No abstract available.
Cerebrospinal Fluid* ; Immunoglobulin G* ; Meningitis, Aseptic*

The serum phosphorus level is maintained through a complex interplay between intestinal absorption, exchange intracellular and bone storage pools, and renal tubular reabsorption. The kidney plays a major role in regulation of phosphorus homeostasis by renal tubular reabsorption. Type IIa and type IIc Na+/Pi transporters are important renal Na+-dependent inorganic phosphate (Pi) transporters, which are expressed in the brush border membrane of proximal tubular cells. Both are regulated by dietary Pi intake, vitamin D, fibroblast growth factor 23 (FGF23) and parathyroid hormone. The expression of type IIa Na+/Pi transporter result from hypophosphatemia quickly. However, type IIc appears to act more slowly. Physiological and pathophysiological alteration in renal Pi reabsorption are related to altered brush-border membrane expression/content of the type II Na+/Pi cotransporter. Many studies of genetic and acquired renal phosphate wasting disorders have led to the identification of novel genes. Two novel Pi regulating genes, PHEX and FGF23, play a role in the pathophysiology of genetic and acquired renal phosphate wasting disorders and studies are underway to define their mechanism on renal Pi regulation. In recent studies, sodium-hydrogen exchanger regulatory factor 1 (NHERF1) is reported as another new regulator for Pi reabsorption mechanism.
Fibroblast Growth Factors ; Homeostasis ; Hypophosphatemia ; Intestinal Absorption ; Kidney ; Membranes ; Microvilli ; Parathyroid Hormone ; Phosphoproteins ; Phosphorus ; Sodium-Hydrogen Antiporter ; Sodium-Phosphate Cotransporter Proteins ; Vitamin D

Fibrous dysplasia infrequently involves the cranium with wide range of variety. Recently, we have expierenced a case of diffuse sclerotic type of fibrous dysplasia which involves frontal and sphenoid bone with vault deformity. Furthermore, we stressed the diagnostic procedures such as carotid angiography, orbital venoraphy & C-T scan, are valuable in recognization of the extent of involvement and in differential diagnosis.
Angiography ; Congenital Abnormalities ; Diagnosis, Differential ; Orbit ; Skull* ; Sphenoid Bone

BACKGROUND/AIMS: The aim of this study was to evaluate the peritonitis-causing bacteria detected in peritoneal fluid using a blood culture bottle in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS: One-hundred and eleven dialysates from 43 patients suspected of peritonitis related to CAPD were retrospectively evaluated between May 2000 and February 2008. In all cases, 5 to 10 mL of dialysate was inoculated into a pair of BacT/Alert blood culture bottles, and 50 mL of centrifuged dialysate was simultaneously inoculated into a solid culture media for conventional culture. The results were compared to those of the conventional culture method. Isolated microorganisms were compared between the two methods. RESULTS: The blood culture method was positive in 78.6% (88 / 112) of dialysate specimens and the conventional culture method in 50% (56 / 112, p < 0.001). CONCLUSIONS: The blood culture method using the BacT/Alert system is useful for culturing dialysates and improves the positive culture rate in patients with suspected peritonitis compared to the conventional culture method.
Culture Media ; Dialysis Solutions ; Gram-Negative Bacterial Infections/*diagnosis/microbiology ; Gram-Positive Bacterial Infections/*diagnosis/microbiology ; Humans ; Kidney Failure, Chronic/*therapy ; Microbiological Techniques/*methods ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects ; Peritonitis/*diagnosis/microbiology ; Sensitivity and Specificity

Dyke-Davidoff syndorme is a rare congenital disorder which developed hemiatropy of brain, enlargement of ventricles and prominent pneumatization of petrous pyramid of the temporal bone. It mainfests unilateral invountary movement such as seizure, athetosis, chorea and mental retardation. This disorder have strong evidence of significance to differential diagnosis of cerebral palsy because of different therapeutic approach and outcome. Recently we examined 10 years old girl who developed seizure at 2 years old and gradually progressed with hemiparesis, hypoplaisa of right side of the body. The brain CT scan showed marked dilatation of lateral ventricle, prominent sylvian fissure and cortical sulci with somewhat thickened skull vault and pneumatization of petrous pyramid of the temporal bone on left side. EEG showed high voltage slow wave and spikes. So we report a case of Dyke-Davidoff syndrome with review of literature.
Athetosis ; Brain ; Cerebral Palsy ; Child ; Child, Preschool ; Chorea ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diagnosis, Differential ; Dilatation ; Electroencephalography ; Female ; Humans ; Intellectual Disability ; Lateral Ventricles ; Paresis ; Petrous Bone ; Seizures ; Skull ; Temporal Bone ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Icodextrin (glucose polymer) is metabolized by a-amylase to oligosaccharides such as maltose and maltotriose. The presence of these metabolites could have an effect on the enzymatic glucose measurement especially the glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) based method. Patients treated with icodextrin are at risk for inaccurate blood glucose measurements. In this study we measured the blood glucose with different methods and analyzed the results to determine the test accuracy. METHODS: The blood glucose was measured, in seven outpatients and in seven inpatients using icodextrin, by the glucose hexokinase laboratory technique method as well as the GDH-PQQ method (Accu Chek Active)at the same time. To estimate an icodextrin residual effect, after discontinuing icodextin, the blood glucose was measured by the two methods after 48 hours in 4 inpatients. RESULTS: In seven outpatients the blood glucose was overestimated by the Accu Chek Active method (mean difference 68 mg/dL, p value 0.012). In seven inpatients the mean difference in the glucose was 56 mg/dL at 6am, 52 mg/dL at 11am, 52 mg/dL at 4pm, and 50 mg/dL at 9pm by the two different methods. In the four inpatients after changing their dialysate, the mean difference in the glucose was 58 mg/dL after 10 hours, 45 mg/dL after 24 hours, 24 mg/dL after 34 hours, and 26 mg/dL after 48 hours. CONCLUSION: Blood glucose was overestimated by the GDH-PQQ method and the inaccuracies were observed for more than 48 hours.
Blood Glucose ; Glucans ; Glucose ; Glucose 1-Dehydrogenase ; Hexokinase ; Humans ; Hypoglycemia ; Inpatients ; Maltose ; Oligosaccharides ; Outpatients ; Peritoneal Dialysis, Continuous Ambulatory ; Trisaccharides

