Bartter syndrome is characterized by markedly reduced or absent salt transport by the thick ascending limb of Henle. The phenotype of Bartter syndrome is renal salt wasting, hypokalemic metabolic alkalosis, increased renin-angiotensin-aldosterone system, with normal or low blood pressure. Most of the cases have been noted in the pediatric age group and adult-onset cases are rare. Nephrocalcinosis is common in antenatal Bartter syndrome. We report a case of adult-onset Bartter syndrome associated with nephrocalcinosis.
Alkalosis ; Bartter Syndrome* ; Extremities ; Humans ; Hypokalemia ; Hypotension ; Nephrocalcinosis* ; Phenotype ; Renin-Angiotensin System

Collapsing glomeruopathy (CG) is a clinicopathologic variant of focal segmental glomerulosclerosis (FSGS) and is characterized by severe nephrotic syndrome, rapid progression to end stage renal disease, and features of visceral epithelial cell injury and glomerular capillary collapse. Such characteristics closely resemble those of HIV associated nephropathy. The frequency of CG has increased over the last decade. The cause of CG is unknown. The lesion has rarely been described in renal allografts with features similar to CG in native kidney. We recently identified allograft CG in a 44 year-old male patient who underwent biopsy for graft dysfunction after autodermic graft. The biopsy showed typical characteristics of CG. Serologically, the patient had no evidence of HIV infection. The renal function was not restored to normal in spite of methylprednisolone pulsing therapy. Now he is on conservative treatment with a functioning graft.
AIDS-Associated Nephropathy ; Biopsy ; Capillaries ; Epithelial Cells ; Glomerulosclerosis, Focal Segmental ; HIV Infections ; Humans ; Kidney ; Kidney Failure, Chronic ; Male ; Methylprednisolone ; Nephrotic Syndrome ; Transplantation, Homologous ; Transplants

Renal biopsy is an essential diagnostic tool for detecting acute and chronic kidney rejection as well as recurrent and de novo nephropathies in renal allograft recipients. However, a well-known complication of percutaneous renal biopsy is arteriovenous fistula (AVF). Most post-biopsy AVFs are asymptomatic and regress spontaneously but some AVFs result in hypertension, hematuria, and renal insufficiency. Whether post-biopsy AVF superimposed on transplant renal artery stenosis (TRAS) also regresses spontaneously is unknown. We present a case of acute renal insufficiency in a 51-year-old female renal allograft recipient with post-biopsy AVF and TRAS. Percutaneous angioplasty with stent implantation was performed for the TRAS and transcatheter arterial coil embolization therapy applied for AVF. The patient's renal function returned to baseline levels and is currently being followed up for 6 months.
Acute Kidney Injury ; Angioplasty ; Arteriovenous Fistula ; Biopsy ; Female ; Hematuria ; Humans ; Hypertension ; Kidney ; Rejection (Psychology) ; Renal Artery ; Renal Artery Obstruction ; Renal Insufficiency ; Stents ; Transplantation, Homologous ; Transplants

Clinically, Dubin-Johnson syndrome is characterized by mild icterus without specific symptoms or signs. The icterus is so mild that it is usually noted only during another illness, pregnancy, or the use of oral contraceptives. There is no pruritus in ubin-Johnson syndrome. The physical examination is usually normal, except for the icterus, although hepatosplenomegaly is seen occasionally. Histologically, the liver is normal, except for the presence of dense pigment making it appear black grossly. Pigmentation of tissues other than the liver in patients with Dubin-Johnson syndrome has been reported only in a few cases. We experienced a case of Dubin-Johnson syndrome with extrahepatic pigmentation in the skin with a neurofibroma in a 66-year-old man.
Aged ; Contraceptives, Oral ; Humans ; Jaundice ; Jaundice, Chronic Idiopathic ; Liver ; Neurofibroma ; Neurofibromatoses ; Physical Examination ; Pigmentation ; Pregnancy ; Pruritus ; Skin

