We report 56 year old female with the left atrial myxoma diagnosed by M mode and 2-D Echocardiography, to be complicated with the cerebral embolism with review of literatures.
Echocardiography ; Female ; Humans ; Intracranial Embolism* ; Middle Aged ; Myxoma*

No abstract available.
Follow-Up Studies* ; Lung Neoplasms* ; Lung*

No abstract available.
Animals ; Dogs ; Mandible

A 3 year and 3 months old boy with recurrent infections since his age of 5 months was presented with clinical data and autopsy findings. He was the 4th product of healthy parents. His elder brother died of recurrent perianal abscess and sepsis at his age of 3 years. His 2nd elder sister died on the 14th day of life probably from the complication of BCG vaccination. Beginnig with perianal abscesses at his age of 5 months, he has been continuously suffering from recurrent infections such as arthritis, ostomyelitis, pneumonia, epididymitis, subcutaneous abscesses and perianal abscesses. In spite of meticulous supportive and aggressive antibiotic therapy persistent positive cultures for staph. Aureus, klebsiella, E. Coli, Enterococcus and coliform bacilli from different sited were noted. Erythrocyte sedimentation rate of 25 to 40 were constant. White cell count varied frem 15500 to 33400 with polymorphonucleocytes predominance. NBT test showed persistent low scoring of 2% throught the course. He finally died of pneumonia and empyema. At postmortem examination, multiple abscesses and grnulomas of right lung and multipe granulomas in the liver, spleen, lymph node, bone, marrow, adrenal gland, kidney and intestinal wass were noted. At microscopic examination histiocytic granulomas with lipid containing histiocyte infiltrations were noted in every organs described including brain.
Abscess ; Adrenal Glands ; Arthritis ; Autopsy ; Blood Sedimentation ; Bone Marrow ; Brain ; Cell Count ; Empyema ; Enterobacteriaceae ; Enterococcus ; Epididymitis ; Granuloma ; Granulomatous Disease, Chronic* ; Histiocytes ; Humans ; Infant ; Kidney ; Klebsiella ; Liver ; Lung ; Lymph Nodes ; Male ; Mycobacterium bovis ; Parents ; Pneumonia ; Sepsis ; Siblings ; Spleen ; Vaccination

Background: Aortic dissection (AD) is one of the most catastrophic diseases and is associated with high morbidity and mortality. The aim of this study is to investigate the hospital incidence and mortality rates of thoracic AD in Korea using a nationwide database. Methods: We conducted a nationwide population-based study using the health claims data of the National Health Insurance Service in Korea. From 2005 to 2016, adult patients newly diagnosed with AD were included. All patients were divided into the following four subgroups by treatment: type A surgical repair (TASR), type B surgical repair (TBSR), thoracic endovascular aortic repair (TEVAR), and medical management (MM). The incidence rate, mortality rate, and risk factors of in-hospital mortality were evaluated. Results: In total, 18,565 patients were newly diagnosed with AD (TASR, n = 4,319 [23.3%];TBSR, n = 186 [1.0%]; TEVAR, n = 697 [3.8%]; MM, n = 13,363 [72.0%]). The overall AD incidence rate was 3.76 per 100,000 person-years and exhibited a gradual increase during the study period (3.29 to 4.82, P < 0.001). The overall in-hospital mortality rate was 10.84% and remained consistent (P = 0.57). However, the in-hospital mortality rate decreased in the TASR subgroup (18.23 to 11.27%, P = 0.046). An older age, the female sex, hypertension, and chronic kidney disease were independent risk factors for in-hospital mortality. Conclusion The incidence of thoracic AD has gradually increased in Korea. The in-hospital mortality in the TASR subgroup decreased over the decade, although the overall mortality of AD patients did not change.

