We report a case of mature cystic teratoma of the anterior mediastinum that ruptured into the pulmonary artery requiring an emergent surgical treatment. A 39-year-old woman presented an episode of massive hemoptysis and treated with bronchial artery embolization (BAE). On the 10th day after BAE, however, she developed sudden massive hemoptysis and had a deteriorated mental status. For a definitive treatment, she underwent the left pneumonectomy and the tumor resection in the anterior mediastinum. On histologic examination, the tumor disclosed cystic structures composed of mature squamous epithelium, pilosebaceous glands, mature fat tissue, cartilage and bone tissue. Also, there was intrapulmonary hemorrhage due to left pulmonary artery invasion of the tumor.
Adult ; Bone and Bones ; Bronchial Arteries ; Cartilage ; Epithelium ; Female ; Hemoptysis ; Hemorrhage ; Humans ; Lung ; Mediastinum ; Pneumonectomy ; Pulmonary Artery* ; Teratoma*

OBJECTIVE: In applying Electro-Convulsive Therapy(ECT) to patients, initial electric stimuli have been often determined without the adequate guidelines. This study was designed to determine adequate numerical value of parameters for initial electric stimuli inducing seizure successfully in ECT. We prepared Asan Medical Center(AMC) guidelines for 4 parameters based on our clinical experiences and MECTA(Monitored Electro-Convulsive Therapy Apparatus, MECTA Crop(R)) instruction manual, and investigated the success rate in the first session of ECT following AMC guidelines for parameters. METHOD: Twenty-two patients(male 10, female 12) treated with ECT using MECTA SR-1 model in Asan Medical Center between september 1996 and october 1998 were included in this study. We carried out bilateral ECT under anesthesia according to AMC guidelines. Seizure that persisted longer than 20 seconds was considered successful. RESULTS: 18 of 22 patients showed successful seizures in the first session (82%). Four patients failed to show successful seizures. One out of the foiled patients received inadequate stimuli due to premature release of switch burton and two patients were taking continuously anticonvulsants and anxiolytics, respectively prior to ECT. But all foiled patients except one, who was thought to have unusually high seizure threshold, demonstrated successful seizures in the second session with the same initial parameters. CONCLUSIONS: The bilateral ECT according to AMC guidelines resulted in the adequate seizures in all patients except one patient who had unusually high seizure threshold. These data show that AMC guidelines can be successfully applied in ECT using MECTA device.
Anesthesia ; Anti-Anxiety Agents ; Anticonvulsants ; Chungcheongnam-do ; Female ; Humans ; Seizures

No abstract available.
alpha-Fetoproteins* ; Mass Screening*

BACKGROUND: A critical shortage of donor organs has necessitated an investigation of new strategies to increase the availability of additional organs available for human transplantation. We investigated the amount of apoptosis and expression of GADD45beta in two groups, a GADD45beta-transfected group and untransfected group. MATERIAL AND METHOD: The experimental groups consist of a control group (normal H9C2 cell line) and GADD45beta-transfected group. After injury of the each group, we evaluated the expression of GADD45beta and the level of apoptosis in each group. RESULT: There was a significant increase in the expression of GADD45beta in the GADD45beta-transfected group at 1 hour, 2 hours, and 3 hours after stimuli as compared with the control group. The amount of cardiac myoblast cell line apoptosis was significantly lower in the GADD45beta-transfected group as compared with the control group. The concentration of annexin in the GADD45beta-transfected group was significantly lower than that of the control group after cell injury. CONCLUSION: Transfection of a rat myoblast cell line with the GADD45beta gene results in decreased susceptibility to cell injury of human serum.
Animals ; Apoptosis ; Cell Line ; Humans ; Myoblasts ; Myoblasts, Cardiac ; Rats ; Tissue Donors ; Transfection ; Transplantation, Heterologous ; Transplants

