Although spontaneous bacterial peritonitis is a frequent complication in the childhood nephrotic syndrome, it is very rare in adults with nephrotic syndrome. It frequently develops when the patients are either in relapse or receiving steroid therapy at the time peritonitis is diagnosed. We report an unusual case of a spontaneous bacterial peritonitis as the presenting feature in a 15-year-old male patient with nephrotic syndrome. He presented with diffuse abdominal pain and distension for 15 days. Abdominal paracentesis revealed the diagnostic laboratory findings of peritonitis, and the bacterial culture of the ascites showed a mixed growth of Escherichia coli and Pseudomonas aeruzinosa. His serum albu- min level was 1.6gldL and the amount of 24 hours proteinuria was 21.0g/day. Although he was treated with adequate antibiotics for 3 weeks, the peritonitis was more aggravated. We decided to insert a catheter into the peritoneal cavity for continuous drainage of the intractable ascites. Two weeks after drainage, the peritonitis improved as the peritonitis subsided, the proteinuria disappeared completely without a steroid therapy. Six months after spontaneous remission, the proteinuria have recurred, and the kidney biopsy then showed focal segmental glomerulorsclerosis.
Abdominal Pain ; Adolescent ; Adult ; Anti-Bacterial Agents ; Ascites ; Biopsy ; Catheters ; Drainage ; Escherichia coli ; Humans ; Kidney ; Male ; Nephrotic Syndrome* ; Paracentesis ; Peritoneal Cavity ; Peritonitis* ; Proteinuria ; Pseudomonas ; Recurrence ; Remission, Spontaneous

Pancreatoblastoma is a rare tumor, which usually affects infants and young children. We report a case of pancreatoblastoma in a 51-year-old man. To our knowledge, this is the first case of pancreatoblastoma occurred in an adult in Korea. A 2,5 * 3.5 cm sized pancreatic mass was detected on routine examination. An enhanced computed, tamography scan showed a slightly low density solid mass in the body of the pancreas. An abrupt occlusion of the main pancreatic duct and filling defect at the body was noted in the endoscopic retrograde pancreatogram. On operation, a well circumscribed yellowish white mass with whitish capsule was found without adhesion. Histologic examination revealed that the tumor was made up predominantly of medium sized round to polygonal cells having finely granular cytoplaam arranged in solid sheet and acinar structure. Squamoid corpuscles with ovoid to elongated cells were also scattered. The patient is doing well postoperatively. In the review of the literature, the tumor may be biologically different in the older and younger age group.
Adult* ; Child ; Humans ; Infant ; Korea ; Middle Aged ; Pancreas ; Pancreatic Ducts

Sutures may cause endothelial trauma and occlusion. The vascular clip system (VCS) clip applier may minimize endothelial injury. Fourteen carotid arteries of nine adult rabbits were transected and re-anastomosed with either #7-0 polypropylene (Group I, n=8) or VCS clips (Group II, n=6). The animals were sacrificed at 1, 3, 8, 14, and 30 days postoperatively. The operation time and bleeding amount were checked for each anastomosis. Carotid angiograms, photography, H&E staining and scanning electron microscopy (SEM) were performed. Fibrin and thrombus, inflammatory cell infiltration, endothelial disruption, luminal distortion, fibrosis, and wall thickening were compared. The luminal diameter was greater in group II. There were minimal differences in thrombosis, wall thickening and fibrosis between the two groups. However, fibrin, inflammatory cell infiltration, multinucleated giant cell formation, endothelial disruption, and luminal distortion were greater in group I. On SEM, group I showed trans-mural penetration. In contrast, group II showed suture margin eversion and no transmural penetration. Stenosis was greater in group I than in group II on carotid angiogram. The operation time was shorter in group II than in group I, i.e. 5+/-1.4 min vs. 11+/-3.8 min, respectively. The current data showed similar or superior results with VCS clips in comparison to conventional suturing with polypropylene.
Angiography ; Animal ; Arteriovenous Shunt, Surgical/*instrumentation/methods ; Carotid Arteries/pathology/*surgery/ultrastructure ; Microscopy, Electron, Scanning ; Rabbits ; Surgical Stapling/*instrumentation/methods

BACKGROUND AND OBJECTIVES: Until now, only a little is known about the mode of parotid involvement in external auditory canal (EAC) carcinoma. We examined the incidence of parotid node metastasis and direct parotid invasion in patients with EAC carcinoma. The purpose of this study was to evaluate the role of parotidectomy and to provide the guidelines for performance of parotidectomy when dealing with EAC carcinoma. MATERIALS AND METHOD: The study comprised of 11 patients with squamous cell carcinomas (SCC) and 10 patients with adenoid cystic carcinomas (ACC). A retrospective review of the surgical specimens was undertaken with specific reference to parotid node metastasis and parotid invasion. RESULTS: Parotid node metastasis was noted only in two cases of advanced staged SCC, whereas none of the ACC patients showed parotid node metastasis. Direct parotid invasion occurred only in advanced staged SCC;however, it did occur in early stage ACC. CONCLUSION: Our data indicated that elective parotidectomy for control of occult parotid node metastasis is necessary only in advanced SCC carcinoma, whereas parotid management to secure adequate safety margin is mandatory for advanced SCC and all cases of ACC.
Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Ear Canal* ; Humans ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Parotid Gland ; Retrospective Studies

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell (WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRSTM (leukoreduction system) and COBE Spectra with PALL PXLTM8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit (APU) in St. Mary's hospital were prospectively randomized into COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6 +/- 1.0X1011 with COBE spectra LRSTM compared to 2.9 +/- 1.1X1011 with COBE Spectra (p=0.002), and the mean WBC content per unit with COBE spectra LRSTM was 4.1X104 (0.4-23.5) compared to 3.7X104 (0.43-17.9) with PALL PXLTM8 (p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRSTM has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXLTM8. Therefore, this data suggests that COBE Spectra LRSTM is conveient than COBE Spectra with PALL PXLTM8 in clinical practice.
Blood Component Removal ; Blood Group Incompatibility ; Blood Platelets* ; Cytomegalovirus Infections ; Humans ; Leukocytes* ; Prospective Studies ; Tissue Donors*