A case of infectious mononucleosis was presented. She was admitted to the hospital with the anterior cervical lymphadenopathy. Erythematous skin rashes on both low extermities, and splenomegaly. Her chief complaints were fever and sore throat. She showed atypical lymphocytes in peripheral blood smear with relative lymphocytosis. Mono-spot test was positive. She received symptomatic therapy and discharged without any complications. So, we report this case and review the brief literatures of infectious mononucleosis with the respect to etiology, clinical course, and histological characteristics of the disease.
Exanthema ; Fever ; Infectious Mononucleosis ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Pharyngitis ; Splenomegaly

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

PURPOSE: To describe our initial experience with a novel method of adenoma retrieval using a pneumovesicum (PNV) after Holmium laser enucleation of the prostate (HoLEP). METHODS: From January 2016 to April 2018, a total of 93 consecutive patients treated with HoLEP were enrolled in this study. For tissue morcellation, we used the PNV morcellation technique for an initial series of 21 patients and the conventional technique (Lumenis VersaCut) for a consecutive series of 72 patients. We compared efficiency and safety between the novel technique and the traditional technique. Subgroup analysis was performed to assess the effectiveness of the current technique in the large prostate (>70 mL). RESULTS: There were significant differences in mean age and prostate volume between the 2 groups. However, there were no significant differences in the baseline characteristics and preoperative parameters in the subgroup analysis of large prostates (>70 mL). The mean morcellation efficiency was higher (8.50±1.94 minutes vs. 1.76±0.45 minutes, P<0.05) and the time of morcellation (7.81±1.25 minutes vs. 34.04±11.14 minutes, P<0.05) was shorter in the PNV group. Moreover, there were no significant differences between groups in hospitalization period (2.62±1.10 days vs. 2.90±1.26 days, P=0.852) and any other postoperative events, including recatheterization, reoperation, clot retention, and urethral stricture (P-value range, 0.194–0.447). In the PNV group, there were some cases of procedure-related complications, including postoperative extravesical leakage (5th case), clot retention (8th case), and recatheterization (9th case). CONCLUSIONS: This method has a higher tissue retrieval efficacy, with the advantage of excellent visibility compared to conventional morcellation. The current method can be applied when a transurethral morcellator is out of order or cannot be used.
Adenoma ; Holmium ; Hospitalization ; Humans ; Lasers, Solid-State ; Methods ; Morcellation ; Prostate ; Prostatic Hyperplasia ; Reoperation ; Urethral Stricture

PURPOSE: The HER-2 oncogene plays a role in cellular oncogenic transformation, and is related to the aggressive tumor behaviour. Several studies have addressed the prognostic and predictive roles of the HER-2 status in gastric cancer; however, the HER-2 gene has not been used as a therapeutic target, as the opinions relating to its prognostic role are controversial. METHODS: Between January 1994 and December 1997 (1995 group), 192 patients who underwent a curative resection for a gastric adenocarcinoma at St. Mary's Hospital, College of Medicine, The Catholic University of Korea, were retrospectively reviewed from their paraffin embedded tissues and medical records. One hundred and twenty-seven patients, with the same characteristics and operated on between January and December 2002 (2000 group) were compared. The expression of HER-2 was analyzed by means of immunohistochemistry, with regard to the clinicopathological features and survival rate. RESULTS: The average ages of patients in the 1995 and 2000 groups were 56.3 and 59.1 years, respectively. In the 1995 group, 40.1, 26.5, 24.0 and 9.4%, had stage I, II, III and IV diseases, Whereas, in the 2000 group, these figures were 57.5, 18.1, 19.7, and 4.7%, respectively. The expression of HER-2 was positive in 12/192 patients (6.3%) in the 1995 group, and in 7/127 (5.5%) in the 2000 group. There was no relation between the overexpression of HER-2 and the pathological findings. However, the 5-year survival rates of patients with negative and positive HER-2 expression were 91.7 and 75.0%, in stage I and II gastric cancers, respectively. There was a significant difference in the survival rates between the two groups (P=0.010). CONCLUSION: HER-2 overexpression is an early event in gastric cancers, appearing at all stages of the disease, and is related to the poor prognosis of stage I, and II diseases. This fact is thought to be the basis of monoclonal antibody treatment and chemotherapy following a surgical operation for early gastric cancer.
Adenocarcinoma* ; Drug Therapy ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; Korea ; Medical Records ; Oncogenes ; Paraffin ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

PURPOSE: This study aimed to evaluate the clinicopathological characteristics of pregnancy-associated breast cancer (PABC) in comparison with non-pregnancy associated breast cancer (non-PABC). METHODS: A total of 344 eligible patients with PABC were identified in the Korean Breast Cancer Society Registry database. PABC was defined as ductal carcinoma in situ, invasive ductal carcinoma, or invasive lobular carcinoma diagnosed during pregnancy or within 1 year after the birth of a child. Patients with non-PABC were selected from the same database using a 1:2 matching method. The matching variables were operation, age, and initial stage. RESULTS: Patients with PABC had significantly lower survival rates than patient with non-PABC (10-year survival rate: PABC, 76.4%; non-PABC, 85.1%; p=0.011). PABC patients had higher histologic grade and were more frequently hormone receptor negative than non-PABC patients. Being overweight (body mass index [BMI], ≥23 kg/m²), early menarche (≤13 years), late age at first childbirth (≥30 years), and a family history of breast cancer were more common in the PABC group than in the non-PABC group. Multivariate analysis showed the following factors to be significantly associated with PABC (vs. non-PABC): early menarche (odds ratio [OR], 2.165; 95% confidence interval [CI], 1.566–2.994; p<0.001), late age at first childbirth (OR, 2.446; 95% CI, 1.722–3.473; p<0.001), and being overweight (OR, 1.389; 95% CI, 1.007–1.917; p=0.045). CONCLUSION: Early menarche, late age at first childbirth, and BMI ≥23 kg/m² were more associated with PABC than non-PABC.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Child ; Female ; Humans ; Menarche ; Methods ; Multivariate Analysis ; Overweight ; Parturition ; Pregnancy ; Survival Rate

