No abstract available.
Glomerulonephritis* ; Humans ; T-Lymphocytes*

No abstract available.
Gangwon-do* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Liver Diseases* ; Liver* ; Prevalence*

No abstract available.
Fetal Macrosomia*

Fournier described five patients with gangrene of male external genitalia in 1883 and emphasized three characteristics: (1) abrupt onset in young healthy male, (2) rapid progression to gangrene,(3) absence of discernible cause. But more recent reports described genital gangrene as occurring in any age group and 4 patients in our cases, the mean age was 46 years with an age range of 31 to 59 years. Predisposing causes were as follows: case 1. prostatic calculi, Buerger's disease, case 2, perianal abscess, case 3, diabetes mellitus, case 4, tuberculous spondylitis accompanied by paraplegia and bed sores, liver cirrhosis. The duration of symptoms prior to the development of gangrene varied between 4 to 10 days. The cultured organisms were as follows : case 1. Alpha-hemolytic streptococcus, case 2. E. coli, Alpha-hemolytic streptococcus case 3. Alpha-hemolytic streptococcus, case 4, Mycobacterium tuberculosis, proteus species. Reconstructive surgery of defected scrotum was performed postoperative 8 to 41 days (mean 28.7) and total admission period was 25 to 83 days (mean 46 days).
Abscess ; Calculi ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Genitalia ; Humans ; Liver Cirrhosis ; Male ; Mycobacterium tuberculosis ; Paraplegia ; Pressure Ulcer ; Proteus ; Scrotum ; Spondylitis ; Streptococcus ; Thromboangiitis Obliterans

We report a caae of hepatic and intestinal infestation with paragonimus wewstermani complicating abscess formation. The pathway by which the paragonimus westermani reaehea liver and intestine is not well understood. However, there was possiblity that it may become lodged in other organs that the lung because of polonged larval migrations through the diaphragm or into various sites in the abdomen. The patient, 52-year-old female gave a history of having reyeatedly consumed raw crabs. An x-ray film of the chest showed clear lunga Skin test for paragonimus-westermani was positive. Abdominal ultrasonogram showed enlargement of the liver with multiple hypoechoic lesiona ERCP revealed multiple ie lesions in the right lobe of the liver. Abdaminal CT showed multifocal abscess cavities with slight rim enhancements. Above meetioned diagnostic procedures suggested liver abscess or hepatoma. Then, an exploratory laparotomy was done for a definite diagnosis, Frozen biopsy, from liver and surgically exe mass from ileocecal region revealed extrpulmonary paragnomiasis involving liver and cecum. Thus, the patient was treated with prasiquantel. Three months later, abdominal ultrasonogram demonstrated slight enlargement of the liver but no evidence of abnormal mass like lesions.
Abdomen ; Abscess ; Biopsy ; Carcinoma, Hepatocellular ; Cecum* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diaphragm ; Female ; Humans ; Intestines ; Laparotomy ; Liver Abscess ; Liver* ; Lung ; Middle Aged ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Praziquantel ; Skin Tests ; Thorax ; Ultrasonography ; X-Ray Film

