PURPOSE: The purpose of this study is to analyze and compare the CT findings of gastric adenocarcmoma and gastric lymphoma. MATERIALS AND METHODS: We retrospectively analyzed and compared the CT findings in 46 cases of adenocarcinoma and 12 cases of lymphoma, which were pathologically confirmed by operation and endoscopic biopsy. RESULTS: Antral involvement was more common in adenocarcinoma(71.7%) than in lymphoma(41.7%). Localized involvement was more common in adenocarcinoma(83.7%), while diffuse involvement was more common in lymphoma(55.6%). Adenocarcinoma tended to have smooth inner margin(83.8%), while lymphoma had nodular or irregular inner margin(36.4%). Mean gastric wall thickness of adenocarcinoma was 1.7cm, while mean thickeness of lymphoma was 2.7cm. The involved wall of adenocarcinoma tended to be highly enhanced (59.5%), while lymphoma was moderately enhanced(90.1%). Perigastric lymphadenopathy was present in 40% (group I) and 42%(group II) of adenocarcinoma and 33% of lymphoma(group I and II). Three cases of lymphoma had lymphadenopathy below renal vascular pedicles with no or minimal perigastric lymphadenopathy. When only the distal portion of the stomach was involved, disturbance in passage developed in six adenocarcinoma (12%), while none developed in the lymphoma. CONCLUSION: CT features help to differentiate between gastric adenocarcinoma and gastric lymphoma
Adenocarcinoma* ; Biopsy ; Lymphatic Diseases ; Lymphoma* ; Retrospective Studies ; Stomach

PURPOSE: We report clinical features and viral studies on 153 children with aseptic meningitis in the Pusan area in 1996 and compare the results of this study with those of other reports in 1990 and 1993. METHODS: One hundred fifty-three children with aseptic meningitis who have been admitted to the Department of Pediatrics, St. Benedict Hospital between July and October 1996 were included. We described age and sex distribution, monthly distribution, clinical manifestations, laboratory data and complication. RESULTS: The male to female ratio was 2.32:1 and the most age was 4.21 years. It occurred mostly in July, August and October. It was later than the peak incidence between May and July in 1990 and 1993. The main symptoms were fever, headache and vomiting in this order. Rash was mostly maculopapular form and frequent in those younger than 4 years-old. No specific results were not found in peripheral blood and CSF studies. We failed to isolate the causative agent in the viral culture, but Echovirus 9 was suspected as a causative agent by its clinical features and other similar reports. The duration of clinical symptoms in the early diagnostic group was significantly shorter that in late diagnostic group. CONCLUSIONS: Aseptic meningitis was prevalent in children in the Pusan area, during the summer of 1996. It was frequent in male and the mean age was 4.21 years. It occurred mostly in July, August and October. Peak incidence was later than in 1990 and 1993. The main symptoms: fever, headache, vomiting and rash were observed frequently.
Busan* ; Child ; Child, Preschool ; Echovirus 9 ; Exanthema ; Female ; Fever ; Headache ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Meningitis, Aseptic* ; Pediatrics ; Sex Distribution ; Vomiting

PURPOSE: The respiratory tract infections including pneumonia have been the major contributing factor for bronchial asthma, and are frequently involved in hospitalization due to asthma attack. We studied clinical characteristics of hospitalized cases due to asthma attack with and without pneumonic infiltrates. METHODS: Over 5 years between January 1993 and December 1997, 628 patients were hospitalized due to asthma attack. 315 of them had pneumonic infiltrates on chest X-ray (defined as pneumonia group) and 197 patients had no pneumonic infiltrates (uncomplicated group). The clinical characteristics of both groups were reviewed retrospectively. RESULTS: The age on admission and first attack in pneumonia group were significantly younger than those of uncomplicated group (P<0.05). The incidence of male was higher than that of female in both groups. The interval from attack to admission and duration of hospitalization were much longer in pneumonia group (P<0.05). The bronchial asthma attack was most frequently occurred between September and November. The atopy-perennial type was predominant in the both groups, and the incidence of non-atopy type was higher in the pneumonia group. The mild asthma attack was predominant in the pneumonia group and moderate one was predominant in the uncomplicated group. The incidence of fever and inflammatory reaction (peripheral blood WBC count, serum CRP level) were higher in the pneumonia group (P<0.05). There was no significant difference in the serum IgE level between two groups. CONCLUSION: Frequency and duration of hospitalization due to asthma attack might be lessened by prevention against respiratory tract infection.
Asthma* ; Female ; Fever ; Hospitalization ; Humans ; Immunoglobulin E ; Incidence ; Male ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Thorax

