No abstract available.
Birth Weight* ; Female ; Fetal Heart* ; Heart Rate, Fetal* ; Parturition* ; Pregnancy

Beckwith-Wiedemann syndrome is a well-known overgrowth syndrome associated with the presence of a wide variety of anomalies and increased risk of cancers. Less frequently, benign neoplasms also develop. We report a female infant with Beckwith-Wiedemann syndrome who developed a mesenchymal hamartoma of the liver. The patient was born with macroglossia, ear lobe crease, and abdominal distension. Laboratory data showed hypoglycemia, and magnetic resonance image revealed both adrenal enlargement, enhancing mass of the pancreas, and multiple hepatic nodules. The histologic findings of the resected distal pancreas and both adrenals were those of Beckwith-Wiedemann syndrome. Microscopic findings of the liver biopsy specimens were compatible with mesenchymal hamartoma. Hamartoma of the urinary bladder, cardiac fibrous hamartoma, and mixed hamartoma of the liver have been documented previously in association with Beckwith-Wiedemann syndrome. However, to our knowledge, this is the first case report of hepatic mesenchymal hamartoma in Beckwith-Wiedemann syndrome. Because of the paucity of hamartomas in childhood, we should be cautious of other features of Beckwith-Wiedemann syndrome and the present case extends the spectrum of tumor formation in this syndrome.
Beckwith-Wiedemann Syndrome* ; Biopsy ; Ear ; Female ; Hamartoma* ; Humans ; Hypoglycemia ; Infant ; Liver Neoplasms ; Liver* ; Macroglossia ; Pancreas ; Urinary Bladder

Metastatic or septic endogenous endophthalmitis is a rare, but devastating complication of systemic septicemia. This condition may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungi) and many clinical conditions (pyelonephritis, endocarditis, meningitis, pneumonia) have been reported to cause endogenous endophthalmitis. Risk factors include most of the known reasons for immune suppression and chronic illness. A high clinical suspicion is required in early diagnosis and treatment. Early antibiotics and vitrectomy are more widely accepted as therapeutic modalities.
Abscess* ; Anti-Bacterial Agents ; Chronic Disease ; Early Diagnosis ; Endocarditis ; Endophthalmitis* ; Escherichia coli* ; Escherichia* ; Humans ; Meningitis ; Pneumonia* ; Risk Factors ; Sepsis* ; Vitrectomy

Crohn's disease and ulcerative colitis are well known risk factors of intestinal cancer in relation to the extent and duration of disease. Rarely, small bowel cancer can develop after a longstanding inflammation of Crohn's disease with a relatively higher incidence than the general population. Signet ring cell carcinoma is a rare condition among intestinal cancers, and the diagnosis or detection is more difficult if the cancer originates from the small bowel. We report a case of a 30-year old female in whom signet ring cell carcinoma of ileum was diagnosed after a 15-year history of Crohn's disease.
Adult ; Carcinoma, Signet Ring Cell/*diagnosis/etiology/pathology ; Colonoscopy ; Crohn Disease/*complications/diagnosis/pathology ; Female ; Humans ; Ileal Neoplasms/*diagnosis/etiology/pathology ; Tomography, X-Ray Computed

PURPOSE: This study was designed to compare the effectiveness of intrarectal lidocaine gel versus periprostatic lidocaine injection during TRUS-guided biopsies. MATERIALS AND METHODS: From April 2003 to September 2003, 90 men undergoing a transrectal prostate biopsy were randomized into three groups. In group 1, 30 patients intrarectally received 20ml of 2% lidocaine gel; and group 2, 30 patients received 5ml(2.5ml per side) of 2% lidocaine solution injected along each side of the prostate, near the junction of the seminal vesicle and the base of the prostate(along the neurovascular bundles); in group 3, 30 patients received 5ml(2.5ml per side) of normal saline injected along the neurovascular bundles. The pain level after the biopsy was assessed using a 10-point linear visual analog pain scale(VAS). A statistical analysis was performed using the Wilcoxon Rank Sum test, and the results compared. RESULTS: Patient who received lidocaine solution injections along the neurovascular bundles (Group 2) had significantly lower VAS scores compared to the control group(mean score 3.56+/-2.13 versus 5.83+/-1.94, p<0.0001), but patients who received intrarectal lidocaine gel did not (mean score 5.46+/-2.70 versus 5.83+/-1.94, p=0.671). Gross hematuria, rectal bleeding and hemospermia occurred in 36(40.0%), 6(6.7%) and 5(5.6%) subjects, respectively. One patient had a vasovagal syncope. No patient reported febrile UTI or urinary retention. CONCLUSIONS: Bilateral nerve blockade with local anesthetic is a safe technique that significantly reduces pain during a prostate biopsy. However, in this study, intrarectal lidocaine injection did not reduce the pain compared to the control group during the prostate biopsy.
Anesthesia, Local* ; Anesthetics, Local ; Biopsy* ; Hematuria ; Hemorrhage ; Hemospermia ; Humans ; Lidocaine ; Male ; Nerve Block ; Prospective Studies* ; Prostate* ; Seminal Vesicles ; Syncope, Vasovagal ; Urinary Retention

