Septic pulmonary emboli(SPE) is derived from a variety of sources, including infected heart valves, peripheral sites of septic thrombophlebitis and infected venous catheters or pacemaker wires. In adult intravenous drug users, the most common cause of septic emboli is tricuspid valve endocarditis, but infective endocarditis in the non-complicated ventricular septal defect is a relatively rare condition in infants and children. Early detection, along with prompt administration of broad-spectrum antibiotics, is an important factor in the prognosis of patients with SPE. Unfortunately, initial clinical diagnosis is often difficult; a heart murmur may or may not be present and blood cultures may remain negative early in the course of infection. And so characteristic chest CT and chest radiographic findings are helpful in non-invasive diagnostic method for early detection. We experienced a case of pulmonary septic emboli associated with ventricular septal defect in a 6-year-old girl. The diagnosis was made on the basis of clinical features, echocardiography, chest x-ray and chest CT. We report this case with brief review related literatures.
Adult ; Anti-Bacterial Agents ; Catheters ; Child ; Diagnosis ; Drug Users ; Echocardiography ; Endocarditis ; Female ; Heart Murmurs ; Heart Septal Defects, Ventricular* ; Heart Valves ; Humans ; Infant ; Prognosis ; Radiography, Thoracic ; Thorax ; Thrombophlebitis ; Tomography, X-Ray Computed ; Tricuspid Valve

No abstract available.
Animals ; Ethanol* ; Metabolism* ; Phenobarbital* ; Rats* ; Trichloroethylene*

New-onset diabetes after transplantation (NODAT) is a common complication of solid-organ transplantation. As long-term posttransplant survival continues to improve, increasing attention has been placed on NODAT. Because NODAT is a potent predictor of graft failure and cardiovascular mortality in the transplant population, early detection and management of NODAT are important issues. The risk factors for NODAT in transplant recipients include older age, obesity, family history, hepatitis C virus infection, and immunosuppressive agents, such as corticosteroids and calcineurin inhibitors. Management of NODAT must be considered at the pretransplantation stage to screen high risk patients and prevent NODAT. Although NODAT management is similar to type 2 diabetes management in the general population, there are some specific considerations in NODAT management, including the immunosuppressive agent. Further studies are needed to suggest optimal management guidelines for NODAT.
Adrenal Cortex Hormones ; Calcineurin ; Diabetes Mellitus ; Hepacivirus ; Humans ; Immunosuppressive Agents ; Obesity ; Organ Transplantation ; Postoperative Complications ; Risk Factors ; Transplants ; Treatment Outcome

OBJECTIVES: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. METHODS & RESULTS: 1) Records of a total of 41 patients with preoperative T1-3N0M0 non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative T2, 2 cases were identified postoperatively as T3 with invasion of chest wall and among 6 cases with preoperative T1-3, 1 case was identified postoperatively as T4 with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with T1-2, 5 cases wore N1 and 3 cases were N2 postoperatively. After the operation of 6 cases with T3, 2 cases were N1 and 3 cases were N2 postoperatively Preoperative T3 showed more intrathoracic lymph node metastases and higher N2/N1 involvement ratio than preoperative T1-2. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative N2 tumors. CONCLUSION: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative T3 non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.
Adenocarcinoma ; Aorta ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Magnetic Resonance Imaging ; Mediastinoscopy ; Neoplasm Metastasis ; Pulmonary Artery ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

PURPOSE: The objective of this study was to ascertain the relationship between epidermal growth factor receptor(EGFR) status and estrogen receptor(ER) and other prognostic factors in primary human breast cancer patients. We tried to evaluate the value of EGFR as a prognostic factor. MATERIALS AND METHODS: EGFR and ER were measured by immunohistochemical staining. It was performed on section from paraffin blocks of 60 primary breast cancer patients who underwent mastectomy at Chung-Ang University Hospital. And we evaluate the relationship between EGFR and ER and other prognostic factors. RESULTS: In 20 of 60 patients(33.3%), the staining was positive for the expression of EGFR. Of the 60 patients, 6 were both positive for EGFR and ER, 25 were both negative, 14 were EGFR positive and ER negative, 15 were EGFR negative and ER positive. Between EGFR and estrogen receptor(ER) status, previously known clear inverse relationship was not observed in our study. The EGFR status was not correlated with axillary lymph node involvement, histologic type, and histologic grading. But it was correlated with tumor size(p=0.049), and there was a high tendency of recurrence rate of patients with EGFR-positive tumors as compared with those with EGFR-negative tumors(p=0.078). CONCLUSION: EGFR status may be valuable as a prognostic factor in determining the prognosis of breast cancer. However, the study of more cases will be needed for the significance of the information about the EGFR as an independent prognostic factor.
Breast Neoplasms* ; Breast* ; Epidermal Growth Factor* ; Estrogens ; Humans ; Lymph Nodes ; Mastectomy ; Paraffin ; Prognosis ; Receptor, Epidermal Growth Factor* ; Recurrence

