Paragonimiasis is prevalent in Far East and a kind of endemic Korean disases. The primary site of humanparagonimiasis is the lung, but hte ectopic infection of lung fluke has been reported by many authors. Weexperienced one case of abdominal paragonimiasis in a 44 year old male with a complaint of left lowerquadrantpain. Physical examination, barium enema, and other data suggested the possibility of tumor originating from thewall of descending colon. (intramural tumor). Postoperative specimen taken from the solid tumorous lesion showedparasitic granuloma, characteristic of Paragonimus Westermani. Here, we report a case of very peculiar ectopicparagonimaisis involved descending colon wall simulating neoplastic tumor, and also review the literaturesbriefly.
Barium ; Colon ; Colon, Descending ; Enema ; Far East ; Granuloma ; Humans ; Lung ; Male ; Mesocolon ; Paragonimiasis ; Paragonimus westermani ; Physical Examination ; Trematoda

PURPOSE: The purpose of this study was to determine the current status of obesity intervention programs, and its effects on endothelium function in adolescents. METHOD: This was a descriptive research study, that investigated domestic and international literature 2009–2018. Using databases inside and outside of Korea to search for ‘adolescent’, ‘obese adolescent’, ‘exercise’, ‘program’, or ‘intervention’, and ‘endothelium function’, a total of 14 literature have been selected for 6 domestic research and 8 international research, excluding overlapping, case studies, literature reviews, and unrelated studies. RESULTS: Interventions for enhancing endothelium function were exercise program, diet, vitamin D3 treatment, and Orlistat intake relative to international research, and combined exercise and purple sweet potato intake, in most domestic research. Dependent variables included FMD, RHI, NMD, EPCs, and EMPs, for measuring endothelium function in international research, and PWV, FMD and RHI, in domestic research. CONCLUSION: Results of this study confirmed that application of obese intervention programs, may improve endothelium function in adolescents. Further studies are required, to develop nursing intervention, that would enhance endothelium function in adolescents.
Adolescent ; Cholecalciferol ; Diet ; Endothelium ; Humans ; Ipomoea batatas ; Korea ; Methods ; Nursing ; Obesity

Purpose: The purpose of this study was to estimate the medical expenditures for poisoning patients in Korea using data from National Health Insurance and the Korea Health Panel Survey. Methods: The operational definition of poisoning was the presence of Korean Standard Classification of Diseases codes from T36 to T65. The number of poisoning patients, the amount of legal copayments, and benefit and non-benefit costs were extracted from both databases. The frequency of emergency, inpatient, and outpatient treatment utilization by poisoning patients was determined, and medical expenses were calculated. Linear regression analyses were performed to investigate factors affecting the medical expenses of poisoning patients. Results: The number of poisoning patients increased from 97,965 in 2011 to 147,984 persons in 2020. Medical expenses also increased by 74% from Korean won (KRW) 30.1 billion to KRW 52.3 billion, and benefit costs also increased by 79%. The average outpatient cost per person was KRW 67,660, and the inpatient cost was KRW 1,485,103. The average non-benefit medical expenses were KRW 80,298, accounting for about 16.2% of the total expenses. Multivariable analysis showed that the total expenditure was associated with economic status and disabilities. Conclusion The average medical expenditure per poisoning patient was KRW 534,302 in 2020, and poisoning-related costs gradually increased during the study period. Further research on the economic burden of poisoning should include indirect costs and reflect disease-adjusted life years.

OBJECTIVE: To evaluate the usefulness of serum CA 125, CA 19-9, and eosinophil as biological markers for the diagnosis and recurrence of endometriosis. METHODS: One hundred seventeen patients who underwent operations for endometriosis between January 2000 and December 2006 at our department were included. A total of 50 reproductive aged women who visited our health care center were the control group. Data on serum level of CA 125, CA 19-9, and eosinophil was collected. Patients symptoms, sonographic findings, stage, treatment, recurrence were also collected. Venous blood sampling was performed 1 month before operation and 1 to 6 months after operation. We analyzed the serum level of CA 125, CA 19-9, and eosinophil according to the endometriosis stage and symptoms. We also analyzed the differences between preoperative and postoperative serum marker levels. RESULTS: The serum level of CA 125 and CA 19-9 was available in 88 patients and 45 patients, respectively. The mean eosinophil count was significantly lower in endometriosis group than in control group. In comparison between preoperative values and postoperative values, the CA 125 and CA 19-9 level showed significant reduction (P<0.05), however the eosinophil level showed no difference. The positive rate of serum CA 125 and CA 19-9 were 68.9% and 60.0% as a single test, whereas the combined positive rate of CA 125 and CA 19-9 was 82.2%. CONCLUSION: For the diagnosis and follow-up of endometriosis, serum CA 125 and CA 19-9 combination test will be valuable. Serum eosinophil count seems to be unsuitable for the screening and follow up test of endometriosis.
Aged ; Biomarkers ; Delivery of Health Care ; Endometriosis ; Eosinophils ; Female ; Follow-Up Studies ; Humans ; Mass Screening ; Recurrence

