No abstract available.
Arthralgia*

A study was carried out to figure the cases and to observe the endemic status of clonorchiasis and metagonimiasis in endemic areas in Korea. Total 13,373 inhabitants living in 40 villages along 7 main rivers and 9 small streams were subjected to stool examination. They were selected randomly among the riverside population. Their specimens were examined both by cellphane thick smear method and Stoll's egg countung technique. This study was performed during the period from May 1979 to April 1980. The results obtained are as follows: The egg positive rate of any kind of helminths was 58.7% out of 13,373 examned cases, and the egg positive rates by each helminth were; Clonorchis sinensis 21.5%, Metagonimus yokogaqai 4.8%, large type Metagonimus eggs 0.4%, Ascaris lumbricoides 22.9%, Trichuris trichiura 35.2%, hookworm 0.2%, Taenia sp. 0.5%, Hymenolepis nana 0.07%, Paragonimus westermani 2 cases, Fasciola sp. 4 cases, Echinostoma sp. 1 case and Hymenolepis diminuta 1 case respectively. Many endemic foci of clonorchiasis were revealed along the 7 major rivers. The egg positive rates of each river basin differed from each other significantly; Nagdonggang 40.2%, Yeongsangang 30.8%, Seomjingang 17.3%, Hangang 15.7%, Tamjingang 15.9%, Geumgang 12.0% and Mangyeonggang 8.0%. The cases of clonorchiasis were estimated in range 830,000 to 890,000 in riverside areas of the 7 rivers. By grading the infection intensity, 64.7% was in Grade I(EPG 0-900), 28.6% in Grade II (EPG 1000-9,900), 5.5% in Grade III (EPG 10,000-29,900) and 1.3% in Grade IV (EPG over 30,000). The proportion of the cases in Grade III and IV was 6.8% among positive cases. Therefore 60,000 cases at least were regarded to suffer from it clinically. Males of 30-60 years of age showed higher positive rate and heavier burden of infection. This makes clonorchiasis more important socially because the patients lose their social productivity. A few endemic foci of metagonimiasis were detected newly by egg detection; Samcheong 28.5% egg positive rate, Uljin 21.3%, Yeuongdeog 46.3%, Milyang 6.7%, Yeongil 9.2% and Geoje 18.2%. The mean EPG values were in range of 320-7, 120 by the focus. The egg positive rate and proportion of EPG Grade varied greatly by the area, and mean proportion of the positive cases were 69.7% in Grade I, 24.1% in Grade II, 5.0% in Grade III and 1.2% in Grade IV. Males of 30-60 years were infected in higher rate also. The large sized eggs of Metagonimus were found also in upper basin of Hangang and Geumgang mainly. They were regarded as eggs of M. takahashii which is mediated by the cyprinid fishes. Its significance should be studied further. Clonorchiasis and metagonimiasis should be realized as important public health problems in Korea by their wide distribution, high prevalence rate and heavy infection intensity. Comprehensive measures against them are needed urgently.
parasitology-helminth-trematoda ; clonorchiasis ; metagonimiasis ; Clonorchisis sinensis ; Metagonimus yokogawai ; epidemiology

