No abstract available.

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.
Alprostadil ; Drug Therapy ; Erectile Dysfunction ; Male ; Needles* ; Sildenafil Citrate

Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year- old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid, tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also, occasional multilobed/ multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma, Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen, CD3, CD30(Ki-1) but negative for cytokeratin, epithelial membrane antigen, and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesions of the stomach and cecum.
Adenocarcinoma ; Amyloid ; Antigens, CD45 ; Biopsy ; Cecum ; Child* ; Cytoplasm ; Diagnosis ; Female ; Histiocytic Sarcoma ; Hodgkin Disease ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Mucin-1 ; Multiple Myeloma ; Pleural Effusion ; Stomach ; Tomography, X-Ray Computed

Rituximab, a chimeric anti-CD20 IgG1 monoclonal antibody, has been used as a rescue therapy for steroid-dependent or refractory nephrotic syndrome. However, the adverse effects of rituximab are yet to be investigated. We report a case of a 9-year-old boy with steroid-dependent nephrotic syndrome who developed Kikuchi-Fujimoto disease after several cycles of rituximab therapy. Kikuchi-Fujimoto disease is a benign, self-limited necrotizing histiocytic lymphadenitis of unknown etiology. In the present case, Kikuchi-Fujimoto disease developed when the peripheral blood B-cell count of the patient was at nadir, and the lesion regressed slowly but spontaneously after recovery of the B-cell count. To our knowledge, although the pathologic diagnosis of Kikuchi-Fujimoto disease was unavailable, this is the first report of Kikuchi-Fujimoto disease with clinical diagnosis as a possible adverse effect of rituximab.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Child ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Immunoglobulin G ; Lymphadenitis ; Nephrotic Syndrome ; Rituximab

Systemic capillary leak syndrome(SCLS) is a rare disorder of unknown etiology, which is characterized by recurrent attacks of hypotension, hemoconcentration, and hypoalbuminemia. Urinary or enteric loss of protein is not demonstrated. It is often associated with monoclonal gammopathy, but does not manifest multiple myeloma. Since Clarkson et al. described the first case in a 34- year-old woman, about 50 cases have been reported in the literature. However, most of the cases were of adult age, and the mean age of onset in the reported cases was 42.6 years. In literature review, we could refer only one pediatric case of SCLC by Foeldvari et al. in 1995. We report another pediatric case of SCLS.
Adult ; Age of Onset ; Capillaries ; Capillary Leak Syndrome* ; Child* ; Female ; Humans ; Hypoalbuminemia ; Hypotension ; Multiple Myeloma ; Paraproteinemias

PURPOSE: The prostate cancer is one of the most prevalent disease in the Western world. Recently, with the increase of old-aged population and the westernized diet, prostate cancer patients have increased in Korea. We have studied the prevalence of prostate cancer in Kangseo-Gu, Pusan. MATERIAL AND METHODS: From September to November 1996, a representative sample of 433 volunteers were chosen randomly and were monitored. Of these, 393 participants were older than 50 years and were not within the urological practice. Screening programs used here are international prostatic symptom score(1-PSS), digital rectal examination(DRE) and serum prostate specific antigen(PSA) with an immunoenzymatic assay(Tandem-E). The transrectal ultrasonography(TRUS) is reserved for the cases with an abnormal finding on the rectal examination or the elevated PSA value. Transrectal biopsy of prostate was recommended in the cases of PSA greater than 4ng/ml, suspicious nodules on DRE or TRUS, or when more than two of these findings were discovered. RESULTS: The detection rates and the positive predictive values for the DRE were 1.02% and 7.7%, TRUS were 1.27% and 15.2%, and PSA were 1.02% and 16.7% respectively. When the TRUS and PSA tests were combined, the positive predictive value was increased to 33.3% and when all three tests were combined, the predictive value increased further to 57.1%. However, the detection rate did not change with combinations of these tests. When the PSA cut-off value was increased from 4.0ng/ml to 10.0ng/ml, the positive predictive value increased from 11.1% to 33.3%. CONCLUSIONS: From the above examinations, 5 of the 393 samples had prostate cancer, yielding detection rate of 1.27%. The results of our community-based study suggest that there are about 4,5000 people suffering from the prostate cancer, with the prevalence of 1.27%. This value of prevalence of prostate cancer in Korean population is much lower than the western world.
Biopsy ; Busan* ; Diet ; Epidemiologic Studies ; Humans ; Korea* ; Mass Screening ; Prevalence* ; Prostate ; Prostatic Neoplasms* ; Volunteers ; Western World

