OBJECTIVE: (99m)Tc-dimercaptosuccinic acid(DMSA) scan is considered to be the most sensitive examination for detection of renal scars. However, because of its high radiation exposure to the kidney and its limited usefulness for patients with low grade vesicoureteral reflux(VUR), some authors have suggested that DMSA scans should be reserved primarily for children with VUR grade 3 and above. The aim of this study was to reevaluate the necessity of DMSA scans as a screening test in infants without reflux or with low grade reflux. METHODS: In this retrospective study, 189 infants(mean age:6.2 months) diagnosed as UTI were enrolled. Voiding cystourethrogram(VCUG), DMSA scan and renal ultrasonography were performed within 1 month of UTI. VUR grade was classified into three subgroups; low grade(grade 1-2), moderate grade(grade 3), and high grade(grade 4-5), respectively. RESULTS: Renal defects were present in 67 of 189 infants, and 82 of the 378 renal units. The incidence of renal defects was significantly correlated with VUR grade(P<0.01); 28 percent without reflux, 38 percent with low grade, 53 percent with moderate grade, 100 percent with high grade, respectively. However, there was no significant differences in incidence of renal defects between the low grade and moderate grade group. CONCLUSION: In this study, renal defects were found in quite high percentages; 28 percent patients without reflux and 38 percent patients with low grade VUR, respectively. Moreover, there was no significant difference in the incidence of renal defects between the low grade and moderate grade groups. Therefore, DMSA scan should be performed for infants with UTI as a screening test regardless of the presence of VUR.
Child ; Cicatrix ; Humans ; Incidence ; Infant* ; Kidney ; Mass Screening ; Retrospective Studies ; Succimer ; Ultrasonography

Abdominal pregnancy that is a life threatening variant of ectopic pregnancy, has been a rare event with high maternal mortality. It is very difficult to diagnose a abdominal pregnancy clinically. We have experienced a case of early abdominal pregnancy diagnosed at emergency laparotomy and this case was presented with a brief review of the literatures.
Emergencies ; Female ; Laparotomy ; Maternal Mortality ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic

Bone Regeneration ; Bone Transplantation ; Humans ; Lifting ; Mandible ; Maxilla ; Survival Rate ; Transplants

BACKGROUND/AIMS: Hyperglycemia is associated with decreased 2-18[F]fluoro-2-deoxy-D-glucose (FDG) uptake by tumors assessed by positron emission tomography (PET). In this retrospective study we investigated a comparison of standardized uptake values (SUVs) in patients with primary colorectal cancers who either had diabetes mellitus (DM) or were otherwise healthy. METHODS: The medical records of 397 patients who were diagnosed with colorectal cancer and underwent PET-CT between January 2006 and December 2012 were analyzed. Eighty patients with DM and 317 patients without DM were included. Clinical characteristics were reviewed and maximal standardized uptake values (SUVmax) were calculated in the primary colorectal lesions. RESULTS: There was no significant difference between tumor SUVmax in DM patients (10.60+/-5.78) and those without DM (10.92+/-5.44). In addition, no significant difference was detected between tumor SUVmax in DM patients with glycated hemoglobin (HbA1c) levels <8% (10.34+/-5.17) and those with HbA1c levels > or =8% (10.61+/-7.27). The maximum size of the primary colorectal tumor was associated with SUVmax in a linear regression analysis. CONCLUSION: The results of this study showed that DM did not influence FDG uptake values in colorectal cancer patients regardless of glucose levels.
Colorectal Neoplasms* ; Diabetes Mellitus* ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Hyperglycemia ; Linear Models ; Medical Records ; Positron-Emission Tomography* ; Retrospective Studies

Neurological manifestations of internal carotid aretry (ICA) dissection include amaurosis fugax, cerebral ischemia, oculosympathetic paresis, and various cranial nerve palsies. Isolated hypoglossal nerve palsy is a rare manifestation of ICA dissection. A 55-year-old man developed dysarthria following sudden pain in the left retroauricular area. His tongue was paralysed on the left side. Magnetic resonance image and carotid angiogram showed characteristic features of left ICA dissection, which may be the most plausible cause of hypoglossal nerve palsy in this patient. Expanding hematoma of dissecting aneurysm of ICA seems to have compressed the nutrient artery of the hypoglossal nerve, although the possibility of direct compression of the hypoglossal nerve itself is not completely ruled out.
Amaurosis Fugax ; Aneurysm, Dissecting ; Arteries ; Brain Ischemia ; Carotid Artery, Internal* ; Carotid Artery, Internal, Dissection* ; Cranial Nerve Diseases ; Dysarthria ; Hematoma ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Middle Aged ; Neurologic Manifestations ; Paresis ; Tongue

PURPOSE:To investigate whether airway eosinophilic degranulation develops in Mycoplasma pneumonia (M. pneumonia), and to elucidate the association between M. pneumonia and asthma. METHODS:Forty patients with M. pneumonia, 20 stable asthma patients (stable asthma) and 20 normal controls were recruited from October 2005 to February 2007. In the M. pneumonia, blood and induced sputum sampling were collected at admission (acute stage) and 6 to 8 weeks later (convalescent stage). Eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) levels in sputum and serum were measured in all 3 groups. RESULTS:Serum levels of EDN and ECP in the acute stage of M. pneumonia were comparable to those in the stable asthma group. However, in the convalescent stage of M. pneumonia, EDN and ECP levels were significantly lower than in the stable asthma (P<0.01 and P<0.05, respectively). Sputum levels of EDN and ECP levels in the acute stage of M. pneumonia were comparable to those in the stable asthma. Sputum EDN levels in the convalescent stage of M. pneumonia were significantly lower than those in the stable asthma (P<0.05), and sputum ECP levels were lower than those in the stable asthma, which was not statistically significant. CONCLUSION:Eosinophilic degranulation may play an important role in the pathogenesis of M. pneumonia, which suggests the association between M. pneumonia and asthma.
Asthma ; Eosinophil Cationic Protein ; Eosinophil-Derived Neurotoxin ; Eosinophils ; Humans ; Inflammation ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Sputum

