No abstract available.
Child* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant* ; Poisoning*

Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.

Hepatocellular carcinoma (HCC) is the most common form of liver malignancy. Spontaneous regression of HCC is extremely rare phenomenon and mechanism of regression remains ob-scure. 75-year-old woman previously diagnosed with hepatitis C virus-related liver cirrhosis was found to have single mass in liver with elevation of alpha-fetoprotein level to 10,320 ng/mL. Transarterial chemoembolization (TACE) was performed. 27 months after TACE recurred HCC with multiple lung nodules were confirmed. The patient refused any therapeutic modality. The patient underwent follow-up without any anti-cancer treatment. 8 months after recur-rence follow up computed tomography scan revealed spontaneous regression of HCC and completely disappeared lung nodules. The patient is currently doing well and without any evidence of recurrence. The causes of spontaneous regression of HCC are not well understood. Proposed mechanisms are ischemic injury, biological factors, herbal medicine, immunological variations. Further studies are necessary to improve our understanding of this rare phenom-enon.
Aged ; alpha-Fetoproteins ; Biological Factors ; Carcinoma, Hepatocellular* ; Chemoembolization, Therapeutic ; Female ; Follow-Up Studies ; Hepatitis C ; Herbal Medicine ; Humans ; Liver ; Liver Cirrhosis ; Lung* ; Neoplasm Metastasis* ; Neoplasm Regression, Spontaneous ; Recurrence

OBJECTIVE: To investigate the clinical efficacy of urgent cerclage on perinatal outcome in cervical incompetence predicted by transvaginal ultrasonography in second trimester. METHODS: We reviewed the medical records of 27 pregnant women who received urgent cerclage at Asan Medical Center between January, 1998 and August, 2002. When the cervical length was less than 25 mm and abnormal cervical shape by transvaginal ultrasonography in second trimester, we performed urgent cerclage. Abnormal cervical shapes were categorized as U-shape, Y-shape and V-shape. These data were compared with those of 102 patients who received prophylactic cerclage and 25 patients who received emergent cerclage during the same period. Analysis of variance and chi-square test were used for statistical analysis. P<0.05 was considered statistically significant. RESULTS: In urgent cerclage, the mean gestational age at delivery was 35.1 +/- 4.4 weeks. The mean birth weight was 2524.2 +/- 860.8 gm and perinatal survival rate was 92.6% (25/27). We compared these data with the other two cerclages. In prophylactic cerclage, the mean gestational age at delivery was 36.2 +/- 4.6 weeks. The mean birth weight was 2711.5 +/- 860.8 gm and perinatal survival rate was 94.1% (96/102). There was no statistically significant difference between urgent cerclage and prophylactic cerclage. In emergent cerclage, the mean gestational age at delivery was 27.5 +/- 6.9 weeks. The mean birth weight was 1373.8 +/- 1196.7 gm and perinatal survival rate was 48.0% (12/25). There was statistically significant difference between urgent cerclage and emergent cerclage based on our finding, The gestational age, birth weight and perinatal survival rate in urgent cerclage were not different from prophylactic cerclage. However, in emergent cerclage, these data were different from the other two cerclages. CONCLUSION: These data suggest that perinatal outcomes after urgent cerclage were comparable to those of prophylactic cerclage. Urgent cerclage could be a valuable alternative to a policy of uniform prophylactic cerclage.
Birth Weight ; Chungcheongnam-do ; Female ; Gestational Age ; Humans ; Medical Records ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Survival Rate ; Ultrasonography*

Human listeriosis is a relatively rare but serious disease with mortality rate 20~40%. Listeria monocytogenes affects patients with decreased cell mediated immunity such as the elderly, transplant recipients, cancer patients, renal failure, diabetes, HIV, pregnant women and unborn child, neonate. We experienced a case of listeriosis in twin pregnant woman at 35th weeks without preterm labor. The pregnant woman present sepsis with fever at first time. Sepsis progress to MODS (multiple organ dysfunction syndrome) and combined endocarditis. We reported it with brief of literatures.
Aged ; Child ; Endocarditis ; Female ; Fever ; HIV ; Humans ; Immunity, Cellular ; Infant, Newborn ; Listeria ; Listeria monocytogenes ; Listeriosis ; Multiple Organ Failure ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin ; Pregnant Women ; Renal Insufficiency ; Sepsis

PURPOSE: To evaluate the utility of dual-exposure dual-energy radiography against the standard chest radiography in the discrimination of lung nodules and the presence of nodule calcification. MATERIALS AND METHODS: Twenty-nine patients with a total of 43 peripheral lung nodules were examined by dual-exposure dual-energy radiography (DER) and confirmed by a chest CT were included in the study. Of the identified peripheral lung nodules, 24 showed calcification and 19 did not. Further, 28 lesion-free regions from the same patient population were selected as negative controls. Two radiologists evaluated 71 marked locations using both standard chest radiographs (SR) and DER to determine whether the marked locations represented a true nodule, and whether nodule calcification was present. A continuous rating scale of 0-10 was used to represent each observer's confidence level. We calculated the areas under ROC curves (AUC) for SR alone and for DER, and performed a statistical analysis to compare the results. RESULTS: The ability to discriminate nodules was higher for DER than for SR. However, the was not statistically significant (p = 0.202). Inter-observer agreement was moderate regardless of if DER was used. The predictability of nodule calcification was significantly higher for DER compared to SR (p < .001). Moreover, inter-observer agreement was slight with SR alone but moderate with DER. CONCLUSION: DER, in conjunction with SR, has no additional benefit in small lung nodule discrimination but does provide a significant benefit in the characterization of nodule calcification.
Discrimination (Psychology) ; Humans ; Lung ; Lung Diseases ; Radiography, Dual-Energy Scanned Projection ; ROC Curve ; Thorax

