No abstract available.
Granuloma* ; Microsporum* ; Tinea*

Cardiac tamponade with pleural and pericardial effusion is a rare but life-threatening complication of umbilical venous catheterization in the newborn. It requires a timely diagnosis and urgent treatment, such as pericardiocentesis, to save lives of affected patients. Recently, we experienced a 7 day-old, very low birth weight infant, who developed a cardiac tamponade with pleural and pericardial effusions complicated by umbilical venous catheterization. The patient was successfully treated with pleural and pericardial drainages. Here, we report this case with a review of literature, since there has been no such previous case reported in Korea.
Cardiac Tamponade* ; Catheterization ; Catheters ; Diagnosis ; Humans ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Korea ; Pericardial Effusion* ; Pericardiocentesis ; Pleural Effusion

Spinal gabapentin and adenosine have been known to display an antinociceptive effect. We evaluated the nature of the interaction between gabapentin and adenosine in formalin-induced nociception at the spinal level. Male Sprague-Dawley rats were prepared for intrathecal catheterization. Pain was evoked by injection of formalin solution (5%, 50 microliter) into the hindpaw. After examination of the effects of gabapentin and adenosine, the resulting interaction was investigated with isobolographic and fractional analyses. Neither gabapentin nor adenosine affected motor function. Gabapentin or adenosine decreased the sum of the number of flinches during phase 2, but not during phase 1 in the formalin test. Isobolographic analysis, in phase 2, revealed an additive interaction between gabapentin and adenosine. Taken together, intrathecal gabapentin and adenosine attenuated the facilitated state and interacted additively with each other.
*Adenosine/administration & dosage/metabolism/therapeutic use ; *Amines/administration & dosage/metabolism/therapeutic use ; *Analgesics/administration & dosage/metabolism/therapeutic use ; Animals ; *Cyclohexanecarboxylic Acids/administration & Dose-Response Relationship, Drug ; Formaldehyde/*toxicity ; Injections, Spinal ; Male ; Motor Activity/physiology ; Pain Measurement ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; *gamma-Aminobutyric Acid/administration & dosage/metabolism/therapeutic

OBJECTIVE: A fibrin sealant is commonly applied after closure of an incidental or intended durotomy to reduce the complications associated with the leakage of cerebrospinal fluid. Routine usage might not be essential after closure of an intended durotomy, which has clear cut-margins. We investigated the efficacy of fibrin sealants for primary intradural spinal cord tumor surgery. METHODS: A retrospective review was performed for 231 consecutive surgically treated patients with primary intradural spinal cord tumors without extradural extension. Fibrin sealants were not used for 47 patients (group I: age, 51.57±16.75 years) and were applied to 184 patients (group II: age, 48.8±14.7 years). The surgical procedures were identical except for the use of a fibrin sealant after closure of the durotomy. The primary outcome was the occurrence of complications (wound problems, hematoma collection, infection, and neurological deterioration). The covariates were age, sex, body mass index, operation time, pre-/postoperative ambulation, number of laminectomies, and type of tumor. RESULTS: Schwannoma was the most common pathology (n=134), followed by meningioma (n=35) and ependymoma (n=31). Complications occurred in 13 patients (3 in group I and 10 in group II, p=0.73). The postoperative ambulation status (p<0.01; odds ratio, 28.8; 95% confidence interval, 6.9-120.0) and operation time (p=0.04; cutoff, 229 minutes; sensitivity, 62%; specificity, 72%) were significant factors, whereas the use of a fibrin glue was not (p=0.47). CONCLUSION: The use of a fibrin sealant might not be essential to reduce complications after surgery for primary spinal intradural tumor.
Body Mass Index ; Cerebrospinal Fluid ; Ependymoma ; Fibrin Tissue Adhesive* ; Fibrin* ; Hematoma ; Humans ; Laminectomy ; Meningioma ; Neurilemmoma ; Odds Ratio ; Pathology ; Retrospective Studies ; Sensitivity and Specificity ; Spinal Cord Neoplasms ; Spine ; Surgical Wound Infection ; Walking

