No abstract available.
Humans ; Hypertension* ; Kidney Failure, Chronic* ; Renal Insufficiency*

No abstract available.
Humans ; Hypertension* ; Kidney Failure, Chronic* ; Renal Insufficiency*

Transitional cell carcinoma is the most common malignant tumor of the urteter, usually presenting as focal ureteral wall thickening or a mass filling the ureter lumen and combined with periureteral infiltration or adjacent lymph node enlargement. Retroperitoneal mass due to exophytic growth of ureteral transitional cell carcinoma has not been described in the literature, and we now report the CT findings in such a case.
Carcinoma, Transitional Cell* ; Lymph Nodes ; Ureter*

Melanoacanthoma is an extremely rare pigmented benign mixed epithelial tumor of both melanocytes and keratinocytes. A 52-year-old female presented an asymptomatic, slightly elevated, 1. 2 cm x 0. 8 cm, dark black-colored plaque on her right buttock of 2 years' duration. Histopathologic finding of the plaque shows hyperkeratosis, focal parakeratosis, follicular plugging, acanthosih, papillomatosis and pseudo-horn cyst in the epidermis. The tumor is composed of basaloid and squarnous cells with many foci of clusters and whorls of melanin pigment-laden cells. Electron microscopic finding reveals many scattered melanocytes in the entire epidermis. Melanin granules are found mostly in the melanocytes but can also be found in a few keratinocytes.
Buttocks ; Epidermis ; Female ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Middle Aged ; Papilloma ; Parakeratosis

Routine chest radiography in a 21-year-old man revealed the presence of an asymptomatic mass at the right lower lung field. Chest radiographs showed multiple cysts with air-fluid level and air-meniscus within the consolidation at the right lower lung field. Chest CT scans demonstrated a non-enhancing solid mass, with air-meniscus, within a thin walled cavity, and multiple cysts with fluid or air-fluid level at the posterior portion of the right lower lobe. An abnormal artery was seen at the level of the 12th thoracic vertebra. Thoracic aortography revealed a feeding artery arising from the descending thoracic aorta and supplying the parenchymal lesion. We report the typical radiologic findings of intralobar pulmonary sequestration with aspergilloma, a condition confirmed by surgery and the pathologic findings.
Aorta, Thoracic ; Aortography ; Arteries ; Bronchopulmonary Sequestration* ; Humans ; Lung ; Radiography ; Radiography, Thoracic ; Spine ; Thorax ; Tomography, X-Ray Computed ; Young Adult

INTRODUCTION: Understanding the normal distribution of the tracheal diameter and crross- sectional area is one of the key elements in the management of various tracheal pathologies or tracheal reconstruction for the patients in growing age. However, data for Korean standard has been lacking. This study was designed to analyze retrospectively the distribution of tracheal diameter and cross-sectional area in young Koreans, which can afford fundamental data for the management of tracheal diseases. MATERIAL AND METHOD: Of the patients who underwent computerized tomogram of the chest between May 1996 and August 1998, one hundred six young patients(age range: 0-20 years) were included. Patients with any conditions which might affect the tracheal cross-sectional area or diameter, such as tracheal disease, previous operation, mediastinal tumor, or obstructive lung disease were excluded from the study. Gender distribution was 69 males and 37 females. Tracheal diameters, anterior-posterior and transverse, were measured at the level of the thoracic inlet(level I) and the aortic arch(level II). Types of the trachea were divided into round, oval, or horseshoe shaped on cross-sectional view, and the dimension was calculated by using the equation of A=1/4(pi)ab(A; area, (pi); 3.14, a; anterior-posterior diameter, b; transverse diameter). We analyzed the distribution of the diameter at each level and compared the cross-sectional area with respect to age and gender. A p-value lower than 0.05 wa considered significant. RESULT: The trachea of patients less than 5 years old were round in shape at both of level I and II, and no differences in cross-sectional area was observed between the levels(p=NS). As the age increased, the trachea become oval in shape at level I while it remained round in shape at level II(p=0.020). The tracheal diameter and cross-sectional area increased as the age increased with a linear correlation(r>0.9). In patients less than 5 years of age, female patients showed larger cross-sectional area than male patients (p=0.020), and it was reversed in patients older than 15 years of age(p=0.002). CONCLUSION: From the above results, we suggest chest computerized tomogram as a safe and reliable tool in measuring the tracheal diameter and cross-sectional area. We also provide the data as a standard for distribution of the tracheal diameter and cross-sectional area in young Korean population.
Age Factors ; Child, Preschool ; Female ; Humans ; Lung Diseases, Obstructive ; Male ; Pathology ; Retrospective Studies ; Thorax ; Trachea ; Tracheal Diseases

