Megaloblastic anemia induced by Vitamin B12 deficiency is a disorder caused by impaired DNA synthesis. It has been previously thought to be rare in children, however, recent studies suggest that this condition is more common than previously recognized. Deficiency can lead to a wide spectrum of hematologic and neuropsychiatric disorders. Especially in children, it often presents with nonspecific manifestations, such as developmental delay, irritability, weakness, and failure to thrive. Early diagnosis and prompt treatment might resolve these complications, but permanent neurologic damage may have already occurred. We experienced two cases of Megaloblastic Anemia induced by Vitamin B12 deficiency and report them with a brief review of the literature.
Anemia, Megaloblastic* ; Child* ; DNA ; Early Diagnosis ; Failure to Thrive ; Humans ; Megaloblasts* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

OBJECTIVE: Ectopic pregnancy is still a major health problem among women of childbearing age, causes major maternal morbidity and mortality with pregnancy loss, and its incidence is increasing worldwide. This study is an analysis of the clinical profile of ectopic pregnancy, the current status of the incidence and the management options. METHODS: One hundred and seventy six cases of ectopic pregnancies managed at the Daedong Hospital between January 1998 and December 2002 were analyzed. RESULTS: The overall incidence of ectopic pregnancy was 1 in 28 pregnanciies and the most common age group was 31-35 years of age (35%). Nullipara was 34.6% and the cases who experienced artificial abortion was 76%. Twenty four percentages of cases had a history of previous abdominal surgery and 20% of patients reported a history of pelvic inflammatory disease. Common complaints of ectopic pregnancy were fallopian tube (91%), interstitial (6.2%), ovary (0.05%) and in tubal pregnancies, the most frequent site was ampullar (74%). Laparotomy was done in 64%, pelviscopic operation was done in 32% and the most common operative procedure was salpingectomy in 76%. CONCLUSION: Early diagnosis and appropriate management of ectopic pregnancy will remain the most effective means of reducing the mortality and morbidity, increasing the fertility. Ectopic pregnancy must be excluded in a sexually active woman with a positive pregnancy test, abdominal pain and vaginal bleeding. treatment should be tailored to individual needs.
Abdominal Pain ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertility ; Humans ; Incidence ; Laparotomy ; Mortality ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Salpingectomy ; Surgical Procedures, Operative ; Uterine Hemorrhage

Teratoma is one of germ cell tumor, common neoplasm in women of reproductive age, but it can arise at any age. Its malignant transformation is rare, less than 2%, frequently at older age. Nearly all the cases are squamous, sarcomatous and adenomatous transformation. Here we present a case of mixed transformation, adeno-squamous cell carcinoma with brief review of the concerned literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Teratoma*

In the past few years a wide variety of fetal abnormalities have been successfully prenatal diagnosed by maternal sonography. Early excision of the choledochal cyst in the newborn is considered to be the optimal treatment and may pose less risk to the patient than delayed surgical exploration. We present a new case diagnosed a choledochal cyst at 23 weeks gestation by routine ultrasound scanning. At 38 weeks gestation a female infant was born by spontaneous delivery. At 7 weeks of age the patient underwent a laparotomy performed cyst excision with Roux-en-Y hepaticojejunostomy. We experienced a case of choledochal cyst at prenatal sonography and report our case with a brief review of literature.
Choledochal Cyst* ; Female ; Humans ; Infant ; Infant, Newborn ; Laparotomy ; Pregnancy ; Prenatal Diagnosis* ; Ultrasonography

A total of 205 larval gnathostomes were collected from 18 (22.5%) of 80 red banded odd-tooth snakes, Dinodon rufozonatum rufozonatum, which had been smuggled from China and confiscated at Customs in Busan, Republic of Korea. In order to identify the species, some of the larvae were observed by a light microscope and a scanning electron microscope (SEM). The larvae were 2.18 x 0.29 mm in average size, and had a pair of lips at the anterior end, a muscular esophagus, 2 pairs of cervical sacs, and brownish intestines. The head bulb was characteristically equipped with 4 rows of hooklets; the average number of hooklets in each respective row was 38.6, 40.5, 41.5, and 43.7. In SEM views, the mouth evidenced a pair of lateral lips of equal size in a half-moon shape. Each lip featured a couple of labial papillae and a small amphid located between the 2 papillae. The hooklets on the head bulb had single-pointed, posteriorly-curved tips. The cuticular spines were larger and more densely distributed on the anterior part of the body, and decreased gradually in size and number toward the posterior body. On the basis of these morphological characteristics, the larvae were identified as the third stage larvae of Gnathostoma hispidum.
Animals ; China ; Colubridae/*parasitology ; Gnathostoma/*isolation & purification/pathogenicity/*ultrastructure ; Larva/ultrastructure ; Microscopy, Electron, Scanning/veterinary ; Muscles/parasitology ; Species Specificity ; Spirurida Infections/parasitology/*veterinary

