Xanthogranulomatous pyelonephritis, an uncommon chronic inflammatory renal disorder of middle-aged women, is rarely seen in childhood. A 10 year-old boy with focal type of this disease in upper and lower pole was experienced. Patient had a intermittent fever and right flank pain without palpable mass. The blood analysis only revealed ESR increase but no anemia, no leukocytosis. There was no history or signs of urinary tract infection or calculi. The urine analysis and culture showed nothing abnormal. An intravenous pyelogram, ultrasonogram, abdominal CT and selective renal arteriography only demonstrated a non functioning upper pole of right kidney. During operation, a gross finding and frozen section strongly showed xanthogranulomatous pyelonephritis and diagnosis was made on histological examination, After nephrectomy, there had been no evidence of disease recurrence during 2 years follow-up period.
Anemia ; Angiography ; Calculi ; Child* ; Diagnosis ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Frozen Sections ; Humans ; Kidney ; Leukocytosis ; Male ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous* ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Tract Infections

No abstract available.
Colitis, Ulcerative* ; Ulcer*

Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.
Adult ; Dyspnea ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary* ; Maternal Mortality ; Mothers ; Pregnancy* ; Prognosis

PURPOSE: To evaluate the sonographic features of mesenteric lymphadenopathy in childhood epidemic aseptic meningitis and to assess their clinical significance. MATERIALS AND METHODS: Thirty-three patients (25 male, 8 female; mean age, 8.6 years) with a diagnosis of aseptic meningitis were prospectively evaluated with abdominal ultrasonography for the presence of enlarged mesen-teric nodes. The size and number of enlarged mesenteric lymph nodes were analyzed in relationship with the pa-tient's age, between the patients with abdominal pain or diarrhea (16 cases, 48%) and asymptomatic patients(17 cases, 52%). RESULTS: Mesenteric lymphadenopathy was seen in 31 patients (94%), all 16 symptomatic and 15 of the 17 asymp-tomatic patients. The number of enlarged nodes was most prevalent between 6 -10, seen in 16 patients (52%) and the largest node ranged in size from 4 to 8 mm. Among the 31 patients with mesenteric lymphadenopathy, the mean size of the largest node was statistically different between the symptomatic (6.0 mm) and asympto-matic (5.0 mm) groups (p = 0.021). The number of enlarged nodes and the patient's age were not statistically d-ifferent between the two groups. CONCLUSION: Mesenteric lymphadenopathy was seen in almost all cases of childhood epidemic aseptic meningitis, and may be related to the mesenteric lymphadenitis caused by enterovirus.
Abdominal Pain ; Diagnosis ; Diarrhea ; Enterovirus ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Male ; Meningitis, Aseptic* ; Mesenteric Lymphadenitis ; Prospective Studies ; Ultrasonography*

No Abstract Available.
Female ; Hormone Replacement Therapy* ; Humans ; Life Style* ; Osteoporosis*

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy

Evaluation of the mechanism of anemia in cancer patients might help to select patients for the more efficient use of erythropoietin (EPO, a growth factor for erythroid precursor cells). For this, we investigated whether the production of EPO responds to anemia and the bone marrow responds to EPO appropriately, and whether chronic inflammation is inhibitory to erythropoiesis in anemic cancer children. Serum levels of EPO, soluble transferrin receptor (sTfR), tumor necrosis factor (TNF)-alpha, and erythrocyte sedimentation rate (ESR) in anemic cancer children were measured by enzyme-linked immunosorbent assay and then the correlation coefficients between those parameters and hemoglobin (Hb) were determined. Both in leukemia and in solid tumor patients, there were significant inverse correlations between Hb and EPO (leukemia: tau=-0.547, p<0.0001; solid tumor: tau=-0.591, p<0.0001), and between sTfR and EPO (leukemia: tau=-0.223, p<0.05; solid tumor: tau=-0.401, p<0.05). In contrast, sTfR showed a correlation with Hb in leukemia (tau=0.216, p<0.05) but not in solid tumor patients. sTfR was suppressed in 53% of anemic episodes of leukemia and 78% of those of solid tumor patients. Our results suggest that in cancer children, the EPO production is not defective and chronic inflammation is not inhibitory to erythropoiesis. Rather, the defective erythropoiesis itself is thought to be responsible for the anemia.
Anemia/etiology/*physiopathology ; Blood Sedimentation ; Bone Marrow/physiology ; Child ; Erythropoiesis/*physiology ; Erythropoietin/blood ; Female ; Humans ; Male ; Neoplasms/complications/*physiopathology ; Receptors, Transferrin/blood ; Solubility ; Tumor Necrosis Factor-alpha/metabolism

BACKGROUND AND OBJECTIVES: Hearing aids are commonly used to alleviate the effects of tinnitus. But the investigations for effectiveness of hearing aids on tinnitus gave variable results according to survey methods. We will determine the effects of the hearing aid on the perception of tinnitus using the THI (Tinnitus Handicap Inventory) and investigate the relationships between THI & SADL (Satisfaction with Amplification in Daily Life) scale. SUBJECTS AND METHOD: THI score was assessed at pre-aid time and 4 weeks after fitting with the same inventory prospectively by 36 hearing impaired patients who reported tinnitus. Also, the SADL scale was completed at 4 weeks after fitting. The relationship between SADL score and THI benefit was evaluated. RESULTS: Twenty-two of thirty six patients (61.1%) showed subjective beneficial effect of hearing aid on tinnitus. The use of hearing aid significantly reduced the tinnitus handicap score in all subclasses and total THI. The only positive effect in the subscale of SADL was related to the THI benefit statistically. CONCLUSION: The hearing aid can provide relief from tinnitus associated with hearing loss and improve the subjective satisfaction of fitting.
Surveys and Questionnaires ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Prospective Studies ; Tinnitus

Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cations. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it diminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.
Brain ; Brain Edema ; Brain Stem ; Cardiopulmonary Resuscitation ; Cations, Monovalent ; Central Nervous System ; Deglutition Disorders ; Dizziness ; Eating ; Heart Arrest ; Ischemia ; Neurons ; Paralysis ; Peripheral Nerves ; Poisoning* ; Reflex ; Salivation ; Seizures ; Tetraodontiformes* ; Tetrodotoxin ; Vomiting

Nimesulide, highly selective cyclooxygenase inhibitor-2, is a newly developed, non-steroidal anti-inflammatory drug (NSAID) with low toxicity in gastrointestinal tract. But recently, seven cases of nimesulide-induced hepatitis of which types were hepatocellular, hepatocanalicular, and mixed damage were reported. Our case of nimesulide-induced hepatic damage was mixed cholestatic and hepatotoxic hypersensititvity reaction, and her story was as follows. A 70-year female patient's first hepatic event happened in Jaunuary, 1998 after taking nimesulide 200mg daily for 50 days from November 1997, but it was cleared. She was admitted to our unit because of jaundice, edema and ascites in May, 1998 after retrial of nimesulide 150 mg daily for 50 days. Biochemical determinations showed increase of AST (181 IU/L), ALT (110 IU/L), bilirubin (20.3 mg/dL) and albumin (2.3 g/dL). Prothrombin time was also prolonged upto 2.51 INR. But neither viral markers such as anti-HCV, HBsAg, anti-HBc IgM, anti-HAV IgM, anti-CMV, anti-EBV IgG and IgM nor other immunologic markers such as ANA, SMA, and AMA were positive. Ultrasonography showed diffuse hyperechogenicity in liver and mild splenomegaly but no dilatation in biliary tract. Liver biopsy showed portal to portal bridging necrosis with severe hepatocytic cholestasis. Her liver function returned to normal after discontinuation of nimesulide. At 8 months after beginning treatment, she complained of recurrent epistaxis and abdominal distension. At this time, her liver biopsy showed cirrhosis. In conclusion, we considered that this case was nimesulide-induced Liver cirrhosis.
Abdominal Abscess ; Ascites ; Biliary Tract ; Bilirubin ; Biomarkers ; Biopsy ; Catheterization ; Cholestasis ; Dilatation ; Drainage ; Edema ; Epistaxis ; Female ; Fibrosis ; Gastrointestinal Tract ; Hepatitis A Antibodies ; Hepatitis B Surface Antigens ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; International Normalized Ratio ; Jaundice ; Liver ; Liver Cirrhosis ; Necrosis ; Prostaglandin-Endoperoxide Synthases ; Prothrombin Time ; Splenomegaly ; Ultrasonography