PURPOSE: A study was done to assess the incidence, clinical characteristics of urinary tract anomalies for decreasing urinary tract morbidity. METHODS: We review 98 cases of anomaly of urinary tract who were admitted Kyung Hee University Hospital between 1986 and 1995. We analyzed incidence and associated anomalies, associated diseases and treatment modalities. RESULTS: 1) It was composed of 45 cases (45%) of renal anomalies, 37 cases (37.7%) of ureteral anomalies, 7 cases (7.1%) of urethral anomalies, 3 cases Prune-belly syndrome, 3 cases of urachal remnants, 2 cases of bladder exstrophy, 1 cases of VATER syndrome. 2) Anomalies of the kidney were composed of 14 cases of renal agenesis, 11 cases of multicystic dysplastic kidney, 10 cases of hydronephrosis 3 cases of hypoplasia, 3 cases of polycystic kidney, 2 cases of ectopia, 1 case of malrotation and 1 case of horseshoe kidney, 20 cases (44.4%) were diagnosed before 1 month of life. 20 cases were male and 25 casses were female. Bilateral involvement were in 7 cases and 38 cases of unilateral involvement were composed of 23 cases of right side and 15 cases of left side. Operative treatment were performed in 15 cases (30%) of renal anomalies. The common chief complaint of renal anomalies were abnormal finding on urinalysis (24.4%), abnormal finding on fetal ultrasonogram (20%), gastrointestinal tract symptom (15.6%), and fever (9%). 3) Anomalies of the ureter were composed of 26 cases of ureteral duplication, 9 cases of UPJ obstruction, 2 cases of megaureter. Ureteric duplications included 8 cases of male and 18 cases of female and 19 cases were unilateral and 7 cases were bilateral. 19 cases were diagnosed before 5 years old. 19 cases (73.1%) had symptoms associated with urinary tract infection. 11 cases had abnormal finding of ipsilateral kidney on DMSA scan or IVP. Associated abnormalities were hydronephrosis, ureterocele and VUR. UPJ obstruction were mostly diagnosed before 1 month of life, 6 cases were male and 3 cases were female. 2 cases were bilateral and 3 cases were right side involvement and 4 cases were left side. CONCLUSIONS: It seems to be reasonable that we should recommend the patients with the symptoms of urinary tract diseases to do evaluate the possibility of congenital urinary tract anomalies.
Bladder Exstrophy ; Child* ; Child, Preschool ; Female ; Fever ; Gastrointestinal Tract ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Male ; Multicystic Dysplastic Kidney ; Polycystic Kidney Diseases ; Prune Belly Syndrome ; Succimer ; Ultrasonography ; Ureter ; Ureterocele ; Urinalysis ; Urinary Tract Infections ; Urinary Tract* ; Urologic Diseases

BACKGROUND: Epicardial fat tissue has unique endocrine and paracrine functions that affect the cardiac autonomic system. The head-up tilt test (HUTT) is a simple non-invasive measurement that assesses autonomic nervous system dysfunction. We investigated the association between epicardial fat thickness (EFT) and autonomic neural tone, such as vagal tone. METHODS: A total of 797 consecutive patients (mean age 46.5 years, male: 45.7%) who underwent HUTT and echocardiography between March 2006 and June 2015 were enrolled. EFT was measured during the diastolic phase of the parasternal long axis view. We excluded patients with prior percutaneous coronary intervention, old age (* 70 years old), valvular heart disease, symptomatic arrhythmias and diabetes. We divided patients into two groups based on the HUTT (positive vs. negative). RESULTS: There were 329 patients (41.3%) with a negative HUTT result and 468 patients (58.7%) with a positive result. The HUTT-positive patients showed a significantly lower waist circumference, body mass index and systolic and diastolic blood pressure, although a significantly higher EFT as compared to the HUTT-negative patients (HUTT-positive, 5.69 ± 1.76 mm vs. HUTT-negative, 5.24 ± 1.60 mm; p < 0.001). EFT > 5.4 mm was associated with a positive HUTT result with 51.7% sensitivity and 63.8% specificity (p < 0.001) on receiving operator characteristic analysis. Multivariate Cox regression analysis revealed that EFT (hazard ratio: 1.02, 95% confidence interval: 1.01–1.30, p = 0.004) was an independent predictor of HUTT-positivity. CONCLSION: EFT was significantly correlated with positive HUTT, which suggests an association between EFT and autonomic dysregulation.
Arrhythmias, Cardiac ; Autonomic Nervous System ; Blood Pressure ; Body Mass Index ; Echocardiography ; Heart Valve Diseases ; Humans ; Male ; Percutaneous Coronary Intervention ; Sensitivity and Specificity ; Syncope* ; Syncope, Vasovagal ; Waist Circumference

