Henoch-Shonlein(H-S) purpura, or anaphylactoid purpura is a hypersensitivity vasculitis characterized by palpable purpura usually on buttock and low extremities; arthralgia mostly polyarhtralgia in the absence of frank arthritis; gastraintestinal involvement with colicky abdominal pain, nausea, vomiting, diarrhea, constipation and bleeding; and renal involvement, manifested chiefly by hematuria and proteinuria. Gastrointestinal involvement is seen in 70 percent of pediatric patients and one third of adult patients. Any portion of the gastrointestinal tract distal to the esophagus maybe involved, but most frequently affected sites are jejunum and ileum. We report one case of H-S purpura with duodenal involvement observed in 16, male patient.
Abdominal Pain ; Adult ; Arthralgia ; Arthritis ; Buttocks ; Constipation ; Diarrhea ; Esophagus ; Extremities ; Gastrointestinal Tract ; Hematuria ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Nausea ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Vasculitis, Leukocytoclastic, Cutaneous ; Vomiting

Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.
Abdominal Pain ; Cardiomyopathies ; Catecholamines ; Female ; Hemodynamics ; Hemoptysis ; Hemorrhage ; Humans ; Hypertension ; Pheochromocytoma ; Pneumonia ; Pulmonary Edema

PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation of the airways and progressive destruction of lung parenchyma. Apoptosis is critical for the maintenance of normal tissue homeostasis and is in equilibrium with proliferation and differentiation. This study was undertaken to investigate relationship between apoptosis of peripheral blood lymphocytes during exacerbation of COPD and inflammatory response that characterizes this condition. MATERIALS AND METHODS: Seventeen patients with COPD exacerbation, 21 stable COPD, and 12 control subjects were included. T lymphocytes were isolated from peripheral blood using MACS. Apoptosis of T lymphocytes was assessed with FACS using annexin V and 7-aminoactinomycin. Serum levels of interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF)-alpha were determined by an immunoassay technique. RESULTS: There was significantly increased percentage of apoptotic lymphocytes, CD 4+, and CD 8+ T cells in the peripheral blood of patients with exacerbation of COPD compared with stable COPD. Serum levels of IL-6, IL-8, and TNF-alpha were significantly increased in patients with exacerbation of COPD compared with stable COPD. Only TNF-alpha presented a positive correlation with apoptotic lymphocytes in patients with exacerbation of COPD. CONCLUSION: Increased apoptotic lymphocytes may be associated with upregulation of TNF-alpha in the peripheral blood of patients with acute exacerbation of COPD.
*Apoptosis ; CD4-Positive T-Lymphocytes/pathology ; CD8-Positive T-Lymphocytes/pathology ; Flow Cytometry ; Humans ; Interleukin-6/blood ; Interleukin-8/blood ; Pulmonary Disease, Chronic Obstructive/blood/*pathology ; T-Lymphocytes/*pathology ; Tumor Necrosis Factor-alpha/blood

BACKGROUND: Systolic and diastolic dysfunction frequently coexist in heart failure. The purpose of this study is to evaluate combined systolic and diastolic function in heart failure using new index presented by Dr. Tei. A new index: [(ICT+IRT)/ET] defined as the sum of isovolemic contraction time(ICT) and isovolemic relaxation time(IRT) divided by ejection time(ET). METHOD: Study patients consisted of 71 subjects. 20 normals, 23 patients in NYHA class II, 22 patients in NYHA class III and 6 patients in NYHA class IV. Left ventricular end-systolic and end-diastolic dimension, FS(fractional shortening) were measured by conventional echocardiography. ICT, IRT, ET, ICT/ET, deceleration time of mitral E wave and E/A of mitral flow were also measured.(ICT+IRT)/ET was easily obtained by subtracting ET from the interval between cessation and onset of the mitral inflow to give the sum of ICT and IRT. Cardiac output was calculated by left ventriculography in 10 normals and 19 patients. RESULTS: The mean value of (ICT+IRT)/ET was significantly different between group IV(0.88 +/-0.03) and group I(0.50+/-0.04) and II(0.50+/-0.03)(p<0.01). also, was significant between group IV and group III(0.63+/-0.04)(p<0.05). FS and deceleration time of mitral E wave were also significant between group III and group IV(p<0.05). Cardiac output calculated by left ventriculography was significantly correlated with(ICT+IRT)/ET(n=29, r=-0.463, p<0.05). CONCLUSION: (ICT+IRT)/ET is a new and simple Doppler index of combined systolic and diastolic left ventricular function in patient with heart failure.
Cardiac Output ; Deceleration ; Echocardiography* ; Heart Failure ; Humans ; Relaxation ; Ventricular Function, Left*

