A 56-year-old female patient presented with decreased visual acuity in her right eye lasting for one day. During the first visit, best corrected visual acuity (BCVA) was 20/80 and 20/20, in the right and left eye, respectively. Fundus examination of the right eye revealed an elevated mass in the superior area of the optic disc and exudative retinal detachment in the macula. Choroidal metastatic tumor secondary to non-small-cell lung cancer (NSCLC) was diagnosed after systemic work up. Photodynamic therapy (PDT) and the intravitreal bevacizumab injection for choroidal metastatic carcinoma were performed. After six months, the BCVA of the right eye was improved to 20/25. Complete regression of the tumor was noticed and serous detachment was resolved. There has been no recurrence for six months. We observed that combined treatment with PDT and intravitreal bevacizumab injection is effective in BCVA improvement and tumor regression, in a patient with choroidal metastasis of NSCLC.
Antibodies, Monoclonal, Humanized ; Choroid ; Eye ; Female ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Photochemotherapy ; Recurrence ; Retinal Detachment ; Triazenes ; Visual Acuity ; Bevacizumab

Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens to cause liver abscess. Because K. pneumoniae is highly virulent, it may cause embolic complications. The rate of metastatic infection has a range of 3.5% to 20%. Thus, a diagnostic work-up for metastatic complications should be employed in K. pneumoniae liver abscess cases, including chest radiography and computed tomography if chest radiographies are abnormal and ophthalmic examination in diabetic patients. Cryptogenic pyogenic liver abscess has been recently reported to potentially signal colorectal cancer, especially in female patients with diabetes. We present a case of liver abscess with endophthalmitis and septic pulmonary embolism, which is associated with silent colon cancer.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Endophthalmitis ; Female ; Humans ; Klebsiella pneumoniae ; Liver Abscess ; Liver Abscess, Pyogenic ; Pneumonia ; Pulmonary Embolism ; Thorax

OBJECTIVE: To promote awareness and efforts by in-hospital child abuse center to identity and prevent child abuse by investigation of victim and types of injury caused by child abuse. METHODS: A retrospective study was performed with 51 patients who had been diagnosed or suspected as child abuse at Shiny kid child abuse center in Soonchunhyang Gumi Hospital from January 2008 to December 2011. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, type of abuse, perpetrator, type of injury, final diagnosis, and follow-up success rate. RESULTS: The mean age of the subjects was 7 years old. Twenty-one patients were between 1 and 6 years old, 14 patients between 7 and 12 years old, 12 patients over 13 years old, and 4 cases less than 1 year old. The sex distribution was 47% (n=24) of male and 53% (n=27) of female. Thirty-five percentage of these patients reported with mixed abuse, 40% neglect, 29% physical abuse, 18% emotional abuse, 10.3% abandonment, and 2.5% sexual abuse, respectively. Twelve cases (23.5%) of them were found out the Routine health checkup. Bleeding and bruising (17.6%) were the second. Contusion and laceration were diagnosed in 9 cases, failure to thrive in 8 cases, tension headache in 5 cases, irritable bowel syndrome in 4 cases, sepsis of newborn in 4 cases, nephrotic syndrome in 3 cases, chronic otitis externa and media in 3 cases, mental retardation in 2 cases, congenital brain anomaly in 2 cases, major depression in 2 cases, pulmonary tuberculosis in 2 cases, diabetes mellitus in 1 case, and others in 6 cases, respectively. CONCLUSION: In-hospital child care team may experience the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.
Brain ; Child ; Child Abuse ; Child Care ; Contusions ; Depression ; Diabetes Mellitus ; Failure to Thrive ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Infant, Newborn ; Intellectual Disability ; Irritable Bowel Syndrome ; Lacerations ; Male ; Medical Records ; Nephrotic Syndrome ; Otitis Externa ; Retrospective Studies ; Sepsis ; Sex Distribution ; Sex Offenses ; Tension-Type Headache ; Tuberculosis, Pulmonary

OBJECTIVE: The incidence of colorectal carcinomas continues to rise in Korea due to the westernized life style. However, the precise colorectal carcinogenic mechanisms remain to be elucidated. The protein products of oncogenes and cancer suppressor genes play important roles in the carcinogenesis. The effects of the proteins are influenced by post-translational modifications as phosphorylation, acetylation, methylation, and ubiquitination. The aberrant sumoylation plays some roles in carcinogenesis. However, the expression pattern of small ubiquitin-related modifier (SUMO)-2/3 in the colorectal cancer has not been reported. We assessed the expression of SUMO-2/3 and evaluated the expression pattern in colorectal cancer. METHODS: The SUMO-2/3 expression was tested in one normal colon mucosal cell line and 5 colorectal cancer cell lines by Western blot. We collected 322 cases of colorectal cancer operated from January 2000 to December 2010 at Soonchunhyang University Cheonan Hospital. We fabricated the tissue microarray and the expression of SUMO-2/3 was evaluated by immunohistochemistry. The results were analyzed with clinicopathologic parameters. RESULTS: The SUMO-2/3 was not expressed in the normal colon mucosal cell line. However, it was expressed highly in all the 5 colorectal cancer cell lines as the beta-actin. The SUMO-2/3 was expressed in 68.3% of the colorectal cancers and its expression was correlated with the pathological tumor stage stage (odds ratio, 2.89; 95% confidence interval, 1.10 to 7.55; P=0.031). CONCLUSION: The SUMO-2/3 plays some roles in carcinogenesis and progression of the colorectal cancer.
Acetylation ; Actins ; Blotting, Western ; Cell Line ; Colon ; Colorectal Neoplasms ; Genes, Tumor Suppressor ; Immunohistochemistry ; Incidence ; Korea ; Life Style ; Methylation ; Oncogenes ; Phosphorylation ; Protein Processing, Post-Translational ; Proteins ; Sumoylation ; Tissue Array Analysis ; Ubiquitin ; Ubiquitination

