OBJECTIVE: To evaluate the change of clinical characteristics of prostatic cancer after the introduction of PSA (Prostate specific antigen) assay and TRUS (Transrectal ultrasonography), we retrospectively reviewed the medical records of 155 patients with prostatic adenocarcinoma who were managed at Seoul National University Hospital from January 1985 to December 1994. MATERIALS AND METHODS: Patients were stratified into 2 groups (Group I: 45pts{1985-1989} and Group II: 110pts{1990-1994}) by the year 1990 when our hospital began to use PSA assay and TRUS to detect prostatic cancer. PSA was measured by monoclonal radioimmunometric assay (ELSA-PSA). Tumor staging consisted of DRE (digital rectal. examination), TRUS, CT, MRI, simple bone X-ray and radionuclide bone scan. Clinical characteristics of 2 groups were compared. RESULT: Proportion of younger pts increased in group II but this was not statistically significant (p>0.05 by chi-square test). Number of pts were annually increasing , especially after the year 1990 when PSA assay and TRUS were introduced into clinical practice. Despite use of PSA and TRUS, the number of clinically localized pts did not differ between 2 groups. There was no difference in distribution of chief complaints between 2 groups. There were 3 pts who were detected by increased PSA alone. CONCLUSION: Prostate cancer incidence is increasing and will substantially increase in the future on the basis of increasing tendency to the old population, improved cancer detection and improved public awareness. More than 70% of pts have metastases or regional extension (Stage C or D). These dismal statistics constitute the main reason for early detection programs in the population at large.
Adenocarcinoma ; Humans ; Incidence ; Magnetic Resonance Imaging ; Medical Records ; Neoplasm Metastasis ; Neoplasm Staging ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Retrospective Studies ; Seoul

A case of infectious mononucleosis was presented. She was admitted to the hospital with the anterior cervical lymphadenopathy. Erythematous skin rashes on both low extermities, and splenomegaly. Her chief complaints were fever and sore throat. She showed atypical lymphocytes in peripheral blood smear with relative lymphocytosis. Mono-spot test was positive. She received symptomatic therapy and discharged without any complications. So, we report this case and review the brief literatures of infectious mononucleosis with the respect to etiology, clinical course, and histological characteristics of the disease.
Exanthema ; Fever ; Infectious Mononucleosis ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Pharyngitis ; Splenomegaly

BACKGROUND: It was previously known that anuric acute kidney injury (AKI) is uncommon and its occurrence suggests complete ureteral obstruction, shock, or a major vascular event. As the epidemiology of AKI has significantly changed over the past decade, it is possible that the incidence, etiology, or clinical characteristics of anuric AKI have also changed. METHODS: A prospective cohort study was conducted that included all patients undergoing renal replacement therapy (RRT) for AKI during a 2-year period in a tertiary hospital. Patients were classified as having anuric, oliguric, or nonoliguric AKI based on their volume of urine when RRT started using the modified Acute Kidney Injury Network criteria. RESULTS: Of the 203 patients included in the study, 21.2% met the criteria for anuric AKI. Septic and postoperative AKI were the main causes of anuric AKI, with 60.5% of incidences occurring in hospital. Anuric AKI was associated with a younger age, a lower prevalence of pre-morbid chronic kidney disease and diabetes, more frequent continuous RRT requirement, and multi-organ dysfunction. In addition, patients with anuric AKI had a higher rate of in-hospital mortality and long-term dependence on RRT than patients with nonanuric AKI. CONCLUSION: Anuric AKI is common, with sepsis as the main etiological insult, and is associated with adverse outcomes among patients with AKI who require RRT.
Acute Kidney Injury* ; Anuria* ; Cohort Studies ; Epidemiology ; Hospital Mortality ; Humans ; Incidence ; Oliguria ; Prevalence ; Prospective Studies ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Sepsis ; Shock ; Tertiary Care Centers ; Ureteral Obstruction

To investigate the underlying mechanisms of C18 fatty acids (stearic acid, oleic acid, linoleic acid and alpha-linolenic acid) on mast cells, we measured the effect of C18 fatty acids on intracellular Ca2+ mobilization and histamine release in RBL-2H3 mast cells. Stearic acid rapidly increased initial peak of intracellular Ca2+ mobilization, whereas linoleic acid and alpha-linolenic acid gradually increased this mobilization. In the absence of extracellular Ca2+, stearic acid (100 microM) did not cause any increase of intracellular Ca2+ mobilization. Both linoleic acid and alpha-linolenic acid increased intracellular Ca2+ mobilization, but the increase was smaller than that in the presence of extracellular Ca2+. These results suggest that C18 fatty acid-induced intracellular Ca2+ mobilization is mainly dependent on extracellular Ca2+ influx. Verapamil dose-dependently inhibited stearic acid-induced intracellular Ca2+ mobilization, but did not affect both linoleic acid and alpha-linolenic acid-induced intracellular Ca2+ mobilization. These data suggest that the underlying mechanism of stearic acid, linoleic acid and alpha-linolenic acid on intracellular Ca2+ mobilization may differ. Linoleic acid and alpha-linolenic acid significantly increased histamine release. Linoleic acid (C18:2: omega-6)-induced intracellular Ca2+ mobilization and histamine release were more prominent than alpha-linolenic acid (C18:3: omega-3). These data support the view that the intake of more alpha-linolenic acid than linoleic acid is useful in preventing inflammation.
alpha-Linolenic Acid ; Fatty Acids* ; Histamine Release* ; Inflammation ; Linoleic Acid ; Mast Cells ; Oleic Acid ; Verapamil

Although ascending aortic aneurysm is a uncommon disease, it has fatal complications such as aortic rupture, dissection, or death. So, experts recommend a preemptive aortic operation. A 77-year-old man with hypertension visited for slow progressive exertional dyspnea and general weakness. Chest X-ray showed deviation of trachea to right, mediastinal widening, cardiomegaly, and bulging of right heart border to right. Transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) showed marked dilated ascending aorta with wall calcification associated with severe aortic regurgitation and pericardial effusion. Measured diameter of ascending aorta was 12 x 11 cm on Chest Computed Tomography (CT) scan, 8.35 cm on TTE, and 10.2 cm on TEE. Our exam found out the obstructive pneumonia and aortic regurgitation as consequences of complications of huge aneurysm. We report a case of huge ascending aortic aneurysm without any previous aortic operation, aortic complications, trauma, or other etiologic factors.
Aged ; Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortic Rupture ; Aortic Valve Insufficiency ; Cardiomegaly ; Dyspnea ; Heart ; Humans ; Hypertension ; Pericardial Effusion ; Pneumonia ; Thorax ; Trachea

Fibrodysplasia ossificans progressiva is a rare hereditary disorder characterized by progressive heterotopic ossifica-tion in muscle and connective tissue, with few reported cases affecting the head and neck region. Although plain radiographic findings and computed tomography features have been well documented, limited reports exist onmagnetic resonance findings. This report presents 2 cases of fibrodysplasia ossificans progressiva, one with limited mouth opening due to heterotopic ossification of the lateral pterygoid muscle and the other with restricted neck movement due to heterotopic ossification of the platysma muscle. Clinical findings of restricted mouth opening or limited neck movement, along with radiological findings of associated heterotopic ossification, should prompt consideration of fibrodysplasia ossificans progressiva in the differential diagnosis. Dentists should be particularly vigilant with patients diagnosed with fibrodysplasia ossificans progressiva to avoid exposure to diagnostic biopsy andinvasive dental procedures.

Gouty ulcer can be caused by the accumulation of clumps of uric acid in body tissues that lead to acute or chronic inflammation at sites of accumulation. Furthermore, tophi-inhibiting granulation tissue may form a canal that channels microbial infection from the underlying involved joint space, and thus, presents the risk of osteomyelitis development. Accordingly, gouty ulcer must be treated appropriately. In this case, refractory wounds on gouty ulcers at the left shin and left radial ankle were treated by surgical debridement. Negative-pressure wound therapy was used successfully to prevent post-operative delayed wound healing.
Ankle ; Debridement ; Gout ; Granulation Tissue ; Inflammation ; Joints ; Negative-Pressure Wound Therapy* ; Osteomyelitis ; Ulcer* ; Uric Acid ; Wound Healing ; Wounds and Injuries