A large-scale survey was conducted to investigate the infection status of fresh water fishes with Clonorchis sinensis metacercariae (CsMc) in 3 wide regions, which were tentatively divided by latitudinal levels of the Korean peninsula. A total of 4,071 freshwater fishes were collected from 3 regions, i.e., northern (Gangwon-do: 1,543 fish), middle (Chungcheongbuk-do and Gyeongsangbuk-do: 1,167 fish), and southern areas (Jeollanam-do, Ulsan-si, and Gyeongsangnam-do: 1,361 fish). Each fish was examined by the artificial digestion method from 2003 to 2010. In northern areas, only 11 (0.7%) fish of 2 species, Pungtungia herzi and Squalidus japonicus coreanus from Hantan-gang, Cheolwon-gun, Gangwon-do were infected with av. 2.6 CsMc. In middle areas, 149 (12.8%) fish were infected with av. 164 CsMc. In southern areas, 538 (39.5%) fish were infected with av. 159 CsMc. In the analysis of endemicity in 3 regions with an index fish, P. herzi, 9 (6.2%) of 146 P. herzi from northern areas were infected with av. 2.8 CsMc. In middle areas, 34 (31.8%) of 107 P. herzi were infected with av. 215 CsMc, and in southern areas, 158 (92.9%) of 170 P. herzi were infected with av. 409 CsMc. From these results, it has been confirmed that the infection status of fish with CsMc is obviously different among the 3 latitudinal regions of the Korean peninsula with higher prevalence and burden in southern regions.
Animals ; Clonorchiasis/epidemiology/parasitology/*veterinary ; Clonorchis sinensis/*isolation & purification ; Fish Diseases/*epidemiology/parasitology ; Fishes ; Fresh Water ; Korea/epidemiology ; Metacercariae ; Prevalence

We encountered an indigenous case of intestinal capillariasis with protein-losing enteropathy in the Republic of Korea. A 37-year-old man, residing in Sacheon-si, Gyeongsangnam-do, admitted to the Gyeongsang National University Hospital (GNUH) due to long-lasting diarrhea, abdominal pain, anasarca, and weight loss. He recalled that he frequently ate raw fish, especially the common blackish goby (Acanthogobius flavimanus) and has never been abroad. Under the suspicion of protein-losing enteropathy, he received various kinds of medical examinations, and was diagnosed as intestinal capillariasis based on characteristic sectional findings of nematode worms in the biopsied small intestine. Adults, juvenile worms, and eggs were also detected in the diarrheic stools collected before and after medication. The clinical symptoms became much better after treatment with albendazole 400 mg daily for 3 days, and all findings were in normal range in laboratory examinations performed after 1 month. The present study is the 6th Korean case of intestinal capillariasis and the 3rd indigenous one in the Republic of Korea.
Adult ; Albendazole/administration & dosage ; Animals ; Anthelmintics/administration & dosage ; Biopsy ; Capillaria/cytology/drug effects/*isolation & purification ; Diarrhea ; Enoplida Infections/drug therapy/parasitology/*pathology ; Feces/parasitology ; Female ; Helminthiasis/drug therapy/parasitology/*pathology ; Humans ; Intestinal Diseases, Parasitic/drug therapy/parasitology/*pathology ; Intestines/parasitology/pathology ; Male ; Protein-Losing Enteropathies/drug therapy/parasitology/*pathology ; Republic of Korea ; Treatment Outcome

