No abstract available.
Hemochromatosis* ; Spleen*

Xanthogranulnmatous pyelonephritis is an unusual chronic renal infection associated with renal calculi, urinary tract infection or obstruction in many cases. It is characterized by orange-yellow nodules of inflamed parenchymal tissue macroscopically and foamy lipid-laden histiocyte microscopically. We report a case of Xanthogranulomatous pyelonephritis in a 74 years old male.
Aged ; Histiocytes ; Humans ; Kidney Calculi ; Male ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous* ; Urinary Tract Infections

PURPOSE: Entering a new century in the year 2001, Chungbuk National University Medical School (CNUMS) decided to adopt a fully integrative curriculum. This plan has been executed from 2002 to 2005. we are now at a point to assess this new curriculum and further improve it for the future. METHODS: We studied 'Curricula for Undergraduate' from Chungbuk National University and 'The Present Educational Status of Medical College' the Dean's Council of Korean Medical College published from 1987 to 2005. RESULTS: All lectures consisted of integrated lectures between the basic and clinical medical sciences. First and second year lectures focused on the horizontal integration of basic and clinical medical sciences, respectively. Also lectures between the first and second years formed longitudinal integration and purposeful repetition. Practical Classes were comprised of essential major clinical medicines and elective clinical medicines. Generally, lectures were reduced to introduce active learning subjects including problem-based learning (PBL), communicational skills, objective structured clinical examination (OSCE) /clinical performance examination (CPX), basic clinical skills, community medicine, and health and society. CONCLUSION: The curriculum of CNUMS was changed from the traditional department-centered lectures to integrated organ-centered integrated lectures and practical classes. However, further innovation is required on the inside of curriculum.
Chungcheongbuk-do* ; Clinical Competence ; Community Medicine ; Curriculum* ; Educational Status ; Lectures ; Problem-Based Learning ; Schools, Medical*

PURPOSE: To find out the problem of modified Bosworth method and improve the method of operation. MATERIALS AND METHODS: 21patients treated with modified Bosworth method were evaluated after a minium follow-up period of two years. The results were analysed clinically and reontgenographically. RESULTS: In postoperative X-ray evaluation, the coracoclavicular interval of the operated side was decreased by an average of 0.8 mm compared with that of the normal side. There was no significant difference in coracoclavicular interval between after screw removal and last follow-up. Loosening of the screw was seen in 3 of the 5 cases overcorrected by more than 2 mm and the result was fair in two of them. A satisfactory result was obtained in 17 (81.1%) of the 21 cases. CONCLUSION: Modified Bosworth method for acute complete acromioclavicular dislocation yields better results provided the overcorrection and anterior displacement of the clavicle are appropriately protected.
Acromioclavicular Joint ; Clavicle ; Dislocations* ; Follow-Up Studies

The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is characterized by congenital or early-onset camptodactyly, childhood-onset noninflammatory arthropathy associated with synovial hyperplasia. Some patients have pro-gressive coxa vara deformity and/or noninflammatory pericardial effusion. CACP is inherited as an autosomal recessive mode and the disease gene is assigned to a 1.9-cM interval on human chromosome 1q25-31. We describe a 10-yr-old boy who has typical features of CACP without familial association.
Adolescent ; Fingers/*abnormalities ; Hip Joint/*abnormalities ; Humans ; Joint Diseases/*congenital/*diagnosis ; Male ; Pericarditis/*congenital/*diagnosis ; Syndrome ; Toes/*abnormalities

