A Case of Emphysematous Pyelonephritis in a Autosomal Dominant Polycystic Kidney Disease Patient Successfully Treated by Medical Treatment / 대한신장학회잡지

Emphysematous pyelonephritis is an uncommon and potentially life-threatening infectious disease. Although there is still controversy about optimal treatment of emphysematous pyelonephritis, published results indicate that the mortality rate in the patients treated with radical nephrectomy is equivalent to that in patients given more conservative treatment. Emphysematous pyelonephritis with autosomal dominant polycystic kidney disease is extremely rare and its clinical course is not revealed clearly. Hearin, we report an emphysematous pyelonephritis in a 64- year-old female patient with autosomal dominant polycystic kidney disease, successfully treated by antibiotics and percutaneous cyst drainage.

A Case of Emphysematous Pyelonephritis in a Autosomal Dominant Polycystic Kidney Disease Patient Successfully Treated by Medical Treatment / 대한신장학회잡지

Emphysematous pyelonephritis is an uncommon and potentially life-threatening infectious disease. Although there is still controversy about optimal treatment of emphysematous pyelonephritis, published results indicate that the mortality rate in the patients treated with radical nephrectomy is equivalent to that in patients given more conservative treatment. Emphysematous pyelonephritis with autosomal dominant polycystic kidney disease is extremely rare and its clinical course is not revealed clearly. Hearin, we report an emphysematous pyelonephritis in a 64- year-old female patient with autosomal dominant polycystic kidney disease, successfully treated by antibiotics and percutaneous cyst drainage.

A Case of Left Atrial Myxoma Presenting as Acute Pulmonary Edema

Myxomas are the most common primary benign cardiac tumor. In general, myxoma has a benign growth and chronic entity, so symtoms of myxoma are vague and mild. Therefore the association of an atrial myxoma with acute pulmonary edema and syncope appears to be very rare. Even though very rare, detection of myxoma is important because it is usually fatal in several cases if unrecognized and untreated. We experienced a case of left atrial (LA) myxoma presenting as acute pulmonary edema and syncope of unknown cause in 47 years old female patient. A mass located on left atrium was excised en bloc, and the patient recovered uneventfully. We report the case along with literature review.

A case of acute pyelonephritis complicated with renal vein thrombosis / 대한내과학회지

A 57-year-old woman who had a history of diabetes was admitted due to fever and left flank pain. Acute pyelonephritis was diagnosed by clinical findings including left costovertebral area tenderness, positive urine and blood cultures. Subsequent abdominal computed tomography demonstrated multiple abscess pockets in the left renal parenchyme and ipsilateral renal vein thrombosis. She was fully recovered after treatment with antibiotics, low-molecular weight heparin and low-dose aspirin for six weeks. Our case emphasizes that renal vein thrombosis could be complicated in acute pyelonephritis, especially in patients with diabetes. It is reasonable to speculate that factors such as hemoconcentration caused by fever and osmotic diuresis and compression of renal vascular pedicle by renal abscess might have had a role in inciting the renal vein thrombosis.

Coexistence of Tyrosine Hydroxylase and Nicotinamide Adenine Dinucleotide Phosphate-Diaphorase in Hypothalamic Neurons of the Rat / 대한해부학회지

The presence and coexistence of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-diaphorase) with tyrosine hydroxylase (TH) was investigated by combining NADPH-diaphorase histochemistry with TH immunohistochemistry in hypothalamic nuclei of the rat. TH-immunoreactive and NADPH-diaphorase positive neurons were found in the medial preoptic area and medial preoptic nucleus, anterior hypothalamic area, dorsomedial hypothalamic nucleus, paraventricular nucleus, supraoptic nucleus and posterior hypothalamic area, respectively. TH and NADPH-diaphorase did not coexist in the anterior hypothalamic area, dorsomedial hypothalamic nucleus, medial preoptic area and posterior hypothalamic area. A considerable portion (30~50%) of the NADPH-diaphorase positive neurons in the supraoptic nucleus colocalized TH. In the medial preoptic area and paraventricular nucleus, some (5~15%) of TH-immunoreactive neurons also contained NADPH-diaphorase activity. NADPH-diaphorase is known to be an indicator of the enzyme nitric oxide synthase; these results therefore suggest that nitric oxide may play an important role in the regulation of the activity of the hypothalamic dopaminergic system of the rat.