OBJECTIVE: To assess prosthetic use by upper extremity amputees, and their difficulties with prostheses in activities of daily living and occupations. METHOD: This study is based on a survey of 307 subjects, who were using prostheses manufactured in the Center of Prosthetics and Orthotics. The survey questionnaire included items about general demographic characteristics, side and level of amputation, type of prosthesis and its use, and difficulties in the activities of daily living, employment and driving. RESULTS: The most common type of prosthesis was the cosmetic hand type (80.2%). There were no statistically significant correlations between satisfaction with prosthesis and the amputation level or type of prosthesis. The most common difficulties in daily living activities experienced by amputees were lacing shoes, removing bottle-tops with a bottle opener, and using scissors. Only 7.3% of amputees received rehabilitation services. Less than half of the amputees (44.7%) used their prostheses for eight or more hours a day, and 76.9% used their prostheses for regular or irregular cosmetic purposes. After amputation, most of the respondents (69.0%) became unemployed or changed workplaces. CONCLUSION: In our study, respondents preferred cosmetic usage to functional usage. Only 30.0% of respondents reported satisfaction with their prostheses. Many of the amputees had difficulties in complex tasks and either changed jobs or became unemployed. Clerical workers were the occupation group, which was most likely to return to work. The development of a more functional prosthetic hand and additional rehabilitation services are required.
Activities of Daily Living ; Amputation ; Amputees ; Cosmetics ; Surveys and Questionnaires ; Employment ; Hand ; Humans ; Occupations ; Prostheses and Implants ; Return to Work ; Shoes ; Upper Extremity ; Surveys and Questionnaires

This study was conducted to investigate the association of the occurrence of pediatric disease with environmental, seasonal and atmospheric factors. The data were collected at 5 pediatric clinics in Seoul and the Department of Pediatrics of Yongin Severance Hospital from May 1986 to April 1987. The results were as follows: 1. Vacation periods had a great influence upon the occurrence of pediatric diseases. 2. The majority of pediatric diseases occurred mainly in spring and autumn, not in summer and winter. 3. The higher the average relative humidity was, the less diseases occurred; and the higher the maximum change of daily temperature, the more diseases occurred. 4. In summer, the pattern of diseases varied along with the environmental factors(eg., toilet).
Gyeonggi-do ; Humidity ; Pediatrics ; Seasons* ; Seoul