Rupture of the lumbar intervertebral disc into the dural sac is very rare. Total of 11 cases have been reported in the literatures. In Korea, one case of the intradural herniated disc of L4,5 interspace was reported at Seoul National University Hospital in 1972. Patients of the intradural herniated disc have usually a long history of recurrent low back pain and sudden exacerbation of symptoms with radiating pain on both lower extremities precipitated by minor trauma. A 47 years old female was admitted to Seoul National University Hospital complaining of wevere low back pain and radiating gluteal pain on both sides. She had had intermittent lumbago of 25 years' duration. Eight months prior to admission, radiating gluteal pain on both sides developed in addition to the aggravation of the lumbago due to minor back trauma. Physical and neurological examination showed local protrusion and the tenderness of the L3, L4 spinous process area, the hyperalgesia on the right L3, L4, and L5 dermatomes, no saddle anesthesia, normal dorsiflexion of both ankles and great toes, slight decrease of the right knee jerk and bilateral absence of the ankle jerk, and no sphincter dysfunction. Myelogram showed complete block at t he L3-4 interspace level. Total laminectomy of the L3 and L4 was done. When the dura was opened, a solid round mass of a thumb-tip size was seen occupying the whole dural sac, compressing the nerve roots. The mass was a herniated disc from L3-4 interspace that had ruptured through central part of the posterior longitudinal ligament and ventral dural wall. Protruded intradural mass was removed en masse after incision of the overlying arachnoid membrance and the remaining L3-4 interspace disc material was removed in pieces extradurally. The mass was revealed as a degenerated nucleus pulposus on microscopic examination. The patient had an uneventful recovery with improvement of the neurological deficits.
Anesthesia ; Ankle ; Arachnoid ; Female ; Humans ; Hyperalgesia ; Intervertebral Disc ; Intervertebral Disc Displacement ; Knee ; Korea ; Laminectomy ; Longitudinal Ligaments ; Low Back Pain ; Lower Extremity ; Middle Aged ; Neurologic Examination ; Rupture ; Seoul ; Toes

The venous thrombosis is the most common vascular event in Behcet's disease. Among the thrombotic complications of Behcet's disease, thrombosis in superior vena cava is rare, but once it happens, it may be life-threatening. In this report, we describe a case of 45-year-old female with Behcet's disease complicated by the superior vena cava thrombosis, which was treated successfully with the operation and then endovascular stenting. This case shows that endovascular stent may be one of good strategies for the management of vascular complication in Behcet's disease.
Female ; Humans ; Middle Aged ; Stents* ; Superior Vena Cava Syndrome* ; Thrombosis ; Vena Cava, Superior* ; Venous Thrombosis

PURPOSE: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. METHODS: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. RESULTS: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. CONCLUSION: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.
Acoustic Impedance Tests ; Congenital Abnormalities ; Evoked Potentials, Auditory, Brain Stem ; Follow-Up Studies ; Hearing ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Tests ; Humans ; Incidence ; Infant ; Infant, Newborn ; Insurance Coverage ; Intensive Care, Neonatal ; Mass Screening ; National Health Programs ; Otolaryngology ; Prevalence ; Reflex

