A case of congenital diaphragmatic eventration on the right and central tendinous portion with accessory hepatic lobe causing direct compression of the right heart is presented. We have performed the video assisted thoracoscopic plication of the right hemidiaphragm and eliminated the mass effect of the accessory hepatic lobe.
Diaphragmatic Eventration* ; Heart ; Thoracoscopy

PURPOSE: The purpose of this predictive study was to identify factors affecting health related quality of life (HRQoL) in patients with rheumatoid arthritis (RA). METHODS: The participants in this study were 131 patients with RA who were recruited from the outpatient clinic of a university hospital in Seoul. Disease activity in rheumatoid arthritis was evaluated by calculating the Disease Activity Score 28. Disability in activities of daily living (ADL) was assessed with the Korean Health Assessment Questionnaire, and depression with The Center for Epidemiologic Studies Depression Scale. HRQoL was evaluated using The Short Form 36 Health Survey. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. RESULTS: Pain, disability in ADL, disease activity, and depression correlated negatively with physical and mental dimensions of HRQoL. But hierachical multiple regression analysis revealed that disability in ADL and depression were the only variables negatively influencing physical and mental QoL after adjustment for influences of sociodemographic variables. CONCLUSION: Results of this study suggest that disability in ADL and depression, rather than disease activity and pain have profound effects on HRQoL in patients with RA. Further studies are needed to assess the predictive ability of disease activity and pain on HRQoL in this population.
*Activities of Daily Living ; Adaptation, Psychological ; Adult ; Aged ; Arthritis, Rheumatoid/pathology/*psychology ; *Depression ; Female ; Health Status ; Hospitals, University ; Humans ; Male ; Middle Aged ; Pain ; *Quality of Life ; Questionnaires ; Republic of Korea

PURPOSE: The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). METHODS: We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. RESULTS: Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. CONCLUSION: Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.
Adolescent ; Cough ; Fever ; Humans ; Lung ; Lymphatic Diseases ; Male ; Medical Records ; Pleural Effusion ; Pleurisy ; Polymerase Chain Reaction ; Prevalence ; Retrospective Studies ; Sputum ; Sweat ; Sweating ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) for decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. MATERIAL AND METHOD: VATS debridement or decortication was performed with endoscopic shaver system in 40 consecutive patients presented with pleural space infections. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. RESULT: VATS evacuation of infected pleural fluid and decortication was successfully performed in 35 of 40 patients. The mean duration of preoperative symptoms before referral was 23 +/- 1.8 days. The mean duration of hospitalization before transfer was 13.5 +/- 1.5 days. Blood loss was 250 to 200 mL. Intercostal drainage was required for 5 +/- 3 days. The postoperative hospital stay was 5 +/- 0.7 days. There were no operative mortalities. CONCLUSION: Video-assisted evacuation of infected pleural fluid and decortication is an effective modality in the management of the fibropurulent stage of empyema. An organized empyema should be approached thoracoscopically, but may require open decortication.
Debridement ; Drainage ; Empyema* ; Empyema, Pleural ; Hospitalization ; Humans ; Length of Stay ; Mortality ; Referral and Consultation ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thoracoscopy

BACKGROUND/AIMS: The incidence of colon cancer has increased since 1990 in Korea. Though the cause of colon cancer is not clear, there are two theories of its development (adenoma-carcinoma sequence and de novo cancer). Recently, frequently performed colonoscopy and videoscopy make it possible to find colon polyps including tiny ones and do polypectomy. So, the authors studied safety of colonoscopic polypectomy on out-patient basis and its clinico-pathologic results. METHODS: From April 1999 to April 2000, the authors performed colonoscopy and polypectomy in patients for various gastrointestinal symptoms, follow-up after colon cancer operation, and colon cancer screening. We studied prospectively in out-patients basis after checking of bleeding tendency. If there was possibility of bleeding or perforation risk, we had done hemoclipping for prevention of complications. RESULTS: One thousand three hundred five colon polyps were found in 586 patients. 1,191 (91.3%) were smaller than 1 cm. Among the total 1,305 polyps, 10 revealed malignant transformation, in which 6 were smaller than 1 cm. Sigmoid colon and ascending colon are most common site of colon polyps, which could be removed with endoscopic mucosal resection snare. Only 1 case of postpolypectomy bleeding was noted after 9 days with mucosectomy without any other complications as perforation. CONCLUSIONS: The colon polyps are popular in the Korean and even the small polyps can be malignant. Any polyps could be removed in spite of small size and the polypectomy in out-patient basis is a safe procedure if postpolypectomy complications are fully comprehended and preventing endoscopic procedures are carried adequately.
Colon ; Colon, Ascending ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopy ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Korea ; Mass Screening ; Outpatients* ; Polyps ; Prospective Studies ; SNARE Proteins

