No abstract available.
Dermatomyositis*

Bezafibrate, a fibric acid derivative related to clofibrate, is being used increasingly in the treatment of hypertriglycemia. It is relatively well tolerated at usual dosage, and has a low incidence of adverse reactions. But we had recently observed a reversible deterioration of renal function requiring hemodialysis, presumed to be caused by bezafibrate treatment in a patient with diabetic nephropathy. A 55 year old man was admitted with complaints of general weakness and painful lower extremities. He had taken bezafibrate (200 mg every 12 hours) for the previous 4 months because of hypertriglycemia. After admission, the drug was withdrawn, and he was treated conservatively management with hydration and diuretics for bezafibrate induced rhabdomyolysis. Nevertheless, his symptom was not improved, so he was taken even hemodialysis. These findings suggested that bezafibrate should be admistered with great caution to patient with renal insufficiency. When it is admistered, CK, LDH, aldolase, and sGOT levels have to be checked for early detection of potential side effect.
Aspartate Aminotransferases ; Bezafibrate* ; Clofibrate ; Diabetic Nephropathies ; Diuretics ; Fructose-Bisphosphate Aldolase ; Humans ; Incidence ; Lower Extremity ; Middle Aged ; Renal Dialysis ; Renal Insufficiency ; Rhabdomyolysis*

PURPOSE: To evaluate differences between dominant and non-dominant eyes through analyzing refractive factors in determination of the dominant eye. METHODS: Sixty-two subjects without underlying ocular disease were recruited. Ocular dominance was determined using the hole-in-the-card test. Uncorrected visual acuity, refractive error, and intraocular pressure (IOP) were checked in both eyes. RESULTS: Mean uncorrected visual acuity of the dominant and non-dominant eye were 0.41 and 0.39, respectively. The number of patients whose uncorrected visual acuity of the dominant eye was superior to the non-dominant eye was 18(29%), and inferior to the non-dominant eye was 18(29%). Mean refractive power in the dominant eye was -3.2 diopter and -3.43 diopter degrees in the non-dominant eye, therefore no difference in degrees of myopia between the groups (P=0.282) was observed. The number of patients whose dominant eye had a greater degree of myopia than the non-dominant eye was 24(39%) and the patients with a lower degree of myopia in the dominant eye was 32(52%). Astigmatism of the dominant eye was lower than the non-dominant eye in 35(56%) of the patients, thus a significant relationship was shown between astigmatism and the dominant eye (P=0.0014). The mean IOP of the dominant eye was 15.4 mmHg and the non-dominant eye was 15.7 mmHg, showing no significant difference between eyes. CONCLUSIONS: The dominant eye showed a lower degree of astigmatism than the non-dominant eye. The previous belief that myopia is more progressed in the dominant eye than the non-dominant eye because of excessive accommodative use of the dominant eye requires further study.
Astigmatism ; Dominance, Ocular ; Eye ; Humans ; Intraocular Pressure ; Myopia ; Refractive Errors ; Visual Acuity

PURPOSE: Early identification of causative agents in lower respiratory infection of pediatric patients can reduce morbidity and prevent an overuse of antimicrobials. Two kinds of multiplex polymerase chain reaction (PCR) and a commercial shell vial viral culture were performed to identify causative agents in pediatric patients. MATERIALS AND METHODS: Nasopharyngeal aspirates of 220 children diagnosed with viral pneumonia were obtained. Two kinds of multiplex PCR (Seeplextrade mark RV detection kit, and Labopasstrade mark RV detection kit), and a shell vial culture by R-Mix were performed. RESULTS: Positive samples from 220 total samples by two multiplex PCRs were 52.7% and 46.4%, respectively. We also cultured 103 samples that showed positive results of the adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV) by two multiplex PCR. The RSV was most frequently detected in 53.0% (Seeplex) and 51.7% (Labopass) of patients. The detection rate of adenovirus (AdV) was 10.3% and 12.1%, influenza virus (IFV) A and B was 12.5% and 3.4%, and parainfluenza virus (PIFV) 1, 2, and 3 were 2.9% and 2.6%. Shell vial cultures showed concordant results with each multiplex PCR by 96.1% and 77.7%, respectively. Sequencing results were 90% consistent with multiplex PCR. CONCLUSION: Multiplex PCR showed more positivity than the shell vial culture and it can be an effective primary test. Other complementary efforts such as viral cultures and sequencing analysis could be considered, according to clinical and laboratory conditions.
Adenoviridae/genetics/*isolation & purification ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Orthomyxoviridae/genetics/*isolation & purification ; Pneumonia, Viral/*virology ; Polymerase Chain Reaction/*methods ; Respiratory Syncytial Viruses/genetics/*isolation & purification ; Respirovirus/genetics/*isolation & purification