PURPOSE: Aeroallergens are important causative factors of allergic diseases. Previous studies on aeroallergen sensitization rates investigated patients groups that had visited pediatric allergy clinics. In contrast, we investigated sensitization rates in a general population group of elementary school to teenage students in Incheon, Jeju, and Ulsan. METHODS: After obtaining parental consent, skin-prick tests were performed on 5,094 students between March and June 2010. Elementary school students were tested for 18 common aeroallergens, whereas middle and high school students were tested for 25 allergens. The 25 allergens included Dermatophagoides pteronyssinus, Dermatophagoides farinae, pollen (birch, alder, oak, Japanese cedar, pine, willow, elm, maple, Bermuda grass, timothy grass, rye grass, orchard grass, meadow grass, vernal grass, mugwort, Japanese hop, fat hen, ragweed, and plantain), and mold (Penicillatum, Aspergillus, Cladosporium, and Alternaria). RESULTS: The sensitization rates in descending order were 25.79% (D. pteronyssinus), 18.66% (D. farinae), 6.20% (mugwort), and 4.07% (willow) in Incheon; 33.35% (D. pteronyssinus), 24.78% (D. farinae), 15.36% (Japanese cedar), and 7.33% (Alternaria) in Jeju; and 32.79% (D. pteronyssinus), 30.27% (D. farinae), 10.13% (alder), and 8.68% (birch) in Ulsan. The dust mite allergen showed the highest sensitization rate among the 3 regions. The sensitization rate of tree pollen was the highest in Ulsan, whereas that of Alternaria was the highest in Jeju. The ragweed sensitization rates were 0.99% in Incheon, 1.07% in Jeju, and 0.81% in Ulsan. CONCLUSION: The differences in sensitization rates were because of different regional environmental conditions and distinct surrounding biological species. Hence, subsequent nationwide studies are required.
Acer ; Allergens ; Alnus ; Alternaria ; Ambrosia ; Artemisia ; Asian Continental Ancestry Group ; Aspergillus ; Child ; Cladosporium ; Cryptomeria ; Cynodon ; Dactylis ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Fungi ; Humans ; Humulus ; Hypersensitivity ; Lolium ; Mites ; Parental Consent ; Phleum ; Poaceae ; Pollen ; Population Groups ; Salix

PURPOSE: The diagnosis of allergic rhinitis (AR) is based upon the concordance between a history of allergic symptoms and diagnostic tests. This study is to investigate the epidemiology of AR by using data from National Health Insurance Corporation (NHIC) and data according to the AR definition in general students health screening. METHODS: We examined medical insurance claims data of NHIC from 2004 to 2010 according to age, area, and gender. We investigated the results of Korean International Study of Asthma and Allergies in Childhood questionnaires and skin prick tests of 14,133 students participated in health screening from 2010 to 2012. RESULTS: The prevalence of AR according to the NHIC data was elementary school students (24.34%); middle school students (13.75%) and high school students (12.17%). The prevalence of AR was higher in boy than in girl, annually. In health screening, the prevalence of AR was elementary school students (19.50%+/-0.26); middle school students (23.19%+/-0.30) and high school students (24.11%+/-0.31). The prevalence of AR had peaking at the age late teens (P<0.0001) and was higher in boy (26.49%+/-0.38) than in girl (17.43%+/-0.35) (P<0.0001). Sensitization rate of allergen in students with AR was house dust mite (86.71%+/-0.48); pollen (41.26%+/-1.01) and molds (14.80%+/-0.52). CONCLUSION: The prevalence according to the AR definition tended to be increased with aging in Korean children. There are some differences in the prevalence of AR in the data of NHIC and health screening study. Further investigation will be needed to reveal the causes of this difference.
Adolescent ; Aging ; Asthma ; Child* ; Diagnosis ; Diagnostic Tests, Routine ; Epidemiology* ; Female ; Fungi ; Humans ; Hypersensitivity ; Insurance ; Male ; Mass Screening ; National Health Programs ; Pollen ; Prevalence ; Pyroglyphidae ; Rhinitis* ; Skin ; Surveys and Questionnaires

BACKGROUND/AIMS: Brain and bone metastases are common in patients with lung cancer. The development of metastasis is associated with poor survival in lung cancer patients. Although tumor morphologic features on radiographs are routinely assessed for differentiation between benign and malignant lung nodules, they are not used to predict metastasis. We assessed morphologic features of pulmonary adenocarcinomas with brain/bone metastasis on computed tomography (CT) to identify related factors for metastasis. METHODS: We performed a retrospective analysis of initial chest CT findings (size, type of contour, percentage of necrosis, enhancement, presence or absence of calcification, and air cavity) from 2009 to 2010 of patients with brain or bone metastasis and compared the findings with those of patients without metastases. RESULTS: In total, 128 patients were included (78 men, 52 women; mean age 69 years; range, 36 to 87). Nineteen patients had brain metastases and 32 had bone metastases. Morphologic features associated with brain metastasis included size ≥ 50 mm (odds ratio [OR], 3.37; 95% confidence interval [CI], 1.24 to 9.17; p = 0.013), necrosis ≥ 30% (OR, 4.51; 95% CI, 1.62 to 12.55; p =0.002), and presence of calcification (OR, 3.97; 95% CI, 1.16 to 13.55; p = 0.035). Morphologic features associated with bone metastasis included necrosis ≥ 30% (OR, 4.639; 95% CI, 1.98 to 10.82; p < 0.001) and T 3 to 4 stage (OR, 2.53; 95% CI, 1.07 to 6.00; p = 0.031). CONCLUSIONS: We found that necrosis ≥ 30% was associated with pulmonary adenocarcinoma with brain and bone metastasis at initial chest CT morphologic feature. To validate these results, further research should be conducted.
Adenocarcinoma* ; Brain ; Female ; Humans ; Lung ; Lung Neoplasms ; Male ; Necrosis ; Neoplasm Metastasis* ; Retrospective Studies ; Tomography, X-Ray Computed

Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort Study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35;95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection.