No abstract available.
Angiotensins* ; Cough* ; Peptidyl-Dipeptidase A* ; Reflex*

Patchy renal vasoconstriction is one of the reversible renal vasoconstrictions, which usually occur in healthy young men following strenuous anaerobic exercise. Analgesics, viral infection, dehydration were known to be the causes of patchy renal vasoconstriction. We experienced two cases of patchy renal vasoconstriction without antecedent anaerobic exercise. The first case is a 54-year-old woman admitted to a hospital with severe loin pain. On admission, serum creatinine was elevated to 2.2 mg/dL. Patchy areas of delayed contrast enhancement in both kidneys were observed on immediate post-contrast CT and 14 hours delayed image. This severe loin pain was initiated without anaerobic exercise. On the 4th day, her loin pain was relieved and on the 12th day of her illness, serum creatinine was normalized with supportive care. The second case is an 18- year-old man presented with pain in the both flanks. Five days earlier, operation had been performed for treatment of gynecomastia. There had been no preceding anaerobic exercise before the flank pain occurred. On admission to the hospital, laboratory studies revealed a serum creatinine 2.3 mg/dL. Computed tomography showed multiple patchy areas of enhancement in the renal parenchyma. On 12 hours delayed image, there were delayed contrast enhancement. On the sixth day, serum creatinine decreased to 1.4 mg/dl and the loin pain was subsided. Patchy renal vasoconstriction can occur without exercise, and we suggest that patchy renal vasoconstriction should be suspected in the patients suffering from acute renal failure with severe loin pain even without strenuous exercise.
Female ; Male ; Humans

No abstract available.
Angiomyolipoma* ; Tuberous Sclerosis*

PURPOSE: To evaluate the utility of high-resolution computed tomography(HRCT), as used to determine the activity of tuberculosis, and to analyze the HRCT findings in active and in inactive tuberculosis. MATERIALS AND METHODS: We analyzed the HRCT findings of 100 patients (54 men, 46 women; average age, 54 years) who according to the results of chest radiography had pulmonary tuberculosis of undetermined activity. We assessed HRCT findings such as the presence of a entrilobular, macro-, or micronodule; consolidation, ground-glass opacity, cavity, interlobular septal thickening, irregular linear opacities, bronchial wall thickening, bronchovascular bundle distortion, bronchiectasis, atelectasis, and pericicatrical emphysema. We compared the ratio of the area of nodule and consolidation to that of whole lung, and compared the findings between active and inactive tuberculosis. RESULTS: Eleven of 100 patients were excluded because the final diagnosis was other than tuberculosis. In 59 patients, the presence of active pulmonary tuberculosis was proven by positive sputum smear and/or culture for Mycobacterium tuberculosis. On the basis of the negative results of these tests, pulmonary tuberculosis was found to be inactive in 30 patients; serial chest radiographs indicated that their condition remained stable over a 6-month period. For HRCT, sensitivity was 96.6%, specificity 56.7%, positive predictive value 81.4%, negative predictive value 89.5%, and accuracy 83.1%. For active tuberculosis, the presence of centrilobular nodules, tree-in-bud, macronodules, cavity within the nodule, and consolidations was statistically significant, while for inactive tuberculosis, that of irregular linear opacities, micronodules, bronchiectasis, and cicatrization atelectasis was similarly significant. The CT score for the area of nodules and consolidations was higher in active than in inactive tuberculosis, but only the nodule score showed statistical significance. CONCLUSION: HRCT can be a useful diagnostic tool for evaluating the activity of pulmonary tuberculosis
Bronchiectasis ; Cicatrix ; Diagnosis ; Emphysema ; Female ; Humans ; Lung ; Male ; Mycobacterium tuberculosis ; Pulmonary Atelectasis ; Radiography ; Radiography, Thoracic ; Sensitivity and Specificity ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

Steatocystoma multiplex is a rare autosomal-dominant disorder characterized by asymptomatic multiple, skin-colored to yellowish nodules on the trunk, proximal extremities, and axillae. Although surgical excision is the most effective method, treatment is difficult when lesions occur in multiple numbers. Therefore, various treatments such as CO2 laser therapy, needle aspiration, and oral isotretinoin have been attempted, but results are variable. A 37-year-old man presented with multiple skin-colored subcutaneous nodules on the abdomen and both axillae. A histopathological examination was consistent with steatocystoma multiplex. The lesions were removed by dermal shaving with a suction-assisted cartilage shaver. It was an effective therapeutic method for multiple lesions with no significant adverse events. Herein, we report a case of steatocystoma multiplex treated with a suction-assisted cartilage shaver.
Abdomen ; Adult ; Axilla ; Cartilage ; Extremities ; Humans ; Isotretinoin ; Lasers, Gas ; Needles ; Steatocystoma Multiplex

