1.Two cases of upper airway obstruction masquerading as asthma: One tracheal adenoid cystic carcinoma, the other foreign body aspiration.
Hak Geun KIM ; Han Kyun LEE ; Bum Chan KWEON ; Choong Ki LEE ; Gun Woo KIM ; Sang Hoon HYUN ; Jong Myung LEE ; Nung Soo KIM
Journal of Asthma, Allergy and Clinical Immunology 1999;19(1):103-109
Reversible airway obstruction and wheezing are typical features of bronchial asthma, but these features may also be observed in other conditions. However, the inclusion of these conditions in the differential diagnosis of asthma-like symptoms in adults is often neglected, resulting in a correct diagnosis being made after months of unsuccessful treatment for asthma. We report two cases of an upper airway obstruction masquerading as asthma. In case one, adenoid cystic carcinoma was identified in the trachea of a patient showing asthma-like symptoms, positive response to allergic skin test and methacholine inhalation challenge. In the other case, aspirated foreign body was misdiagnosed and treated as asthma for more than one year. A high degree of suspicion and a thorough medical evaluation censisting of history, physical examination and pulmonary function test including shapes of spirogram are essential to the differential diagnosis of asthma-like symptoms
Adenoids*
;
Adult
;
Airway Obstruction*
;
Asthma*
;
Carcinoma, Adenoid Cystic*
;
Diagnosis
;
Diagnosis, Differential
;
Foreign Bodies*
;
Humans
;
Inhalation
;
Methacholine Chloride
;
Physical Examination
;
Respiratory Function Tests
;
Respiratory Sounds
;
Skin Tests
;
Trachea
2.A Case of Gastritis Cystica Profunda with Long Pendulous Pedicle.
Bum Chan KWEON ; Jin Seouk PARK ; Kyung Soon SHIN ; Duk Hyun LEE ; Hyo Jong BAEK ; Choong Ki LEE
Korean Journal of Gastrointestinal Endoscopy 1999;19(1):81-83
Gastritis cystica profunda (GCP) is a rare disease which is mainly observed at the site of gastroenterostomy. However, it may occur in the stomach without a previous history of surgery. Under histologic examination GCP shows hyperplastic and cystic dilatation of the pseudopyloric glands with submucosal invasion. GCP with sessile polypoid pro-trusion is most commonly found but, submucosal tumors, giant gastric mucosal folds and pedunculated forms are occasionally found. We present the case of GCP showing a large sized polyp (3 2.5 2.5 cm) with a long pendulous pedicle that had developed in the fundus of the stomach without previous surgical history. Endoscopic polypectomy was performed for confirmation.
Dilatation
;
Gastritis*
;
Gastroenterostomy
;
Polyps
;
Rare Diseases
;
Stomach
3.A Case of Mesenteric Fibromatosis after Appendectomy.
Keun Ha NAM ; Bum Chan KWEON ; Han Kyun LEE ; Dong Wook LEE ; Chang Keun WOO ; Jin seouk PARK ; So Jung KWEON ; Joong Ha HWANG ; Choong Ki LEE
Korean Journal of Medicine 1998;54(4):577-581
Mesenteric fibromatosis is a rare nonmetastasizing fi brous tumor, characterized by fibroblastic proliferation without evidence of inflammatory response or definite neoplasia. It appears at any age, but mainly in the second to fifth decades as incidence of two to four desmoid tu mor cases per 1 million people per annum. It is pseudoen capsulated and locally invasive and has a tendency to recur, but metastases are rare. It is more frequent with Gardner's syndrome(adenomatosis coli) in which 50% of them will appear as mesenteric fibromatosis. Trauma, especially that of previous surgery, has been associated with the subsequent development of desmoid tumor. The treatment of choice is a wide margin resection of the tumor. we experienced a case of mesenteric fibromatosis without Gardner's syndrome 2 years after appendectomy in a 31-year old man and recurred at 21 months after resection and report with a review of literatures. 6
Adult
;
Appendectomy*
;
Fibroblasts
;
Fibroma*
;
Fibromatosis, Aggressive
;
Gardner Syndrome
;
Humans
;
Incidence
;
Neoplasm Metastasis
4.Wilson`s Disease with Abnormal Secretion of Pituitary Hormones.