Tumor necrosis factor-alpha (TNF-alpha) plays a important role in the pathogenesis of rheumatoid arthritis and Crohn's disease, TNF-alpha antagonist has been widely used for these disease, but it also plays a major role in cell mediated immunity. Cryptococcus neoformans, an encapsulated, ubiquitous environmental yeast, is pathogenic for humans, primarily those with compromised immune function. Cryptococcus neoformans is believed to be a facultative intracellular pathogen. We report a case of pulmonary cryptococcosis after chimeric anti-TNF monoclonal antibody therapy. No case has been reported in Korea for the best of our knowledge. A 66-year old woman was admitted because of severe cough. She was diagnosed to have rheumatoid arthritis 4 years ago and taken prednisolone and methotrexate. She was started on infliximab and received ten doses, the last dose being administered 6 weeks prior to above symptom. Chest PA and computed tomography of chest revealed multifocal consolidative lesions in both lungs. Pulmonary cryptococcosis confirmed by thoracoscopic lung biopsy tissue stained with Grocott-Gomori methenamine-silver (GMS). Initially the lung lesion responded to amphotericin B but leukopenia developed after 12 days of treatment. It was changed to fluconazole, then leukopenia and the pneumonia also improved. Physicians should remind pulmonary cryptococcosis in patients receiving TNF-alpha antagonist therapy.
Aged ; Amphotericin B ; Arthritis, Rheumatoid* ; Biopsy ; Cough ; Crohn Disease ; Cryptococcosis ; Cryptococcus neoformans ; Female ; Fluconazole ; Humans ; Immunity, Cellular ; Infliximab ; Korea ; Leukopenia ; Lung ; Methotrexate ; Pneumonia* ; Prednisolone ; Thorax ; Tumor Necrosis Factor-alpha* ; Yeasts

BACKGROUND AND OBJECTIVES: The matrix metalloproteinases (MMPs) have been associated with tumor cell invasion and metastasis by mediating the degradation of extracellular matrix components. Cyclooxygenase-2 (COX-2) plays an important role in promotion of carcinogenesis, tumor invasiveness and angiogenesis. Recently, some investigators have reported that COX-2 could promote secretion of MMP-2 and MMP-9. Therefore, an interrelation between MMPs and the associated COX-2 may play a significant role in the invasive phenotype of malignant tumors. In the present study, the authors investigated the correlation between expressions of COX-2 and MMPs. MATERIALS AND METHOD: Immunohistochemical staining of MMP-2, -3 and -9, and COX-2 were performed on paraffin-embedded tissue sections of 51 nasal cavity and paranasal sinuses tumors (27 inverted papillomas, 5 inverted papillomas with malignant transformation, and 19 squamous cell carcinomas). Co-expression of these MMPs and COX-2 was visualized with confocal laser scanning microscope. RESULTS: MMP-2, -3 and -9 were found mainly in malignant lesions in concert with COX-2. However, the co-expressions of MMP-2 and COX-2, MMP-9 and COX-2 were detected with significance. CONCLUSION: These results suggest a potentially important role for COX-2 in the regulation of MMPs, malignant transformation, and progression of squamous cell carcinoma, and it points out the potential use of COX-2 inhibitors, in the prevention and treatment of squamous cell carcinoma of nasal cavity and paranasal sinuses.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cyclooxygenase 2 Inhibitors ; Cyclooxygenase 2* ; Extracellular Matrix ; Humans ; Matrix Metalloproteinases* ; Nasal Cavity ; Negotiating ; Neoplasm Metastasis ; Papilloma, Inverted ; Paranasal Sinuses ; Phenotype ; Research Personnel

