PURPOSE: The purpose of this study was to evaluate the CT findings of acute pyelonephritis (APN) in children and to assess the correlation between these findings, clinical parameters and renal scar development, as seen on follow-up CT scans. MATERIALS AND METHODS: Contrast-enhanced CT scans of thirty children in whom APN had been diagnosed were assigned to one of three groups according to whether an abscess had formed, and then to subgroups on the basis of the number of lesions in the renal parenchyme. Initial CT findings were retrospectively correlated with five clinical parameters (maximal body temperature, fever duration, leukocytosis, pyuria and admission period) and renal scar development, as seen on follow-up CT (n=12). RESULTS: CT scans demonstrated linear, wedge-shaped, low-density renal parenchymal lesions in 35 kidneys of 25 patients and abscesses in seven kidneys of seven patients, but no abnormal lesions in five patients. In the three groups there was correlation between these findings and some clinical parameters (maximal body temperature, fever duration and admission period), but no subgroup showed significant correlation with any clini-cal parameter. Renal cortical scars detected by follow-up CT were more prevalent in patients in whom initial CT demonstrated the presence of an abscess. CONCLUSION: Clinical parameters correlated with the presence of renal parenchymal hypoenhancing lesions and abscess formation, as seen on CT scans, rather than the number of renal parenchymal lesions. Renal cortical scars were more prevalent in patients in whom initial CT revealed the presence of an abscess. Enhanced CT is thought to be useful both for diagnosing APN and for predicting its clinical course in children.
Abscess ; Body Temperature ; Child ; Cicatrix ; Fever ; Follow-Up Studies ; Humans ; Kidney ; Leukocytosis ; Pyelonephritis* ; Pyuria ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Humans ; Infant, Newborn* ; Mothers* ; Thrombocytopenia

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

Intraluminal duodenal diverticulum (IDD) is a rare congenital abnormality, consisting of a sac-like mucosal lesion in the duodenum. Cases of IDD can present with gastrointestinal bleeding, duodenal obstruction, or pancreatitis. Here, we report a rare case of a 25-year-old female presenting with IDD complicated by duodeno-duodenal intussusception and recurrent pancreatitis. The diagnosis was based on findings from radiologic examinations (CT and MRI), upper gastrointestinal series (barium swallow), and gastroduodenofiberscopy. Laparoscopic excision of the presumed duodenal duplication was performed. The subsequent histopathologic evaluation of the excised sac revealed normal mucosa on both sides, but the absence of a proper muscle layer confirmed the diagnosis of IDD. Radiologic detection of a saccular structure in the second portion of the duodenum can indicate IDD with duodeno-duodenal intussusception as the lead point

No abstract available.
Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Immunomodulation*

Almost all colorectal carcinomas have been thought to develop from pre-existing adenomas. However, some colorectal carcinomas can arise directly from normal flat mucosa, and usually form infiltrative mass at the early stage. The carcinogenesis of this infiltrative carcinoma may be different from the well-known adenoma-carcinoma sequence, which usually forms a polypoid mass. The purpose of this study is to investigate the different expression of various oncogenes in polypoid carcinoma and infiltrative carcinoma. We performed immunohistochemical staining on p53, bcl-2, c-erbB-2 and MIB-1 in 29 polypoid carcinomas arised from adenomas, and 21 infiltrative carcinomas. The average tumor size of infiltrative carcinomas (5.5 cm) was larger than that of polypoid carcinomas (3.1 cm), and the polypoid carcinomas were differentiated more than the infiltrative carcinomas. The results of p53, bcl-2, c-erbB-2, and MIB-1 antisera immunoreactivity in the polypoid carcinoma were 79%, 17%, 21%, and 100%, and those in the infiltrative carcinoma were 71%, 29%, 29%, and 100%, respectively. However the diffuse positivities of p53 and MIB-1 antisera were slightly higher in the infiltraive carcinomas (62%, 76%) than in the polypoid carcinomas (55%, 41%) (p=0.63, 0.01). And the results of p53 and c-erbB-2 immunoreactivity in the adenomas were 52% and 17%, respectively, which is significantly lower than that in the polypoid carcinoma(p=0.03, 0.74). The immunoreactivty of bcl-2 in the adenoma was 72%, which was significantly higher than that in the polypoid carcinoma (17%) (p<0.01). In summary, we did not show the significant difference in expression of p53, bcl-2, c-erbB-2, and MIB-1 proteins between polypoid and infiltrative carcinomas. However, the tendency of infiltrative carcinomas having a more aggressive nature suggests another carcinogenetic mechanism is involved in the colorectal carcinogenesis.
Adenoma ; Carcinogenesis ; Colorectal Neoplasms* ; Immune Sera ; Ki-67 Antigen ; Mucous Membrane ; Oncogenes