Congenital lobar emphysema (CLE) is an overinflation of infantile pulmonary lobe caused by air trapping within the affected area. This is usually diagnosed on radiological findings postnatally. Most cases present in the neonatal period with signs of acute or chronic respiratory distress. There are only a few reports of CLE in the literature with prenatal sonographic feature documented. The routine use of prenatal sonography has helped to find fetal anomalies, such as fetal lung mass, that pose a challenge to early diagnosis, appropriate counselling, postnatal follow-up, and better outcome. A boy with CLE was detected by prenatal sonogram. He had a uniformly echogenic right lung with mediastinal shift to the left which was suspected type III congenital cystic adenomatoid malformation prenatally. He showed no evidence of respiratory distress at birth, but experienced progressive tachypnea and chest retraction. He had right middle lobectomy on the seventh postnatal day and pathologic diagnosis of CLE had been made. We report this rare case with brief review of literature. This is the first domestic case which was detected prenatally and confirmed pathologically after lobectomy.
Cystic Adenomatoid Malformation of Lung, Congenital ; Diagnosis ; Early Diagnosis ; Emphysema* ; Follow-Up Studies ; Humans ; Lung ; Male ; Parturition ; Tachypnea ; Thorax ; Ultrasonography

OBJECTIVE: Growing evidence suggests the separate associations of apolipoprotein E e4 allele (apo E4) and depression with incident dementia. This study investigated the separate and combined effects of apo E4 and depression on the incidence of dementia in both men and women. METHODS: Of 625 elderly without dementia at baseline, 518 (83%) were followed over a 2.4-year period and were assessed clinically for incident dementia. The apo E polymorphism was ascertained, and depression was identified using the Korean version of the Geriatric Depression Scale (KGDS). Covariates included age, gender, education, disability, alcohol history, physical activity, and vascular risk factors. RESULTS: The incidence of dementia was significantly higher in elderly Koreans with both apo E4 and depression compared to those without both factors [adjusted odds ratio (95% CI)=5.85 (1.77-19.38)]. This interaction was significant in men (p=0.049), but not in women (p=0.354). CONCLUSION: Depressed elderly people are at great risk for incident dementia in the presence of apo E4. Potential gender differences require further evaluation.
Aged ; Alleles ; Alzheimer Disease ; Apolipoprotein E4 ; Apolipoproteins ; Apolipoproteins E ; Dementia ; Depression ; Female ; Genotype ; Humans ; Incidence ; Male ; Motor Activity ; Odds Ratio ; Risk Factors

Malignant lymphoma of the bladder is a rare lesion, representing approximately 0.2% of the primary lesions and approximately 1.8% of the secondary lesions. A disseminated lymphoma presenting as a bladder mass is an infrequent phenomenon. The authors report the case of a 71-year-old patient with concurrent bladder lymphoma and bladder cancer presenting as metastatic bladder cancer. To the best of our knowledge, this is the first report of concurrent bladder lymphoma and bladder cancer.
Aged ; Carcinoma, Transitional Cell ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND: Vancomycin assay was performed to evaluate the clinical significance of therapeutic drug monitoring (TDM) of vancomycin and to compare pharmacokinetic parameters of vancomycin in our patients with population pharmacokinetic parameters. METHODS: In seventy-eight patients (45 males, 33 females), vancomycin serum concentrations were measured by fluorescence polarization immunoassay. At steady-state, peak levels were obtained one hour postinfusion, and trough levels were obtained just before a next dose. And also predicted serum vancomycin levels were determined by CAPCIL program in all subjects and compared with measured values, respectively. All patients were divided into two groups. Sixty-two patients in group I had a creatinine concentration in serum of < or =1.2 mg/dL and sixteen patients in group IIhad abnormal renal function as defined by a creatinine concentration in serum of >1.2 mg/dL. Follow-up second vancomycin concentrations were measured in 22 of 78 patients several days after initial TDM and were compared with initial TDM results. RESULTS: Mean values of peak and trough vancomycin concentration were 30.1 and 10.4, and 37.3 and 14.5 microgram/mL in groups I, and II, respectively. Predicted mean values of those were 26.3 and 9.2, and 28.2 and 7.8 microgram/mL in groups I, and II, respectively. Statistically significant differences between predicted and measured values in peak levels of group I,and IIand in trough level of group IIwere observed (P<0.01). Dose modification were required in 13 (21%) of 62 patients with normal renal function, and in 9 (56%) of 16 patients with abnormal renal function. Among 79 paired samples with a trough value below 15 mg/L, there were no peaks greater than 40 mg/L except two samples. CONCLUSION: Significant differences were noted between predicted and measured serum vancomycin concentrations and so TDM of vancomycin is needed to obtain effective dose and interval of vancomycin. More data about measured peak and trough values should be collected to establish pharmacokinetic parameters of vancomycin in Korean population.
Creatinine ; Drug Monitoring* ; Fluorescence Polarization Immunoassay ; Follow-Up Studies ; Humans ; Male ; Vancomycin*

