No abstract available.
Paragonimiasis*

PURPOSE: A complete duplicated collecting system complicated with an ectopic ureter or ureterocele results in renal damage due to a ureteral obstruction or reflux. The clinical outcome of ureteropyelostomy in complicated complete duplicated collecting system was evaluated. MATERIALS AND METHODS: 20 children received a ureteropyelostomy for either an ectopic ureter or ureterocele with a complete duplicated collecting system anomaly. The median age was 3.2 months. Of the children, 11 had ureteroceles including 7 cecoureteroceles, and 9 had ectopic ureters. The associated anomalies were 3 UPJ obstructions of the lower pole and 9 VUR. All received a ureteropyelostomy. The lower pole ureter was used as the common ureter except in 2 cases with a lower ureter in poor condition. A lower pole pyeloplasty was combined in 3 cases with UPJ obstructions of the lower pole. A distal ureteral stump was left open except in the cecoureterocele in order to prevent VUR. Their clinical courses were followed up with an ultrasonogram and 99mTc-DMSA scan. The median follow-up after surgery was 17.8 months. RESULTS: A reduced upper pole hydronephrosis was observed in 19 patients and an improvement in the differential renal function was noted in 17 patients on the follow-up studies. All ureteroceles had either disappeared or were reduced in size. 7 patients showed an intermittent asymptomatic bacteriuria and 1 patient showed symptomatic UTI who required an ureteroneocystostomy during the follow-up. CONCLUSIONS: A ureteropyelostomy is recommended as a first-line treatment modality for patients with a complicated complete duplicated collecting system owing to the lower chance of secondary surgery, the prevention of deterioration in the bladder function and the possibility of early correction.
Bacteriuria ; Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter* ; Ureteral Obstruction ; Ureterocele* ; Urinary Bladder

PURPOSE: A complete duplicated collecting system complicated with an ectopic ureter or ureterocele results in renal damage due to a ureteral obstruction or reflux. The clinical outcome of ureteropyelostomy in complicated complete duplicated collecting system was evaluated. MATERIALS AND METHODS: 20 children received a ureteropyelostomy for either an ectopic ureter or ureterocele with a complete duplicated collecting system anomaly. The median age was 3.2 months. Of the children, 11 had ureteroceles including 7 cecoureteroceles, and 9 had ectopic ureters. The associated anomalies were 3 UPJ obstructions of the lower pole and 9 VUR. All received a ureteropyelostomy. The lower pole ureter was used as the common ureter except in 2 cases with a lower ureter in poor condition. A lower pole pyeloplasty was combined in 3 cases with UPJ obstructions of the lower pole. A distal ureteral stump was left open except in the cecoureterocele in order to prevent VUR. Their clinical courses were followed up with an ultrasonogram and 99mTc-DMSA scan. The median follow-up after surgery was 17.8 months. RESULTS: A reduced upper pole hydronephrosis was observed in 19 patients and an improvement in the differential renal function was noted in 17 patients on the follow-up studies. All ureteroceles had either disappeared or were reduced in size. 7 patients showed an intermittent asymptomatic bacteriuria and 1 patient showed symptomatic UTI who required an ureteroneocystostomy during the follow-up. CONCLUSIONS: A ureteropyelostomy is recommended as a first-line treatment modality for patients with a complicated complete duplicated collecting system owing to the lower chance of secondary surgery, the prevention of deterioration in the bladder function and the possibility of early correction.
Bacteriuria ; Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Ureter* ; Ureteral Obstruction ; Ureterocele* ; Urinary Bladder

