Evaluations of residual renal function and the therapeutic effectiveness in renal tuberculosis have largely been dependent on intravenous pyelogram or Contrast-CT scan, even though, exact renal function are not evaluated with there methads. 99mTc-DMSA is a radiopharmaceutical that is trapped in the functioning tubular cells of the kidney and therefore, quantitative renal function could be evaluoted by ineasuring the counts of renal radioactivity and concomittant evaluation of renal morphology could be passible with the analog imapes of the radioactivity. The authors retrospectively analyzed 99mTc-DMSA scans of 75 kidndys of 67 patients with confirmed renal tuberculosis. We classified the morphologies of tuberculous kidneys as 6 types. We classified the morphologies of tuberculous kidneys as 6 types such as the type with small cortical defect, with parenchymal ulcerocavernous lesions, ulcerocavernous fistula to pelvis, mass-like defects, contracted kidney with ureter visualization, and the type with nonvisualization of kidney, corresponding to the characters of renal tuberculous pathogenesis with abscess formation, ulcerocavernous fistula, and fibrosis, and correspondings to the renal anatomy with parenchyma, and pelvocalyceal collecting system. Their mean residual renal functions measured with 99mTc-DMSA uptake rates were 19.0%, 18.4%, 7.9%, 12%, 4.1%, 3.4% respectively.
Abscess ; Fibrosis ; Fistula ; Fluspirilene ; Humans ; Kidney ; Pelvis ; Radioactivity ; Retrospective Studies ; Succimer* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Tuberculosis, Renal* ; Ureter

Hallervorden-Spatz disease (HSD) is a rare, progressive, autosomal recessive hereditary disorder characterized by pyramidal and extrapyramidal signs, speech disturbances, mental deterioration and retinal degeneration during childhood or adolescence. In late-onset form after the age of 20, parkinsonian features may be the predominant clinical manifestation. Meanwhile, involuntary tongue movements are rare and poorly understood, which have been reported in tardive dyskinesia, neuroacanthocytosis, chronic epilepsy, and after head trauma. We report a case of a patient with 'fly catcher's tongue' as a major clinical presentation, accompanied with mild parkinsonism, and typical MR findings of HSD.
Adolescent ; Craniocerebral Trauma ; Diptera* ; Epilepsy ; Humans ; Movement Disorders ; Neuroacanthocytosis ; Pantothenate Kinase-Associated Neurodegeneration* ; Parkinsonian Disorders ; Retinal Degeneration ; Tongue*

No abstract available.
Stomach Neoplasms*

Pseudothrombocytopenia is an in vitro phenomenon usually associated with anticoagulant (ethylene diaminetetraacetic acid, EDTA)-dependent IgG platelet agglutinins. Two cases of pseudothrombocytopenia due to EDTA-independent agglutinins are reported. The fingerstick blood smear showed platelet clumping as well as EDTA, citrate and heparin samples. In a case with malaria, serum IgM was 985 mg/dL and serum protein immunofixation demonstrated an additional IgM band which disappeared together with platelet clumping a month later. The increased immunoglobulin (especially, IgM) appeared to be associated with platelet agglutinin. Another case had cold reactive agglutinin because the electronic platelet counts were dependent on temperature. These cases illustrate that pseudothrombocytopenia may be caused by more than one type of agglutinin and can be confirmed by using a direct fingerstick, keeping the sample warm, or drawing the blood into another anticoagulant.
Agglutinins* ; Blood Platelets ; Citric Acid ; Edetic Acid ; Heparin ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Malaria ; Platelet Count

