Idiopathic Retroperitoneal Fibrosis Associated with a Horseshoe Kidney / 대한신장학회지

A case of a 52-year-old man with retroperitoneal fibrosis and a horseshoe kidney is presented. Horseshoe kidney is one of the most common renal anomalies and complicated with urinary tract infection, hydronephrosis, calculi, tumor of the renal pelvis, and other multiple congenital abnormalities. Idiopathic retroperitoneal fibrosis is a rare disease characterized by the presence of a retroperitoneal tissue, consisting of chronic inflammation and marked fibrosis, which often entraps ureters or other abdominal organs. The correlation between horseshoe kidney and retroperitoneal fibrosis has not been described. We report a rare case of idiopathic retroperitoneal fibrosis with horseshoe kidney disease demonstrating good response to steroid therapy.

Pulmonary Paragonimiasis Mimicking Lung Malignancy

A 50-year-old man was admitted to our hospital with a complaint of blood-tinged sputum. Chest computed tomography (CT) showed a 37 mm sized heterogeneously lobulated enhancing mass in the central aspect of the left upper lobe and this mass was abutting the adjacent mediastinum (Fig. 1). There was either a focal fibrotic pleural thickening or fissural thickening adjacent to the pulmonary mass. Conglomerated enlarged lymph nodes were observed in the left paraaortic and left anterior cardiophrenic angle areas. 18-Fluorodeoxyglucose positron emission tomography demonstrated hypermetabolic activity in the left upper lobe and the right thyroid gland (Fig. 2). The pathology of the fine needle aspiration from the thyroid gland revealed papillary carcinoma. Since primary or metastatic lung cancer could not be ruled out, video-assisted thoracic surgery was performed. The microscopic findings demonstrated numerous eosinophil infiltrations and many eggs of paragonimiasis westermani, which were observed in the necrotized granuloma area (Fig. 3). He was underwent subtotal thyroidectomy. Moreover, he subsequently received iodine ablation therapy due to papillary carcinoma with regional lymph node invasion.

Diagnostic Performance of Fractional Excretion of Urea in Evaluating Patients with Acute Kidney Injury with Diuretics Treatment / 대한신장학회지

PURPOSE:Although fractional excretion of sodium (FENa) has been used to distinguish transient-acute kidney injury (T-AKI) from persistent-AKI (P-AKI), the availability of FENa in the diagnosis of T-AKI is reported low in patients with diuretics use. We compared the diagnostic performance of fractional excretion of urea (FEUrea) with that of FENa in patients with diuretics use. METHODS:One hundred seven AKI patients were classified as having T-AKIor P-AKI according to the clinical context. Each group was again subdivided according to exposure to diuretics. According to the cut off value generated by receiver operating characteristic (ROC) curves, sensitivity and specificity of FENa and FEUrea were compared with each other. RESULTS:The numbers of patients administered with diuretics were 67 out of total 107 AKI patients (63%), 27 out of 52 (52%) of T-AKI patients, and 40 out of total (65) 55 (73%) of P-AKI patients. When the cutoff value of T-AKI was defined as FENa < or =1.5 and FEUrea < or = 30 according to the ROC curves, sensitivity and specificity of FENa were 96% and 100% in non-diuretics group, and 63% and 98% in diuretics group, respectively. Sensitivity and specificity of FEUrea were 92% and 87% in non- diuretics group, and 96% and 83% in diuretics group, respectively. CONCLUSION:FEUrea is as good as FENa at distinguishing T-AKI from P-AKI in patients administered with diuretics.

Relations between the concentrations of IL-1beta and TNF-alpha and clinical features in middle ear effusion / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Inflammatory mediators retained in middle ear effusion are important in influencing the clinical outcome of this disease. Interleukins and tumor necrosis factor, important immunomodulatory proteins, undoubtedly influence middle ear effusion. MATERIALS AND METHODS: We analyzed 72 human middle ear effusion samples for IL-1beta and TNF-alpha and tried to elucidate the relationship between the levels of IL-1beta and TNF-alpha and clinical findings in OME patients. RESULTS: 1) IL-1beta and TNF-alpha correlated inversely (P<0.05) with age. The younger the patient, the higher the level of IL-1beta and TNF-alpha in middle ear effusion by simple linear regression analysis. 2) Significantly higher mean levels (P<0.05) of IL-1beta were observed in effusion from patients who showed recurrence. 3) The level of TNF-alpha was significantly higher in men than in women. 4) Any differences of IL-1betaand TNF-alpha levels are not found depending on other clinical variables. i.e. sex, duration of disease, bilaterality, type of effusion, etc. CONCLUSION: The results of this study show that IL-1beta and TNF-alpha are present in human middle ear effusion of otitis media and suggest that these cytokines may be important mediators involved in the disease processes of otitis media.

Expression of Fibronectin Activities in Rat Tongue Mucosal Wound Healing Following CO2 Laser Incision / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The CO2 laser is commonly used in the oral cavity and pharyngolaryngeal lesion, since, unlike the conventional scalpel technique, it provides excellent hemostasis and visualization and thus enables the surgeon to operate in a precise manner. Additional advantages include decreased postoperative pain and less swelling. Despite this advantage, several studies have reported impaired wound healing associated with the use of CO2 laser. Fibronectin is a high molecular weight glycoprotein and serves as a substrate for adhesion and migration of cells which repair cell defects together with fibrin. Fibronectin is involved in the generation of reticulin matrix together with the type III collagen. MATERIALS AND METHODS: The histological changes and the expression of fibronectin activities following incision of tongue mucosa by the CO2 laser and the conventional scalpel technique were compared over a period of 7 days in a rat model. RESULTS: A delay was noted in the healing of the CO2 laser wound. Both CO2 laser and scalpel wound expressed fibronectin, soon after wounding. The expression of fibronectin activities in the CO2 laser rose to the maximal level more slowly than the scalpel wound and its degree was weaker. CONCLUSION: Delayed expression in fibronectin may play a role in the delay of the CO2 laser wound healing.