No abstract available.
Candidiasis* ; Diabetes Mellitus*

Wegener's granulomatosis is characterized by necrotizing granulomatosis lesion of the respiratory tract, glomerulonephritis and frequently vasculitis involving other organs. The basic pathophysiologic mechanism of Wegener's granulomatosis is not defined yet. However, it may be suspected an autoimmune disease. We experienced a case of Wegener's granulomatosis which are associated with acute renal failure and pneumothorax. The patient suffered from hemoptysis, fever and cough. Despite antibiotic therapy, symtoms did not improved and multiple varying sized nodules were aggravated on chest roentogenogram and serum creatinine elevated 3.4mg/dl. After diagnosis using video associated thoracoscopic surgery, the patient was treated with cyclophsphamide, glucocorticoid and sulfamethoxasole-trimethoprime. With the combination therapy, the patient felt completely well and chest roentogenogram showed lungs were improved and serum creatinine was normal. The patient was readmitted because of right pleuritic pain and dyspnea 15 day after discharge. The patient was developed a right pneumothorax. The lung was easily expanded by intercostal tube drainage with a one way valve. The patient has been treated as an out- patient with immunosuppressive agents continously.
Acute Kidney Injury* ; Autoimmune Diseases ; Cough ; Creatinine ; Diagnosis ; Drainage ; Dyspnea ; Fever ; Glomerulonephritis ; Hemoptysis ; Humans ; Immunosuppressive Agents ; Lung ; Pneumothorax* ; Respiratory System ; Thoracoscopy ; Thorax ; Vasculitis ; Wegener Granulomatosis*

BACKGROUND: Although congenital anomalies of the coronary arteries are rare, which may cause serious clinical problems in diagnostic or surgical procedures, the accurate knowlegde and understanding of these are essential. We are to assess the clinical and angiographic characteristics of congenital anomalies of the coronary arteries detected in adulthhood. METHODS: We retrospectively analyzed a total of 67 cases of primary congenital anomalies of the coronary arteries with particular emphasis in angiographic findings in corelation with the clinical and surgical findings, reviewing 16,099 coronary angiography performed during last 6 years in three institutes. RESULTS: The incidence of congenital anomalies of the coronary arteries detected in coronary angiography was 0.4% and all were primary anomalies, among which major anomalies were 53 cases(79%) and minor anomalies were 14 cases(21%). Twenty-nine cases had associated cardiac defects. Among them congenital heart disease were 10 cases(34%), valvular heart disease were 10 cases(34%), coronary atherosclerotic disease were 8 cases(28%) and hypertrophic obstructive cardiomyopathy was 1 cases(4%). The coronary artery fistula were 40 cases, which was the most common anomaly among major group and the communication between coronary artery and bronchial artery were 6 cases, which was the most common one among minor group. Myocardial ischemia was observed in 49% of major and in 29% of minor anomalies. CONCLUSION: We are reporting 67 cases of the congenital anomalies of the coronary arteries detected in adulthood with the clinical and the angiographic characteristics. We suggest that new modified classification of the congenital coronary anomalies is necessary, because symptoms and signs of myocardial ischemia were observed in a significant number of patients among minoranomaly group.
Academies and Institutes ; Bronchial Arteries ; Cardiomyopathy, Hypertrophic ; Classification ; Coronary Angiography ; Coronary Vessels* ; Fistula ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Incidence ; Myocardial Ischemia ; Retrospective Studies

An ABO discrepancy was encountered in a 29-year-old woman with a pregnancy of 36 weeks. The patient's red cell was typed as group O and her serum had only anti-A antibody. Absence of B antigen on patient's RBC was confirmed by adsorption-elution test, B substance was not demonstrated in the saliva and serum. B-transferase activity was not detected in the serum. Patient's serum Ig level was within normal range. The patient's father and son had normal O phenotype and no additional abnormalities were detected among the family members studied.
Adult ; Fathers ; Female ; Humans ; Phenotype ; Pregnancy ; Reference Values ; Saliva

No abstract available.
Pulmonary Artery*

Protein and energy malnutrition are common in dialysis patients. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increased morbidity and mortality in both hemodialysis and peritoneal dialysis. To validate subjective global assessment(SGA) in dialysis patients we compared subjective global assessment with objective measurements(anthropometry, bioelectrical impedance, biochemical measurements) in 54 chronic hemodialysis patients. We divided patients into three groups(SGA1, SGA2, SGA3) according to modified subjective global assessment performed by an observer. Body weight, %IBW, BMI, TSF, MAC, nPCR were different significantly among three groups. SGA was related objective measurements such as body weight, %IBW, BMI, %Fat, TSF, MAC, nPCR(p<0.001). Multiple regression analysis showed that the relationship of SGA(as a dependent variable) with objective measurement(covariate) was stronger(multiple r=0.789, R2=60%) than the relationship found with univariate analysis. In other words, since no single objective method can be considered a gold standard of nutritional assessment, our data show that subjective global assessment is a clinically adequate method for assessing nutritional status in maintenance hemodialysis patients.
Body Weight ; Dialysis ; Electric Impedance ; Humans ; Malnutrition ; Mortality ; Nutrition Assessment ; Nutritional Status ; Peritoneal Dialysis ; Renal Dialysis*

