BACKGROUND: Experimental data indicate that low-flow reperfusion following prolonged cardiocirculatory arrest may aggravate early cerebral microcirculatory repefusion disorders. We investigated the influence of cerebral repefusion flow change to the ischemic histopathologic damage of brain tissue after incomplete forebrain ischemia in rats. MATERIALS AND METHOD: Anesthetized Sprague-Dawley rats were undergone ligation of both infernal carotid artery by microvascular clamp for 10 minutes. After release of the clamp, reperfusion was started with several different flow levels (0, 10, 20, 30, 50, and 100%) of infernal carotid artery comparing to pre-clamping phase using flowmeter. After 15minutes of reperfusion, rat brains were prepared by perfusion-fixation with 3% formaldehyde. Under light microscopic examination of Hematoxylin-Eosin stained tissue slide, histopathologic damage was examined at cortex, putamen, and hippocampus regions. Categorical hisotopathologic damage scores were derived in each regions by manual counts of ischemic neurons. RESULT: The histopathologic damage scores were 0, 10. 2+/-0.5, 7.6+/-1.5, 5.9+/-1.4, 5.0+/- 2.8, 3.5+/-0.7, and 1.0+/-0.0 in control, 0, 10, 20, 30, 50, and 100% reperfusion groups, respectively(p<0.05). CONCLUSION: Our insults showed significant increment of brain histopathologic damage scores along with decreasing amount of cerebral reperfusion know after incomplete forebrain ischemia. We believe restoration of repefusion flow to pre-ischemic level would be a critical component in attenuation of brain ischemic damage.
Animals ; Brain ; Carotid Arteries ; Flowmeters ; Formaldehyde ; Hippocampus ; Ischemia* ; Ligation ; Models, Animal* ; Neurons ; Prosencephalon* ; Putamen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion*

The term MYH9-related disorders indicates a group of autosomal dominant illnesses, formerly known as May-Hegglin anomaly, Sebastian syndrome, Fechtner syndrome and Epstein syndrome, caused by mutations of MYH9, the gene encoding for the heavy chain of non-muscle myosin IIA (NMMHC-IIA). We experienced a family with macrothrombocytopenia without leukocyte inclusion. A 5-year-old girl was found to have macrothrombocytopenia incidentally. Her father also had macrothromtocytopenia, but had been suffering from hearing loss and chronic renal failure. Meticulous search by light and electron microscopy failed to detect leukocyte inclusions. To our knowledge, these cases seem to be the first description of autosomal dominant Epstein giant platelet syndrome in Korea.
Bernard-Soulier Syndrome* ; Child, Preschool ; Fathers ; Female ; Hearing Loss ; Humans ; Kidney Failure, Chronic ; Korea ; Leukocytes ; Microscopy, Electron ; Nonmuscle Myosin Type IIA

Pseudomonas stutzeri is a Gram-negative, rod-shaped, motile, single polar-flagellated, soil bacterium that was first isolated from human spinal fluid and is widely distributed in the environment. It was isolated as an uncommon opportunistic pathogen from humans, and a few cases of P. stutzeri-induced peritonitis have been reported in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Catheter removal with antibiotic treatment is generally recommended because peritonitis by Pseudomonas species is commonly associated with catheter-related infection. Here, we describe the first case of P. stutzeri-induced peritonitis in an 82-year-old woman in Korea. She had received two antipseudomonal antibiotics, an aminoglycoside (isepamicin, Yuhan corporation, Seoul, Korea) and a fluoroquinolone (ciprofloxacin), and was successfully treated without removal of the CAPD catheter.
Aged, 80 and over ; Anti-Bacterial Agents ; Catheter-Related Infections ; Catheters ; Female ; Humans ; Korea ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Pseudomonas ; Pseudomonas stutzeri ; Soil

Selective IgA deficiency is one of the most common primary immunodeficiency. Some patients with IgA deficiency also have deficits in one or more immunoglobulin G subclasses. It has been estimated that up to 25% of patients with certain primary immunodeficiencies will develop tumors, primarily B-cell lymphomas during their lifetime. We hereby present 2 cases of malignant lymphomas, one diffuse large cell lymphoma and another mixed cellularity Hodgkin's disease, respectively, which developed in patients with selective IgA and IgG subclass deficiency.
Child* ; Hodgkin Disease ; Humans ; IgA Deficiency ; Immunoglobulin A* ; Immunoglobulin G* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin

Patients with cardiac rupture due to blunt trauma have more than 50% mortality rate and most of them expire before they arrive at the hospital emergency room. Since patients typically present with cardiac tamponade, the diagnosis can be easily confirmed with physical examination, echocardiography, and chest CT scan. However, in our case of the massive hemothorax on right side without evidence of cardiac tamponade, the diagnosis for cardiac rupture does not seems to be easy. Therefore, we must assume the probability of cardiac rupture if we plan an explo-thoracotomy in a patients with massive right hemothorax without rib fracture. We describe two cases of cardiac rupture combined with pericardial laceration and right massive hemothorax by blunt chest trauma. The ruptured hearts of the patients were successfully closed using cardio-pulmonary bypass or cell saver system without detrimental sequelae.
Cardiac Tamponade ; Diagnosis ; Echocardiography ; Emergency Service, Hospital ; Heart ; Heart Rupture* ; Hemothorax* ; Humans ; Lacerations ; Mortality ; Physical Examination ; Rib Fractures ; Thorax* ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to identify the prevalence of stroke in Pyongchang county, Kangwon do. METHODS: The presumptive stroke patients of Pyongchang county were identified with a key-person method in October 2000. And then, medical records of these patients were reviewed by well-trained two students who major in the science of medical record. RESULTS: In the year 2000, there were 92 males and 68 females of self-diagnosed stroke. Of these, stroke patients based on physician's diagnosis were 102, and stroke patients based on CT/MRI findings or Minnesota criteria were 93. Prevalence rate of self-reported stroke, stroke based on physician's diagnosis, and stroke based on CT/MRI findings or Minnesota criteria were 0.33%, 0.29%, and 0.26% respectively. CONCLUSION: We conclude that verifying process of diagnosis is needed to estimate the prevalence of stroke in community.
Diagnosis ; Female ; Gangwon-do ; Humans ; Male ; Medical Records ; Minnesota ; Prevalence* ; Stroke*

Objective: It is difficult to predict medical outcomes for acute pyelonephritis (APN) in women. A delay in diagnosis and treatment results in rapid progression to circulatory collapse, multiple organ failure, and death. We investigated the value of procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR) in APN patients hospitalized through the emergency room. Methods: We retrospectively evaluated women with APN presenting in the emergency room from January 2014 to May 2018. Inflammatory biomarkers, including PCT and NLR, were measured, and the severity of pyelonephritis was assessed using the Surviving Sepsis Campaign definitions (Sepsis-3). Multivariable logistic regression analysis was used to evaluate the risk factors associated with septic shock and the prediction for septic shock was compared using a receiver operating characteristic (ROC) curve. Results: A total of 357 female patients with APN were included. The median level of PCT and NLR was higher in the septic shock group compared with other groups. Multivariate logistic regression analysis showed that age and PCT were risk factors for septic shock. When the ROC curve of septic shock was compared, PCT showed a higher area under the curve than NLR (NLR 0.65 vs. PCT 0.80). Conclusion The initial NLR in the emergency room showed significant differences depending on the severity as classified by Sepsis-3 definitions. However, NLR was not found to be associated with septic shock in female patients with APN.

Objective: It is difficult to predict medical outcomes for acute pyelonephritis (APN) in women. A delay in diagnosis and treatment results in rapid progression to circulatory collapse, multiple organ failure, and death. We investigated the value of procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR) in APN patients hospitalized through the emergency room. Methods: We retrospectively evaluated women with APN presenting in the emergency room from January 2014 to May 2018. Inflammatory biomarkers, including PCT and NLR, were measured, and the severity of pyelonephritis was assessed using the Surviving Sepsis Campaign definitions (Sepsis-3). Multivariable logistic regression analysis was used to evaluate the risk factors associated with septic shock and the prediction for septic shock was compared using a receiver operating characteristic (ROC) curve. Results: A total of 357 female patients with APN were included. The median level of PCT and NLR was higher in the septic shock group compared with other groups. Multivariate logistic regression analysis showed that age and PCT were risk factors for septic shock. When the ROC curve of septic shock was compared, PCT showed a higher area under the curve than NLR (NLR 0.65 vs. PCT 0.80). Conclusion The initial NLR in the emergency room showed significant differences depending on the severity as classified by Sepsis-3 definitions. However, NLR was not found to be associated with septic shock in female patients with APN.

These guidelines aim to establish the standard practice for diagnosing and treating patients with differentiated thyroid cancer (DTC). Based on the Korean Thyroid Association (KTA) Guidelines on DTC management, the “Treatment of Advanced DTC” section was revised in 2024 and has been provided through this chapter. Especially, this chapter covers surgical and nonsurgical treatments for the local (previous surgery site) or regional (cervical lymph node metastasis) recurrences. After drafting the guidelines, it was finalized by collecting opinions from KTA members and related societies. Surgical resection is the preferred treatment for local or regional recurrence of advanced DTC. If surgical resection is not possible, nonsurgical resection treatment under ultrasonography guidance may be considered as an alternative treatment for local or regional recurrence of DTC. Furthermore, if residual lesions are suspected even after surgical resection or respiratory-digestive organ invasion, additional radioactive iodine and external radiation treatments are considered.

Pediatric differentiated thyroid cancers (DTCs), mostly papillary thyroid cancer (PTC, 80-90%), are diagnosed at more advanced stages with larger tumor sizes and higher rates of locoregional and/or lung metastasis. Despite the higher recurrence rates of pediatric cancers than of adult thyroid cancers, pediatric patients demonstrate a lower mortality rate and more favorable prognosis. Considering the more advanced stage at diagnosis in pediatric patients, preoperative evaluation is crucial to determine the extent of surgery required. Furthermore, if hereditary tumor syndrome is suspected, genetic testing is required. Recommendations for pediatric DTCs focus on the surgical principles, radioiodine therapy according to the postoperative risk level, treatment and follow-up of recurrent or persistent diseases, and treatment of patients with radioiodine-refractory PTCs on the basis of genetic drivers that are unique to pediatric patients.