PURPOSE: To compare the efficacy of a 20-gauge and an 18-gauge needle in sono-guided percutaneous automated gun biopsy for establishing the specific diagnosis of renal parenchymal disease in pediatric kidneys. MATERIALS AND METHODS: In 60 pediatric patients with renal parenchymal diseases, percutaneous sono-guided gun biopsy was performed by an experienced radiologist. In two groups of 30 patients, regardless of their age, two needle passes were performed, using alternately an 18-gauge or a 20-gauge biopsy needle. The core of renal tissue thus obtained was examined with light, immunofluorescent or electron microscopy by the renal pathologist. The mean number of intact glomeruli of whole tissue core per biopsy, as seen on the light microscopy, and post-bioptic complications were compared between the two different needle size groups. RESULTS: The number (mean+/-1 standard deviation) ofglomeruli obtained per biopsy was 17+/-8 in the 18-gauge needle group, and 14+/-5 in the 20-gauge group. Between two groups, there was no major post-bioptic complication requiring specific treatment, nor a statistically significant difference in the frequency of minor complications. CONCLUSION: Even though more glomeruli were obtained with an 18-gauge needle, the number obtained with a 20-gauge needle also permitted adequate pathologic examination. Both an 18-gauge and a 20-gauge needle may thus be suitable for renal biopsy in pediatric patients.
Biopsy* ; Diagnosis ; Humans ; Kidney ; Microscopy ; Microscopy, Electron ; Needles*

Lipoleiomyoma is a rare benign neoplasm of the uterus. I present here a case of exophytic uterine lipoleiomyoma in a 77-year-old woman. Due to its exophytic nature, this fatty tumor mimicked ovarian teratoma on the imaging studies.
Aged ; Female ; Humans ; Leiomyoma ; Lipoma ; Teratoma* ; Uterine Neoplasms ; Uterus*

Lipoleiomyoma is a rare benign neoplasm of the uterus. I present here a case of exophytic uterine lipoleiomyoma in a 77-year-old woman. Due to its exophytic nature, this fatty tumor mimicked ovarian teratoma on the imaging studies.
Aged ; Female ; Humans ; Leiomyoma ; Lipoma ; Teratoma* ; Uterine Neoplasms ; Uterus*

Thymoma is an uncommon tumor of childhood and familial occurrence is very rare. Here we report two sisters and their father with thymoma identified by imaging findings.
Fathers ; Humans ; Mediastinum ; Siblings ; Thymoma*

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

OBJECTIVE: To evaluate the usefulness of power spectral analysis on fetal heart rate variability as a new diagnostic method of fetal distress. STUDY DESIGN: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into 3 groups, i.e.; normal fetus group (36), presumed distress group (26) and acidemic distress group (14). In order to perform linear analysis on the raw data of the fetal heart rate, after resampling, we performed Fourier transformation and investigated power distributions among very low frequency (VLF), low frequency (LF), high frequency (HF) bands, and autonomic balance (LF/HF). RESULTS: The results of the spectral analysis showed that in normal fetus group, the difference in the distribution of power spectrums of VLF, LF and HF was significantly higher than in presumed distress group and acidemic distress group. In fetal distress, the LF and VLF value (0.0023, 0.0437) were good predictors (sensitivity 97.5%, 75.0% and specificity 86.1%, 94.4%). The LF value (0.0013) was a good predictor in fetal acidemia (sensitivity 97.5% and specificity 86.1%). CONCLUSIONS: A computerized spectral analysis of fetal heart rate variation is a good predictor of fetal distress, which is made automatically and objectively.
Female ; Fetal Blood ; Fetal Distress* ; Fetal Heart* ; Fetal Monitoring ; Fetus ; Fourier Analysis ; Heart Rate, Fetal* ; Humans ; Pregnancy ; Pregnant Women ; Sensitivity and Specificity

Sjogren's syndrome is a chronic autoimmune inflammatory disorder characterized by dryness of the eyes, mouth, and other mucous membranes with multiple abnormalities of cellular and humoral immunity. There are numerous neurologic symptoms in Sjogren's syndrome involving the central, peripheral and autonomic nervous system. Transverse myelitis is an uncommon and serious complication of Sjogren's syndrome. It is an inflammatory process affecting one or more segments of the spinal cord that interrupts most of the large tracts across the greater part of the horizontal extent of the cord at the level of the lesion. The dramatic presentation with rapidly progressive symptoms involving motor, sensory, and autonomic functions makes transverse myelitis a medical emergency. We describe a patient of Sjogren's syndrome associated with transverse myelitis, manifest as paraparesis and urinary retention. MRI showed involvement of the spinal cord from C3 to T3. The patients symptoms improved to the therapy with corticosteroid and cyclophosphamide.
Abnormalities, Multiple ; Autonomic Nervous System ; Cyclophosphamide ; Emergencies ; Humans ; Immunity, Humoral ; Magnetic Resonance Imaging ; Mouth ; Mucous Membrane ; Myelitis, Transverse* ; Neurologic Manifestations ; Paraparesis ; Sjogren's Syndrome* ; Spinal Cord ; Urinary Retention

Leprosy is an infectious disease caused by Mycobacterium leprae and characterized by dermal and peripheral nerve lesions. The facial nerve is also frequently involved in leprosy. There are a few electrophysiologic studies on the facial nerve involvement in leprosy patients, but there is no electrophysiologic study on the facial nerve involvement in cured leprosy patitents. So we performed facial nerve conduction study and Blink reflex study in 19 cured leprosy patients who have been managed with Dapsone for a long time. Facial motor latencies were prolonged in 11 patients(57.9%).: 10 of 15 patients in lepromatous type; 1 of 4 patients in tuberculoid type. Prolonged latencies were shown in temporal branch, zygomatic branch, buccal branch, and mandibular branch in 9(47.4%), 6(31.6%), 5(26.3%), and 3(15.8%), respectively. Blink reflex study suggests combined facial nerve and trigeminal nerve lesion in 2 patients.
Blinking ; Communicable Diseases ; Dapsone ; Facial Nerve* ; Humans ; Leprosy* ; Mycobacterium leprae ; Peripheral Nerves ; Trigeminal Nerve

BACKGROUND: Although organotin compounds are widely used as PVC stabilizers, catalysts and biocides, their effects on humans are not well known. However, their acute intoxication is known to cause neurotoxicity in the central nervous system, renal toxicity, and hepatotoxicity. As there has been no previously published case of organotin intoxication in Korea, we report here the first Korean case of acute exposure to organotin. CASE REPORT: A 43-year-old male with disorientation and behavioral change was admitted to a hospital. He had been working as a tank cleaner for several different companies in the previous 8 years and a week before admission, he had cleaned a tank containing dimethyltin (DMT) for 4 days. A day after finishing the job, he suffered decreased memory, behavioral change and progressive mental deterioration when he arrived at the emergency room. The result of spinal tapping was negative but on the 4th day of admission he deteriorated into a state of coma along with metabolic acidosis and severe hypokalemia. High levels of DMT and trimethyltin (TMT) were detected in a highly sensitive urine analysis. After conservative treatment and chelation therapy, the patient showed some clinical improvement but the neurological defects persisted. CONCLUSION: The patient appeared to have been intoxicated from the acute exposure to a high level of organotin while cleaning the tank.
Acidosis ; Adult ; Central Nervous System ; Chelation Therapy ; Coma ; Disinfectants ; Emergency Service, Hospital ; Humans ; Hypokalemia ; Korea ; Male ; Memory ; Organotin Compounds ; Poisoning* ; Spinal Puncture