No abstract available.
Aneurysm* ; Aorta*

Hemophagocytic syndrome (HPS) is a rare but potentially life-threatening disease in kidney transplant recipients, and is caused by systemic proliferation of macrophages actively phagocytizing other blood cells in the bone marrow, lymph nodes, and the spleen.Here, we report a 40-year-old male kidney transplant recipient who presented with fever, bicytopenia, and elevated liver enzymes 2 months after transplantation. Given that cytomegalovirus antigenemia and real-time polymerase chain reaction tests were positive, liver biopsy was performed under an assumption of cytomegalovirus-induced hepatitis. Hepatic histology revealed multifocal microabscess with cytomegalovirus inclusion bodies, marked Kupffer cell hyperplasia, and erythrophagocytosis by activated macrophages. As laboratory findings such as hyperferritinemia, elevated serum lactate dehydrogenase, low natural killer cell activity, and high soluble interleukin-2 receptor were also compatible with HPS, the recipient was diagnosed as having cytomegalovirus-induced hepatitis combined with reactive HPS. Following intravenous ganciclovir therapy with continuous administration of tacrolimus and corticosteroid, the symptoms resolved and laboratory findings were normalized. As far as we know, this is the first report of cytomegalovirus-induced hepatitis combined with reactive HPS in a kidney transplant recipient that is diagnosed by liver biopsy.

OBJECTIVE Licorice is used throughout the world as a traditional herbal remedy. Ac-cording to Chinese traditional medicine licorice alone can be used to treat inflammation.Although there have been some studies investigated the anti-inflammatory ingredients of licorice, but for the potency of flavonoid glycoside and their aglycones on inflammation are not evaluated.This study was designed to assess the contributions of licorice flavonoid glycosides and their aglycons to its anti-inflammatory and hypnotic effects. METHODS For the flavonoid aglycone's enrichment, the extract of licorice (EL) was fermented in submerged culture of the edible fungus Grifola frondosa HB0071 mycelia which can produce β-glucosidase and catalyze the flavonoid glycosides to aglycones.EL and fermented extract of licorice (FEL) were used in this study. The anti-inflammation test was carried out in arachidonic acid (AA)-induced ear edema model and the hypnotic test was performed by using electroencephalogram (EEG)analysis method in normal freely moving SD rats.The chemicals constituents were analyzed by HPLC.RESULTS During fermentation,the falvonoid glycosides of licorice were hydrolyzed by the time process.Along with fermentation time,the concentration of the major flavonoid glycosides,liquiritin and isoliquiritin were decreased obviously, and simultaneously their aglycons, liquiritigenin and isoliquiriti-genin were remarkably increased in FEL.Moreover,the content of another major constituent glycyrrhi-zic acid and glycyrrhetinic acid were not changed after the fermentation. In AA-induced mice ear ede-ma test,after topical application,FEL(effective dose range:5-20 μg·ear-1)showed more potent inhibito-ry activity than EL(effective dose range:25-100 μg·ear-1).On the other hand,oral administration of EL and FEL exhibited the same hypnotic potency and both enhanced the total sleep time including rapid eye movement (REM) sleep and non-REM sleep time. CONCLUSION These results suggested that the enrichment of flavonoid aglycons such as liquiritigenin and isoliquiritigenin enhanced the anti-inflam-matory potency of licorice extract,and this potentiation has nothing to do with glycyrrhizic acid or glycyr-rhetinic acid.In addition,enrichment of flavonoid aglycones did not alter the hypnotic effect of licorice.

