No abstract available.
Hyperostosis, Cortical, Congenital*

BACKGROUND: Serious organ shortage necessitates ABO incompatible (ABOi) kidney transplantation (KT). Recent reports utilizing rituximab instead of splenectomy and tacrolimus (FK)-based triple immunosuppressants showed excellent graft outcome. METHODS AND RESULTS: Thirteen cases of ABOi living donor KT have been performed since Feb. 2007 in our center. Donor and recipient blood group was B to O (n=5), A1 to O (2), AB to B (2), AB to A1 (1), A1 to B (2) and B to A1 (1). Rituximab was given at 4 weeks before transplantation. Plasmapheresis (PP) was initiated at 7~14 days before transplantation with concurrent immunosuppressants. The number of pretransplant PP was 5.7+/-1.4. Posttransplant PP was also performed in 6 patients with higher initial titer of ABO antibody (IgG > or =256; n=2), rapidly rising antibody titer during the critical period of 2 weeks posttransplantation (n=2), or increase in serum creatinine during the critical period while awaiting pathology report of graft biopsy (n=2). Mean number of posttransplant PP in these 6 patients was 2.2+/-1.3. Median IgG anti-ABO antibody titer before precondition, at transplantation, at 2 weeks and at 6 months was 64 (8~512), 2 (1~8), 2 (1~16) and 6 (1~16), respectively. IgM titer at corresponding time point was 16 (2~128). 1 (1~1), 1 (1~2) and 1.5 (1~4), respectively. Median follow up was 8 (5~27) months. No patient or graft was lost. No patient developed acute humoral rejection. Graft function remained stable with latest serum creatinine 1.2+/-0.3 mg/dl. CONCLUSIONS: ABOi living donor KT without splenectomy can be safely performed with the use of current preconditioning and immunosuppressive regimen, and is therefore a valuable option for expanding donor pool and should be actively performed in Korea.
Antibodies, Monoclonal, Murine-Derived ; Biopsy ; Creatinine ; Critical Period (Psychology) ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Living Donors ; Plasmapheresis ; Rituximab ; Rejection (Psychology) ; Splenectomy ; Tacrolimus ; Tissue Donors ; Transplants

Brain stem hematomas, expecially due to ruptured angiographically occult vascular malformation(AOVM), are of great interest because they are potentially curable. Preoperative diagnosis has been difficult due to poor resolution of CT scans in the posterior fossa region. The advent of MRI has made the identification of the angiographically occult vascular malformation possible before surgical excision. We preset 3 cases of brainstem hematoma due to vascular malformations which wre not visualized by angiography but were diagnosted by MRI. The patients were treated surgically and vascular malformations were confirmed.
Angiography ; Brain Stem* ; Diagnosis ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Vascular Malformations

Food allergy is a disease caused by an abnormal immunological reaction to specific food proteins. Whole milk and soy beans are the most frequent causes of food allergy, some studies show that 2.2~2.8% of children aged between 1 and 2 year are allergic to milk. It can be classified to acute (urticaria, asthma, anaphylaxis) or chronic (diarrhea, atopic dermatitis) allergy according to clinical symptoms, or to IgE related or non IgE related allergy by an immunological aspect. Generally, allergies invading only the GI tract are mostly due to a non IgE related reaction. These hypersensitive, immunologic reactions of the GI tract, not related to specific IgE for food, present themselves in many ways such as food protein-induced enteropathy, food protein-induced enterocolitis syndrome (FPIES), celiac disease, food induced protocolitis, or allergic eosinophillic gastroenteritis. FPIES is one kind of non IgE related allergic reaction and is manifested as severe vomiting and diarrhea in infants between 1 week and 3 months. We report a case of FPIES in a 40-day old male infant presenting with 3 times of repeated events of watery diarrhea after cow's milk feeding.
Asthma ; Celiac Disease ; Child ; Diarrhea ; Enterocolitis* ; Eosinophils ; Food Hypersensitivity ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk Proteins* ; Milk* ; Soybeans ; Vomiting

Malignant CNS lymphoma is a malignant intracranial tumor and in most cases they run a fulminating course if left untreated, with 3 to 5 months survival after appearance of the initial symptoms. Sixteen patients with malignant lymphoma were treated in Asan Medical Center from 1989 to 1994. All patients were underwent tissue diagnosis with subtotal resection or stereotactic biopsy and followed by cranial or craniospinal irradiation with or without systemic chemotherapy. One and three year survival rate of the patients was 88% and 78% respectively. In conclusion, addition of chemotherapy and/or cranial radiation for treatment of the CNS lymphoma may improve survival.
Biopsy ; Chungcheongnam-do ; Craniospinal Irradiation ; Diagnosis ; Drug Therapy ; Humans ; Lymphoma* ; Survival Rate

An adult raccoon dog with extensive, deep, and contaminated wounds on the right hip and multiple fractures was rescued. The open wound was managed daily by debridement and flushing for 3 weeks. Modified active drainage was then performed, and antibiotics administered according to the antibiotic susceptibility test. After 2 weeks, the exudate disappeared and the drain was removed. After monitoring for 1 month, the animal was released in to the wild. This case shows that even if infection remains, rapid wound repair is possible if appropriate antibiotic selection through regular examination and active drainage are combined.

