Sarcoidosis is a disease of unknown cause characterized by the presence of noncaseating granulomatous inflammation. Because the lungs and thoracic lymph nodes are almost always involved, most patients report acute or insidious respiratory problems. Although pulmonary manifestations are usually the major clinical concern in sarcoidosis, extrapulmonary involvement is common. We report a case of sarcoidosis of the axillary lymph nodes with no evidence of lung alteration.
Humans ; Inflammation ; Lung ; Lymph Nodes* ; Sarcoidosis*

OBJECT: Pre-ALL is a very rare preteukemic state, which percedes acute lymphocytic leukemia, while MDS(pre-ANLL), usually the well-known type of preleukemic state, precedes acute non-lymphocytic leukemia. Initially it shows transient pancytopenia without any evidence of leukemia in bone marrow findings, followed by acute lymphocytic leukemia after recovery from pancytopenia of a short period within weeks or months. We report a case with pre-ALL in childhood. CASE: A 15-month-old male baby was admitted with the complaints of fever and cough for 5 days and pallor for 2 weeks prior to admission. On admission, CBC showed pancytopenia without any evidence of leukemia, which was recovered spontaneously in a short period, and then was followed by acute lymphocytic leukemia of CALLA negative, early pre-B cell type. During antileukemic chemotherapy, he had suffered from severe bacterial infections and was finally died of sepsis 8 months after first admission. CONCLUSION: We report a case of pre-ALL in childhood, which was preceded by CALLA negative, early pre-B cell ALL, with a review of the literatures, briefly.
Bacterial Infections ; Bone Marrow ; Cough ; Drug Therapy ; Fever ; Humans ; Infant ; Leukemia ; Male ; Pallor ; Pancytopenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Sepsis

No abstract available.
Wernicke Encephalopathy*

We investigated a correlation of serum prostate specific antigen(PSA) and preoperative prostatic volume measured by transrectal ultrasonography (TRUS) in 66 patients with pathologically con- firmed benign prostatic hyperplasia (BPH), as aids in the early detection of prostate cancer and in the improvement of specificity in BPH. The preoperative serum PSA value was also measured in 18 patients with pathologically confirmed prostate cancer and 15 men without prostatic disease as normal control using Tandem-R PSA radioimmunometric assay. There was a highly significant correlation between natural logarithm transformed PSA(In PSA) and non-transformed prostatic volume by linear regression analysis(r=0.6668, p<0.0001). Given above data, we determined a volume adjusted 95th percentile upper confidence limit for n PSA as an appropriate cutoff between normal and abnormal PSA value, according to prostatic volume in BPH. In the patients with BPH and prostate cancer, sensitivity, specificity, diagnostic accuracy and positive predictive value were 94%, 72%, 68% and 48%, respectively. A statistical results by the volume-adjusted cutoff for in PSA was similar to that at 10 ng/ml as cutoff for PSA value. Above 40ml in prostatic volume, however, a false positive rate was decreased in inverse proportion to prostatic volume in BPH. In summary, the prostatic volume must be considered in BPH patients with elevated serum PSA value, negative digital rectal examination and negative TRUS of prostate. And when the volume adjusted PSA cutoff is clinically applied to BPH patients for the early detection of prostate cancer, we thought that the false positive rate can be decreased in BPH patients.
Diagnosis* ; Digital Rectal Examination ; Humans ; Linear Models ; Male ; Prostate* ; Prostatic Diseases ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Sensitivity and Specificity ; Ultrasonography*

The coronary artery fistula from right coronary artery to left ventricle is a rare disease among coronary artery anomaly. We experienced three cases of rare coronary fistula and report with literature review. Although symptoms of coronary artery fistula are associated with arteriovenous shunt and coronary steal phenomenon, many cases are asymptomatic. In this report, all patients had no symptom. but incidental murmur was noted (two are continuous, one is diastolic rumbling). The diagnosis was made by transthoracic or transesophageal echocardiogram and selective coronary angiography. Because patients were relatively young and the diameter of dilated coronary artery were huge, we perfomed operation on three patients.
Coronary Angiography ; Coronary Vessels* ; Diagnosis ; Fistula* ; Heart Ventricles* ; Humans ; Rare Diseases