Dae Hyun KIM ; Bum Chan KWEON ; Han Keun LEE ; Keun Ha NAM ; Seog Jun KIM ; Dong Wook LEE ; Chan Gyu PARK ; Chang Gi LEE ; Sang Moon LEE ; Choong Ki LEE
Korean Journal of Medicine 1997;52(3):429-435
Wilson`s disease is a hereditary disorder in hepatic excretion of copper that results in toxic accumulations of the metal in liver, brain and other organs. Though there have been some reports of Wilson's disease with hepatic, neurologic, psychiatric symptoms, or hemolytic anemia, a case of Wilson's disease with abnormal secretion of pituitary hormones is, to our best knowledge, the first report in Korea. We report a case of Wilson`s disease with abnormal secretion of pituirary hormones, chronic active hepatitis with feature of early cirrhosis and hemolytic anemia in 18-year-old man showing delayed puberty. And also we describe a case of successful desensitization to penicillamine in a penicillamine hypersensitivity.
Adolescent
;
Anemia, Hemolytic
;
Brain
;
Copper
;
Fibrosis
;
Hepatitis, Chronic
;
Hepatolenticular Degeneration
;
Humans
;
Hypersensitivity
;
Korea
;
Liver
;
Penicillamine
;
Pituitary Hormones*
;
Puberty, Delayed
5.Recurrent Paravalvular Leakage after Mitral Valve Replacement with Annular Reconstruction for Paravalvular Leakage Due to a Paravalvular Abscess: A case report.
Chan Beom PARK ; Yong Han KIM ; Jong Bum KWEON ; Kuhn PARK ; Mee Young CHUNG ; Ung JIN ; Tae Ho ROH ; Chi Kyung KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2008;41(2):268-272
Paravalvular abscess is defined as infective necrosis of the mitral annulus and surrounding tissue that requires debridement of the necrotic tissue and patch reconstruction before valve implantation. Paravalvular abscess is associated with high operative mortality, postoperative complications, and recurrence. We report here a case of a 59-year old woman that had undergone mitral valvular replacement with a mechanical valve 13 years ago. The patient was determined to have paravalvular leakage due to paravalvular abscess as seen during follow-up. The patient underwent repeat mitral valvular replacement with annular reconstruction. However, the patient with mitral annular reconstruction and valvular replacement on the fifteenth postoperative day due to recurrence of paravalvular leakage. The patient is now receiving follow-up eight months after surgery.
Abscess
;
Debridement
;
Endocarditis
;
Female
;
Follow-Up Studies
;
Humans
;
Mitral Valve
;
Necrosis
;
Postoperative Complications
;
Recurrence
;
Reoperation
6.Postoperative Atrial Fibrillation after Isolated Coronary Artery Bypass Graft Surgery.
Jong Hui SUH ; Chan Beom PARK ; Mi Hyoung MOON ; Jong Bum KWEON ; Young Du KIM ; Ung JIN ; Seok Whan MOON ; Chi Kyung KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2009;42(1):14-21
BACKGROUND: Postoperative atrial fibrillation (AF) is a common complication after coronary artery bypass graft (CABG) surgery. Although postoperative AF is regarded as benign, transient and self-limited, it has been associated with increased morbidity, thromboembolic events and an increased duration and cost of hospitalization. MATERIAL AND METHOD: From January 1994 to December 2007, 190 patients that had isolated CABG surgery were divided into two groups. Group 1 (n=139) involved those who had postoperative atrial fibrillation, and group 2 (n=51) did not have any such events. We reviewed the medical records retrospectively including the incidence of postoperative AF, patient characteristics, surgery related factors and the outcome of the patients with postoperative AF. RESULT: The frequency of postoperative AF was 26.8%, the conversion rate to regular sinus rhythm before discharge was 82.4%; 82.4% of the AF developed within the first three postoperative days. Although the postoperative AF group was significantly older and had a prolonged postoperative Intensive care unit (ICU) stay, there was no difference in the aortic crossclamp time or duration of hospitalization. No spontaneous defibrillation at declamping, and longer duration of cardiopulmonary bypass were significantly related to the development of postoperative AF. However, postoperative treatment with a beta blocker was associated with a decreased incidence of postoperative AF. The multivariate analysis showed that age and ICU stay were significantly associated with the development of POAF. Spontaneous defibrillation and postoperative beta blocker treatment were significantly associated with a decreased frequency of POAF. CONCLUSION: AF after CABG surgery is a common complication associated with increased morbidity and a longer ICU stay. Therefore, various strategies aimed at reducing AF, and its complications, such as postoperative treatment with a beta blocker should be considered.