BACKGROUND/AIMS: Phosphatase and tensin homolog (PTEN) is a known tumor suppressor gene that is downregulated in hepatocellular carcinoma (HCC). Here, we investigated the association between single nucleotide polymorphisms (SNPs) of PTEN and HCC development in patients with hepatitis B virus (HBV) infection. METHODS: Six SNPs of PTEN at positions rs1234221, rs1903860, rs1234220, rs1903858, rs2299941, and rs17431184 were analyzed in a development population (417 chronic HBV carriers without HCC and 281 chronic HBV carriers with HCC). PTEN rs1903858, rs1903860, and rs2299941 SNPs were further assessed for the development of HCC in a validation population of 200 patients with HBV-related liver cirrhosis. RESULTS: In the development population, PTEN rs1903860 C allele, rs1903858 G allele, and rs2299941 G allele were associated with a low risk of HCC. The haplotype A-T-A-A-A was associated with an increased risk of HCC (recessive model; odds ratio=2.277, 95% confidence interval [CI] =1.144-4.532, P=0.019). In the validation population, PTEN rs2299941 G allele was the only significant protective genetic polymorphism related to HCC development after adjustment for age and sex (hazard ratio=0.582, 95% CI =0.353–0.962, P=0.035). CONCLUSIONS: These findings suggest that genetic polymorphisms in PTEN may affect HCC development in patients with chronic HBV infection.
Alleles ; Carcinoma, Hepatocellular ; Genes, Tumor Suppressor ; Haplotypes ; Hepatitis B virus ; Hepatitis B ; Hepatitis ; Humans ; Liver Cirrhosis ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

Endoscopic biopsy is necessary to confirm a histopathologic diagnosis. Currently, 6 to 8 biopsies are recommended for diagnosis of a suspected malignant lesion. However, multiple biopsies may result in several problems, such as an increased risk of bleeding, procedure prolongation, and increased workload to pathologists. The aim of this study was to clarify the optimal number of endoscopic biopsy specimens required in diagnosis of advanced gastrointestinal cancer. Patients who were diagnosed with advanced gastrointestinal cancer during endoscopy were included. Five specimens were obtained sequentially from viable tissue of the cancer margin. Experienced pathologists evaluated each specimen and provided diagnoses. A total of 91 patients were enrolled. Fifty-nine subjects had advanced gastric cancer, and 32 had advanced colon cancer. Positive diagnosis rates of the first, second, and third advanced gastric cancer specimens were 81.3%, 94.9%, and 98.3%, respectively, while positive diagnosis rates of advanced colon cancer specimens were 78.1%, 87.5%, and 93.8%. Further biopsies did not increase positive diagnosis cumulative rates. This study demonstrated that three specimens were sufficient to make correct pathologic diagnoses in advanced gastrointestinal cancer. Therefore, we recommend 3 or 4 biopsies from viable tissue in advanced gastrointestinal cancer to make a pathologic diagnosis during endoscopy.
Adult ; Aged ; Biopsy/*statistics & numerical data ; Colorectal Neoplasms/*diagnosis/pathology ; *Endoscopy, Digestive System ; Female ; Humans ; Male ; Middle Aged ; Stomach Neoplasms/*diagnosis/pathology

BACKGROUND: A web-based surveillance of surgical-site infections (SSIs) in Korean Nosocomial Infections Surveillance System (KONIS) was performed to determine the incidence of SSIs after 15 operative procedures. METHODS: Forty-three hospitals participated in the surveillance system for 15 operative procedures. A year-round observation was carried out, and the duration of participation was shortened for 3 months unit. All data were collected using a real-time web-based reporting system. RESULTS: From July 2010 through June 2011, SSI surveillance data of 18,644 cases were collected from 43 hospitals. SSIs were found to occur in 2.10% of the total cases. The SSI rates after various surgeries were as follows: 4.49%, rectal surgery; 4.41%, colon surgery; 3.50%, gastric surgery; 3.12%, craniotomy; 1.25%, abdominal hysterectomy; 0.93%, laminectomy; 0.63%, cesarean section; 0.62%, gallbladder surgery; and 0.54%, vaginal hysterectomy. The interim results of implant-related surgery are given below as SSI rates: 3.78%, ventricular shunt operation; 3.23%, coronary artery bypass graft; 2.20%, cardiac surgery; 1.31%, spinal fusion; 0.96%, knee prosthesis; and 0.88%, hip prosthesis. CONCLUSION: The SSI rate was found to be 2.10% by the KONIS 2010. The maintenance of a surveillance system for SSI is very important, as it will help in decreasing SSIs via feedback to the involved surgeons and infection-control personnel.
Colon ; Coronary Artery Bypass ; Cross Infection ; Female ; Gallbladder ; Hip ; Hysterectomy, Vaginal ; Incidence ; Knee ; Surgical Procedures, Operative

