Detection of JC Virus in the Brains of Korean Glioblastoma Multiforme Patients

OBJECTIVE: The ubiquitous human polyomavirus, JC virus(JCV) is the etiologic agent of the fatal demyelinating central nervous system(CNS) disease, progressive multifocal leukoencephalopathy(PML). Recent studies have reported the detection of the JCV in samples derived from several type of human neural tumors and suggested the possible association of JCV with CNS tumors. Here we report for the first time, the presence of JCV in Korean glioblastoma multiforme(GM) patients. METHODS: Two Korean GM patients were assayed for JCV. To detect JCV, we performed immunohistochemical analysis using anti-JCV and anti-glial fibrillary acidic protein(GFAP) serum and polymerase chain reaction(PCR) using primers. RESULTS: JCV antigen was detected in cytoplasm abundantly in cells of this tumor case. Also, GFAP immunoreactivity was predominantly observed in cytoplasm of the cells that were morphologically bizarred appearing astrocytes in GM. In addition, both of the large T antigen gene and the VP1 gene were detected and this result correspond with previous result of immunohistochemistry. CONCLUSION: Although it is not certain that GM is associated with the JCV, we are attempted to elucidate the possible implication of JCV in the tumorigenesis of certain human malignant gliomas.

Cervical Spinal Epidural Abscess due to Salmonella Group D

We report a case of cervical spinal epidural abcess due to Salmonella group D. A 58-year-old man complained of progressive neck pain and right arm weakness with fever. Clinical and radiographic findings including cervical magnetic resonance(MR) image showed paraspinal soft tissue inflammation of neck and abcesses in prevertebral and epidural space at C3-5 level. The patient underwent a C4 corpectomy and adjacent diskectomy and continous irrigation suction drainage. A MR image taken at second postoperative day revealed diffuse cord swelling from C2 to T1 suggesting edema and/or myelitis and then laminectomy from C3 to C6 was performed immediately to decompress the spinal cord. The patient recovered excellently and the abscess culture revealed Salmonella group D.

Clinical Analysis of Malarial Infections between January and September 1998 / 대한내과학회지

OBJECTIVE: Annually, the prevalence of indigenous and imported malarial infections is steadily increasing since 1993 in Korea. In order to understand the current characteristics of malarial infections and to prevent, the present research reviewed twenty-seven cases between January and September 1998. METHOD:In this study, all the twenty-seven (twenty- six patients) cases were obtained from admitted patients between January and September 1998. We had performed routine blood chemical studies, peripheral blood thin and thick smear, physical examination and abdominal sonography. Any patient with a previous history of a narcotic drug injection or had blood transfusion was excluded. RESULTS: Twenty cases (74.1%) were indigenous and seven (25.9%) were imported malaria. Yeonchon-Gun (nine cases) was the most prevalent area in the indigenous cases; Cambodia (three cases) were the most one in the imported cases. Peripheral blood thin smear revealed Plasmodium vivax in all (100%) indigenous malaria, while four cases (57.1%) were P. vivax and one (14.3%) was P. falciparum and two (28.6%) were mixed infections with P. vivax and P. falciparum in the imported cases. In a 3-month period between July and September, peak prevalence (80.4%) was observed. The negative conversion of peripheral blood smear was achieved much earlier in the indigenous (3.9+/-1.4day) than in the imported (5.7+/-1.9day) after the treatment but, was not statistically signifcant. CONCLUSION: Plasmodium ovale was the only unique causative species in the indigenous malaria. Also Yeonchon-Gun and Cheolwon-Gun had been the most important endemic areas as previous reports. One relapse case had been occurred in the imported malaria. On the basis of our data, more efforts for control of malaria should be necessary for eradication and prevention of indigenous and imported malarial infections in Korea.

Age-related trend of diseases distribution in the elderly aged 60 years and older / 대한내과학회지

With increasing life expectance and improvement of the overall health of the elderly, the understanding of geriatric disease becomes an important aspect of medical services. In the elderly, the frequencies of hypertension, DM, & anemia are increased according to aging and renal function is decreased progressively. As screening test for cervical cancer Papanicolaou smear is recommended due to its cost-effective benefits in females. In age-adjusted elderly male and female study populations, authors investigated the alterations of the above diseases, hypercholesterolemia, liver disease, obesity, & proteinuria distributions. METHODS: This study included 1,181 aged 40 years (600 males, 581 females) visitors between January 1, 1997 and December 31, 1997 in National Medical Center, Seoul, South Korea. Authors divided these populations into two large groups such as group A and B. Group A was composed of 40-59 years, group B 60 years and older. Group A and B were subdivided into 4 subgroups each other, such as A-1, A-2, A-3 and A-4, B-1, B-2, B-3 and B-4 by means of age-adjusted dividing scale. We used our inclusion criteria to define each disease. RESULTS: Hypertension was the most common disease in males of group B, but obesity was in females. The age-adjusted frequencies of hypertension, anemia, obesity & proteinuria were increased according to aging in the elderly aged 60 years and older. Though hypercholesterolemia revealed non-specific distribution in each group, increased frequency was observed in females compared to males in group B. With increasing their age, abnormal findings of Papanicolaou smear were found in females of group B. CONCLUSIONS: As the frequencies of hypertension, anemia, obestiy, proteinuria & abnormal findings of Papanicolaou smear were increased in the elderly aged 60 years and older as increasing their age. Much more attentions and follow up plans for these disease should be needed in the elderly.

