No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Humans ; Proteinuria*

PURPOSE: This study was conducted to evaluate the efficacy of 2 percutaneous breast biopsy techniques for diagnosing microcalcification: stereotactic Vacuum-assisted biopsy (VAB) and needle localization VAB. METHODS: Between November 2002 and September 2007, 138 patients underwent percutaneous breast biopsy for microcalcification. Of these, 59 patients underwent needle localization VAB and 79 patients underwent stereotactic VAB with using a prone-table mammographic unit, respectively. Patients with focally clustered microcalcification underwent stereotactic VAB. Patients with diffuse or deep seated microcalcification and patients with small breast underwent needle localization VAB. We retrospectively reviewed the characteristics of the lesions and the percutaneous biopsy results for all the cases. RESULTS: Percutaneous biopsy was successful in 135 cases (97.8%). Of the 135 successfully performed cases, 34 cases (25.2%) were malignant and there were 4 (11.8%) underestimations. For the stereotactic VAB group, 13 of the successfully performed 76 cases (17.1%) were malignant and there were 2 (15.4%) underestimations. In needle localization VAB group, 21 (36.6%) of the 59 cases were malignant and there were 2 (9.5%) underestimations. There was no major complication in all the cases. CONCLUSION: With using stereotactic VAB and needle localization VAB, we can biopsy accurately and safely in almost all cases with leaving only minimal scar. So, percutaneous biopsy can be considered as a substitute for surgical biopsy for microcalcification of the breast.
Biopsy ; Breast ; Cicatrix ; Humans ; Needles ; Retrospective Studies

PURPOSE: This study was conducted to evaluate the efficacy of 2 percutaneous breast biopsy techniques for diagnosing microcalcification: stereotactic Vacuum-assisted biopsy (VAB) and needle localization VAB. METHODS: Between November 2002 and September 2007, 138 patients underwent percutaneous breast biopsy for microcalcification. Of these, 59 patients underwent needle localization VAB and 79 patients underwent stereotactic VAB with using a prone-table mammographic unit, respectively. Patients with focally clustered microcalcification underwent stereotactic VAB. Patients with diffuse or deep seated microcalcification and patients with small breast underwent needle localization VAB. We retrospectively reviewed the characteristics of the lesions and the percutaneous biopsy results for all the cases. RESULTS: Percutaneous biopsy was successful in 135 cases (97.8%). Of the 135 successfully performed cases, 34 cases (25.2%) were malignant and there were 4 (11.8%) underestimations. For the stereotactic VAB group, 13 of the successfully performed 76 cases (17.1%) were malignant and there were 2 (15.4%) underestimations. In needle localization VAB group, 21 (36.6%) of the 59 cases were malignant and there were 2 (9.5%) underestimations. There was no major complication in all the cases. CONCLUSION: With using stereotactic VAB and needle localization VAB, we can biopsy accurately and safely in almost all cases with leaving only minimal scar. So, percutaneous biopsy can be considered as a substitute for surgical biopsy for microcalcification of the breast.
Biopsy ; Breast ; Cicatrix ; Humans ; Needles ; Retrospective Studies

PURPOSE: The tunneled hemodialysis catheter has been widely used for a temporary or an alternative permanent vascular access in patients requiring hemodialysis. The tunneled hemodialysis catheter is also widely used for a reliable vascular access in children who need stem cell transplantation. METHOD: We reviewed the results of 150 catheters inserted in 108 patients for the duration of the indwelling catheter, the complication rate and the reasons for insertion and removal. RESULT: The mean duration of the indwelling catheter was 5.7 months (1 d~52.2 mo). In the stem cell transplantation group, the mean duration of the indwelling catheter was significantly longer than for the hemodialysis group (mean: 9.9 mo vs. 3.6 mo, P<0.05). Fifty-one catheters (39.8%) were removed due to complications. The most common complications were infection (n=23: 17.9%) and dislocation (n=15: 11.7%). In the hemodialysis group, the complication-related catheter removal was more frequent than in the stem cell transplantation group (43.9% vs. 32.6%, P<0.05). CONCLUSION: The tunneled hemodialysis catheter remains a reliable short-term vascular access for hemodialysis and a good vascular access in stem cell transplantation.
Catheterization, Central Venous ; Catheters* ; Catheters, Indwelling ; Child* ; Dislocations ; Humans ; Renal Dialysis* ; Stem Cell Transplantation

Background: This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI). Methods: A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS−. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed. Results: Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS− group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI. Conclusion Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI.