Disturbances of the surrounding vascular system and the severe cicatrical entrapment of the injured plexus should be considered, with its neural damage, in brachial plexus injury by Gun-Shot. Therefore, Subclavian arteriography and Subclavian venography before operation should be essential and the correction of the deficit of the vascular system may be a factor in the determination of prognosis in relation to pain control. We have reported 2 cases of the brachial plexus injury by Gun-shot and discussed the importance of Subcalvian arteriography and Subclavian venography. External neurolysis seems to be beneficial in Causalgia caused by brachial plexus injury.
Angiography ; Brachial Plexus* ; Causalgia ; Phlebography ; Prognosis

PURPOSE: The Physiological and Operative Severity Score for the enumeration of Morbidity and Mortality (POSSUM), the Portsmouth-POSSUM (P-POSSUM), and the colorectal-POSSUM (Cr-POSSUM) are relative scoring systems for the prediction of postoperative morbidity and mortality. This study is designed to evaluate the usefulness of each scoring system in elderly colorectal cancer patients undergoing major colorectal surgery. METHODS: From January 2000 to May 2008, the authors retrospectively analyzed the medical records of 251 elderly colorectal cancer patients who had undergone surgery. Collected data were analyzed using the Mann-Whitney U-test, a risk stratification analysis, and a receiver-operator characteristic (ROC) curve to evaluate the usefulness and the accuracy of each scoring system. RESULTS: All the predicted morbidity and mortality rates calculated by using the three POSSUM systems were higher than the observed morbidity and mortality rates. A risk stratification analysis showed a considerable correlation in risk prediction between the observed data and the calculated data. The ROC curves showed that all three POSSUM scoring systems had quite high accuracies as predictors of postoperative morbidity and mortality. POSSUM and P-POSSUM were more accurate than Cr-POSSUM. CONCLUSION: All three scoring systems have a tendency for overestimation. The accuracies of POSSUM, P-POSSUM, and Cr-POSSUM as predictors are acceptance, and POSSUM and P-POSSUM are more accurate than Cr-POSSUM for prediting postoperative morbidity and mortality.
Aged ; Colorectal Neoplasms ; Colorectal Surgery ; Humans ; Medical Records ; Retrospective Studies ; ROC Curve

Despite the frequent occurrence of peritonitis in patients with continuous ambulatory peritoneal dialysis (CAPD), fungal peritonitis is uncommon and usually associated with antibiotics and immunodeficiency. Most of the fungal isolates are usually Candida albicans, Candida parapsilosis, Candida guilliermondii or Candida torulopsis. The authors report a case of fungal CAPD related peritonitis due to Candida zeylanoides that occurred in a patient with the absence of the usual risk factors for fungal peritonitis. Treatment with intravenous fluconazole was successful.
Anti-Bacterial Agents ; Candida ; Candida albicans ; Candida glabrata ; Candidiasis ; Fluconazole ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Risk Factors

Post transplant lymphoproliferative disorder is a serious complication after renal transplantation. Although the precise etiology is unknown, the Ebstein-Bar virus and immunosuppressive agents appear to be risk factors. The presentation of PTLD is diverse. Many patients develop symptoms in head and neck, which make diagnosis difficult. We experienced 3 cases of PTLD successively one or three months apart during year 2002. Before 2002, PTLD was very rare in our center. The incidence of PTLD in renal transplants in our center is 0.7% (5 out of 752), which is similar to that of other reports. But the incidence is very high during year 2002. This seems to be intensified immunosuppression recently adopted. EBV monitoring is necessary for early detection of PTLD in renal transplants.
Diagnosis ; Head ; Herpesvirus 4, Human ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation ; Lymphoproliferative Disorders* ; Neck ; Risk Factors