Emphysematous pyelonephritis is a necrotizing renal infections characterized by intrarenal and occasional perirenal gas production. Although uncommon (89 cases in the literature), it occurs almost exclusively in diabetic patients (87% of the cases). Prompt and aggressive management is required to sahage these patients. We describe a recent case of a diabetic woman with emphysematous pyelonephritis due to E. Coll, successfully managed with unilateral nephrectomy.
Female ; Humans ; Nephrectomy ; Pyelonephritis*

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Peptic Ulcer* ; Prevalence* ; Stomach Neoplasms*

Human Fasciola hepatica infection is a rare entity involving infestation of the liver and biliary tree with adult flukes, which can result in hepatitis, cirrhos is and biliary tract inflammation, obstruction and lithiasis. The patient had the typical diagnostic tetrad of fever, eosinophilic leukocytosis, tender hepatomegaly and fluke ova in the stools. Treatment consists of Emetine hydrochloride hydrochloride administration for hepatic involvement and common bile duct exploration for removal of flukes, with cholecystectomy for associated cholelithiasis. The combination of medical and surgical therapy can be expected to produce an arrest of this infection. The removed liver revealed eggs of the fasciola species in the intrahepatic bile duct. The clinical history, pathological findings and treatment of this case were described.
Adult ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholecystectomy ; Cholelithiasis ; Common Bile Duct ; Eggs ; Emetine ; Eosinophils ; Fasciola ; Fasciola hepatica ; Fascioliasis* ; Fever ; Hepatitis ; Hepatomegaly ; Humans* ; Inflammation ; Korea* ; Leukocytosis ; Lithiasis ; Liver* ; Ovum ; Trematoda

Cholinesterase (ChE) is one of the most ubiquitous enzymes and in addition to its well characterized catalytic function, the morphogenetic involvement of ChE has also been demonstrated in neuronal tissues and in non-neuronal tissues such as bone and cartilage. We have previously reported that during mouse tooth development, acetylcholinesterase (AChE) activity is dynamically localized in the dental epithelium and its derivatives whereas butyrylcholinesterase (BuChE) activity is localized in the dental follicles. To test the functional conservation of ChE in tooth morphogenesis among different species, we performed cholinesterase histochemistry following the use of specific inhibitors of developing molar and incisors in the hamster from embryonic day 11 (E11) to postnatal day 1 (P1). In the developing molar in hamster, the localization of ChE activity was found to be very similar to that of the mouse. At the bud stage, no ChE activity was found in the tooth buds, but was first detectable in the dental epithelium and dental follicles at the cap and bell stages. AChE activity was found to be principally localized in the dental epithelium whereas BuChE activity was observed in the dental follicle. In contrast to the ChE activity in the molars, BuChE activity was specifically observed in the secretory ameloblasts of the incisors, whilst no AChE activity was found in the dental epithelium of incisors. The subtype and localization of ChE activity in the dental epithelium of the incisor thus differed from those of the molar in hamster. In addition, these patterns also differed from the ChE activity in the mouse incisor. These results strongly suggest that ChE may play roles in the differentiation of the dental epithelium and dental follicle in hamster, and that morphogenetic subtypes of ChE may be variable among species and tooth types.
Acetylcholinesterase ; Ameloblasts ; Animals ; Butyrylcholinesterase ; Cartilage ; Cholinesterases ; Cricetinae ; Dental Sac ; Epithelium ; Incisor ; Mice ; Molar ; Morphogenesis ; Neurons ; Tooth ; Tooth Germ

PURPOSE: Novel influenza H1N1 A virus developed pandemic infection, and patients requiring hospitalization have rapidly increased because of severe clinical symptoms and signs. We describe the clinical features of hospitalized pediatric patients with novel influenza virus infection. METHODS: We reviewed the medical charts of 128 pediatric patients under the age of 16 who were hospitalized in Dongguk University Ilsan Hospital between September 2009 and February 2010. We compared the clinical features of the pneumonia and non-pneumonia groups of patients, and analyzed clinical difference according to M. pneumoniae coinfection and severity of pneumonia. RESULTS: The male to female sex ratio of the subjects was 2.2:1, and the average age was 6.2 years. Sixty-five patients (50.8%) had pneumonia and their average age was 6.7 years. Variables including duration of admission, total WBC counts, neutrophil percentage and CRP were significantly different between the 2 groups, however, the other variables were not. The number of patients diagnosed with severe pneumonia was 20 (30.8%). M. pneumoniae coinfection occurred in 24.6% of patients in the pneumonia group, however, it did not influence the severity of pneumonia. Underlying asthma was more significantly associated with severe pneumonia than with mild pneumonia. There was no death case. CONCLUSION: In this study, 2009 novel influenza infection was more prevalent in school-age boys. M. pneumoniae coinfection occurred frequently, however, it did not seem to influence disease severity. Patients with underlying asthma tend to develop severe pneumonia more frequently.
Asthma ; Coinfection ; Female ; Hospitalization ; Humans ; Influenza, Human ; Male ; Mycoplasma pneumoniae ; Neutrophils ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Sex Ratio ; Viruses

