Acute idiopathic scrotal edema (AISE) is a self-limiting condition that is characterized by acute scrotal swelling and erythema. AISE is a very rare cause of acute scrotum, especially in neonates. We report a case of AISE in a 26-day-old infant who was admitted to the outpatient clinic with swelling and erythema of the penis and scrotum for a week. His vital signs were stable, and laboratory findings were non-specific. A diagnosis of AISE was made using scrotal ultrasonography with color Doppler. His symptoms resolved within four days after the onset of supportive treatment, and he was discharged from the hospital. In neonates with an acute scrotum, AISE should be considered to prevent unnecessary surgical exploration.
Ambulatory Care Facilities ; Diagnosis ; Edema ; Erythema ; Humans ; Infant ; Infant, Newborn ; Male ; Penis ; Scrotum ; Ultrasonography ; Urologic Diseases ; Vital Signs

OBJECTIVES: The distributive pattern of atherosclerotic vascular disease is known to be different among the races. In Caucasian population, renal artery stenosis (RAS) was reported to be a frequent finding in the patients with ischemic heart disease (IHD), ranging from 5% to 29%. We investigated the prevalence of RAS and the risk factors in Korean patients. METHODS: Over a 12-month period, 574 patients (M:F, 407:167) with clinical IHD underwent cardiac catheteriza tion. Before the procedure, demographic data, medical history, physical findings, and blood chemistries were ob tained. During the procedure, selective renal arteriogram was also obtained. The degree of renal artery stenosis was quantitated with automatic edge detection technique, and narrowing of diameter greater than 50% was considered to be significant. RESULTS: RAS was identified in 42 patients (7%), of whom 5 patients (1%) had bilateral disease. Angiographi cally significant coronary artery disease was present in 473 patients. The prevalence of RAS in patients with single, double and triple vessel disease of coronary artery were 4% (9/235), 13% (20/154), and 12% (10/84), respec tively. Among the 101 patients with normal coronary arteries, 3 (3%) had RAS. By univariate analysis, there was significant difference between RAS and non-RAS in age (66+/-8 yrs vs 59+/-10 yrs, p<0.0001), duration of hypertension (7.3+/-1.3 yrs vs 3.40.3 yrs, p=0.0002), and the frequency of double or triple +/-coronary artery disease (p=0.004). However, no association was found between RAS and serum lipids, lipoprotein(a), creatinine, sex, smoking, diabetes mellitus, or peripheral vascular disease. By multivariate logistic regression analysis, the following parameters were independent risk factors for RAS: age over 65 years (p<0.001), duration of hypertension (p=0.003), and coronary artery disease involving double or triple vessels (p=0.004). CONCLUSION: The prevalence of RAS in Koreans is somewhat lower than in western population. However, in patients with high degree coronary heart disease, old age over 65 years, or long history of hypertension, the possibility of combined RAS should be considered.
Arteries ; Cardiac Catheterization ; Continental Population Groups ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Creatinine ; Diabetes Mellitus ; Humans ; Hypertension ; Lipoprotein(a) ; Logistic Models ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Prevalence* ; Renal Artery Obstruction* ; Renal Artery* ; Risk Factors* ; Smoke ; Smoking ; Vascular Diseases

No abstract available.
Diabetes Mellitus, Type 1* ; Genotype* ; Humans ; Korea* ; Thyroid Diseases* ; Thyroid Gland*