PURPOSE: According to the recent studies on the carcinogenic factors of gastric cancer in Koreans, dietary factors, such as stew, roasted fish, and fish boiled in soy with spices, salted foods, as well as smoking, might be risk factors of gastric cancer. N-acetyltransferase 2 (NAT2) is an enzyme that plays a role in the reduction of the toxicity of various carcinogens. There is a possibility that the genetic polymorphism of NAT2 might change a subject's susceptibility to gastric cancer. The aim of this study was to examine the effects of diet, the genetic polymorphism of NAT2 and their interaction on the risk of gastric cancer in Koreans. METHODS: The subjects of this case-control study were 214 gastric cancer patients, and 214 controls, who were admitted at the Chungbuk National or Eulji University Hospitals. Each subject was directly interview, by an experienced interviewer, with a structured questionnaire. A NAT2 genetic polymorphism analysis was performed, with a PCR-RFLP technique, and the data analyzed using the PC-SAS software package. RESULTS: Increased intakes of makkoli, soybean paste stew, kimchi and ggakdugi, soy milk, chicken boiled with rice and boiled chicken were all associated with an increased risk of gastric cancer, whereas those of fermented soybean stew, Welsh onion or leek, onions, peaches, chestnuts or gingko nuts, fatsia shoots, raw fish, salted seafood and laver were all associated with a decreased risk of gastric cancer. The odds ratio (95% confidence interval) for gastric cancer for the rapid acetylators was 1.64 (1.12, 2.41), which was statistically significant. With respect to the rapid acetylators, makkoli, kimchi and soy milk were significant risk factors, and Welsh onion/leek and onions were protective factors for gastric cancer. Whereas, soybean paste stew was a risk factor of gastric cancer with the slow or intermediate acetylators. CONCLUSION: These results suggest the genotype of a rapid acetylation is a risk factor of gastric cancer, and the effects of diet on the risk of gastric cancer vary according to the genotype of the NAT2 enzyme.
Acetylation ; Carcinogenesis* ; Carcinogens ; Case-Control Studies ; Chickens ; Chungcheongbuk-do ; Diet* ; Genotype ; Ginkgo biloba ; Hospitals, University ; Humans ; Nuts ; Odds Ratio ; Onions ; Polymorphism, Genetic* ; Prunus persica ; Surveys and Questionnaires ; Risk Factors ; Seafood ; Smoke ; Smoking ; Soy Milk ; Soybeans ; Spices ; Stomach Neoplasms*

Bronchial foreign body aspirations are uncommon in adults and usually have various underlying conditions, otherwise accidentally occurred in dental procedure, medical, surgical procedure. The most commonly aspirated objects were food materials, with peanuts leading the list. When bronchial foreign body was aspirated, no definite respiratory symptoms or foreign body is may not seen, then diagnosis is delayed. Therefore late complications was developed. The tendency to use fiberoptic bronchoscope for removal of foreign bodies in adults is increased. We report a rare case of bronchial pneumonia due to occult aspiration of a twig before 1 year with a review of the literatures.
Adult ; Arachis ; Aspirations (Psychology) ; Bronchopneumonia ; Bronchoscopes ; Diagnosis ; Foreign Bodies ; Humans ; Pneumonia*

The layers of keratinocytes form an acid mantle on the surface of the skin. Herein, we investigated the effects of acidic pH on the membrane current and [Ca2+](c) of human primary keratinocytes from foreskins and human keratinocyte cell line (HaCaT). Acidic extracellular pH (pHe< or =5.5) activated outwardly rectifying Cl- current (I(Cl,pH)) with slow kinetics of voltage-dependent activation. I(Cl,pH) was potently inhibited by an anion channel blocker 4,4`-diisothiocyanostilbene-2,2`-disulphonic acid (DIDS, 73.5% inhibition at 1micrometer). I(Cl,pH) became more sensitive to pHe by raising temperature from 24degrees C to 37degrees C. HaCaT cells also expressed Ca2+ -activated Cl- current (I(Cl,Ca)), and the amplitude of I(Cl,Ca) was increased by relatively weak acidic pHe (7.0 and 6.8). Interestingly, the acidic pHe (5.0) also induced a sharp increase in the intracellular [Ca2+] (delta[Ca2+](acid)) of HaCaT cells. The delta[Ca2+](acid) was independent of extracellular Ca2+, and was abolished by the pretreatment with PLC inhibitor, U73122. In primary human keratinocytes, 5 out of 28 tested cells showed delta[Ca2+](acid). In summary, we found I(Cl,pH) and delta[Ca2+](acid) in human keratinocytes, and these ionic signals might have implication in pathophysiological responses and differentiation of epidermal keratinocytes.
Cell Line ; Estrenes ; Foreskin ; Humans ; Hydrogen-Ion Concentration ; Keratinocytes ; Kinetics ; Membranes ; Pyrrolidinones ; Skin

No abstract available.
Camptothecin ; Recurrence ; Small Cell Lung Carcinoma