Hyaluronidase has been gaining interest because it reduces tissue edema and fibrosis. Although rare, hyaluronidase has been shown to cause allergic reactions. A few cases of allergic reactions following hyaluronidase administration have been reported. Most of the described patients presented allergic reactions after peribulbar anesthesia for eye surgery. In this report, we describe three patients who experienced with allergic reactions to hyaluronidase following pain management. Two of the patients had a history of uneventful injection with hyaluronidase. All patients were afebrile and blood tests results were normal. Intradermal skin tests were positive. These clinical findings were helpful in establishing the differential diagnosis of infection. Although allergic reaction to hyaluronidase is rare and mostly benign, this must be considered before treating patients.
Anesthesia ; Diagnosis, Differential ; Edema ; Eye ; Fibrosis ; Hematologic Tests ; Humans ; Hyaluronoglucosaminidase ; Hypersensitivity ; Pain Management ; Skin Tests

PURPOSE: Fracture of the distal radius is one of the most common fractures encountered in the emergency room. The incidence of distal radius fracture has increased substantially according to several studies that estimated the overall incidence in various general populations. However, there is a paucity of epidemiological data regarding distal radius fracture in Korea. The aim of this study was to estimate the epidemiology and seasonal variance of incidence of distal radius fractures in the Korean population. MATERIALS AND METHODS: Medical records and radiographs of the 432 patients who visited the emergency room for distal radius fractures from January 2012 to December 2013 were reviewed retrospectively. Authors analyzed the epidemiologic parameters including age, gender, injury mechanism, fracture classification, combined fracture, treatment method and monthly incidence. RESULTS: The mean age of the patients at the time of injury was 53 years (41.6 years in 171 men, 64.5 years in 261 women). The highest incidence in age distribution was the sixth and seventh decade (45.2%) and male to female ratio was 1.0:2.5. Most fractures (78.4%) were caused by a lower energy fall and the most common combined fractures were the ulnar styloid fracture (38.6%). According to the AO classification, 54.5% were type A, 14.5% were type B and 31.0% were type C and 39.2% of the patient underwent surgery for treatment. The incidence of fracture began to rise in November (12.1%) and peaked in December (14.2%). CONCLUSION: This study examined the epidemiology and seasonal variance of incidence of distal radius fractures from the patient records of a single University hospital. The epidemiological data gathered in this study could be added to our knowledge of distal radius fractures in the Korean population, thus it enables the Korean surgeon to determine the best management for individual patients.
Age Distribution ; Classification ; Emergency Service, Hospital ; Epidemiology* ; Female ; Humans ; Incidence* ; Korea ; Male ; Medical Records ; Radius Fractures* ; Radius* ; Retrospective Studies ; Seasons*

The number of workers with noise induced hearing loss which comprise 56.9% in the total number of workers with work-related diseases in Korea of 1994, are becoming in position of the most serious problem. Periodic health examination system which was introduced for health care of workers on hazardous workplace has played important role in health care and the prevention of work-related diseases. The goal of periodic health examination may be obtained when we not only discover occupational disease, but also control them effectively. To study the post-examination health status of workers with noise induced hearing loss diagnosed from 1991 to 1994 in the periodic health examination, all 154 workers in 102 manufacturing factories in Banwol and Siwha industrial complex were reviewed. ' 1. Among 154 workers, 87 workers (56.5%) were changed to different department, 67 workers (43. 5%) remained in the same department. 2. Among 102 workplaces, only 23 workplaces (22.9%) 'had changed their working environment while 79 workplaces (77.1%) did not. 3. In this study, post-examination health care of the workers diagnosed as noise induced-hearing loss had significant correlated with the presence of health care manager, Industrial Health and Safety Committee in workplace and size of industry. The improvement of working environment is also closely related with the presence of health care manager in workplace. 4. Among 154 respondents, 3 Wkers(l. 9%) had received! compensationwhile 151; workers(98.1%) did not. 5. The reasons for not requesting the compensation were that 117 workers (77.5^) were ignorant of the administrative procedure for compensation, 30 workers (19.9%) were not sure of receiving compensation, 4 workers (2.6%) were busy. Considering the result of this study, we must establish the guide of management or contents of post management for noise induced hearing loss. To prevent the noise induced hearing loss, and protect the workers with noise induced hearing loss, education about post management is much required for employer and employee.
Compensation and Redress ; Data Collection ; Delivery of Health Care* ; Education ; Hearing Loss* ; Hearing* ; Korea ; Noise* ; Occupational Diseases ; Occupational Health

