Sclerosing lymphangitis of the penis occurs as a skin-colored or dusty red, cord-like thickening of tissue at the corona or within the coronal sulcus. The thickened, elongated lesion is firm and relatively nontender. The cause is unknown: because it occurs primarily in those who are sexually very active, however, it is likely that chronic trauma plays an important etiologic role. We experienced a case of pathologically proven sclerosing lymphangitis in a 31 year-old man. Ultrasonographic finding showed circumferential cord like hypoechoic band with irregular, but well demarcated margin.
Lymphangitis* ; Male ; Penis*

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.
Candida albicans ; Candidemia ; Fungemia ; Fungi ; Humans ; Incidence ; Neurosurgery ; Retrospective Studies* ; Trichosporon ; Urinary Tract Infections ; Yeasts

No abstract available.
Pulmonary Artery*

A 56-year-old woman with emphysematous pyelonephritis underwent an emergent left nephrectomy due to her religious creed. Postoperative hemoglobin level was decreased to 4.4 g/dL from preoperative value of 13.9 g/dL. The patient completely recovered without transfusion and was discharged on the 40th postoperative day without complication.
Anemia* ; Female ; Humans ; Middle Aged ; Nephrectomy* ; Pyelonephritis

PURPOSE: The purpose of this study was to evaluate the HRCT findings of bronchial asthma during maintenance bronchodilator therapy and to determine whether there were irreversible bronchial changes occurred in pediatric patients with this condition. MATERIALS AND METHODS: HRCT findings of the lung in 21 asthmatic children [14 boys and 7 girls aged between 3.5 and 13.8 (mean : 7.7) years] who were receiving maintenance bronchodilator therapy were retrospectively studied. At the time of CT examination, 16 were receiving nonsteroid bronchodilator therapy only, and five were receiving both bronchodilator and steroid therapy. Thirteen patients were defined as allergic and eight were nonallergic. The clinical severity of chronic asthma was graded as severe in seven cases, and moderate in 14. The duration of the disease ranged from 4 months to 6 years (mean 3.2 years). HRCT was performed in 19 cases for evalvation of the atelectasis, hyperinflation, and prominent bronchovascular bundles seen on plain radiographs, and in two cases for evaluation following acute exacerbation. A CT W-2000 scanner (Hitachi Medical Co. Tokyo, Japan) was used during the end inspiratory phase, and in addition, ten patients were scanned during the expiratory phase. Scans were reviewed for evidence of bronchial thickening, bronchiectasis, emphysema, abnormal density, mucus plugs, and other morphological abnormalities. The presence of bronchial wall thickening or air trapping was evaluated according to the duration, severity and type of asthma. RESULTS: Among the 21 patients, 7(33.3%) had normal HRCT findings, while in 14 (66.7%), bronchial wall thickening was demonstrated. Eleven of the 14 patients with bronchial wall thickening (78.6%) also had air trapping. No patient was suffering from bronchiectasis or emphysema. There were no statistically significant correlations between the presence of bronchial wall thickening or air trapping and the duration of the disease, its severity, or type of asthma. There was, however, a statistically significant correlation between bronchial wall thickening and air trapping (p < . 0 5 ). CONCLUSION: In asthmatic children who were under maintenance therapy, the most frequent HRCT findings were bronchial wall thickening and air trapping, with significant correlation between the presence of these two phenomena. No destructive lesion such as bronchiectasis or emphysema was found in these asthmatic children, however, and this is probably due to the short duration of the disease, and different disease processes.
Asthma ; Bronchiectasis ; Child* ; Emphysema ; Female ; Humans ; Lung ; Mucus ; Pulmonary Atelectasis ; Retrospective Studies

Takayasu arteritis is a chronic inflammatory arteriopathy of unknown etiology affecting large vessels, the aorta and its main branches. We experienced a case of Takayasu arteritis type III in a 9 years old girl. The diagnosis was made by physical examinations and digital subtration aortography (DSA) which showed occlusion of left subclavian artery and left renal artery and stenosis of abdominal aorta. Medical treatment and percutaneous transluminal angioplasty (PTA) were performed. A brief review of literatures was made.
Angioplasty* ; Aorta ; Aorta, Abdominal ; Aortography ; Child ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Physical Examination ; Renal Artery ; Subclavian Artery ; Takayasu Arteritis*