PURPOSE: There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. METHODS: One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept.of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. RESULTS: Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. CONCLUSIONS: For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.
Age of Onset ; Anticonvulsants ; Child* ; Drug Therapy* ; Epilepsy* ; Follow-Up Studies* ; Humans ; Multivariate Analysis ; Neurologic Manifestations ; Parents ; Proportional Hazards Models ; Recurrence* ; Risk Factors

Purpose: Given the morphological characteristics of schistocytes, thrombotic microangiopathy (TMA) score can be beneficial as it can be automatically and accurately measured. This study aimed to investigate whether serial TMA scores until 48 h post admission are associated with clinical outcomes in patients undergoing targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA). Materials and Methods: We retrospectively evaluated a cohort of 185 patients using a prospective registry. We analyzed TMA scores at admission and after 12, 24, and 48 hours. The primary outcome measures were poor neurological outcome at discharge and 30-day mortality. Results: Increased TMA scores at all measured time points were independent predictors of poor neurological outcomes and 30-day mortality, with TMA score at time-12 showing the strongest correlation [odds ratio (OR), 3.008; 95% confidence interval (CI), 1.707–5.300; p<0.001 and hazard ratio (HR), 1.517; 95% CI, 1.196–1.925; p<0.001]. Specifically, a TMA score ≥2 at time-12 was closely associated with an increased predictability of poor neurological outcomes (OR, 6.302; 95% CI, 2.841–13.976; p<0.001) and 30-day mortality (HR, 2.656; 95% CI, 1.675–4.211; p<0.001). Conclusion Increased TMA scores predicted neurological outcomes and 30-day mortality in patients undergoing TTM after OHCA. In addition to the benefit of being serially measured using an automated hematology analyzer, TMA score may be a helpful tool for rapid risk stratification and identification of the need for intensive care in patients with return of spontaneous circulation after OHCA.

PURPOSE: Mycoplasma pneumoniae is one of the most common causes of pneumonia in children and adolescents. Though cold agglutinin test and specific antibody test are used in the diagnosis of mycoplasma pneumonia, there are some limitations in early diagnosis. In this study, we evaluated the availability and usefulness of polymerase chain reaction (PCR) in the diagnosis of M. pneumoniae pneumonia and compared it with serologic test. METHODS: One hundred twenty four children who were clinically diagnosed with pneumonia and admitted to Kyunghee Hospital from January 1998 to March 2001 were enrolled. Mycoplasma specific antibody test using commercial kit (Serodia-MYCO II, Fusirebio Inc., Tokyo, Japan) and PCR using mycoplasma DNA obtained from throat swabs were done. The sensitivity and specificity of PCR were evaluated. RESULTS: M. pneumoniae pneumonia was diagnosed when the mycoplasma specific antibody titer was over 1: 160 or when the titer increased more than fourfold during follow-up period. The specificity, sensitivity, false-positive rate and false-negative rates of PCR were 93.0%, 58.3%, 33.3%. and 9.7%, respectively. CONCLUSION: PCR has shown high specificity. But, the positive result in PCR don't correlate with the disease activity and PCR does not have high sensitivity. So PCR must be used alongside with serologic test in the diagnosis of pneumonia. But, it seems possible to improve sensitivity by delicate handling of samples and by improving PCR technology, and PCR will possibly be used in the diagnosis of early infections of M. pneumoniae pneumonia and in the evaluation of treatments in the future.
Adolescent ; Child* ; Diagnosis ; DNA ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Serologic Tests