No abstract available.
Breast* ; Hamartoma*

Pyelitis and ureteritis cystica which is characterized by cyst formations mucosa or submucosa of the ureter and renal pelvis caused by inflammation. We are reporting a case of ureteritis cystica with review of the literatures.
Inflammation ; Kidney Pelvis ; Mucous Membrane ; Pyelitis* ; Ureter*

BACKGROUND: Churg-Strauss syndrome (CSS) is characterized by disseminated vasculitis with multi-organ involve-ment. The purpose of this study was to determine the frequency and the types of neurologic involvement in a series of patients with CSS. METHODS: We reviewed the medical records of 16 patients (seven men and nine women, age = 41.9 (18.6) with CSS who were examined at Seoul National University Hospital. The diagnosis of CSS was based on the presence of asthma, peripheral eosinophilia (more than 10% eosinophiles), and histopathological or clinical findings of vasculitis. RESULTS: Of the 16 patients, 12 (75%) had neurologic involvement. Nine (56%) had neurologic symptoms as initial presentations of CSS. Peripheral neuropathy was detected in nine patients (56%) ; six had multiple mononeu-ropathy, and three had distal symmetric polyneuropathy. Three patients (19%) had cerebral infarctions; in two of them, a delayed diagnosis of CSS caused the recurrence of ischemic stroke. Corticosteroid therapy combined with immuno-suppressive agents usually yielded improvement or stabilization of symptoms. CONCLUSIONS: Neurologic involvement is common in CSS, usually manifesting as peripheral neuropathy. Neurologic symptoms are important initial manifesta-tions at the time of diagnosis of CSS. Furthermore, cerebral involvement is not uncommon; thus any neurologic symp-toms in patients with asthma or eosinophilia prompts an aggressive diagnostic approach to CSS.
Asthma ; Cerebral Infarction ; Churg-Strauss Syndrome* ; Delayed Diagnosis ; Diagnosis ; Eosinophilia ; Female ; Humans ; Male ; Medical Records ; Neurologic Manifestations* ; Peripheral Nervous System Diseases ; Polyneuropathies ; Recurrence ; Seoul ; Stroke ; Vasculitis

BACKGROUND: Churg-Strauss syndrome (CSS) is characterized by disseminated vasculitis with multi-organ involve-ment. The purpose of this study was to determine the frequency and the types of neurologic involvement in a series of patients with CSS. METHODS: We reviewed the medical records of 16 patients (seven men and nine women, age = 41.9 (18.6) with CSS who were examined at Seoul National University Hospital. The diagnosis of CSS was based on the presence of asthma, peripheral eosinophilia (more than 10% eosinophiles), and histopathological or clinical findings of vasculitis. RESULTS: Of the 16 patients, 12 (75%) had neurologic involvement. Nine (56%) had neurologic symptoms as initial presentations of CSS. Peripheral neuropathy was detected in nine patients (56%) ; six had multiple mononeu-ropathy, and three had distal symmetric polyneuropathy. Three patients (19%) had cerebral infarctions; in two of them, a delayed diagnosis of CSS caused the recurrence of ischemic stroke. Corticosteroid therapy combined with immuno-suppressive agents usually yielded improvement or stabilization of symptoms. CONCLUSIONS: Neurologic involvement is common in CSS, usually manifesting as peripheral neuropathy. Neurologic symptoms are important initial manifesta-tions at the time of diagnosis of CSS. Furthermore, cerebral involvement is not uncommon; thus any neurologic symp-toms in patients with asthma or eosinophilia prompts an aggressive diagnostic approach to CSS.
Asthma ; Cerebral Infarction ; Churg-Strauss Syndrome* ; Delayed Diagnosis ; Diagnosis ; Eosinophilia ; Female ; Humans ; Male ; Medical Records ; Neurologic Manifestations* ; Peripheral Nervous System Diseases ; Polyneuropathies ; Recurrence ; Seoul ; Stroke ; Vasculitis