No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Humans ; Proteinuria*

Neisseria meningitidis is an important cause of sporadic meningitis and fatal sepsis. Skin manifestations like urticaria, maculopapular eruption, and petechial rash occur in the majority of patients with meningococcal infections. However, meningococcal cellulitis is extremely rare and has not been reported in patients with systemic lupus erythematosus (SLE). SLE patients who have low complement level are more susceptible to meningococcal infections than healthy population with normal complement level. We report a case of cellulitis associated with meningococcal infection, which manifested as knee arthritis, skin erythema, and low grade fever mimiking SLE flare in a 54 year-old female patient who had long standing SLE and hypocomplementemia.
Arthritis ; Cellulitis* ; Complement System Proteins ; Erythema ; Exanthema ; Female ; Fever ; Humans ; Knee ; Lupus Erythematosus, Systemic* ; Meningitis ; Meningococcal Infections ; Middle Aged ; Neisseria meningitidis ; Sepsis ; Skin ; Skin Manifestations ; Urticaria

Neisseria meningitidis is an important cause of sporadic meningitis and fatal sepsis. Skin manifestations like urticaria, maculopapular eruption, and petechial rash occur in the majority of patients with meningococcal infections. However, meningococcal cellulitis is extremely rare and has not been reported in patients with systemic lupus erythematosus (SLE). SLE patients who have low complement level are more susceptible to meningococcal infections than healthy population with normal complement level. We report a case of cellulitis associated with meningococcal infection, which manifested as knee arthritis, skin erythema, and low grade fever mimiking SLE flare in a 54 year-old female patient who had long standing SLE and hypocomplementemia.
Arthritis ; Cellulitis* ; Complement System Proteins ; Erythema ; Exanthema ; Female ; Fever ; Humans ; Knee ; Lupus Erythematosus, Systemic* ; Meningitis ; Meningococcal Infections ; Middle Aged ; Neisseria meningitidis ; Sepsis ; Skin ; Skin Manifestations ; Urticaria

PURPOSE: Transurethral resection of prostate(TURP) is the gold standard for the treatment of benign prostate hyperplasia(BPH) at the present. But many attempts have been made to develop minimally invasive method. We studied the efficacy of transurethral needle ablation(TUNA) of prostate for treatment of BPH. MATERIALS AND METHODS: We performed TUNA in 20 BPH patients including 13 patients with acute urinary retention. Preoperatively all patients were evaluated using urinary flow rates, International Prostate Symptom Score(1-PSS), Quality of life and cystoscopic examination. The urinary flow rates, 1-PSS and Quality of life were checked at 1, 3 and 6 months after TUNA in all patients. RESULTS: The average value of peak flow rate of the patients with urinary retention were 10ml/sec, 12ml/sec and 13ml/sec at 1, 3 and 6 months follow-up. The average value of Qmax of the patients without urinary retention were 9ml/sec preoperatively and increased to 13ml/sec, 13ml/sec and 14ml/sec at 1, 3 and 6 months postoperatively. 1-PSS of patients with urinary retention improved from average 26 at preoperation to 14, 13, 10 at 1, 3 and 6 months postoperatively. Quality of life of patients with urinary retention improved from average 5 at preoperation to 2, 2, 2 at 1, 3 and 6 months postoperatively. The average value of patients without urinary retention improved from average 26, 5 at preoperation to 14, 11, 11 and 2, 2, 2 at 1, 3 and 6 months follow-up. No patients complained of erectile dysfunction and retrograde ejaculation postoperatively. CONCLUSIONS: The result of our preliminary study suggest that TUNA can be considered to be a simple, safe and efficacious procedure for the treatment of BPH including urinary retention.
Ejaculation ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Needles* ; Prostate ; Quality of Life ; Tuna ; Urinary Retention

