Infestation of tissue by fly larvae is termed myiasis, and it is unusual in humans. Nasal myiasis is common in low socioeconomic status individuals due to poor nasal hygiene. It commonly affects the skin and rarely the nasal and paranasal sinuses. Recently an 82-year-old female was admitted to the emergency department because of discharge of live maggots from the nasal cavity. She had been diagnosed with brain infarction and Alzheimer's disease several years previous. We successfully removed all the maggots from the patient's nasal cavity and sinuses via endoscopic surgery under local anesthesia. Subsequently, the patient's nasal problem resolved completely.
Aged, 80 and over ; Alzheimer Disease ; Anesthesia, Local ; Brain Infarction ; Cerebral Infarction* ; Diptera ; Emergency Service, Hospital ; Female ; Humans ; Hygiene ; Larva ; Myiasis* ; Nasal Cavity ; Paranasal Sinuses ; Skin ; Social Class

Fungus ball is commonly found in the paranasal sinus, mostly in the maxillary, followed by sphenoid, ethmoid and frontal sinuses in order of frequency. However, fungus ball in the nasal cavity is extremely rare. In the present case, fungus ball in the nasal cavity was so large that it destroyed the nasal septum and caused nasal septal perforation. We report a rare case of fungus ball in the nasal cavity in a 60-year-old woman, who was successfully treated by nasal endoscopic surgery.
Female ; Frontal Sinus ; Fungi ; Humans ; Nasal Cavity ; Nasal Septal Perforation ; Nasal Septum

Microscopic polyangiitis (MPA) is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. The kidney is the most often affected organ in the majority of patients with MPA, and renal manifestations are usually the first symptoms. Glomerular capillaries are affected most often, resulting in necrotizing glomerulonephritis, usually in a crescent formation, with no or few immune deposits able to be demonstrated at the sites of vasculitis and glomerulonephritis. We report a case of microscopic polyangiitis in both legs with pitting edema in a 50-year-old female. Laboratory findings showed hematuria, proteinuria, and a positive peripheral antineutrophil cytoplasmic antibody. A renal biopsy revealed pauci-immune splitting and necrotizing capillary loop walls necrotizing vasculitis and membranoproliferative glomerulonephritis (MPGN). With a diagnosis of MPA, she has been managed with high dose steroid and cyclophosphamide. To our knowledge, this is the first reported case of MPA with MPGN.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Capillaries ; Cyclophosphamide ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glycosaminoglycans ; Hematuria ; Humans ; Inflammation ; Kidney ; Leg ; Microscopic Polyangiitis ; Middle Aged ; Proteinuria ; Vasculitis

Armeniacae semen has been used in traditional medicine for the treatment of pain and inflammatory diseases. Amygdalin is the major compound of Armeniacae semen, and it is used for treatment of pain and cancers. In the present study, we compared the effects of aqueous extract of Armeniacae semen and a solution of amygdalin extracted from Armeniacae semen on the lipopolysaccharide (LPS)-stimulated cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS) mRNA expressions in mouse BV2 microglial cells. We also compared the effects of these compounds on the prostaglandin E2 synthesis and the nitric oxide production in mouse BV2 microglial cells. In the present results, Armeniacae semen and amygdalin suppressed prostaglandin E2 synthesis and nitric oxide production by inhibiting the LPS-induced enhancement of COX-2 mRNA and iNOS mRNA expressions in mouse BV2 cells. For the COX-1 expression, Armeniacae semen showed more potent suppression effect compared to the amygdalin. However, amygdalin more potently suppressed the LPS-induced COX-2 mRNA expression compared to aqueous extract of Armeniacae semen. In the case of iNOS mRNA expression, Armeniacae semen and amygdalin showed similar suppressing effects. For the LPS-induced PGE2 synthesis, amygdalin showed more potent suppressing effect, meanwhile, Armeniacae semen and amygdalin showed similar suppressing effect on NO production. Based on the present results, amygdalin may exert anti-inflammatory and analgesic effect though mainly the inhibition of COX-2 pathway, in contrast Armeniacae semen may exert such effect though both the inhibition of COX-2 and iNOS pathways.
Amygdalin ; Animals ; Cyclooxygenase 1 ; Cyclooxygenase 2 ; Dinoprostone ; Medicine, Traditional ; Mice ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Prostaglandin-Endoperoxide Synthases ; RNA, Messenger ; Semen