PURPOSE: A scoring system could be clinically useful in determining cases in which a throat culture may be omitted or in cases whether antibiotics may be initiated or not. We propose to make a clinical guideline of antibiotics administration in patients with pharyngitis. METHODS: From Apr. 1996. to Mar. 1997, throat cultures were taken from 321 cases (72 cases from Kyung-Hee Medical Center, 249 cases from 3 local pediatric clinics). On the first day of visit, 9 clinical items on a score-card were checked and a tentative diagnosis for streptococcal or non-streptococcal infection was made. These clinical scores were compared with the results of the throat swab cultures. RESULTS: Of 321 cases with pharyngitis, 55 cases (17%) proved to have group A streptococci by throat culture. The positive culture rate of group A streptococci was 18.5% from 3 local pediatric clinics, and 12.5% from Kyung-Hee Medical Center. The positive culture rate of group A streptococci were 40% in above 31 points of score, 31.5% in 29 to 30 points, 20.5% in 27 to 28 points. The sensitivity and specificity of the scoring system using a score at least 28 above points were 71% and 67%, respectively. CONCLUSION: The clinical diagnosis of streptococcal pharyngitis indicates that patients age 5 to 10 years, findings of abnormal pharynx, high fever and no past history of antibiotics use. Further modification of the scoring system for diagnosis of streptococcal pharyngitis should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.
Anti-Bacterial Agents ; Diagnosis* ; Fever ; Humans ; Pharyngitis* ; Pharynx ; Sensitivity and Specificity

PURPOSE: The aim of this study was to develop a new middle cerebral artery occlusion (MCAO) model in rabbits using a less invasive, endovascular interventional technique. The new animal model's technical feasibility and its success in producing lesions was evaluated using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Ten rabbits were used to develop the MCAO models using a transfemoral catheter-based technique. After catheterization of the common carotid artery, a microcatheter was introduced coaxially through the catheter to cannulate the internal carotid artery and to embolize the MCA with polyvinyl alcohol particles. We evaluated how successful we were in selecting the vessels, catheterization, embolization, and also evaluated how many of the animals survived until the end of experiment. Diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) were performed in one-hour intervals to monitor the ischemic lesion for a total of six hours following successful occlusion of the target artery. The relative volume of the lesion was calculated as a hemispheric lesion volume (HLV, %). The signals of the lesion and contralateral normal brain (control) were measured in each image at every time point. Lesion-to-control signal-intensity ratio (SIR) of DWI, and T2WI were obtained together with relative apparent diffusion coefficient (rADC). RESULTS: Catheterization and embolization of the internal carotid artery were successful in all 10 rabbits, which showed relevant lesions on MRI. All rabbits survived until the end of the experiment. The HLV (mean+/-standard deviation) was 35.7+/-14.6%. The relative ADC was 0.80+/-0.13. The lesion signals on DWI and T2WI showed a gradual increase as time passed, while the ADC value of the lesion gradually decreased (p<0.0001). CONCLUSION: The rabbit MCAO model using an endovascular interventional technique is technically feasible, and provides a reproducible lesion in the target arterial territory. MRI successfully revealed a typical finding of acute cerebral infarction. This model is also believed to be suitable for the MRI investigation of acute cerebral ischemia.
Animals ; Arteries ; Brain ; Brain Infarction ; Brain Ischemia ; Carotid Artery, Common ; Carotid Artery, Internal ; Catheterization ; Catheters ; Cerebral Infarction ; Diffusion ; Endovascular Procedures ; Infarction, Middle Cerebral Artery* ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Models, Animal ; Polyvinyl Alcohol ; Rabbits*