Percutaneous interventional procedures under image guidance, such as biopsy, ethanol injection therapy, and radiofrequency ablation play important roles in the management of hepatocellular carcinomas. Although uncommon, the procedures may result in tumor implantation along the needle tract, which is a major delayed complication. Implanted tumors usually appear as one or a few, round or oval-shaped, enhancing nodules along the needle tract on CT, from the intraperitoneum through the intercostal or abdominal muscles to the subcutaneous or cutaneous tissues. Radiologists should understand the mechanisms and risk factors of needle tract implantation, minimize this complication, and also pay attention to the presence of implanted tumors along the needle tract during follow-up.
Aged ; Aged, 80 and over ; Biopsy, Needle/adverse effects ; Carcinoma, Hepatocellular ; Catheter Ablation/adverse effects ; Ethanol/administration & dosage ; Female ; Humans ; Injections ; Liver Neoplasms/*pathology ; Male ; Middle Aged ; *Neoplasm Seeding ; Tomography, X-Ray Computed

Papillary cystic neoplasms of the pancreas are uncommon. They occurs almost entirely in young women. Generally, the lesion averages 10 cm 17 size and are usually located in the pancreatic tail, resulting in displacement of the pancreatic duct. A varialbe amount of hemorrhage and liquefaction necrosis occurs, resulting in pseudopapillae cysts. Resection of the tumor is usually associated with a excellent prognosis because of the lack of metastases and rare recurrences. In this report present a case of a papillary cystic neoplasm of the pancreas with a review of references. Unlike most, the neoplasm we discovered was small (about 1.5 x 1.5 cm), and, occured in the pancreatic head of eldcrly woman. Moreover it was communicated by the main pancreatic duct via a side branch.
Female ; Head ; Hemorrhage ; Humans ; Necrosis ; Neoplasm Metastasis ; Pancreas* ; Pancreatic Ducts* ; Prognosis ; Recurrence

Granular cell tumors (GrCTs) of the spinal cord are rare benign tumors with a high rate of local recurrence. Only 6 cases of spinal GrCTs have been reported. GrCT is difficult to distinguish from other benign tumors such as schwannoma using imaging. A radiological "speckled dots" sign may be a useful differentiating feature of GrCT based upon experience with two cases and a review of the literature.
Diagnosis, Differential ; Granular Cell Tumor ; Magnetic Resonance Imaging ; Neurilemmoma ; Recurrence ; Spinal Cord

BACKGROUND/AIMS: Renal dysfunction commonly develops in patients with established liver disease. The assessment of renal function is of clinical importance in patients with cirrhosis and ascites. Renal function indices such as glomerular filtration rate and the plasma renin activity (PRA) could be better predictors of survival than the parameters usually used to estimate liver function including Child-Pugh score. This study was designed to find whether renal function indices are useful in determining the prognosis concerned with the survival of patients with liver cirrhosis. METHODS: A total of 110 patients was selected and followed for 89 weeks. As indices reflecting renal function, creatinine clearance rate, PRA, aldosterone concentration, and the pulsatility index (PI) and resistive index (RI) by Doppler ultrasonography were measured. The prognostic values of these indices were determined by comparison and analysis according to survival or death of the patients. For the statistics, univariate and multivariate analysis was done. RESULTS: Child-Pugh score (> or =10), creatinine clearance rate (<80 mL/min), plasma alodosterone concentration (> or =15 ng/dL), PRA (> or =8 ng/mL/hr), renal PI (> or =1.15) and RI (> or =0.7) were prognostic indicators in univariate analysis (p<0.05). Multivariate analysis disclosed two independent survival predictors of creatinine clearance rate (<80 mL/min) (OR:5.37, 95% CI: 2.09-13.82) and plasma aldosterone concentration (> or =15 ng/dL) (OR: 3.65, 95% CI: 1.09-12.18). CONCLUSION: Various renal function indices are closely related to the survival of patients with liver cirrhosis. Creatinine clearance rate and plasma aldosterone concentration are especially important prognostic factors in predicting the survival of patients with liver cirrhosis.
Aldosterone ; Ascites ; Creatinine ; Fibrosis ; Glomerular Filtration Rate ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Multivariate Analysis ; Plasma ; Prognosis* ; Renin ; Ultrasonography, Doppler