Hemorrhagic cystitis is defined as diffuse mucosal inflammation of the urinary bladder that presents with gross hematuria. A variety of factors, including chemotherapeutic agents, radiation therapy and infection, can cause hemorrhagic cystitis. Among them, BK virus-associated hemorrhagic cystitis is common in patients who have undergone stem cell transplantation but relatively rare in kidney transplantation patients. Here, we present the case of a kidney-transplant patient with BK virus-associated hemorrhagic cystitis and interstitial nephritis who was successfully treated with leflunomide and ciprofloxacin.
BK Virus ; Ciprofloxacin ; Cystitis* ; Hematuria ; Humans ; Inflammation ; Kidney Transplantation ; Kidney* ; Nephritis, Interstitial ; Stem Cell Transplantation ; Urinary Bladder

Nasogastric tube insertion is a routine clinical procedure for nutritional support, gastric aspiration and decompression. Although it is generally a safe procedure, complication rates range from 0.3~8%. Submucosal esophageal dissection is a rare disorder caused by mucosal tearing and bleeding between the mucosal and muscular layers of the esophagus, leading to their separation. We report a case of submucosal esophageal dissection secondary to the accidental iatrogenic intramural insertion of a nasogastric tube.
Decompression ; Esophagus ; Hemorrhage ; Nutritional Support

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies in children on a weaning diet. We investigated weaning practices in infants and children, as well as their mothers' knowledge about weaning. METHODS: We investigated 129 children with IDA and 166 without IDA (aged 6-36 months) who had visited 10 university hospitals between March 2006 and July 2007. We investigated the hematologic values of both groups. A questionnaire on weaning was answered by the mothers of these children. RESULTS: The hematologic values in the IDA group showed a significant difference from those in the comparison group (P<0.05). Children who were solely breastfed until 6 months of age were 85%, 34% (P<0.05), and weaning was started by 6.3, 6.4 months, respectively (P>0.05). Rice gruel, boiled rice, and fruit juice accounted for approximately 8 0% of the starting foods in both groups (P>0.05). Only 40% of the children in the IDA group had a balanced diet within a month, versus 38% in the comparison group. In response to questions about the necessity of iron-fortified foods for breast-fed infants, less than 50% of mothers in both groups answered correctly. In the IDA group, 42% showed serum ferritin less than 10 ng/ mL, while 92% showed serum MCV less than 72 fL. CONCLUSION: In conclusion, collection of information on history should be thorough for feeding and selective examinations for IDA in high-risk groups. Considering the adaptation period, we suggest beginning children on a weaning diet at 45 months. In addition, we need to educate mothers on weaning practice, especially on the necessity of iron-fortified foods for breast-fed infants.
Anemia, Iron-Deficiency ; Child ; Diet ; Ferritins ; Fruit ; Hospitals, University ; Humans ; Infant ; Iron ; Malnutrition ; Mothers ; Surveys and Questionnaires ; Weaning

Inhibitory motor seizure or ictal hemiparesis is very infrequent seizure type and sometimes difficult to differentiate from acute cerebrovascular disease. We report two patients with hemiparesis as manifestation of status epilepticus. One patient showed epileptic discharge on midline frontocentral region by EEG-Video monitoring, another patient showed continuous slowing wave associated with hyperperfusion findings of brain SPECT on left fronto-temporo-parietal region. Both patients showed normal brain imaging.
Brain ; Humans ; Neuroimaging ; Paresis* ; Seizures ; Status Epilepticus* ; Tomography, Emission-Computed, Single-Photon

Spontaneous urine extravasation due to metastatic cancer is extremely rare. We experienced a case of urine extravasation caused by ureteral metastasis from a cervical adenocarcinoma in a 69-year-old woman. On operating, a 3cm length ureter stricture was found in the upper third of the left ureter. There were no malignant cells in a frozen biopsy, and no urine leakage site was detected. An end-to-end ureteroureterostomy was performed by the tension-free method. The permanent histology of the ureterectomy specimen revealed a metastatic adenocarcinoma, identical to that obtained from the punch biopsy of the cervix. The urine leakage persisted following the end-to-end ureteroureterostomy, whereupon a nephroureterectomy was performed.
Adenocarcinoma* ; Aged ; Biopsy ; Cervix Uteri ; Constriction, Pathologic ; Female ; Humans ; Neoplasm Metastasis* ; Ureter*