PURPOSE: Ultrasound(US) findings of hyperechoic renal medulla in gouty nephropathy were compared with clinical features such as serum uric acid level to evaluate its usefulness in determination of the treatment and prognosis. MATERIALS AND METHODS: A retrospective review of US of 36 cases of gouty arthritis was classified into four groups according to the medullary echogenicity (O:normal, grade 1 :renal medulla as isoechoic as renal cortex, grade 2'heterogeneous increased echogenicity of renal medulla than that of renal cortex, grade 3 :the echogenicity of all renal medulla higher than that of renal cortex with renal contour deformity) which were compared with the serum urate level and associated conditions. Nephrocalcinosis and nephrolithiasis were analyzed through the KUB and the RGP. RESULTS: The degree of hyperechoic renal medulla was related to the level of serum uric acid, and in group IV, six cases of obstructive uropathy (nephrocalcinosis and nephrolithiasis) showed deformed renal contour. Associated conditions such as hypertension, alcoholism, diabetes mellitus and drug abuse were distributed in relation to the degree of hyperechoic renal medullas. CONCLUSION: US findings of hyperechoic renal medulla was related with uric acid level in gouty nephropathy and thus could be valuable for treatment decision and prediction of prognosis.
Alcoholism ; Arthritis, Gouty ; Diabetes Mellitus ; Hypertension ; Nephrocalcinosis ; Nephrolithiasis ; Prognosis ; Retrospective Studies ; Substance-Related Disorders ; Ultrasonography* ; Uric Acid

PURPOSE: Heat shock protein 27 (HSP27) is induced by heat shock and other pathophysiologic stresses. We examined the relationship between HSP27 expression and Gleason score and pathologic stage of prostate cancer. MATERIALS AND METHODS: Fifty-three men were treated by radical prostatectomy for prostate cancer diagnosed from May 2004 to April 2007. Prostate tissues (n=53) were obtained from radical prostatectomy specimens of prostate cancer. The overall percentage of cancer cells showing staining (0% to 100%) was indicated by visual scoring. Specimens were graded from +1 to +3 intensity representing the range of staining area, for which below 5% is +1 grade, 5-50% is +2 grade, over 50% is +3 grade and focal reaction is +0.5 grade. RESULTS: An HSP27-positive reaction was seen in 2 of 11 cases (18.2%) with a Gleason score of 4-6, 11 of 19 cases (57.9%) with a Gleason score 7, 6 of 10 cases (60.0%) with a Gleason score 8, 12 of 13 cases (92.3%) with a Gleason score of 9 (p=0.001); the mean HSP27 reaction scores were 0.27, 0.86, 0.83, and 1.54 respectively (p=0.006). An HSP27-positive reaction was seen in 17 of 37 cases (46.0%) with pathologic stage T2, 10 of 12 cases (83.3%) with pathologic stage T3, and 4 of 4 cases (100%) with pathologic stage T4 (p=0.0032); the mean HSP27 reaction scores were 0.64, 1.17, and 2, respectively (p=0.007). HSP27 expression was not statistically significant according to age. CONCLUSIONS: There is correlation between HSP27 expression and Gleason score, pathologic stage of prostate cancer.
Heat-Shock Proteins ; Hot Temperature ; HSP27 Heat-Shock Proteins ; Humans ; Male ; Neoplasm Grading ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Shock