BACKGROUND/AIMS: The detection and removal of colorectal polyps are important for secondary prevention of colorectal cancer. We investigated the characteristics and histopathologic finding of polyps to better plan their management. METHODS: We analyzed 334 patients who underwent polypectomies for 770 colorectal polyps between October, 2005 and April, 2007 at Bong Seng Memorial Hospital. RESULTS: Colorectal polyps were frequent in the sixth decade in both sexes. The ratio of male to female patients was 1.72:1. Abdominal pain/discomfort was the most common symptom (34.4%), and the most common site of polyp localization was the rectosigmoid colon. Histopathologic examination showed tubular adenomas (54.6%), hyperplastic polyps (36.4%), and inflammatory polyps (5.6%). Adenomatous polyps were more common in patients with multiple polyps than in patients with a single polyp. Adenomatous polyps with villous histology were more common in patients with large polyps than in patients with small polyps. Non-neoplastic polyps were common before the fifth decade. Neoplastic polyps were common past the fifth decade. CONCLUSIONS: In this study, tubular adenomas were frequently found on histopathologic examination, sessile type were frequently found on gross examination, and colorectal polyps were found principally in the rectosigmoid colon. Neoplastic polyps were more frequent in patients beyond the fifth decade. There fore colonoscopy examination is recommended for secondary prevention of colon cancer.
Adenoma ; Adenomatous Polyps ; Colon ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Female ; Humans ; Male ; Polyps ; Secondary Prevention

PURPOSE: As a result of the development and the supply of vaccination, the epochal progress in vaccination against measles has been made. Nevertheless measles intermittent prevalence throughout the world was reported and measles prevailed throughout country in 1993 & 1994. So, we studied the epidemics of measles which prevailed in the Kyungi-Incheon districts and then evaluated the effects of the present vaccination indirectly and estimated the necessity of booster vaccination in addition to initial and second vaccination. METHODS: This study was based on the questionnaires to 233 patient who were diagnosed as measles in Holy Family Hospital and Our Lady Of Mercy Hospital from July, 1993 to June, 1994. RESULTS: 1) The incidence peaked in Jan(24.0%) and April(23.2%). 2) In sex distribution, we could not find any difference between boys(116 case) and girls(117 case). 3) The age distribution showed that the children between 0 and 12 month of age were 81 cases(34.8%), the children between 13 and 24 month of age 28 cases(12.0%), 8 year old children 21 cases(9.0%), 6 year old children 18 cases(7.7%), 7 year old children 16 cases(6.9%) and 9 year old children 14 cases(6.0%). 4) 6 month age group with one-dose schedule of vaccination was 2 cases. 9 month age group with one-dose schedule of vaccination was 14 cases and their outbreak age was 4.1+/-3.3 years old. 12 month age group with one-dose schedule of vaccination was 1 case. 15 month age group with one-dose schedule of vaccination was 48 cases and their outbreak age was 7.8+/-2.9 years old. Age group with two-dose schedule of vaccination was 51 cases and their outbreak age was 7.3+/-2.9 years old. Therefore, trimed mean age of 15 month age group with one-dose schedule was 7.8+/-2.0 years old and their 99% confidence interval was 7.0~9.2 years old. Trimed mean age of two-dose schedule age group was 8.3+/-2.0 years old and their 99% confidence interval was 7.6~9.2 years old. 5) Among the siblings(n=236) of subjects 224 cases were vaccinated and among vaccinated children 18 cases infected(8.0%). 6) There were no reinfected subjects. CONCLUSIONS: 15 months age group with one-dose schedule and two-dose schedule group showed similar outbreak age. In the case that measles prevails, the proper time for vaccination seems to be at or earlier than 6 months of age and the booster dose should also be considered at age 6.
Age Distribution ; Appointments and Schedules ; Child ; Epidemiology* ; Humans ; Incidence ; Measles* ; Prevalence ; Surveys and Questionnaires ; Sex Distribution ; Vaccination