The effects of subarachnoid administration of 0.5% bupivacaine in 5% and 10% glucosesolution were investigated in a randomized 30 cases undergoing a low limb and low abdominal surgery in the Department of Anesthesiology at the Hanyang University Hospital from October 1st, 1984 to March 31st, 1985. The results are as follows: 1) These were no significant differences between the patients of the three groups in relation to sex, age, weight, height and operation time. 2) The oneset time of the maximum segmental spread of analygesia in the control group was 5 to 10 minutes and 10 to 15 minutes in the experimental groups. 3) The spread of sensory blockade in the experimental groups was lowered 2~3 segment compared with control group. 4) The onset time of complete motor blockade in the control group was 5 minutes and 5~10 minutes in the experimental group. 5) Duration of complete motor blockade in experimental groups was shorter than the control group. 6) The cardiovascular changes were investigated with no significant differences between the patients of the three groups. 7) The minimal complications such as mild hypotension in three cases, micturition difficulty in one case, mild translent headache in one case were investigated in the three groups. According to our investigation of subarachnoid blockade with 0.5% bupivacain 2ml in 5% and 10% glocose solution, it considered that the spread was limited and produced intense sensory and motor block of long duration which was suitable of the low limbs and low abdominal surgery.
Anesthesiology ; Bupivacaine ; Extremities ; Headache ; Humans ; Hypotension ; Urination

BACKGROUND AND OBJECTIVES: As a result of increasing the use of hematopoietic stem cell transplantation (HSCT) for hematologic malignancies and certain solid tumors, more patients have become susceptible to infection. Sinonasal infections in patients with HSCT frequently cause problems which are sometimes fatal. The purpose of this study is to determine the clinical features of sinonasal infections in the immunocompromised patients who received HSCT and to suggest a proper evaluation of these patients. MATERIALS AND METHOD: We reviewed retrospectively 1814 patients who had received HSCT in St. Mary's hospital from August 1995 to May 2003 to determine the clinical features of sinonasal infections in these patients and to analyze the correlation between sinonasal infection of pre- and post-HSCT. RESULTS: 403 patients (22.2%) had sinonasal infections. The infection occurred before HSCT in 206 patients (11.3%), whereas it occurred after HSCT in 197 patients (10.8%). Of 197 patients (27.4%) 54 had previously sinonasal infections. CONCLUSION: Sinonasal infection in the patients of pre-HSCT increased incidence of post-HSCT sinonasal infection. Early detection using endoscopic examination and sinus computed tomography scan as well as employing an aggressive combined treatment of medical and surgical modalities are essential for the treatment of sinonasal infections in the HSCT patients.
Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Immunocompromised Host ; Incidence ; Retrospective Studies ; Sinusitis

BACKGROUND: Congenital adrenal hyperplasia (CAH) results from an inherited defect in enzymatic steps required to synthesize cortisol from cholesterol. 21-hydroxylase deficiency accounts for 95% cases of CAH. It appears that the frequency and the type of the responsible mutations differ according to the ethnic background and the type of mutation can predict the clinical outcomes such as salt losing type (SL), simple virilizing type (SV) and non-classic type (NC). METHODS: We have analyzed CYP21 genes in 55 Korean cases (110 chromosomes) of CAH by Southern blotting, PCR-dot hybridization and PCR amplification-created restriction site method. The patients include 43 cases of SL and 12 of SV. None of the NC was found. RESULTS: We found the mutations in 94% (103/110) of the examined chromosomes. A total of 10 types of mutations were discovered. The mutations include aberrant splicing of intron 2 (i2, 35%), CYP21 gene deletion (32%) and I172N (11%) in order. When the relationship between the clinical types and genotypes were correlated, most of the SL patients have either i2 (42%) or CYP21 gene deletion (41%), while SV patients have I172N (33%) or P30L (21%). The parents' mutation was investigated in 20 cases. In 4 families, one of the parents was not the obligatory heterozygote carrier i.e. did not have a mutation. The results suggest the high incidence of de novo mutation. CONCLUSION: We have identified the frequency of mutations of the CYP21 in Korean AGS patients. Our results shows that the clinical type of AGS can be predicted from the genotypes of CYP21. Also the high incidence of de novo mutation of CYP21 confirmed the genetic instability of major histocompatibility III region where the CYP21 is located.
Adrenal Hyperplasia, Congenital ; Adrenogenital Syndrome* ; Blotting, Southern ; Cholesterol ; Gene Deletion ; Genotype* ; Heterozygote ; Histocompatibility ; Humans ; Hydrocortisone ; Incidence ; Introns ; Parents ; Phenotype* ; Polymerase Chain Reaction ; Steroid 21-Hydroxylase*