The technique of plssma exchange has been applied to a number of immune disorders in which c4eulating antibodies are present. We observed a patient with bullous pemphigoid and serious side effects of longterm use of steroid therspy. We applied ten times of plasmapheresis to him over six months period. After the plasmapheresis, clinical symptoms have greatly improved and steroid maintenance doses have been decreased. We have not observed any side effect of plasmapheresis such as thrambotopenia or hypogarnrnaglobulinemia during the whole therapeutic period.
Antibodies ; Humans ; Immune System Diseases ; Pemphigoid, Bullous* ; Plasmapheresis*

OBJECTIVE: Oxytocin antagonists maybe useful in inhibiting the uterine contractions of preterm labor. One such compound is TT-235. The purpose of this study was to compare the resistance of TT-235 and oxytocin to enzymatic degradation by oxytocinase in pregnant human. METHODS: Blood samples from pregnant women not in labor were incubated in vitro with known amounts of oxytocin and TT-235. Samples were collected at 0, 15, 30, 45 and 60 minute intervals for oxytocin analysis and at 0, 10, 60 and 360 minutes for TT-235 analysis. Oxytocin was analyzed by radioimmunoassay after extraction while TT-235 was analyzed by radioreceptor assay. RESULTS: In human blood, oxytocin was readily metabolized with greater than 83% disappearance over the 60 minute incubation period. In contrast, TT-235 was stable up to 360 minutes of incubation. CONCLUSION: This study suggests that: (1) blood from pregnant human does contain oxytocinase at least in vitro; and (2) TT-235 was resistant to enzymatic degradation by human blood, implying that this oxytocin antagonist may have prolonged activity in vivo in humans.
Cystinyl Aminopeptidase ; Female ; Humans ; Metabolism* ; Obstetric Labor, Premature ; Oxytocin* ; Plasma* ; Pregnancy ; Pregnant Women* ; Radioimmunoassay ; Radioligand Assay ; Uterine Contraction ; Uterus

Proliferative myositis is very rare and was first described as a specific entity in 1960 by Kern. Proliferative myositis is a benign reactive condition that appears as a rapidly growing mass in the proximal muscles of the extremities of adults. Proliferative myositis can be confused with sarcoma clinically as well as microscopically. Proliferative myositis is a bizarre, self-limiting fibroblastic proliferation, the presence of very large basophilic cells with vesicular nucleoli and very prominent nucleoli which resemble ganglion cells or rhabdomyoblast, the cause of which is unclear. The symptoms are non-specific and the diagnosis always rests on a histological examination of the tissue. Local excision is curative and recurrence or metastasis has not been reported even when the abnormal tissue has not been completely excised. The authors report a case of Proliferative myositis in a 59-year-old male.
Adult ; Male ; Female ; Humans

PURPOSE: A papillary thyroid microcarcinoma (PTMC) measures 1 cm or less in diameter. The diagnosis, and thus the apparent incidence, of PTMC has recently increased owing to an increase in the detection of subclinical small and low-risk carcinomas with ultrasonography and fine needle aspiration cytology. However, central neck lymph node metastasis (CLNM) can occur in patients with PTMC. We evaluated the factors influencing CLNM in patients with PTMC. METHODS: We reviewed medical records including clinical information and pathologic reports, and analyzed 622 patients with PTMC who underwent thyroid surgery from January 2002 to December 2012. RESULTS: CLNM was detected in 119 patients (19.1%) of the 622 with PTMC. Lymph node metastasis occurred more frequently in males (P=0.025), and those with bilateral tumors (P=0.016), more than two tumors (P=0.035), tumor size greater than 5 mm (P<0.001), and lymphovascular invasion (P=0.024). There were no statistically significant differences in age and capsular invasion. Multivariate analysis showed that significant factors affecting lymph node metastasis included age at operation (odds ratio [OR]=0.647, 95% confidence interval [CI]=0.422∼0.990, P=0.045), sex (OR=0.489, 95% CI=0.268∼0.891, P=0.020), tumor size (OR=3.034, 95% CI=1.761∼5.224, P<0.001), and lymphovascular invasion (OR=15.036, 95% CI=1.450∼155.911, P=0.023). CONCLUSION: Age less than 45 years, male sex, tumor size greater than 5 mm, and lymphovascular invasion were risk factors associated with CLNM.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Humans ; Incidence ; Lymph Nodes* ; Male ; Medical Records ; Multivariate Analysis ; Neck* ; Neoplasm Metastasis* ; Risk Factors ; Thyroid Gland* ; Ultrasonography

We experienced a case of vitamin B12 unresponsive methlymalonic acidemia in a 4 day old female, who had poor feeding, dehydration with metabolic acidosis, and hyperammonernia and died at 7 days of age. Diagnosis was made by gas chromatography and mass spectrometry, and this case is probably a methylmalonyl CoA mutase apoenzyme deficiency type.
Acidosis ; Apoenzymes ; Chromatography, Gas ; Dehydration ; Diagnosis ; Female ; Humans ; Mass Spectrometry ; Methylmalonyl-CoA Mutase ; Vitamin B 12

