Renal tuberculosis commonly involves the urinary tract and results in multifocal fibrosis and stricture. Rarely, it presents as a renal mass with or without urinary tract abnormality. The radiologic features of this rare pseudotumor have not been sufficiently described in the previous literature, and we now report a case of tuberculosis presenting as an isolated renal mass and multiple hepatic nodules without evidence of associated urinary tract abnormality. The condition mimicked malignant neoplastic disease and occurred in a patient who had undergone chemotherapy for leukemia.
Constriction, Pathologic ; Drug Therapy ; Fibrosis ; Humans ; Immunocompromised Host* ; Leukemia ; Tuberculosis ; Tuberculosis, Renal* ; Urinary Tract

BACKGROUND: Neuroendocrine tumors of the pancreas are classified according to the endocrine function as insulinomas gastrinomas somatostatinomas, or nonfunctioning tumors. However, the morphologic features are not different from each other. Therefore, we tried to compare correlations among the morphologic features, endocrine function, and the immunohistochemical reaction with specific monoclonal antibodies to the tumors. METHOD: We reviewed the medical records of seven patients with pancreatic neuroendocrine tumors retrospectively, and analysed the clinical manifestations, the methods of diagnosis, the pathological characteristics and the results of surgery. Additionally, we compared the correlation between the clinical manifestations and the expression of immunohistochemical staining by using six different kinds of monoclonal antibodies to each tumor. RESULTS: The seven pancreatic neuroendocrine tumor patients were treated by surgical excision. Four patients had benign insulinomas, two had nonfunctioning malignant tumor and one patient had a benign nonfunctioning tumor associated with stomach cancer. The pattern of immunohistochemical stain of each tumor was not correlate with the clinical manifestations. CONCLUSION: The morphologic study with H & E stain, even with immunohistochemical staining of pancreatic neuroendocrine tumor, cannot support differentiation of the functional diagnoses, such as insulinoma, gastrinoma, somatostatinoma, nonfunctional tumors and so forth.
Antibodies, Monoclonal ; Diagnosis ; Gastrinoma ; Humans ; Insulinoma ; Medical Records ; Neuroendocrine Tumors* ; Pancreas ; Retrospective Studies ; Somatostatinoma ; Stomach Neoplasms

PURPOSE: Metacarpal fractures are common hand injury that may require operative intervention to ensure adequate reduction and stabilization. Traditionally, titanium miniplate was used for rigid fixation of bone fractures. However, the use of permanent plate lends itself to multiple complications such as infection, exposure of the hardware, tendon adhesions, tendon rupture, prolonged pain, bony atrophy and osteoporosis (stress shielding), metal sensitization, and palpation under the skin. This study evaluated the usefulness and stability of biodegradable plates and screws for treatment of metacarpal bone fractures. METHODS: There was 17 patients who had surgery for metacarpal bone fracture from April 2007 to June 2010. All patients had open reduction and internal fixation. We used absorbable plates and screws (Inion CPS(R)) for internal fixation. Postoperative results were assessed with x-ray. Stability of plates and screws, healing process and its complications were observed by clinical and radiographic assessment. RESULTS: All patients were successfully reduced of bone fracture, and fixations with absorbable plates and screws were stable. The mean follow up period was 7.1 months. 2 patients complained postoperative pain, but they were relieved with analgesics. All patients experienced transient stiffness, but they were relieved with active assistive range of motion after removal of splint. No patients suffered complications which could be occurred by using metallic plate. CONCLUSION: There was no critical complications such as re-fracture or nonunion among patients. No patients suffered side effects related with metallic implants. Biodegradable implants can offer clinically stable and attractive alternative to metallic implants to stabilize metacarpal bone fractures in the hand.
Absorbable Implants ; Analgesics ; Atrophy ; Dietary Sucrose ; Follow-Up Studies ; Fracture Fixation ; Fractures, Bone ; Hand ; Hand Injuries ; Humans ; Metacarpal Bones ; Osteoporosis ; Pain, Postoperative ; Palpation ; Range of Motion, Articular ; Rupture ; Skin ; Splints ; Tendons ; Titanium

