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*

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

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.
Hepatitis E virus* ; Hepatitis E* ; Hepatitis* ; Korea* ; Prevalence*

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*

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

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*

In clinical practice, Tc-99m DTPA renal scan has been using for screening for the presence of renal dysfunction to determine the need for early treatment in kidney transplantation patients. We measured glomerular filtration rate(GFR) using Gates method during the routine Tc-99m DTPA renal scan, predicted creatinine clearance estimated by Cockcroft and Gault formula and 24-hour creatinine clearance and compared each other in 88 kidney transplantation patients simultaneously. The range of renal uptake(%) of Tc-99m DTPA was from 1.8% to 10.4% and the correlation between 24-hour creatinine clearance and renal uptake showed Y=7.176X8.975Y=creatinine clearance(ml/min), X=renal uptake(%) and the correlation coefficient was 0.771. The correlation coefficient between GFR (ml/min) using Tc-99m DTPA renal scan and predicted creatinine clearance was 0.765. The correlation coefficient between predicted creatinine clearance and 24-hour creatinine clearance was 0.850. We concluded that the measurement of GFR using Tc-99m DTPA renal scan was clinically useful in kidney transplantation patients with the advantage of simplicity, low expense, opportunity for renal imaging.
Creatinine ; Filtration ; Humans ; Kidney Transplantation* ; Kidney* ; Mass Screening ; Pentetic Acid*

OBJECTIVE: The selection of dialysis modalities for end-stage renal disease patient is often a complex decision process involving considerations of efficacy in terms of life maintenance, quality of life, convenience and cost. In order to facilitate informed decisions, we have compared the clinical outcome of CAPD and HD patients. METHODS: From May 1992 to May 1997, we observed the followings: patients` survival rate, the causes of death in CAPD and HD patients, the frequency of CAPD peritonitis, CAPD catheter survival rate and the causes of catheter removal. Patients were categorized in the following ways: DM and non-DM, alive or expired, above and below the age of 60 years, and treatment duration of more or less than 5 years. Six items (serum albumin, serum creatinine, hemoglobin, BMI, NPCR and KT/V) were measured, their values were evaluated and compared with each group using univariated statistics. RESULTS: The total number of patients was 508 (369 CAPD, 139 HD). 58 of them expired during the observation period. The overall 5 year patient survival rate was 81.4% for CAPD, 80.5% for HD, and 57.8% for CAPD with DM and 25% for HD with DM using the Kaplan-Meier method. In the CAPD group, the frequency of peritonitis was 0.52 /pt, yr; the 5 year technical survival of the catheter was 80.5%. 42 (88%) of 48 technical failures of the catheter were removed due to peritonitis. Regardless of the modes of replacement therapy used to treat DM and non-DM groups, the DM patients had longer duration of admission, older age, lower serum albumin and serum creatinine levels , and a lower 5 year patient survival rate than the non-DM group. Death in CAPD and HD was positively correlated with a long duration of admission and old age; CAPD patients who expired had lower serum albumin, smaller BMI and more frequent peritonitis than the surviving group. CONCLUSION: 1. There was no significant difference in the 5 year patient survival rate between CAPD and HD (81.4% in CAPD, 80.5% in HD). 2. DM patients had lower serum albumin, creatinine and BUN levels than non-DM patients. 3. The mortality rate was positively correlated with old age and duration of admission in CAPD and HD ; frequent CAPD peritonitis, lower serum albumin and small BMI in CAPD were also positively correlated with the death rate. 4. The higher the serum albumin and NPCR, the higher the survival rate for CAPD patients. 5. The serum creatinine was lower in patients above 60 years old and in those treated more than 5 years. 6. The DM group had a higher mortality rate than the non-DM group; the DM CAPD group had a higher 5 year survival rate than the DM HD group but it was not statistically significant.
Catheters ; Cause of Death ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Mortality ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Quality of Life ; Renal Dialysis* ; Serum Albumin ; Survival Rate