No abstract available.
Proteinuria*

We present a case of hyaline vascular type Castleman disease involving the bilateral cervical lymph nodes. To our knowledge, no previous case of this localized form of the disease has been reported. Dynamic CT demonstrated a hypervascular pattern of enhancement, with central less enhanced areas that corresponded histologically to fibrosis. For the diagnosis of this uncommon lymph node disease, these findings might be helpful.
Diagnosis ; Fibrosis ; Giant Lymph Node Hyperplasia* ; Hyalin ; Lymph Nodes ; Neck*

We report a case of rhabdomyolysis in a 29-year-old man, presenting pain on neck and shoulder and dark urine, which developed after taking Bear's gall and swimming. Laboratory studies revealed serum creatinine 0.9 mg/dL, creatinine kinase 83,045 IU/L, serum myoglobin 794.6 ng/mL, urine myoglobin 220.2 ng/mL. Tc-99m MDP whole bone scan showed diffuse increased uptake confined to the soft tissue of upper chest. The condition resolved spontaneously when consumption of the product ceased, he was recovered with normal creatine kinase. Generally, the Bear's gall is termed gall bladder of bear dried under the air-flow, which has been applied as versatile treatment in oriental medcine. Rhabdomyolysis is a well known complication of HMG-CoA inhibitor therapy, the Bear's gall has not yet been reported as a cause of rhabdomyolysis. We postulate that the Bear's gall may result in muscle injury.
Adult ; Creatine Kinase ; Creatinine ; Humans ; Myoglobin ; Neck ; Phosphotransferases ; Rhabdomyolysis* ; Shoulder ; Swimming ; Technetium Tc 99m Medronate ; Thorax ; Urinary Bladder

BACKGROUND: An initiating time of renal replacement therapy (RRT) for patients with end-stage renal disease (ESRD) has great influence on prognosis of the patients, however, there are currently no accurate guidelines for initiation of renal replacement therapy. Traditionally, nephrologists usually initiate RRT on the basis of observation of uremic symptoms and changes of laboratory parameters, such as serum creatinine concentration and/or glomerular filtration rate (GFR). DOQI guidelines suggest weekly Kt/Vurea < 2.0 or nPNA < 0.8 g/kg/day for an objective index of the initiation of dialysis. Then, we designed to formulate KP index {(weekly Kt/Vurea + 2.5 X nPNA) X 1/2} using two indices above as a clinically useful objective index to determine the initiation of RRT for patients with ESRD. METHODS: Patients with ESRD having the weekly Kt/Vurea index below 3.0 were selected from 186 patients who came to renal unit of Soonchunhyang Bucheon hospital. The patients having the weekly Kt/Vurea index between 1.0 and 2.0 were classified into two groups, KP index > 2.0 and KP index < 2.0. The groups were compared and analyzed via renal function, biochemical index and the number of patients starting a first RRT. Further, the correlations between KP index and other indices were analyzed over all patients. Then, the numbers per group of patients starting RRT were compared after all patients were divided into two groups, one of which is between 1.5 and 2.0 and the other is between 2.0 and 2.5 by weekly Kt/Vurea index and KP index. RESULTS: The group of KP index < 2.0 indicated significantly lower indices in weekly Kt/Vurea, nPNA (B2) and % LBM (%) than those of the group of KP index > 2.0, while no significant differences between the groups were in serum albumin concentration, serum creatinine concentration, FFEFBM and RRF. And the frequency of patients starting RRT was significantly higher in the group of KP index < 2.0 rather than the group of KP index > 2.0 in statistics. There was a significant correlation between KP index and other indices in all patients. In comparing and analyzing the number of patients starting RRT, weekly Kt/Vurea index did not demonstrate significant differences between two groups of 1.5 < weekly Kt/Vurea < 2.0 and 2.0 < weekly Kt/Vurea < 2.5, but the frequency of patients in the group of 1.5 < KP index < 2.0 was significantly higher than that in the group of 2.0 < KP index < 2.5. CONCLUSION: It is considered that KP index is an index clinically useful for ESRD patients to determine an appropriate timing for the initiation of RRT, and that the timing should be fixed with regard for other various indices and clinical features for advisable prognosis of the patients. In addition, accurate guideline to determine such an appropriate time needs to be suggested by further new studies.
Creatinine ; Dialysis* ; Glomerular Filtration Rate ; Gyeonggi-do ; Humans ; Kidney Failure, Chronic* ; Prognosis ; Renal Replacement Therapy ; Serum Albumin