Arrhythmias, Cardiac
;
Atrial Fibrillation
;
Cardiopulmonary Bypass
;
Coronary Artery Bypass
;
Coronary Vessels
;
Hospitalization
;
Humans
;
Incidence
;
Intensive Care Units
;
Medical Records
;
Multivariate Analysis
;
Retrospective Studies
;
Transplants
7.Altered Expression of beta3 Integrin on Sclerotic Aortic Valves in a Hypercholesterolemic Rabbit Model.
Chan Beom PARK ; Young Du KIM ; Misun CHOE ; Ung JIN ; Seok Whan MOON ; Yong Han KIM ; Chi Kyung KIM ; Keon Hyon JO ; Jong Bum KWEON
The Korean Journal of Thoracic and Cardiovascular Surgery 2008;41(6):687-694
BACKGROUND: Although aortic valve sclerosis causes no significant hemodynamic alterations, it is associated with an increased risk of cardiovascular death and myocardial infarction. However, the role of beta3 integrin in aortic valve sclerosis remains unclear. MATERIAL AND METHOD: Twenty male New Zealand rabbits were divided into two groups. Group 1 rabbits (n=10) received a normal chow diet, while group 2 (n=10) rabbits received a diet containing 1% cholesterol for 12 weeks. After the rabbits were euthanized, their aortic valves and ascending aortas were excised for analysis. RESULT: Total serum cholesterol (2,148.3+/-1,012.5 mg/dL versus 53.7+/-31.8 mg/dL, p<0.05), triglyceride (240.4+/-218.3 mg/dL versus 31.6+/-6.4 mg/dL, p<0.05), and low density lipoprotein (LDL)-cholesterol (2,065.3+/-960.9 mg/dL versus 29.1+/-30.9 mg/dL, p<0.05) levels were significantly higher in the cholesterol diet group compared with the normal diet group. Myofibroblasts and macrophages were more highly expressed in the aortic valve leaflets of rabbits in the cholesterol diet group than of those in the normal diet group. A real-time polymerase chain reaction revealed decreased beta3 integrin mRNA levels in the hypercholesterolemic aortic valves and aortas. CONCLUSION: The present study shows that hypercholesterolemia induces aortic valve sclerosis. These findings suggest that alterations in beta3 integrin may play a role in the development of aortic valve sclerosis.
Aorta
;
Aortic Valve
;
Atherosclerosis
;
Cholesterol
;
Diet
;
Hemodynamics
;
Humans
;
Hypercholesterolemia
;
Integrin beta3
;
Integrins
;
Lipoproteins
;
Macrophages
;
Male
;
Myocardial Infarction
;
Myofibroblasts
;
Rabbits
;
Real-Time Polymerase Chain Reaction
;
RNA, Messenger
;
Sclerosis
8.Intrapleural Chemotherapy with Cisplatin and Cytarabine in the Management of Malignant Pleural Effusion.
Kee Won KIM ; Suk Young PARK ; Myung Sook KIM ; Seok Chan KIM ; Eun Hee LEE ; So Young SHIN ; Jong Ho LEE ; Jong Bum KWEON ; Kuhn PARK
Cancer Research and Treatment 2004;36(1):68-71
PURPOSE: The purpose of this study was to evaluate the efficacy of intrapleural chemotherapy (IPC) with cisplatin and cytarabine in the management of malignant pleural effusion (MPE) from non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: A prospective analysis was carried out on 40 patients with pathologically proven MPE from NSCLC who had received IPC. A single dose of cisplatin 100 mg/m2 plus cytarabine 1200 mg/m2 in 250 ml normal saline was instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicities and responses at 1, 2, & 3 weeks and then at monthly intervals if possible. Systemic chemotherapy was administered, if the patient agreed to receive it, after achieving complete control (CC) of MPE. RESULTS: The median duration of chest tube insertion for drainage was 7 (3~32) days. Among the assessable 37 patients, CC and partial control (PC) were 32 (86.5%) and 4 (10.8%) patients, respectively (overall response rate 97.3%). The median duration of response was 12 months (2~23) and there were only two relapses of IPC after achieving CC. Among the 35 patients who were assessable until they died, 28 patients (80.0%) maintained CC until the last follow-up. There was only one toxic death and the toxicities of IPC, versus the results obtained, were deemed acceptable. CONCLUSION: The procedures were tolerable to the patients and chemotherapy-induced complications were at an acceptable level. The outcome of this trial indicates that IPC has a superior and long lasting treatment response in the management of patients with MPE from NSCLC.
