Cystitis glandularis is a benign metaplastic proliferative lesion of the urinary bladder which usually occurs in the setting of chronic irritation and infection or in some cases as a congenital process. Sometimes it presents as a tumor mass-like florid lesion, grossly mimicking malignancy. We report a case of 59-year-old man with multiple mass lesions around the trigone and the neck portion, which suggested the possibility of malignancy in clinical and radiological evaluations. Final diagnosis was confirmed by transurethral resection. The surface urothelial lining was intact. The submucosa showed von Brunn's nests, cystitis glandularis and cystitis cystica in the edematous lamina propria. There were numerous glands lined by tall columnar, mucin producing epithelium without atypia, conforming to the appearance of the intestinal variant of cystitis glandularis. The cystitis glandularis may mimic a neoplasm on gross evaluation. The intestinal variant of cystitis glandularis is particularly likely to be problematic when florid.
Cystitis* ; Diagnosis ; Epithelium ; Humans ; Middle Aged ; Mucins ; Mucous Membrane ; Neck ; Urinary Bladder Neoplasms* ; Urinary Bladder*

KearnsSayre syndrome (KSS) is a mitochondrial DNA disorder characterized by the onset before age 20 years, progressive external opthalomoplegia, atypical retinal pigmentation and cardiac conduction disturbance. This report describes a 24-year-old woman who experienced syncope due to complete atrioventricular block complicated by KSS. At 12 years old, she was diagnosed KSS. The consecutive change of EKG shows typical progression of cardiac conduction disturbance of KSS. She was successfully treated with implantation of a pacemaker.
Atrioventricular Block* ; Child ; DNA, Mitochondrial ; Electrocardiography ; Female ; Humans ; Kearns-Sayre Syndrome ; Pigmentation ; Retinaldehyde ; Syncope ; Young Adult

Schwannoma is a tumor that arises from neural sheath Schwann cells of peripheral nerves. Schwannoma is mostly solitary, except when it occurs in association with Von Recklinghausen's disease. Solitary schwannoma can occur in association with a nerve anywhere within the body, but rarely occurs in the pelvis. Microscopically, the tumors can be divided into hypercellular bundles of spindle-shaped cells (Antoni A area) and areas of lower cellularity, with loose myxomatous arrangement of cells and fibers (Antoni B area). Complete resection of pelvic schwannoma is a curative treatment. We report a case of benign presacral cystic schwannoma that caused recurrent acute urinary retention in a 79-year-old woman, along with a review of the literature.
Aged ; Female ; Humans ; Neurilemmoma* ; Neurofibromatosis 1 ; Pelvis ; Peripheral Nerves ; Schwann Cells ; Urinary Retention*

Colorectal varix (CRV) is a rare cause of lower gastrointestinal bleeding and usually associated with portal hypertension from liver cirrhosis or portal venous obstruction. Idiopathic CRV have no identifiable underlying cause and can only be diagnosed after the cause of portal or mesenteric vein circulation have been excluded. We report a case of idioipathic CRV presented with rectal bleeding for a week. Colonoscopy revealed markedly dilatated tortuous, and bluish veins in the rectum as well as coexistent adenomatous polyp and internal hemorrhoid. Despite extensive investigation, there was no evidence of portal hypertension or any other cause. Family history was also negative. Although blood transfusions were required, the patient remained asymptomatic without further rectal bleeding.
Adenomatous Polyps ; Blood Transfusion ; Colonoscopy ; Hemorrhage ; Hemorrhoids ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Mesenteric Veins ; Rectum ; Varicose Veins* ; Veins

The transpetrosal approach to the anterior portion of a brain stem lesion with intact hearing is often limited by portions of the labyrinth. The technique of partial labyrinthectomy, by which the posterior and superior semicircular canals, maximizes surgical exposure while preserving hearing. We report the case of a patient who underwent a modified partial labyrinthectomy involving resection of the posterior semicircular canal only in the area of the labyrinth. Technical modification of the partial labyrinthectomy approach simplifies tumor removal while preserving hearing.
Brain Stem ; Ear, Inner ; Hearing ; Hemangioma, Cavernous* ; Humans ; Semicircular Canals

Cardiac involvement in systemic lupus erythematosus(SLE) is common and has been reported in more than 50% of the patients at the same stage during their illness. SLE can affect the heart in a number of ways;myocarditis, pericarditis, aortic insufficiency, hypertensive heart disease, and coronary arteritis. In recent years, with prolonged survival and improvement in diagnostic modalities, the cardiovascular manifestations of SLE have become more apparent. Coronary artery disease has a number of possible pathogenic mechanisms;atherosclerosis, coronary arteritis, spasm, and hypercoagulability. For management purposes, differentiation between arteritis and artheroslerosis is important. Atherosclerosis in the coronary as well as other vessels appears to be accelerated by SLE. Cardiovascular care to the SLE patients should be emphasized, because corticosteroid treatment and auto-immune mechanisms of SLE are able to promote the atherosclerosis of coronary arteries. We report 36-year-old otherwise healthy female with SLE who presented with severe ischemic heart disease requiring coronary by-pass surgery.
Adult ; Arteritis ; Atherosclerosis ; Coronary Artery Disease* ; Coronary Vessels ; Female ; Heart ; Heart Diseases ; Humans ; Lupus Erythematosus, Systemic* ; Myocardial Ischemia ; Pericarditis ; Spasm ; Thrombophilia

