Spinal arteriovenous malformations(AVMs) and aneurysms should be suspected when patient present with subarachnoid hemorrhage and intracranial source has not been identified with neurologic findings attributable to the spinal cord. We report a case of subarachnoid hemorrhage(SAH) with ruptured spinal artery aneurysm associated with spinal cord AVM in 37-year old man who presented with sudden loss of consciousness with paraplegia. The result of CT-head arteriography of the brain was SAH with intraventricular hemorrhage but no intracranial aneurysm was identified. Spinal angiography revealed a cervical spinal cord AVM supplied by anterior spinal artery with an aneurysm in the feeder. The treatment of the spinal cord AVM was performed with liquid coil embolic agent, polyvinylacetylate(PVAc) and feeding artery aneurysm was treated with Guglielmi detachable coils(GDCs).
Adult ; Aneurysm* ; Angiography ; Arteries* ; Arteriovenous Malformations* ; Brain ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Neurologic Manifestations ; Paraplegia ; Spinal Cord* ; Subarachnoid Hemorrhage* ; Unconsciousness

No Abstract available.
Arthritis, Rheumatoid* ; Humans ; Osteoclasts*

Malignant leptomeningeal metastases involving both internal auditory canals (IACs) are rare and can mimic neurofibromatosis type 2 (NF2). Rapid progression of symptoms and involvement of facial nerve are characteristic clinical courses in contrast to the slow progression of symptoms in NF2. We report a rare case suspected to be metastatic tumor involving bilateral IACs, and presenting sudden bilateral hearing loss in a patient who was previously treated for adenocarcinoma of lung.
Adenocarcinoma ; Facial Nerve ; Hearing Loss, Bilateral ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Neurofibromatosis 2

Polyarteritis nodosa (PAN) is a systemic vasculitis involving small- and medium-sized arteries, which presents with necrotizing inflammation. PAN occurs as a systemic disease or as a limited form confined to a single organ. Few cases have been reported with single organ involvement, and even fewer have been reported with skeletal muscle involvement. Herein, we report the ultrasonography and magnetic resonance imaging findings in a rare case of PAN with limited muscle involvement in a 66-yearold man.

Polyarteritis nodosa (PAN) is a systemic vasculitis involving small- and medium-sized arteries, which presents with necrotizing inflammation. PAN occurs as a systemic disease or as a limited form confined to a single organ. Few cases have been reported with single organ involvement, and even fewer have been reported with skeletal muscle involvement. Herein, we report the ultrasonography and magnetic resonance imaging findings in a rare case of PAN with limited muscle involvement in a 66-yearold man.

Objectives: Osteoporosis and fracture are known complications of systemic lupus erythematosus (SLE). We assessed the prevalence and risk factors for osteoporosis in patients with SLE. Methods: A total of 155 female SLE patients were recruited retrospectively in 5 university hospitals. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and the fracture risk assessment tool (FRAX) for high-risk osteoporotic fractures was calculated with and without BMD. Results: The mean age was 53.7 ± 6.8 years, and osteoporotic fractures were detected in 19/127 (15.0%) patients. The proportion of patients having a high-risk for osteoporotic fractures in the FRAX with and without BMD, and osteoporosis by the World Health Organization (WHO) criteria were 25 (16.1%), 24 (15.5%), and 51 (32.9%), respectively, and 48.0–68.6% of them were receiving treatment. On multivariate logistic analysis, nephritis (odds ratio [OR] 11.35) and cumulative dose of glucocorticoid (OR 1.1) were associated with high-risk by the FRAX with BMD, and low complement levels (OR 4.38), erythrocyte sedimentation rate (ESR) (OR 1.04), and cumulative dose of glucocorticoid (OR 1.05) were associated with osteoporosis by the WHO criteria in patients with SLE. Conclusions Among Korean female patients with SLE, the proportion of patients having a high-risk of osteoporotic fractures by the FRAX tool was 15.5%–16.1% and the proportion of patients having osteoporosis by the WHO criteria was 32.9%. In SLE, nephritis, low level of complement, ESR, and cumulative dose of glucocorticoids may contribute to fracture risk.