Polyploid cells in the urinary sediments often give an erroneous clinical judgement in cases of post-pelvic irradiation follow-up, but their nature and evolution have remained unclarified. An experimental induction of polyploid cells in the transitional epithelium of the urinary bladder was carried out in Sprague-Dawley rats by administration of 3,000 rads in a single dose, and their sequential morphological changes were analysed under light and electron microscopes. 1. The acute post-irradiation changes of transitional epithelial cells were manifested with two consecutive phases of degenerative process ; the early lesion started to appear from the first day after irradiation and diminished partly at the 7th day; the later changes became enhanced progressively from the 2nd week and maximized at the 3rd week, but regressed thereafter . 2. The general histological alterations of the transitional epithelial cells in the acute stage were characterized by cytoplasmic vacuolization due to profound widening of intercellular cisternal spaces and dilatation of smooth endoplasmic reticulum aside from severe disruption of mitochondria and increase of lysosomes, especially in the superficial and intermediate cells, and by eventual outcome of cell death by nuclear pyknosis and karyorrhexis. 3. The polyploid cell change was demonstrated as a spectrum of the later alterations of acute irradiation injury to the basal layer cells, and appeared early from the 2nd week and regressed after the 4th week. 4. Based on their increased size and nuclear abnormalities, those polyploid cells exhibited features of both amitotic nuclei and cytoplasmic degenerative processes ultrastructurally, and in the acute phase the nuclear indentation and lobulation were associated with increased amount of heterochromatins and margination together with nucleolar enlargement and increase in number. 5. The above cells started to regress thereafter, being terminated by nuclear pyknosis and karyolysis, and numerical reduction of the polyploid cells was accompanied concomitantly with basal (reserve) cell hyperplasia of the remained epithelium. It is of the author's assumption that the polyploid cell phenomenon induced by irradiation onto the transitional epithelium of the urinary bladder is a transient manifestation of irradiated amitotic basal cells during the later phase of acute post-irradiation injury and is subsequently removed out by nuclear pyknosis and karyolytic processes.
Animals ; Cell Death ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum, Smooth ; Epithelial Cells ; Epithelium* ; Follow-Up Studies ; Heterochromatin ; Hyperplasia ; Lysosomes ; Mitochondria ; Polyploidy* ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neoplasms ; Urinary Bladder*

Dieulafoys lesion consists of abnormally large gastric submucosal artery which ruptures into the stomach causing massive or recurrent intragikstric bleeding. The lesion is very small and easily overlooked even at laparatomy and aan only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. Three patients who were admitted with bleeding of upper gastrointestinal tract and eventually diagnosed as having Dieulafoys lesions were analysed. All were men with age range of 44 to 55 years. All patient were asymptomatic before presenting with hematemesis. Two of the three patients had had history of upper Gl bleeding. One patient used analgesics daily for ureteral colic and two patient drank alcohol excessively. Gastroscopy was performed during the bleeding episode in all three patients. Dieulafoy's lesion was seen in all three cases and in the second case, there was concomittent diffuse petechia in the whole stomach. The lesion was situated on the posterior wall of upper body in one, on anterior wall of upper body in another, lesser curvature side of gastric fundus in the other case. All three patient underwent laparotomy for persistent bleeding and the lesion was suture ligated only in two patients while in one patient vagotomy and pyloroplasty was added. Resection biopsy was performed in two cases and both revealed only normal gastric mucosa. All patients discharged after complete recover.
Analgesics ; Angiography ; Arteries ; Biopsy ; Endoscopy ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Renal Colic ; Rupture ; Stomach ; Sutures ; Upper Gastrointestinal Tract ; Vagotomy