Calving records of Holstein dairy cows from 2005 to 2010 comprising Goyang and Paju cities herd with 2,362 calving events representing 240 twin births were used to evaluate the effect of abomasal displacement and retained placenta after single or twin births on fertility. In retained placenta cows, the period of twin pregnancy (mean 270.5 days) was shorter than that of single pregnancy (mean 274.8 days), however first artificial insemination period (twin: mean 107.4 days, single: mean 92.0 days), non-pregnant period (twin: 154.8 days, single: 132.2 days), and number of insemination (twin: mean 2.00 times, single: mean 1.87 times) of twin pregnancy were increased as compared with single pregnancy. In abomasal displacement cows, first artificial insemination period (twin: mean 122.9 days, single: mean 106.0 days), non-pregnant period (twin: 172.4 days, single: 152.0 days), and number of insemination (twin: mean 2.16 times, single: mean 1.89 times) of twin pregnancy were increased as compared with single pregnancy. The prevalence of complication such as retained placenta, abomasal displacement with single or twin births increased first artificial insemination period, non-pregnant period, and number of insemination period.
Displacement (Psychology) ; Fertility ; Humans ; Insemination ; Insemination, Artificial ; Korea ; Parturition ; Placenta, Retained ; Pregnancy ; Pregnancy, Twin ; Prevalence ; Twins

Detailed information on additional drug resistance patterns of multidrug-resistant tuberculosis (MDR-TB) is essential to build an effective treatment regimen; however, such data are scarce in Korea. We retrospectively analyzed the results of phenotypic drug susceptibility testing (DST) of culture confirmed-TB patients from January 2010 to December 2014 in 7 university hospitals in Korea. MDR-TB was identified among 6.8% (n = 378) of 5,599 isolates. A total of 57.1% (n = 216) of the MDR-TB patients had never been treated for TB. Strains from MDR-TB patients showed additional resistance to pyrazinamide (PZA) (35.7%), any second-line injectable drug (19.3%), and any fluoroquinolone (26.2%). Extensively drug resistant TB comprised 12.4% (n = 47) of the MDR-TB patients. Of 378 MDR-TB patients, 50.3% (n = 190) were eligible for the shorter MDR-TB regimen, and 50.0% (n = 189) were fully susceptible to the 5 drugs comprising the standard conventional regimen (PZA, kanamycin, ofloxoacin, prothionamide, and cycloserine). In conclusion, the proportion of new patients and the levels of additional drug resistance were high in MDR-TB patients. Considering the high levels of drug resistance, the shorter MDR-TB treatment regimen may not be feasible; instead, an individually tailored regimen based on the results of molecular and phenotypic DST may be more appropriate in MDR-TB patients in Korea.

BACKGROUND: Serial volumetric changes of reconstructed breasts have not been studied in detail. In this study, we analyzed serial volumetric changes of reconstructed and contralateral normal breasts during long-term follow-up, with a focus on the effect of various adjuvant therapies. METHODS: Among all patients who underwent immediate breast reconstruction with a unilateral pedicled transverse rectus abdominis musculocutaneous (p-TRAM) flap, 42 patients with valid data from ≥3 postoperative positron emission tomography-computed tomography (PET-CT) scans were included. The volumes of the reconstructed and normal breasts were measured, and the ratio of flap volume to that of the contralateral breast was calculated. Serial changes in volume and the volume ratio were described, and the effects of chemotherapy, radiation therapy, and hormone therapy on volumetric changes were analyzed. RESULTS: The mean interval between the initial reconstruction and each PET-CT scan was 16.5, 30, and 51 months respectively. Thirty-five, 36, and 10 patients received chemotherapy, hormone therapy, and radiation therapy, respectively. The flap volume at each measurement was 531.0, 539.6, and 538.0 cm3, and the contralateral breast volume was 472.8, 486.4, and 500.8 cm3, respectively. The volume ratio decreased from 115.1% to 113.4%, and finally to 109.6% (P=0.02). Adjuvant therapies showed no significant effects. CONCLUSIONS: We demonstrated that the p-TRAM flap maintained its volume over a long-term follow up, while the volume of the contralateral native breast slowly increased. Moreover, adjuvant breast cancer therapies had no statistically significant effects on the volume of the reconstructed p-TRAM flaps or the contralateral native breasts.
Breast Neoplasms ; Breast ; Drug Therapy ; Electrons ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Myocutaneous Flap ; Radiotherapy ; Rectus Abdominis ; Surgery, Plastic

Breast Neoplasms ; Breast ; Female ; Free Tissue Flaps ; Humans ; Mammaplasty ; Mastectomy ; Mastectomy, Subcutaneous ; Necrosis ; Nipples ; Skin ; Traction ; Transplants