PURPOSE: When performing partial nephrectomy, there is a risk of excessive blood loss; this necessitates transfusion and it also results in deterioration of the renal function when a vascular clamp is used. We evaluated the usefulness of the microwave tissue coagulator for performing partial nephrectomy for renal cell carcinoma and benign renal tumors. MATERIALS AND METHODS: From October 2000 to January 2005, partial nephrectomy was performed without renal pedicle clamping with using the microwave tissue coagulator for 9 patients with seven renal cell carcinomas and two angiomyolipomas. RESULTS: In 6 patients, partial nephrectomy was successful with using the microwave tissue coagulator without renal pedicle clamping. The mean operative time and blood loss were 184 minutes and 223ml, respectively. For the remaining cases, three had positive tumor margins, so radical nephrectomy was performed for those cases. The mean creatinine level was not increased postoperatively. The mean preoperative and postoperative hemoglobin levels were 12.6g/dl and 11.7g/dl, respectively. CONCLUSIONS: Partial nephrectomy with using the microwave tissue coagulator can be safe and successful without performing renal pedicle clamping. However, the insertion line of the microwave electrode must be carefully determined for the resection to be curative, the same as when making the cut line for conventional partial nephrectomy.
Angiomyolipoma ; Carcinoma, Renal Cell ; Constriction ; Creatinine ; Electrodes ; Humans ; Kidney ; Microwaves* ; Nephrectomy* ; Operative Time

No abstract available.
Carcinoma, Renal Cell*

The Dandy-Walker syndrome is a developmental disorder of the brain characterized by cystic dilatation of the fourth ventricle and agenesis or hypoplasia of the cerebellar vermis. We experinced a case of Dandy-Walker syndrome with complex cardiac anomaly in female newborn who presented with apnea at birth. Physical examination showed coloboma on left eye, low estting malformed ear, and high arched palate. Autopsy revealed cystic dilatation of the fourth ventricle with secondary loss of cerebellar vermis. The floor of the fourth ventricle is exposed through this defect. Heart showed aortic atresia and univentricular heart. The case is reported with the review of the literatures.
Apnea ; Autopsy ; Brain ; Coloboma ; Dandy-Walker Syndrome* ; Dilatation ; Ear ; Female ; Fourth Ventricle ; Heart ; Humans ; Infant, Newborn ; Palate ; Parturition ; Physical Examination

A 14-year-old girl had a history of Graves' disease and received propylthiouracil (PTU) treatment for 2 years before admission to our hospital. She developed skin rash over her, whole body 1 month before admission, and laboratory examination revealed pancytopenia. Positive antinuclear antibodies, antihistone antibodies and reduced complement levels were noted, although anti-double-stranded DNA and anti-Sm antibodies were negative. A biopsy specimen revealed mild epidermal atrophy and peri-adnexal lymphoid cell infiltration. Linear deposition of IgM along the basement membrane zone was noted by direct immunofluorescence array. After discontinuation of PTU and steroid treatment, eruptions and pancytopenia improved, suggesting drug-induced lupus erythematosus.
Adolescent ; Antibodies ; Antibodies, Antinuclear ; Atrophy ; Basement Membrane ; Biopsy ; Complement System Proteins ; DNA ; Exanthema ; Female ; Fluorescent Antibody Technique, Direct ; Graves Disease ; Humans ; Immunoglobulin M ; Lymphocytes ; Pancytopenia ; Propylthiouracil

Purpose: The aim of this study was to conduct research on the pre- treatment prognostic factors that may influence the continuation or cessation of adrenergic alpha-antagonist (alpha-blocker) in benign prostatic hyperplasic (BPH) patients. Materials and Methods: 56 patients who were responsive to alpha-blocker, and returned for follow-up for more than 5 months, were evaluated. The patients in whom the therapeutic effect persisted for more than 8 and for less than 4 weeks after cessation of alpha-blocker were designated as groups 1 (29 patients) and 2 (27 patients), respectively. An evaluation between the groups, based on age, prostate specific antigen (PSA), total prostate volume (TPV), transition zone volume (TZV), transition zone index (TZI), International Prostate Symptom Score (I-PSS), quality of life (QoL index), peak flow rate (Qmax), residual urine, and the duration of treatment, was conduct. All parameters were initially checked before medication. Results: This study showed that younger age, lower PSA level, smaller volume of residual urine and higher Qmax were useful indicators on the persistency of the therapeutic effect. However, TPV, TZV, TZI, I-PSS, QoL index and the duration of treatment did not affect the outcome. Conclusions: It was concluded that age, PSA, Qmax and residual urine measured before medication were useful pre-treatment prognostic factors in the prediction of the persistency of the therapeutic effect after cessation of alpha-blockers.
Adrenergic alpha-Antagonists* ; Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms* ; Prognosis ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Quality of Life ; Recurrence*