PURPOSE: Recently, paranasal sinus(PNS) CT has increasingly been used because of the wide applications of a functional endoscopic sinonasal surgery(FESS) as one of the therapeutic modalities of the chronic sinonasal inflammatory disease. MATERIALS AND METHODS: We retrospectively analyzed PNS CT findings in 76 patients with chronic sinonasal inflammatory disease who had undergone the PNS CT from April 1991 to July 1992. RESULTS: There were 5 sinonasal patterns of inflammation ;4 cases of infundibular type(5.3%), 14 cases of ostiomeatal unit(OMU) type(18%), one case of sphenoethmoidal(SER) type(1%), 56 cases of sinonasal polyposis type(74%), and one case of sporadic type(1%). The mucosal abnormality was seen in 74 OMU cases, 71 maxillary sinus cases, 69 ethmoidal sinus cases, 55 frontal sinus cases, 49 SER, and 46 sphenoidal sinus cases. The normal bony variant included ethmoid bulla(25 cases, 335), concha bullosa (20 cases 25%), Hailer cells(10 cases, 13%), paradoxical curvature of middle turbinate (4 cases, 5%), lateral deviation of uncinate process(3 cases, 4%), and deviation of nasal septurn(31 cases, 41%). CONCLUSION: The PNS CT is an excelleht imaging method providing detailed informations about the mucosal abnormality, pathological pattern, the anatomical structure and landmark, and bony variants prior to an operation.
Frontal Sinus ; Humans ; Inflammation ; Maxillary Sinus ; Retrospective Studies ; Turbinates

A ICL TM(STAAR Collamer Posterior chamber Implantable Contact Lens) lents ranging from -11D to -21.3D. And then we investigated the visualwas implanted in 12 eyes of 7 patients with preoperative spherical equivalents ranging from -11 D to -21.3 D. And then we investigated the visual acuity, mean endothelial cell loss, change of refractive error and postoperative complications.Average follow-up was 28.1 months. In the immediate postoperative days, all eyes had a significant increase in uncorrected visual acuity and the best corrected visual acuity was improved in 7 eyes(58.3%). Mean percent difference between preoperative and postoperative endothelial cell count was 3.22+/-0.05% . The mean preoperative spherical equivalent refraction was -15.65+/-2.78 D. At a mean follow-up of 1 month, mean spherical equivalent refraction was -1.67+/-0.72D, at a 6months, 12 months, 24 months, mean spherical equivalent refraction was each -1.56+/-0.72D, -1.63+/-0.68D, -1.73+/-0.76D. During follow-up days one eye developed an faint anterior subcapsular cataract but the patient remained symptom free. Other reported complication was transient increased intraocular pressure. Although the follow-up in our study was limited cases(12 eyes), from our experience, the posterior chamber implantable contact lens was efficacious and safe in the correction of high myopic refraction errors.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Refractive Errors ; Refractive Surgical Procedures ; Visual Acuity

To evaluate the value of HRCT imaging in middle ear cholesteatoma, we prospectively analysed the CT images in 28 surgically proven cases with cholesteatomas regarding main site of lesion, ossicular change, facial nerve exposure and fistula formation . The most common main site of lesion was the epitympanum (92.8%). The results of sensitivity, positive predictability, and accuracy by CT imagings were as follows: for ossicular involvement, 94.1%, 88.8%, and 86.2% in malleus, 96.0%, 88.8%, and 85.7% in incus, 81.2%, 81.2%, and 78.5% in stapes; for facial verve exposure, 66.6%, 57.1%, and 81.2%; for fistula formation, 100%, 75.0%, and 96.4%, respectively. In conclusion, the temporal bone HRCT imaging is an accurate preoperative method in detecting main lesion site, ossicular involvement, fistula formation. Because of the low sensitivity and positive predictability in detecting facial nerve exposure, it is necessary to correlate the HRCT images with the clinical status.
Cholesteatoma ; Cholesteatoma, Middle Ear* ; Ear, Middle* ; Facial Nerve ; Fistula ; Incus ; Malleus ; Methods ; Prospective Studies ; Stapes ; Temporal Bone* ; Tomography, X-Ray Computed*

No abstract available.

The metastasis of renal cell carcinoma to ureter, urinary bladder and uterus are not common, only a few cases were reported. A 63 years old female was admitted to department of urology, Korea university hospital with intractable hematuria, vaginal bleeding and severe frank pain on left is side with abdominal distension. Herein we are presenting a case of metastatic renal cell carcinoma with review and literature.
Carcinoma, Renal Cell* ; Female ; Genitalia* ; Hematuria ; Humans ; Korea ; Middle Aged ; Neoplasm Metastasis ; Ureter* ; Urinary Bladder* ; Urology ; Uterine Hemorrhage ; Uterus