Chondromyxoid fibroma is an uncommon benign cartilaginous tumor of the bone. It occurs most frequently in the metaphysis of long tubular bones, and an epiphyseal location is exceedingly rare. We present here an unusual case of a chondromyxoid fibroma that occurred in the epiphysis of the proximal tibia with an open growth plate. MR imaging findings of this tumor, which has, to the best of our knowledge, never been described in an epiphyseal location, makes the present case unique.
Adolescent ; Bone Neoplasms/*diagnosis ; Chondroma/*diagnosis ; Epiphyses ; Fibroma/*diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; *Tibia

BACKGROUND/AIMS: This randomized, double-blind, phase III, multicenter trial was carried out to compare the efficacy and safety of revaprazan, a novel acid pump antagonist, with that of omeprazole in patients with more than one of gastric ulcers. METHODS: Two hundred and ninety two subjects were randomized to 4~8 weeks of treatment with either revaprazan 200 mg or omeprazole 20 mg. The primary efficacy parameter was the cumulative healing rate determined by endoscopy after 4 and 8 weeks of treatment, and the secondary efficacy parameter was an improvement rate of pain. RESULTS: The intention-to-treat analysis revealed revaprazan and omeprazole to have similar cumulative healing rates (93.0% and 89.6%, respectively; p=0.3038). The per-protocol analysis revealed revaprazan and omeprazole to also have similar cumulative healing rates (99.1% and 100%, respectively; p= 0.3229). In both analyses, there were no significant differences in an improvement rate of pain between the two groups. Both drugs were well tolerated. CONCLUSIONS: Revaprazan has similar efficacy to omeprazole in the treatment of patients with gastric ulcer with a once a day application of revaprazan 200 mg or omeprazole 20 mg over a 4 to 8-week period. In terms of safety, revaprazan was well tolerated.
Endoscopy ; Humans ; Omeprazole ; Stomach Ulcer*

Ventricular perforation is a rare complication of permanent cardiac pacemaker implantation. We report here on a 68-year-old woman with a dual chamber permanent pacemaker that had been implanted one month earlier, and she suffered cardiac perforation from the pacemaker lead. Frequent follow-up via12-lead surface electrocardiography and chest radiography and the proper work-up for pacemaker implantation are needed for detecting rare complications after pacemaker implantation.
Aged ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Ventricles* ; Humans ; Radiography ; Thorax

BACKGROUND/AIMS: We performed a randomized, double-blind, phase III, multicenter trial to assess the comparative efficacy and safety of revaprazan, which is a novel acid pump antagonist in comparison with ranitidine for treating patients suffering with acute gastritis and acute aggravation of chronic gastritis. METHODS: Five hundred and twelve subjects were randomized to 2 weeks of treatment with either revaprazan 200 mg q.d. or ranitidine 150 mg b.i.d. The primary efficacy parameter was the estimated improvement rate according to endoscopy, and the secondary efficacy parameter was the improvement rate for the subjects' symptoms. RESULTS: The estimated improvement rates at 2 weeks (intention-to-treat analysis) were 79.9% with revaprazan and 60.5% with ranitidine; a significant difference was found between the two groups (p<0.0001). On the per-protocol analysis, the estimated improvement rates for revaprazan and ranitidine were 79.4% and 60.2%, respectively. There was a significant difference in the estimated improvement rates between the two groups (p<0.0001). On both analyses, there were no significant differences between the two groups for the improvement rates of the subjects' symptoms. Both drugs were well tolerated. CONCLUSIONS: The efficacy of revaprazan was higher than that of ranitidine for the estimated improvement rate according to endoscopy and also for the symptomatological improvement rate, and revaprazan was well tolerated by the subjects suffering with gastritis.
Endoscopy ; Gastritis* ; Humans ; Ranitidine