BACKGROUND AND PURPOSE: Elevated plasma total homocysteine (tHcy) levels are reported to be associated with an increased risk of Alzheimer's disease (AD). However, the mechanism by which homocysteine contributes to the pathogenesis of AD is as yet unknown. The aim of this study was to elucidate the relationship between white matter changes (WMC) and medial temporal lobe atrophy (MTA) on brain magnetic resonance imaging (MRI), and plasma levels of tHcy in AD patients. METHODS: Seventy-two patients with a clinical diagnosis of probable AD were recruited to the study. Plasma tHcy levels, vascular risk factors, and WMC and MTA on brain MRI were evaluated in all patients. The AD patients were classified into two groups: those with no or minimal WMC (69.2+/-8.8 years, mean+/-SD, n=36) and those with moderate-to-severe WMC (74.6+/-4.6 years, n=36) on brain MRI. RESULTS: In a univariate logistic regression analysis, the risk of moderate-to-severe WMC in AD was significantly associated with increasing age, female gender, lower education level, hypertension, high plasma tHcy levels, and lower Mini-Mental State Examination (MMSE) score. Multivariate logistic regression analysis revealed only high plasma tHcy as the independent and significant risk factor for moderate-to-severe WMC [odds ratio (OR; adjusted for age, gender, education level, MMSE score, and hypertension comparing the top tertile - tHcy levels > or =12.9 micromol/L - with the bottom tertile - tHcy levels < or =9.4 micromol/L)=7.35; 95% confidence interval, confidence interval=1.36-39.84; p=0.02], and age as a borderline significant risk factor (OR=1.08, 95% CI=0.99-1.19, p=0.09) in AD patients. Plasma tHcy levels were not correlated significantly with either right or left MTA. CONCLUSIONS: Our results suggest that the vascular pathway mediates the association between elevated plasma tHcy levels and AD.
Alzheimer Disease ; Atrophy ; Brain ; Female ; Glutamates ; Guanine ; Homocysteine ; Humans ; Hypertension ; Leukoaraiosis ; Logistic Models ; Magnetic Resonance Imaging ; Plasma ; Risk Factors ; Temporal Lobe ; Pemetrexed

PURPOSE: Gastrointestinal stromal tumors (GISTs) frequently harbor activating gene mutations in either KIT or platelet-derived growth factor receptor A (PDGFRA) and are highly responsive to several selective tyrosine kinase inhibitors. In this study, a targeted next-generation sequencing (NGS) assay with an Oncomine Focus Assay (OFA) panel was used for the genetic characterization of molecular targets in 30 Korean patients with GIST. MATERIALS AND METHODS: Using the OFA that enables rapid and simultaneous detection of hotspots, single nucleotide variants (SNVs), insertion and deletions (Indels), copy number variants (CNVs), and gene fusions across 52 genes relevant to solid tumors, targeted NGS was performed using genomic DNA extracted from formalin-fixed and paraffin-embedded samples of 30 GISTs. RESULTS: Forty-three hotspot/other likely pathogenic variants (33 SNVs, 8 Indels, and 2 amplifications) in 16 genes were identified in 26 of the 30 GISTs. KIT variants were most frequent (44%, 19/43), followed by 6 variants in PIK3CA, 3 in PDGFRA, 2 each in JAK1 and EGFR, and 1 each in AKT1, ALK, CCND1, CTNNB1, FGFR3, FGFR4, GNA11, GNAQ, JAK3, MET, and SMO. Based on the mutation types, majority of the variants carried missense mutations (60%, 26/43), followed by 8 frameshifts, 6 nonsense, 1 stop-loss, and 2 amplifications. CONCLUSIONS Our study confirmed the advantage of using targeted NGS with a cancer gene panel to efficiently identify mutations associated with GISTs. These findings may provide a molecular genetic basis for developing new drugs targeting these gene mutations for GIST therapy.

BACKGROUND: This study was to verify the necessity of a control program developed to improve compliance, by conducting a research on the status of medication compliance in the elderly with chronic diseases in rural area and analyzing the related variables. METHODS: The organized questionnaire and pill-count were used to collect information on personal details, physical status, drugs taken in the elderly over 65 years old suffering from more than two chronic diseases in one rural area. RESULTS: The mean age of the subjects was 73.13+/-6.36 (65~93), and the number of the subjects in compliance group was 60 (77.9%) and the accuracy of self-report which was identified by pill-count was 0.86. Polypharmacy and visiting several clinics were the main factors that decided a low- degree of compliance, with OR of 5.92 (95% CI 1.11~31.44, P=0.037), and 4.25 (95% CI 1.03~17.53, P=0.045), respectively. CONCLUSION: Systematic efforts are necessary and plans must be established without delay to increase compliance in the elderly in the rural, expansively to manage chronic diseases in stay-at-home elders.
Aged ; Chronic Disease ; Compliance ; Humans ; Medication Adherence ; Polypharmacy ; Republic of Korea ; Stress, Psychological ; Surveys and Questionnaires

BACKBROUND AND PURPOSE: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature. MATERIALS AND METHODS: We evaluated 9 small aneurysms among 19 unruptured intracranial aneurysms from eight patients who underwent stenting. The patients had unexplainable severe headache (n = 8), aneurysm originating from the anterior choroidal artery (n = 3), potential growth or rupture risks including hypertension (n = 5), and multiple aneurysms (n = 6). Stents with a relatively low-wall coverage ratio (8-10%) were used. Clinical and angiographic outcomes were assessed. RESULTS: One (n = 8) or two stents (n = 1) were used without any procedural difficulties or complications. Although no immediate changes of aneurysm morphology were observed, aneurysms decreased in size (n = 8) when examined by DSA (n = 8) or MRA (n = 1) during a median 28.9-month follow-up. There were no adverse events, including thromboembolism, aneurysm rupture, or stent movement during a median 31.9-month clinical follow-up (range: 17-69 months). CONCLUSION: Although a variable degree of aneurysm size decrease may not prevent further growth or rupture of small aneurysms, stenting with a low-wall coverage ratio may have some advantageous hemodynamic effect. Flow modification of stent architecture vs. aneurysm characteristics, including size and location, on long-term outcome, requires further clarification.
Aneurysm* ; Arteries ; Choroid ; Follow-Up Studies ; Headache ; Hemodynamics ; Humans ; Hypertension ; Intracranial Aneurysm ; Rupture ; Stents* ; Thromboembolism