Collapsing glomeruopathy (CG) is a clinicopathologic variant of focal segmental glomerulosclerosis (FSGS) and is characterized by severe nephrotic syndrome, rapid progression to end stage renal disease, and features of visceral epithelial cell injury and glomerular capillary collapse. Such characteristics closely resemble those of HIV associated nephropathy. The frequency of CG has increased over the last decade. The cause of CG is unknown. The lesion has rarely been described in renal allografts with features similar to CG in native kidney. We recently identified allograft CG in a 44 year-old male patient who underwent biopsy for graft dysfunction after autodermic graft. The biopsy showed typical characteristics of CG. Serologically, the patient had no evidence of HIV infection. The renal function was not restored to normal in spite of methylprednisolone pulsing therapy. Now he is on conservative treatment with a functioning graft.
AIDS-Associated Nephropathy ; Biopsy ; Capillaries ; Epithelial Cells ; Glomerulosclerosis, Focal Segmental ; HIV Infections ; Humans ; Kidney ; Kidney Failure, Chronic ; Male ; Methylprednisolone ; Nephrotic Syndrome ; Transplantation, Homologous ; Transplants

PURPOSE: Excluding RSV, the relationship between bronchiolitis caused by viruses and the development of wheezing and atopy in childhood has not been well studied. We studied this relationship in children who had bronchiolitis caused by human bocavirus before 2 years of age. METHODS: We retrospectively investigated 2,430 throat swab obstained between January 2005 and December 2007 from pediatric in-patients with acute respiratory tract disease at the Kwangju Christian Hospital. Human bocavirus was detected in 112 patients. A total of 61 patients less than 2 years of age were finally enrolled in this study. Patients were followed up between April and June of 2008. We measured the frequency of wheezing and atopic status using (allergy skin-prick tests, CAP tests and MAST tests). RESULTS: Of the 61 patients, 16 (26.2%) had recurrent wheezing. Of these 16 patients, 8 (13.1%) had Infrequent wheezing (1-2 wheezing episodes) and 8 (13.1%) had frequent wheezing (3 and over wheezing episodes). Of the total 61 patients, 18 (29.5%) completed allergy tests. Of the 18 patients, 10 (55.6%) were sensitized to at least 1 allergen. Recurrent wheezing was significantly associated with the severity of bronchiolitis (mild vs. moderate vs. severe; 9.1% vs. 22.2% vs. 66.7%). CONCLUSION: Human bocavirus-induced bronchiolitis in childhood are an independent risk factor for development of wheezing in childhood and may be associated with an increased risk of allergic sensitization. The most important risk factor for recurrent wheezing is the severity of lower respiratory tract illnesses.
Bronchiolitis ; Child ; Human bocavirus ; Humans ; Hypersensitivity ; Korea ; Pharynx ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Diseases ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: The clinical usefulness of nasogastric tube insertion in poisoning patients is controversial. This study compared the incidence of aspiration pneumonia between patients with or without nasogastric tubes. METHODS: We retrospectively reviewed the clinical reports of poisoning patients seen from January 2006 to December 2007. We classified the patients into groups with and without nasogastric tube insertion and evaluated the incidence and risk factors of aspiration pneumonia. RESULTS: Ultimately, 63 patients were included. The incidence of aspiration pneumonia was higher in patients with nasogastric tube insertion than in patients without nasogastric tube insertion (conscious patients: 58.8% vs. 11.8%, p=0.010; unconscious patients: 72.2% vs. 27.3%, p=0.027). Nasogastric tube insertion was a significant risk factor for developing aspiration pneumonia (odds ratio 3.54; 95% confidence interval 1.74~12.34). CONCLUSIONS: Nasogastric tube insertion did not prevent aspiration pneumonia, but was a risk factor. The results have implications in the development of a hypothesis about why a nasogastric tube increases the risk of aspiration pneumonia. This study has important limitations stemming mostly from other compounding factors and its retrospective design.
Charcoal ; Humans ; Incidence ; Pneumonia, Aspiration ; Retrospective Studies ; Risk Factors ; Unconscious (Psychology)

