In 1941, Jaffe and coworkers studied a lesion with histologic appearance of fibrous stroma, pigmented deposition and histiocytic infiltration as well as giant cell, for which they named pigmented villonodular synovitis, bursitis and tenosynovitis. Thereafter many authors have discussed etiology, clinical and radiological features, pathology and treatment regarding the disease. Almost all, this disease is monoarticular and knee joint is most common site. We experienced a case of localized pigmented villonodular synovitis involving an shoulder joint which was treated by local excision and obtained good result.
Bursitis ; Giant Cells ; Knee Joint ; Pathology ; Shoulder Joint ; Shoulder ; Synovitis, Pigmented Villonodular ; Tenosynovitis

No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Korea* ; Prevalence*

The cause responsible for the lack of an efficient cell-mediated immunity or a delayed type hypersensitivity to M. leprae in lepromatous patients is poorly understood. But the resistance to M. leprae infection in humans is likely mediated by the activated macrophages to present M. leprae antigen to T cells for cell-mediated immunity. Phenolic glycolipid-I (PGL-I) is a M. leprae-specific antigen and is supposed to play a significant role in the long lasting unresponsiveness in lepromatous leprosy. In this study, IL-1 activities were tested among leprosy patients to evaluate monocyte function and the role of IL-1 in the immunosuppression in leprosy. We found that peripheral blood mononuclear cells (PBMCs) from tuberculoid patients were strongly reactive to M. leprae (mean cpm; 28,853 +/- 28,916), but the proliferative responses of PBMCs from lepromatous patients (mean cpm; 6,051 +/- 803) were significantly lower. IL-1 concentration in culture supernatant of monocytes from lepromatous patients was similar to that from tuberculoid patients with stimulation of M. leprae (lepromatous: 1,014 +/- 637 pg/ml, tuberculoid: 1,012 +/- 167 pg/ml) or lipopolysaccharides (IPS) (lepromatous: 3,479 +/- 2,188 pg/ml, tuberculoid: 4,246 +/- 2,432 pg/ml). The IL-1 concentration is sera from lepromatous patients (42 +/- 30 pg/ml) tended to be higher than those from tuberculoid patients (28 +/- 69 pg/ml). And there was no significant difference in IL-1 production between peritoneal macrophages from mice sensitized with PGL-1 and those from nonsensitized mice. In conclusion, this study suggests that the immunosuppression in lepromatous patients may not be due to the decreased production of IL-1. And the increased IL-1 activity in sera may affect the inflammatory response of lepromatous patients.
Glycolipids/pharmacology ; Human ; Immunity, Cellular ; Interleukin-1/*biosynthesis ; Leprosy, Lepromatous/blood/*metabolism ; Lymphocyte Activation ; Monocytes/*metabolism ; Mycobacterium leprae/metabolism ; Support, Non-U.S. Gov't

No abstract available.
Antibodies, Monoclonal* ; Borrelia burgdorferi* ; Borrelia* ; Lyme Disease*

No abstract available.
Hepatitis E virus* ; Hepatitis E* ; Hepatitis* ; Korea* ; Prevalence*

PURPOSE: To investigate patients who had transrectal ultrasonography (TRUS)-guided prostate biopsy to define the role of the serum testosterone level in predicting prostate cancer risk and its association with a high Gleason score. MATERIALS AND METHODS: A total of 568 patients who underwent prostate biopsy were entered in this study. We divided the patients into two groups according to serum testosterone level (median level, 3.85 ng/ml): the high-testosterone group (n=285) and the low-testosterone group (n=283). Multivariate regression analysis was used to define the effect of age, prostate volume, serum prostate-specific antigen (PSA) level and PSA density, and serum testosterone level on the risk of prostate cancer and a high Gleason score. RESULTS: Baseline characteristics did not differ significantly between the two groups. Compared with the high-testosterone group, the low-testosterone group had a significantly higher prostate cancer incidence (38.9% vs. 29.5%, p=0.018). Factors associated with an increased risk of prostate cancer were increased age (odds ratio [OR]=1.08, 95% confidence interval [CI]=1.25-3.16, p=0.001), a high serum PSA level (OR=3.35, 95% CI=2.63-4.25, p=0.001), a low prostate volume (OR=0.183, 95% CI=0.11-0.30, p=0.001), and a low serum testosterone level (OR=1.99, 95% CI=1.25-3.16, p=0.001). Among these, only the serum PSA level was a strong predictor of high-grade prostate cancer (Gleason score > or =7) (OR=2.19, 95% CI=1.57-2.95, p=0.001). CONCLUSIONS: Patients with lower levels of serum testosterone had a higher risk of prostate cancer than did patients with high serum testosterone. Even though a lower serum testosterone level was a predictor of prostate cancer risk, it was not associated with an increased risk of high-grade prostate cancer.
Biopsy ; Cohort Studies ; Humans ; Incidence ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Risk Factors ; Testosterone

A leukemoid reaction is usually associated with malignancies of the lung, stomach, and thyroid. In contrast, urothelial cell carcinoma is rarely associated with leukemoid reactions, with few cases reported over the past 30 years. Here, we describe a patient with urothelial cell carcinoma who exhibited a leukemoid reaction. The patient had an elevated white blood cell count and experienced a rapid and aggressive clinical course, terminating in death. For urothelial cell carcinoma patients exhibiting a leukemoid reaction, removal of the inciting tumor is the definitive treatment. However, considering the aggressive nature of these tumors, if the patient is unsuitable for radical surgical management, palliative chemotherapy should be considered.
Drug Therapy ; Humans ; Leukemoid Reaction* ; Leukocyte Count ; Lung ; Paraneoplastic Syndromes* ; Prognosis* ; Stomach ; Thyroid Gland

