No abstract available.
Pregnancy* ; Spermatozoa*

PURPOSE: The purpose of this study was to investigate the relationship between aberrant p53 expression and the presence of human papillomavirus DNA in transitional cell carcinomas of the urinary bladder. MATERIALS AND METHODS: This study analyzed 30 paraffin-embedded transitional cell carcinoma of the urinary bladder, including 10 cases of grade I, 10 cases of grade II, and 10 cases of grade III, for the presence of DNA-HPV and abnormal accumulation of p53. We used immunohistochemical staining for p53 protein and in situ hybridization for HPV DNA, respectively. RESULTS: Overall positive rate of HPV DNA type 16 and type 18 was 60.0% and 53.3%, respectively. Nuclear accumulation of p53 was found in 13 cases (43.3%) of all transitional cell carcinomas. In HPV DNA type 16 positive cases, the p53 was positive in 8 cases and negative in 10 cases. In HPV DNA type 16 negative cases, the p53 was positive in 5 cases and negative in 7 cases. In HPV DNA type 18 positive cases, the p53 was positive in 7 cases and negative in 9 cases. In HPV DNA type 16 negative cases, the p53 was positive in 6 cases and negative in 8 cases. CONCLUSION: This results suggest that HPV infection and p53 gene accumulation may contribute to the significant role in the carcinogenesis of the utinary bladder. In additon, HPV infection and p53 accumulation may be related to tumor progression and higher grade.
Carcinogenesis ; Carcinoma, Transitional Cell ; DNA ; Genes, p53 ; Humans ; In Situ Hybridization ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Chryseobacterium meningosepticum is rarely encountered as a pathogen causing peritonitis in peritoneal dialysis (PD) patients. We report a case of peritonitis due to Chryseobacterium meningosepticum, which was treated successfully with intraperitoneal (IP) vancomycin and ciprofloxacin, and without PD catheter removal. Peritonitis was developed in a 53-year-old PD patient on the third hospital day. Although empirical IP treatment with cefazolin and tobramycin was initiated and maintained for 3 days, the fever and signs of peritonitis persisted. Antibiotics were changed to cefoperazone/sulbactam, amikacin, and vancomycin due to clinical deterioration. After 3 days of vancomycin use, leukocyte count in PD fluid was less than 100/mm3 and the patient became asymptomatic. On seventh day after the onset of peritonitis, Chryseobacterium meningosepticum was isolated from initial dialysate sample, and this strain was susceptible to ciprofloxacin, piperacillin, and piperacillin/tazobactam. Accordingly, we changed the antibiotics to ciprofloxacin and vancomycin, which were given for the total of 14 days. Even though Chryseobacterium meningosepticum is an uncommon causative organism of peritonitis in PD patients, this report suggests that vancomycin and ciprofloxacin are effective as empiric therapy, and early suspicion and appropriate antimicrobial therapy are crucial to the successful treatment of peritonitis due to Chryseobacterium meningosepticum without catheter removal.
Amikacin ; Anti-Bacterial Agents ; Catheters ; Cefazolin ; Chryseobacterium ; Ciprofloxacin ; Fever ; Humans ; Leukocyte Count ; Middle Aged ; Peritoneal Dialysis ; Peritonitis ; Piperacillin ; Sprains and Strains ; Tobramycin ; Vancomycin

We report a case of patient with malignant thymoma, who developed nephrotic syndrome several years after thymectomy. This 38-year-old man was diagnosed as myasthenia gravis and malignant thymoma and underwent thymectomy in 2004. Tumor resection and systemic chemotherapy were performed after recurrence in pleura in 2006. He also took pyridostigmine to control his symptoms of myasthenia gravis after thymectomy. Four years later, even though there was no evidence of recurrence of thymoma, he developed a nephrotic syndrome and was diagnosed as a minimal change disease on renal biopsy. After pulse therapy with methylprednisolone followed by oral administration of prednisolone therapy, nephrotic syndrome was improved.
Administration, Oral ; Adult ; Biopsy ; Humans ; Methylprednisolone ; Myasthenia Gravis ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Pleura ; Prednisolone ; Pyridostigmine Bromide ; Recurrence ; Thymectomy ; Thymoma

We report a case of pancreatic pseudocyst presenting as an intramural gastric tumor on upper gastrointestinal examination, endoscopic ultrasound and computed tomography of the abdomen. Pancreatic pseudocysts in the stomach wall is rare and the most of them presented as a cystic mass, but this case was presented as a gastric mural solid tumor. Exploration revealed an about 4 4 2 cm sized round mass at the midbody of great curvature of stomach, it was in the muscle layer, and removed by surgical operation. The correct diagnosis of this case was established postoperately on the pathologic examination revealed pancreatic pseudocyst.
Abdomen ; Diagnosis ; Pancreatic Pseudocyst* ; Stomach ; Ultrasonography