BACKGROUND: One of the groups with highest risk for avascular necrosis is patient with systemic lupus erythematosus (SLE). Corticosteroid therapy is also the most important risk factor. No predictive test, however, was known to detect avascular necrosis. The purpose of this study is to evaluate hemodynamic flow to the proximal femur in patients with SLE with long term corticosteroid therapy. METHODS: Twenty-two patients with SLE without avascular necrosis and with long-term corticosteroid treatment (mean months; 41 (1-156)) versus 15 healthy controls were evaluated. Medial and lateral circumflex arteries of 44 hips in 22 SLE patients and 30 hips in healthy controls were examined using ultrasoud equipment with color Doppler and power Doppler capability. Arterial pulstality index (PI) and peak systolic velocity (PSV) were determined with neutral and internal rotation position (stimulated ischemia). RESULTS: PSV was significantly increased in patients with SLE than healthy controls (70.6+/-40.4 vs 46.9+/-19.3; p<0.001) with neutral position as well as (74.8+/-42.3 vs 49.9+/-19.9; p<0.001) with internal rotation. PI was also higher in SLE patients than healthy controls (8.9+/-6.3 vs 5.5+/-3.4; p<0.001) with neutral position as well as (8.1+/-7.1 vs 3.9+/-2.5; p<0.001) with internal rotation. PI strongly correlated with PSV (r=0.99, p<0.001). But PSV or PI did not correlate with duration of corticosteroid use. CONCLUSION: Peak systolic velocity and pulstality index of arteries to the femur head in patients with SLE with long-term corticosteroid treatment were significantly higher than healthy controls. These hemodynamic changes may contribute to develop avascular necrosis of the hip in patients with SLE.
Arteries ; Femur Head* ; Femur* ; Hemodynamics* ; Hip ; Humans ; Lupus Erythematosus, Systemic* ; Necrosis ; Osteonecrosis ; Risk Factors ; Ultrasonography

Laryngeal involvement in systemic lupus erythematosus (SLE) is rare. It can range from mild ulcerations, vocal cord paralysis, and edema to necrotizing vasculitis with airway obstruction. The causes of vocal cord paralysis included vasculitis of the vasa nervorum, neuritis, thromboembolic effect on recurrent laryngeal nerves, and compression of the left recurrent laryngeal nerve by an enlarged left pulmonary artery. Few cases on the association of vocal cord palsy and pulmonary hypertension in SLE patient have been reported. We report a case of left vocal cord palsy and pulmonary hypertension in a patient with SLE who experienced improvement of vocal cord palsy and dyspnea after steroid pulse therapy.
Airway Obstruction ; Dyspnea ; Edema ; Humans ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Neuritis ; Pulmonary Artery ; Recurrent Laryngeal Nerve ; Ulcer ; Vasa Nervorum ; Vasculitis ; Vocal Cord Paralysis* ; Vocal Cords*

Sjogren's syndrome(SS) is an autoimmune disease characterized by inflammation induced chronic dysfunction of the exocrine glands. Neurologic manifestations occurs in 30% of patients. We report a 55-year-old woman with primary SS, who presented with subacute aseptic meningitis combined with an unnoticed polyneuropathy. SS was confirmed by dry eyes and Schirmer's test, salivary scintigraphy and serum autoantibodies. We suggest SS as a cause of subacute aseptic meningitis in an elderly female patient with dry eyes and mouth.
Aged ; Autoantibodies ; Autoimmune Diseases ; Exocrine Glands ; Female ; Humans ; Inflammation ; Meningitis, Aseptic ; Middle Aged ; Mouth ; Neurologic Manifestations ; Peripheral Nervous System* ; Polyneuropathies ; Radionuclide Imaging ; Sjogren's Syndrome*

Verrucous carcinoma is a form of low grade squamous cell carcinoma that is characterized grossly by its exophytic and wart-like appearance. We experienced a case of verrucous carcinoma in a 63-year-old female patient who presented with pyelonephritis caused by staghorn calculi. Abdominal CT scan showed a renal pelvic mass and nephrectomy was done. Histologic examination showed extensive keratinizing squamous metaplasia of pelvic urothelium with an area of verrucous acanthosis. To our knowledge, this is the second case of verrucous carcinoma of renal pelvis that has been reported in literature. We describe a case and review the literature concerning verrucous carcinoma.
Calculi ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Female ; Humans ; Kidney Pelvis* ; Metaplasia ; Middle Aged ; Nephrectomy ; Pyelonephritis ; Tomography, X-Ray Computed ; Urothelium