PURPOSE: This study was performed to evaluate chromatin condensation of morphologically mature sperm using a modified aniline blue-eosin (AB-E) staining method in azoospermia. MATERIALS AND METHODS: Chromatin condensation was analyzed using an AB-E staining method in 61 cases (50 patients) of TESE or testicular biopsy with the patient's own sperm. Obstructive azoospermia (OA) was present in 48 cases in 39 patients and non-obstructive azoospermia (NOA) was present in 13 cases in 11 patients, respectively. Immature sperm heads were stained dark blue, whereas mature sperm were stained red-pink by the eosin. The percentage of sperm chromatin condensation was calculated from the ratio of the number of red-pink sperm to the total number of sperm analyzed. RESULTS: The percentage of chromatin maturity was 37.7% vs. 30.3% in OA and NOA, respectively, of the total sperm cell count. The maturity of fresh testicular sperm was 38.3% and 36.3% in OA and NOA, respectively. Also, the maturity of thawed testicular sperm was 34.5% and 10.3% (p<0.05) in OA and NOA, respectively. The maturity of fresh and thawed testicular sperm was 36.3% and 10.3% (p<0.05), respectively, in NOA. These results suggest that chromatin condensation is less stable in sperm of NOA and freezing and thawing procedures may impair sperm chromatin condensation. CONCLUSIONS: In our results, the aniline blue-eosin staining method improved the visualization of excessive histones in sperm and the diagnosis of sperm immaturity in morphologically normal testicular sperm. We found that AB-E staining method can be an effective method for analyzing testicular sperm chromatin condensation in azoospermia.
Aniline Compounds ; Azoospermia ; Biopsy ; Cell Count ; Chromatin ; Eosine Yellowish-(YS) ; Freezing ; Histones ; Humans ; Sperm Head ; Spermatozoa

PURPOSE: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo SET(R) was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor N-595(R) and Masimo SET(R)) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. METHODS: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2< or =85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. RESULTS: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo SET(R) pulse oximetry (48 in Nellcor N-595(R), 27 in Masimo SET(R)) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor N-595(R), 19 in Masimo SET(R)). CONCLUSION: The Masimo SET(R) pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor N-595(R) pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.
Anoxia ; Artifacts ; Body Weight ; Clinical Alarms ; Electrocardiography ; Enzyme Multiplied Immunoassay Technique ; Foot ; Handling (Psychology) ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Oximetry ; Oxygen

PURPOSE: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo SET(R) was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor N-595(R) and Masimo SET(R)) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. METHODS: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2< or =85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. RESULTS: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo SET(R) pulse oximetry (48 in Nellcor N-595(R), 27 in Masimo SET(R)) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor N-595(R), 19 in Masimo SET(R)). CONCLUSION: The Masimo SET(R) pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor N-595(R) pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.
Anoxia ; Artifacts ; Body Weight ; Clinical Alarms ; Electrocardiography ; Enzyme Multiplied Immunoassay Technique ; Foot ; Handling (Psychology) ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Oximetry ; Oxygen

Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogastroduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage.
Aged ; Carcinoma, Hepatocellular/*diagnosis/radiography/secondary ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Neoplasm Seeding ; Peritoneal Neoplasms/*diagnosis/radiography/secondary ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Tomography, X-Ray Computed

STUDY DESIGN: Retrospective case series. PURPOSE: The purpose of this study was to examine the incidence of neural axis abnormalities and the relevant risk factors in patients with adolescent idiopathic scoliosis (AIS). OVERVIEW OF LITERATURE: The use of preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with idiopathic scoliosis is controversial, and indications for such MRI evaluations have not been definitively established. However, we routinely use whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction. METHODS: A total of 378 consecutive patients with presumed AIS who were admitted for spinal surgery were examined for neural axis abnormalities using MRI. To differentiate patients with normal and abnormal MRI findings, the following clinical parameters were evaluated: age, sex, menarcheal status, rotation angle (using a scoliometer), coronal balance, shoulder height difference, and low back pain. We radiographically evaluated curve type, thoracic or thoracolumbar curve direction, curve magnitude and flexibility, apical vertebral rotation, curve length, coronal balance, sagittal balance, shoulder height difference, thoracic kyphosis, and the Risser sign. RESULTS: Neural axis abnormalities were detected in 24 patients (6.3%). Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in terms of the other measured parameters. CONCLUSIONS: Among the patients with presumed AIS who received preoperative whole-spine MRI, 6.3% had neural axis abnormalities. Males and patients with increased thoracic kyphosis were at a higher risk.
Adolescent* ; Female ; Humans ; Incidence ; Kyphosis ; Low Back Pain ; Magnetic Resonance Imaging* ; Male ; Pliability ; Retrospective Studies ; Risk Factors ; Scoliosis* ; Shoulder ; Spine