Tuberculosis and lymphoma, these 2 diseases can present with lyphadenopathy in anywhere of the body. Therefor differentiation of tuberculosis from lymphoma is often difficult. CT scans of 17 patients with tuberculosis and 23 patients with lymphoma were retrospectively reviewed to evaluate the efficacy of CT scans in differentating adenopathy between tuberculosis and lymphoma, All the patients underwent abdominal CT scans with contrast enhancement before treatment. The size, internal architecture, distribution of lymph nodes, and associated findings on CT scans were analyzed. As compared with lymphoma, tuberculous lymphadenopathy showed 1) female preponderance (65%), 2) predilection for portocaval lymph nodes (47%), 3) internal low attenuation in lymph nodes (82%), 4) cold abscess formation (24%). Characteristics of lymphoma on CT scans included 1) male prepondrance (78%), 2) conglomeration of lymph nodes (39%), 3) homogenous internal lymph node structure (83%). These results suggest that evaluation of the characteristics of lymphadenopathy on CT scans is helpful for differentiating between tuberculosis and lymphoma.
Abscess ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis*

Tuberculosis and lymphoma, these 2 diseases can present with lyphadenopathy in anywhere of the body. Therefor differentiation of tuberculosis from lymphoma is often difficult. CT scans of 17 patients with tuberculosis and 23 patients with lymphoma were retrospectively reviewed to evaluate the efficacy of CT scans in differentating adenopathy between tuberculosis and lymphoma, All the patients underwent abdominal CT scans with contrast enhancement before treatment. The size, internal architecture, distribution of lymph nodes, and associated findings on CT scans were analyzed. As compared with lymphoma, tuberculous lymphadenopathy showed 1) female preponderance (65%), 2) predilection for portocaval lymph nodes (47%), 3) internal low attenuation in lymph nodes (82%), 4) cold abscess formation (24%). Characteristics of lymphoma on CT scans included 1) male prepondrance (78%), 2) conglomeration of lymph nodes (39%), 3) homogenous internal lymph node structure (83%). These results suggest that evaluation of the characteristics of lymphadenopathy on CT scans is helpful for differentiating between tuberculosis and lymphoma.
Abscess ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis*

No abstract available.
Humans

PURPOSE: This study was undertaken to review the clinical and hematologic findings of the preterm infants delivered from pregnancy induced hypertension(PIH) mothers. METHODS: The data were collected by reviewing the medical records on the current prognosis of preterm birth and sending questionnaires on the status of NICU. We reviewed the medical records from two university hospitals and two resident training hospitals in Gwangju-Chonnam to evaluate the neonatal prognosis of preterm birth from Jan. 1, 1995 to Dec. 31, 1997. RESULTS: The average survival rate of total preterm babies was 79.6%. According to birth weights, survival rate from less than 1,000 gm was 10%, 1,000-1,499 gm was 55.3%, 1,500-1,999 gm was 82.2%. Maternal risk factors were pretmature rupture of membrane(42.2%), preterm labor (21.3%), PIH(10.7%), multiple pregnancy(8.2%) and incompetent internal os of cervix(4.2%). The average gestational age and birth weight were 34.2+/-2.3 weeks and 1,940+/-620 gm in the preterm infants born to mothers with PIH. The death rate was 12.9% in the preterm infants born to mothers with PIH. There were no significant differences in the incidence of RDS, use of assisted ventilation and surfactant, and frequency of the blood transfusion between the preterm infants born to normotensive mothers and those to mothers with PIH. There were significant differences in the total WBC count, platelet count and the concentration of the Mg, Ca and P between the preterm infants born to normotensive mothers and those to mothers with PIH. CONCLUSION: Our results may be helpful to predict the perinatal complications and manage the preterm infants by considering the clinical and hematologic findings of preterm infants born to mothers with PIH.
Birth Weight ; Blood Transfusion ; Female ; Gestational Age ; Hospitals, University ; Humans ; Hypertension, Pregnancy-Induced* ; Incidence ; Infant, Newborn ; Infant, Premature* ; Medical Records ; Mortality ; Mothers* ; Obstetric Labor, Premature ; Platelet Count ; Pregnancy ; Premature Birth ; Prognosis ; Surveys and Questionnaires ; Risk Factors ; Rupture ; Survival Rate ; Ventilation

Bilateral cortical necrosis accounts for up to 2% of cases of acute renal failure. More than half of cases of bilateral renal cortical necrosis occure in association with pregnancy complicated by antipartum or postpartum hemorrhage. Other causes including severe bacterial infections, hemolytic uremic syndrome, trauma, postoperative shock, burns, Acute pancreatitis, diabetic ketoacidosis, snake venoms, and phosphorus poisoning. A 53-year-old woman presented with acute pancreatitis and acute renal failure. Diffuse bilateral renal cortical necrosis was diagnosed by renal biopsy and computed tomography. The patient recovered from the attack of pancreatitis but remained anuric. Then, we report this case of acute renal cortical necrosis associated with acute pancreatitis.
Acute Kidney Injury ; Bacterial Infections ; Biopsy ; Burns ; Diabetic Ketoacidosis ; Female ; Hemolytic-Uremic Syndrome ; Humans ; Kidney Cortex Necrosis* ; Middle Aged ; Necrosis ; Pancreatitis* ; Phosphorus ; Poisoning ; Postpartum Hemorrhage ; Pregnancy ; Shock ; Snake Venoms