The corpus callosum is the main interhemispheric connection in human brain. Agenesis of corpus callosum may partial or complete, and it may have not functional abnormalities. Its prenatal sonographic diagnosis is difficult because of fetal head position, especially in a cephalic presentation. We experienced a case of complete agenesis of corpus callosum. The prenatal sonographic findings was disproportionate dilatation of lateral ventricle, which were suggestive finding of agenesis of corpus callosum or hydrocephalus. We could confirm the diagnosis of complete agenesis of corpus callosum by postnatal MRI.
Agenesis of Corpus Callosum* ; Brain ; Corpus Callosum ; Diagnosis ; Dilatation ; Head ; Humans ; Hydrocephalus ; Lateral Ventricles ; Magnetic Resonance Imaging ; Ultrasonography

Adult ; Anesthesia ; Colloids ; Dizziness ; Equidae ; Fluid Therapy ; Headache ; Humans ; Orthognathic Surgery ; Postoperative Period ; Pulmonary Edema ; Surveys and Questionnaires ; Sleep Stages ; Surgery, Oral ; Thirst

PURPOSE: In developed countries, acute rheumatic fever appears to be a vanishing disease. In Korea, the incidence and severity of acute rheumatic fever (ARF) has significantly decreased in recent 30 years. According to this report, Korea sustained low incidence of ARF. METHODS: The medical records of 5 children diagnosed as ARF from January 2000 to September 2006 were reviewed retrospectively about clinical manifestations and laboratory findings. RESULTS: The average incidence of rheumatic fever was 0.17 per annual pediatric in-ward 1,000 patients. During study period, only 1 case had a definite history of preceding infection. Among 5 patients, the incidence of major manifestations were as follows:carditis 5 cases, chorea 1 case, arthritis 1 case and erythema marginatum 2 cases. Clinical findings of carditis were cardiac murmur, cardiomegly, congestive heart failure and pericardial effusion. Significant valvular lesions were mitral and aortic insufficiency. Minor manifestations and other clinical manifestations were fever, arthralgia, dyspnea, coughing, palpitation, weakness and chest pain. Laboratory findings were increased antistreptolysin O titer, positive C reactive protein (CRP) and increased erythrocyte sedimentation rate (ESR). CONCLUSION: The incidence of ARF has reduced but rheumatic carditis varies in severity from moderate to severe cardiac involvement. For many reasons ARF is being diagnosed inappropriately resulting from lack of awareness about the disease due to rarity and secondary prophylaxis. We should be aware of acute rheumatic fever and should pay attention to the treatment of the patients with streptococcal pharyngitis.
Antistreptolysin ; Arthralgia ; Arthritis ; Blood Sedimentation ; C-Reactive Protein ; Chest Pain ; Child ; Chorea ; Cough ; Developed Countries ; Dyspnea ; Erythema ; Fever ; Heart Failure ; Heart Murmurs ; Humans ; Incidence ; Korea ; Medical Records ; Myocarditis ; Pericardial Effusion ; Pharyngitis ; Retrospective Studies ; Rheumatic Fever*

PURPOSE: We have investigated the prognostic significance of the expression of basal markers for triple-negative (estrogen receptor-negative, progesterone receptor-negative and human epidermal growth factor receptor-2-negative) breast cancers (TNBCs). METHODS: An immunohistochemical study was performed on tissue microarrays constructed with 643 invasive breast carcinoma samples. We subclassified the TNBCs into basal phenotype (BP) and non-BP groups by the use of four different criteria according to the immunprofiles for cytokeratin5/6 (CK5/6), epidermal growth factor receptor (EGFR), vimentin, c-Kit, p63 and P-cadherin. The criteria consisted of criterion 1: CK5/6+ only, criterion 2: CK5/6+ and/or EGFR+, criterion 3: CK5/6+ and/or EGFR+ and/or vimentin+ and criterion 4: one or more marker(s) positive among the six basal markers. Each of these criteria, as well as the status of each individual marker, was evaluated to estimate prognosis for TNBC patients. RESULTS: Of the breast carcinomas, 165 cases (25.7%) were TNBCs. As compared with the non-TNBCs, TNBCs were associated with a larger tumor size (p=0.001), higher histological grade (p<0.001) and shorter overall survival (OS) (p=0.002) and disease-free survival (DFS) (p=0.05). Lymph node status, tumor size and expression of EGFR or c-Kit were independent prognostic factors for patients with TNBC. As compared with the non-BP, BP as defined by criterion 2 was an independent poor prognostic factor for OS and DFS among patients with a lymph node metastasis (p=0.044 and p=0.01) and among patients who received anthracycline-based adjuvant chemotherapy (p=0.009 and p=0.01, respectively). CONCLUSION: Patients with TNBCs showed a poorer prognosis as compared to patients with non-TNBCs. Selected group of the basal-like breast cancers (BLBCs) defined by the immunohistochemical profiles of basal markers showed survival differences from non-BLBCs in subgroups of TNBCs with a homogeneous clinical finding.
Breast ; Breast Neoplasms ; Cadherins ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Epidermal Growth Factor ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Phenotype ; Progesterone ; Prognosis ; Receptor, Epidermal Growth Factor ; Vimentin

