The first case report of granular cell tumor was by Abrikossoff in 1926, the tumor has been named with more than 20 different synonyms. It is found usually in the tongue, oral cavity, and the skin. It occurs rarely in the esophagus. Esophageal granular cell tumor is a benign lesion which can be diagnosed by endoscopic biopsy. Large symptomatic lesion can be removed by polypectomy. A 29-year-old female visited our hospital for intermittent epigastric pain and anterior chest discomfort. Endoscopy showed a 0.6 *0.4 cm whitish yellow nodule in the mid-esophagus, 25 cm from the incisor teeth. Endoscopic polypectomy was performed with "O"-type rubber band for endoscopic variceal ligation(EVL). A case of esophageal granular cell tumor conformed by S-100 protein stain is reported with the review of literature.
Adult ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Granular Cell Tumor* ; Humans ; Incisor ; Mouth ; Rubber ; S100 Proteins ; Skin ; Thorax ; Tongue ; Tooth

No abstract available.
Retroperitoneal Fibrosis*

Almost all advanced glomerular diseases have glomerular sclerotic changes to varying degrees whatever causes their primary glomerular disease are. Pathogenesis of these sclerosis has been thought of as the hyperfiltration in the primary glomerulosclerosis due to development of glomerular hypertension in each insulted glomeruli. This background gave the theoretical bases for antihypertensive therapies for supporting chronic renal insufficient patients. Angiotensin converting enzyme (ACE) inhibitor, one of the antihypertensive drugs, has received attention recently for its effectiveness. The aims of this study determined the effects and mechanism of the ACE inhibitor, enalapril, on the glomerulosclerosis in FGS/NgaKist mice, which was an animal model of chronic renal failure by generating spontaneously heavy proteinuria and progressive glomerulosclerosis. Five-week-old FGS/NgaKist mice (n=38) were assigned to four groups. Group 1a (n=6) and group 2a (n=8) fed with a vehicle, were sacrificed at the end of 10 weeks and 15 weeks, respectively. Group 1b (n=12) and 2b (n=12) received enalapril (100 mg/L) in drinking water for 5 weeks and 10 weeks from 6th week of age respectively, and were sacrified on the same day as the control groups. Doses of enanapril were maintained to 2 mg/kg/day by measuring the amount of water consumption. In enalapril groups 1b and 2b, systemic blood pressure (74.7 14.0 mm Hg, 74.3 15.9 mmHg) were significantly lower than control group 2a (116.1 4.6 mmHg, P<0.001). Similarly, degree of proteinuria lowered in enalapril group 2b versus control group 2a (0% and 50.0%, P<0.001). Glomerulosclerosis percentage significantly decreased (P<0.001) (group 1b and 2b; 1.9 6.5, 5.6 7.0 vs control 1a and 2a; 32.8 15.5, 31.4 13.8). Glomerulosclerosis score also decreased (P<0.001) (group 1b and 2b; 0.02 0.08 vs control 1a and 2a; 0.48 0.12, 0.30 0.14). The immunofluorescent staining of enalapril groups showed negative for mesangial deposition of IgG, IgA, IgM, and C3 which were positive in control groups. Immunohistochemical staining with TGF-beta1 was negative in enalapril groups and sclerotic glomeruli both enalapril groups and control groups. These results support that the ACE inhibitor has a renoprotective effect on glomerulosclerosis not only by decreasing the blood pressure but also by suppressing the immune deposits on glomeruli.
Angiotensins* ; Animals ; Antihypertensive Agents ; Blood Pressure ; Drinking ; Drinking Water ; Enalapril ; Humans ; Hypertension ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Kidney Failure, Chronic ; Mice ; Models, Animal ; Peptidyl-Dipeptidase A* ; Proteinuria ; Sclerosis* ; Transforming Growth Factor beta1

No abstract available.
Constriction, Pathologic* ; Humans ; Infant, Newborn* ; Pulmonary Artery* ; Systolic Murmurs*

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*

PURPOSE: The morphogenic mechanism of tetralogy of Fallot is known to be an antero-superior deviation and hypertrophy of the subpulmonary infundibulum. We performed this study to measure the subpulmonary infundibulum in patients with tetralogy of Fallot and compare those with normal control. METHODS: Echocardiographic data and medical reports of 12 patients, with classical tetralogy of Fa11ot who were diagnosed echocardiographically from Dec. 1996 to Jan. 1999 in Kyungpook National University Hospital, were retrospectively reviewed. A control group consisted of 11 children who underwent a complete echocardiographic examination for a heart murmur and were found to be structually norrnal. Measurements of the subpulmonary infundibulum were performed in systolic still frames with the subxiphoid short axis view. RESULTS: Compared with the normal control children, the following indexed infundibular dimensions in patients with tetralogy of Fallot were significantly smaller' volume, length, cross-sectional area, diameters of pulmonary valve annulus, main, left and right pulmonary arteries, PA index and McGoon ratio. The following measurements were increased in tetralogy patients ' the angle between infundibular septum and ventricular septum, and infundibular free wall thickness. CONCLUSION: We confirmed both antero-superior deviation of infundibular septum and infundibular hypoplasia as morphologic abnormalities in tetralogy of Fallot. We also revealed relatively equal contributions of shortening of infundibular length, and increased infundibular septal and free wall thickness to infundibular hypoplasia.
Axis, Cervical Vertebra ; Child ; Echocardiography ; Gyeongsangbuk-do ; Heart Murmurs ; Humans ; Hypertrophy ; Pulmonary Artery ; Pulmonary Valve ; Retrospective Studies ; Tetralogy of Fallot* ; Ventricular Septum

