The systemic lupus erythematosus is a self-perpetuating disease with multisystem involvement, i.e.; skin, kidney, serous membrane, nervous system and other organs. The mortality in SLE is determined primarily by the extent of renal involvement and the degree of immunosuppression resulting from the therapy. We experienced two cases of lupus nephritis in SLE with clinical, serologic, immunologic and pathologic evaluations. Renal biopsy revealed focal and segmental proliferative glomerulonephritis and mesangial proliferative glomerulonephritis. Both patients have been improving with prednisolone on follow-up studies.
Biopsy ; Follow-Up Studies ; Glomerulonephritis ; Humans ; Immunosuppression ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Mortality ; Nervous System ; Prednisolone ; Serous Membrane ; Skin

The need for film recording in endoscopic practice is important with the present demand for documentation and teaching (legal problem). The electronic endoscopy which has a very small charge coupled device (CCD) at the distal end of an endoscope yields several times more resolving power than conventional optical endoscopes. However the system has not been utilized in Urologic field because there has not enough space for CCD at the end of the telescope comparing to the endoscope in Gastroenterology field. However the video converter with CCD could be adapted to the eyepiece of the telescope, and the automatic monitor photo unit (CVP 600, SAMSUNG, KOREA), video system and monitor were used for imaging, which is so called Urologic Video Information System (UV1S). The image processing was done by instantaneous system (CCD color camera, EC-202 II, ELMO, Japan) with conventional optical light source. From September 1992 to August 1996, we did cystoscopic examination with CCD in 1079 cases.
Cystoscopy ; Endoscopes ; Endoscopy ; Gastroenterology ; Information Systems ; Telescopes

Aggressive fibromatosis is a neoplastic lesion derived from musculoaponeurotic tissue. By its ability to spread locally and infiltratively, it mimics a low-grade malignant tumor. Wide excision is the recommended primary therapy but recurrences are numerous. We report a primary pelvic fibromatosis arising from retroperitoneum, which managed by surgical excision and radiation therapy.
Fibroma* ; Fibromatosis, Aggressive ; Recurrence

BACKGROUND: Appendicitis is one of the most common causes of abdominal emergency with a life time risk of 6-8%. Children are unable to give an accurate history, and since acute nonspecific abdominal pain is more common than appendicitis at this age, diagnosis and management of appendicitis are often delayed. This results in more frequent complications and difficult management. In order to evaluate whether pediatric appendicitis should be thought as more urgent and serious because of the delay in its diagnosis, we compared the clinical characteristics and outcomes of appendicitis in children with those of adults. METHODS: We retrospectively reviewed 106 adults and 43 children who were pathologically verified with appendicitis after an appendectomy. RESULTS: There was no difference in the duration of symptoms. Advanced appendicitis was more frequent in children (60.5% vs. 53.7%). In children, the symptom durations of advanced appendicitis were similar to those that of early appendicitis, but were significantly longer in adults. Children showed no increase in cumulative rate of advanced appendicitis in relation with prolonged symptom duration whereas adults showed a steady increase after 72 hours of onset. The complication rate was higher in advanced cases in both, but children had a lower complication rate than adults. The postoperative hospital stay was significantly longer in advanced cases in both, but children had a relatively shorter hospital stay. CONCLUSIONS: Pediatric appendicitis was more prone to early perforation with a relatively higher perforation rate. However, children had a lower morbidity rate and a shorter admission stay. Therefore, appendicitis in children is not necessarily more serious and urgent than in adults.
Abdominal Pain ; Adult* ; Appendectomy ; Appendicitis* ; Child* ; Diagnosis ; Emergencies ; Humans ; Length of Stay ; Retrospective Studies

Primary pulmonary hypertension is a rare and progressive disease with poor prognosis. Despite much previous studies, there is neither clear explanation in the etiology and the pathogenesis nor confirmative treatment modalities. Its main cause of death is due to the right ventricular failure but the left ventricular function is relatively well preserved. The chest pain mimickig the angina pectoris is common and it is mostly due to the right ventricular ischemia or distension of pulmonary artery, but left ventricular ischemia or infarction is very rarely seen. We experienced a case of primary pulmonary hyperetension with left ventricular hypertrophy that complicated to acute myocardial infarction in 14-year-old male.
Adolescent* ; Angina Pectoris ; Cause of Death ; Chest Pain ; Humans ; Hypertension, Pulmonary* ; Hypertrophy, Left Ventricular* ; Infarction ; Ischemia ; Male* ; Myocardial Infarction* ; Prognosis ; Pulmonary Artery ; Ventricular Function, Left