A Case of Primary Pulmonary Hypertension Associated with Pregnancy

Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.

Epidemiological Study of Heart Disease in Korea: 5 Year Interval Change

In order to investigate the trend of prevalence of heart disease in Korea, statistical observation was made on 19,239 cases of medical in-patients who were treated in 3 general hospitals, Korea University Hospital, Seoul Red Cross Hospital and Seoul Adeventist Hospital, on 73,484 cases of medical out-patients who were seen at Korea University Hospital and Seoul Adventist Hospital during the period of 5 years, from 1972 through 1976, on 7,746 cases of medical in-patients during the period of 10 years (1967 through 1976), and on 50,083 cases of medical out-patients during the period of 15 years (1962 through 1976) who were treated in Korea University Hospital. The results obtained were as follows. 1. Heart disease was 5.5% (male 5.4%, female 5.7%) of medical out-patients and 16.1% (male 16.7%, female 15.5%) of medical in-patients. 2. The incidence of heart disease was increased with the increase of age in both out-patients and in-patients. The incidences of heart disease in out-patients by age group to the total out-patients of each age group were 1.8% in 15~40 year group, 10.2% in 41~60 year group and 18.4% in over 61 year group, and those in in-patients were 5.0% in 15~40 year group, 24.4% in 41~60 year group and 30.8% in over 61 year group. 3. The incidences of individual heart disease to 4,074 cases with heart disease (male 1,986, female 2,088) of out-patients were as follows. Rheumatic myocarditis was 0.5% (male 0.6%, female 0.5%), mitral valvular disease 8.3% (male 5.8%, female 10.6%), aortic valvular disease 3.1% (male 3.9%, female 2.2%), mitral and aortic valvular disease 0.7% (male 1.3%, female 0.7%), hyper tension 72.0% (male 72.8%, female 71.0%), myocardial infarction 0.7% (male 1.2%, female 0.2%), angina pectoris 2.2% (male 3.1%, female 1.4%), atherosclerotic heart failure 4.5% (male 4.8%, female 4.1%), pericarditis 0.4% (male 0.6%, female 0.3%), idiopathic myocardiopathy 0.5% (male 0.5%, female 0.6%), postpartum myocardiopathy 0.3% in female, cor pulmonale 0.3%(male 0.2%, female 0.4%) and congenital heart disease 1.4% (male 1.8%, female 1.1%). 4. Incidences of individual heart disease to total 3,091 cases with heart disease (male 1,573, female, 1,518) of in-patients were as follows. Rheumatic myocarditis was 0.4% (male 0.5%, female 0.3%), mitral valvular disease 8.1% (male 5.1%, female 11.2%), aortic valvular disease 1.1% (male 1.3%, female 0.8%), mitral and arotic valvular disease 0.3% (male 0.3% female 0.4%), hypertension 69.6% (male 71.3%, female 68.5%), myocardial infarction 2.8% (male 4.3%, female 1.4%), angina pectoris 1.7% (male 2.0%, female 1.3%), atherosclerotic heart failure 7.5%(male 7.7%, female 6.8%), pericarditis 0.8% (male 0.9%, female 0.8%), idiopathic myocardiopathy 1.3% (male 1.3%, female 1.3%), postpartum myocardiopathy 0.7% in female, cor pulmonale 1.5% (male 1.5%, female 1.6%) and congenital heart disease 0.5% (male 0.4%, female 0.5%). 5. There was no significant seasonal variation of the incidences of individual heart diseases. 6. The incidences of rheumatic valvular heart disease, coronary heart disease and congenital heart disease of medical out-putients of Korea University hospital by 5-year-period for 3 consecutive periods (1962 through 1976) were increased and those of hypertension and cor pulmonale were decreased. 7. The incidneces of coronary heart disease and idiopathic myocardiopathy of medical in-patients of Korea University Hospital by 5-year-period for 2 consecutive periods (1967 through 1976) were increased and those of rheumatic myocarditis, hypertension and postpartum myocardiopathy were decreased. There was no change in incidence of rheumatic heart disease including rheumatic myocarditis, and congenital heart disease. 8. The trend of increasing prevalence of coronary heart disease, especially angina pectoris, was noted. Although hypertension was decreased in relative incidence, the total number of patients with hypertension was increased. This seems to suggest that hypertension tends to increase.