Central nervous system (CNS) manifestations in acquired immunodeficiency syndrome (AIDS) patients are an earlyand common feature. The spectrum of AIDS-related CNS diseases are encephalitis caused by the human immunodeficiency virus(HIV) itself, opportunistic infection, infarct and malignancy. We experienced two cases of CNS involvement in AIDS and they were serologically diagnosed as HIV encephalitis and CNS toxoplasmosis, respectively. In the case of the HIV encephalitis patient, brain MRI showed a non-enhancing lesion with high signal intensity on T2WI and low signal on T1WI and there was no mass effect on the right frontal lobe,periventricular white matter, splenium of the corpus callosum or bilateral basal ganglia. In the other case of CNS toxoplasmosis, MR showed multiple nodular and rim enhanced mass lesions in the right basal ganglia, thalamus and periventricular white matter, which were of low signal intensity on T1WI and of high intensity on T2WI. We thus report the related MRI findings.
Acquired Immunodeficiency Syndrome* ; Basal Ganglia ; Brain ; Central Nervous System Diseases ; Central Nervous System* ; Corpus Callosum ; Encephalitis ; HIV ; Humans ; Magnetic Resonance Imaging ; Opportunistic Infections ; Thalamus

The clinico-pathological observation was done on 28 children with recurrent hematuria, who had been admitted to the Pediatric ward of NMC from January 1981 to July 1991. The results were as follows; 1) Most of the children with recurrent hematuria were over 6 years of age(24 cases, 85.7%)and the sex ratio was about 2.5:1. 2) IgA nephropathy (17 cases, 60.7%) was the leading pathologic lesion and mild focal nonspecific glomerulonephritis (5 cases), membranous nephropathy (2 cases), minimal chage (2 cases), Alport syndrome (1case), abnormal glomerular basement membrane (1 case) followed. 3) Types of recurrent hematuria ware gross in 22 cases and microscopic in 6 cases. Flank pain was noted only 1 case. The prodromal events of hematuria were upper respiratory infection in 15 cases and severe exercise in 2 cases. 4) There were no significant differences in clinical features and laboratory findings between IgA nephropathy and other pathologic lesions, except for higher frequency of proteinuria in former group. 5) During the follow-up periods, three cases were resulted in chronic renal failure and they were two cases of IgA nephropathy Class IV and one case of Alport syndrome. And one case of IgA nephropathy was resulted in nephrotic syndrom.
Child ; Flank Pain ; Follow-Up Studies ; Glomerular Basement Membrane ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Hematuria* ; Humans ; Kidney Failure, Chronic ; Nephritis, Hereditary ; Proteinuria ; Sex Ratio

PURPOSE: This study investigated the changes of quality of life after the supplement of testosterone in the aging male partial androgen deficiency(PADAM). MATERIALS AND METHODS: The changes of subjective symptoms were estimated in 56 cases(experimental group: 48 cases, placebo group: 8 cases) with PADAM over 55 year-old, who were treated with transdermal testosterone(Androderm(R)) or a placebo patch by single blind method from September, 1997 to July, 1998. The 12.2mg testosterone patch was attached daily on the lower abdomen, thigh, upper arm and back on a period of three months. Laboratory tests were done on pretreatment and monthly after treatment, which include serum testosterone, PSA, cholesterol, AST and ALT. Changes in the quality of life were evaluated by the PNUH QOL system, which consisted of 21 questions inquiring the following 7 functions: metabolic, cardiopulmonary, musculoskeletal, gastrointestinal, neurologic, psychiatric and sexual function. RESULTS: The 56 cases showed an age distribution of 55-80 year-old(mean 64.3 year-old). During the follow-up period, the drop-out rate after treatment in the experimental group was 18 cases(37.5%) and 7 cases(14.6%) in the posttreatment 1st and 2nd months, respectively. Serum testosterone was significantly increased in the posttreatment 1st, 2nd, 3rd months when compared to pretreatment levels only in the experimental group(r=0.897, p=0.009). Prior to treatment, sexual dysfunction was inquired the most common problem, and followed by psychiatric, musculoskeletal, metabolic, cardiopulmonary, neurologic and gastrointestinal dysfunction in order. After treatment, sexual dysfunction showed the most improvement, and followed by metabolic, musculoskeletal, cardiopulmonary, psychiatric, gastrointestinal and neurologic dysfunction in order. Except for neurologic and gastrointestinal dysfunctions, other subjective symptoms improved in proportion to duration of treatment. The most common complication was a skin rash, which occured in 36 cases(64.2%) and caused the drop out of 14 cases(25%). CONCLUSIONS: According to the above results, it revealed that testosterone supplement therapy induced the improvement of the quality of life in PADAM. Therefore, treatment proctocols including indication, dosage and duration as well as the exact mechanism of the biological role of testosterone should be prepared to popularize hormonal therapy in PADAM.
Abdomen ; Age Distribution ; Aging* ; Arm ; Cholesterol ; Exanthema ; Follow-Up Studies ; Humans ; Male* ; Middle Aged ; Neurologic Manifestations ; Quality of Life* ; Single-Blind Method ; Testosterone* ; Thigh