Although gastrointestinal manifestations are very common in patients with Henoch-Sch nlein purpura, protein losing enteropathy is a rare complication. We here report a case of protein losing enteropathy in a patient with Henoch-Sch nlein purpura. A 52-year old woman presented with lower abdominal pain, purpura and edema on lower extremity. Serum albumin was 1.9g/dL and 24 hour urine protein was 4.7g/ day. Skin and kidney biopsy revealed leukocytoclastic vasculitis and mesangial proliferative glomerulonephritis consistent with Henoch-Sch nlein purpura, respectively. Colonoscopy showed diffuse mucosal erosion at right colon. 99mTc-human serum albumin scintigraphy and fecal alpha-1-antitrypsin clearance confirmed protein losing enteropathy. The protein losing enteropathy improved with steroid treatment.
Abdominal Pain ; Biopsy ; Colon ; Colonoscopy ; Edema ; Female ; Glomerulonephritis ; Humans ; Hypoalbuminemia ; Kidney ; Lower Extremity ; Middle Aged ; Protein-Losing Enteropathies* ; Purpura* ; Radionuclide Imaging ; Serum Albumin ; Skin ; Technetium Tc 99m Aggregated Albumin ; Vasculitis

Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infection. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.
Amebiasis ; Diagnosis* ; Entamoeba histolytica ; HIV Infections ; HIV* ; Humans* ; Korea ; Liver Abscess ; Liver Abscess, Amebic* ; Mass Screening

Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infection. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.
Amebiasis ; Diagnosis ; Entamoeba histolytica ; HIV Infections ; HIV ; Humans ; Korea ; Liver Abscess ; Liver Abscess, Amebic ; Mass Screening

BACKGROUND: The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. MATERIAL AND METHODS: By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. RESULTS: All of S. aureus used in this study were MRSA, and MIC90 of linezolid was below 2 microgram/ml (MIC ranged between 1-2 microgram/ml). All of Enterococcus spp. were VRE, and had MIC90 of 2 microgram/ml (MIC ranged between 1 to 4 microgram/ml). One of the VRE showed intermediate susceptibility with MIC of 4 microgram/ml. However, none was resistant with MIC breakpoint above 8 microgram/ml. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MIC90 of 1 microgram/ml(MIC range 0.5-1 microgram/ml). CONCLUSION: In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.
Agar ; Anti-Bacterial Agents ; Biological Availability ; Community-Acquired Infections ; Enterococcus ; Gram-Positive Cocci ; Humans ; Korea ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxazolidinones ; Penicillins ; Pneumonia ; Skin

BACKGROUND: The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. MATERIAL AND METHODS: By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. RESULTS: All of S. aureus used in this study were MRSA, and MIC90 of linezolid was below 2 microgram/ml (MIC ranged between 1-2 microgram/ml). All of Enterococcus spp. were VRE, and had MIC90 of 2 microgram/ml (MIC ranged between 1 to 4 microgram/ml). One of the VRE showed intermediate susceptibility with MIC of 4 microgram/ml. However, none was resistant with MIC breakpoint above 8 microgram/ml. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MIC90 of 1 microgram/ml(MIC range 0.5-1 microgram/ml). CONCLUSION: In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.
Agar ; Anti-Bacterial Agents ; Biological Availability ; Community-Acquired Infections ; Enterococcus ; Gram-Positive Cocci ; Humans ; Korea ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxazolidinones ; Penicillins ; Pneumonia ; Skin