Purpose: Although Mycoplasma pneumoniae (M. pneumoniae) infection can cause wheezing in non-asthmatic children, the mechanisms of this symptom remain unclear. Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and vascular permeability, and is also known to be elevated in cases of chronic pulmonary disease such as asthma. We hypothesized that VEGF may increase in children with acute M. pneumoniae pneumonia and wheezing. Methods: Nine patients with clinical and laboratory evidence of acute M. pneumoniae pneumonia were enlisted from children admitted to Korea University Hospital. They had had more than one episode of wheezing during the illness, which was confirmed by a physician; they comprised the wheezer group. The individuals with M. pneumoniae pneumonia without wheezing were 63 in number, and they comprised the non-wheezer group. Patients with a history of asthma or who had received asthma medications were excluded. Serum concentrations of VEGF, total IgE, eosinophil cationic protein (ECP), and peripheral blood eosinophil counts were measured. Results: The serum VEGF concentrations were higher in the wheezer group (mean+/-SD; 650.2+/-417.9 pg/mL) than in the non-wheezer group (376.5+/-356.2 pg/mL, P=0.049). M. pneumoniae antibody (1:1,380 vs. 1:596, P=0.048) and serum total IgE (591.8 IU/mL vs. 162.2 IU/mL, P=0.032) were higher in the wheezer group than in the non-wheezer group. There were no differences between the two groups in terms of serum ECP concentration or blood eosinophil count. Conclusion: In the presence of wheezing, serum VEGF concentrations were higher in the children with M. pneumoniae pneumonia. This finding suggests that VEGF may associate with wheeze-related symptoms in children with acute M. pneumoniae pneumonia.
Asthma ; Capillary Permeability ; Child ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin E ; Korea ; Lung Diseases ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Sounds ; Vascular Endothelial Growth Factor A

Leber's hereditary optic neuropathy (LHON) is a maternally transmitted disease causing acute or subacute, bilateral optic atrophy mainly in young men. It is found to be a mitochondrial disorder with the primary mitochondrial DNA (mtDNA) mutations at 11778, 3460, and 14484. The incidence of each mutation is reported to be race-dependent. Point mutations at mtDNA nucleotide position 11778 and 14484 have been reported in Korean patients with LHON, however there has been no report of mtDNA mutation at nucleotide position 3460. Molecular genetic analyses at four primary sites (11778, 14484, 15257, and 3460) of mitochondrial DNA using the polymerase chain reaction, restriction enzyme digestion, and direct sequencing were performed in a 35-yr-old man with severe visual loss. A point mutation in the mtDNA at nucleotide position 3460 was identified and a conversion of a single alanine to a threonine was confirmed. To our knowledge, this is the first report confirming mtDNA mutation at nucleotide position 3460 in Korean patients with LHON. Detailed molecular analyses would be very helpful for the correct diagnosis of optic neuropathy of unknown etiology and for genetic counseling.
Adult ; *DNA, Mitochondrial ; Humans ; Male ; Optic Atrophy, Hereditary, Leber/*genetics ; *Point Mutation

Lamotrgine is an antiepileptic drug that is effective for multiple types of seizure and has side-effects such as headache, nausea, dizziness, diplopia, ataxia, cutaneous lesions, and anticonvulsant hypersensitivity syndrome. Anticonvulsant hypersensitivity syndrome consists of the hallmark features of fever, rash, lymphadenopathy and internal organ involvement, induced by aromatic anticonvulsants, for example phenytoin, phenobarbital, carbamazepine, and lamotrigine. We report a case of 13-year-old girl who had a fever, generalized erythematous skin eruption, facial edema, eosinophilia, and elevated liver enzyme induced by lamotrigine and resolved with discontinuation of medication and intravenous steroid and immunoglobulin.
Adolescent ; Anticonvulsants ; Ataxia ; Carbamazepine ; Diplopia ; Dizziness ; Edema ; Eosinophilia ; Exanthema ; Female ; Fever ; Headache ; Humans ; Hypersensitivity* ; Immunoglobulins* ; Liver ; Lymphatic Diseases ; Nausea ; Phenobarbital ; Phenytoin ; Seizures ; Skin

Cutaneous plasmacytosis is a rare disorder characterized by disseminated, macular, red-brown skin eruptions, which commonly occur on the trunk. Histologically, polyclonal lymphoplasmacytic infiltrates are sometimes shown to be associated with variable extracutaneous manifestations. Cutaneous plasmacytosis should be differentiated from primary cutaneous plasmacytoma, because both diseases are clinicopathological similar. Most cases of cutaneous plasmacytosis have been reported in Japanese literature. However, this case deals with a Korean female patient who was diagnosed with cutaneous plasmacytosis and subsequently received systemic PUVA therapy.
Asian Continental Ancestry Group ; Female ; Humans ; Plasmacytoma ; PUVA Therapy ; Skin