PURPOSE: To evaluate the efficacy and toxicity of heptaplatin, paclitaxel, and 5-fluorouracil combination chemotherapy in patients with advanced gastric cancer. MATERIALS AND METHODS: Between July 2002 and September 2003, nineteen patients were enrolled in this study. Paclitaxel 135 mg/m(2) iv on day 1, heptaplatin 400 mg/m(2) iv on day 2 and 5-fluorouracil 800 mg/m(2) on day 2~4 were administered and the regimen was repeated every 3 weeks. RESULTS: The median age of the patients was 60 years (range: 32~74) and the most common sites of metastasis were liver and lymph nodes. In the 16 evaluated patients, the overall response rate was 43.8%, but this was without any complete response. The median time to disease progression was 3.93 months (range: 0.26~8.1) and the median response duration for the 7 responding patients was 3.83 months (range: 1.48~6.07). The median overall survival for 19 patients was 7.01 months (range: 0.26~17.44). A median of 3 cycles (range: 1~7) and a total of 65 cycles were administered and evaluated for toxicity. The most common hematologic toxicities were NCI grade I/II anemia (47.7%), neutropenia (9.2%) and thrombocytopenia (6.2%). The most common non-hematologic toxicities more than grade II were nausea/vomiting (30.8%/9.2%). One elderly patient with ECOG 2 had a life- threatening complication of pneumonia. CONCLUSION: The combination of heptaplatin, paclitaxel, and 5-fluorouracil showed significant activity and favorable toxicity profiles in patients with advanced gastric cancer. However, one elderly patient who had poor performance experienced a life-threatening toxicity/complication. Our results suggest that the efficacy of this combination chemotherapy can be maximized when administered to the patients with good performance status. Further studies with large numbers of patients and long-term follow-up study will be needed.
Aged ; Anemia ; Disease Progression ; Drug Therapy, Combination* ; Fluorouracil* ; Follow-Up Studies ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Neutropenia ; Paclitaxel* ; Pilot Projects* ; Pneumonia ; Stomach Neoplasms* ; Thrombocytopenia

In the present study, the signs of airflow obstruction on inspiratory and expiratory CT scans in 45 patients with rheumatoid arthritis were investigated. Radiologic findings were evaluated and correlated with the clinical data, which included rheumatoid factors and pulmonary function tests results. A lung biopsy was performed in five patients. The pattern of CT findings was as follows: infiltrative (n=15), obstructive (n=12), mixed (infiltrative and obstructive; n=10), other complicating diseases (n=7), and normal (n=1). The rheumatologic factor between patients with bronchial wall thickenings and patients without thickenings was significantly different (p=0.009). The forced expiratory flow rate between 25% and 75% of the vital capacity (FEF25-75%) was significantly more reduced in patients with interlobular septal thickenings than in patients without these thickenings. The patients with mosaic attenuation had significantly lower mean values of FEF25-75% (p=0.001) and a lower peak expiratory flow (p=0.003) than patients without mosaic attenuation. On expiratory scans, the mean air-trapping score was 21%. These air-trapping scores were found to be well correlated with FEV1/FVC (r=0.230, p=0.0452), and FEF25-75% (r=-0.63, p= 0.05). It is widely known that a relatively higher percentage of mosaic attenuation with air-trapping and a good correlation between these and functional values contribute to the detection of early airway obstruction in patients with rheumatoid arthritis, and even in patients with infiltrative lung disease only.
Adolescent ; Adult ; Aged ; Airway Obstruction/*epidemiology/physiopathology/*radiography ; Arthritis, Rheumatoid/*epidemiology ; Female ; Forced Expiratory Flow Rates ; Human ; Incidence ; Male ; Middle Aged ; Peak Expiratory Flow Rate ; *Respiratory Function Tests ; *Tomography, X-Ray Computed ; Vital Capacity