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing disease with genetic and environmental background. Many factors may act as triggers and affect the course of the disease. However, little is known about the factors affecting the disease severities in Korean childhood AD. OBJECTIVE: The aim was to document the distinct characteristics of childhood AD in Korea and to determine which manifestations are prone to be present in the settings of different severity of the disease. METHOD: The clinical manifestations, past medical and family history, and inducing or aggravating factors were studied in patients, who participated in the open lectures for childhood AD patients in three provinces of Korea. The severity of the disease was evaluated using the Eczema Area and Severity Index (EASI) and the factors affecting the severity of the disease were determined. Skin prick tests with four allergens, Dermatophagoides pteronyssinus, milk, peanut and egg, were also carried out. RESULTS: Of the 93 patients, 38.7% had the disease onset between the age of three and six, while 17.2% had it between the age of seven and fifteen. Sixty-five percent of the patients had family members with a history of atopic diseases, such as AD, asthma, allergic rhinitis and allergic conjunctivitis. In order of frequency, the patients either had a history of or presently accompanying infantile eczema, allergic rhinitis, asthma or allergic conjunctivitis. Among the patients, 27% took herbal medication. The most frequently involved site was the flexural area. The most common aggravating factors were sweating in hot environment, wool fabric and stress. When AD patients were categorized into mild, moderate and severe groups by EASI, the older onset age, the longer duration, facial distribution, history of taking herbal medication, cholinergic condition, wool fabric and stress were found to be significant factors influencing the severity of the disease. Skin prick test with the four major allergens revealed the highest prevalence in Dermatophagoides pteronyssinus. CONCLUSION: The age of onset of AD was higher than that has been reported. Many suffered from infantile dermatitis and had other accompanying atopic diseases. Aggravating factors should be avoided to minimize the risk of disease aggravation. Based on the fact that late onset age, duration, facial distribution, history of taking herbal medication, cholinergic condition, wool and stress were the statistically significant factors, we may predict the severity or the course of the disease.
Age of Onset ; Allergens ; Antigens, Dermatophagoides ; Asthma ; Conjunctivitis, Allergic ; Dermatitis ; Dermatitis, Atopic* ; Dermatophagoides pteronyssinus ; Eczema ; Humans ; Korea* ; Lectures ; Milk ; Ovum ; Prevalence ; Rhinitis ; Skin ; Sweat ; Sweating ; Wool

BACKGROUND/AIMS: To assess the comparative efficacy and safety of revaprazan, a novel acid pump antagonist, versus omeprazole in patients with duodenal ulcer, we performed a randomized, double-blind, phase III, multicenter trial. METHODS: Two hundred and twenty eight patients were randomized to 4 weeks of treatment with either revaprazan 200 mg or omeprazole 20 mg once daily. Primary efficacy parameter was complete ulcer healing by endoscopy, and secondary parameter was the improvement in the severity of daytime and nighttime pain. RESULTS: Healing rates at 4 weeks (intention-to-treat analysis) were 91.7% with revaprazan 200 mg and 91.3% with omeprazole 20 mg; there were no significant differences between two groups (p=0.9228). In per-protocol analysis, healing rates of revaprazan 200 mg and omeprazole 20 mg were 94.4% and 92.3%, respectively. There was no significant difference in healing rate between two groups (p=0.5666). There was no significant difference between two groups in improvement rates of daytime and nighttime pain. Both drugs were well tolerated. CONCLUSIONS: Revaprazan 200 mg was equivalent to omeprazole 20 mg for both ulcer healing and symptom relief, and was well tolerated in patients with duodenal ulcer.
Duodenal Ulcer* ; Endoscopy ; Humans ; Omeprazole ; Ulcer