Cytomegalovirus(CMV) infection occurs more frequently in renal transplant recipients than in the normal population. But the incidence and severity of CMV infection and antibody positivity are different between countries. We studied the incidence of CMV infection with a long term follow up in renal transplant recipients who were IgG CMV positive and whose donors were also IgG CMV positive preoperatively. We studied the difference and usefulness of various detection methods including IgM CMV antibody by ELISA, shell vial culture, and quantitative dual polymerase chain reaction(PCR). We also studied possible factors that may affect CMV infection and the function of the grafted kidney in CMV infected patients. This study included 36 patients, 20 males and 16 females, who received renal transplantation at Hanyang University Hospital between July, 1994 and March, 1995. IgG and IgM CMV antibodies were detected and shell vial cultures were performed in recipient candidates and donor candidates preoperatively. Postoperatively, we checked IgM CMV and performed shell vial cultures in renal transplant recipients every month after the operation and when CMV infections were suspected. We also performed dual PCR with endpoint titration to quantify the amount of CMV DNA. The total incidence of CMV infection was 30.6% (11 patients among 36 patients). Three patients had CMV disease, and only one patient was severe enough to need gancyclovir therapy. The average onset of infection was 12.9 weeks after the operation(earliest 5weeks-latest 33weeks). In all patients with CMV disease, CMV positivity appeared by all three detection methods. But detection time and duration of positivity were different. The amount of CMV DNA in patients with active CMV disease was higher than those of asymptomatic patients and one patient following antiviral therapy. Age, sex, donor type, HLA matching and rejection did not affect CMV infection. Incidence of CMV infection was higher in patients who were transfused within 3 weeks before the operation(6/8 vs 5/28, p=0.048). Changes of creatinine level from initial outpatient department(OPD) visit to last OPD visit which were corrected by OPD follow up time showed no significant difference between CMV infected and non-infected patients In conclusion, the incidence of CMV infection and disease was relatively low, and the degree of disease severity was mild. In our renal transplant recipients, CMV infection may not be a serious problem. Quantitative dual PCR using end-point titration is a good method to detect CMV infections and monitor the clinical course. Because it is easy to use, detect disease earlier and can quantify the amount of CMV DNA. Among various factors, transfusion affected CMV infection significantly in our patients. In an average of 231 days of OPD follow up time, CMV infected patients showed no impairment of grafted kidney function, but a more long term follow up is needed.
Antibodies ; Creatinine ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Ganciclovir ; Humans ; Immunoglobulin G* ; Immunoglobulin M ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Outpatients ; Polymerase Chain Reaction ; Tissue Donors ; Transplantation* ; Transplants

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Differential diagnosis of cavitary lung lesions is frequently problematic. We studied 35 patients with cavitary lung lesions, consisting of lung cancer (17 patients). Pulmonary tuberculosis(11 patients), and lung abscess (7 patients). We analysed CT scans in terms of irregularities of the cavity wall, maximum wall thickness, the presence of air-fluid level, location of the cavity within the mass, number of cavities within the mass, size of the cavity and the presence of calcification within the mass. Cancer cavity showed irregular inner (100%) and outer margins(100%), and thick wall (mean, 1.94cm), eccentrical location(94%) and multiplicity within a mass(38%). Tuberculous cavity showed smooth inner (56%) and irregular outer margins(75%), thin wall (mean 0.96cm), central location (62%), and multiplicity in one patient (36%). Abscess cavity showed irregular inner (57%) and outer margins(91%), relatively thin wall (mean 1.0cm), central location (57%), and air-fluid level (86%). CT scan could differentiate malignant lesions from benign condition such as tuberculosis and lung abscess by observing characteristics of the cavities.
Abscess* ; Diagnosis, Differential ; Humans ; Lung Abscess ; Lung Neoplasms* ; Lung* ; Tomography, X-Ray Computed ; Tuberculosis*

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

BACKGROUND AND OBJECTIVES: Dual isotope myocardial SPECT, rest thallium-201/dipyridamole stress Tc-99m sestamibi is used to diagnose coronary artery disease. We examined predictive value of myocardial SPECT for the prognosis of patients having or suspected coronary artery disease. MATERIALS AND METHOD: We examined 692 patients referred for dipyridamole stress myocardial perfusion SPECT. Cardiac events (hard and soft events) were followed up with medical record review and telephone interview. Survival analysis and multivariate Cox proportional hazard model were used to find significant predictors and the incremental predictive value of myocardial SPECT. Patients with coronary angiography (n=246) were analyzed in separate group. RESULTS: There were 4 hard events and 3 soft events in 341 normal SPECT group (1.20%/yr). There were 5 hard events and 21 soft events in 351 abnormal SPECT group (4.69%/yr). Survival curve was separated between normal SPECT group and abnormal SPECT group (p<0.01). In univariate analysis, smoking, history of myocardial infarction, typical chest pain and SPECT findings were important variables. In multivariate analysis, SPECT result was the single most independent predictor. Large reversible perfusion abnormality predicted worse prognosis. In patients with coronary angiography, SPECT did not add statistically significant predictive value to the coronary angiography. CONCLUSION: Dipyridamole stress Tl-201/ MIBI dual isotope myocardial perfusion SPECT provided excellent prognostic information. Extent of reversible perfusion decrease was the independent predictor of future cardiac events.
Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Dipyridamole ; Humans ; Interviews as Topic ; Medical Records ; Multivariate Analysis ; Myocardial Infarction ; Perfusion ; Prognosis ; Proportional Hazards Models ; Smoke ; Smoking ; Tomography, Emission-Computed, Single-Photon*