Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathologic syndrome of pulmonary inflammatory responses which has become increasingly recognized and has been described in association with a variety of disorders. We present a case of polymyositis associated with BOOP that responded to a corticosteroid therapy. The patient had a nonproductive cough, increasing dyspnea, fatigue, mild proximal limb weakness, and bilateral basal interstitial infiltrates on chest X-ray. This case will add further strength to the association of BOOP with polymyositis. (J Korean Neurol Assoc 19(5):547~549, 2001)
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cough ; Creatine Kinase ; Cryptogenic Organizing Pneumonia* ; Dyspnea ; Extremities ; Fatigue ; Humans ; Polymyositis* ; Thorax

The Mayer-Rokitanski-Kuster-Hauser Syndrome refers to the clinical entity consistingof primary amenorrhea associated with congenital absence of the vagina, 46XX Karyotype,a rudimentary uterus in the form of bilateral noncanaliculated muscular band or completeabsence, normal ovarian function and normal ovulation, normal breast development, bodyproportion and body hair, frequent associated of renal, skeletal and other congenitalanomalies. A case of Mayer-Rokitanski-Kuster-Hauser syndrome was presented and the literatureswere reviewed briefly.
Amenorrhea ; Breast ; Female ; Hair ; Ovulation ; Uterus ; Vagina*

Organ transplantation has become a' widely accepted treatment modality for end-stage organ disease. The shortage of allogenic donors for organ transplantation has brought about the necessity of xenotransplantation as an unlimited source of organ donation. However, organ transplantation between different species have never been successful because of hyperacute rejection. Although the mechanism of this phenomenon is not fully understood, many researchers believe that the natural antibodies present in the recipient's serum may bind to the graft and induce the activation of complement cascade triggering the process of hyperacute rejection. ...continue...
Antibodies ; Complement System Proteins ; Heterografts ; Humans ; Organ Transplantation ; Tissue and Organ Procurement ; Tissue Donors ; Transplantation, Heterologous ; Transplants

BACKGROUND: Efforts for improving surgical outcomes in elderly patients should include the prevention of perioperative complications and proper postoperative pain management. Epidural analgesia is effective in decreasing perioperative stress and postoperative complications, and in improving recovery. Recently, it has been suggested that epidural analgesia may attenuate immune suppression during the perioperative period and lead to reductions in cancer recurrence and improvements in overall survival. Assuming that these effects of epidural analgesia are present in vulnerable elderly patients, we compared the efficacy of epidural patient-controlled analgesia and intravenous patientcontrolled analgesia on postoperative outcomes in elderly patients who had undergone gastrectomy. METHODS: We evaluated 214 elderly patients who had undergone elective open gastrectomy for gastric cancer from 2011 to 2014. The demographic characteristics, analgesic efficacy, complications within the first 30 postoperative days, hospital stay, 24-month postoperative morbidity, cancer recurrence, and mortality were studied retrospectively. RESULTS: Two-hundred and five patients were analyzed. Eighty-five patients received epidural patient-controlled analgesia (EPCA group) and 120 patients received intravenous patient- controlled analgesia (IVPCA group). The maximum pain scores were decreased to a greater extent in the EPCA group on the day of the operation (P < 0.001) and on the first postoperative day (P = 0.001) when compared to the IVPCA group. The patients in the EPCA group also required less analgesics on the day of the operation (P = 0.033) than those in the IVPCA group. The effect of EPCA on complications within the first 30 postoperative days, 24-month postoperative morbidity, cancer recurrence, and mortality were negligible in our study. CONCLUSIONS: EPCA provided more effective pain control than IVPCA in elderly patients who had undergone elective gastric cancer surgery, but did not affect postoperative outcomes.
Aged* ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled* ; Analgesics ; Gastrectomy* ; Humans ; Length of Stay ; Mortality ; Pain, Postoperative ; Perioperative Period ; Postoperative Complications ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms

BACKGROUND: Efforts for improving surgical outcomes in elderly patients should include the prevention of perioperative complications and proper postoperative pain management. Epidural analgesia is effective in decreasing perioperative stress and postoperative complications, and in improving recovery. Recently, it has been suggested that epidural analgesia may attenuate immune suppression during the perioperative period and lead to reductions in cancer recurrence and improvements in overall survival. Assuming that these effects of epidural analgesia are present in vulnerable elderly patients, we compared the efficacy of epidural patient-controlled analgesia and intravenous patientcontrolled analgesia on postoperative outcomes in elderly patients who had undergone gastrectomy. METHODS: We evaluated 214 elderly patients who had undergone elective open gastrectomy for gastric cancer from 2011 to 2014. The demographic characteristics, analgesic efficacy, complications within the first 30 postoperative days, hospital stay, 24-month postoperative morbidity, cancer recurrence, and mortality were studied retrospectively. RESULTS: Two-hundred and five patients were analyzed. Eighty-five patients received epidural patient-controlled analgesia (EPCA group) and 120 patients received intravenous patient- controlled analgesia (IVPCA group). The maximum pain scores were decreased to a greater extent in the EPCA group on the day of the operation (P < 0.001) and on the first postoperative day (P = 0.001) when compared to the IVPCA group. The patients in the EPCA group also required less analgesics on the day of the operation (P = 0.033) than those in the IVPCA group. The effect of EPCA on complications within the first 30 postoperative days, 24-month postoperative morbidity, cancer recurrence, and mortality were negligible in our study. CONCLUSIONS: EPCA provided more effective pain control than IVPCA in elderly patients who had undergone elective gastric cancer surgery, but did not affect postoperative outcomes.
Aged* ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled* ; Analgesics ; Gastrectomy* ; Humans ; Length of Stay ; Mortality ; Pain, Postoperative ; Perioperative Period ; Postoperative Complications ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms

BACKGROUND/AIMS: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. METHODS: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. RESULTS: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and Deltaphosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. CONCLUSIONS: Preoperative ALP, preoperative iPTH, and Deltaphosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization.
Administration, Intravenous ; Administration, Oral ; Adult ; Aged ; Biomarkers/blood ; Calcium/blood ; Calcium Carbonate/*administration & dosage ; Calcium Compounds/*administration & dosage ; Calcium Gluconate/*administration & dosage ; *Decision Support Techniques ; *Dietary Supplements ; Female ; Humans ; Hyperparathyroidism, Secondary/blood/diagnosis/*surgery ; Hypocalcemia/diagnosis/etiology/*prevention & control ; Lactates/*administration & dosage ; Linear Models ; Male ; Middle Aged ; Models, Biological ; Multivariate Analysis ; Parathyroid Hormone/blood ; Parathyroidectomy/*adverse effects ; Phosphorus/blood ; Recurrence ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult

BACKGROUND: A prospective multicenter study was performed to make a surgical site infections (SSI) surveillance system for hip (HRA) and knee (KRA) replacement arthroplasties and gastrectomies (GAST) in Korea. The rates, risk factors, and clinical characteristics of SSI were evaluated. METHODS: Demographic data, clinical and operative risk factors for SSI, and information of prophylactic antibiotic uses for the patients who took HRA/KRA and GAST in 7 and 5 hospitals, respectively were collected during July through December of 2007. SSI surveillance for HRA/KRA and GAST was done for 1 year and 1 month after operations, respectively. RESULTS: A total of 1,294 cases (HRA, 342; KRA, 453; GAST, 499) were monitored for SSI. The SSI rates of HRA, KRA, and GAST were 1.75 (6/342), 1.10 (5/453), and 4.41 (22/499) per 100 operations, respectively. Diabetes mellitus (DM) was more frequently accompanied and the dates of hospitalization before operations were longer in the infected group than the non-infected group of HRA. DM was more frequently found in the infected groups of KRA and GAST. Reoperation, emergent operation, and transfusion were more frequent in the infected group of GAST. Prophylactic antibiotics were used in 1,279 operations (99%) and started within 60 minutes before skin incision in 93% (1,190/1,279). The most frequently used antibiotics were 1st generation cephalosporins. Prophylactic antibiotics were used in combination in 33 operations (3%) and the median duration of antibiotic use was 4 days (0-89). CONCLUSION: The SSI rates of HRA, KRA, and GAST in this SSI surveillance system were 1.75, 1.10, and 4.41 per 100 operations, respectively.
Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement ; Cephalosporins ; Chronology as Topic ; Diabetes Mellitus ; Gastrectomy ; Hip ; Hospitalization ; Humans ; Knee ; Korea ; Prospective Studies ; Reoperation ; Risk Factors ; Skin

PURPOSE: The optimal cytotoxic regimens have not been established for patients with non-small cell lung cancer (NSCLC) who develop disease progression on first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). MATERIALS AND METHODS: We conducted a multi-center randomized phase II trial to compare the clinical outcomes between pemetrexed plus cisplatin combination therapy followed by maintenance pemetrexed (PC) and pemetrexed monotherapy (P) after failure of first-line EGFR-TKI. The primary objective was progression-free survival (PFS), and secondary objectives included overall response rate (ORR), overall survival (OS), health-related quality of life (HRQOL), and safety and toxicity profiles. RESULTS: A total of 96 patientswere randomized, and 91 patientswere treated at 14 centers in Korea. The ORR was 34.8% (16/46) for the PC arm and 17.8% (8/45) for the P arm (p=0.066). With 23.4 months of follow-up, the median PFS was 5.4 months in the PC arm and 6.4 months in the P arm (p=0.114). The median OS was 17.9 months and 15.7 months in PC and P arms, respectively (p=0.787). Adverse events ≥ grade 3 were reported in 12 patients (26.1%) in the PC arm and nine patients (20.0%) in the P arm (p=0.491). The overall time trends of HRQOL were not significantly different between the two arms. CONCLUSION: The outcomes of pemetrexed therapy in NSCLC patients with disease progression after firstline EGFR-TKI might not be improved by adding cisplatin.
Arm ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Disease Progression ; Disease-Free Survival ; Epidermal Growth Factor ; Follow-Up Studies ; Humans ; Korea ; Lung Neoplasms ; Lung ; Pemetrexed ; Protein-Tyrosine Kinases ; Quality of Life ; Receptor, Epidermal Growth Factor ; Tyrosine