Objectives: Osteoporosis and fracture are known complications of systemic lupus erythematosus (SLE). We assessed the prevalence and risk factors for osteoporosis in patients with SLE. Methods: A total of 155 female SLE patients were recruited retrospectively in 5 university hospitals. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and the fracture risk assessment tool (FRAX) for high-risk osteoporotic fractures was calculated with and without BMD. Results: The mean age was 53.7 ± 6.8 years, and osteoporotic fractures were detected in 19/127 (15.0%) patients. The proportion of patients having a high-risk for osteoporotic fractures in the FRAX with and without BMD, and osteoporosis by the World Health Organization (WHO) criteria were 25 (16.1%), 24 (15.5%), and 51 (32.9%), respectively, and 48.0–68.6% of them were receiving treatment. On multivariate logistic analysis, nephritis (odds ratio [OR] 11.35) and cumulative dose of glucocorticoid (OR 1.1) were associated with high-risk by the FRAX with BMD, and low complement levels (OR 4.38), erythrocyte sedimentation rate (ESR) (OR 1.04), and cumulative dose of glucocorticoid (OR 1.05) were associated with osteoporosis by the WHO criteria in patients with SLE. Conclusions Among Korean female patients with SLE, the proportion of patients having a high-risk of osteoporotic fractures by the FRAX tool was 15.5%–16.1% and the proportion of patients having osteoporosis by the WHO criteria was 32.9%. In SLE, nephritis, low level of complement, ESR, and cumulative dose of glucocorticoids may contribute to fracture risk.

OBJECTIVE: To see whether the active inflammation in Behcet's disease (BD) can cause thrombotic disorders by decreasing the protein S activity (PSA), we evaluated the relationship between PSA decrease and disease activity of BD. METHODS: We included 122 patients with BD whose PSAs were measured between August 1998 and April 2005. In 51 BD patients, the PSA was measured again when there were changes in the number of items of "The Behcet's Disease Current Activity Form (BDCAF)". RESULTS: Thrombosis rate was 2.5% (3/122), and the PSA was low in all 3 of the patients. The incidence of low PSA in total 122 BD patients was 27% (33/122). The incidence of low PSA in active BD patients was 33.7% (31/92), and it was significantly more frequent in active BD patients than in inactive patients, 6.7% (2/30) (chi2-test, p value=0.0038). The decrease of PSA had good correlation with the number of BDCAF items (r=-0.351, p=0.012). CONCLUSION: The PSA decrease is related to the disease activity of BD. PSA could be not only the risk factor for thrombotic disorder but also the activity marker for the BD and other inflammatory diseases.
Humans ; Incidence ; Inflammation ; Protein S* ; Risk Factors ; Thrombosis

We report a case of group O losing anti-B selectively. A 25-year-old male donated blood; on the donor test an ABO discrepancy was noted, and a further evaluation study was performed. ABO genotyping with an allele specific polymerase chain reaction assay revealed O/O and DNA sequencing of exons 6 and 7 of the ABO gene showed O01/O02. The serum gammaglobulin level was decreased and only 0.2% CD19 pan-B positive lymphocytes were present in a subset of lymphocytes. In a previous donor study, anti-B of the patient was lost from a third donor study and was still not detected.
Adult ; Agammaglobulinemia ; Alleles ; Exons ; Humans ; Lymphocytes ; Male ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Tissue Donors

The adequacy of the urologist work force in Korea has never been investigated. This study investigated the geographic distribution of urologists in Korea. County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. Urologist density was defined by the number of urologists per 100,000 individuals. National patterns of urologist density were mapped graphically at the county level using GIS software. To control the time sequence, regression analysis with fitted line plot was conducted. The difference of distribution of urologist density was analyzed by ANCOVA. Urologists density showed an uneven distribution according to county characteristics (metropolitan cities vs. nonmetropolitan cities vs. rural areas; mean square=102.329, P<0.001) and also according to year (mean square=9.747, P=0.048). Regression analysis between metropolitan and non-metropolitan cities showed significant difference in the change of urologists per year (P=0.019). Metropolitan cities vs. rural areas and non-metropolitan cities vs. rural areas showed no differences. Among the factors, the presence of training hospitals was the affecting factor for the uneven distribution of urologist density (P<0.001).Uneven distribution of urologists in Korea likely originated from the relatively low urologist density in rural areas. However, considering the time sequencing data from 2007 to 2012, there was a difference between the increase of urologist density in metropolitan and non-metropolitan cities.
Cities/statistics & numerical data ; Health Services Accessibility/*statistics & numerical data/trends ; Korea/epidemiology ; Physicians/*supply & distribution/trends ; Republic of Korea/epidemiology ; Rural Health Services/*manpower/statistics & numerical data/trends ; Rural Population/statistics & numerical data/trends ; Urban Health Services/*manpower/statistics & numerical data/trends ; Urology/*manpower/*statistics & numerical data/trends