PURPOSE: Emphysematous pyelonephritis is a rare, life threatening infection of kidney and the pennephric space, characterized by the production of gas within the renal parenchyma. The aim of this study is to analyze the clinical and radiologic characteristics of emphysematous pyelonephritis. MATERIALS AND METHODS: We reviewed 7 cases of the emphysematous pyelonephritis. Six patients had plain abdominal radiographs, ultrasonograms and abdominal CT scans. Only one patient had plain radiograph and ultrasonogram. In 5 operated cases, CT findings were compared with surgical records. RESULTS: Plain radiographs showed characteristic diffuse mottling of gas in renal fossa. On sonogram, intrarenal gas was identified as echogenic loci with dirty shadows. CT scan showed inflammatory mass with gas and fluid levels in adjacent to the kidney. CT findings corresponded relatively wall with the surgical findings in regard to disease extent. CONCLUSION: lntrarenal gas in appropriate clinical setting is highly specific for emphysematous pyelonephritis. CT is the most sensitive method for demonstrating the disease extent as well as specific diagnosis.
Diagnosis ; Humans ; Kidney ; Pyelonephritis* ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Emphysematous pyelonephritis is a rare, life threatening infection of kidney and the pennephric space, characterized by the production of gas within the renal parenchyma. The aim of this study is to analyze the clinical and radiologic characteristics of emphysematous pyelonephritis. MATERIALS AND METHODS: We reviewed 7 cases of the emphysematous pyelonephritis. Six patients had plain abdominal radiographs, ultrasonograms and abdominal CT scans. Only one patient had plain radiograph and ultrasonogram. In 5 operated cases, CT findings were compared with surgical records. RESULTS: Plain radiographs showed characteristic diffuse mottling of gas in renal fossa. On sonogram, intrarenal gas was identified as echogenic loci with dirty shadows. CT scan showed inflammatory mass with gas and fluid levels in adjacent to the kidney. CT findings corresponded relatively wall with the surgical findings in regard to disease extent. CONCLUSION: lntrarenal gas in appropriate clinical setting is highly specific for emphysematous pyelonephritis. CT is the most sensitive method for demonstrating the disease extent as well as specific diagnosis.
Diagnosis ; Humans ; Kidney ; Pyelonephritis* ; Tomography, X-Ray Computed ; Ultrasonography

Although lipomas are among the most common benign tumors, their occurrences in the oral cavity has been reported infrequently, accounting for only 2.2% to 4.4% of all benign tumors in this site. Especially, lipomas of the tongue are rare tumors that are represented by less than 0.5% of all benign tumors in the oral cavity. There are two types of solitary lipomas, the cutaneous (superficial) type and the deep-seated (subfascial) type. The deep and soft tissue-infiltrating lipomas are classified into between-muscle groups (intermuscular lipoma) or within-muscle groups (intramuscular lipoma). Intramuscular lipoma is composed of mature adipose tissues that infiltrate into muscles in a diffuse manner, and the entrapped muscle fibers exhibited varying degrees of atrophic change. We experienced a case of bilateral multiple intramuscular lipomas of the tongue which was cured by surgery.
Lipoma* ; Mouth ; Muscles ; Tongue*

PURPOSE: Bilirubin values may vary depending on the site of sampling. The purpose of this study is to compare simultaneously obtained capillary and venous serum bilirubin to assess neonatal jaundice. METHODS: The subjects for the study included 135 healthy inborn as well as outborn full-term infants admitted to Dong-Eui Medical Center for evaluation of jaundice from May 1997 to February 1999. A paired capillary and venous sample was simultaneously drawn from each neonate, and their serum bilirubins were measured by direct spectrophotometric method. RESULTS: A high correlation between capillary and venous serum bilirubin(correlation coefficient(r) =0.949, P<0.05) was observed. No significant difference between mean capillary and venous bilirubin was detected when capillary bilirubin was less than 10 mg/dL(P>0.05), however, the mean venous bilirubin was significantly higher than the mean capillary bilirubin(mean difference;0.65+/-1.04 mg/dL, P<0.0001) when the capillary bilirubin was greater or equal to 10 g/dL(P>0.05). CONCLUSION: There was a trend toward venous bilirubin being higher than capillary bilirubin at higher serum bilirubin levels. However, further studies are needed to ascer-tain the relationship between the site of the sampling and methodology in measurement of bilirubin.
Bilirubin* ; Capillaries* ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal*

