PURPOSE: Emphysematous pyelonephritis is a rare, life threatening infection of kidney and the pennephric space, characterized by the production of gas within the renal parenchyma. The aim of this study is to analyze the clinical and radiologic characteristics of emphysematous pyelonephritis. MATERIALS AND METHODS: We reviewed 7 cases of the emphysematous pyelonephritis. Six patients had plain abdominal radiographs, ultrasonograms and abdominal CT scans. Only one patient had plain radiograph and ultrasonogram. In 5 operated cases, CT findings were compared with surgical records. RESULTS: Plain radiographs showed characteristic diffuse mottling of gas in renal fossa. On sonogram, intrarenal gas was identified as echogenic loci with dirty shadows. CT scan showed inflammatory mass with gas and fluid levels in adjacent to the kidney. CT findings corresponded relatively wall with the surgical findings in regard to disease extent. CONCLUSION: lntrarenal gas in appropriate clinical setting is highly specific for emphysematous pyelonephritis. CT is the most sensitive method for demonstrating the disease extent as well as specific diagnosis.
Diagnosis ; Humans ; Kidney ; Pyelonephritis* ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: Emphysematous pyelonephritis is a rare, life threatening infection of kidney and the pennephric space, characterized by the production of gas within the renal parenchyma. The aim of this study is to analyze the clinical and radiologic characteristics of emphysematous pyelonephritis. MATERIALS AND METHODS: We reviewed 7 cases of the emphysematous pyelonephritis. Six patients had plain abdominal radiographs, ultrasonograms and abdominal CT scans. Only one patient had plain radiograph and ultrasonogram. In 5 operated cases, CT findings were compared with surgical records. RESULTS: Plain radiographs showed characteristic diffuse mottling of gas in renal fossa. On sonogram, intrarenal gas was identified as echogenic loci with dirty shadows. CT scan showed inflammatory mass with gas and fluid levels in adjacent to the kidney. CT findings corresponded relatively wall with the surgical findings in regard to disease extent. CONCLUSION: lntrarenal gas in appropriate clinical setting is highly specific for emphysematous pyelonephritis. CT is the most sensitive method for demonstrating the disease extent as well as specific diagnosis.
Diagnosis ; Humans ; Kidney ; Pyelonephritis* ; Tomography, X-Ray Computed ; Ultrasonography

Angioedma is a group of disorders with multifactorial etiology but a similar clinical expression, is characterized by swelling of subcutaneous or submucosal tissue. Systemic lupus erythematosus(SLE) is a chronic multi-systemtic disease characterized by inflammation and tissue damage resulting from deposition of auto-antibodies and immune complex. We experienced a case of angioedema which was the first manifestation of SLE in 24-year-old female patient. She had suffered from severe facial edema and multiple lymphadenopathy for six months and she also had pleural effusion, positive anti-nuclear and anti-DNA antibody test. Marked decrease of C3 and C4 levels was noted with normal antigenic level, and activity of Cl esterase inhibitor. The angioedema was not improved with anti-hitamine agents and instead disappeared with use of corticosteroid and non-steroidal anti-inflammatory drugs. Complement levels normalized after corticosteroid treament. We report a case of SLE which initial manifestation was angioedema.
Angioedema ; Antigen-Antibody Complex ; Complement System Proteins ; Edema ; Female ; Humans ; Inflammation ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Pleural Effusion ; Young Adult

PURPOSE: To evaluate the efficacy of combined treatment of metallic biliary stent placement and radiotherapy in malignant biliary obstruction. MATERIALS AND METHODS: Between January 1992 and February 1994, 22 patients with malignant biliary obstruction were treated with metallic biliary stent placement and radiotherapy. The causes of the obstruction included cholangiocarcinoma(n=14), gallbladder carcinoma(n=4), colon cancer(n=2), pancreatic head cancer (n=1), and stomach cancer(n=1). According to the sites of obstruction level, patient were divided into 2 groups; hilar obstruction(n=18) and common bile duct obstruction(n=4). The patients received dose of 45 Gray/18 fraction by external radiotherapy and 20Gy/8f by high dose rate brachytherapy with iridium--192 source through percutaneous transhepatic biliary drainage(PTBD) catheter. The duration of stent patency after placement, survival period and survival rate by Kaplan Meier method were calculated in dead and alive patients, respectively. RESULTS: In all 22 patients, the duration of stent patency was 5.5(1.3--18.5)months. Survival periods after stent placement and PTBD were 5.3(2.0--8.5 )months and 7.9(4.0--14.7)months respectively in 9 dead patients and 7.7(1.3--21.0)months and 9.5(2.3--23.0)months in 13 alive patients. In all 22 patients, the survival rates in 6, 12 and 18 months were 78.9%, 47.5 % and 35.6 %, respectively. CONCLUSIONS: The results with combined metallic biliary stent placement and radiotherapy for the palliative treatment of malignant biliary obstruction in this study was more favorable, as compared with those of the other authors with only metallic biliary stent placement.
Brachytherapy ; Catheters ; Colon ; Common Bile Duct ; Gallbladder ; Head and Neck Neoplasms ; Humans ; Palliative Care ; Radiotherapy* ; Stents* ; Stomach ; Survival Rate