BACKGROUND: Recently, body composition analyzer has been used widely clinically. Various indirectly measured values of body are calculated without direct measuring. The abdominal circumference that is presented by such instrument may be used for diagnosing abdominal obesity, but the reliable evidence of the accuracy and the validity may be not be enough for application to general population. For this reason, the author investigated the usefulness of automatically produced abdominal circumference for diagnosing abdominal obesity. METHODS: The medical records of 5,555 outpatients who had undergone body composition analysis in a tertiary hospital was collected. The usefulness of the automatically presented abdominal circumference for diagnosing abdominal obesity among general population was investigated. RESULTS: There was a significant positive correlation between abdominal circumference measured by body composition analyzer and measuring tape in the normal, the overweight, and the obese groups of both gender. But, the results were the same only in females in the underweight group. The most significant difference between the two values were 4.8+/-5.0 cm in normal male group and -5.7+/-5.5 cm in female obese group. The difference of the male obese group was lesser than that of the overweight, the normal and the underweight groups. The difference of the male overweight group was lesser than that of the normal group. The difference of the female obese group was lesser than that of the overweight, the normal and the underweight groups. The sensitivity and specificity to detect abdominal obese person among the total subjects was 76.3% and 79.1%, respectively. The specificity was higher in all male and the normal female groups, wheras the sensitivity was higher in the obese and the overweight female groups. CONCLUSION: Physicians should confirm the accuracy of abdominal circumference, especially in normal males and obese female group, although the automatically presented value is convenient and reflects the manually measured one very well which is useful to diagnose abdominal obesity.
Body Composition* ; Body Mass Index* ; Female ; Humans ; Male ; Medical Records ; Obesity, Abdominal ; Outpatients ; Overweight ; Sensitivity and Specificity ; Tertiary Care Centers ; Thinness ; Waist Circumference

PURPOSE: To determine whether the up-regulation of the differentiation related gene (Drg-1) enhances the progression of prostate cancer into the androgen independent phenotype, via escaping androgen signal transduction. MATERIALS AND METHODS: A full length of Drg-1 cDNA was obtained using the Drg-1 primer, which was inserted into LNCaP cells. The sensitivities of dihydrotestosterone and bicalutamide were then examined. In addition, the level of the Drg-1 gene expression was examined in derivatives of the LNCaP cell lines obtained from the orthotopic animal model. RESULTS: The Drg-1 transfected LNCaP cells, which highly expressed the Drg-1, were established (LNCaP/D2). The LNCaP/D2 slowly grew in a culture medium, supplemented with 10% charcoal stripped fetal bovine serum, whereas the control cells did not. When the sensitivities of DHT and bicalutamide were examined, the PC-3 and LNCaP/D2 cells were not sensitive to either. The metastatic androgen independent prostate cancer cells (LNCaP-AI-Lung), which were obtained from the orthotopic animal model, showed higher levels of Drg-1 expression than the parental cells. CONCLUSIONS: Androgen dependent prostate cancer cells, expressing high levels of the Drg-1 gene, behave like androgen independent prostate cancer cells. This finding suggest that the Drg-1 gene may play an important role in the initiation of an androgen-independent state.
Cell Line ; Charcoal ; Dihydrotestosterone ; DNA, Complementary ; Gene Expression ; Humans ; Models, Animal ; Parents ; Phenotype ; Prostate* ; Prostatic Neoplasms* ; Signal Transduction ; United Nations ; Up-Regulation*

Coronary stent dislodgement during percutaneous coronary intervention, which occurs when the stent is passed through tortuous and calcified lesions, is not a rare complication. Without proper treatment, such as fixing with another stent in the coronary artery or removing the undeployed stent from the coronary artery or systemic artery system, this complication can cause serious problems. We experienced the unusual situation of a dismounted and dislodged coronary stent, in which retrograde retrieval to the radial artery was impossible during transradial coronary intervention. We report on use of a rendezvous and snare technique at the brachial artery level via femoral puncture, which resulted in resolution without surgery.
Arteries ; Brachial Artery* ; Coronary Vessels ; Endovascular Procedures ; Percutaneous Coronary Intervention ; Punctures ; Radial Artery ; SNARE Proteins* ; Stents*