Chest Tubes
;
Cisplatin*
;
Cytarabine*
;
Drainage
;
Drug Therapy*
;
Follow-Up Studies
;
Humans
;
Lung Neoplasms
;
Pleural Effusion
;
Pleural Effusion, Malignant*
;
Prospective Studies
;
Recurrence
9.Efficacy of hyaluronic acid film on perianal wound healing in a rat model
Jung Rae CHO ; Myoung-Han LEE ; Heung-Kwon OH ; Hyojin KIM ; Dong-Keon KWEON ; So Min KANG ; Baek Kyu KIM ; Chan Yeong HEO ; Duck-Woo KIM ; Sung-Bum KANG
Annals of Surgical Treatment and Research 2021;101(4):206-213
Purpose:
Postoperative pain and delayed wound healing are the main complications following anal surgery associated with poor quality of life. Hyaluronic acid (HA) supports tissue regeneration and rapid wound healing by promoting cell proliferation and migration. We investigated the effects of HA on perianal wound healing in a rat model.
Methods:
Forty-eight 8-week-old Sprague-Dawley rats with perianal wounds created by biopsy punch were divided into 3 groups: simple dressing with gauze (control), dressing with topical HA film, and dressing with topical HA gel. HA agents were not reapplied postoperatively. Wound healing was evaluated by measuring the healed area, and histological analyses were randomly performed using hematoxylin and eosin and Masson trichrome staining.
Results:
Fewer mean days were required for complete wound healing in the HA film and HA gel groups than in the control group (11.6 vs. 11.9 vs. 13.8 days, respectively; P = 0.010). The healed area in the HA film group on day 11 was larger than that in the HA gel and control groups (80.2% vs. 61.9% vs. 53.2%, respectively; P < 0.001). Histologically, the HA film group showed accelerated reepithelialization, a rapid transition to lymphocyte-predominant inflammation, and increased fibroblastic proliferation and collagen deposition compared to the other groups. There was no treatment-related toxicity in the HA application groups.
Conclusion
Topical application of HA film to perianal wounds improves the wound healing rate in a rat model. This finding suggests a potential benefit of HA film application in promoting wound healing after anal surgery in humans.
10.Epidemiology of infectious KeratitisI A Multi-center Study.
Young Hoo HAHN ; Tae Won HAHN ; Si Hwan CHOI ; Kee yong CHOI ; Won Ryang WEE ; Ki San KIM ; Hyo Myung KIM ; Hung Won TCHAH ; Jang Hyun CHUNG ; Ha Bum LEE ; Jae Duck KIM ; Jae Chan KIM ; Kyung Hyun JIN ; Young Su YUN ; Yoon Won MYONG ; Wung Kun CHUNG ; Choun Ki JOO ; Man Soo KIM ; Myung Kyoo KO ; Eung Kweon KIM ; Jong Hyuck LEE ; Hyung Jun KIM ; Jin Hak LEE
Journal of the Korean Ophthalmological Society 1998;39(8):1633-1651
Infectious keratitis is the most common serious ocular infection, and may be caused by various bacteria, fungi, viruses and parasites. The authors performed prospectively an epidemiological study to identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis under the identical protocol from April 1995 to September 1997. Logistic regression analysis [univariate analysis and multivariate analysis] was used to evaluate possible risk factors. Six hundred sixty cases of infectious keratitis reported from 19 hospitals were studied. Two hundred eighty-three organisms[247 bacteria, 32 fungi, 4 acanthamoeba] were detected in 626 eyes with infectious keratitis excluding 34 pherpetic keratitis. The Pseudomonas aeruginosa, coagulase negative staphylococcus, Staphylococcus aureus and Serratia marcescens were the major orgnisms in bacterial keratitis. Aspergillus, Fusarium and Candida were the major isolates in fungal keratitis. Contact lens wear was a risk factor for bacterial keratitis. Female, age[less than 40 years] and occupation[student, house-wife, office worker, servise] were associated with bacterial keratitis. Risk factors in herpetic keratitis were age[between 40 and 59 years] and ocular adnexal diseases. Male was associated factor with herpetic keratitis.
Adnexal Diseases
;
Aspergillus
;
Bacteria
;
Candida
;
Coagulase
;
Epidemiologic Studies
;
Epidemiology*
;
Eye Infections
;
Female
;
Fungi
;
Fusarium
;
Humans
;
Keratitis
;
Keratitis, Herpetic
;
Logistic Models
;
Male
;
Parasites
;
Prospective Studies
;
Pseudomonas aeruginosa
;
Risk Factors
;
Serratia marcescens
;
Staphylococcus
;
Staphylococcus aureus