A pre-transplant screening work-up of donors for allogeneic hematopoietic stem cell transplantation (HSCT) is essential. Inadvertent transmission of malignancy from donors with subclinical diseases to recipients has been reported recently in several cases. A 49-year-old male was diagnosed with acute myeloid leukemia. He underwent a course of induction chemotherapy and achieved cytogenetic complete remission (CR). He was treated with an additional cycle of consolidation chemotherapy followed by full matched sibling allogeneic HSCT due to an additional deletion in 9q known as an adverse prognostic factor. Post transplantation bone marrow biopsy revealed molecular CR, but conventional cytogenetics identified the presence of 46,XY,t(1:2)(p32:q35). A cytogenetic analysis of the donor graft specimen revealed t(1:2). We confirmed the donor origin of t(1:2). We report the first case of a person with constitutional t(1;2) serving as a stem cell donor.
Biopsy ; Bone Marrow ; Chromosome Aberrations* ; Consolidation Chemotherapy ; Cytogenetic Analysis ; Cytogenetics ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemia, Myeloid, Acute ; Male ; Mass Screening ; Middle Aged ; Siblings ; Stem Cells ; Tissue Donors ; Transplants

Cerebrovascular disorders (infarction and intracranial hemorrhage), otherwise collectively referred to as stroke, are an uncommon and feared complication of pregnancy. Collectively, these disorders contribute up to 12% of all maternal deaths. Because of the common presentation with seizures, hypertension, proteinuria, and visual disturbance there has been diagnostic confusion with eclampsia, especially when cerebrovascular disorders occur antepartum or intrapartum. This case is intended to assist the clinician with clues for prompt diagnosis and therapy for this uncommon and unpreventable medical complication of pregnancy.
Cerebral Hemorrhage* ; Cerebrovascular Disorders ; Diagnosis ; Eclampsia ; Female ; Hypertension ; Intracranial Hemorrhages ; Maternal Death ; Pre-Eclampsia* ; Pregnancy ; Proteinuria ; Seizures ; Stroke

PURPOSE: There are some methods for preventing massive intraoperative blood loss during major hepatic resection such as temporary vascular occlusion, but this can consequently lead to ischemia and reperfusion injury in the remnant liver. The purpose of this study is to assess ischemia-reperfusion (I/R) injury in a porcine hepatectomy model with continuous or intermittent inflow occlusion of a prolonged duration. METHODS: We performed right hepatic lobectomy in a porcine model with a liver ischemia lasting 120 mins; there was continuous (n=4) or intermittent (8 subsequent periods of 12 min ischemia and 3 min recirculation; n=4) inflow occlusion, and this was followed by 6 hours of reperfusion. We assessed hepatocytic injury by the serum levels of liver enzymes (AST, ALT, LDH), and we assessed the hepatocellular functions by the indocyanine green clearance test, inflammatory reactions by the serum levels of IL-6, and injury to the SECs (sinusoidal endothelial cell) by hyaluronic acid uptake. We compared these parameters during a preischemic period, a ischemic period and reperfusion period between the two groups. RESULTS: There were significant differences in the serum AST levels, IL-6 levels and HA uptake between the continuous and intermittent occlusion groups. In the intermittent occlusion group, we observed 1) less severe hepatocytic injury (p= 0.041) ; 2) more preserved HA uptake meaning less I/R injury (p=0.031) ; and 3) less inflammatory responses in the reperfusion period (p=0.045). CONCLUSION: During prolonged hepatic ischemia in a porcine model, the intermittent inflow occlusion method seemed to cause less hepatocellular injury and less SEC injury when compared to the continuous occlusion method. This means that we can expect less reperfusion injury in the intermittent inflow occlusion during a major hepatic resection with a prolonged ischemia.
Hepatectomy ; Hyaluronic Acid ; Indocyanine Green ; Interleukin-6 ; Ischemia ; Liver* ; Reperfusion ; Reperfusion Injury*

Nephrocalcinosis is described as the deposition of calcium crystals in the renal parenchyma that result from prolonged states of hypercalcemia. Recently recognized is the deposition of calcium phosphate in the renal tubular injury by using sodium phosphate cathartics commonly used for the colonic cleansing. This phenomenon was termed phosphate nephropathy. Acute renal failure secondary to phosphate nephropathy has been increasingly recognized as a complication after the administration of sodium phosphate solution for colonoscopy. We report a case of acute phosphate nephropathy following oral sodium phosphate solution to cleanse the bowel for colonoscopy. A renal biopsy showed diffuse tubular calcium deposition.
Acute Kidney Injury ; Biopsy ; Calcium ; Calcium Phosphates ; Cathartics ; Colon ; Colonoscopy ; Hypercalcemia ; Nephrocalcinosis ; Phosphates ; Renal Insufficiency ; Sodium