The congenital diverticulum of ventricle is a rare cardiac malformation arising from the left or right ventricle, the former being more common. Ventricular diverticulum is usually associated with other anomalies including intracardiac, midline thoracic, diaphragmatic and abdominal wall defect. The authors experienced a case of congenital diverticulum of left ventricle in nine month-old female infant. Left Blolock-Taussig shunt operation was done and total correction will be done later. Thereafter we presented a case with brief review of the related literatures.
Abdominal Wall ; Diverticulum* ; Female ; Heart Ventricles ; Humans ; Infant ; Pulmonary Atresia*

No abstract available.
Cryptococcosis*

Inverted papilloma is a rare urothelial neoplasm most frequently occurred in the trigonal region of the urinary bladder. But, it rarely arises in the renal pelvis. The characteristic downward proliferation of urothelial cells within the underlying lamina propria is of such magnitude as to result in an exophytic papillomatous tumor. It was regarded as a benign neoplasm, but the malignant tendency is now being reported with inverted papillomas of urinary tract, and therefore they are no longer regarded as innocuous benign neoplasms. We report a very rare case of inverted papilloma of the renal pelvis and review the relevant literatures.
Kidney Pelvis* ; Mucous Membrane ; Papilloma, Inverted* ; Urinary Bladder ; Urinary Tract

Steroid mvopathy is a skeletal muscle disease that develops in condition both endogenous and exogenous glucocorticoid excess and is characterized by muscle weakness. Myalgia, and wasting. The onset is usually insidious and the distribution of weakness is primarily proximal uith the legs more severely involved than the arms; cranial-nerve-in nervated muscles and sphin ers are usually spared. We report a 60-year-old man with rheumatoid arthritis uho was managed by prednisone and dexamethasone over 20 years and showed progressive lower limb weakness afterwards.
Arm ; Arthritis, Rheumatoid ; Dexamethasone ; Humans ; Leg ; Lower Extremity ; Middle Aged ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Muscular Diseases* ; Myalgia ; Prednisone

Acinetobacter species encounters frequently with clinical specimens and now accounts for a substantial proportion of endemic nosocomial infections in Korea. Recent trends indicate that the antimicrobial resistant strains of Acinetobacter species are increasing. Sixty-one strains were isolated from specimens of patients suspected of nosocomial infections during 1991 to 1996. At present, phenotypic identification of Acinetobacter using biochemical test may not be reliable and resulted in the difficulty to clarify the source of infections and epidemiological study of hospital-acquired infections. Aware of the importance of rational taxonomic proposal for these isolates, correct species identification of these organisms by molecular typing method was carried out. A total of fifty-four strains of A. calcoaceticus-A. baumannii complex species which were identified to genospecies 2 and 13 by biochemical characteristics was subjected to identify by ribotyping using restriction endonuclease EcoRI, ClaI, and SalI. Of fifty-four strains, twenty-five strains were identified as A. baumannii (genospecies 2) and twenty-one strains as genospecies 13, and six strains changed to genospecies 3, and the rest two strains were confirmed as A. haemolyticus (genospecies 4). This result suggests that the ribotyping may be of value for identification of genospecies and epidemiological information of Acinetobacter strains.
Acinetobacter baumannii* ; Acinetobacter calcoaceticus* ; Acinetobacter* ; Cross Infection ; DNA Restriction Enzymes ; Humans ; Korea ; Molecular Typing ; Ribotyping*

Two patients with spontaneous intraretinal or subretinal hemorrhages were found, on evaluation by fluorescein angiography, to have macroaneurysms involving the major retinal arteries. Both patients were male in their seventies. One patient had a history of systemic hypertension. In the other patient, hypertension was discovered at the time of consultation. With absorption of the hemorrhage and the macular star, two patients experienced appreciable improvement in vision. Laser thrapy was not applied to both patients. The aneurysms diminished in size after 6 to 8 months as a result of fibrous changes within the arterial walls.
Absorption ; Aneurysm ; Fluorescein Angiography ; Hemorrhage ; Humans ; Hypertension ; Male ; Retinal Artery* ; Retinaldehyde*