Allografts or autografts of bone-tendon unit has been used widely for ligament or tendon reconstruction of ligament injuries or ligament deficiencies after limb salvage operation to treat malignant bone tumors around joints. While the remodeling process of the ligament or tendon itself after allograft or autograft and the microscopic and biomechanical changes of tendon- bone graft interface have been widely investigated, little is known about the ultrastructural and biochemical changes of the transitional zone in tendon-bone junction. This study was performed to analyze the morphological changes by microscopic (part I), and ultrastructural, and biochemical remodeling of the transitional zone after tendon-bone auto- and allo-grafting (part II). Preliminary, a microscopic studies at bone to tendon insertion site was done as control (part I). And as an experimental work (part II), a total of twenty four rabbits were divided into two group. In 12 animals (allograft group), an Achilles tendon-bone unit was taken with tenotomy 3 cm proximal to calcaneal attachment and osteotomy 5mm distal to the attachment site. This unit was preserved below -70degrees C for 2 weeks and then it was transplanted to another rabbit. In the other 12 animals (autograft group), the Achilles tendon-bone unit was harvested with the same maneuver from one side and transplanted to the other side of the rabbit. After operation, their legs were immobilized with short leg cast for 4 weeks, and then mobilized freely. Four animals in each group were sacrificed at four, eight and sixteen-weeks after transplantation, and their grafted Achilles tendon-bone interfaces were used for analysis of the ultrastrucural and biochemical changes. The following results were obtained. Part I: We conducted an experiment (part I) to investigate the histologic chronologic changes of tendon to bone fixation using the Cole's method and the role of periosteum to the tenodesis. The periosteum around the tenodesis was excised in group I, but it was incised longitudinally and sutured to tendon in group II. As a result, the tendons in the marrow cavity of tibia were firmly fixed by fibrosseous metaplasia in group I at 8 weeks after experiment, but not formed the fibrocartilagenous layer in both groups as a transitional zone of internal stress transmission from tendon to bone in normal tendon, and the group II show the firm connection between sutured periosteum and transferred tendon by external calluses after 3 weeks. These mean the periosteum should be sutured over the inserted tendon to get the early rigid fixation by the induction of external callus around the edges of the tendon to bone insertion. Part II: Histologically in part II experiment, new cartilage cells were observed at postoperative 16 weeks with locally presence of faint tidemark in the autograft group but not in the allograft group. Complete histological remodeling of the transitional zone had not restored both groups.. Ultrastructural analysis revealed no definite differences, but showed time-related restoration of fibers and fibroblasts between both groups except the slightly rapid appearance of parallelism and cross-striation of microfibrils in the autograft group. From biochemical analysis, type I collagen was increased in its concentration, and an early rapid increase of type III collagen and glycosaminoglycan was also observed. In conclusion, these data suggested that type III collagen and glycosaminoglyan are important in stabilization of grafted tendon-bone unit, especially in the transitional zone. The histological and biochemical changes in allograft group were relatively similar to that of autograft group although the allograft group showed the delayed pattern of remodeling. And so the tendon-bone allograft could be used as a good but second substitute followed by autograft.
Allografts ; Animals ; Autografts ; Bone Marrow ; Bony Callus ; Cartilage ; Collagen Type I ; Collagen Type III ; Fibroblasts ; Joints ; Leg ; Ligaments ; Limb Salvage ; Metaplasia ; Microfibrils ; Osteotomy ; Periosteum ; Rabbits* ; Tendons ; Tenodesis ; Tenotomy ; Tibia ; Transplants*

Hidradenoma papilliferum is a rare benign neoplasm that usually occurs in the female anogenital area. We present a 43-year-old female with a non-anogenital (ectopic) hidradenoma papilliferum on her nose. The patient had had a skin-colored subcutaneous nodule on her nose for 7 years. The histopathological findings showed variously shaped cystic spaces in the tumor. And the lumina were surrounded by a single or double layer of cell which showed decapitation secretion. In the English dermatological literature, only one case of ectopic hidradenoma papilliferum arising in nasal skin has been reported. Hence we suggest hidradenoma papilliferum occurring on the nasal skin is a peculiar and interesting event.
Acrospiroma ; Adult ; Decapitation ; Female ; Humans ; Nose ; Skin

Even though hydrocolloid dressings have been widely used for the past 15 years in the treatment of various types of wounds; allergic contact dermatitis to these dressings have been rarely reported. Duoderm(R) is representative agent of hydrocolloid dressing, and Duoderm Extrathin(R) is a new formulation of Duoderm(R) that contains pentaerythritol ester as a tacking agent, a substance used in several other adhesives. In Korean dermatologic literature, only 1 case of the allergic contact dermatitis due to Duoderm CGF(R) has been reported. However allergic contact dermatitis due to Duoderm Extrathin(R) has not been reported. We report a case of allergic contact dermatitis in a 22-year-old female during wound management using Duoderm Extrathin(R).
Adhesives ; Bandages ; Bandages, Hydrocolloid ; Colloids ; Dermatitis, Allergic Contact ; Female ; Humans ; Propylene Glycols ; Young Adult