The deletion 22q13 syndrome (Phelan-McDermid syndrome) is a rare microdeletion syndrome characterized by prominent neurobehavioral deficits including neonatal hypotonia, developmental delay, language delay, autism, and minor dysmorphic features. Due to nonspecific facial features and difficulties in detection in routine chromosome analysis, this chromosome deletion syndrome has gone under-diagnosed. Fluorescence in situ hybridization (FISH) is required to confirm the presence of this deletion. Here we report the first case of 22q13 deletion syndrome in Korea. An 18-month-old girl was admitted to a pediatric clinic due to severe developmental delay and hypotonia from the neonatal period. She was diagnosed as 22q13 deletion syndrome through a chromosomal analysis and FISH using arylsulfatase A probe.
Autistic Disorder ; Cerebroside-Sulfatase ; Chromosome Deletion ; Developmental Disabilities ; Fluorescence ; Humans ; In Situ Hybridization ; Infant ; Korea ; Language Development Disorders ; Muscle Hypotonia

Pollinosis is one of the allergic diseases which caused by airborne pollens from allergic plants, such as allergic rhinitis, asthma, and allergic conjunctivitis. The distribution of pollens in the air is fully related to weather condition, especially temperature and humidity, etc. This study is focused on the evaluation of the relation between pollen count and the outbreak of allergic diseases (symptom index) from allergic patients in Korea and this data would be necessary to evaluate Korean own allergy index for pollen forecasting system. Airborne particles carrying allergens were collected daily from nationwide 8 stations (Seoul, Guri, Daejeon, Daegu, Kwangju, Busan, Kangneung, and Jeju) by using 7 days-Burkard sampler (Burkard Manufacturing Co Ltd, Hertfordshire, UK) for 10 year in South Korea (March 1, 2008-October 30, 2008). They were counted and recorded along with the weather factors. Symptom index was evaluated and recorded by calling to allergic patients daily. Airborne pollen has two peak seasons that is May and September in Korea. The peak season for mold was June. There was the tree pollen seasons from the middle of February to late July, then followed during the grasses and weed season from the middle of July to the end of October. Ragweed was one of the most common pollen of autumn in Korea. In skin prick test, Ragweed was the highest sensitization rate (5.9%), followed by Mugwort (5.8%), alder (4.9%), birch (4.8%), oak grasses among the pollen extracts in Korean school aged children. Ragweed pollen counts were gradually increased since 2000. In same period, sensitization rates for airborne pollen, especially weeds in Korean children were increased annually (1999: 4.4%, 2000: 7.1%, 2001: 7.4%, 2002: 8.5%, 2003: 7.7%). There are significantly related between symptom index from allergic patients and allergic pollen concentrations. Sensitization rates for pollens are increased in Korean children with age. There are significantly related between symptom index from allergic patients and allergic pollen concentrations. Risk Grade of pollen for allergy pollen forecast among each allergic plant was established and still remain to confirm it.
Aged ; Allergens ; Alnus ; Ambrosia ; Antigens, Plant ; Artemisia ; Asthma ; Betula ; Child ; Conjunctivitis, Allergic ; Forecasting ; Fungi ; Humans ; Humidity ; Hypersensitivity ; Korea ; Lifting ; Plant Extracts ; Plants ; Poaceae ; Pollen ; Republic of Korea ; Rhinitis ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal ; Seasons ; Skin ; Weather