We report one case of renal PV infection after renal allograft transplantation leading to graft dysfunction. According to prior reports, PV induced interstitial nephritis might be a cause of graft loss. Pathologic findings show varying degrees of interstitial infiltration and tubular degenerative changes, which resemble acute cellular rejection. Therapeutic strategies have not yet been developed. Case ; A 23 years old male underwent renal transplantation from his HLA haploidentical 25 year old sister. His renal function had been good with cyclosporin, steroid and azathioprine until 9 months after transplantation, when his serum creatinine level rose to 2.2mg/dl. The renal biopsy revealed diffuse lymphocyte infiltration in the interstitium and feature of the tubulitis. Also, giant tubular epithelial cells with large, hyperchromic nuclei were present. Despite steroid pulsing and OKT3, renal function progressively de- teriorated. After 10 days of OKT3 therapy, the patient suffered from high fever, dyspnea and general aches. A chest X-ray revealed interstitial infiltration in both lung fields and the cytomegalovirus PCR (polymerase chain reaction) test of serum and blood was positive. Intravenous ganciclorvir was administered and immunosuppressants were tapered. 4 months after admission, he lost his graft function and underwent hemodialysis. The aforementioned renal biopsy was retested immunohistochemically. Nuclear inclusions in renal tubular epithelial cells were shown and these inclusions were reacted positively with PV monoclonal antibodies.
Adult ; Allografts* ; Antibodies, Monoclonal ; Azathioprine ; Biopsy ; Creatinine ; Cyclosporine ; Cytomegalovirus ; Dyspnea ; Epithelial Cells ; Fever ; Humans ; Immunosuppressive Agents ; Intranuclear Inclusion Bodies ; Kidney Transplantation ; Lung ; Lymphocytes ; Male ; Muromonab-CD3 ; Nephritis, Interstitial ; Polymerase Chain Reaction ; Renal Dialysis ; Siblings ; Thorax ; Transplants ; Young Adult

PURPOSE: This study was performed to compare the accuracy of noncontrast helical computerized tomography (NHCT) with that of intravenous pyelography (IVP) in the evaluation of urolithiasis in the emergency room (ER). METHODS: Between November 2003 and February 2004, a total of 47 consecutive patients presenting to the emergency department with acute flank pain were evaluated with NHCT followed by IVP. The mean of the time interval between NHCT and IVP was less than 5 minutes. All 47 sets of evaluations were later assessed randomly by an independent consulting radiologist for the presence, size, and location of a stone, ureteral dilatation, and secondary signs of ureteral obstruction. RESULTS: Forty-three of the 47 patients were diagnosed with urolithiasis. In 39 of the 43 patients diagnosed with ureteral calculi, the NHCT made the diagnosis. IVP made the diagnosis in 26 of the 43 patients. NHCT had a 90.7% sensitivity, 100% specificity, and 68% accuracy. Compared with IVP, using the McNemar test, NHCT was significantly better able to predict the presence of urolithiasis (p<0.001). CONCLUSIONS: Unnenhanced helical CT is superior to IVP in the demonstration of ureteral calculi in patients with suspected acute urolithiasis in the ER.
Diagnosis ; Dilatation ; Emergencies* ; Emergency Service, Hospital* ; Flank Pain ; Humans ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urography* ; Urolithiasis*

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on long-term hemodialysis(HD) patients. And assessment of nutritional status of HD patients has assumed greater importance because of the association of protein- calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling in HD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 48 HD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling with the other parameters of nutritional status. RESULTS: The malnutrition index classified 12(25 %) patients as normal, 28(58%) intermediately malnourished, and 8(17%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), mid-arm circumference(MAC), mid-arm muscle area(MAMA), duration of HD, total lymphocyte count,trnsferrin. The malnutrition index also showed a significant correlation with renal creatinine clearance(Ccr), alkaline phosphatase. However, malnutrition index showed no meaningful correlation with TWR-Kt/V, TW-Kt/V, BUN, cholesterol,calcium, triglyceride. The value of Ccr was significantly lower in the severely malnourished and intermediately group than in the normal group. CONCLUSION: In assessing the nutritional status of HD patients, body weight, MAC, MAMA, duration of HD, total lymphocyte count, transferrin, alkaline phosphatase and Ccr were considered useful parameters. No meaningful relationships between TW-Kt/V and malnutrition index or between NPCR (normalized protein catabolic rate) and malnutrition index were found in this cross-sectional study. As the number of patients with longer duration of HD or negligible Ccr has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and residual renal function may be helpful to assess dialysis adequacy to keep good nutritional status of each HD patient.
Alkaline Phosphatase ; Anthropometry ; Body Weight ; Chemistry ; Creatinine ; Cross-Sectional Studies ; Dialysis ; Humans ; Incidence ; Lymphocyte Count ; Lymphocytes ; Malnutrition ; Mortality ; Nutritional Status ; Protein-Energy Malnutrition ; Renal Dialysis* ; Transferrin ; Triglycerides ; Urea*