A Case of Hepatic Paragonimiasis Combined with Intrahepatic Bile Duct Stones

Paragonimiasis is essentially a pulmonary disorder, but many organs such as the brain, muscle, mesentery, genital tract, spinal cord, spleen, and liver may be involved. Cases of hepatic paragonimiasis presented with hepatic masses have rarely been reported in Korea. We experienced a case of hepatic paragonimiasis incidentally found after a hepatic resection for treatment of localized left intrahepatic stones in an asymptomatic 51-year-old female patient. We report this interesting case of hepatic paragonimiasis accompanied with intrahepatic bile duct stones with a review of literature.ope

Effective Use of Methane as a Reducing and Carburization Gas

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Production of ultra high nitrogen stainless steel by ammonia solution nitriding

MasterNitrogen addition to stainless steel is very effective for improving not only mechanical properties but also corrosion resistance. Moreover, if steel contains enough nitrogen to maintain austenitic structure, it is possible to make a nickel-free austenitic stainless steel. However, nitrogen-alloying offers unique challenges since the solubility of nitrogen in liquid Fe and Fe-based alloy is very low at atmospheric pressure. To overcome this problem, ammonia solution nitriding is investigated as a promising process to produce high nitrogen stainless steel.In the present work, N2 and NH3 solid solution nitriding are compared with each other. As a result, when we applying NH3 nitriding instead of N2, enhanced equilibrium N contents and nitriding rate are achieved. Moreover, equilibrium N contents and rate can be controlled by NH3 and H2 ratio. Therefore, Ni-free austenitic steels are effectively acquired by ammonia solid solution. Because of high nitridation potential of ammonia, however, chromium nitride formation is observed. And it is confirmed that the nitrides are homogenized and removed by austenitizing at 1573K. In addition, the grain size of ultra high nitrogen stainless steel is reduced from 500㎛ to 20㎛ through the reversion of eutectoid structure

Effective Use of CH4 Gas as a Reducing Agent in Suspension Reduction Process

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Production of ultra high nitrogen stainless steel by NH3 solution nitriding

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Clinical manifestations and diagnosis of extrapulmonary tuberculosis

Since the diagnosis of extrapulmonary tuberculosis (EPT) is largely depended on the physician's suspicion in respect of the disease, we believed that it would be worthwhile to scrutinize the clinical characteristics of EPT. Thus, here we present retrospectively evaluated clinical manifestations of patients who were diagnosed as EPT cases in a tertiary referral care hospital. Medical records of 312 patients, diagnosed as having EPT at Yongdong Severance hospital from January 1997 to December 1999, were reviewed retrospectively. In total 312 patients, 149 (47.8%) males and 163 (52.2%) females aged from 13 years to 87 years, were included into this study. The most common site of the involvement was pleura (35.6%). The patients complained of localized symptoms (72.4%) more frequently than systemic symptoms (52.2%). The most common symptom was pain at the infected site (48.1%). Leukocytosis, anemia, and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were found in 12.8%, 50.3%, 79.3% and 63.1% of the patients, respectively. Twenty-four percent of the patients had underlying medical illnesses such as, diabetes mellitus or liver cirrhosis, or were over 60 years old. In 67.3% of patients, tuberculosis was suspected at the initial visit. However, tuberculosis was microbiologically proven in only 23.7% of the patients. The time interval from the symptom onset to the diagnosis varied, with the mean duration of the period 96 days. Pulmonary parenchymal abnormal lesions were found in 133 patients (42.6%) on chest radiographs. EPT has a wide spectrum of clinical manifestations, so it is difficult to diagnose it. Based on our studies, only 11.2% of the patients were confirmed as EPT. So it is important that the physician who first examines the patient should have a high degree of suspicion based on the chest radiography, localized or systemic symptoms and several laboratory parameters reviewed in this study.ope

Uremic Encephalopathy Associated with Bilateral Basal Ganglia and Cerebellar Lesion in a Non-diabetic Hemodialysis Patient

Involvement of central nervous system is a well-known compication in uremic patients. However, development of acute extrapyramidal symptoms with bilateral basal ganglia involvement (acute basal ganglia syndrome), especially in non-diabetic hemodialysis patient is very rare. We report a case of acute basal ganglia syndrome in a non-diabetic hemodialysis patient. A 45-year-old man with autosomal dominant polycystic kidney disease (ADPKD) on chronic hemodialysis treatment for the last 4 years was admitted due to generalized myalgia. On admission, the patient was found to have rhabdomyolysis and intractable metabolic acidosis. Nine days after admission, he suddenly developed dysarthria, lateralizing ataxia, and bradykinesia. Brain MRI demonstrated low and high signals in bilateral basal ganglia and cerebellar vermis in T1-weighted and T2-weighted images, respectively. Intensified hemodialysis treatment combined with general supportive therapy resolved the severe metabolic acidosis and the neurologic manifestations gradually improved. Follow up brain CT scan taken 3 months later showed decreased size of initial low attenuation lesions in bilateral basal ganglia and cerebellar vermis. Although no definite pathophysiology is yet established, severe metabolic disorder is believed to play an important role in development of acute basal ganglia syndrome. Correction of metabolic acidosis and hypoglycemia in our patient lead to improvement in neurologic manifestations and organic brain lesions. Our case suggests that severe metabolic acidosis and hypoglycemia in uremic patient may act as risk factors for acute basal ganglia syndrome even in non-diabetic patient.ope