No abstract available.
Gastrointestinal Hemorrhage ; Intussusception

It was suggested that temporary vascular insufficiency within the wall of the colon causes iachemic colitis. So, motivated by this fact, we studied and analyzed 15 cases of iachemic colitis, which were confirmed by the diagnostic criteria of Nagasako(1982), through 32 months from January, 1993 to August, 1995 at Our Lady of Mercy Hospital, Incheon.(continue...)
Colitis ; Colitis, Ischemic* ; Colon

It was suggested that temporary vascular insufficiency within the wall of the colon causes iachemic colitis. So, motivated by this fact, we studied and analyzed 15 cases of iachemic colitis, which were confirmed by the diagnostic criteria of Nagasako(1982), through 32 months from January, 1993 to August, 1995 at Our Lady of Mercy Hospital, Incheon.(continue...)
Colitis ; Colitis, Ischemic* ; Colon

OBJECTIVE: This study sought to investigate independent predictive factors for subclinical atherosclerosis in Korean patients with rheumatoid arthritis (RA). METHODS: We used high-resolution B-mode ultrasonography to measure the carotid artery intima-media thickness (IMT) and carotid plaque in 367 patients with RA. Detailed information on the demographic characteristics, cardiovascular (CV) risk factors, and RA disease characteristics were collected on all subjects. The relationship of the carotid artery IMT and carotid plaque to relevant clinical and laboratory variables were examined. RESULTS: Old age and male sex had the most significant association with increased IMT and presence of plaque than other factors. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and mKHAQ (Korean version of modified health assessment questionnaire) were significantly associated with both increased IMT and presence of plaque after univariate analysis adjusting for age and sex. A multivariable logistic regression analysis revealed that ESR and TJC68 were independent factors associated with the presence of plaque (p<0.001 and p=0.019, respectively). There was a significant linear correlation between the number of plaques and ESR (p<0.001 and R2=0.07). CONCLUSION: Our results indicated that markers of systemic inflammation contributed significantly to subclinical atherosclerosis in patients with RA. We emphasize the need for aggressive control of RA disease activity in patients who persistently demonstrate highly elevated ESR levels.
Arthritis, Rheumatoid ; Atherosclerosis ; Blood Sedimentation ; C-Reactive Protein ; Cardiovascular Diseases ; Carotid Arteries ; Cohort Studies ; Humans ; Inflammation ; Logistic Models ; Male ; Risk Factors

BACKGROUND: The p16 protein is a cyclin-dependent kinase inhibitor (CDKI) that inhibits cell cycle progression from phase G1 to phase S in the cell cycle. Many p16 gene mutations have been noted in many cancer-cell lines and in some primary cancers. These mutated genes caused abnormal or aberrant expression of the p16 protein, which might have contributed to the malignant progression of the cells by deranging the cell cycle. This study was to examine the abnormal or aberrant expression of the p16 protein in breast cancer tissue by using p16 protein specific immunohistochemical staining. METHODS: p16-protein-specific immunohistochemical staining was performed on 31 breast-cancer tissue samples. Twenty-four cases among the 31 tissue staining slides simultaneously showed a normal breast-tissue portion on the same staining slide. Microscopic photographs of both the breast-cancer and the normal- tissue portion were taken at the same magnification to compare the statistically analyzed fraction of red or brown colored p16 stained nuclei. RESULTS: In the breast cancer tissue, 7 (22.6%) showed totally negative, with less than 5% of the nuclei staining. The completely negative cases were not related to the stage of the disease (p=0.096) or to the histopathologic grade (p=0.20). The staining ratios of the breast-cancer tissue and the normal tissue were 26.2 ( +/- 18.7)% and 72.4 ( +/- 18.8)%, respectively. In the breast-cancer tissue, the ratio of expression of the p16 protein was significantly lower than in the normal tissue (p=0.001). CONCLUSIONS: In the carcinogenesis of some breast cancers, low expression of the p16 protein may play an important role in the unlimited proliferation of tumor cell due to a loss of the cell-cycle-regulating role of the p16 protein.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p16* ; Genes, p16 ; Humans* ; Phosphotransferases

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
Abscess ; Anti-Bacterial Agents/therapeutic use ; Cystitis/diagnosis ; Diabetes Mellitus/complications ; Drainage ; Emphysema/diagnosis/*microbiology ; Human ; Klebsiella Infections/*diagnosis/drug therapy ; Klebsiella pneumoniae/*metabolism ; Male ; Middle Aged ; Prostate/*microbiology ; Prostatic Diseases/*diagnosis/microbiology/radiography

May-Thurner syndrome, which refers to an iliofemoral venous thrombosis caused by chronic compression of the left common iliac vein by the right common iliac artery, usually manifests as left lower extremity pain and swelling. The syndrome is particularly evident in patients with health conditions including obesity, smoking, pregnancy, surgery, or prolonged immobility. Antiphospholipid syndrome consists of arterial or venous thrombosis and the association of lupus anticoagulant or anticardiolipin antibodies. Most common clinical manifestations include pregnancy loss and deep vein thrombosis. We experienced a rare case of May-Thurner syndrome concurrent with antiphospholipid syndrome, secondary to systemic lupus erythematosus. The patient was treated successfully by catheter-directed percutaneous thrombectomy, venous thrombolysis, and stent insertion, followed by oral anticoagulant therapy.
Antibodies, Anticardiolipin ; Antiphospholipid Syndrome ; Humans ; Iliac Artery ; Iliac Vein ; Lower Extremity ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; May-Thurner Syndrome ; Obesity ; Postthrombotic Syndrome ; Pregnancy ; Smoke ; Smoking ; Stents ; Thrombectomy ; Venous Thrombosis