Voiding cystourethrography (VCUG) is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-month-old infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patient's bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.
Bacteremia ; Catheters ; Child ; Contrast Media ; Humans ; Infant ; Kidney Failure, Chronic ; Rupture ; Urinary Bladder ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: Growth patterns of colorectal carcinomas can be divided into polypoid growth (PG) and nonpolypoid growth (NPG). This study was intended to find characteristic clinicopathologic features and the expression status of p53, p21, and p16 with relation to growth patterns in colorectal carcinomas. METHODS: Sixty-one surgically resected colorectal carcinomas including 43 PG and 18 NPG carcinomas were reviewed in this study. Immunohistochemical stains for p53, p21, and p16 were done, and the results were analyzed with respect to growth patterns, and other prognosic parameters. RESULTS: PG carcinomas were significantly correlated with adenoma (p=0.0001), and with favorable histology group (p=0.04). On the contrary, NPG carcinomas were significantly correlated with unfavorable histology group (p=0.04). In NPG carcinomas, the frequency of positive expression of p53 was higher and the expression of p16 was lower than that of PG carcinomas. But there was no statistical significance (p=0.150, 0.210 respectively). The expression of p21 has no difference between NPG and PG carcinomas (p=0.953). CONCLUSIONS: As a result, it can be thought that the tendency of higher expression of p53 and lower expression of p16 in NPG carcinomas than in PG carcinomas may suggest more aggressive biologic behavior of NPG carcinomas.
Adenoma ; Colorectal Neoplasms* ; Coloring Agents ; Genes, Tumor Suppressor*

Focal nodular hyperplasia (FNH) is a benig nepithelial tumor of the liver. The etiology of FNH is unknown, but recent evidence suggests that FNH may represent a localized, hyperplastic response to a pre-existing vascular malformat ion. There is a high probability of as sociat edlesions , most commonly hepatic hemangiomas, meningioma, as trocytoma, and arterial dysplasia in various organs . In the present report we describe a FNH with aberrant lymphatics in a 24-year-old woman. In operation field, lymphatics were located on the site of falciform ligament. Histologically, aberrant lymphatics were composed of well vas cularized complex lymphatic channels and the mass were typical FNH. In this case, the role of aberrant lymphatics in the development of FNH was unclear . But as the FNH frequently as sociated with ot her anomalies , we think the aberrant lymphatic as such anomaly that have not been reported.
Carcinoma, Hepatocellular* ; Female ; Focal Nodular Hyperplasia ; Hemangioma ; Humans ; Ligaments ; Liver ; Meningioma ; Young Adult

Hypertension is a frequent complication after organ transplantation and remains risk factor for the development of cardiovascular disease and graft dysfunction after renal transplantation. The prevalence of hypertension after renal transplantation varies from 50% to 93%. There are multiple mechanisms for development of post-transplant hypertension. To examine the effects of hypertension on renal allograft survival, we studied the clinical course of 319 kidney transplant recipients(male:female=231:88, mean age=32.9+/-10.4 yrs) who had functioning graft at least 6 months. The patients were divided into three groups : normotensive groups(n=90), controlled hypertensive groups(n=176) and uncontrolled hypertensive groups(n=53). Among 319 patients, 229(72%) were hypertensive at the time of renal transplantation. The incidence of hypertension decreased progressively to 68%, 65% and 61% at 1, 3 and 5 years after transplantation (p<0.05). The numbers of antihypertensive medication at the time of operation was 1.35+/-1.09, which decreased significantly to 0.98+/-0.76 at 12 months after renal transplantation(p<0.05). Cumulative graft survival at 5 years for normotensive and controlled hypertensive patients were 44% and 50% respectively, 20% for uncontrolled hypertensive patients. The difference of 5 years graft survival between controlled hypertensive and uncontrolled hypertensive patietns was significant (p<0.01), whereas the difference between the normotensive and controlled hypertensive group was not significant. We conclude that hypertension per se may not be an important risk factor for renal graft survival. However, the control of hypertension appear to be a more important risk factor for renal allograft survivial.
Allografts* ; Cardiovascular Diseases ; Graft Survival ; Humans ; Hypertension* ; Incidence ; Kidney Transplantation* ; Kidney* ; Organ Transplantation ; Prevalence ; Risk Factors ; Transplants

Uterine myomas are the most common benign tumor of the female genital organ. Uterine artery embolization is well reported of primary treatment of uterine myoma. A 29 year-old nulliparous woman was diagnosed as uterine myoma by ultrasonogram. We embolize both uterine artery after treatment with GnRH analog and then we experience a case of improvement of menorrhagia, with reduction in uterine myoma size. So we report that case with a brief review.
Adult ; Female ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Leiomyoma* ; Menorrhagia ; Ultrasonography ; Uterine Artery Embolization* ; Uterine Artery*

Uterine myomas are the most common benign tumor of the female genital organ. Uterine artery embolization is well reported of primary treatment of uterine myoma. A 29 year-old nulliparous woman was diagnosed as uterine myoma by ultrasonogram. We embolize both uterine artery after treatment with GnRH analog and then we experience a case of improvement of menorrhagia, with reduction in uterine myoma size. So we report that case with a brief review.
Adult ; Female ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Leiomyoma* ; Menorrhagia ; Ultrasonography ; Uterine Artery Embolization* ; Uterine Artery*