BACKGROUND: A nationwide prospective multicenter study was performed in Korea to determine the incidence and risk factors for surgical site infections (SSI) after craniotomies (CRAN), ventricular shunt operations (VS), gastric operations (GAST), colon operations (COLO), rectal operations (RECT), hip joint replacements (HJR), and knee joint replacements (KJR). METHODS: We collected data regarding demographics, clinical and operative risk factors for SSI, and antibiotics administered to the patients who underwent CRAN in 18 hospitals, VS in 19 hospitals, GAST in 19 hospitals, COLO in 19 hospitals, RECT in 19 hospitals, HJR in 24 hospitals, and KJR in 23 hospitals between January and December 2009. All the data were collected using a real-time web-based reporting system. RESULTS: The SSI rate of CRAN, VS, GAST, COLO, RECT, HJR, and KJR was 3.68 (22/1,169), 5.96 (14/235), 4.25 (75/1,763), 3.37 (22/653), 5.83 (27/463), 1.93 (23/1,190), and 2.63 (30/1,139), respectively, per 100 operations. The only significant risk factor for SSI after CRAN was postoperative cerebrospinal fluid leakage. The independent risk factors for SSI after GAST were multiple procedure, reoperation, infection of other sites, and transfusion. In HJR, the duration of preoperative hospital stay and operation time were longer, and the need for general anesthesia, transfusion, and steroid use and the incidence of contaminated/dirty wound, obesity, and infection of other sites were significantly increased in the infected group. In KJR, the duration of preoperative hospital stay was longer and the need for reoperation was significantly higher in the infected group, and in addition, the incidence of SSI was higher among males. CONCLUSION: The maintenance of surveillance on SSI is very important because surveillance provides valuable information to the surgeon and infection control personnel, which in turn helps decrease the incidence of SSI.
Anesthesia, General ; Anti-Bacterial Agents ; Colon ; Craniotomy ; Demography ; Hip Joint ; Humans ; Incidence ; Infection Control ; Knee Joint ; Korea ; Length of Stay ; Male ; Obesity ; Reoperation ; Risk Factors

Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy and has relatively favorable prognosis. Blood-borne metastases of PTC are very rare among the thyroid malignancies. Moreover a case of blood-borne central nervous system metastasized PTC with only unilateral Horner's syndrome, and without any abnormalities in laboratory or physical examinations has not been described before. A 53-year-old female patient had been managed in ophthalmologic clinic due to vague symptoms of right monocular blurred vision with eye dryness for 3 months, but showed no signs of improvement. So it was performed a magnetic resonance imaging and magnetic resonance angiography to evaluate the possibilities of cerebral lesion. And a left frontal mass was incidentally found, and the tumor turned out to be a PTC that had metastasized to brain, regional lymph node, cervical, thoracic spine, and lung. We describe a PTC with extraordinary initial symptoms that metastasized to an unusual site. We recommend that if a papillary thyroid tumor with unusual symptoms or at an advanced stage is found, further investigation should be performed for distant metastasis.
Brain* ; Central Nervous System ; Female ; Horner Syndrome* ; Humans ; Lung ; Lymph Nodes ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Physical Examination ; Prognosis ; Spine ; Thyroid Gland ; Thyroid Neoplasms*