A case of sarcomatoid carcinoma in the gallbladder / 대한내과학회지

Sarcomatoid carcinomas are rare neoplasms that have been described using various terms, pseudosarcoma, carcinosarcoma or spindle cell carcinoma. Sarcomatoid carcinomas are epithelial tumors with sarcomatoid components and characterized by the presence of cytokeratin in pleomorphic spindle cells. These tumors of gallbladder rarely have been reported predominantly in older women with associated gallstones and their prognosis was very poor. However, the clinical and histological data are very limited. We report a case of sarcomatoid carcinoma in gallbladder confirmed by light microscopy and immunohistochemistry.

A Case of Splenic Abscess with Multiple Fistulas Caused by Klebsiella pneumoniae / 감염

Splenic abscess is an uncommon but frequently fatal condition. Signs and symptoms are variable and do not always include left upper quadrant pain or tenderness. Unexplained thrombocytosis in a septic patient with persistent left pleural effusion is suggestive of splenic abscess. We report a case of splenic abscess with complicated multiple fistulas by Klebsiella pneumoniae which was successfully managed by antibiotic therapy, and percutaneous catheter drainage.

Severe hypoglycemia in the elderly diabetes

BACKGROUND: Hypoglycemia is the most common therapeutic complication of diabetes mellitus and especially in elderly diabetic patients with diminished cardiac and cerebral circulation can cause serious tissue damage. Though many studies have attempted to evaluate hypoglycemia in IDDM or adult diabetic patients, few studies in the elderly. We have compared clinical characteristics of severe hypoglycemia in elderly diabetes with adult diabetes. METHODS: This study include 56 severe hypoglycemic patients who have admitted to emergency department of National Medical Center from march 1, 1992 to december 31, 1997. they are divided two group (adult group; 21, elderly group; 35) and authors investigate the cause, the symptom, the time of severe hypoglycemia, degree of education, treatment method in each group. RESULTS: 1) DM education was not well done in severe hypoglycemic patients. 2) The frequency of severe hypoglycemia in the elderly was more than adult (adult: 21 (38%), elderly 35 (62%)). 3) In both population, the most common symptom of severe hypoglycemia was neuroglycopenic symptom, especially in the elderly (adult: 57%, elderly: 77%). 4) Decreased food intake (49%) in the elderly and overdose of insulin (38%) in the adult were the most common cause of severe hypoglycemia. 5) Severe hypoglycemia occurred more often between midnight and 6 AM in the adult, between noon and 6 PM in the elderly. 6) The treatment of diabetes mellitus is insulin (71%) and oral hypoglycemic agent (29%) in the adult, oral hypoglycemic agent (51%) and insulin (49%) in the elderly. CONCLUSION: For prevention of severe hypoglycemia, we should emphasize the importance of DM education and especially elderly diabetic patients should be educated about the symptoms of hypoglycemia, the self-management of hypoglycemia, the need for a regular carbohydrate intake and more easy and effective diet program is require in elderly diabetes.

A Case of Pneumocystis Carinii Pneumonia with Histopathologic Finding of Bronchiolitis Obliterans with Organizing Pneumonia in Patient with AIDS / 결핵

PCP remains the leading cause of deaths in patients with AIDS. As familiarity with PCP increases, atypical manifestations of the diseases are being recognized with greater frequency. There are following "atypical" manifestations of PCP; 1) interstitial lung response that include diffuse alveolar damage, bronchiolitis obliterance, interstitial fibrosis, and lymphoplasmocytic infiltrate 2) striking localized process frequently exhibiting granulomatous features 3) extensive necrosis & cavitation 4) extrapulmonary dissemination of the disease. A wide variety of pathologic manifestations may occur in PCP in human immunodeficiency virus- infected patienst and that atypical features should be sought in lung biopsies from patients at risk for PCP. We had experienced a case of PCP, which presented with severe hypoxia, progressive dyspnea and fine crackles. It was diagnosed as PCP in AIDS with manifestation of BOOP by open lung biopsy and showed good response to Bactrim & corticosteroid therapy.

Nocturnal Penile Tumescence Monitoring with Stamps / 대한비뇨기과학회지

Nocturnal penile tumescence monitoring has gained wide acceptance in differential diagnosis of impotence. We developed a modified stamp technique which use a strip of stamps, each 2.2cm by 2.5cm, and the vinyl plaster for snugger wrapping and sealing of stamps around the penile shaft. This is a simple, time-saving and useful screening test for organic impotence.

Cavernous Hemangioma of the Renal Pelvis Associated with Renal Infarction and Hemorrhage: A Case Report / 대한비뇨기과학회지

Cavernous hemangioma of the renal pelvis is a rare benign vascular tumor. We experienced a case of this disease, which associated with renal infarction and hemorrhage in 35 year-old female. I. V. P, R. G. P and abdominal C. T were performed. Now, we introduced the pathologic and radiographic findings.