Morphological characteristics of Mesocestoides lineatus tetrathyridia collected from Chinese snakes and their adults recovered from experimental animals were studied. The tetrathyridia were detected mainly in the mesentery of 2 snake species, Agkistrodon saxatilis (25%) and Elaphe schrenckii (20%). They were 1.73 by 1.02 mm in average size and had an invaginated scolex with 4 suckers. Adult tapeworms were recovered from 2 hamsters and 1 dog, which were orally infected with 5-10 larvae each. Adults from hamsters were about 32 cm long and those from a dog were about 58 cm long. The scolex was 0.56 mm in average width with 4 suckers of 0.17 by 0.15 mm in average size. Mature proglottids measured 0.29 by 0.91 mm (av.). Ovaries and vitellaria bilobed and located in the posterior portion of proglottids. The cirrus sac was oval-shaped and located median. Testes were follicular, distributed in both lateral fields of proglottids, and 41-52 in number per proglottid. Gravid proglottids were 1.84 by 1.39 mm (av.) with a characteristic paruterine organ. Eggs were 35 by 27 microm in average size with a hexacanth embryo. These morphological characteristics of adult worms were identical with those of M. lineatus reported previously. Therefore, it has been confirmed that the tetrathyridia detected in 2 species of Chinese snakes are the metacestodes of M. lineatus, and 2 snake species, A. saxatilis and E. schrenckii, play the role of intermediate hosts.
Animals ; Cestode Infections/*parasitology ; Cricetinae ; Dogs ; Larva ; Mesocestoides/anatomy & histology/*classification/isolation & purification ; Snakes/*parasitology

The present study was performed to investigate the infection status with Clonorchis sinensis metacercariae (CsMc) in fishes from 2 sites, the middle and lower reaches, of Tamjin-gang (River) in Jeollanam-do, the Republic of Korea. Total 1,132 fishes in 22 species were collected from the middle reaches in Jangheung-gun for 4 years (2014–2017) and 517 fishes in 17 species were also collected from the lower reaches in Gangjin-gun in 2014 and 2017. They were all individually examined with the artificial digestion method in our laboratory. CsMc were detected in 322 (28.5%) out of 1,132 fishes from Jangheung-gun, and in 161 (31.1%) out of 517 fishes from Gangjin-gun, and their densities were 51 and 57 per fish infected each. In the fish species with CsMc, positive rates were 61.5% in Jangheung-gun and 62.7% in Gangjin-gun. A total of 222 Pungtungia herzi were examined and they were all infected with CsMc. The average intensity was 103 CsMc in the index fish, P. herzi (95 in Jangheung-gun and 121 in Gangjin-gun). In P. herzi bimonthly examined in 2017, the intensity was commonly most higher in March in 2 surveyed sites, however the significant seasonal endemicity was not showed. Conclusively, it was confirmed that CsMc is more or less prevalent in fishes from Tamjin-gang and their endemicity is higher in fish from the lower reaches in Gangjin-gun than the middle reaches in Jangheung-gun in Jeollanam-do, Korea.
Clonorchis sinensis ; Digestion ; Fishes ; Jeollanam-do ; Korea ; Metacercariae ; Methods ; Republic of Korea ; Seasons

To grasp the infection status of Metagonimus spp. metacercariae (MsMc), the freshwater fishes were surveyed from Seomjin-gang (river) and Tamjin-gang in the Republic of Korea. Total 1,604 fishes from 7 local sites of Seomjin-gang and 1,649 fishes from 2 sites of Tamjin-gang were examined for 6 years (2012–2017) by the artificial digestion method. MsMc were detected in fishes from 7 sites, i.e., Osucheon in Imsil-gun (36.3% fish in 6 spp.), Seomjin-gang in Sunchanggun (49.8% in 18 spp.), Songdaecheon in Namwon-si (64.5% in 8 spp.), Seomjin-gang in Gokseong-gun (72.4% in 14 spp.) and in Gurye-gun (78.8% in 17 spp.), Hoengcheon (75.9% in 11 spp.) and Namsancheon (58.9% in 7 spp.) in Hadong-gun. Their average densities were 4.2, 86.8, 39.9, 43.1, 246.5, 173.6 and 67.5 per fish infected respectively. Prevalence with MsMc in rasborinid fish from Seomjin-gang was 89.2% and their intensity was 73.6 per fish infected. Endemicities of MsMc in rasborinid fish from Seomjin-gang were significantly higher in fishes from the lower reaches (prevalence: 98.7%; density: 137) rather than in fishes from the middle (93.5%; 38) and upper (72.4%; 13) reaches. MsMc were also detected in 56.1% and 66.4% fishes from 2 surveyed areas, i.e., the middle reaches in Jangheung-gun and the lower reaches in Gangjin-gun, of Tamjin-gang, and their densities were 147 and 121 per fish infected. In susceptible fishes from Tamjin-gang, the prevalence was 84.1% and density was 227 per fish infected. By the present study, it was confirmed that MsMc is highly prevalent in the fishes from Seomjin-gang and Tamjin-gang in Korea.
Digestion ; Fishes ; Fresh Water ; Hand Strength ; Heterophyidae ; Korea ; Metacercariae ; Methods ; Prevalence ; Republic of Korea