Shenqi-wan, Oriental herbal medicine formulation, has been traditionally used for delayed mental and physical development in children, complications of diabetes, and glomerulonephritis. In the present study, the protective effect of the aqueous extract of Shenqi-wan against traumatic brain injury (TBI) in the rat hippocampal dentate gyrus was investigated. For this study, step-down avoidance task, terminal deoxynuclotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay, Bax immunohistochemistry, and 5-bromo-2'-deoxyuridine (BrdU) immunohistochemistry were conducted. In the present results, it was shown that apoptotic cell death and cell proliferation in the dentate gyrus were significantly increased following TBI in rats and that the aqueous extract of Shenqi-wan suppressed the TBI-induced increase in apoptosis and cell proliferation in the dentate gyrus. Based on the present results, it is possible that the aqueous extract of Shenqi-wan has a neuroprotective effect on TBI-induced neuronal cell death.
Animals ; Apoptosis ; Brain ; Brain Injuries ; Bromodeoxyuridine ; Cell Death ; Cell Proliferation ; Child ; Dentate Gyrus ; Glomerulonephritis ; Herbal Medicine ; Humans ; Immunohistochemistry ; Neurons ; Neuroprotective Agents ; Rats ; Transferases

BACKGROUND: It is necessary to measure total body water (TBW) in evaluation of the hemodialysis adequacy. Waston's equation has been used clinically. And it is important to measure adequate dry body weight to avoid fluid overloading after hemodialysis. But there was no objective method to measure dry body weight, it was estimated subjectively by clinicians (doctors and nurses). Multi-frequency bioelectrical impedance analysis (MFBIA) has emerged as a clinical tool of the measurement of total body water (TBW) and body fluid compartment (ICW, ECW). The purpose of this study is to investigate the correlation MFBIA-TBW and Watson equation, Then intracellular water (ICW)/extracellular water (ECW) ratio (I/E ratio) usefulness in the evaluation of dry body weight. METHODS: 20 HD patients treated 3 times/week and 21 sex and age adjusted normal control subjects were studied. We measuerd and compared MFBIA-TBW to Waston equation, estimate reproducibility MFBIA-TBW measurement. Then MFBIA-ECW, ICW and I/E ratio were measured and compared dialysis patients both pre- and post dialysis to control group. RESULTS: The correlation between Wastron-TBW and MFBIA-TBW for patients was 0.948 (p<0.001). The closeness of agreement between MFBIA-TBW and Waston-TBW is shown Bland-Altman plots. There was no difference in post-dialysis patient's ICW/ECW ratio compared to control group. CONCLUSION: MFBIA is useful tool for dialysis patients' TBW measurements. Also ICW/ECW ratio measurement by MFBIA may be used to estimate the adequate ultrafiltration.
Body Fluid Compartments ; Body Water* ; Body Weight ; Dialysis ; Electric Impedance* ; Humans ; Renal Dialysis* ; Ultrafiltration

We experienced a case of secondary renal amyloidosis diagnosed by renal biopsy in a patient who had been diagnosed as RA two years ago. A 62-year old man was admitted to neurology departement because of right hemiplegia. During conservative care at neurology department, he was consulted to us because of aggravated generalized edema and proteinuria. He was diagnosed as rheumatoid arthritis and ulcerative colitis two years ago, and then he had taken prednisolone, methotrexate, mesalazine regularly. At physical examination, there was no abnormal finding except pretibial pitting edema and right hemiplegia. In urinalysis, specific gravity was 1.025, pH was 5.5, protein was 4+ and RBC 0-1/ HPF and WBC 0-1/HPF. Total protein of 24 hour's urine was 5.5 g/day. The blood BUN and creatinine level were 16.4 mg/dL, 0.4 mg/dL and cholesterol level were 154 mg/dL, total protein and albumin were 4.4 g/dL and 1.9 g/dL. Serum RA factor and CRP showed high level as 94.90 IU/mL and 118.00 mg/L. On urine electrophoresis, albuminuria was dominant but M-spike was not founded. On urinalysis taken at the time of first diagnosis of rheumatoid arthritis two years ago, proteinuria was negative and serum albumin levels was 3.6 g/dL. At that time, there was no evidence of nephropathy. In renal biopsy, electron microscope showed heavy nonbranching amyloid fibrils accumulated in mesangium and polarized light microscopy after Congo-red staining revealed apple-green birefringent amyloid deposits in glomeruli and blood. So we diagnosed renal amyloidosis associated with RA.
Albuminuria ; Amyloid ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Cholesterol ; Colitis, Ulcerative ; Creatinine ; Diagnosis ; Edema ; Electrophoresis ; Hemiplegia ; Humans ; Hydrogen-Ion Concentration ; Mesalamine ; Methotrexate ; Microscopy, Polarization ; Middle Aged ; Neurology ; Physical Examination ; Plaque, Amyloid ; Prednisolone ; Proteinuria ; Serum Albumin ; Specific Gravity ; Urinalysis

