No abstract available.
Arthroscopy* ; Knee* ; Magnetic Resonance Imaging*

Although spontaneous bacterial peritonitis is a frequent complication in the childhood nephrotic syndrome, it is very rare in adults with nephrotic syndrome. It frequently develops when the patients are either in relapse or receiving steroid therapy at the time peritonitis is diagnosed. We report an unusual case of a spontaneous bacterial peritonitis as the presenting feature in a 15-year-old male patient with nephrotic syndrome. He presented with diffuse abdominal pain and distension for 15 days. Abdominal paracentesis revealed the diagnostic laboratory findings of peritonitis, and the bacterial culture of the ascites showed a mixed growth of Escherichia coli and Pseudomonas aeruzinosa. His serum albu- min level was 1.6gldL and the amount of 24 hours proteinuria was 21.0g/day. Although he was treated with adequate antibiotics for 3 weeks, the peritonitis was more aggravated. We decided to insert a catheter into the peritoneal cavity for continuous drainage of the intractable ascites. Two weeks after drainage, the peritonitis improved as the peritonitis subsided, the proteinuria disappeared completely without a steroid therapy. Six months after spontaneous remission, the proteinuria have recurred, and the kidney biopsy then showed focal segmental glomerulorsclerosis.
Abdominal Pain ; Adolescent ; Adult ; Anti-Bacterial Agents ; Ascites ; Biopsy ; Catheters ; Drainage ; Escherichia coli ; Humans ; Kidney ; Male ; Nephrotic Syndrome* ; Paracentesis ; Peritoneal Cavity ; Peritonitis* ; Proteinuria ; Pseudomonas ; Recurrence ; Remission, Spontaneous

Nitric oxide (NO) elevates intracellular calcium. But the actions of calcium in NO-induced cell death are not well understood. This study was carried out to investigate the signal transduction pathways of calcium and NO-induced cytotoxicity in H9c2 cardiac myoblasts by using NO donor compounds such as sodium nitroprusside (SNP) and S-nitroso-N-acetylpenicillamine (SNAP). Pretreatment of intracellular calcium chelating agent (BAPTA/AM) or L-type calcium channel blockers (nicardipine, nifedipine, diltiazem and veraparmil) or T-type calcium channel blocker (flunarizine) blocked SNP-induced cytotoxicity respectively only in a three hours. However, thapsigargin (TG), which inhibits endoplasmic reticulum dependent Ca(2+)-ATPase and thereby increases cytosolic Ca(2+), augmented SNP-induced cytotoxicity. The protective effect of BAPTA/AM was inhibited by treatment of protein synthesis inhibitor, cyclohexamide. In addition, pyrrolidine dithiocarbamate (PDTC), NF-kB inhibitor, attenuates the protective effect of BAPTA/AM against SNP-induced cytotoxicity. It is indicated that the protective effect of BAPTA/AM against NO-induced cytotoxicity might be due to the expression of protein related to activation of NFkB. From these results, it is concluded that SNP-induced cytotoxicity is mediated by calcium in a 3 hours via down regulation of protein expression rleated to activation of NFkB.
Calcium Channels, L-Type ; Calcium Channels, T-Type ; Calcium* ; Cell Death ; Cytosol ; Diltiazem ; Down-Regulation ; Endoplasmic Reticulum ; Humans ; Myoblasts, Cardiac* ; NF-kappa B ; Nifedipine ; Nitric Oxide ; Nitroprusside ; S-Nitroso-N-Acetylpenicillamine ; Signal Transduction* ; Thapsigargin ; Tissue Donors