PURPOSE: The study for bronchiectasis in children is rare in Korea. The aim of this study was investigate the clinical characteristic and associated etiology in pediatric patients with bronchiectasis. METHODS: We studied 29 pediatirc patients with bronchiectasis from January 2008 to December 2012 at Pusan National University Hospital. The age, sex, clinical symptoms, signs, radiologic findings, associated etiologic factors, and clinical course were investigated retrospectively. RESULTS: The median age at the time of diagnosis of bronchiectasis was 8.7 years. Chronic coughing was the most common symptom. The associated etiologies were immunodeficiency (31.0%), respiratory infection (27.6%), bronchiolitis obliterans (13.8%), interstitial lung disease (10.3%). The median age at the time of diagnosis of bronchiectasis in immunodeficient patients was 8.3 years. Post infectious bronchiectasis and severe respiratory symptom tend to occur in younger children. CONCLUSION: The risk factors of bronchiectasis in children are immunodeficiency and respiratory infection. Physicians should evaluate bronchiectasis in children with chronic cough.
Bronchiectasis* ; Bronchiolitis Obliterans ; Busan ; Child* ; Cough ; Diagnosis ; Humans ; Korea ; Lung Diseases, Interstitial ; Retrospective Studies ; Risk Factors

Cranial capacity was measured in Korean adult skulls. The cavity was filled with rice seeds and the volume of the seeds were measured in a graduated cylinder. The results were 1470 +/- 107 (mean +/- standard deviation) in male and 1317 +/- 117 cc in female skulls. These values were in good accordance with those previously reported. In addition, regression formulae were obtained with the product of the length, breadth, and height of the skull as an independent parameter and the measured capacity as a dependent one. With known external measurements, the expected cranial capacity was as follows: when using baso-bregmatic height, male: capacity = 307.5 + 333 x 10(-6) x (length.breadth.baso-bregmatic height) female: capacity = -12.0 + 435 x 10(-6) x (length.breadth.baso-bregmatic height) and, when using auriculo-bregmatic height, male: capacity = 214.6 + 429 x 10(-6) x (length.breadth.auriculo-bregmatic height) female: capacity = 131.6 + 461 x 10(-6) x (length.breadth.auriculo-bregmatic height).
Adult ; Aged ; Brain/*anatomy & histology ; Female ; Human ; Male ; Middle Age ; Sex Factors ; Support, Non-U.S. Gov't

BACKGROUND/AIMS: Cardiovascular complications are commonly seen in patients with chronic kidney disease (CKD). Recently, the prevalence of left ventricular diastolic dysfunction (LVDD) has increased, and the importance of LVDD has emerged in patients with CKD. The objectives of this study were to identify diagnostic criteria for LVDD related to ischemic heart disease (IHD) and evaluate the prognostic impact of diastolic dysfunction in patients with CKD. METHODS: A total of 71 patients with CKD who were evaluated between January 2005 and May 2010 were included in this study. These patients were evaluated by conventional echocardiography and tissue Doppler imaging (TDI) for diastolic dysfunction. RESULTS: Diagnostic cutoff values for LVDD related to IHD were E/E' = 15.55 (sensitivity: 100%, specificity: 64.7%, p = 0.005) and E/A = 0.79 (sensitivity: 84.6%, specificity: 55.9%, p = 0.006). Group I consisted of 19 patients with an E/E' > 15.55 and E/A > 0.79. Group II consisted of the remaining patients. Factors contributing to LVDD were age, history of ischemic heart disease, anemia, and high low-density lipoprotein (LDL) level. Factors contributing to IHD were LVDD, smoking, high LDL level, and high parathyroid hormone (PTH) level. The disease-free survival for IHD was significantly lower in group I compared to group II (p = 0.001). However, there was no significant difference in overall survival between groups I and II (p = 0.177). CONCLUSIONS: Our study showed that moderate LVDD (E/E' > 15.55 and E/A > 0.79) in patients with CKD is positively associated with IHD.
Anemia ; Disease-Free Survival ; Echocardiography ; Heart Failure, Diastolic ; Humans ; Lipoproteins ; Myocardial Ischemia ; Parathyroid Hormone ; Prevalence ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Smoke ; Smoking

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the proliferation of dendritic cells resulting in local or systemic symptoms. The clinical symptoms of patients with Langerhans cell histiocytosis depend on the site and the degree of involvement. This article describes two case histories of unifocal bony Langerhans cell histiocytosis with mandibular involvement and further discusses the appropriate management of such via a review of the literature.