OBJECTIVE: Although gadolinium enhancement of compression fractures is well known, the enhancement pattern of the acute stage of a fracture is not completely understood. Here, we investigated the enhancement pattern of acute vertebral compression fractures (VCFs). METHODS: We conducted a retrospective study of patients with acute osteoporotic VCFs admitted to hospital between January 2004 and December 2005. The demographic details, stage of the fracture, management data, and results were analyzed. There were nine men and 22 women, and the mean age was 71 years (range, 53-92 years). According to the onset of pain, patients were divided into the following four groups : Group I (less than 3 days), Group II (4-7 days), Group III (8-14 days), and Group IV (14-30 days). RESULTS: All patients had central low-signal intensity of the nonenhancing part of vertebral bodies on T1 images. Enhancing box sign (EBS) was seen 7 days of VCF development. After 7 days of onset (Groups III and IV), patch or Kummell's enhancements occurred. EBS has been statistically correlated with stage of compression fracture (Pearson's correlation = -0.774). However, EBS had no statistically significant correlation with prognosis in our study (Pearson's correlation = 0.059). CONCLUSION: EBS represents a characteristic sign 7 days of VCF development.
Female ; Fractures, Compression ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retrospective Studies

PURPOSE: Leigh syndrome is a kind of mitochondrial disease with a pathological production of lactate and variable clinical manifestations. Recently biochemical assay of the mitochondrial enzyme activity and MRS are becoming a powerful tool for the definitive antemorterm diagnosis of this disease. The aim of this study was designed to determine the usefulness of biochemical enzyme assay and MRS in Leigh syndrome. METHODS: A clinical study of 8 cases of pediatric patients were diagnosed as Leigh syndrome on the basis of clinical manifestations and MRI features at the department of pediatrics, Ulsan university hospital, from July, 1992 to June, 1997. Biochemical enzyme assay of the cultured skin fibroblasts was consulted to hospital for sick children, Toronto, Canada. Cerebral lactates were detected on MRS were analysed in relation to the MRI findings and lactate levels in the CSF. RESULTS: 1) Age at diagnosis ranged from 7 months to 8.9 years; seven were boys and one was girl. 2) Main clinical symptoms were as follows in the order of frequency; seizure(75%), ophthalmoplegia(50%), hemiplegia(50%), hypotonia(50%), respiratory difficulty(50%), developmental delay(38%), consciousness change(38%), mental retardation( 25%). 3) Anatomical locations of the focal lesions detected on the initial MRI were as follows in the order of frequency; putamen(75%), caudate nuclei(63%), medulla oblongata (18,50%), substantia nigra(38%), thalamus(38%). 4) Biochemical enzyme assay revealed deficiency of NADH cytochrome c reductase (complex I) and deficiency of cytochrome c oxidase(complex N) respectively in 2 patients who had markedly elevated serum and CSF lactate levels and lactate/pyruvate ratio. 5) Cerebral lactates were detected by MRS from 6 lesions of 1 week-4 months old in 6 patients who had normal or mildly elevated serum and CSF lactate levels and lactate/pyruvate ratio. CONCLUSION: MRS detected the brain parenchymal lactate non-invasively from the acute or subacute lesions. Therefore, combined evaluation by MRS and biochemical enzyme assay will provide an important information for the diagnosis and estimation of disease activity in pediatric patients who are suspected to have Leigh syndrome.
Brain ; Canada ; Child ; Consciousness ; Cytochromes c ; Diagnosis ; Enzyme Assays* ; Female ; Fibroblasts ; Humans ; Lactates ; Lactic Acid ; Leigh Disease* ; Magnetic Resonance Imaging ; Medulla Oblongata ; Mitochondrial Diseases ; NADH Dehydrogenase ; Pediatrics ; Skin ; Ulsan