PURPOSE: Transrectal ultrasound-guided prostate needle biopsy (TRUS-PBx) is the standard procedure to diagnose prostate cancer. We evaluated the incidence and risk factors of infectious complications, the species cultured and rates of resistance for antibiotics of microorganism in infectious complications after TRUS-PBx. MATERIALS AND METHODS: We retrospectively evaluated the medical records of 742 patients who underwent TRUS-PBx from January 2004 to May 2007. All patients were treated with intravenous ciprofloxacin and oral ciprofloxacin for 1 week after discharge. Patients who presented infectious complications were performed chest x-ray, blood analysis, urine analysis and culture studies. RESULTS: Among 742 patients, 15 patients (2.0%) developed infectious complications. There were no significant differences between the complication and non-complications groups in age, PSA, prostate volume, nodule, hypoechoic lesion on transrectal sonography and underlying medical diseases. Twelve cases were performed in outpatient department and 3 cases were in operation room and that suggests high frequency of infectious complication when transrectal prostate biopsy is performed in outpatient department (p=0.007). Six kinds of microorganisms were cultivated in 12 patients (1.9%). E. coli (7/12) was most common. Extended-spectrum beta-lactamase suggesting nosocomial infection was positive in 3 cases of outpatient department. On logistic regression analysis, urethral catheter indwelling was a significant risk factor increasing infectious complications. CONCLUSIONS: After TRUS-PBx, the rate of severe infectious complications and nosocomial infections were more frequent in outpatient department. And urethral catheter indwelling significantly increased infectious complication rate. So we should sublate the urethral catheter and keep in mind the aseptic technique at outpatient department.
Anti-Bacterial Agents ; beta-Lactamases ; Biopsy ; Biopsy, Needle ; Ciprofloxacin ; Cross Infection ; Humans ; Incidence ; Logistic Models ; Medical Records ; Needles ; Outpatients ; Prostate ; Prostatic Neoplasms ; Retrospective Studies ; Risk Factors ; Thorax ; Urinary Catheters

PURPOSE: To investigate the relationship of transrectal ultrasound (TRUS) findings with the pathological characteristics of prostate cancer (PCa). MATERIALS AND METHODS: The study was conducted retrospectively by analyzing the data for 970 patients who underwent prostate biopsies. Gleason scores and other clinical variables were compared between PCa patients with and without hypoechoic lesions on TRUS. RESULTS: Of the 970 patients, PCa was diagnosed in 291 (30%). Of these, high-grade PCa (Gleason score of 7 or more) was diagnosed in 190 (65%). The cancer detection rate was higher in patients with hypoechoic lesions (43.9%) than in those without hypoechoic lesions (21.4%, p<0.001). High-grade PCa was detected more often in patients with hypoechoic lesions than in those without hypoechoic lesions (p<0.001). Independent predictors for high-grade PCa by logistic regression analysis included hypoechoic lesions on TRUS and abnormal digital rectal examination findings. CONCLUSIONS: Patients with PCa who had hypoechoic lesions on TRUS had more aggressive pathological disease than did those without lesions. Therefore, hypoechoic lesions on TRUS could be a marker for clinically significant PCa.
Biomarkers ; Biopsy ; Digital Rectal Examination ; Humans ; Logistic Models ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Retrospective Studies