PURPOSE: We investigated the trends and results of the outcome in patients with localized and locally advanced prostatic cancer treated with neoadjuvant androgen deprivation (NAAD) and external beam radiotherapy. MATERIALS AND METHODS: 14 patients with localized prostate cancer were treated with a 4 month-scheduled treatment that consisted of NAAD and radiotherapy. The number of patients in the clinical stage T1, T2, T3, and T4 were 3, 5, 2, and 4, respectively. External beam radiotherapy was performed for 6 weeks during NAAD period. After treatment, PSA relapse was evaluated with periodic PSA follow-up. RESULTS: There was no lymph node or distant metastasis in 14 patients. In all cases, PSA was less than 1ng/ml within 3 months of treatment. The number of patients with Gleason scores 2-4, 5-7 and 8-10 were 1, 7, and 4, respectively. In only one case with preradiotherapy PSA nadir level of 0.23ng/ml, the rising PSA level (>2.5ng/ml) was observed at 6 months after the end of the treatment, and the androgen deprivation resumed 10 months after the end of the treatment. No severe complication was observed in all patients, and the observed minor complications were dysuria (3; 21.4%), frequency (2; 14.3%), urgency (1; 7.1%), urethral stricture (1; 7.1%), proctitis (2; 14.3%) and gastrointestinal discomfort (1; 7.1%). CONCLUSIONS: In patients treated with NAAD and radiation therapy for localized or locally confined prostate carcinoma, generally good responses were observed. No se vere complication was observed and more patients and follow up are required for the further conclusion.
Dysuria ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proctitis ; Prostate* ; Prostatic Neoplasms* ; Radiotherapy* ; Recurrence ; Urethral Stricture

Several cases of Polygonum multiflorum Thunb-induced hepatitis have been reported worldwide. Anthraquinone is an active ingredient of P. multiflorum Thunb. that has been thought to play a role in its hepatotoxicity. Here we report the case of a 34-year-old Korean man who had P. multiflorum Thunb-induced hepatitis and reactivation of pulmonary tuberculosis caused by bone marrow suppression, which developed simultaneously. He was admitted to our hospital with recently developed fatigue and aggravated jaundice. He was a previously healthy man except for the sequelae of pulmonary tuberculosis seen on chest X-ray. He had a 30-day history of ingesting the root of P. multiflorum as a form of liquor and tea. The patient was diagnosed with P. multiflorum Thunb-induced hepatitis after excluding all other potential causes of acute hepatitis. Liver function gradually improved following the total cessation of the consumption of the material. However, he suffered from spiking fever with progressive pancytopenia during the hospital stay. A bone marrow biopsy showed markedly hypocellular marrow, suggesting transient bone marrow suppression, which was probably caused by extrinsic factors such as drugs, toxins, and viral infection. Although he began to complain of a dry cough, repeated sputum investigations revealed positive acid-fast bacillus staining. The fever subsided and pancytopenia improved after treatment for pulmonary tuberculosis. These observations suggest that P. multiflorum Thunb induces both bone marrow suppression and hepatotoxicity.
Adult ; Bacillus ; Biopsy ; Bone Marrow ; Cough ; Fatigue ; Fever ; Hepatitis ; Humans ; Jaundice ; Length of Stay ; Liver ; Pancytopenia ; Polygonum ; Sputum ; Tea ; Thorax ; Tuberculosis, Pulmonary

Schwannomas or neurilemmomas of the gastrointestinal tract are very rare and constitute less than 1% of all gut neoplasms. We experienced a case of schwannoma in the stomach, which is an extremely rare site. The patient was a 55-year-old woman who complained of an abdominal mass. At endoscopy, a 10-cm ulcerated submucosal mass was seen in the posterior wall of the body of the stomach. Computed tomography showed a heterogenous mass in the stomach without metastasis. The tumor was resected with the stomach. Both histological and immunohistochemical staining with S-100 protein revealed that it was a schwannoma.
Endoscopy ; Female ; Gastrointestinal Tract ; Humans ; Middle Aged ; Neoplasm Metastasis ; Neurilemmoma ; S100 Proteins ; Stomach ; Ulcer