PURPOSE: The purpose of this study was to evaluate the role of glucose transporter in peritoneal glucose and fluid transport. METHODS: Male Sprague-Dawley rats were used. 5mL normal saline with(CB) and without(C) Cytochalasin B(1 muM) was intraperitoneally injected once. From the next day 25 mL commercial dialysis solutions containing 4.25% glucose was injected into the peritoneal cavity twice a day for 8 weeks in a half of each group(CB-IP, n=6 and C-IP, n=8). The other half of each group served as control without IP(C- Control, n=7 and CB-Control, n=7). A 2 hour dwell study was performed using dialysis solutions containing 4.25% glucose. Intraperitoneal volume(IPV) after 2 hours of dwell was measured and peritoneal fluid absorption rate(Qa) was calculated as RISA disappearance rate. Dialysate glucose amount remaining after 2hour dwell(DGA) was calculated and expressed as % of the initial value. RESULTS: IPV was significantly higher in CB than in C in both IP and Control. IPV was significantly lower in C-IP than in C-Control and CB-IP while it was similar between CB-Control and CB-IP. Qa was significantly higher in IP than in Control. DGR was significantly higher in CB than in C and in control than in IP. CONCLUSION: Longterm peritoneal exposure to high glucose dialysis solution increased peritoneal glucose absorption and decreased ultrafiltration volume in rat. A single IP use of glucose transporter inhibitor attenuated increased glucose absorption and decreased ultrafiltration after longterm peritoneal exposure to dialysate.
Absorption* ; Animals ; Ascitic Fluid ; Dialysis ; Dialysis Solutions ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Humans ; Male ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory ; Rats ; Rats, Sprague-Dawley ; Ultrafiltration

PURPOSE: It is essential to know the functional and morphologic changes of the larynx in the evaluation of laryngeal lesions. Conventional CT which has relatively long examination time is not suitable for this aim. The purposes of this study are to evaluate the capability of spiral CT in the dynamic study of the larynx and to know whether this new technique can replace conventional laryngography or not. MATERIALS AND METHODS: Five healthy volunteers and 20 patients with laryngeal lesions underwent spiral dynamic CT scans with 3-dimensional reconstruction of the mucosal surface. A series of spiral CT scans were done while the volunteers performed various laryngeal positions to obtain the functional and morphologic information. The maneuvers used were:quite breathing, "E" phonation, Valsalva maneuver, modified Valsalva maneuver, and a new method of our own, "modified breath holding" technique. The patients were scanned when in quite breathing. Additioal scans were obtained by using the "modified breath holding" technique. RESULTS: The dynamic study with spiral CT could provide high resolutional images which nicely depicted the mobility of vocal cords and the mucosal changes of the laryngeal cavity in both healthy volunteer and patient groups. In patient group, the new "modified breath holding" technique was easier and more reproducible than other maneuvers. CONCLUSION: Spiral CT allows a dynamic study of the larynx and can be a new alternative of laryngography.
Healthy Volunteers ; Humans ; Larynx* ; Phonation ; Respiration ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Valsalva Maneuver ; Vocal Cords ; Volunteers

We injected tPA into the anterior chamber of 43 pesudophakic eyes with moderate to severe fibrinous membrane which had developed following cataract surgery from January, 1990 to August, 1990 at St. Mary's hospital. The results were as follows: 1. Intraocular tPA injection was resulted in complete fibrinolysis within 1 hour in 38 of 43 eyes and patial fibrinolysis in 5 of 43. 2. No corneal endothelial cell loss was found, and tPA did not appear to cause a significant rise in intraocular pressure. 3. Complications of tPA injection included mild, transient, periocular pain(3 eyes), anterior chamber fibrin debris(2 eyes) and anterior chamber hemorrhage(1 eye). The results indicated that tPA is dramatically effective for the clearance of fibrinous membrane after cataract surgery.
Anterior Chamber ; Cataract* ; Corneal Endothelial Cell Loss ; Fibrin* ; Fibrinolysis ; Intraocular Pressure ; Membranes* ; Tissue Plasminogen Activator*

Lymphangioma occuring in the gastrointestinal tract is a rare benign tumor, which is composed of lymphatic vessels of various size. A sharply demarcated smooth, soft, cystic submucosal tumor which is easily compressible and covered with normal mucosa is a characteristic eadoscapic feature. Recently, we experienced a case of lymphangioma in ascendmg colon and removed it successfully by colonoscopic snare polypectomy.
Colon ; Colonoscopy ; Gastrointestinal Tract ; Intestine, Large* ; Lymphangioma* ; Lymphatic Vessels ; Mucous Membrane ; SNARE Proteins