OBJECTIVE: It is difficult to make a distinction between acute pyelonephritis and lower urinary tract infection due to nonspecific clinical symptoms and laboratory findings. We measured the spot urine beta2-microglobulin in children with urinary tract infection (UTI) to distinguish between acute pyelonephritis and lower UTI. We compared the accuracy of urine beta2-microglobulin measurement with other inflammatory markers. METHODS: We studied 83 children (mean, 86+/-44.9 months) who suspected of having UTI. Leukocyte counts, erythrocyte sedimentation rates (ESR) and C-reactive protein (CRP), beta2-microglobulin were measured. Renal parenchymal involvement was evaluated by 99mTc dimercaptosuccinic acid scintigraphy in the first 7 days after admission. beta2-microglobulin was measured by radioimmunoassay. RESULTS: Urine beta2-microglobulin values were correlated with the presence of renal defects in children with UTI (n=22) (0.98+/-0.24 microg/mL, P<0.05). Using a cutoff of 0.4 microg/mL for spot urine beta2-microglobulin and 20 mm/hr for ESR, 2.6 mg/L for CRP, sensitivity and specificity between UTI with and without renal involvement were 78.7% and 90.1% for spot urine beta2-microglobulin, 77.2% and 90.1% for spot urine beta2-microglobulin/creatinine (Cr), 77.2%, 68.8% for ESR, 86.3%, 68.8% for CRP, respectively. Positive and negative predictive values were 72.7%, 90.1% for spot urine beta2-microglobulin, 73.9% and 91.6% for spot urine beta2-microglobulin/Cr, and 57.5%, 94% for CRP, respectively. CONCLUSION: In febrile UTI, spot urine beta2-microglobulin and beta2-microglobulin/Cr values were more specific than CRP, ESR, and leukocyte count for determine the renal defects.
beta 2-Microglobulin ; Blood Sedimentation ; C-Reactive Protein ; Child ; Humans ; Leukocyte Count ; Pediatrics ; Pyelonephritis ; Sensitivity and Specificity ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections

OBJECTIVE: This study was carried out to evaluate short-term respiratory morbidity in late preterm births compared with term births at a single center in Korea. METHODS: In retrospective study, we reviewed medical records of neonates that were born at Soonchunhyang University Bucheon Hospital from January 2002 to January 2011 and their mothers. The neonates were divided into two groups by their gestational age (GA): 535 late preterm births (GA, 34+0 to 36+6 weeks) and 3,037 term births (GA, 37+0 to 41+6 weeks). We compared late preterm births and term births in regard to maternal characteristics, neonatal characteristics, respiratory morbidities, and respiratory supports. RESULTS: Of 535 late preterm births, 117 (21.9%) had respiratory tract disease. Of 3,037 term births, 105 (3.5%) had respiratory tract disease. Compared term births, late preterm births had significantly more respiratory diseases such as apnea (odds ratio [OR], 37.3), respiratory distress syndrome (OR, 34.0), transient tachypnea of newborn (OR, 5.9), and pneumonia (OR, 2.2). Duration of oxygen supply was longer in term than in preterm births. Oxygen supply through isolette and use of surfactant were more frequent in late preterm than term births. It was not differ from two groups to use continuous positive airway pressure and mechanical ventilation. CONCLUSION: This study showed that late preterm births had significantly higher respiratory morbidity than term births. Therefore, we should have more attention to evaluate and manage when late preterm birth occur than before. Also it is necessary to study long-term respiratory outcomes of late preterm births and discuss about perinatal care system.
Apnea ; Continuous Positive Airway Pressure ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Medical Records ; Mothers ; Oxygen ; Perinatal Care ; Pneumonia ; Premature Birth ; Respiratory Tract Diseases ; Retrospective Studies ; Term Birth ; Transient Tachypnea of the Newborn