Changes in morphology, immunophenotypes and proliferative activity of neuroglia are key features in most forms of CNS pathology. We compared proliferative activity of neuroglial cells in response to two different types of brain injury induced by medial forebrain bundle (MFB) axotomy. In the cannula track where acute necrosis occurs due to mechanical lesion caused by cannula inserted to incise the MFB, many BrdU-immunoreactive (ir) cells appeared around the cannula track already at 1 day post-lesion (1 dpl). Their number significantly increased by 7 dpl and then decreased, but considerable number of BrdU-ir cells was still found at 14 dpl. Some of the BrdU-ir cells were double-labeled with either OX-42 or GFAP. This finding suggests that both microglia and astrocytes are activated and proliferate immediately after the mechanical damage, and the proliferative activity is maintained in a considerable number of these cells by 14 dpl. In general, the main cell type showing BrdU immunoreactivity was amoeboid microglia within the necrotic zone immediately surrounding the cannula track, and was astrocytes in the periphery of the necrotic zone more or less apart from the cannula track. Previously, we reported that MFB axotomy induces apoptosis of dopaminergic (DA) neurons in the substantia nigra (SN). In the SN where axotomized DA neurons undergo apoptosis, only a few BrdU-ir cells were found at 1 dpl. Their number increased gradually from 3 dpl and peaked at 7 dpl, then significantly reduced at 14 dpl. Most of them were double-labeled with OX -42-positive ramified microglia but not with GFAP. This data indicates that microglia but not astrocyte are the cell type that proliferate in response to apoptotic neuronal cell death, and their morphology and proliferative activity are different from those observed in the cannula track. Meanwhile, in the both cannula track and SN, some BrdU-ir cells were thought to be neither GFAP-positive nor OX-42-positive, and thus they were presumed to be infiltrated peripheral immune cells. These results demonstrate that different types of neuronal cell death are accompanied with different neurogilal proliferative activities.
Apoptosis ; Astrocytes ; Axotomy* ; Brain Injuries ; Bromodeoxyuridine ; Catheters ; Cell Death ; Medial Forebrain Bundle* ; Microglia ; Necrosis ; Neuroglia ; Neurons ; Pathology ; Substantia Nigra

Medial forebrain bundle (MFB) transmits the nigrostriatal dopaminergic (DA) axons, and previously we reported that transection of the MFB causes apotosis-like neurodegeneration of nigral DA neurons. On the other hand, it is likely to occur necrosis at the lesioned site where MFB is cut, due to direct mechanical transection of the brain tissue. To clarify the pathological dynamics of microglia reacting to the two different types of neuronal cell death, immunophenotypic and morphological features of microglia were compared and analyzed in the substantia nigra (SN) and lesioned site of the MFB axotomized rat brain. OX42 (mouse anti-rat CD 11b; pan-microglia marker), ED1 (mouse anti-rat lysosomal enzyme; phagocytic marker), and OX6 (mouse anti-rat MHC II) were used as primary antibodies for immunohistochemical localization of microglia, ED2 (mouse anti-rat macrophage) for macrophages, and anti-tyrosine hydro-xylase (TH) antibody for DA neurons. Quite numerous activated microglia with strong OX42 immunoreactivity were found in the SN at 1 day post-lesion (dpl), but most of them were ED1-and OX6-negative except only a few which were ED1-positive. This phenomenon was thought to be related with the stage of alert, the first step of microglial activation. It could be presumed that microglial phagocytosis may precede MHC II expression, because ED1-positive microglia appeared from 1 dpl while OX6-positive ones from 3 dpl. Number of activated microglia showing strong ED1, OX6 and OX42 immunoreactivity increased significantly by 7 ~14 dpl, and they specifically stick to various parts of dendrites and somas of TH-immunoreactive neurons of the SN. The phagocytic microglia of the SN maintained ramified form although they retained enlarged soma and shortened, thickened processes. The lesioned site was surrounded by numerous microglia showing strong OX42 and ED1 immunoreactivity as early as 1 dpl, indicating that microglial phagocytosis starts earlier in the lesioned site than in the SN. OX42-positive microglia of the lesioned site were ED2-negative, and showed amoeboid morphology already from 1 dpl. The amoeboid microglia became to be enlarged in their soma size by 3 dpl, and fused each other to form clumps within the necrotic zone by 5 ~7 dpl. The entire necrotic zone was completely filled with microglia of obscure outline with strong OX42 and ED1 immuno-reactivity. However, the majority of amoeboid microglia of the lesioned site were OX6-negative except a few. These results clearly demonstrate that activated microglia reacting to apoptotic neurodegeneration show different pathodynamic characteristics in terms of immunological phenotypes and morphology from those reacting to necrotic, mechanical lesion.
Animals ; Antibodies ; Apoptosis ; Axons ; Axotomy ; Brain ; Carisoprodol ; Cell Death ; Dendrites ; Hand ; Macrophages ; Medial Forebrain Bundle* ; Microglia* ; Necrosis ; Neurons ; Phagocytosis ; Phenotype ; Rats ; Substantia Nigra*