Klebsiella are opportunistic pathogens that cause a wide spectrum of severe diseases, such as septicemia, pneumonia, urinary tract infection, and soft tissue infection. Klebsiella oxytoca is rarely isolated from human clinical specimens, and bacteremia due to Klebsiella oxytoca remains relatively uncommon. We experienced a case of liver abscess due to Klebsiella oxytoca in a 71-year-old male with a history of pylorus-preserving pancreaticoduodenectomy (PPPD) 4 years earlier. The patient was diagnosed with hemobilia secondary to a pseudo-aneurysm at the lower pole of the abscess cavity during antibiotic treatment and was treated successfully with selective percutaneous transcatheter embolization
Abscess ; Aged ; Bacteremia ; Hemobilia ; Humans ; Klebsiella ; Klebsiella oxytoca ; Liver ; Liver Abscess ; Male ; Pancreaticoduodenectomy ; Pneumonia ; Sepsis ; Soft Tissue Infections ; Urinary Tract Infections

PURPOSE: Although ultrasonography and diuretic renography are routinely performed for evaluation of ureteropelvic junction obstruction, no reported studies have systemically investigated the correlation of the two methods. We investigated the correlation and values of the two methods. MATERIALS AND METHODS: We studied 44 patients who presented with unilateral hydronephrosis due to ureteropelvic junction obstruction from 1994 to 1999. Patients were evaluated with ultrasound and nuclear renograms with furosemide. Hydronephrosis grade on ultrasonography and the severity of obstruction on diuretic renography were in accordance with the SFU (Society for Fetal Urology) system and "The Well Tempered Renogram", respectively. RESULTS: 27 patients showed grade III hydronephrosis and the remaining 17 patients showed grade IV hydronephrosis on ultrasonography. Kidneys of grade IV hydronephrosis had poorer washout patterns on diuretic renography than those of grade III hydronephrosis (p <0.001). In regard of mean split renal function ratios, there was no statistically significant difference between two groups (p >0.05). In 37.0% (10/27) and 47.1% (8/17) of patients with grade III and grade IV hydronephrosis, hydronephrotic kidney had a differential function greater than 50%. CONCLUSIONS: Our study suggests that diuretic renography is not always indicated in the patients with grade IV hydronephrosis, but, must be performed to confirm the severity of obstruction in the patients with grade III hydronephrosis.
Furosemide ; Humans ; Hydronephrosis ; Infant* ; Kidney ; Radioisotope Renography* ; Ultrasonography*

Langerhans cell histiocytosis (LCH) is reported less frequently in adults than in children. The most common site of involvement in adults is the bone, accounting for 30-50% of cases. The gastrointestinal tract is very rare, accounting for approximately 2%. We present a case of Langerhans cell histiocytosis that simultaneously invaded multiple organs, including the stomach and colon, in an adult. A 37-year-old woman with no underlying disease complained of chest discomfort and a palpable right submandibular mass. A right Level II neck mass and mediastinal LN enlargement were confirmed on the pharynx and chest CT scan. Multiple subepithelial masses with central ulceration and erosion were observed in the corpus and fundus on the esophagogastroduodenoscopy and in the right colon on the colonoscopy. The histopathology findings were the same in each tissue biopsied from the stomach, colon, and right neck lymph nodes. Langerhans cells with classical reniform nuclei and prominent eosinophils invaded the normal glands, and S100 and CD1a were positive in the immunohistochemical stain. Gastrointestinal involvement of LCH in adults is rare, asymptomatic,and can involve multiple digestive organs simultaneously, so upper endoscopy and colonoscopy should be considered for a diagnosis.

A gastric suture granuloma is an uncommon postsurgical complication. When nonabsorbable sutures are used, the inflammation can persist months after the original procedure with the subsequent formation of an abscess around the sutures surrounded by granulation tissue. Suture granulomas are usually asymptomatic, and have clinical importance as a differential diagnosis of a gastric submucosal tumor. The incidence of suture granuloma is low using absorbable sutures in gastrointestinal anastomosis. We report a case of a 70 year old man diagnosed with a suture granuloma. Approximately 30 years earlier, he underwent primary closure due to gastric ulcer perforation. When a gastroscopy was performed to assess upper abdominal soreness, it revealed a submucosal tumor that indicated a malignancy, which was diagnosed as a suture granuloma after surgery.
Abscess ; Aged ; Diagnosis, Differential ; Gastroscopy ; Granulation Tissue ; Granuloma* ; Humans ; Incidence ; Inflammation ; Methods ; Stomach Ulcer ; Sutures*