Bilateral cortical necrosis accounts for up to 2% of cases of acute renal failure. More than half of cases of bilateral renal cortical necrosis occure in association with pregnancy complicated by antipartum or postpartum hemorrhage. Other causes including severe bacterial infections, hemolytic uremic syndrome, trauma, postoperative shock, burns, Acute pancreatitis, diabetic ketoacidosis, snake venoms, and phosphorus poisoning. A 53-year-old woman presented with acute pancreatitis and acute renal failure. Diffuse bilateral renal cortical necrosis was diagnosed by renal biopsy and computed tomography. The patient recovered from the attack of pancreatitis but remained anuric. Then, we report this case of acute renal cortical necrosis associated with acute pancreatitis.
Acute Kidney Injury ; Bacterial Infections ; Biopsy ; Burns ; Diabetic Ketoacidosis ; Female ; Hemolytic-Uremic Syndrome ; Humans ; Kidney Cortex Necrosis* ; Middle Aged ; Necrosis ; Pancreatitis* ; Phosphorus ; Poisoning ; Postpartum Hemorrhage ; Pregnancy ; Shock ; Snake Venoms

Amyloidosis is a heterogenous group of often fatal disorders characterized by extracellular deposition of a proteinaceous material with a unique fibrillar form in various tissues and organs. Deposition of amyloid may cause widespread dysfunction of the involved organs. Recently, we experienced a case of 40-year-old male patient with nephrotic syndrome, uncontrolled ascites and jaundice, which developed after cholecystectomy. We confirmed systemic amyloidosis involving kidney, liver and peritoneum by kidney and liver and peritoneum biopsy. The case that, having about a month of incubation period after cholecystectomy, amyloidosis occurred in a healthy man before the operation, and that amyloid was deposited in the peritoneum site incised during the operation provides grounds that amyloidosis may be triggered by cholecystectomy. Given the rarity of this case, the following is a report of this case and a review of the relevant literatures.
Adult ; Amyloid ; Amyloidosis* ; Ascites ; Biopsy ; Cholecystectomy* ; Humans ; Jaundice ; Kidney* ; Liver* ; Male ; Nephrotic Syndrome ; Peritoneum*

A 39-year-old man with a history of hypertension for 10 years and 10 pack-years smoking, was admitted with dyspnea and generalized edema. On admission, renal insufficiency accompanied with nephrotic syndrome was diagnosed. Even on careful examination including history, blood chemistry test, and fundoscopic examination, no clinical evidence of diabetes was found. Renal biopsy findings, which strongly resembled that of diabetic nodular glomerulosclerosis in microscopic features, showed glomerular hypertrophy and nodular mesangeal sclerosis. Additional immunohistochemistry and ultrastructural investigations excluded other possible diseases that should be differentiated; membranoproliferative glomerulonephritis, thrombotic microangiopathy, amyloidosis, monoclonal immunoglobulin deposition disease, fibrillary glomerulonephritis, and immunotactoid glomerulopathy. Idiopathic nodular glomerulosclerosis is histopathologically similar to nodular diabetic glomerulosclerosis but is unusually developed in persons with hypertension and smoking history. Though there were three reports about cases of nodular glomerulosclerosis in the Korean literature, the cases were related to hepatitis B virus or diabetic retinopathy without overt diabetes. We report a rare case of idiopathic nodular glomerulosclerosis that was related to hypertension and smoking without other medical history.
Adult ; Amyloidosis ; Biopsy ; Chemistry ; Diabetic Nephropathies* ; Diabetic Retinopathy ; Dyspnea ; Edema ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Hepatitis B virus ; Humans ; Hypertension* ; Hypertrophy ; Immunoglobulins ; Immunohistochemistry ; Nephrotic Syndrome ; Renal Insufficiency ; Sclerosis ; Smoke* ; Smoking* ; Thrombotic Microangiopathies