BACKGROUND AND PURPOSE: Frovatriptan is a selective 5-HT1B/1D agonist with a long duration of action and a low incidence of side effects. Although several placebo-controlled trials have documented the clinical efficacy and safety of frovatriptan in adults with migraine, this drug has not previously been studied in Asian including Korean patients. METHODS: In this double-blind multicenter trial, 229 patients with migraine were randomized to receive frovatriptan 2.5 mg or placebo upon the occurrence of a moderate-to-severe migraine. The primary outcome was the 2-hour headache response rate. RESULTS: Frovatriptan significantly increased the 2-hour headache response rate compared with placebo (52.9% vs. 34.0%, p=0.004). The headache response rates at 4, 6, and 12 hours were significantly higher in the frovatriptan group than in the placebo group, as was the pain-free rate at 2 hours (19.0% vs. 5.7%, p=0.004), 4 hours (40.7% vs. 23.0%, p=0.006), and 6 hours (56.1% vs. 34.0%, p=0.002). The median time to a headache response was significantly shorter in the frovatriptan group than in the placebo group (2.00 hours vs. 3.50 hours, p<0.001). The use of rescue medications was more common in the placebo group (p=0.005). Chest tightness associated with triptan was infrequent (2.5%), mild, and transient. CONCLUSIONS: These results demonstrate that 2.5-mg frovatriptan is effective and well tolerated in Korean migraineurs for acute treatment of migraine attacks.
Adult ; Asian Continental Ancestry Group ; Carbazoles ; Headache ; Humans ; Incidence ; Migraine Disorders ; Oxalates ; Thorax ; Tryptamines

Object of this study was to make comparison between acetazolamide and dipyridamole activated SPECT for measurement of cerebral vascular reserve capacity. This study was also carried out to evaluate response in acetazolamide and dipyridamole activated SPECT in relation to clinical parameters, such as Glasgow Coma Scale, Hunt & Hess grade, Fisher grade and Glasgow Outcome Scale. It is concluded from study that. Acetazolamide and dipyridamole activated SPECT study proved to be valuable for cerebral vascular reserve capacity. Dipyridamole activated SPECT study was somewhat equivocal because of systemic vascular dilatation effect, but this problem could be resolved by Gamma Count Ratio. Although there were minimal transient side effect of dipyridamole such as dizziness, no complication.
Acetazolamide* ; Dilatation ; Dipyridamole* ; Dizziness ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Subarachnoid Hemorrhage ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVES: ICAM-1 has been shown to be required for leukocyte migration into inflammed area and plays a significant role in inflammatory disease including bronchial asthma, and various infectious disease such as tuberculosis and malaria. Although, the significance of soluble ICAM-1(sICAM-1) in rickettial disease has not been recognized. The present investigation was designed to evaluate the sICAM-1 levels in patients with tsutsugamushi disease, and the correlation factors between sICAM-1 level and subject characteristics including clinical and laboratory indices. METHODS: Eight normal controls and thirteen patients with tsutsugamushi disease underwent serum sampling for sICAM-1 level, which was measured by using ELISA kit. RESULTS: 1) sICAM-1 level is significantly elevated in patients group. 2) sICAM-1 level is a significantly correlation with AST level, titer of anti-tsutsugamushi antiboby, and leukocyte counts, but other factors such as age, sex, differential fraction of leukocyte, ALT, duration of fever, and total hospital day etc, are not. CONCLUSION: These results show that sICAM-1 may be a role in the pathogenesis of tsutsugamushi disease.
Asthma ; Communicable Diseases ; Enzyme-Linked Immunosorbent Assay ; Fever ; Humans ; Intercellular Adhesion Molecule-1* ; Leukocyte Count ; Leukocytes ; Malaria ; Scrub Typhus* ; Tuberculosis

PURPOSE: In this study, we attempted to characterize capsaicin's effects with regard to the apoptosis of murine bladder cancer cells (MBT-2) as well as the pharmacodynamics of nano-encapsulated capsaicin formulation for intravesical instillation. MATERIALS AND METHODS: We assessed the viability of the MBT-2 cells via MTT staining, agarose gel electrophoresis, and flow cytometric apoptosis analysis. Intravesical reagents were instilled into 3 groups of male white New Zealand rabbits. Instillation agents were nano-encapsulated capsaicin dissolved in saline, capsaicin dissolved in saline, and capsaicin dissolved in dimethyl sulfoxide (DMSO). We also determined the pharmacokinetics of urine, plasma, and bladder tissue after intravesical capsaicin instillation. RESULTS: Capsaicin treatment was determined to reduce cell viability in a time- and dose-dependent manner. The capsaicin concentrations in the urine of the rabbits decreased in each of the treatment groups, but we noted a more profound reduction of capsaicin concentration in the nano-encapsulated capsaicin group. Plasma concentrations were definitely lower as compared with the levels measured in the bladder tissue and urine. We noted distinctive differences in patterns of concentration change between the capsaicin with normal saline solution (NSS) or DMSO and the nano-encapsulated capsaicin groups. The concentration of nano-encapsulated capsaicin in the tissue appeared to increase directly with tissue depth. CONCLUSIONS Our results show that capsaicin can induce apoptosis in MBT-2 cells, as well as the excellent permeation properties of nano-encapsulated capsaicin. Treatment with intravesical capsaicin may be a promising alternative therapeutic modality for the treatment of bladder cancer.