BACKGROUND: Fungal sinusitis (mycetoma)is distinguished from chronic sinusitis in the aspect of unilateral maxillary sinus involvement. We aimed to elucidate the mechanism of localization in fungal sinusitis by comparing the inflammatory cells infiltrating into the mucosa. MATERIALS AND METHOD: Study subjects were 10 patients with chronic sinusitis involving the maxillary sinus and 10 patients with fungal sinusitis (mycetoma of the maxillary sinus). Pathological mucosa of the maxillary sinus near the ostium were obtained during endoscopic sinus surgery. We counted the number of basophils, eosinophils, neutrophils, plasma cells, and lymphocytes within 1 mm2 (2 mmX0.5 mm)of the central, superficial area of the lamina propria of the pathological mucosa, under a light microscope (X400)using eye reticule. RESULTS: The average numbers of basophils, eosinophils, neutrophils, plasma cells, lymphocytes, and the total inflammatory cells in chronic sinusitis were 7, 50, 71, 231, 647, and 1,008, respectively: and in fungal sinusitis, the numbers were 5, 36, 18, 444, 676, and 1,180. In chronic sinusitis, neutrophils were significantly increased when compared to those of fungal sinusitis patients. In fungal sinusitis, infiltration of plasma cells was significantly increased when compared to that of chronic sinusitis. And for both groups, plasma cells and lymphocytes were the two most predominant inflammatory cells. CONCLUSION: The increased plasma cells in non-invasive fungal sinusitis could be the mechanism for the localization of the fungal lesion within the maxillary sinus, possibly by producing immunoglobulin against fungi.
Basophils ; Eosinophils ; Fungi ; Humans ; Immunoglobulins ; Lymphocytes ; Maxillary Sinus* ; Mucous Membrane* ; Neutrophils ; Plasma Cells ; Sinusitis*

BACKGROUND AND OBJECTIVES: As septoplasty has been performed more often in recent years, the incidence of septal perforation as one of its complications has also been increased. Authors aimed to elucidate the etiology and clinical characteristics of the septal perforation. MATERIALS AND METHODS: Fifty-eight patients with septal perforation were diagnosed between 1991 and 1998 at the Department of Otolaryngology, Asan Medical Center. Of them, 46 were male and 12 were female, and their ages ranged from 14 to 76 years of age (mean : 47 years). Medical records were retrospectively reviewed to investigate the etiology, clinical symptoms, and treatment results. RESULTS: The most common cause of septal perforation was associated with nasal surgery (41 patients ; 72%) such as submucous resection (22 patients), septoplasty (10 patients), and transseptal pituitary tumor surgery (7 patients). Malignancy involving the nasal septum was the second common cause (8 patients ; 14%). Nasal stuffiness was the most common complaint (36 patients ; 62%), followed by crust formation (24 patients ; 41%), and nasal bleeding (7 patients ; 12%). Around three quarters of patients had perforation smaller than 10 mm in diameter and the cartilaginous septum was the most common site of perforation (88%). Eleven patients not responding to medical treatment underwent surgical repair with a success rate of 91%. CONCLUSIONS: This study shows that most of the septal perforations are caused by previous nasal surgery involving the nasal septum. Surgeons should be very careful not to make a bilateral corresponding mucosal tear during the septal surgery. If this occurs, meticulous suture-repair with interposition of graft should be applied. For the chronic symptomatic perforation that is refractory to medical treatment, surgical repair using flap and grafts could be performed with a success rate of 90%.
Chungcheongnam-do ; Epistaxis ; Female ; Humans ; Incidence ; Male ; Medical Records ; Nasal Septal Perforation* ; Nasal Septum ; Nasal Surgical Procedures ; Otolaryngology ; Pituitary Neoplasms ; Retrospective Studies ; Transplants

Encephalomeningocele is a rare disease presenting extracranial protrusion of the brain and meninges through the skull base defect. The authors experienced a case of cerebrospinal fluid (CSF) rhinorrhea developing from encephalomeningocele which was protruded into the nasal cavity through the cribriform plate. It was repaired successfully with septal bone and middle turbinate mucosa under nasal endoscopy. The radiologic features and techniques for the endoscopic management of meningoencephalocele with CSF rhinorrhea are discussed.
Brain ; Cerebrospinal Fluid Rhinorrhea* ; Cerebrospinal Fluid* ; Endoscopy ; Ethmoid Bone ; Meninges ; Mucous Membrane ; Nasal Cavity ; Rare Diseases ; Skull Base ; Turbinates

Primary endodermal sinus tumor (yolk sac tumor) of the mediastinum is rare. Most patients are young and male, and the great majority of tumors are found in the anterior mediastinum, and spontaneous hemothorax is a rare presentation of intrathoracic tumors. We report a case of spontaneous hemothorax associated with a posterior mediastinal endoderml sinus tumor occuring in a female patient. Brief review and related literatures were also presented.
Endoderm* ; Endodermal Sinus Tumor* ; Female* ; Hemothorax* ; Humans ; Male ; Mediastinum

Mesenteric lymphangioma was first recognized when an autopsy case was recorded in 1507 by Benevieni. It has been known clinically rare disease and probably a congenital developmental abnormality due to failure of drainage of peripheral primary lymphatic spaces. We experienced a case of abnormal rotation in intestine by mesenteric lymphangioma in a 8 years old male who showed vomiting and abdominal pain. A brief review of related literatures is also presented.
Abdominal Pain ; Autopsy ; Child ; Drainage ; Humans ; Intestines ; Lymphangioma* ; Male ; Rare Diseases ; Vomiting