PURPOSE: Endourological management of ureteropelvic junction obstruction (UPJO) has gained increased acceptance with high procedural success rates and low morbidity being reported. It has been suggested that Acucise endopyelotomy should be the procedure of choice for patients with UPJO. The purpose of this study is to determine the efficacy of the Acucise balloon for the treatment of ureteral strictures and UPJO. MATERIALS AND METHODS: Between March 2004 and June 2005, 13 consecutive patients (8 primary and 5 secondary cases of UPJO) underwent Acucise endopyelotomy at our institution. The preoperative evaluation included ultrasound and/or intravenous urogram with diuretic renography. The success of the procedure was based on objective radiologic improvement and the subjective resolution of symptoms. RESULTS: The mean follow-up was 6.77+/-3.83 months (range: 3-14). The mean operating time was 64.23+/-34.87 min and the mean hospital stay was 4.15+/-2.44 days. The objective success rate was 61.5% and the subjective success rate was 69.2%. There were no major complications such as vascular injury requiring transfusion. Yet a small urinoma developed in one patient. Of the 5 objective failures, 3 patients have since successfully undergone open pyeloplasty. CONCLUSIONS: In this small series, Acucise endopyelotomy is a safe and minimally invasive procedure that offered effective first-line treatment for UPJO, although multicenter randomized trials are needed to make a better comparison with the other techniques.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Length of Stay ; Radioisotope Renography ; Ultrasonography ; Ureter* ; Ureteral Obstruction ; Urinoma ; Urologic Surgical Procedures ; Vascular System Injuries

No abstract available.
Humans ; Smoke* ; Smoking*

OBJECTIVE: The variable operative methods are underwent as a treatment of tuberculous spondylitis. We propose hemilaminectomy and debridement as a one of operative method at a certain circumstance. METHODS: From July 1998 to June 2002, 13 consecutive patients with spinal tuberculosis were treated surgically in our institution. Among them, the authors analysed 7 patients in whom posterior approach were performed. The lumbar spine was involved in 6 patients, the thoracic in 1. The hemilaminectomy with debridement was done in all cases. The changes in the Kyphotic angle and the height of involved vertebras retrospectively measured from lateral spinal radiographs obtained preoperatively and postoperatively. Mean follow up periods were 16 months. RESULTS: Clinical symptoms and signs were improved in all cases. One patient (14%) was needed anterior fusion because of aggravation of lesion. Another one needed reoperation because of relapse of epidural abscess. The arithmethical average of kyphotic angle was worsened about 2 degrees and that of height loss was lesser than 5% postoperatively. CONCLUSION: The hemilaminectomy with debridement for spinal spondylitis can be a first therapeutic modality in a mild neurologic deficit and minor lesions with extended epidural abscess and granulation tissue to the adjacent vertebras in radiologic finding. Especially if epidural abscess and granulation tissue involve the multiple vertebras, we recommend this operative method.
Debridement ; Epidural Abscess ; Follow-Up Studies ; Granulation Tissue ; Humans ; Neurologic Manifestations ; Recurrence ; Reoperation ; Retrospective Studies ; Spine ; Spondylitis ; Tuberculosis, Spinal*