One hundred and eighty one cases, which comfirmed tobe intussusception, were reviewed retrospectively to identify the differences between radiologic findings of reduced and nonreduced intussusceptions by barium enema. The number of cases of reduced intussusception was 148 and nonreduced was 33, so the rate of reduction was 82%. On conventional radiographs, air-fluid levels were seen in 23 cases(15.5%) of the reduced intussusception and in 18 cases(54.6%) of the nonreduced intussusception, and soft tissue masses were seen in 20 cases(13.5%) of the reduced intussusception and in 2 cases(36.4%) of the nonreduced intussusception. The mean value of a ratio of maximal diameter of small bowel to interpedicular distance of L3vertebral body was 0.93 in the reduced intussusception and 1.25 in the nonreduced intussusception. On barium enema, the dissection sign was seen in 33.1% of the reduced intussusception and in 75.8% of the nonreduced intussusception. The morphologic abnormalities of ascending colon were seen in 11.5% of the reduced intussusception and in 38.7% of the nonreduced intussusception. So, the findings of the air-fluid level soft tissue mass, marked small bowel dilatation, dissection sign and morphologic abnormality of ascending colon were more frequently seen in the nonreduced intussusception than the reduced cases. There was no correlation between the location of intussusceptum and the reduction rate.
Barium* ; Colon, Ascending ; Dilatation ; Enema* ; Intussusception* ; Retrospective Studies

Therapy-related ALL (t-ALL) is a rare secondary leukemia that develops after chemotherapy and/or radiotherapy for primary malignancies. Chromosomal 11q23 abnormalities are the most common karyotypic alterations in t-ALL. The t(11;19)(q23;p13) aberration is extremely rare and has not been confirmed at the molecular genetic level. Here, we report a case of t-ALL with t(11;19)(q23;p13.3) and MLL-MLLT1 (alias ENL) gene rearrangement confirmed by cytogenetic analysis, multiplex reverse transcription-PCR (multiplex RT-PCR), and DNA sequencing in a patient who had undergone treatment for breast cancer. A 40-yr-old woman developed acute leukemia 15 months after undergoing 6 cycles of adjuvant chemotherapy (doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2), radiation therapy (dose, 5,900 cGy), and anticancer endocrine therapy with tamoxifen. The complete blood cell counts and bone marrow examination showed increased blasts and the blasts showed B lineage immunophenotype (positive for CD19, CD34, and cytoplasmic CD79a). Cytogenetic analysis revealed the karyotype 47,XX,+X,t(11;19)(q23;p13.3)[4]/46,XX[16]. FISH analyses, multiplex RT-PCR, and DNA sequencing confirmed the MLL-MLLT1 gene rearrangement. The patient underwent induction chemotherapy with fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD) and achieved complete remission. Subsequently, she underwent consolidation chemotherapy, but died of brain ischemia in the pons and the region of the middle cerebral artery. To our knowledge, this is the first case report of t-ALL with t(11;19)(q23;p13.3) and the MLL-MLLT1 gene rearrangement.
Adult ; Antineoplastic Agents/therapeutic use ; Base Sequence ; Breast Neoplasms/drug therapy/radiotherapy ; *Chromosomes, Human, Pair 11 ; *Chromosomes, Human, Pair 19 ; Combined Modality Therapy ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Female ; Gene Rearrangement ; Humans ; Immunophenotyping ; Karyotyping ; Molecular Sequence Data ; Myeloid-Lymphoid Leukemia Protein/*genetics ; Neoplasm Proteins/*genetics ; Nuclear Proteins/*genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*diagnosis/genetics ; Sequence Analysis, DNA ; Tamoxifen/therapeutic use ; Transcription Factors/*genetics ; *Translocation, Genetic

Advances in neonatal intensive care have improved the chances for survival of extremely low birth weight (ELBW) infants. However, ELBW infants are at high risk of meningitis and resulting neurologic complications. The most common organisms associated with neonatal bacterial meningitis include Listeria monocytogenes, Escherichia coli, and Group B Streptococcus. Bacillus cereus (B. cereus), an organism commonly found in soil, vegetation, and daily products, can sometimes cause meningitis owing to preformed toxins. We report a rare case of meningoencephalitis caused by B. cereus that resulted in a detrimental neurological outcome in an ELBW infant.
Bacillus cereus* ; Escherichia coli ; Humans ; Infant ; Infant, Extremely Low Birth Weight* ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Listeria monocytogenes ; Meningitis ; Meningitis, Bacterial ; Meningoencephalitis* ; Soil ; Streptococcus