A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

OBJECTIVES: To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. METHODS: 581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. RESULTS: All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. CONCLUSIONS: We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.
Blood Pressure ; Cholesterol ; Female ; Gynecology ; Hospital Records ; Hospitals, Veterans ; Humans ; Hypertension ; Hysterectomy* ; Korea ; Obesity* ; Risk Factors ; Smoke ; Smoking ; Triglycerides

BACKGROUND: Eruptive syringoma is a very rare variant of syringoma and arises most frequently on the anterior trunk of young people. Because eruptive syringoma represents clinically a very rare distinct entity, clinicopathologic studies rarely have been described in literature. OBJECTIVE: The aim of this study is to characterize clinical and histopathologic findings of eruptive syringomas which were diagnosed by histopathologic examination for a 10 year period in Asan medical center. METHODS: The hospital records, clinical history, and biopsy slides of 13 eruptive syringoma were reviewed retrospectively. RESULTS: There were 5 men(38%) and 8 women (62%) with the mean age of 31 years. The mean age of onset was 23 years and 3 patients(23%) presented the lesions before puberty. The most frequently involved sites were anterior trunk, axilla, upper extremities, neck, and face in descending order. The most common initial clinical diagnosis was verruca plana(38%). Most of the lesions did not show self-limiting course and several treatment modalities including oral isotretinoin or CO2 laser were not so effective. All cases showed characteristic histopathologic features of syringoma and 76% of them revealed increased basal melanin pigment or pigmentary incontinence. CONCLUSION: Eruptive syringoma should be included in the differential diagnosis of flat papular lesions by histopathologic examination and it may help to avoid inappropriate therapeutic approach.
Adolescent ; Age of Onset ; Axilla ; Biopsy ; Chungcheongnam-do ; Diagnosis ; Diagnosis, Differential ; Female ; Hospital Records ; Humans ; Isotretinoin ; Lasers, Gas ; Melanins ; Neck ; Puberty ; Retrospective Studies ; Syringoma* ; Upper Extremity ; Warts

Benign symmetric lipomatosis is characterized by diffuse symmetric deposits of nonencapsulated fat, generally affecting the cervical and upper dorsal regions. There is a history of alcohol abuse in nearly all the cases. It is rarely reported in non-drinkers. Herein we report a 63-year-old man presenting with one year's history of multiple ill-defined symmetric soft mass on posterior neck, upper trunk and upper extremities without the history of alcohol abuse. We ad-ministered corticosteroid orally due to osteoarthritis of the knee for a long time.
Alcoholism ; Humans ; Knee ; Lipomatosis* ; Middle Aged ; Neck ; Osteoarthritis ; Upper Extremity

BACKGROUND: Because of widespread and long-term use of lead, many lead poisoning cases were reported. Especially, in Korea including Southeast Asia, we observed non-occupational lead poisoning cases by herbal medication. METHODS: We identified total 45 cases of lead poisoning through Medric search, from 1973 to 2002. Bibliographies of relevant articles were reviewed. We arranged cases by attributes following 1) reported year, 2) age, 3) sex, 4) exposure sources, 5) exposure duration, 6) clinical manifestation, 7) treatments. RESULTS: The average age of the patients was 41.4 +/- 15.7 year-old. The distribution by sex did not have difference each other. The non-occupational lead poisoning cases were mostly caused by Chinese herbal medication. On the cases of the herbal lead poisoning, average exposure duration was 7.3 +/- 3.8 months and the various dosages were taken from 5 mg to 3 g. The major clinical symptoms were abdominal pain, headache, and constipation. The typical laboratory finding was anemia. Major treatment agent was oral penicillamine. CONCLUSION: To differential diagnose of the lead poisoning from many diseases with similar symptoms is very difficult solely on the clinical aspect. Especially, in non-occupational cases it is more difficult. In Korea, non-occupational lead poisoning cases by herbal medication have been discovered more than in western countries. We reviewed about the lead poisoning cases since 1973, so we want to make an aware of scientific and rational making and management of lead in the health supplementary food and herbal medicine.
Abdominal Pain ; Anemia ; Asia, Southeastern ; Asian Continental Ancestry Group ; Constipation ; Headache ; Herbal Medicine ; Humans ; Korea* ; Lead Poisoning* ; Penicillamine

Mitochondrial myopathies are diseases caused by defects in metabolic pathway of mitochondria. Mitochondrial myopathy is known as one of the causes of recurrent myoglobinuria, while clinically, rarely causes acute renal failure requiring medical treatments. We report a case of rhabdomyolysis and acute renal failure associated with mitochondrial myopathy. A 58-year-old male was presented with dyspnea and hypotensive shock. The patient had a history of recurrent dark colored urine and cramping leg pain after prolonged fasting. Laboratory findings showed hyperkalemia, azotemia, metabolic acidosis, and elevated AST, ALT, and creatinine kinase. He had no history of trauma or medication. Muscle biopsy showed "ragged red fibers" in modified Gomori staining. On electron microscope, increased number of mitochondria and abnormal mitochondria were seen. He received hemodialysis and his renal function recovered after 1 month.
Acidosis ; Acute Kidney Injury* ; Azotemia ; Biopsy ; Creatinine ; Dyspnea ; Fasting ; Humans ; Hyperkalemia ; Leg ; Male ; Metabolic Networks and Pathways ; Middle Aged ; Mitochondria ; Mitochondrial Myopathies* ; Muscle Cramp ; Myoglobinuria ; Phosphotransferases ; Renal Dialysis ; Rhabdomyolysis* ; Shock

