2 consecutive days with dramatic symptom improvement. Five more monthly IV gammaglobulin had been given and the side reaction of injection were nausia, fever, and headache which were controlled by the decrease of infusion rate. Four months after the last IVIG injection she had no symtom of arthritis and the hepatosplenomegaly was decreased. Hemoglobin level was increase to 12.2 mg/dL form 6.2mg/dL and ESR was decrease to 15mm/h. The oral prednisolne and ibuprofen were stopped one year after th last IVIG injection. All the laboratory parameters of arthritis and physical examinations had been normal for more than two year after the stop of all the medications until March of 1994. We suggest that high dose intravenous gammaglobulin can be one of treatments for severe systemic juvenile rheumatoid arthritis.
Antibodies, Neutralizing ; Arthralgia ; Arthritis ; Arthritis, Juvenile ; Aspirin ; Autoimmune Diseases ; Child ; Cough ; Diagnosis ; Exanthema ; Female ; Fever ; Gold Sodium Thiomalate ; Headache ; Hepatitis ; Hepatomegaly ; Humans ; Ibuprofen ; Immunoglobulins, Intravenous ; Leukopenia ; Naproxen ; Physical Examination ; Pneumonia ; Prednisolone ; Receptors, Fc ; Superior Mesenteric Artery Syndrome ; Vomiting

Three cases of human embryo of Carnegie stage 13 were described. The CR length of these embryos were 3.0-5.3mm. The authors made a reconstruction model using photograph, photocopy and computer. These embryos were characterized externally by 4 limb buds and 4 pairs of branchial arches, and internally closed otic pits, appearance of venous valves, septum primum and foramen primum in the heart, beginning of the right and left lung buds, appearance of lens disk.
Branchial Region ; Embryonic Structures* ; Heart ; Humans* ; Limb Buds ; Lung ; Venous Valves

The toxic effect of carp bile is well documented since earlier times but its exact mechanism of toxicity is unclear till now. Recently we have experienced a case of acute renal failure with toxic hepatitis in a 32-year-old man who ingested raw carp bile. He suffered from abdominal pain, nausea, vomiting and diarrhea, which occurred 3 hours after the ingestion of raw carp bile juice. Hematuria, proteinuria, oliguria and jaundice developed subsequently. 9 times of hemodialyses was performed and hepatitis was treated by conservative measure. The patient was discharged after 17 days of hospitalization. About 1 month after carp bile ingestion, no sequelae was detected. The authors report a case of acute renal failure due to carp bile juice ingestion with review of literature. Further study in needed as to the toxic substances of carp bile and pathogenesis.
Abdominal Pain ; Acute Kidney Injury* ; Adult ; Bile* ; Carps* ; Diarrhea ; Drug-Induced Liver Injury* ; Eating ; Hematuria ; Hepatitis ; Hospitalization ; Humans ; Jaundice ; Nausea ; Oliguria ; Proteinuria ; Renal Dialysis ; Vomiting

Clinical electrophysiological studies(EPS) were done in seven patients with chronic recurrent sustained ventricular tachycardia(VT) in an attempt to delineate the reproducibility and to select the effective antiarrhythmic drugs for the prevention of the recurrence of VT. We could induce and terminate the sustained VT, and could select the effective antiarrhythmic drugs in all patient in the cardiac catheterization laboratory with EPS. With these effective antiarrhythmic drugs VT did not recur for the follow up period of 15 to 20 months. In view of the serious nature of the VT and the demonstrated benefits of EPS, we could conclude that patients with chronic recurrent sustained VT should undergo EPS.
Anti-Arrhythmia Agents ; Cardiac Catheterization ; Cardiac Catheters ; Follow-Up Studies ; Humans ; Recurrence ; Tachycardia, Ventricular*

The antihypertensive action of Lasix(R) retard 30 was evaluated in 20 cases of essential hypertension on an outpatient basis. The following results were obtained. 1. The patient population comprised 11 males and 9 females, aged 32 to 67 years, with mild to moderate essential hypertension. mean age was 50 years, with 75% between 40 and 59 years of age. 2. The daily effective doses ranged from 1 to 3 capsules with an average of 1.7 capsules. The total duration of medication ranged from 4 to 12 weeks with an average of 6.5 weeks. 3. In 60% of the cases, good or fair control of blood pressure was resulted. Most of the poor results were in the cases of moderate hypertension, but the results could be improved with continuous treatment or combination with other antihypertensive drugs. 4. Transient dizziness and drowsiness were complained by 2 patients, but subsided spontaneously with continuous treatment. 5. In view of these results, Lasix retard 30 appears to be effective and well tolerated agent for the treatment of mild to moderate hypertension, either used alone or combined with other antihypertensive drugs.
Antihypertensive Agents ; Blood Pressure ; Capsules ; Dizziness ; Female ; Furosemide ; Humans ; Hypertension ; Male ; Outpatients ; Sleep Stages

No abstract available.

Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.
Carcinosarcoma* ; Cystadenocarcinoma, Serous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Middle Aged ; Ovary* ; Sarcoma

A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Mitosis ; Mucins* ; Ovarian Cysts ; Ovary

No abstract available.
Child* ; Encephalitis* ; Female* ; Humans

No abstract available.
Adolescent* ; Child* ; Humans ; Periodicals* ; Suicide*