Only a few cases of cyst related to cruciate ligament were reported in the literatrure. It is not only because of rarity but also difficulty of diagnosis by conventional method. Recentely, the precise intraarticular structure of the knee joint became to be seen by introduction of MRI and arthroscope and cycts would bave been found incidentally during the workup of the internal derangement of knee. We have experienced three cases of ganglion around the cruciate ligament in the patients whose symptom was mimic of intemal derangement of knee. We excised the ganglion with good clinical results.
Arthroscopes ; Diagnosis ; Ganglion Cysts ; Humans ; Knee Joint ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Methods

No abstract available.
Child* ; Humans ; Nephrosis, Lipoid* ; Rifampin*

BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

No abstract available.
Child* ; Heart Defects, Congenital* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

BACKGROUND: Introduction of calcineurin inhibitor (CNI) has markedly improved the outcome of kidney transplantation. While therapeutic drug monitoring is used to adjust the dosage of CNI, some patients, particularly children, still suffer from rejection, infection, and CNI toxicity. This study was conducted in order to assess the adequacy of immunosuppression using pharmacodynamic monitoring. METHODS: Pharmacodynamic monitoring was performed for 64 pediatric kidney allograft recipients. Expression of nuclear factor of activated T lymphocytes (NFAT)-regulated genes in patients' mononuclear cells was measured by quantitative polymerase chain reaction of interleukin-2, interferon-gamma (IFN-gamma), and granulocyte-macrophage colony stimulating-factor before (trough) and 1.5 hour (peak) after ingestion of tacrolimus and the residual gene expression (RGE) was calculated. Global immune response was assessed by Cylex-ImmuKnow assay. Trough and peak levels of tacrolimus were measured and clinical findings of rejection episodes and infectious complications were reviewed retrospectively. RESULTS: Global immune response measured byImmuKnow did not show correlation with trough and peak levels of tacrolimus. Adenosine triphosphate level of ImmuKnow was higher in patients with Epstein-Barr virus (EBV) infection than in those without infectious complications (515.4+/-149.0 ng/mL vs. 342.7+/-155.3 ng/mL, P=0.006). Mean RGE of the three NFAT-regulated genes showed negative correlation with tacrolimus peak levels. RGE of IFN-gamma was lower in patients with other infections except EBV than in those without infectious complications (34.0%+/-7.5% vs. 56.0%+/-30.2%, P <0.001). CONCLUSIONS: RGE of NFAT-regulated genes and ImmuKnow did not show significant correlation with clinical manifestation of under- or over-suppression of immune function in pediatric kidney allograft recipients. Further studies are required for development of optimal pharmacodynamic monitoring for pediatric kidney transplantation recipients.
Adenosine Triphosphate ; Allografts ; Calcineurin* ; Child ; Drug Monitoring ; Eating ; Gene Expression ; Herpesvirus 4, Human ; Humans ; Immunosuppression ; Interferon-gamma ; Interleukin-2 ; Kidney ; Kidney Transplantation* ; Polymerase Chain Reaction ; Retrospective Studies ; T-Lymphocytes ; Tacrolimus

Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year- old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid, tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also, occasional multilobed/ multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma, Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen, CD3, CD30(Ki-1) but negative for cytokeratin, epithelial membrane antigen, and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesions of the stomach and cecum.
Adenocarcinoma ; Amyloid ; Antigens, CD45 ; Biopsy ; Cecum ; Child* ; Cytoplasm ; Diagnosis ; Female ; Histiocytic Sarcoma ; Hodgkin Disease ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Mucin-1 ; Multiple Myeloma ; Pleural Effusion ; Stomach ; Tomography, X-Ray Computed

Rituximab, a chimeric anti-CD20 IgG1 monoclonal antibody, has been used as a rescue therapy for steroid-dependent or refractory nephrotic syndrome. However, the adverse effects of rituximab are yet to be investigated. We report a case of a 9-year-old boy with steroid-dependent nephrotic syndrome who developed Kikuchi-Fujimoto disease after several cycles of rituximab therapy. Kikuchi-Fujimoto disease is a benign, self-limited necrotizing histiocytic lymphadenitis of unknown etiology. In the present case, Kikuchi-Fujimoto disease developed when the peripheral blood B-cell count of the patient was at nadir, and the lesion regressed slowly but spontaneously after recovery of the B-cell count. To our knowledge, although the pathologic diagnosis of Kikuchi-Fujimoto disease was unavailable, this is the first report of Kikuchi-Fujimoto disease with clinical diagnosis as a possible adverse effect of rituximab.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Child ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Immunoglobulin G ; Lymphadenitis ; Nephrotic Syndrome ; Rituximab

BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is a rare disease that is often associated with genetic defects. Mutations of complement factor H (CFH) are the most common genetic defects that cause aHUS and often result in end-stage renal disease. Since CFH is mainly produced in the liver, liver transplantation (LT) has been performed in patients with defective CFH. METHODS: The clinical courses of four kidney allograft recipients who lost their native kidney functions due to aHUS associated with a CFH mutation were reviewed. RESULTS: Subject A underwent kidney transplantation (KT) twice, aHUS recurred and the allograft kidney failed within a few years. Subject B received a KT and soon experienced a recurrence of aHUS coinciding with infection. Her allograft kidney function has worsened, and she remains on plasma infusion therapy. Subject C underwent LT followed by KT. She is doing well without plasma infusion therapy after combined LT-KT for 3 years. Subject D received KT following LT and is now recurrence-free from aHUS. CONCLUSION: In patients with aHUS associated with a CFH mutation, KT without LT was complicated with a recurrence of aHUS, which might lead to allograft loss. Conversely, LT was successful in preventing the recurrence of aHUS and thus might be another option for a recurrence-free life for aHUS patients associated with CFH mutation.
Allografts ; Atypical Hemolytic Uremic Syndrome ; Complement Factor H ; Complement System Proteins ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney ; Liver Transplantation ; Liver ; Plasma ; Rare Diseases ; Recurrence

An application of the multi-detector computed tomography (MDCT) for cardiac imaging is the non-invasive CT angiographic assessment of the cardiac morphology and the coronary arteries. The most important application is for the non-invasive diagnosis of coronary artery disease, and this includes assessment of coronary artery anomaly and stenosis, the evaluation of non-calcified atherosclerotic plaque and the follow-up examinations after stent deployment and bypass surgery. In the study, we have illustrated a variety of diseases of the coronay artery by using MDCT. These may facilitate the understanding of MDCT features of coronary artery lesions.
Arteries ; Constriction, Pathologic ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Follow-Up Studies ; Multidetector Computed Tomography* ; Plaque, Atherosclerotic ; Stents

Renal transplantation is the optimal treatment for children with end-stage renal disease. While it is largely recognized that improvements in immunosuppressive management, technical advances, and improved long-term care have had beneficial impacts on pediatric renal transplant outcome, graft survival of pediatric renal transplants is inferior to that of adult renal transplants. In order to investigate factors affecting graft survival and to devise better strategies for successful pediatric renal transplant outcome, a retrospective study was conducted. One hundred and eleven renal allografts(LRD:80, LUD:20, CAD:11) were transplanted to 111 pediatric ESRD patients under the age of 20 during the period between July, 1979 and June, 1997. Male to female ratio was 77:34. Mean duration of follow up was 55.9 months. Mean age at transplantation was 12.9 yrs. including 24 patients under the age of 10. Thirty one acute rejection episodes in 25 patients(22.5%) and 24 chronic rejections(21.6%) developed. Original diseases recurred in 12 patients, especially, 8/19 in focal segmental glomerular sclerosis(FSGS). Twenty three grafts were lost(20.7%) due to 18 chronic rejections, 3 recurrences of the original renal disease and 2 patient deaths with functioning graft. Overall 1, 3, 5, 10yr graft and patient survival rates were 94.3%, 86.3%, 76.3%, 62.5% and 98.2%, 96.1%, 94.0%, 94.0%, respectively. In univariate analysis, presence of acute rejection(p=0.012), posttransplant 1 week serum creatinine>or=2.5mg/dL(p=0.022), and LUD (p=0.028) were significant risk factors for poor graft survival. In multivariate analysis, presence of acute rejection(p=0.024) and LUD(p=0.027) were the poor prognostic factors for graft survival. In conclusion, improvement in graft survival of pediatric renal transplantation can be achieved by early detection and aggressive management of acute rejection and preferred selection of related donor in living donor kidney transplantation.
Adult ; Child ; Female ; Follow-Up Studies ; Graft Survival* ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Living Donors ; Long-Term Care ; Male ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tissue Donors ; Transplants*