Laminin, an extracellular matrix glycoprotein composed of three polypeptide chains such as alpha , beta, and gamma is distributed in basement membranes of epithelium, muscle, and nervous tissues. Laminin functions as an extracellular cytoskeleton and regulates the differentiation and polarization of cells adjacent to the basement membrane. Along with type IV collagen and heparan sulfate proteoglycan, laminin forms a spike -like structure in the renal glomerular basement membrane (GBM). It has been previously demonstrated that the distribution and immune reaction of laminin are changed in response to the conditions of glomerulonephritis and that laminin plays a role in the reformation of GBM as well as the regeneration of renal glomerular cells. In the present study, the profile of expression and distribution of laminin/laminin beta1 chain were examined in different developmental stages and upon adriamycin administration. Kidney obtained from fetuses (16, 18, and 20 days old) and infants (1 and 7 days old) of Sprague -Dawley rats were either cryosectioned for immunohistochemical assays or ultrathin -sectioned for electron microscopy using immunogold staining methods. The results were as follows: 1. Intensive expression of laminin was observed in the GBM and surrounding mesenchymal tissues obtained from 16, 18, and 20 days old fetuses and in the glomerulus from one day neonates, whereas the level of staining decreased in the glomerulus from 7 days old infants. 2. Immunogold particles were observed in the comma -shaped nephron, in particular in cisternae of rough endoplasmic reticulum, vesicles and nuclear membrane of endothelial cells and mesangial cells obtained from 18 days old fetuses. 3. The immune reactions of laminin beta1 chain were trace detected in the kidney from fetuses (16, 18, and 20 days old) and weakly in tissues surrounding blood capillary and mesangial tissues from one day old neonates. 4. After 24 hours following adriamycin treatment, the reactivity of laminin was slightly enhanced in the renal glomerulus, when compared with that of untreated controls. This enhancement persisted up to 1 week of adriamycin treatment. Laminin beta1 chain was weakly detectable, while further treatment with adriamycin for another 24 hours reduced the intensity of laminin beta1 chain. Taken together, these results suggest that laminin is localized in the GBM at the high level during early fetal stages but the expression levels decrease after birth. Moreover, administration with adriamycin may result in an increase in the immune reactivities of laminin and laminin beta1 chain by renal tissue damage followed by renal regeneration.
Animals ; Basement Membrane ; Capillaries ; Collagen Type IV ; Cytoskeleton ; Doxorubicin ; Endoplasmic Reticulum, Rough ; Endothelial Cells ; Epithelium ; Extracellular Matrix ; Fetus ; Glomerular Basement Membrane ; Glomerulonephritis ; Glycoproteins ; Heparan Sulfate Proteoglycans ; Humans ; Infant ; Infant, Newborn ; Kidney* ; Laminin* ; Mesangial Cells ; Microscopy, Electron ; Nephrons ; Nuclear Envelope ; Parturition ; Rats* ; Regeneration

Adult intusussception is a rare entity and this usually has a definable cause. We describe here two cases of adult patients with ileocolic intussusception that was secondary to a lymphoma of the cecum. The one patient was a 23-year-old man. We diagnosed ileocolic intussusception by performing abdominal computed tomography. At laparotomy, a 5.0 x 5.0 cm polypoid tumor was found in the cecum. Histologic examination disclosed the diffuse large B-cell lymphoma. The other patient was a 32-year-old man. Preoperatively, we diagnosed intussusception in the ileocolic lesion by performing a barium study and computed tomography. At laparotomy, a 3.1 x 4.0 cm tumor was found in cecum, and histologic examination revealed the diffuse small noncleaved type lymphoma (Burkitt's lymphoma). So far as we are aware, this is the first report of a Korean adult patient with intussusception that was secondary to a cecal lymphoma, and it was not secondary to an ileal lymphoma.
Adult ; Barium ; Cecum ; Humans ; Intussusception ; Laparotomy ; Lymphoma ; Lymphoma, B-Cell ; Young Adult

Hair follicle nevus is a very rare hair follicle tumor and should be differentiated from other hair follicle hamartomas, such as trichofolliculoma, dilated pore of Winer, pilar sheath acanthoma, and trichodiscoma. We describe a 4-year-old female patient who presented erythematous papule on the face that was histopathologically diagnosed as hair follicle nevus.
Acanthoma ; Child, Preschool ; Female ; Hair Follicle* ; Hair* ; Hamartoma ; Humans ; Nevus*

Palmoplantar keratodermas are divided into autosomal dominant and autosomal recessive groups by the mode of transmission. The autosomal dominantly transmitted group is further divided into epidermolytic and nonepidermolytic types according to the histological findings. Hereditary epidermolytic palmoplantar keratoderma manifests clinically as a localized thickening of the palms and soles. Herein we report a 29-year-old woman showing the typical clinical and histologic features of epidermolytic palmoplantar keratoderma without family history. This case could be spontaneous mutations that will later breed a true autosomal dominant trait.
Adult ; Female ; Humans ; Keratoderma, Palmoplantar ; Keratoderma, Palmoplantar, Epidermolytic*