BACKGROUND: Chromosomal abnormalities are confirmed as one of the frequent causes of male infertility. The microdeletion of the azoospermia factor (AZF) region in the Y chromosome was discovered as another frequent genetic cause associated with male infertility. The aim of this study was to evaluate the frequency and type of chromosomal abnormalities and Y chromosome microdeletions in Korean infertile men. METHODS: A total of 846 infertile men with azoospermia and severe oligozoospermia were included for genetic screening. Cytogenetic analyses using G-banding and screening for Y chromosome microdeletions by multiplex PCR for AZF genes were performed. RESULTS: Chromosomal abnormalities were detected in 112 infertile men (13.2%). Of these, Klinefelter's syndrome was the most common (55.4%, 62/112), followed by balanced translocation including translocation between sex chromosome and autosome (14.3%), Yq deletion (13.4%), X/XY mosaicism with Yq deletion (12.5%), and XX male (4.5%). The overall prevalence of Y chromosome microdeletions was 9.2% (78/846). Most microdeletions were in the AZFc region (51.3%) with a low incidence in AZFa (7.7 %) and AZFb (6.4 %). Combined deletions involving the AZFbc and AZFabc regions were detected in 26.9 % and 7.7 % of men, respectively. Among the infertile men with Y chromosome microdeletions, the incidence of chromosomal abnormality was 25.6% (20/78). CONCLUSIONS: There was a high incidence (20.1%) of chromosomal abnormalities and Y chromosome microdeletions in Korean infertile men. These findings strongly suggest that genetic screening for chromosomal abnormalities and Y chromosome microdeletions should be performed, and genetic counseling should be provided before starting assisted reproductive techniques.
Azoospermia ; Chromosome Aberrations* ; Cytogenetic Analysis ; Genetic Counseling ; Genetic Testing* ; Humans ; Incidence ; Infertility, Male ; Klinefelter Syndrome ; Male ; Mass Screening ; Mosaicism ; Multiplex Polymerase Chain Reaction ; Oligospermia ; Prevalence ; Reproductive Techniques, Assisted ; Sex Chromosomes ; Y Chromosome*

Background: Delayed postoperative hyponatremia (DPH) is the most common cause of readmission after pituitary surgery. In this study, we aimed to evaluate the cutoff values of serum copeptin and determine the optimal timing for copeptin measurement for the prediction of the occurrence of DPH in patients who undergo endoscopic transsphenoidal approach (eTSA) surgery and tumor resection. Methods: This was a prospective observational study of 73 patients who underwent eTSA surgery for pituitary or stalk lesions. Copeptin levels were measured before surgery, 1 hour after extubation, and on postoperative days 1, 2, 7, and 90. Results: Among 73 patients, 23 patients (31.5%) developed DPH. The baseline ratio of copeptin to serum sodium level showed the highest predictive performance (area under the curve [AUROC], 0.699), and its optimal cutoff to maximize Youden’s index was 2.5×10–11, with a sensitivity of 91.3% and negative predictive value of 92.0%. No significant predictors were identified for patients with transient arginine vasopressin (AVP) deficiency. However, for patients without transient AVP deficiency, the copeptin-to-urine osmolarity ratio at baseline demonstrated the highest predictive performance (AUROC, 0.725). An optimal cutoff of 6.5×10–12 maximized Youden’s index, with a sensitivity of 92.9% and a negative predictive value of 94.1%. Conclusion The occurrence of DPH can be predicted using baseline copeptin and its ratio with serum sodium or urine osmolarity only in patients without transient AVP deficiency after pituitary surgery.

BACKGROUND: There have been many efforts to determine maximum surgical blood order schedule (MSBOS) of elective surgery in Korea since 1980?. But most of these data were confined to single hospital, so it was somewhat irrelevant to suggest them as general data in Korea. In this study, we tried to establish MSBOS which can be suggested as substantial and objective data in our country and to increase the efficiency of limited blood products. METHODS: From September 2003 to February 2004, we analyzed average RBC utilization for elective surgery in four university hospitals (Soonchunhyang University Hospital, Soonchunhyang University Bucheon Hospital, Korea University Ansan Hospital, Ajou University Hospital) by referring to anesthesiologic records and blood delivery sheets. Also, we established MSBOS range in operations performed more than five times in three among four hospitals. RESULTS: Sixty-seven operations were analyzed in our study and 18 of them were performed in department of general surgery. Type and screen (T&S) was recommended in 69.8~83.6% and the percentage of operations recommended as T&S in all four hospitals was 52.2%. Operations of obstetric/gynecology, urology and otorhinolaryngology were mostly applicable to T&S. CONCLUSION: We suggested comprehensive and substantial MSBOS range by analyzing the operations performed in four hospitals whose operation numbers ranged from 470 to 1,200 per month. It was considered that MSBOS range, which could be applicable to various hospitals, should be reestablished and enforced regularly to decrease medical cost and improve blood utility
Appointments and Schedules* ; Gyeonggi-do ; Hospitals, University ; Korea* ; Otolaryngology ; Urology