One of the moot important goals of modem gynexologic oncology is the adequate management of ocarian cancer. This includes early detection and differenciation of recurrence or residurd turnur. A promising method is availaible today with the use of mctabolic suubstrates used by tumor cells that are labeled with positron emittillg isotopes and a special instrument capable of detecting the radiations in vivo. Measuring tumor metabolic characteristics appear also to diffnencinte tumor recurrence or reeidual tumor from surgical or irradiation changes which is important since this wil1 not be defferentiaited by other modalities such ac CT or MRI. The goal of this study was to rletennine the potential utility uf whole-body PET using the giucose malogue 2-(18F)-fluoro-2-deoxy-D-glucoae(F-18-FDO for the detection of primey, metastatic, and recurrent ovarian cancer. Six patients had imaging studies prior to laparotomy for suspected ovarian cancer. PET(Positron Emission Tomogrnphy) scans were done with an ECAT 921(Emission Computed Axial Tomograpy 921, Sieinens/CTI. The result of this study show good correla- tion between PET nnd pathological findirs. The tumor detection rate of CT, MRI, CA-125, PET for ocarian cancer was 50%, 75%, 25%, 100% respectively. In summary, this work indicates that PET may be useful in the rnanagement of patients with ovwrian cancers by idengying occult foci of rnetabolically active tumor that do not appear on morphological studies.
Electrons* ; Humans ; Isotopes ; Laparotomy ; Magnetic Resonance Imaging ; Modems ; Ovarian Neoplasms ; Recurrence

One of the moot important goals of modem gynexologic oncology is the adequate management of ocarian cancer. This includes early detection and differenciation of recurrence or residurd turnur. A promising method is availaible today with the use of mctabolic suubstrates used by tumor cells that are labeled with positron emittillg isotopes and a special instrument capable of detecting the radiations in vivo. Measuring tumor metabolic characteristics appear also to diffnencinte tumor recurrence or reeidual tumor from surgical or irradiation changes which is important since this wil1 not be defferentiaited by other modalities such ac CT or MRI. The goal of this study was to rletennine the potential utility uf whole-body PET using the giucose malogue 2-(18F)-fluoro-2-deoxy-D-glucoae(F-18-FDO for the detection of primey, metastatic, and recurrent ovarian cancer. Six patients had imaging studies prior to laparotomy for suspected ovarian cancer. PET(Positron Emission Tomogrnphy) scans were done with an ECAT 921(Emission Computed Axial Tomograpy 921, Sieinens/CTI. The result of this study show good correla- tion between PET nnd pathological findirs. The tumor detection rate of CT, MRI, CA-125, PET for ocarian cancer was 50%, 75%, 25%, 100% respectively. In summary, this work indicates that PET may be useful in the rnanagement of patients with ovwrian cancers by idengying occult foci of rnetabolically active tumor that do not appear on morphological studies.
Electrons* ; Humans ; Isotopes ; Laparotomy ; Magnetic Resonance Imaging ; Modems ; Ovarian Neoplasms ; Recurrence

BACKGROUND: Angiotensin converting enzyme(ACE) inhibition as a means of controlling blood pressure began in the 1970s. This increasing knowledge of ACE inhibitors has resulted in their being used with confidence in a antihyertensive therapy, combining high efficacy with very low levels of side effects. METHOD: In this study, the antihyertensive effect of ramipril was assessed in 28 patients(9 males and 19 females with mean age of 52 years)with mild-to-moderate hypertension. After a placebo run-in phase, patients received ramipril as monotherapy in a dose 2.5 to 5 mg daily for 6 weeks. RESULTS: 1) At the end of 6 weeks, ramipril induced clinically significant reduction in supine(30.1mmHg in systole, 17mmHg in diastole) and sitting(33.4mmHg in systole, 18.5mmHg in diatole)blood pressure. 2) The heart rate was similar after 6 weeks. 3) The most frequent side effect was dry cough in 6 patients(5.6%) followed by dizziness. CONCLUSION: This study indicate that ramipril is effective in the treatment of mild to moderate essential hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Blood Pressure ; Cough ; Dizziness ; Female ; Heart Rate ; Humans ; Hypertension* ; Male ; Ramipril* ; Systole