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*

Multiple primary cancer is defined as the case of primary malignant tumors of different histologic origins each other in one person, The incidence of multiple primary cancer has been increasing recently due to more developed diagnostie procedure and long survival of cancer patients. In esophageal cancer patients, comibined prevalence of other malignancy is rela tively high. We have experienced three cases of gastric adenocarcinoma with esophageal squamous cell carcinoma and report these cases with a review of literatures.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Esophagus* ; Humans ; Incidence ; Prevalence ; Stomach*

BACKGROUND: Platelet clumping is a common cause of erroneous platelet counts by automated blood cell counter. The most commonly employed solution to this problem is to redraw the specimen into a different anticoagulant. However, this is unpleasant for the patient and not rapid for reporting of the corrected platelet count. Mixing of blood with a vortex mixer was evaluated as a method to disaggregate platelet clumps in blood and thus obtain accurate platelet counts. METHODS: Whole blood samples coated with ethylenediaminetetraacetic acid (EDTA) from 28 patients with platelet clumping and 20 controls without platelet clumping from July to September 2002 were mixed for 30 seconds with a vortex mixer. Platelet counts, blood smears, erythrocyte counts, Hgb, MCV and total leukocyte counts were evaluated before and after mixing. RESULTS: Vortex mixing of blood samples with platelet clumps caused an increased platelet count in 96% (27/28) and a decreased total leukocyte count in 68% (19/28). The mean platelet and total leukocyte counts of 28 blood samples before mixing were 155.0+/-89.6 (x10(3)/microL) and 12.9+/-5.5 (x10(3)/microL) and after mixing they were 249.2+/-116.2 (x10(3)/microL) and 12.0+/-5.4 (x10(3)/microL). Total erythrocyte counts, Hgb, MCV were not significantly affected by vortex mixing. Further, vortex mixing of 20 control samples had no consistent effect on each items. CONCLUSIONS: Vortex mixing of blood samples is a simple, rapid method without re-sampling in correction of erroneous platelet count induced by platelet clumps.
Blood Cell Count ; Blood Platelets ; Edetic Acid ; Erythrocyte Count ; Humans ; Leukocyte Count ; Platelet Count*

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

The common arterial trunk is a congenital cardiovascular malformation in which one arterial trunk gives origin to the aortic arch, pulmonary and coronary arteries. Other cardiovascular malformations are often associated, such as ventricular septal defect, aortic arch interruption, patent arterial duct and so on. During the early period of life, the persistence of the increased pulmonary arteriolar resistance results in cyanosis. As the pulmonary vascular resistance decreases, the cyanosis disappears but signs of congestive heart failure become the main problems. We report five cases of common arterial trunk that was confirmed by autopsy at Chungnam National University Hospital, Seoul National University Hospital, and Yonsei University Severance Hospital between 1983 and 1995. The ages of these patients at autopsy were 8-28 days and four of them were male. Pulmonary arteries arose as a pulmonary trunk in two cases but three cases showed two arteries arising separately from the posterior wall of the common trunk. The type of ventricular septal defect was juxtatruncal in every case. All five cases had three leaflet truncal valves but three cases showed dysplasia of the leaflets. Interruption of aortic arch was associated in two cases. The cause of death was renal failure in two cases, cardiac failure after corrective surgery in two cases, and pulmonary edema and failure in one case.