PURPOSE: Underlying bone sclerosis is frequently observed in clinical settings when oral squamous cell carcinoma (OSCC) invades the jaw bone. The aim of this study was to assess the prevalence and characteristics of underlying bone sclerosis in patients with OSCC. MATERIALS AND METHODS: We retrospectively reviewed the computed tomographic (CT) images of 131 patients who underwent mandibulectomy between January 2012 and December 2015 to treat OSCC. The presence, degree, and extent of underlying bone sclerosis were assessed on CT images and correlated with the following imaging patterns of bone invasion: cortical invasion, medullary invasion with a smooth margin, and medullary invasion with an irregular margin. The chi-square test was used to determine the relationships between the variables. RESULTS: The prevalence of underlying bone sclerosis on CT images was 70.1% (47 of 67). The prevalence was 85.7% (42 of 49) in patients with medullary invasion, but it was 27.8% (5 of 18) in patients with only cortical invasion, indicating a significant increase in the prevalence of underlying bone sclerosis in patients with medullary invasion (P < .05). Aggressive patterns of bone invasion were associated with increases in the degree and extent of the underlying bone sclerosis (P < .05). CONCLUSION: More than two-thirds of OSCC cases with bone invasion showed underlying bone sclerosis. On CT images, reactive sclerosis in the remaining margin of the alveolar bone should not be used as the primary means to differentiate periodontal inflammatory lesions from those resulting from OSCC.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Jaw ; Mandible ; Prevalence ; Retrospective Studies* ; Sclerosis* ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The potential physiologic roles of Klotho in acute kidney injury (AKI) have recently been demonstrated in animal models. However, to date, there have been no human studies investigating the expression of renal Klotho in AKI. METHODS: We retrospectively collected biopsy specimens and clinical data of AKI patients between January 2001 and December 2012. Klotho expression was determined by immunohistochemical staining, and the clinical-pathological correlation was examined. RESULTS: Among the 34 patients diagnosed with acute tubular necrosis or acute tubulointerstitial nephritis, 21 patients without chronic histological lesions were included. The mean age was 37.3 +/- 18.5 years and the mean peak creatinine level was 8.2 +/- 5.5 mg/dL. In total, 10 patients (47.6%) received temporary renal replacement therapy (RRT); however, 17 patients (81%) showed functional recovery with creatinine levels of < 1.3 mg/dL after 1 month. The intensity of Klotho expression was scored as a percentage of Klotho-positive area. The renal Klotho score showed a significant negative correlation with the initial or peak creatinine level. When the patients were divided into three groups according to the Klotho score (low, middle, high), the low group had a significantly higher peak creatinine level and a more frequent requirement for RRT. However, the Klotho score was not a significant predictor of renal recovery. CONCLUSIONS: The results demonstrated that renal Klotho expression in humans decreased significantly according to the severity of AKI, regardless of the etiology, and that low expression was associated with a poor short-term outcome.
Acute Kidney Injury/diagnosis/etiology/*metabolism/physiopathology/therapy ; Adolescent ; Adult ; Biomarkers/analysis ; Biopsy ; Down-Regulation ; Female ; Glucuronidase/*analysis ; Humans ; Immunohistochemistry ; Kidney/*chemistry/pathology/physiopathology ; Kidney Tubular Necrosis, Acute/diagnosis/etiology/*metabolism/physiopathology/therapy ; Male ; Middle Aged ; Necrosis ; Predictive Value of Tests ; Recovery of Function ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Time Factors ; Treatment Outcome ; Young Adult

OBJECTIVE: The aim of this study is to evaluate factors influencing on perinatal outcomes of pregnancy with IgA nephropathy and the effect of pregnancy on the prognosis of IgA nephropathy. METHODS: We retrospectively reviewed clinical and laboratory findings of 28 pregnancies in 25 pregnant women with biopsy-proven IgA nephropathy at six hospitals of Catholic Medical Center throughout the period of January 1999 to December 2009. They are divided into two groups by presence or absence of perinatal complications such as preeclampsia and preterm labor and then compared. The prognosis of IgA nephropathy was determined by serum creatinine level and diagnosis of end stage renal disease (ESRD) until 3 years after delivery. Fisher exact test and Mann-Witney U test were used for statistical analysis. RESULTS: The factors that related perinatal complications included high blood pressure (P=0.019), low glomerular filtration rate (less than 50 mL/min) (P=0.029), and high creatinine level (more than 2.0 mg/dL) (P=0.005). Especially, hypertension and high creatinine level (more than 2.0 mg/dL) increased risk of not only preterm birth (P=0.017, P=0.026, respectively) but also preeclampsia (P=0.008, P=0.001, respectively). The factors that increased risk of ESRD within 2 years after delivery included high creatinine level (more than 2.0 mg/dL) (P=0.018) and preeclampsia (P=0.018). CONCLUSION: Our results indicate that hypertension and poor renal function could be predictors of poor perinatal outcomes, and when pregnancies with IgA nephropathy are complicated by preeclampsia or high creatinine level (more than 2.0 mg/dL), the prognosis of IgA nephropathy might be poor.
Creatinine ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA ; Humans ; Hypertension ; Immunoglobulin A ; Kidney Failure, Chronic ; Obstetric Labor, Premature ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Premature Birth ; Prognosis ; Renal Insufficiency ; Retrospective Studies