BACKGROUND: It is well known that the prevalence of lung cancer is higher in idiopathic pulmonary fibrosis(IPF) patients than in the general population. This high prevalence is explained by the concept of 'scar carcinoma'. There have been several reports on the prevalence of histologic type of lung cancer in IPF with conflicting results. Despite of the high smoker rate in almost all previous reports, none considered the smoking history of patients. Therefore we performed a separate studies on fibrosis associated lung cancer and smoking associated lung cancer. The purpose of this study is to investigate the proportion of lung cancer in IPF that is fibrosis assiciated and to determine the most common histologic type in fibrosis associated lung cancer in IPF. METHODS: A retrospective review of medical records and radilolgic studies was performed for cases of lung cancer with IPF. We investigated smoking history, sequence of diagnosis of lung cancer and IPF, histologic type of lung cancer and the cancer location, especially whether the location is associated with fibrosis. To evaluate the proportion of fibrous associated lung cancer, the lung cancer in IPF were categorized according to the presence of fibrosis at cancer location. RESULTS: Fifty seven patients were subjects for this analysis. Six(11%) cases were diagnosed as lung cancer during follow-up for IPF, and both diseases were diagnosed simultaneously in the others. Ninety four percent of patients were smokers and the average smoking amount was 47.1±21.9 pack-year. Among the patients with IPF and lung cancer, 42(80.8%) cases were considered as 'fibrosis associated'. The remainder was 'not fibrosis associated' and probably was due to smoking etc. Although the most frequent histologic type was squamous cell carcinoma as a whole, adenocarcinoma was the prominent histologic type in 'fibrosis associated lung cancer.' CONCLUSION: Considering the proportion of 'fibrosis not associated lung cancer' in the patients with IPF and lung cancer, significant proportion of lung cancer in IPF may not be fibrosis induced. This may influence the distribution of histologic type of lung cancer in IPF.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Diagnosis ; Fibrosis* ; Follow-Up Studies ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung Neoplasms* ; Lung* ; Medical Records ; Prevalence ; Retrospective Studies ; Smoke ; Smoking

OBJECTIVE: Cancer pain has been treated by gamma knife radiosurgery(GKS), targeted to the pituitary gland-stalk, as an alternative new pain control method. The purpose of this study is to prove the efficacy and the safety of this treatment. METHODS: Seven patients with intractable cancer pain underwent pituitary gland-stalk irradiation by gamma knife. Selections for patient inclusion in this treatment protocol were no other effective pain treatment options, general condition rated as greater than 40 on Karnofsky Performance Scale, and pain relief by morphine though not satisfactory. The target was the junction between the pituitary stalk and the neurohypophysis. The maximum dose was 150~160Gy with one isocenter in 8mm collimator or two isocenters in 4mm collimator keeping the radiation dose to the optic nerve less than 8Gy. RESULTS: In all seven cases, the significant pain reduction was obtained during immediate post-GKS period without serious complications except one patient who developed transient hypopituitarism and diabetes insipidus. Pain relief was observed within several days, and this effect was prolonged for a quite long time. At a follow up of 1.5 to 13 months, pain recurred in two patients and no hormonal and visual dysfunctions were observed. CONCLUSION: Despite insufficient experience, the efficacy and the safety of GKS for intractable cancer pain were demonstrated in seven patients. This treatment has the potential to ameliorate cancer pain, and GKS will play a more important role in the treatment of intractable pain.
Clinical Protocols ; Diabetes Insipidus ; Follow-Up Studies ; Humans ; Hypopituitarism ; Morphine ; Optic Nerve ; Pain, Intractable ; Pituitary Gland ; Pituitary Gland, Posterior ; Pituitary Irradiation* ; Radiosurgery