Stenotrophomonas maltophilia (previously named Xanthomonas maltophilia) is an aerobic, non-fermentive, Gram-negative bacillus that is wide spread in the environment. It was considered to be an organism with limited pathogenic potential, which was rarely capable of causing diseases in human other than those who were in debilitated or immunocompromised state. More recent studies have established that Stenotrophomonas maltophilia can behave as a true pathogen. Endocarditis due to this organism is rare, and only 24 cases of Stenotrophomonas maltophilia endocarditis have been reported in the medical literature. Most cases were associated with risk factors, including intravenous drug abuse, dental treatment, infected intravenous devices, and previous cardiac surgery. We present a case with two episodes of Stenotrophomonas maltophilia endocarditis after mitral valve prosthesis implantation, which was treated with antibiotics initially, and a combination of antibiotics and surgery later. To our knowledge, this is the first case of repetitive endocarditis due to Stenotrophomonas maltophilia.
Adult ; Anti-Bacterial Agents/*therapeutic use ; Bioprosthesis/adverse effects/*microbiology ; Endocarditis, Bacterial/*drug therapy/physiopathology ; Gentamicins/therapeutic use ; Gram-Negative Bacterial Infections/*drug therapy/physiopathology ; Heart Valve Prosthesis/adverse effects/*microbiology ; Humans ; Male ; Mitral Valve ; Recurrence ; Stenotrophomonas maltophilia/*drug effects ; Treatment Outcome ; Trimethoprim-Sulfamethoxazole Combination/*therapeutic use ; Vancomycin/therapeutic use

PURPOSE: To re-evaluate the appearance of the anterior diaphragm by the use of MDCT. MATERIALS AND METHODS: We performed a retrospective review of 81 consecutive patients that underwent chest CT by using 64 channel MDCT. We classified the anterior diaphragm as three types (types 1-3) based on 5 mm axial scans: a line behind the xiphoid, a discontinuity and opening anteriorly, and the presence of broad and poorly defined bands. We also classified the anterior diaphragm as three types (types A-C) using 2 mm sagittal reformation images, based on the shape of the anterior diaphragmatic fibers traveling from the base of the pericardium to the xiphoid: a downward slope, an upward slope, and a flat shape, and compared the two groups using a correlation determined by statistical analysis. RESULTS: We could classify the appearance of the anterior diaphragm for all cases on the axial scans and sagittal reformation images. The number of types 1, 2, 3 on the axial scans was 30.9%, 38.3%, and 30.9% and the number of types A, B, C on the sagittal reformation images was 33.3%, 22.2%, and 44.4%, respectively. Type A was seen for 92% of type 1 cases, type C was seen for 88% of type 3 cases, and type B was seen for 54.8% of type 2 cases. The types seen between the axial and sagittal reformation images showed a significant agreement (r=0.868, p < 0.01). CONCLUSION: The shape of the anterior diaphragm correlated with the relationship between the base of the pericardium and the xiphoid.
Diaphragm* ; Humans ; Pericardium ; Retrospective Studies ; Tomography, X-Ray Computed ; Xiphoid Bone

Non-Hodgkin's lymphoma frequently involves the kidneys, with previous reports demonstrating approximately a 48 Yo incidence at autopsy. In contrast, lymphoma originating within the kidneys is a rare event, because the renal parenchyma does not have lymphatics. Most common type of primary renal lyrnphoma that calssified by Working formulation and irnmunohistochemistry was diffuse large B-cell, intermediate grade. A 43-year-old woman presented with epigastric discomfort, anorexia, fever, and weight loss. The past rnedical history was unremarkable. On physical examination, she was febrile, and conjunctiva was pale. Lymph node was enlarged and palpated at right inguinal area. But no other lymphadenopathy or hepatosplenomegaly was found. Laboratory study showed WBC 6,900/mm, hemoglobin 6.7g/dL, serum LDH 783IU/L, GFR 31.45 ml/min. The chest X-ray was within normal limit; no mediastinal lympha- denopathy was present. The abdominal X-ray revealed enlargement of right kidney. The abdominal CT scan showed markedly enlarged both kidneys containing inhomogeneous solid masses with poor excretion of intravenous contrast, a few small paraaortic lymphadenopathies, and contour bulging on the pancreas body. A percutaneous renal biopsy was obtained from this patient at the right kidney. Microscopic exarnination showed a diffuse infiltrate of predominantly large lymphoid cells having round to oval vescicular nuclei. Immunohistochemical studies revealed a B-cell-type lymphoma. The tumor was judged to be an intermediate-grade, large-cell, diffused, B-cell-type non-Hodgkin's lymphoma. We report a case of primary bilateral B-cell renal lymphoma in a 43-year-old female patient with review of the literature.
Adult ; Anorexia ; Autopsy ; B-Lymphocytes* ; Biopsy ; Conjunctiva ; Female ; Fever ; Humans ; Incidence ; Kidney ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Pancreas ; Physical Examination ; Thorax ; Tomography, X-Ray Computed ; Weight Loss