Pseudohypoparathyroidism(PHP) is a genetic disorder characterized by target cell resistance to the effect of parathyroid hormone(PTH). The disorder is classified into type I a, I b, I c and II depending on the phenotype and biochemical findings. In type I a, urinary cyclic AMP and urinary phosphate excretion are not increased after PTH stimulation because of deficient G unit activity in target cells. Deficiency of the G unit is a generalized cellular defect and accounts for the association of other endocrine disorders with type I a PHP. Type I b PHP shows resistance to PTH but not to other hormones and normal phenotypic appearance. In type I c PHP affected children have defect in catalytic unit of adenylate cyclase and in addition to resistance to PTH, resistance to the metabolic effects of TSH, gonadotropins, and glucagon may be detected. Typical appearance of Albright's hereditary osteodystrophy is common in PHP type Ia and Ic. In type II PHP, urinary cyclic AMP response is generated but this does not lead to phosphaturia. We experienced two patients with PHP. One is a 11-year-old girl diagnosed type I a PHP and the other is a 11-year-old boy suspected type I b PHP. They visited emergency room because of tetanic movement. Both patients had no previous history of tetany and showed low serum calcium level, high phosphorus level and high PTH level. The girl had typical features of Albright's hereditary osteodystrophy such as round face, short neck, obese feature, brachydactyly and mental retardation but didn't have basal ganglia calcification on brain CT. The boy showed normal appearance and no mental retardation.
Adenylyl Cyclases ; Basal Ganglia ; Brachydactyly ; Brain ; Calcium ; Child ; Cyclic AMP ; Emergency Service, Hospital ; Female ; Glucagon ; Gonadotropins ; Humans ; Hypophosphatemia, Familial ; Intellectual Disability ; Male ; Neck ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Tetany

Developing of digital technique, it is possible to fabricate implant prostheses for edentulous area using intraoral 3-dimentional information throughout implant diagnosis and treatment process. It is being changed that from the method using CAD/CAM, producing prostheses by model scanning after conventional impression and model processing, to the method of fabricating implant provisional restorations and customized abutments by digital impression after connecting digital impression copings (scanbody) and implant fixtures without models. But, this digital method has not been actively used for implant prostheses not yet. Specially, it is short of intraoral digital impression cases for immediate provisional restorations of the maxillary anterior implants. The gingival contour impression of maxillary anterior area is very important for esthetic restorations. Accordingly, in this case report, the using a digital impression coping (scanbody) and digital impression by CEREC Omnicam (Sirona, Bensheim, Germany) or Trios (3shape, Copenhagen, Denmark) were introduced for immediate provisional restorations in 3 cases needed a single implant restoration in maxillary anterior area. The clinical results were satisfactory on the convenience and accuracy of digital impression technique and the good esthetics of final restorations.
Diagnosis ; Esthetics ; Prostheses and Implants

Purpose: This study aims to investigate regional patterns and graft survival rates in kidney transplantation (KT) within South Korea using the National Health Insurance Service database. Methods: By analyzing KT data from 2002 to 2017, including patient residency, KT location, and post-KT dialysis information, graft survival was assessed through post-KT dialysis and validated against Ulsan University Hospital and the Korean Organ Transplantation Registry’s 2017 report. Results: Among the 20,978 KTs, 60.5% occurred in the Korean capital, Seoul, whereas 39.5% occurred outside. The overall graft survival rate was 81.5% with a median survival duration of 57 months. Patient survival was 83.8%, with a median survival duration of 61 months. For KTs from 2002 to 2007, the 10-year graft and patient survival rates were 89.1% and 90.3%, respectively. The KT recipients living outside Seoul who underwent the KT within their residential regions had a graft survival rate of 88.3%, and those receiving KTs outside their original region had a graft survival rate of 88.0%. Among Seoul residents who underwent KTs in the city, the graft survival rate was 90.5%. Importantly, hospital location did not significantly affect graft survival rates (P = 0.136). Conclusion This study revealed a regional preference for KT in South Korea, particularly in the capital city, likely because of nonresidents. Nevertheless, the graft and patient survival rates showed no significant regional disparities. These findings emphasize the necessity for equitable KT service access across regions in order to optimize patient outcomes.

OBJECTIVE: To investigate pathologic discrepancies between colposcopy-directed biopsy (CDB) of the cervix and loop electrosurgical excision procedure (LEEP) in women with cytologic high-grade squamous intraepithelial lesions (HSILs). METHODS: We retrospectively identified 297 patients who underwent both CDB and LEEP for HSILs in cervical cytology between 2015 and 2018, and compared their pathologic results. Considering the LEEP to be the gold standard, we evaluated the diagnostic performance of CDB for identifying cervical intraepithelial neoplasia (CIN) grades 2 and 3, adenocarcinoma in situ, and cancer (HSIL+). We also performed age subgroup analyses. RESULTS: Among the study population, 90.9% (270/297) had pathologic HSIL+ using the LEEP. The diagnostic performance of CDB for identifying HSIL+ was as follows: sensitivity, 87.8%; specificity, 59.3%; balanced accuracy, 73.6%; positive predictive value, 95.6%; and negative predictive value, 32.7%. Thirty-three false negative cases of CDB included CIN2,3 (n=29) and cervical cancer (n=4). The pathologic HSIL+ rate in patients with HSIL− by CDB was 67.3% (33/49). CDB exhibited a significant difference in the diagnosis of HSIL+ compared to LEEP in all patients (p<0.001). In age subgroup analyses, age groups <35 years and 35–50 years showed good agreement with the entire data set (p=0.496 and p=0.406, respectively), while age group ≥50 years did not (p=0.036). CONCLUSION A significant pathologic discrepancy was observed between CDB and LEEP results in women with cytologic HSILs. The diagnostic inaccuracy of CDB increased in those ≥50 years of age.