Emphysematous pyelonephritis is rare but frequently fatal disease that usually occures in diabetic patients, 6cases having been reported in Korea. We have experienced a case of simultaneously occuring emphysematouspyelonephritis and emphysematous cystitis in 54 years old female patient, which have never been reported in Korea,and got satisfactory improvement with medical treatment.
Cystitis ; Female ; Humans ; Korea ; Pyelonephritis

Animals ; Axis, Cervical Vertebra ; Bone Marrow ; Corrosion ; Granulation Tissue ; Guided Tissue Regeneration ; Membranes ; Microvessels ; Rats ; Regeneration

Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this is syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blind in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II), clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization, significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she bad the improvement of symptoms arid iron deficiency anemia.
Adult ; Anemia, Iron-Deficiency ; Angiodysplasia ; Arteriovenous Fistula* ; Brain Abscess ; Capillaries ; Cyanosis ; Dyspnea ; Embolization, Therapeutic* ; Female ; Fingers ; Fistula ; Follow-Up Studies ; Gastric Mucosa ; Hemorrhage ; Hepatic Artery ; Humans ; Iron ; Mucous Membrane ; Multiple Pulmonary Nodules ; Oxygen ; Polycythemia ; Pulmonary Artery ; Pulmonary Veins ; Rupture ; Skin ; Steel ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Thorax

No abstract available.
Aorta, Thoracic*

PURPOSE: We performed this study to evaluate the most common site of the nasolacrimal systemic obstruction and causes of the nasolacrimal stent insertion failure and reobstruction following the insertion of the stent. MATERIAL AND METHODS: Nasolacrimal stent insertion was attempted in 26 cases(24 patients) of 30 cases (25 patients) with complete obstruction of the nasolacrimal system at the dacryocystography. We retrospectively assessed the obstruction site of nasolacrimal system, and evaluated the rate and causes of stent insertion failure and reobstruction following insertion of the stent on follow-up. RESULT: The obstructive sites of then asolacrimal system were junction level of the lacrimal sac and nasolacrimal duct(80%), common canaliculi(10%),and nasolacrimal duct(10%). In seven cases, we failed to insert the nasolacrimal stent. Four of the seven cases had a history of previous operation on paranasal sinus or nasolacrimal system. At 4 weeks follow up, epiphorare developed in four of 10 cases(reobstruction rate, 40%). Inflammatory process around the nasolacrimal duct stent was conndered to be the cause of reobstruction in two of the four reobstructed cases. CONCLUSION: Success rate of nasolacrimal duct stent insertion was 73%, and failure rate was 27%. The causes of the stent insertion failure included fibrosis and granulation tissue due to the previous operation around nasolacrimal duct system and paranasal sinus area. Inflammatory process around the stent caused recurrent obstruction.
Fibrosis ; Follow-Up Studies ; Granulation Tissue ; Nasolacrimal Duct* ; Stents*

It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.
Adenocarcinoma ; Lung Neoplasms ; Risk Factors ; Solitary Pulmonary Nodule ; Tuberculoma

PURPOSE: Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. METHODS: The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. RESULTS: The CSAI of the RPA without stenosis changed from mean 238+/-17 mm2/BSA to mean 249+/-20 mm2/BSA(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean 102+/-12 mm2/BSA to mean 125+/-11 mm2/BSA(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. CONCLUSION: In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.
Child ; Male ; Female ; Humans

Duplications of the gastrointestinal tract are rare congenital malformations that are usually present during the first decade of life. However, a smaller number of cases may remain occult until adulthood. Overall, the colon is the least common site of congenital gastrointestinal duplications. Colonic duplications can present with symptoms of diverticulitis and can be confused with acquired giant cysts or masses. We present a rare case of a duplication cyst of the colon in a female adult. Although the preoperative evaluations, including an abdominal CT scan and colonoscopy, were suggestive of a gastrointestinal tumor of the colon, the final diagnosis was a colonic duplication cyst based on the histopathologic examination of the resected specimen. Even if intestinal duplication cysts are uncommon, they should be considered in the differential diagnosis of intestinal masses.
Adult ; Colon ; Colonoscopy ; Diagnosis, Differential ; Digestive System Abnormalities ; Diverticulitis ; Female ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans

Psoriasis is a chronic inflammatory skin disorder, which is characterized by erythematous, sharply demarcated papules, and rounded plaques covered by silvery micaceous scale. Psoriatic arthritis is a heterogeneous disease with typical features of the spondyloarthropathies. Behcet's disease is an inflammatory condition involving multiple organ systems such as mucous membrane, skin, joint, intestine, lung, central nervous system, and vessel. The inclusion of Behcet's disease among seronegative spondyloarthropathies is still being debated. We described a 47-year-old female patient who currently had psoriasis and Behcet's disease. She developed a sacroiliitis that was probably precipitated by trauma.
Arthritis, Psoriatic ; Central Nervous System ; Female ; Humans ; Intestines ; Joints ; Lung ; Middle Aged ; Mucous Membrane ; Psoriasis* ; Sacroiliitis* ; Skin ; Spondylarthropathies

PURPOSE: Hyperbilirubinemia, jaundice and gallbladder hydrops are unusual manifestations of Kawasaki disease (KD). In this case, abdominal pain, anorexia and abdominal distension may follow eventfully. We reviewed the clinical and laboratory data to investigate the causative factors of hyperbilirubinemia in patients with KD. METHODS: Two-hundred eighty two children diagnosed and hospitalized with KD were identified by searching patients' charts. Cases were included in the study if diagnosed between January 1997 and December 2004. We reviewed clinical data, age, sex, duration from the onset of fever to admission and duration from start of treatment to defervescence. Clinical and laboratory data were compared between normal (A) and hyperbilirubinemia (B) groups. RESULTS: Thirteen patients (4.6 percent) showed hyperbilirubinemia. In the hyperbilirubinemia group, age and initial ALT value were higher than group A (P=0.003, 0.018 respectively). Duration from the onset of fever to admission and age were relative risk factors in hyperbilirubinemia (P=0.007, 0.003 respectively) in patients with KD. CONCLUSION: Shorter duration from the onset of fever to admission and older age group were relative risk factors of hyperbilirubinemia in patients with KD.
Abdominal Pain ; Anorexia ; Child ; Edema ; Fever ; Gallbladder ; Humans ; Hyperbilirubinemia* ; Jaundice ; Mucocutaneous Lymph Node Syndrome* ; Risk Factors