BACKGROUND: The most effective means of preventing chronic disease is known to be promoting health behaviors; but this is difficult because health behaviors are associated with the socioeconomic status (SES). SES is a measure of access to material resources and social resources. This study aimed to assess the association between metabolic syndrome (MetS) and SES after controlling for health behaviors (smoking, alcohol intake, physical activity, and diet). METHODS: 24,515 participants (8,214 men, 16,301 women) older than 40 years were recruited from the 2004-2008 Korean Health Examinee Cohort. Along with MetS components, SES and health behaviors data were collected through individual interviews. SES was classified into tertiles (high, middle, and low groups) measured by education and house income levels. MetS was defined using the criteria from the modified National Cholesterol Education Program Adult Treatment Panel-lll (NCEP ATP-lll, 2007). RESULTS: Among the study subjects, the prevalences of MetS were 13.8%, 17.4%, and 25.3% in the high, middle, and low SES groups, respectively. After controlling for age and health behaviors, the odds ratios for MetS in the high, middle, and low SES were 1.0, 1.54 (95% confidence interval [95% CI]=1.34-1.76), and 2.01 (95% CI=1.72-2.36), respectively, for women. This association was not seen in men. CONCLUSION: SES was inversely associated with metabolic syndrome, as with health behaviors, but only for women.
Adult* ; Cholesterol ; Chronic Disease ; Cohort Studies ; Education ; Female ; Health Behavior* ; Humans ; Male ; Motor Activity ; Odds Ratio ; Prevalence ; Social Class*

BACKGROUND: The most effective means of preventing chronic disease is known to be promoting health behaviors; but this is difficult because health behaviors are associated with the socioeconomic status (SES). SES is a measure of access to material resources and social resources. This study aimed to assess the association between metabolic syndrome (MetS) and SES after controlling for health behaviors (smoking, alcohol intake, physical activity, and diet). METHODS: 24,515 participants (8,214 men, 16,301 women) older than 40 years were recruited from the 2004-2008 Korean Health Examinee Cohort. Along with MetS components, SES and health behaviors data were collected through individual interviews. SES was classified into tertiles (high, middle, and low groups) measured by education and house income levels. MetS was defined using the criteria from the modified National Cholesterol Education Program Adult Treatment Panel-lll (NCEP ATP-lll, 2007). RESULTS: Among the study subjects, the prevalences of MetS were 13.8%, 17.4%, and 25.3% in the high, middle, and low SES groups, respectively. After controlling for age and health behaviors, the odds ratios for MetS in the high, middle, and low SES were 1.0, 1.54 (95% confidence interval [95% CI]=1.34-1.76), and 2.01 (95% CI=1.72-2.36), respectively, for women. This association was not seen in men. CONCLUSION: SES was inversely associated with metabolic syndrome, as with health behaviors, but only for women.
Adult* ; Cholesterol ; Chronic Disease ; Cohort Studies ; Education ; Female ; Health Behavior* ; Humans ; Male ; Motor Activity ; Odds Ratio ; Prevalence ; Social Class*

BACKGROUND: The most effective means of preventing chronic disease is known to be promoting health behaviors; but this is difficult because health behaviors are associated with the socioeconomic status (SES). SES is a measure of access to material resources and social resources. This study aimed to assess the association between metabolic syndrome (MetS) and SES after controlling for health behaviors (smoking, alcohol intake, physical activity, and diet). METHODS: 24,515 participants (8,214 men, 16,301 women) older than 40 years were recruited from the 2004-2008 Korean Health Examinee Cohort. Along with MetS components, SES and health behaviors data were collected through individual interviews. SES was classified into tertiles (high, middle, and low groups) measured by education and house income levels. MetS was defined using the criteria from the modified National Cholesterol Education Program Adult Treatment Panel-lll (NCEP ATP-lll, 2007). RESULTS: Among the study subjects, the prevalences of MetS were 13.8%, 17.4%, and 25.3% in the high, middle, and low SES groups, respectively. After controlling for age and health behaviors, the odds ratios for MetS in the high, middle, and low SES were 1.0, 1.54 (95% confidence interval [95% CI]=1.34-1.76), and 2.01 (95% CI=1.72-2.36), respectively, for women. This association was not seen in men. CONCLUSION: SES was inversely associated with metabolic syndrome, as with health behaviors, but only for women.
Adult ; Cholesterol ; Chronic Disease ; Cohort Studies ; Education ; Female ; Health Behavior ; Humans ; Male ; Motor Activity ; Odds Ratio ; Prevalence ; Social Class

Pseudomembranous colitis is a dangerous but unusual side effect of antibiotics usage. We report a case of pseudomembranous colitis that developed in a 50-year-old female patient with diabetes mellitus during first line anti-tuberculous therapy including rifampicin. The patient was diagnosed with active pulmonary tuberculosis 70 days earlier. On admission, she suffered intermittent abdominal pain and watery diarrhea for 2 weeks. Colonoscopy revealed exudative, punctuate, raised plaques with skip areas or edematous hyperemic mucosa, and histopathologic findings were consistent with pseudomembranous colitis with typical volcano-like exudate. Symptoms improved on treatment with metronidazole. There was no recurrence after reinstitution of the anti-tuberculous agents excluding rifampicin. In patients with persistent diarrhea receiving anti-tuberculosis treatment, rifampicin associated pseudomembranous colitis should always be kept in mind.
Antibiotics, Antitubercular/*adverse effects ; English Abstract ; Enterocolitis, Pseudomembranous/*chemically induced/diagnosis/drug therapy ; Female ; Humans ; Middle Aged ; Rifampin/*adverse effects ; Tuberculosis, Pulmonary/drug therapy