PURPOSE: Urinary N-acetyl-beta-D-glucosaminidase (NAG) has been known to reflect the damage of proximal tubular cells in the early stages of renal disease. Recent studies have demonstrated that tubular grade predicted renal outcome better than did other histological parameters in IgA nephropathy. We evaluated the meaning of urinary NAG in relation with initial histological features and renal outcomes in early subclinical IgA nephropathy. METHODS: Among the firstly diagnosed IgA nephropathy patients from Jan 2001 to Dec 2002, 43 subjects were selected with the criteria of normal renal function and 24-h urinary protein excretion <3.5 g/day. The subjects were followed for 2 years. Pathologic lesion was graded according to HASS classification and semiquantitative scorings, from 0 to 3, were carried out for glomerular (GG), interstitial (IG), tubular (TG), and vascular (VG) lesion. RESULTS: The subjects consisted of 20 male and 23 female with mean age of 30+/-13 years, baseline blood pressure 116+/-15/74+/-10 mmHg, Cr 1.03+/-0.24 mg/dL, Ccr 88+/-19 mL/min, 24-h urinary protein excretion (UPER) 1, 790+/-1, 610 mg/24-h, urinary NAG 11.8+/-11.0 U/g cr at the time of biopsy. Hass subclass was correlated significantly with glomerular, tubular, and interstitial grades (all p<0.05). In comparison with clinical parameters, glomerular grade was significantly related with 24-h UPER (p<0.05) and tubular grade was significantly related with systolic blood pressure (p<0.05). Urinary NAG level at the time of biopsy show significant correlation with tubular grade (p<0.05). Progression of renal disease occurred in nine patients (20.9%). The patients with renal disease progression showed significantly low baseline Ccr, high 24-h UPER, and high NAG (all p<0.05). In pathological findings, tubular grade was significantly related with renal prognosis (p<0.05). In regression analysis, tubular grade was a independent predictor of renal prognosis among above four parameters showing significant differences. In survival analysis, tubular grade 0, 1 and grade 2, 3 showed significant difference in renal survival as compared to each other. The patients with baseline NAG urinary NAG above 10 U/g Cr showed significantly worse renal survival as compared with those below 10 U/g Cr (p<0.05). CONCLUSION: Tubular lesion is an independent factor associated with renal progression in these patients. Urinary NAG reflects well the degree of tubular lesion at the time of biopsy. We carefully suggest, therefore, that the measurement of urinary NAG level is helpful to estimate tubular lesion and predict renal prognosis in subclinical asymptomatic IgA nephropathy patients before they undergo renal biopsy.
Acetylglucosaminidase ; Biopsy ; Blood Pressure ; Classification ; Disease Progression ; Female ; Glomerulonephritis, IGA* ; Hexosaminidases* ; Humans ; Immunoglobulin A* ; Male ; Prognosis*

BACKGROUND: It is widely believed that Graves' disease is an autoimmune disorder characterized by the presence of the circulating TSH receptor antibody (TRAb). The majority of the activity of TRAb is of the immunoglobulin G (IgG) class. However, other immunoglobulin such as immunoglobulin E (IgE), may play a role in the activity. IgE accumulation has been reported to occur in the thyroid gland and ocular muscles of subjects with Graves' disease. Furthermore, it has been noted that recurrence of Graves' disease can be induced by an allergy to pollen. Because an allergy to pollen is commonly associated with IgE, IgE might play a role in the induction of Graves' disease. Therefore, investigated whether IgE was elevated in Graves' disease, and evaluated the potential relationship between the levels of TRAb and IgE Graves' disease. METHODS: Forty-six patients with Graves' disease, and 6 with chronic thyroiditis, diagnosed at the Kosin Medical Center between April, 2000 and July, 2000 were included in this study. Thirty-five persons without thyroid disease or a history of allergic rhinitis were used as normal controls. The level of TRAb was measured using thyrotropin binding inhibitory immunoglobulin (TBII). Serum total IgE was measured using an enzymeimmunoassay method. Test for thyroid function, TBII and total IgE were performed in all cases, and the results statistically analyzed. RESULTS: TBII, as IgG, and the serum IgE level were higher in the patients with Graves' disease, and the levels of the latter were 598.1+/-1112.9U/mL, 98.5+/-79.7U/mL and controls 161.7+/-194.4U/mL in the Graves' patients, those with thyroiditis and the controls, respectively (p<0.05). The prevalence of allergic rhinitis in Graves' disease was 10.9%. The serum IgE level in Graves' disease with, and without, allergic rhinitis were 903.1+/-1152.2U/mL and 560.8+/-1117.0U/mL, respectively, although there was no significancant difference between the two groups. According to the clinical stage, the serum TBII level was higher in the untreated Graves', and relapsed patients 49.9+/-23.9% and 21.1+/-3.1%, respectively, than in the treated group, 7.4+/-18.6% (p<0.05). The serum IgE level was higher in the untreated Graves' and relapsed patients 758.6+/-1250.2U/mL and 1198.5+/-1952.1U/mL, respectively, than in the treated group 233.8+/-432.7U/mL, although this was not significant. According to the duration of treatment, the serum TBII levels were higher in the untreated Graves' patients, and those treated for less than 1 year, than in those treated for more than 1 year, with values of 49.9+/-23.9, 24.8+/-3.8 and 2.22+/-1.97%, respectively (p<0.05). The serum IgE level was higher in the untreated Graves' disease (758.6+/-1250.2U/mL) than in the groups treated for less than 12 months (158.3+/-91.5U/mL) and more than 12 months (252.7+/-483.4U/mL), but the differences were not significant. CONCLUSIONS: The concentration of IgE was high in Graves' patients, and although not statistically significant, the serum IgE level in Graves' patients with allergic rhinitis was higher than those without. With regard to the clinical stage of Graves' disease, the change in the IgE level tended to follow that of the TBII. Further study will be required to define the possible role of IgE in the pathogenesis in Graves' disease.
Graves Disease* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Muscles ; Pollen ; Prevalence ; Receptors, Thyrotropin ; Recurrence ; Rhinitis ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis ; Thyrotropin