BACKGROUND/AIMS: The natural history of severe erosive reflux disease in Korea remains uncertain. We aimed to evaluate endoscopic follow-up results in subjects with severe reflux esophagitis under routine clinical care. MATERIALS AND METHODS: A total 61,891 subjects underwent an upper endoscopic examination in the health check-up program from January 2007 to December 2013. We reviewed medical charts of patients who had been diagnosed with severe reflux esophagitis. The severity of reflux esophagitis was determined by the Los Angeles (LA) classification system. Patients underwent at least one follow up endoscopy after diagnosis of severe reflux esophagitis. We classified the patients into two groups; regressed in severity and remained unchanged, according to follow up endoscopic status. RESULTS: Based on endoscopic findings, 5,938 subjects (9.6%) were found to have reflux esopohagitis: 121 subjects (0.2%) in LA-C; 39 subjects (0.06%) in LA-D. Among 31 patients who had endoscopic follow-up, 23 patients (74.2%) showed regression from LA C/D to LA A/B or minimal change disease or normal. The mean follow up duration was 42.2 months in regression group and 53.2 months in no change group. All patients had been treated with proton pump inhibitors (PPIs) on a regular or on-demand basis. Age, sex, smoking, alcohol, exercise, hypertension, diabetes mellitus, dyslipidemia, sliding hiatal hernia, body mass index, waist circumference and duration of PPIs therapy did not significantly influence regression of severe reflux esophagitis. CONCLUSIONS: The majority of severe reflux esophagitis patients under routine clinical care showed improvement on endoscopic follow-up.
Body Mass Index ; Classification ; Diabetes Mellitus ; Diagnosis ; Dyslipidemias ; Endoscopy* ; Esophagitis ; Esophagitis, Peptic* ; Follow-Up Studies* ; Gastroesophageal Reflux ; Hernia, Hiatal ; Humans ; Hypertension ; Korea* ; Natural History ; Nephrosis, Lipoid ; Proton Pump Inhibitors ; Smoke ; Smoking ; Waist Circumference

Congenital left atrial appendage aneurysm is a very rare congenital cardiac abnormality. That is postulated to arise from a developmental weakness in the atrial wall in utero. Clinically, patients are often asymptomatic and are diagnosed incidentally, but supraventricular arrhythmias and systemic thromboembolism have also been reported in some cases. Surgical resection at the time of diagnosis is recommended because of the propensity for thromboembolic complications. A 13-month-old female, who was suspected preoperatively as having partial absence of pericardium with left atrial herniation through the defect, underwent surgical resection of the left atrial appendage aneurysm. Exposure through a median sternotomy showed an intact pericardium. The postoperative course was uneventful.
Aneurysm* ; Arrhythmias, Cardiac ; Atrial Appendage* ; Diagnosis ; Female ; Humans ; Infant ; Pericardium ; Sternotomy ; Thromboembolism

BACKGROUND: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. MATERIAL AND METHOD: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6+/-9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). RESULT: The mean time interval from PAB to the second-stage operation was 15.5+/-8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. CONCLUSION: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.
Anemia, Hemolytic, Autoimmune ; Angioplasty ; Cardiac Output, Low ; Cause of Death ; Child* ; Diagnosis ; Estrogens, Conjugated (USP) ; Heart Failure ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Incidence ; Ligation ; Mortality ; Polyethylene Terephthalates ; Pulmonary Artery* ; Pulmonary Valve ; Risk Factors ; Thoracic Surgery*