Postoperative visual loss (POVL) after non-ophthalmic surgery is rare, with a reported incidence ranging from 0.013 to 0.2%. Most perioperative visual loss is associated with spine operations and cardiac bypass procedures. The most common cause of POVL is ischemic optic neuropathy. However, there are no previous reports of postoperative visual loss after laparoscopic appendectomy. A 43-year-old female with no underlying disease underwent laparoscopic appendectomy; the operation was completed in one hour and her blood pressure was stable during the perioperative period. In the post-anesthetic care unit, the patient complained of nausea and headache, but she did not complain of any unusual visual symptoms. Approximately one hour after arriving at the ward, the patient complained of visual disturbance. Neurologic examination revealed left homonymous hemianopsia, and subarachnoid hemorrhage and intracerebral hemorrhage were found in the occipital area on brain MRI.
Adult ; Appendectomy* ; Blood Pressure ; Brain ; Cerebral Hemorrhage* ; Female ; Headache ; Hemianopsia ; Humans ; Incidence ; Magnetic Resonance Imaging ; Nausea ; Neurologic Examination ; Optic Neuropathy, Ischemic ; Perioperative Period ; Spine ; Subarachnoid Hemorrhage

BACKGROUND: Host genetic polymorphisms in the HIV-1 co-receptor CCR5 and CCR2b and SDF-1, ligand for co-receptor CXCR4, have been known to be associated with the resistance of HIV infection and/or the delayed disease progression in HIV-infected patients. METHODS: We examined the frequencies of SDF1-3'A and CCR2b-64I alleles of 354 Koreans including 100 HIV-uninfected persons, 13 discordant spouses of HIV-infected persons, and 241 HIV-infected persons. The genotyping assays of SDF1 and CCR2b genes were carried out by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: The frequencies of CCR2b-64I and SDF1-3'A alleles in Koreans were very high compared with Caucasians and blacks. Observed frequencies of CCR2b-64I and SDF1-3'A allelic variants were 25.1% and 28.7%, respectively. The frequency of the CCR2b-64I allele in Koreans was 2~4 times higher than those of other ethnic groups with the exception of Asian. The frequencies of CCR2b-64I and SDF1- 3'A genotypes did not show the significant difference between HIV-infected and uninfected Koreans. However, the prevalence of CCR2b-64I genotype of the LTNP group was about two times higher than that of the remainder group (P < 0.05). Four (45%) out of 9 LTNPs (long-term nonprogressors) showed having the SDF1-3'A allele and 7 (78%) out of 9 LTNPs carried the CCR2b-64I allele. 3 (33%) out of 9 LTNPs had both SDF1-3'A and CCR2b-64I alleles. But none of 5 RPs (rapid progressors) appeared to have both SDF1-3'A and CCR2b-64I alleles. CONCLUSION: The different genetic backgrounds in study populations may affect the disease progression and the AIDS epidemic in each country. Further studies need to define whether high frequencies of CCR2b-64I and SDF1-3'A allelic variants may affect the HIV disease progression.
African Continental Ancestry Group ; Alleles ; Asian Continental Ancestry Group ; Chemokine CXCL12* ; Disease Progression ; Ethnic Groups ; Genotype ; HIV Infections* ; HIV* ; HIV-1 ; Humans ; Polymorphism, Genetic ; Prevalence ; Spouses