BACKGROUND AND OBJECTIVES: We studied the correlation between radiologically identified bony osteitis and prognosis of the functional endoscopic sinus surgery in chronic rhinosinusitis patients. SUBJECTS AND METHOD: A retrospective review of medical records were carried out on 77 patients who had been diagnosed as chronic paranasal sinusitis and undergone endoscopic sinus surgery from 2002 through 2003 at our institution. Computed tomography scans were used for grading according to the Lund-Mackay radiologic grading system and diagnosis the pansinusitis coexistence. Medical records were used for grading according to the Lund-Mackay surgical grading system and for follow-up observation and age. Statistical analysis was done for correlation between radiologically identified indices and post-operative prognosis. RESULTS: The study revealed that radiologically identified bony osteitis need a longer post-operative medical management period and also found that if pansinusitis coexist with osteitis, poorer outcome would be accompanied. CONCLUSION: This study provides further evidence that radiologically identified bony osteitis and pansinusitis may act as poor prognostic factors.
Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Osteitis* ; Prognosis* ; Retrospective Studies ; Sinusitis ; Tomography, X-Ray Computed

Mucoceles of the paranasal sinuses are chronic expanding lesions containing inspissated mucus, which occurs when sinus ostium is obstructed. A variety of conservative and radical surgical procedures have been introduced, with each approach having advantages as well as disadvantages. Diseased frontal sinus mucosa and bone were commonly ablated by radical frontal sinus surgery such as osteoplastic flap surgery in the past. During the last decade, endoscopic sinus surgery has become the major choice for the treatment of paranasal sinus mucoceles, and the technique of endoscopic sinus marsupialization has been considered non-invasive and successful. But the technique has limitation in cases with small frontal recess or mucocele in the lateral portion of the frontal sinus which is not accessible via the nose, and hypertrophic mucosa obstructing the entire sinus. A 52-year-old man was presented with a supraorbital cell mucocele located in the lateral side of frontal sinus mucocele, which could not be treated by endoscopic surgery alone. Endoscopic surgery with sinus marsupialization, trephination and transillumination technique was introduced. We report this case with a review of related literatures.
Endoscopy ; Frontal Sinus ; Humans ; Middle Aged ; Mucocele* ; Mucous Membrane ; Mucus ; Nose ; Paranasal Sinuses ; Transillumination* ; Trephining*

Cerebral air embolism is a rare, potentially catastrophic iatrogenic complication of central venous catheter removal. Cerebral air embolism can lead to serious neurological sequelae, resulting from cerebral infarction. Early radiological diagnosis of cerebral air embolism is critical for emergent hyperbaric oxygen treatment. In this study, we report the case of a 68-year-old man who developed cerebral air embolism after the removal of a central venous catheter that was immediately diagnosed using brain CT and brain diffusion-weighted imaging.

PURPOSE: Various causes may be the etiology of gynecomastia. We investigated the levels of serum estradiol (E2), testosterone (T), ratio of E2 to T (E2/T) as well as associated diseases, drugs as the cause of gynecomastia. MATERIALS AND METHODS: E2, T, E2/T in 37 patients from gynecomastia patients (GP) and 10 healthy men were measured, and the associated diseases and drugs in 68 GP were also evaluated. Ultrasound for the adrenal gland diseases, physical examination or ultrasound for the testicular pathology were performed. RESULTS: The cause of gynecomastia varied according to the age. The levels of E2, T, E2/T in control group (CG) were 35.3 3.9 pg/ml, 5.0 0.4 ng/ml, 7.1 0.5. Those in GP were 48.7 7.1 pg/ml, 4.3 0.3 ng/ml, 12.0 1.8, respectively. The difference of E2/T as well as E, T between CG and GP was not significant. Various associated diseases or drugs were found in GP. Adrenal diseases or testicular cancer were not found in GP. CONCLUSIONS: The difference of E2/T between CG and GP is not the only cause of gynecomastia. Thus, the consideration of the age as well as associated diseases or drugs will be helpful for the better understanding of high E2/T as the cause of gynecomastia
Adrenal Gland Diseases ; Estradiol ; Gynecomastia* ; Humans ; Male ; Pathology ; Physical Examination ; Testicular Neoplasms ; Testosterone ; Ultrasonography

Metastatic urethral tumor is extremely rare. We report a case of anterior urethral and hepatic metastasis from a rectal adenocarcinoma developed 17 months after radical resection of rectal cancer. The patient was performed suprapubic cystostomy for management of voiding difficulty, thereafter, died 4 months after presentation.
Adenocarcinoma* ; Cystostomy ; Humans ; Neoplasm Metastasis* ; Rectal Neoplasms