The population aged 95 years and older in Seoul approximately increased to five-fold over the past 10 years, while nationwide rates increased to three-fold. In order to examine the dietary habit and nutritional status of oldest-old population living in Seoul, we recruited 87 subjects (25 males and 62 females) aged 95 years and older. The prevalence of underweight (BMI < 18.5 kg/m2) and obesity (BMI > or = 25 kg/m2) were 18.2% and 18.2% in males, and 20.8% and 9.4% in females, respectively. In self-assessment of health, only 25.3% answered to be unhealthy. More males exercised regularly and reported a wide range of activities than females. The average of %Kcal from carbohydrate, protein and fat (C : P : F) was 64.9 : 13.8 : 21.2 in males and 68.1 : 14.2 : 17.7 in females. The average daily energy intake was 1,307 kcal in males and 1,304 kcal in females. More than 75% of subjects were taking under estimated average requirements (EAR) for vitamin B1, B2 & C and Ca. The average of mean adequacy ratio (MAR) was 0.66 in males and 0.70 in females, and 28.8% of males and 12.9% of females were in MAR < 0.50. Based on MAR, 32.0% of males and 14.5% females were classified as normal and 16.0% of males and 25.8% of females were classified as malnourished. Our subjects were taking more animal food, especially milk and its products, compared to those living, in rural areas. However, a significant proportion did not meet the EAR for vitamin B1, B2 & C and Ca.
Aged ; Animals ; Ear ; Energy Intake ; Female ; Food Habits ; Humans ; Male ; Milk ; Nutritional Status ; Obesity ; Prevalence ; Self-Assessment ; Thiamine ; Thinness

OBJECTIVES: Gallium 67(Ga-67) scintigraphy has been used to diagnose inflammatory and neoplastic diseases. We undertook a study to determine the clinical value of Ga- 67 renal scan in patients with various glomerular diseases. METHODS: Ga-67 scintigraphy was performed in 48 patients with various biopsy proven forms of renal diseases. Renal uptake in 48 patients images was graded as follow: Grade 0 = not visualization at 48 hours: 1 = faintly visualize: 2 = equal to uptake in spine: 3 = greater than over the spine: 4 = greater than activity over the liver. RESULTS: 1) Of the 48 patients, 31 were male, and mean age was 32 years. 11 patients had hypertension and 29 patients had hematuria. 2) Positive scintigram were seen in 40 of 48(83%) cases. In results of renal biopsy, IgA nephropathy(IgAN) was 15 patients, minimal change disease(MCD) was 14, focal segmental glomerulosclerosis (FSGS) was 8, membranoproliferative glomerulonephritis (MPGN) was 3, lupus nephritis(LN) was 3, poststreptococcal glomerulonephritis(PSGN) was 3 and membranous glomerulonephritis(MGN) was 2. 3) In 26 patients (54%) with nephrotic-range proteinuria, Grade 2 or higher renal uptake was observed in 9 (75%) of MCD, 5(100%) of FSGS, 2(100%) of LN and 3(75%) of IgAN. 4) In comparision nephrotics with non-nephrotics at biopsy, renal Ga-67 uptake in who patients had nephrotic-range proteinuria was correlated with clinical severity determined by serum albumin, serum total cholesterol and 24 hours urine protein excretion. CONCLUSIONS: Renal Ga-67 scintigraphy may be able to be a predictor in the assessment for severity of nephrotic syndrome.
Biopsy ; Cholesterol ; Gallium ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A ; Liver ; Male ; Nephrotic Syndrome ; Proteinuria ; Radionuclide Imaging* ; Serum Albumin ; Spine

PURPOSE: We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. MATERIALS AND METHODS: We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. RESULTS: The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83+/-SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83+/-SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. CONCLUSION: Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland.
Catheter Ablation* ; Follow-Up Studies ; Hoarseness ; Humans ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

Brain death is irreversible coma due to injury of brain hemisphere and brain stem regardless of any treatment. In brain-dead patients, acute respiratory failure frequently results from capillary endothelial damage in the lung and diabetes insipidus and hypothermia occur due to brain stem compression injury. Ultimately, it has been known that the brain-dead patients progress to multiple organ failure. The primary goal of organ donor management is maintenance of optimal physiologic environment for organs prior to recovery. This study is performed for suggesting the guideline of the prediction and management of complications in the brain-dead patient. We analyzed 6 brain-dead patients waiting for organ donation in the intensive care unit. The causes of brain death among the donors consisted of closed head injury in 4 patients, subarachnoid hemorrhage in 1, and drowning in l. AaDO2(alveolar-arterial oxygen tension difference) and PaO2F1O2 (arterial oxygen tension/fractional inspired O2 concentration) were analyzed to demonstrate the progress of respiratory failure. Body temperature, vital signs, urine output, serum osmolality, serum K(+), serum Na(+), AST(aspartate aminotransferase), ALT(alanine aminotransferase), BUN(blood urea nitrogen) and creatinine were also analyzed in all patients. Diabetes insipidus were found in 5 patients and hypothermia in 4 patients. AaDO increased and PaO2/F1O2 decreased in 5 patients with time. Hepato-renal function remained relatively normal during observation. We concluded that brain-dead patients rapidly progressed to acute respiratory failure. It can be suggested that for successeful organ transplantation, organ procurement should be performed as soon as possible after brain death was confirmed.
Body Temperature ; Brain ; Brain Death ; Brain Stem ; Capillaries ; Creatinine ; Diabetes Insipidus ; Drowning ; Head Injuries, Closed ; Humans ; Hypothermia ; Intensive Care Units ; Lung ; Multiple Organ Failure ; Organ Transplantation ; Osmolar Concentration ; Oxygen ; Respiratory Insufficiency ; Subarachnoid Hemorrhage ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; Urea ; Vital Signs