Congenital aniridia is a rare ocular malformation that presents with severe hypoplasia of the iris and various ocular manifestations. Most cases of congenital aniridia are known to be related to mutations in the paired box gene-6 (PAX6), which is an essential gene in eye development. Herein, we report a familial case of autosomal dominant congenital aniridia with four affected members in 3 consecutive generations and describe the detailed ophthalmologic findings for one of these members. As expected, mutational analysis revealed a nonsense mutation (p.Ser122*) in the PAX6 gene. Thus, our findings reiterate the importance of PAX6 mutations in congenital aniridia.
Aniridia* ; Codon, Nonsense ; Family Characteristics ; Genes, Essential ; Humans ; Iris ; WAGR Syndrome ; Wilms Tumor

The Russell-Silver syndrome (RSS) is a disease characterized by intrauterine growth retardation with preserved head circumference, facial dysmorphism and short stature. Reported renal and urinary manifestations of RSS include horseshoe kidney, renal tubular acidosis, hydronephrosis, ureteropelvic obstruction and vesicoureteral reflux. Here we report a case of end-stage renal disease associated with RSS, which, to the best of our knowledge, has not been reported yet.
Acidosis, Renal Tubular ; Fetal Growth Retardation ; Head ; Hydronephrosis ; Kidney ; Kidney Failure, Chronic ; Silver-Russell Syndrome ; Vesico-Ureteral Reflux

PURPOSE: The present study was designed to examine the distribution of dorsal root ganglion(DRG) cells innervating the anterior and posterior cruciate ligaments of the Sprague-Dawley rat knee joint. MATERIALS AND METHODS: Fluoro-gold(FG) was used to identify the distribution of DRG cells innervating the ligaments, and horseradish peroxidase(HRP) was used to measure the DRG cell size innervating the ligaments. RESULTS: Neural tracers-labelled DRG cells were found ipsilaterally only in the lumbosacra1 DRGs. FG-labelled DRG cells innervating the anterior and posterior cruciate ligaments were found from the 1st lumbar DRG to the 1st sacral DOR(L1-Sl). The majority of FG-labelled DRG cells innervating the poste-rior cruciate ligaments were located in the L4, and the majority innervating the anterior cruciate ligaments were found in the L3, The size of HRP-labelled DRG cells innervating the cruciate ligaments was below 800 micromiter (c), showing that these cells were small. CONCLUSION: This study indicates that the DRG origin of sensory nerves is different in each cruciate ligament of the knee joint. But the size and the type innervating each ligament is similar.
Animals ; Anterior Cruciate Ligament ; Armoracia ; Cell Size ; Diagnosis-Related Groups ; Horseradish Peroxidase ; Knee Joint* ; Knee* ; Ligaments ; Posterior Cruciate Ligament* ; Rats* ; Rats, Sprague-Dawley ; Spinal Nerve Roots*

Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.
Adenoviridae Infections* ; Adenoviridae* ; Allografts* ; Biopsy ; Cerebrospinal Fluid ; Child* ; Cystitis ; Dysuria ; Emergencies ; Ganciclovir ; Hematuria ; Humans ; Immunization, Passive ; Immunocompromised Host ; Immunosuppressive Agents ; Kidney Transplantation ; Mass Screening ; Mortality ; Nephritis, Interstitial ; Opportunistic Infections ; Pediatrics ; Renal Dialysis ; Renal Insufficiency ; Seizures ; Sputum