PURPOSE: We evaluated whether a 6Fr transurethral catheter affects urinary flow in women undergoing pressure-flow studies. MATERIALS AND METHODS: We retrospectively reviewed urodynamics database of 201 consecutive women referred for the evaluation of lower urinary tract symptoms from January 1997 to June 2000. Before the urodynamic study, all patients voided privately using a standard toilet and free uroflowmetry parameters were recorded. Then, a standard pressure-flow study was performed using 6Fr transurethral catheter. We excluded the patients with inadequate voided volume(<150ml) and volume difference more than 30% between two studies. Urinary flow parameters between the two studies were analysed by paired t-test according to voided volume, main urodynamic diagnosis and uroflowmetry pattern. RESULTS: Of 201 women, 144 were excluded and 57 were subjects of our analysis. According to voided volume, pressure-flow study parameters were significantly different from the equivalent free uroflowmetry parameters: the maximum flow rate and average flow rate were significantly lower and flow time was significantly longer in pressure-flow studies(p<0.01). According to main urodynamic diagnosis categories, the subgroups of patients with normal urodynamic study, bladder outlet obstruction, detrusor instability and others showed significantly lower maximum flow rate and average flow rate in pressure-flow studies(p<0.01). According to uroflowmetry pattern, obstructive patterns such as undulating and intermittent pattern were more common in pressure-flow studies. CONCLUSIONS: The 6Fr transurethral catheter used in pressure-flow studies significantly affects urinary flow parameters. In order to make a accurate diagnosis, we must not merely rely on the results of pressure-flow studies, but we must take into account patient's individual clinical situation and also, if available, the results of free uroflowmetry in addition to pressure flow study parameters.
Catheters* ; Diagnosis ; Female ; Humans ; Lower Urinary Tract Symptoms ; Retrospective Studies ; Urinary Bladder Neck Obstruction ; Urodynamics

PURPOSE: There are few reports concerning the first-line treatment of choice for an overactive bladder. The aim of this study was to compare the effects of bladder training, tolterodine, and bladder training with tolterodine, as first-line treatments in patients with an overactive bladder. MATERIALS AND METHODS: A prospective randomized study was conducted on 99 female patients with overactive bladders. The patients were treated with bladder training, tolterodine (2mg twice daily), and bladder training with tolterodine, as first-line treatments, for 12 weeks. Of the 99 patients, 74 (bladder training: 24, tolterodine: 24, combined: 26) were followed up for 12 weeks. The treatment efficacy was measured by a micturition diary, subjective urgency scores and subjective perception of bladder condition at the end of the treatment. The safety and tolerability were assessed from adverse events and treatment withdrawals. RESULTS: After 12 weeks of treatment, the mean frequency of micturition and nocturia decreased by 27.1 and 55.8% in the bladder training group, 30.3 and 61.9% in the tolterodine group and 32.6 and 63.2% in the combined therapy group. The subjective mean urgency score decreased by 48.4, 62.5 and 63.2% in the three respective groups. The subjective perception of bladder symptom scores at the end of the treatments were 1.5, 1.42 and 1.31, with significant improvement rates of 50.0, 58.3 and 69.3% in the bladder training, tolterodine and combined therapy groups, respectively. Adverse events, and withdrawals due to adverse events, were 23.1 and 7.7% in the tolterodine and 28.6 and 7.1% in the combined therapy groups, but there were none in the bladder training group. CONCLUSIONS: Bladder training, tolterodine and combined therapy are all effective first-line treatments in female patients with overactive bladders. There are some enhanced effects with the combined therapy than with the bladder training and tolterodine monotherapies. Because of its high success rate, relatively low cost and absence of adverse events, bladder training should be included as a first-line treatment.
Female* ; Humans ; Nocturia ; Prospective Studies* ; Treatment Outcome ; Urinary Bladder* ; Urinary Bladder, Overactive* ; Urination ; Tolterodine Tartrate