The number of workers with noise induced hearing loss which comprise 56.9% in the total number of workers with work-related diseases in Korea of 1994, are becoming in position of the most serious problem. Periodic health examination system which was introduced for health care of workers on hazardous workplace has played important role in health care and the prevention of work-related diseases. The goal of periodic health examination may be obtained when we not only discover occupational disease, but also control them effectively. To study the post-examination health status of workers with noise induced hearing loss diagnosed from 1991 to 1994 in the periodic health examination, all 154 workers in 102 manufacturing factories in Banwol and Siwha industrial complex were reviewed. ' 1. Among 154 workers, 87 workers (56.5%) were changed to different department, 67 workers (43. 5%) remained in the same department. 2. Among 102 workplaces, only 23 workplaces (22.9%) 'had changed their working environment while 79 workplaces (77.1%) did not. 3. In this study, post-examination health care of the workers diagnosed as noise induced-hearing loss had significant correlated with the presence of health care manager, Industrial Health and Safety Committee in workplace and size of industry. The improvement of working environment is also closely related with the presence of health care manager in workplace. 4. Among 154 respondents, 3 Wkers(l. 9%) had received! compensationwhile 151; workers(98.1%) did not. 5. The reasons for not requesting the compensation were that 117 workers (77.5^) were ignorant of the administrative procedure for compensation, 30 workers (19.9%) were not sure of receiving compensation, 4 workers (2.6%) were busy. Considering the result of this study, we must establish the guide of management or contents of post management for noise induced hearing loss. To prevent the noise induced hearing loss, and protect the workers with noise induced hearing loss, education about post management is much required for employer and employee.
Compensation and Redress ; Data Collection ; Delivery of Health Care* ; Education ; Hearing Loss* ; Hearing* ; Korea ; Noise* ; Occupational Diseases ; Occupational Health

To perform voluntary occupational health program in worksites, regulational supports are necessary. The regulational supports include assessment of current occupational health program and appropriate incentives. The purpose of this study is to find out the requirements of voluntary occupational health program and conditions to be improved. Study population was industrial health managers of both industries with less than 300 workers and over 300 workers, and the member of labor union who is responsible for safety and health in worksite. Two different questionnaire were used to find out the requirements and conditions to be improved respectively. The results were; 1. The category which prevalence rate of occupational injuries and occupational disease should be lower than national average was most important in health managers employed in industries over 300 workers and followed by reporting system, education, worksite policy, work environment assessment, protective equipment, consequently. But those employed in industries less than 300 workers showed high importance in prevalence rate of occupational injuries and disease, reporting system, worksite policy, work environment assessment, protective equipment, education, consequently. 2. The members of labor union thought that worksite policy was most important and the next is education, reporting system, work environment assessment, protective equipment, prevalence rate of occupational injuries and disease. 3. There were difference in importance of education and worksite policy according to the size of industries. Reporting system, prevalence rate of occupational injuries and disease, and worksite policy had different importance between members of labor union and health managers. 4. In the results of questionnaire for conditions to be improved, the most important condition was top manager's willingness except personal protective equipments, and followed by financial support, legal support. The limitations of this study were the problems of representativeness of study population. but voluntary health program should be performed in worksites which have relatively good occupational health system. So, this selection bias could not disrupt our results.
Education ; Financial Support ; Humans ; Labor Unions ; Motivation ; Occupational Diseases ; Occupational Health* ; Occupational Injuries ; Prevalence ; Surveys and Questionnaires ; Selection Bias ; Workplace*