BACKGROUND: The time at which renal replacement therapy (RRT) is initiated in patients with end-stage renal disease (ESRD) has a great influence on the prognosis of the patient; however, there are currently no accurate guidelines for the initiation of RRT. Traditionally, nephrologists usually initiate RRT on the basis of the observation of the uremic symptoms and changes in the laboratory parameters, such as the serum creatinine concentration and/or glomerular filtration rate (GFR). DOQI guidelines suggest a weekly Kt/Vurea < 2.0 or an nPNA < 0.8 g/kg/day as objective indices for the initiation of dialysis. Thus, a KP index was formulated (weekly Kt/Vurea+2.5 X nPNA) X (1/2) using the above two clinically useful and objective indices to determine the adeguate time to initiate RRT in patients with ESRD. METHODS: Of 186 patients admitted to the renal unit of Soonchunhyang Bucheon hospital, those with ESRD and a weekly Kt/Vurea below 3.0 were selected. The patients with a weekly Kt/Vurea index between 1.0 and 2.0 were classified into one of two groups; KP index > 2.0 and KP index < 2.0. The groups were compared and analyzed in relation to their renal function, biochemical indices and the numbers of patients per group starting RRT. Further, the correlations between the KP and other indices were analyzed in all the patients. The patients were then further divided into another two groups according to their weekly Kt/Vurea and KP index: group one; between 1.5 and 2.0 and group 2; between 2.0 and 2.5. The numbers of patients per group starting RRT were compared. RESULTS: The KP index < 2.0 group showed significantly lower indices for weekly Kt/Vurea, nPNA and %LBM (%) than those of the KP index > 2.0 group, while there were no significant differences between the groups in the serum albumin concentration, serum creatinine concentration, FFEFBM and RRF. Also, there was a statistically significant higher rate of incidence of patients starting RRT in the KP index < 2.0 group than in the KP index > 2.0 group. There was a significant correlation between the KP and other indices in all patients. When comparing the number of patients starting RRT, the weekly Kt/Vurea index demonstrated no significant differences between the 1.5 < weekly Kt/Vurea < 2.0 and 2.0 < weekly Kt/Vurea < 2.5 groups, but the number of patients starting RRT in the 1.5 < KP index < 2.0 group was significantly higher than that in the 2.0 < KP index < 2.5 group. CONCLUSION: The KP index is considered a clinically useful index in ESRD patients for determining an appropriate time for the initiation of RRT. Also, the timing of the initiation of RRT should be fixed with regard to the various other indices and clinical features for a desirable prognosis of the patients. In addition, further studies will be required to determine accurate guidelines for an appropriate time for RRT initiation.
Adult ; Aged ; Blood Urea Nitrogen ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Humans ; Kidney/metabolism ; Kidney Failure, Chronic/epidemiology/*metabolism/physiopathology/*therapy ; Korea/epidemiology ; Male ; Middle Aged ; Nutritional Status ; *Renal Dialysis ; Serum Albumin/metabolism ; Severity of Illness Index ; Urea/blood

Osteomyelitis of the maxilla is a relatively rare disease. Although the advent of antibiotics has decreased its incidence and morbidity significantly, osteomyelitis still remains a potentially dangerous condition because of the possible risk of intracerebral complications. Clinically, patients present facial swelling, localized pain and tenderness, low-grade fever, draining sinus tracts, suppuration, dental loss, and sequestrum formation. We experienced a case of osteomyelitis of the maxilla with associated aspergillosis. In this paper, we report this case with a review of literature.
Anti-Bacterial Agents ; Aspergillosis* ; Fever ; Humans ; Incidence ; Maxilla* ; Osteomyelitis* ; Rare Diseases ; Suppuration

Esophageal hematoma is a rare form of esophageal injury. It may occur spontaneously, or in association with direct esophageal damage or a bleeding diathesis. Endoscopy and computed tomography are generally necessary for the establishment of a diagnosis. In this report, we present a case of esophageal hematoma that was discovered via a bedside transthoracic echocardiography. The echocardiography was conducted to evaluate an unexplained shock in a critically ill-patient. After conservative treatment, complete resolution of the esophageal hematoma was documented by a 7-day short-term follow-up of bedside transthoracic echocardiography. To the best of our knowledge, this is the first case report regarding transthoracic echocardiographic detection, differential diagnosis, and follow-up for esophageal hematoma.
Diagnosis ; Diagnosis, Differential* ; Disease Susceptibility ; Echocardiography* ; Endoscopy ; Follow-Up Studies* ; Hematoma* ; Hemorrhage ; Shock

No abstract available.
Paragonimiasis*

PURPOSE: Seasonal variations in asthma-related hospitalizations and emergency department visits have long been recognized. This study aimed to investigate the seasonal patterns of asthma in children and adolescents who presented at emergency departments in Korea. METHODS: We analyzed the National Emergency Department Information System records from 117 emergency departments in Korea that comprised all of the patients with asthma who were aged 3-18 years and who presented at the emergency departments from 2007 to 2012. The children and adolescents were divided into 3 groups based on their ages, namely, 3-6 years, 7-12 years, and 13-18 years. The data were tabulated, and graphs were created to show the seasonal trends in the monthly numbers of emergency department visits as a consequence of asthma. RESULTS: A total of 41,128 subjects were identified, and the male-to-female ratio was 1:0.5. General ward admissions comprised 42.6% (n=17,524 patients) of the emergency department visits, and intensive care unit admissions comprised 0.8% (n=335 patients) of the emergency department visits. The monthly numbers of emergency department visits for asthma varied according to the season, with high peaks during fall, which was from September to November, and low levels in summer, which was from June to August. CONCLUSIONS: Important differences in the seasonal patterns of emergency department visits for asthma were evident in children and adolescents. Identifying seasonal trends in asthma-related emergency department visits may help determine the causes and reduce the likelihood of asthma exacerbation.
Adolescent* ; Asthma* ; Child* ; Emergencies* ; Emergency Service, Hospital* ; Epidemiology ; Hospitalization ; Humans ; Information Systems ; Intensive Care Units ; Korea* ; Patients' Rooms ; Seasons*

Pulmonary sequestration is a relatively rare congenital anomaly in which a mass of abnormal pulmonary tissue without a normal connection to the tracheobronchial tree receives its blood supply from one or more anomalous systemic arteries. Its incidence increased as prenatal ultrasound become a routine component of prenatal care. We report one case of intra-abdominal extralobar pulmonary sequestration detected by prenatal ultrasound and diagnosed at surgery after birth.
Arteries ; Bronchopulmonary Sequestration* ; Incidence ; Parturition ; Prenatal Care ; Ultrasonography*