BACKGROUND: The relationship between Helicobacter pylori (H. pylori) infection and chronic idiopathic thrombocytopenic purpura (ITP) has been confirmed; however, no clear evidence for the effectiveness of H. pylori eradication on ITP exists thus far. The purpose of this study was to investigate platelet recovery in chronic ITP after H. pylori eradication. METHODS: A total of 25 patients (18 male, 7 female; the median age of 55 years) diagnosed with ITP, whose platelet counts were less than 100x10(3)/microliter, were enrolled. They were tested for H. pylori infection by the rapid urea test or urea breath test. All patients received triple therapy for 7 or 14 days to eradicate H. pylori infection. RESULTS: Of the 25 patients, 23 (92%) were diagnosed with H. pylori infection. Of all the ITP patients, 11 (44%) exhibited a complete response (CR) to H. pylori eradication therapy; 6 (24%), a partial response (PR); and 8 (32%) were nonresponsive (NR). Predictive factors of response after H. pylori eradication therapy were platelet counts at the initial response (27.3% responders among patients with platelet counts <100x10(3)/microliter vs 100% responders among patients with platelet counts > or =100x10(3)/microliter, P<0.001) and H. pylori infectivity (73.9% responders among the H. pylori positive patients vs 0% responders among the H. pylori negative patients, P=0.032). CONCLUSION: This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in ITP patients. Further studies with a larger number of patients are necessary to identify the crucial predictive factors responsible for platelet recovery in chronic ITP patients with the H. pylori infection.
Blood Platelets ; Breath Tests ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Urea

Prostate cancer is the most common type of male cancer worldwide. Although radical prostatectomy (RP) is advised for prostate cancer in patients with a life expectancy of more than 10 years by various guidelines, most elderly men still do not undergo the procedure regardless of increasing life expectancy. This study aimed to determine whether RP is suitable for patients with prostate cancer aged 75 years or older. A retrospective study of patients who underwent RP at 6 institutions between 2005 and 2012 was conducted. Patients were divided into 2 groups at the time of surgery: 65-69 years (younger group) and 75 years or older (older group). We compared clinical characteristics, pathological results, complication rates, and recurrence-free survival between the two groups. Compared with the younger group, the older group had significantly higher preoperative serum prostate-specific antigen level, pre- and postoperative Eastern Cooperative Oncology Group (ECOG) performance status grade, hypertension prevalence, and Gleason score at biopsy and RP. However, except urinary incontinence, there were no statistically significant differences in the peri- and post-operative complications. After median follow-up periods of 36 months (younger group) and 40 months (older group), the biochemical recurrence-free survival rates were not significantly different (P = 0.581). Although the urinary incontinence rate was higher in the older group, RP was a suitable option for selected Korean men aged 75 years or older with limited complication rates and excellent outcomes similar to those for patients aged 65-69 years.
Age Factors ; Aged ; Biopsy ; Disease-Free Survival ; Humans ; Hypertension/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/mortality/pathology/*surgery ; Republic of Korea ; Retrospective Studies

A boy since 6 years of his age who have had complex partial seizure was referred to our Department in March 1998. The left anterior temporal lobectomy with the resection of the head and body of hippocampus and gross total tumor removal was also performed in April 1998. He has been seizure free and stable about 3 years postoperatively. In January 2001, he revisited us due to headache, nausea, and vomiting from one week before. MRI revealed recurrence of the tumor, and a partial removal of the tumor was performed. Nine months from the second operation, the tumor recurred again and the thrid operation was followed. The pathologic findings were dysembryoplastic neuroepithelial tumor (DNT) in all three cases and no evidences of anaplastic changes were found in two recurrent cases. In general, DNT is known to be a disease that rarely transforms into the malignant, postoperative adjuvant radio-or chemotherapy is unnecessary even after partial resection of the tumor. However, in our case, there were two episodes of recurrence after the total resection. Here, we report the first case of recurrent DNT even after the total resection within three years in our knowledge.
Anterior Temporal Lobectomy ; Drug Therapy ; Head ; Headache ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Male ; Nausea ; Neoplasms, Neuroepithelial* ; Recurrence ; Seizures ; Temporal Lobe* ; Vomiting