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

To investigate the influence of first six-month mean for serum biochemical markers, albumin, cholesterol, triglyceride, inorganic phosphate, BUN, creatinine, on survival in hemodialysis, we retrospectively analyzed the 57 patients who were monitored from the start of HD for more than 6 months between January 1988 and December 1995. Exclusion criteria were as follows: transfer to CAPD, transplantation or another dialysis center, HD for less than 6 months, non-compliant, death due to malignant disease, accident and self-withdrawal. The patients were divided into two groups according to the demographic characteristics and the median value of first six-month mean for serum biochemical markers. The mean age was 46.7+/-11.7 year, male-to female ratio was 1.6:1, diabetics were 12 (21.1%), and mean follow-up duration was 39.0+/-26.4 months. Among them 30 patients (52.6%) were died. Diabetic patients had significantly lower 1 year (63.6 vs. 88.8%, p<0.05) and 3 year survival rate (19.1 vs. 62.2%, p<0.05) than non-diabetic patients. Low serum albumin(<3.5g/dl), low serum cholesterol(<130mg/dl) and low serum P (<5.0mg/dl) groups were significantly lower 1 and 3 year survival rate than high serum albumin (63.6 vs. 97.0%; 25.5 vs. 74.6%, p<0.05), cholesterol (71.4 vs. 88.0%; 38.1 vs. 60.8%, p<0.05) and p (71.9 vs. 96.3% ; 47.1 vs. 62.9%, p<0.05) groups, respectively. There were no differences in survival rate according to sex, BUN, TG, and creatinine. By Cox's proportional hazard model, low serum albumin(odds ratio 1.98), cholesterol(odds ratio 1.60), and P(odds ratio 2.09) group were independent risk factors for early death. Low serum albumin level at the start of HD maintained during the follow-up period. Cholesterol and P showed similar results. In conclusion, basal serum biochemical markers associated with visceral protein depletion such as low serum albumin, cholesterol and P seem to be early predictors of mortality in hemodialysis patients.
Biomarkers* ; Cholesterol ; Creatinine ; Dialysis ; Female ; Follow-Up Studies ; Humans ; Mortality ; Peritoneal Dialysis, Continuous Ambulatory ; Proportional Hazards Models ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Survival Rate ; Triglycerides

Day-to-day insulin requirements often change due to subtle variations in insulin metabolism in patients with type 2 diabetes undergoing hemodialysis. In such cases, intra-hemodialysis hypoglycemia frequently occurs and is a main factor interfering with the delivery of dialysis. As a result, it reduces the quality of life in patients undergoing hemodialysis. The long-acting insulin analogue glargine provides peakless, continuous release over 24 h that approximates a normal basal insulin pattern. Because it has no peak, its use in patients with diabetes undergoing hemodialysis would hypothetically be useful. Specifically, patients would be able to avoid intra-hemodialysis hypoglycemia without the necessity of skipping insulin administration on the day of hemodialysis and achieving adequate glucose control on other days. We recently experienced six cases that switched from treatment with intermediate-acting insulin to a long-acting insulin analogue, which provided better glycemic control by reducing hypoglycemia risk. Limited data are available in the literature concerning insulin analogue usage in patients with diabetes undergoing hemodialysis. Our experience suggests a large-scale prospective investigation is required on this issue.
Dialysis ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Insulin, Long-Acting ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis ; Insulin Glargine

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

In systemic lupus erythematosus (SLE), acute renal failure (ARF) is usually associated with severe lupus nephritis and ARF associated with other glomerular diseases is extremely rare. We recently encountered a patient with ARF that was associated with a minimal change nephrotic syndrome (MCNS) in SLE. A 41-year-old woman presented with a nephrotic syndrome and ARF. She fulfilled four of the American College of Rheumatology criteria for the classification of SLE. However, a renal biopsy revealed that there were no glomerular abnormalities and no deposition of immune complex. The generalized edema disappeared and the high creatinine levels decreased after prednisolone therapy.
Adult ; Case Report ; Female ; Human ; Kidney Failure, Acute/*etiology ; Lupus Erythematosus, Systemic/*complications ; Nephrosis, Lipoid/*complications