Mature teratoma is the most common germ cell tumor of the ovary. The tumor is essentially a benign neoplasm and surgical resection of the tumor is the treatment of choice. Recurrence with colorectal involvement after surgical removal of the primary lesion is exceedingly rare and has not been reported in Korea. We present a 43-year-old patient with a rectal mass who had already undergone left oophorectomy due to mature cystic teratoma and right oophorectomy due to hemorrhagic corpus luteum. The rectal mass was composed of a mature teratoma tissue. We postulate that leakage of the tumor elements from the cyst wall led to peritoneal tumor implantation and invasion to the rectal wall.
Adult ; Female ; Humans ; Ovarian Neoplasms/*pathology ; Rectal Neoplasms/diagnosis/*secondary ; Teratoma/diagnosis/*secondary

Renal anemia is a common complication of chronic kidney disease and known to be caused by erythropoietin or iron deficiency. However, erythrocytosis in patients on dialysis has rarely been reported and usually associated with renal cell carcinoma, polycythemia vera or acquired cystic kidney disease. Here we report a case of erythrocytosis in an ESRD patient with resolution after kidney transplantation. A 38-year-old man on peritoneal dialysis for 5 years was admitted for kidney transplantation. On admission, blood Hgb and Hct was 19.7 g/dL and 61.4%, respectively. Serum erythropoietin level was 347 mIU/mL. Multiple variable sized cystic lesions were identified on both kidneys without evidence of internal malignancy in abdomen and pelvis CT scan. After kidney transplantation, Hgb was 12.5 g/dL and serum erythropoietin level was 13.1 mIU/mL. Some of renal cysts on CT scan disappeared or decreased in size. This finding suggests that erythrocytosis in this patient can be associated with acquired cystic kidney disease.
Abdomen ; Adult ; Anemia ; Carcinoma, Renal Cell ; Dialysis ; Erythropoietin ; Humans ; Iron ; Kidney ; Kidney Diseases, Cystic ; Kidney Failure, Chronic ; Kidney Transplantation ; Pelvis ; Peritoneal Dialysis ; Polycythemia ; Polycythemia Vera ; Renal Insufficiency, Chronic

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. METHODS: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male: female 20: 7; age 47.6+/-12.9 years old; age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. RESULTS: Mean total sleep time on polysomnography was 401.4+/-57.8 min (range of 274.0 to 514.1 min). Mean RDI was 21.7+/-20.4 /hour. Mean FI was 21.9+/-13.0 / hour. RDI and FI showed significant correlation (r=0.55, p< 0.01). CONCLUSIONS: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.
Accident Proneness ; Actigraphy* ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Outpatients ; Polysomnography ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Deprivation ; Sleep Wake Disorders ; Wrist

OBJECTIVES: We attempted to compare the performance of 2 commercially available actigraphies with focus on sleep parameters, using polysomnography as standard comparison tool. METHODS: Fourteen normal volunteers (5 males and 9 females, mean age of 28+/-4.6 years) participated in this study. All the participants went through one night of polysomnography, simultaneously wearing 2 different kinds of actigraphies on each wrist. Polysomnographic and actigraphic data were stored, downloaded, and processed according to standard protocols and then statistically compared. RESULTS: Both ActiWatch (r) and SleepWatch (r) tended to overestimate the total sleep time, compared to the polysomnography. Sleep-Watch (r) tended to underestimate the sleep latency. The two actigraphs and the polysomnograph did not show significant difference of sleep efficiency, when compared with one another. In addition, all of the sleep parameters from the instruments showed linear correlations except in SleepWatch (r) 's sleep latency. The sleep parameters from the two actigraphs did not show much noteworthy difference, and linear relationships were found between the sleep parameters from the two actigraphs. There was no significant distinction in the results of the two different actigraphs. CONCLUSION: The results of two actigraphies can be used interchangeably since the sleep parameters of the two different actigraphies do not show significant differences statistically. Overall, it is not legitimate to use actigraphy as a substitute for polysomnography. However, since sleep parameters except sleep latency show linear correlations, actigraphy might possibly be used to follow up patients after polysomnography.
Actigraphy ; Female ; Healthy Volunteers ; Humans ; Male ; Polysomnography* ; Wrist

Until 1972, many carcinoid tumors of the thymus were not recognized as distinct lesions and were mistakenly labeled as variants of thymomas. Thymic carcinoid tumors are unusual neoplasms that show different morphological, functional, and behavioral characteristics than those of thymomas. We report a case of a 65-year-old woman with thymic carcinoid tumor. The cinicopathological findings are discussed with a review of the literature.
Aged ; Carcinoid Tumor* ; Female ; Humans ; Thymoma ; Thymus Gland