PURPOSE: To evaluate the characteristics of magnetic resonance (MR) images in Peyronie's disease and to assess the usefulness of post-erection penile MRI. MATERIALS AND METHODS: We retrospectively reviewed the MR images of seven patients in whom Peyronie's disease was clinically suspected. All seven underwent pre- and post-erectile MRI. After the aquisition of erectile MRI, three patients also underwent contrast-enhanced MRI. We compared image quality and the rate of detection of penile plaque between pre-erectile and post-erectile images. In three patients who underwent contrast- enhanced MRI, we assessed correlation between the contrast enhancement pattern, as seen on MRI, of the plaque and corpus cavernosa and clinical inflammatory signs such as painful erection. RESULTS: In the seven patients, all post-erectile MRI images showed localized thickening and irregularities of the tunica albuginea and the septum penis, suggesting penile plaque. On pre-erectile MRI, however, plaque was detected in five cases. In six of seven cases, plaque as seen on T2-weighted images (T2WI) showed low signal intensity similar to that of the tunica albuginea, and as seen on T1-weighted images (T1W1), a signal intensity of signal intensity similar to or similar to or slightly higher than that of the tunica albuginea. In one case, plaque showed high signal intensity on both T1WI and T2WI. On T1WI, the corpus cavernosa showed homogeneous medium-signal intensity on all pre- and post-erectile MR images. On pre-erectile T2WI, the corpus cavernosa of six patients showed heterogeneous high signal intensity, whereas on post-erectile T2WI the corpus cavernosa of all patients showed homogeneous high signal intensity. Due to the enlarged penis and homogeneous signal intensity of the corpus cavernosa, the image quality of post-erectile images was superior to that of pre-erectile imjages. The images of two of three patients who underwent contrast enhanced MRI showed strong enhancement of the plaque and adjacent corpus cavernosa, while in one case, no enhancement was noted. Independently of the enhancement pattern, these three patients had no active inflammatory clinical signs such as painful erection. CONCLUSION: In Peyronie's disease, all plaque is clearly, visualized on MRI. In terms of image quality and plaque detection, post-erectile penile MR imaging is superiou to pre-erectile imaging.
Humans ; Magnetic Resonance Imaging* ; Male ; Penile Induration* ; Penis ; Retrospective Studies

In schizophrenia, when treatment using antipsychotics fails, lithium, which is known as an antimanic drug, can also be administered. It is reported that 12~20% of patients taking lithium develop nephrogenic diabetes lactotrophs. Hyperprolactinemia is induced by typical antipsychotics, as they block the dopamine-2 receptors of latotrophs in the pituitary gland. Therefore, atypical antipsychotics for decreasing the side effect, such as hyperprolactinemia, can be used. However, hyperprolactinemia can be induced by risperidone, one of the atypical antipsychotics. Here, a case of drug induced nephrogenic diabetes insipidus and simultaneous hyperprolactinemia, which occurred in a patient with schizophrenia, is reported.
Antipsychotic Agents ; Diabetes Insipidus, Nephrogenic* ; Humans ; Hyperprolactinemia* ; Lactotrophs ; Lithium ; Pituitary Gland ; Risperidone ; Schizophrenia*

Subclinical Cushing's syndrome is defined as an autonomous cortisol hyperproduction without specific clinical signs of cortisol excess, but detectable biochemically as derangements of the hypothalamic-pituitary-adrenal axis function. We report a case of a 33-year-old woman with subclinical Cushing's syndrome caused by left adrenocortical adenoma, mistaken for Liddle's syndrome. The patient complained of fatigue. Laboratory findings showed metabolic alkalosis, hypokalemia, high TTKG (transtubular K concentration gradient), low plasma renin activity, and low serum aldosterone level, that findings implied as Liddle's syndrome. So we performed further study. Hormonal and radiologic studies revealed subclinical Cushing's syndrome with a left adrenal mass. The adrenal mass was resected and pathologically diagnosed as adrenocortical adenoma. After the resection of the left adrenal mass, patient's hormonal levels showed normal range.
Adrenocortical Adenoma* ; Adult ; Aldosterone ; Alkalosis ; Axis, Cervical Vertebra ; Cushing Syndrome* ; Fatigue ; Female ; Humans ; Hydrocortisone ; Hypokalemia ; Plasma ; Reference Values ; Renin

BACKGROUND: Cervical tuberculous lymphadenopathy is a very common disease with a similar incidence to pulmonary tuberculosis. Dendritic cells play a role of initial antigen presentation of this illness. Nevertheless, the precise role of these antigen-presenting cells according to the clinical features in unclear. The aim of this study was to determine the clinical implication of dendritic cell infiltration in the cervical lymph nodes. METHODS: A review of the clinical characteristics was carried out retrospectively based on the clinical records and radiography. Immunohistochemical staining was performed on the available histology specimens of 72 cases using the S-100b polyclonal antibody for dendritic cells. The number of dendritic cells with tuberculous granuloma were determined. A x2 test, unpaired T test and multiple logistic regression analysis were performed. RESULTS: Thirty percent of subjects had previous or concurrent pulmonary TB. Twenty one percent of cases showed a positive reaction on the AFB stain. Within a granuloma, the number of infiltrated dendritic cells was 113.0+/-7.0. The incidence of fever and cough decreased with increasing infiltration of dendritic cells Multivariate regression analysis showed that the infiltration of dendritic cells could significantly contribute to fever. CONCLUSION: Overall, dendritic cells can control a Mycobacterium tuberculosis infection and modulate the immune response, as well as resolve the clinical manifestations of TB lymphadenopathy.
Antigen Presentation ; Antigen-Presenting Cells ; Cough ; Dendritic Cells* ; Fever ; Granuloma ; Incidence ; Logistic Models ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium tuberculosis ; Radiography ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary

BACKGROUND: Although tetanus infections have diminished dramatically since the advent of tetanus vaccination, this disease has not disappeared. Those 60 years and older are still very much at risk for this infection. Thus, we investigated the tetanus antibody titers in people 60 years and older in Korea. METHODS: Our subjects included those visiting eight emergency departments from March 2009 to February 2010 after an injury with stable vital signs and without acute disease. Samples obtained were tested using the tetanus immunoglobulin enzyme-linked immunosorbent assay method. The resultant tetanus antibody titers were analyzed. RESULTS: The number of subjects enrolled was 462. The mean titer was 0.09+/-0.14 IU/mL. Twenty-two percent of the subjects had a safe titer level (>0.1 IU/mL). Males and urban subjects had higher tetanus antibody titers than did females and suburban subjects. Subjects living in Incheon, Gangwon-do, Chungcheong-do, and Jeju-do had lower titers. CONCLUSION: The results of this study showed that Koreans 60 years and older did not have a protective mean level of tetanus antibody titer and that 78% of the subjects did not have a seroprotective level after tetanus exposure. Therefore, a national effort to administer tetanus vaccination to elderly Koreans is needed.
Acute Disease ; Aged ; Emergencies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulins ; Korea ; Male ; Tetanus ; Vaccination ; Vital Signs