Renal infarction usually occurs in patients with atrial fibrillation, valvular heart disease, trauma, renal artery stenosis, atherosclerosis and coagulopathy. However it may occur rarely in patients without such underlying disease. We report on 3 patients who developed renal infarction and had no underlying disease. In two cases, renal artery thrombosis occured. And in the other case, renal artery dissection occured. All patients of the renal infarction experienced severe flank pain. And increased serum LDH, ALT and ALP was noted. The differential diagnosis of renal artery dissection and renal artery thrombosis was established by renal artery angiography. In two patients with renal artery thrombosis, anticoagulation therapy was performed. In the other patient with renal artery dissection, only conservative therapy was performed. All 3 patients of renal infarction preserved normal renal function. but developed hypertension. Two patients were given anti-hypertensive agents. In the other patient, hypertension was normalized spontaneously.
Adult* ; Angiography ; Antihypertensive Agents ; Atherosclerosis ; Atrial Fibrillation ; Diagnosis, Differential ; Flank Pain ; Heart Valve Diseases ; Humans ; Hypertension ; Infarction* ; Renal Artery ; Renal Artery Obstruction ; Thrombosis

BACKGROUND: LB20304(gemifloxacin) is a new fluoroquinolone antibacterial agent with excellent activity against both Gram-negative and Gram-positive organisms. In vitro studies using clinical isolates have shown gemifloxacin to be highly active against penicillin-resistant strains of S. pneumoniae and in contrast to other reference quinolones, gemifloxacin retained good activity against clinical isolates of S. pneumoniae that were resistant to other members of the quinolone class. Therefore, gemifloxacin is thought to be effective in treating acute bacterial exacerbation of chronic bronchitis(AECB). The objective of this study was to evaluate the efficacy and safety of oral gemifloxacin at doses of 160mg or 320mg once daily for 7 days for the treatment of AECB in Korean adult population. METHODS: This was a randomized, multicenter, double-blind, parallel group Phase II study to assess the clinical and antibacterial efficacy and safety of oral gemifloxacin for the treatment of AECB. Treatment Group A (67 patients) took oral gemifloxacin 160mg once daily for seven days and treatment Group B (70 patients) took oral gemifloxacin 320mg once daily for seven days. RESULTS: The demographic profiles of the two treatment groups were similar. The clinical response at follow-up was 84.2% in the gemifloxacin 160-mg group, and 88.7% in the gemifloxacin-320 mg group, showing no statistically significant difference between two treatment groups(p=0.49). The clinical response at the end of therapy was 96.5% in the 160-mg group, and 96.4% in the 320-mg group. The bacteriological response at the end of therapy and follow-up were 81.8% and 78.9%, respectively, in the 160-mg group, and 86.4% and 84.2%, respectively, in the 320-mg group, showing no statistically significant difference between two treatment groups(p=0.68 and 0.68, respectively). S. pneumoniae(12 isolates) and H. influenzae(10 isolates) were the most prevalent pathogens. The MICs were lower for gemifloxacin than other quinolones against these key pathogens, and for S. pneumoniae, the MICs for gemifloxacin were considerably lower(< or = 0.03 ug/mL) than those for other quinolones, beta-lactams and acrolides. In the period on-therapy plus 30 days post-therapy, a total of 18 patients(26.9%) in the gemifloxacin 160mg group and 22 patients(31.4%) in the 320mg group reported at least one adverse event(AE). The most frequently reported AE was abdominal pain(3/67 patients, 4.5%) in the gemifloxacin 160mg group and increased level of hepatic enzyme(5/70 patients, 7.1%) in the 320mg group. The overall AE profiles for the two treatment groups were similar. Two out of 67 patients(3.0%) in the gemifloxacin 160mg group and 1/70 patients(1.4%) in the 320mg group reported at least one serious AE, however, none of which was considered by the investigator to be of suspected or probable relationship to study medication. CONCLUSION: The results of this study showed that gemifloxacin at doses of 160mg or 320mg once daily for 7 days in the treatment of acute exacerbations of chronic bronchitis(AECB) in adult Koreans was a very effective and safe treatment both clinically and bacteriologically.
Adult* ; beta-Lactams ; Bronchitis, Chronic* ; Double-Blind Method* ; Follow-Up Studies ; Humans ; Mesylates* ; Pneumonia ; Quinolones ; Research Personnel