Myxoid neurofibroma is a benign tumor of perineural cell origin, which is demonstrated with a positive immunohistochemical stainig for S-100. The most common locations of the myxoid neurofibroma are face, shoulder, arm, periungual and foot. We experienced an unusual case of myxoid neurofibroma which originated from labia majora area then reported it. To our knowledge, this is the first time that a labia majora location is reported.
Arm ; Foot ; Neurofibroma ; Shoulder

Myxoid neurofibroma is a benign tumor of perineural cell origin, which is demonstrated with a positive immunohistochemical stainig for S-100. The most common locations of the myxoid neurofibroma are face, shoulder, arm, periungual and foot. We experienced an unusual case of myxoid neurofibroma which originated from labia majora area then reported it. To our knowledge, this is the first time that a labia majora location is reported.
Arm ; Foot ; Neurofibroma ; Shoulder

BACKGROUND: Portable glucometers are often utilized at the patient's bedside in the ICU or operating room for frequent measurements of the blood glucose concentration. Many of these devices are based on a glucose oxidase method that may be influenced by PO2. The aim of this study was to evaluate the influence of a high PO2 of arterial blood on measured glucose values compared with venous blood. METHODS: Forty adult patients who underwent surgery with general anesthesia were included in this study. Each patient had a cannula inserted into the radial artery and a central venous catheter through the right internal jugular vein. Two hours after the induction of anesthesia, we drew arterial and venous blood and measured the blood glucose concentration using both a bedside glucometer based on a glucose oxidase method and a laboratory glucometer based on a hexokinase method. We also measured blood gas, electrolyte, and hematocrit values. Statistical analyses were performed with repeated measure ANOVA, multiple linear regression, and Bland-Altman's analysis. Data is expressed as mean +/- SD. RESULTS: The arterial blood glucose concentration measured by the glucose oxidase method (119.5 +/- 25.0 mg/dl) was significantly lower than the venous blood (133.5 +/- 24.8 mg/dl) and hexokinase method (134.2 +/- 27.1 mg/dl). There was no significant difference between the venous blood glucose concentration by the glucose oxidase method and hexokinase method. When we used the correction formula: corrected glucose value = arterial glucose value by glucose oxidase method + 0.1053 X PaO2 - 5.414, the bias improved from - 14.6 mg/dl to 1.0 mg/dl. CONCLUSIONS: The blood glucose concentration measured by the glucose oxidase method is more accurate in venous blood than oxygenated arterial blood. When we measure the blood glucose level using the glucose oxidase method, we should consider the influence of high oxygen tension.
Adult ; Anesthesia ; Anesthesia, General ; Bias (Epidemiology) ; Blood Glucose* ; Catheters ; Central Venous Catheters ; Glucose Oxidase* ; Glucose* ; Hematocrit ; Hexokinase ; Humans ; Jugular Veins ; Linear Models ; Operating Rooms ; Oxygen* ; Radial Artery

Agenesis of dorsal pancreas is a rare congenital anomaly that arises from the failure of the dorsal pancreatic bud of endodermal cells to form the body and tail of the pancreas. It may be associated with diabetes mellitus, pancreatic exocrine dysfunction, or abdominal pain. Complete or partial agenesis of dorsal pancreas has been reported in a small number of pediatric and adult patients. A case is herein described involving a complete agenesis of dorsal pancreas and diabetes mellitus. A 38-year-old man with a 7-months history of non-insulin dependent diabetes mellitus was admitted due to weight loss and abdominal pain. Abdominal ultrasonography and computed tomography showed a normal biliary tree and enlarged head of the pancreas without visualization of the pancreatic body and tail. Endoscopic retrograde cholangiopancreatography (ERCP) revealved the short duct of Wirsung in the uncinate process and a head without opacification of any ducts in the pancreatic body or tail. The patient underwent explo-laparotomy for evaluation of the suspected pancreatic cancer. The patient was diagnosed as having complete agenesis of the dorsal pancreas by ERCP, CT, and surgery.
Abdominal Pain ; Adult ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Endoderm ; Head ; Humans ; Pancreas* ; Pancreatic Ducts ; Pancreatic Neoplasms ; Ultrasonography ; Weight Loss