BACKGROUND: The detection of residual stenosis of infarct related artery (IRA) at early stage after acute myocardial infarction (AMI) is crucial in clinical decision making for interventional revascularization. The aim of this study was to evaluate the relevancy of early dipyridamole stress myocardial SPECT to detect functionally and luminologically significant residual stenosis of IRA after AMI. METHOD: Twenty five consecutive patients (M:F=19:6, age: 56+/-13yrs) with AMI underwent SPECT and coronary angiography within 5 days of the attack. Infarct related arteries with FFR < 0.75 and diameter stenosis (DST) >70% were regarded to have functionally and morphologically significant residual stenosis. Reversible perfusion defect was defined if there was improvement of the perfusion score more than one grade in infarct segments on rest images of SPECT compared with stress images. RESULTS: Mean FFR and DST were 0.76+/-0.14 and 74+/-15%. SPECT showed no significant correlation with both FFR and DST with Kendall's coefficiency of 0.28 (p=0.05) and 0.13 (p=0.35). The sensitivity and specificity of SPECT to detect functionally and morphologically significant residual stenosis were 92%, 31% and 83%, 29%. CONCLUSION: The early dipyridamole stress myocardial SPECT after AMI does not seem to be a useful non-invasive test for the detection of functionally and luminologically significant residual stenosis of IRA.
Adult ; Aged ; Blood Flow Velocity ; Comparative Study ; *Coronary Angiography ; Coronary Circulation ; Coronary Stenosis/physiopathology/radiography/*radionuclide imaging ; Dipyridamole/diagnostic use ; *Exercise Test ; Female ; Human ; Male ; Middle Age ; Myocardial Infarction/physiopathology/radiography/*radionuclide imaging ; Sensitivity and Specificity ; Severity of Illness Index ; *Tomography, Emission-Computed, Single-Photon

Clinically detectable metastatic follicular thyroid carcinoma to the thymus is very rare in the literature and sometimes confused with false positive uptake of Iodine
Adenocarcinoma, Follicular/*secondary ; Adult ; Case Report ; Female ; Human ; Iodine Radioisotopes/diagnostic use ; Thymus Neoplasms/*secondary ; Thyroid Neoplasms/*pathology/radionuclide imaging/surgery ; Tomography, Emission-Computed

BACKGROUND: Little has been known about the incidence, the relationship with H. pylori infection and the prognosis of the multiple gastric polyposis. Recently, it was suggested that the eradication of H. pylori infection led the disappearance of the gastric polyps associated with H. pylori. We carried out a prospective study to determine the effect of H. pylori eradication on multiple gastric polyposis associated with H. pylori. METHODS: From July 1997 through August 2000, 13 patients who had multiple gastric polyposis on upper gastrointestinal endoscopy were recruited for this study. After eradication of H. pylori, we performed follow-up endoscopy at 2-3 months and 5-6 months later. RESULTS: The topographical distributions of gastric polyps were as following : antrum only in 7 cases, antrum and lower body in 4 cases, antrum and fundus area in 1 case, and entire stomach in 1 cases, respectively. The histopathological findings were as following : 13 cases showed chronic active gastritis, 2 cases with hyperplastic polyps, and 1 case with adenomatous polyps. After eradication of H. pylori infection, regression of multiple gastric polyps occurred in 7 cases (53.8%). In 7 cases with regression, regression was observed in 5 cases with chronic active gastritis alone, 1 case with hyperplastic polyps, and 1 case with adenomatous polyps. The re-biopsy specimens in 7 cases with regression revealed that the grade of inflammation decreased from 2.2 to 1.5 by the histological index of the updated Sydney system. CONCLUSION: With these results, we may conclude that the development of multiple gastric polyposis might be closely related with chronic H. pylori infection, and the eradication of H. pylori could lead to the regression of polyposis.
Adenomatous Polyps ; Drug Therapy ; Endoscopy ; Endoscopy, Gastrointestinal ; Follow-Up Studies ; Gastritis ; Humans ; Incidence ; Inflammation ; Polyps ; Prognosis ; Prospective Studies ; Stomach