BACKGROUND: Bilateral microsurgical autologous reconstruction is known to increase operating time, costs, and complications compared to unilateral procedures. This study aimed to determine whether a unilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flap and a unilateral deep inferior epigastric artery perforator (DIEP) free flap could be a feasible option for bilateral reconstruction in selected circumstances. METHODS: A retrospective chart review identified patients who underwent unilateral pedicled TRAM and unilateral DIEP reconstruction for bilateral breast reconstruction between 2011 and 2014. Surgical outcomes, complications, and aesthetic scale questionnaire responses were evaluated. RESULTS: Fourteen patients were included in this study. Ten patients received bilateral immediate reconstruction, while four patients with a previous history of mastectomy underwent unilateral immediate reconstruction and contralateral delayed reconstruction. All flaps survived without any major complications. A case of nipple-areolar skin necrosis on the pedicled TRAM side and a case of mild abdominal bulging at the free DIEP donor site were reported. There was no partial flap necrosis or palpable fat necrosis. On the aesthetic outcome scale, the free DIEP flaps scored significantly higher than did the pedicled TRAM flaps for overall shape, the upper medial and lower lateral quadrant, and the lateral chest wall. CONCLUSIONS: Our findings suggest that a unilateral pedicled TRAM flap together with a unilateral free DIEP flap could be performed as a bridging surgical option as institutions move toward bilateral free-flap reconstructions, as a way to reduce operating time and the risk of microsurgery-related complications with acceptable donor site morbidity and aesthetic outcomes.
Breast ; Epigastric Arteries ; Fat Necrosis ; Female ; Free Tissue Flaps ; Humans ; Mammaplasty ; Mastectomy ; Myocutaneous Flap ; Necrosis ; Perforator Flap ; Rectus Abdominis ; Retrospective Studies ; Skin ; Thoracic Wall ; Tissue Donors

Dystrophic calcinosis cutis associated with spontaneous hyperadrenocorticism was diagnosed in a 8-year-old female Chihuahua dog with erythematous, erosive, numerous papules, plaques, and crusts on the bilateral trunk, and inguinal region. Serum biochemical abnormalities included increases in alkaline phosphatase (ALP), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and cholesterol. Radiographs showed mild hepatomegaly and subcutaneous lobulated calcific deposits. Histopathologic examination demonstrated diffuse deposition of basophilic calcified material in the dermis. Von Kossa's stain confirmed calcium deposition. Therapy with diltiazem was useful in resolving calcinosis.
Adrenocortical Hyperfunction ; Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Basophils ; Calcinosis* ; Calcium ; Child ; Cholesterol ; Dermis ; Diltiazem* ; Dogs* ; Female ; gamma-Glutamyltransferase ; Hepatomegaly ; Humans

BACKGROUND AND OBJECTIVES: Tetranychus urticae(TU) is a widely distributed parasitic mite found on fruit trees and green house flowers. A recent investigation demonstrated that TU inhalation causes allergic asthma even in non-farmers. We tried to evaluate skin reactivity and specific IgE sensitization to TU, identify IgE binding components, and evaluate allergenic rela- tionship with house dust mite(HDM). MATERIALS AND METHODS: We carried out skin prick test with TU in 1806 respiratory allergy patients over 1 year living in urban and rural areas. ELISA was performed for detection of specific IgE antibody. To evaluate the cross allergenicity between TU and HDM, ELISA inhibition test was carried out with two kinds of pooled sera ; serum pool A included patients' sera sensitized to both TU and HDM, and serum pool B included sera sensitized only to TU. To identify IgE binding components, SDS-PAGE followed by IgE-immunoblot were applied. RESULTS: 358 patients(19.8%) showed positive response(A/H > or = 2+) on skin prick test. Twelve patients showed isolated positive response to TU. Specific IgE was detected in sixty patients(54.5%) out of 110 sensitized patients. ELISA inhibition test using two sera pools (A and B) showed significant inhibitions by TU with minimal inhibitions by HDM. SDS-PAGE and IgE-immunoblot with patients' individual sera sensitized to both TU and HDM showed 10 IgE binding components (67kD, 29kD, 27kD, 10kD, 14kD, 39kD, 46kD, 35kD, 72kD, 77kD) and two(67kD and 29kD) were bound to IgE in more than 50% of sera tested. In patients' sera sensitized only to TU, nine IgE binding components(67kD, 10kD, 14kD, 29kD, 39kD, 46kD, 72kD, 77kD, 9kD) were found and two(67kD and 10kD) were bound to IgE in more than 50%. CONCLUSION: Of allergy patients visiting the Allergy Clinic, 19.8% were sensitized to TU and specific IgE was detected in 54.5% of them. No cross allergenicity was noted between TU and HDM. Eleven IgE binding components and three (67kD, 10kD and 29kD) major allergens were identified.
Allergens ; Asthma ; Dust ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Flowers ; Fruit ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Inhalation ; Mites ; Pyroglyphidae ; Skin* ; Trees