BACKGROUND AND OBJECTIVES:Conventional vestibular rotation testing with the head centered on the axis stimulates the semicircular canals evoking compensatory eye movements. By placing subjects off from the axis of rotation, the otolithic organ may also be simultaneously stimulated by additional linear acceleration forces. In the present study, we compared the rotation with subjects placed on axis to those placed in an eccentric position. MATERIALS AND METHOD:In the eccentric rotation, the head of subject was facing outward and placed eccentrically for 33cm on naso-occipital axis. Slow harmonic acceleration test and velocity step test were performed. RESULTS:The sinusoidal eccentric rotation at 0.32, 0.64 Hz produced a significantly higher vestibulo-ocular reflex gain than did on axis rotation. In velocity step test, initial slow component velocity was significantly higher in eccentric rotation than in centric rotation. CONCLUSION:These finding suggest that the gain enhancement due to eccentric rotation is a result of tangentiallinear acceleration, probably sensed by the otolithic organ. This study raises the possibility of using eccentric rotation for the diagnosis of the patients with otolithic dysfunction.
Acceleration ; Axis, Cervical Vertebra ; Diagnosis ; Exercise Test ; Eye Movements ; Head ; Humans ; Otolithic Membrane ; Reflex* ; Reflex, Vestibulo-Ocular ; Semicircular Canals

Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*

We present a case of liposarcoma related with minimal change nephrotic syndrome. A 49-year-old woman was admitted due to generalized edema and a palpable mass at epigastric area. Her laboratory data were as follows : serum creatinine 0.6mg/dl, BUN 7mg/dl, serum total protein 3.6g/dl(albumin 0.6 g/dl) serum total cholesterol 299mg/dl, 24 hour-urine protein 5.1g. A CT scan of the abdomen revealed huge adult head sized mass(15X10X15cm) consisted with mixed pattern of well enhancing solid, cystic and fat portion which is located between the liver and the stomach. A kidney biopsy showed minimal change nephropathy. At explo-laparostomy the tumor was well differentiated liposarcoma. After operation and steroid therapy, her proteinuria and hypoalbuminemia were a little improved. And then radiation therapy(daily 180 cGy, 5 fx/wk, upto 5040cGy/28 fx/42 day) was done. Complete remission of liposarcoma was followed by regression of the nephrotic syndrome. After radiation therapy, her laboratory data were serum total protein 6.7g/dl (albumin 4.3g/dl), total cholesterol 170mg/dl, 24 hour-urine protein 0.3g. She has been maintained complete remission of the nephrotic syndrome by steroid maintenance dose.
Abdomen ; Adult ; Biopsy ; Cholesterol ; Creatinine ; Edema ; Female ; Head ; Humans ; Hypoalbuminemia ; Kidney ; Liposarcoma* ; Liver ; Middle Aged ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Proteinuria ; Stomach ; Tomography, X-Ray Computed

BACKGROUND: There are some studies concerning fasting insulin and insulin resistance in normal healthy Korean adults, but none exists especially for adolescence. Therefore, we investigateck insulin resistance and its related factors in adolescence. METHODS: We analyzed 582 10th grade high school students. Height, weight, abdominal circumference, systolic and diastolic blood pressure, fasting glucose, total cholesterol, hemoglobin were measured. Fasting state and parent's and student's previous medical history were guestioned. We used Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) as an indicator of insulin resistance. RESULTS: By HOMA-IR 2.15, the subjects were divided into the insulin sensitive and the resistant groups. Two groups showed significant differences in body mass index, systolic diastolic blood pressure, fasting glucose, fasting insulin, total cholesterol and abdominal circumference (P <0.05). HOMA-IR was strongly related to the body mass index (r=0.53) and abdominal circumference (r=0.52), but weakly related to the total cholesterol (r= 0.20). According to logistic regression analysis of HOMA-IR, the odds ratio of the body mass index was 1.17 and that of abdominal circumference was 1.06 (P <0.05). CONCLUSION: HOMA-IR showed strong relationship with body mass index, abdominal circumference, but showed weak relationship with total cholesterol. There was no significant correlation with the parent's diabetic medical history. Therefore we conclude that in adolescence the body mass index or the abdominal circumference is far more important factor than the parent's diabetic history.
Adolescent* ; Adult ; Blood Pressure ; Body Mass Index ; Cholesterol ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Logistic Models ; Odds Ratio ; Seoul*