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of transradial percutaneous coronary intervention (TRI) compared with transfemoral percutaneous coronary intervention (TFI) in patients with ischemic heart disease. METHODS: We reviewed retrospectively the medical records including imaging data of the patients with ischemic heart disease who underwent TRI or TFI from January 2007 to December 2009 in Soonchunhyang University Seoul Hospital. We compared major adverse cardiac and cerebrovascular events (MACCEs) including death, myocardial infarction, revascularization, stent thrombosis, and cerebrovascular accident during follow-up period. We also compared procedure related vascular complications including hematoma, arteriovenous fistula, pseudoaneurysm, and infection. RESULTS: Total number of patients was 347 (256 patients of TRI and 91 patients of TFI). There were no significant differences in the rate of MACCEs between two groups. There were significantly less procedure-related vascular complications in TRI group (3.1% vs. 11.0%, P=0.010). CONCLUSION: TRI is as effective as TFI with no difference in the rate of MACCEs in patients with ischemic heart disease. TRI is superior to TFI in safety with reduction of vascular complications.
Aneurysm, False ; Arteriovenous Fistula ; Coronary Artery Disease ; Femoral Artery ; Follow-Up Studies ; Heart ; Hematoma ; Humans ; Medical Records ; Myocardial Infarction ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Radial Artery ; Retrospective Studies ; Stents ; Stroke ; Thrombosis

OBJECTIVE: Deep inspirations (DI) provide physiologic protection against airway narrowing and DI-induced bronchoprotection and bronchodilation are impaired in asthma. METHODS: To evaluate effect of DI on airway narrowing during methacholine challenge, we compared the 2 minutes tidal breathing method and the breath dosimeter method. Methacholine challenge in 12 asthmatics and 10 healthy controls was cross-overly performed by two methods. On first visit, a questionnaire for symptoms, allergy skin test, spirometry, and methacholine challenge was performed. On second visit, spirometry and methacholine challenge using the 25 mg/mL at 5 minutes intervals during the 2 minutes tidal breathing method and the ten-breath dosimeter method were performed on two separate days at same time each day. RESULTS: The decreases in forced expiratory volume in one second (FEV1) and forced vital capacity during the 2 minutes tidal breathing method and dosimeter method in patients with asthmatics were higher than those in normal controls. The decreases in FEV1 and forced vital capacity during the 2 minutes tidal breathing method were higher than during dosimeter method in both asthmatics and controls. CONCLUSION: These observations indicate that the continuous generation method produce more bronchoconstriction than the dosimeter method during methacholine challenge and asthmatics had more bronchoconstriction than controls, suggesting inhibition of DI enhance methacholine induced airway narrowing in asthmatics.
Asthma ; Bronchoconstriction ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Methacholine Chloride ; Surveys and Questionnaires ; Respiration ; Skin Tests ; Spirometry ; Vital Capacity

OBJECTIVE: Voiding dysfunction may be occurred due to the herpes zoster with lumbosacral lesion. We studied the clinical symptoms in patients with voiding dysfunction caused by herpes zoster. METHODS: We have investigated the medical records in 10 patients. These patients had urinary symptoms associated with herpes zoster. RESULTS: Dermatome levels were sacral(s) in 10 patients (s2, 4 patients; s3, 6 patients). Urologic symptoms were acute urinary retention in 10 patients who showed detrusor areflexia (7 patients) or detrusor hyporeflexia (3 patients) in urodynamics. All patients were managed by inserting catheter with alpha blocker. After 1 week we removed indwelling catheter. All patients were no problem in urination. CONCLUSION: The cause of voiding dysfunction is not known clearly in herpes zoster infection. But we investigated that Famciclovir 750 mg using oral medication and the urethral catheter insertion performed by one week was recovered from herpes zoster. Authors think it is useful for patients with impaired urination.
2-Aminopurine ; Catheters ; Catheters, Indwelling ; Female ; Herpes Zoster ; Humans ; Medical Records ; Reflex, Abnormal ; Urinary Catheters ; Urinary Retention ; Urination ; Urodynamics

OBJECTIVE: Because tuberculosis is a major global health problem, rapid and accurate identification of Mycobacterium tuberculosis complex (MTBC) in clinical specimens is essential for the control of the spread of tuberculosis. One of real-time polymerase chain reaction assays for direct detection of MTBC, Cobas TaqMan MTB (Roche Diagnostics) assay has been widely used in clinical setting in Korea. The aim of study was to evaluate of the performance of Cobas TaqMan MTB assay in respiratory specimens. METHODS: Total of 619 respiratory specimens (572 sputum specimens and 47 bronchoalveolar washing fluid specimens) was collected in August and September, 2011. All specimens were analyzed for the detection of MTBC by direct smear examination, mycobacterial culture, and Cobas TaqMan MTB assay. RESULTS: When the culture method was used as the gold standard test for comparison, Cobas TaqMan MTB assay for detection of MTBC had a sensitivity and specificity of 80.9% (38/47) and 100% (572/572), respectively. Positive predictive value and negative predictive value of Cobas TaqMan MTB assay was 100% and 98.5%, respectively. The sensitivity of Cobas TaqMan MTB assay was 100% in AFB smear-positive samples and 59.1% in smear-negative samples. CONCLUSION: Cobas TaqMan MTB assay has an excellent performance in smear-positive respiratory specimens. But performance of Cobas TaqMan MTB assay in smear-negative respiratory samples was not good. For detection of paucibacillary tuberculosis, conventional mycobacterial culture must not be replaced by Cobas TaqMan MTB assay.
Korea ; Mycobacterium ; Mycobacterium tuberculosis ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Sputum ; Tuberculosis