A Case of Type I Pyelocalyceal Diverticulum Containing Calcified Stone / 대한신장학회잡지

Pyelocaliceal diverticula are eventrations of the upper collecting system, lying within the renal parenchyma and communicating with the main collecting system via a narrow channel. They may be detected in as many as 0.5% of excretory urograms but are usually small(<1cm in diameter) and asymptomatic. Urinary stasis may predispose patient to infection or stone formation. Rarely, transitional cell carcinoma originates within the diverticulum. Symptomatic, complicated diverticula should be treated by 5 different therapeutic alternatives which is open surgery, a percutaneous approach, shock wave lithotripsy ureterorenoscopy and retroperitoneoscopy. We report a incidentally found calculi-containing type I pyelocalyceal diverticulum patient who initially presented with epigastric pain.

A Case of Type I Pyelocalyceal Diverticulum Containing Calcified Stone / 대한신장학회잡지

Pyelocaliceal diverticula are eventrations of the upper collecting system, lying within the renal parenchyma and communicating with the main collecting system via a narrow channel. They may be detected in as many as 0.5% of excretory urograms but are usually small(<1cm in diameter) and asymptomatic. Urinary stasis may predispose patient to infection or stone formation. Rarely, transitional cell carcinoma originates within the diverticulum. Symptomatic, complicated diverticula should be treated by 5 different therapeutic alternatives which is open surgery, a percutaneous approach, shock wave lithotripsy ureterorenoscopy and retroperitoneoscopy. We report a incidentally found calculi-containing type I pyelocalyceal diverticulum patient who initially presented with epigastric pain.

A Case of Vasospastic Angina Pectoris Occurring Following Administration of Oral Imigran(R) for Migraine

Imigran(R) (sumatriptan), a 5-hydroxytryptamine (HT) derivative, is highly effective in aborting attacks of migraine and cluster headache. The drug is generally well tolerated. However tolerated, although up to 8% of patients consistently have demonstrate chest symptoms, including chest pressure, tightness, and pain, often mimicking angina pectoris. It has been suggested that these chest symptoms are caused by coronary vasoconstriction, and that this effect may be mediated by endothelial dysfunction. This can be reversed by the administration of glyceryl trinitrate. We report a case of vasospastic angina pectoris occurring after the administration of oral sumatriptan in a patient with migraine.

Various Pulmonary Manifestations of the Cryptococcal Pneumoniae in the three Immunocompetent Patients / 결핵

More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this from of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary crytococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocmpetent patients.

Diclofenac inhibits IFN-gamma plus lipopolysaccharide-induced iNOS gene expression via suppression of NF-kappaB activation in RAW 264.7 macrophages

Diclofenac, a phenylacetic acid derivative, is a widely used non-steroidal anti-inflammatory drug (NSAID) to provide effective relief of inflammation and pain. Nitric oxide (NO) synthesized by inducible nitric oxide synthase (iNOS) has been implicated as a mediator of inflammation. We examined the inhibitory effects of diclofenac on the induction of iNOS in RAW 264.7 macrophages which were activated with lipopolysaccharide (LPS) plus interferon-gamma (IFN-gamma). Treatment of RAW 264.7 cells with diclofenac and other NSAIDs (aspirin and indomethacin) significantly inhibited NO production and iNOS protein expression induced by LPS plus IFN-gamma. Also, diclofenac but not aspirin and indomethacin, inhibited iNOS mRNA expression and nuclear factor-kappa B (NF-kappaB) binding activity concentration-dependently. Furthermore, transfection of RAW 264.7 cells with iNOS promoter linked to a CAT reporter gene revealed that only diclofenac inhibited the iNOS promoter activity induced by LPS plus IFN-gamma through the NF-kappaB sites of iNOS promoter. Taken together, these suggest that diclofenac may exert its anti-inflammatory effect by inhibiting iNOS gene expression at the transcriptional level through suppression of NF-kappaB activation.

A Case of Necrotizing FasciitisZ in Chronic Renal Failure Patient / 대한신장학회잡지

Necrotizing fasciitis is an uncommon severe infection involving the subcutaneous soft tissue, particularly the superficial and often deep fascia. It is usually associated with systemic toxicity, rapid progression and a mortality rate which varies between 20 and 60%. It can affect any part of the body but is most common on the extremities, especially the leg. Predisposing factors include diabetes mellitus, alcoholism, intravenous drug abusers, abdominal surgery, perineal infection. The prognosis for necrotizing fasciitis depends so heavily on early recognition and determination of the extent of necrosis. Whilist there are reports of acute renal failure occuring in the presence of necrotizing fasciitis, descriptions of the condition in patients with chronic renal failure are rare in the literature. Hence we report a case of necrotizing fasciitis, diagnosed by MRI(Magnetic Resonance Imaging) in chronic renal failure patient.