Adult ; Case Report ; Goodpasture Syndrome/physiopathology ; Goodpasture Syndrome/complications* ; Hemoptysis/etiology* ; Human ; Kidney/physiopathology ; Male

PURPOSE: Phototherapy uses the changes caused by the athermal and atraumatic absorption of the photon's energy by the tissue for therapeutic effect. Phototherapy has been proven to be useful in various conditions, for example, in pain attenuation, wound healing and skin rejuvenation. The aim of this research was to evaluate the clinical efficacy of 830 nm LED phototherapy for burn patients. METHODS: We recruited 11 patients who visited this hospital between June and December 2012 with superficial 2nd degree burns to the face for comparative analysis. For phototherapy, we used infrared LED with wavelength of 830 nm. For comparative analysis, we covered one side of the face with sterile aluminum foil and fabric during the treatment. Photographs were taken at the time of each treatment and the time taken for epithelialization and the level of patient satisfaction were also investigated. RESULTS: All 11 patients were male and the mean age was 44.0+/-11.9 years (range of 28~63 years). The cause of the burns was flame burn for 7 patients, and electric sparks in 4 patients. The time taken to achieve epithelialization after the burns was 8.1+/-2.2 days (range 4~12 days) for the side that received phototherapy, while it was 9.1+/-2.9 days (range 4~14 days) for the side that was not treated with phototherapy. In terms of patient satisfaction, 3 patients were 'Very Satisfied', 6 patients were 'Satisfied', 2 patients replied 'Adequate' and none of the patients were 'Unsatisfied'. CONCLUSION: LED phototherapy of 830 nm wavelength can shorten the time taken for burn wound healing. It also was not associated with serious complications except for skin dryness, so it can be a useful treatment method for burns that produces satisfactory outcome for the patients.
Absorption ; Aluminum ; Burns ; Humans ; Infrared Rays ; Lasers, Semiconductor ; Male ; Patient Satisfaction ; Phototherapy ; Rejuvenation ; Skin ; Wound Healing

PURPOSE: Marjolin's ulcer is a rare malignancy that occur in chronic wounds or scars. Marjolin's ulcers tend to infiltrate adjacent tissue more extensively than squamous cell carcinoma that occurs in normal skin, and it is prone to recurrence and metastases, leading to a poor prognosis. Hence, its accurate diagnosis and treatment is very important. The aim of this study was to investigate the diagnostic value and clinical efficacy of preoperative 18F-FDG-PET/CT. METHODS: The study population consisted of 27 patients who were suspected to have Marjolin's ulcer who visited this hospital between January 2009 and June 2012, and who had also received preoperative PET/CT. To confirm the diagnostic efficacy of preoperative PET/CT, the PET/CT findings of the primary lesion and the lymph node, as well as the post-operative histology results were compared to investigate the sensitivity, specificity, false-positive and false-negative rates. RESULTS: The sensitivity and the specificity for the primary lesion of the Marjolin's ulcer in the preoperative PET/CT were 93.3% and 100% respectively. The false-positive rate and the false-negative rate here were 0% and 6.7% respectively. The sensitivity and the specificity for the lymph node metastases of the Marjolin's ulcer in the preoperative PET/CT were 100% and 66.7% respectively. The false-positive rate and the false-negative rate here were 33.3% and 0% respectively. The histological results of Marjolin's ulcer showed that 14 patients had squamous cell carcinoma and 1 had sarcoma. CONCLUSION: Preoperative PET/CT used for the assessment of Marjolin's ulcer and its primary lesion showed a high level of sensitivity and specificity. It was also useful because it allowed the assessment of the primary lesion, lymph node metastases, and distant metastases with a single test. However, the specificity for lymph node metastases was relatively lower, and more research would be needed to improve this.
Carcinoma, Squamous Cell ; Cicatrix ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Recurrence ; Sensitivity and Specificity ; Skin ; Ulcer