OBJECTIVES: This study was conducted to evaluate the association of cumulative exposure to organic solvent with liver function. METHODS: We conducted a cross sectional study. 461 male workers who perform painting job at a shipyard and use organic solvents routinely and 125 workers of the same shipyard who never have been exposed to organic solvents were studied. All subjects who were confirmed not having HBsAg surveyed their age, BMI(body mass index), alcohol drinking and smoking history, and examined liver function test (SGOT, SGPT, gamma-GTP, Total protein, albumin, total bilirubin, direct bilirubin). The amount of cumulative exposure (CE) to mixed organic solvents were measured by biological monitoring method using their metabolites in urine. RESULTS: The CE was observed as a significant variable with logistic regression analysis on abnormality of SGOT(>35IU/L), SGPT(>40IU/L) and gamma-GTP(>63IU/L), their odds ratio were 1.10 (95 %CI, 1.02-1.20), 1.10 (95 %CI, 1.01-1.19), and 1.10 (95 %CI, 1.01-1.19) each. CONCLUSIONS: Therefore we suggest that the cumulative exposure to mixed organic solvents might be a significant variable on abnormal liver function indices (SGOT, SGPT,gamma-GTP) in male shipyard workers
Alanine Transaminase ; Alcohol Drinking ; Bilirubin ; Environmental Monitoring ; Hepatitis B Surface Antigens ; Humans ; Liver Function Tests ; Liver* ; Logistic Models ; Male ; Odds Ratio ; Paint ; Paintings ; Smoke ; Smoking ; Solvents*

Prune belly syndrome is a rare anomaly complex associated with absence of abdominal muscle combined with urinary tract abnormalities. We have encountered stillbirth female with severely distended abdomen without external genitalia end anus who was Finally confirmed as prune belly syndrome by an autopsy. Herein we report a case with review of literature.
Abdomen ; Abdominal Muscles ; Anal Canal ; Autopsy ; Female ; Genitalia ; Humans ; Prune Belly Syndrome* ; Stillbirth ; Urinary Tract

We experienced a case of transureteroureterostomy in a single kidney with multiple distal ureteral strictures. The patient had received nephrectomy due to staghorn calculi 14 years ago. We have utilized the abandoned ureter from the transureteroureterostomy with stenting. We have confirmed good drainage through the anastomosed ureter by radiological imaging. No other complications were observed except Pseudomonas urinary tract infection. Thereby we report this unique procedure of transureteroureterostomy using the 14-year-age abandoned ureter.
Calculi ; Constriction, Pathologic ; Drainage ; Humans ; Kidney ; Nephrectomy ; Pseudomonas ; Stents ; Ureter ; Urinary Tract Infections

It is well known that malnutrition is a predictor of mortality in hemodialysis patients. The number of diabetic nephropathy patients is increasing rapidly. This study aimed to investigate nutritional status and nutrient intake according to the presence of diabetes among hemodialysis patients. The nutritional intake and general characteristics of outpatients at Ajou University Hospital (24 with diabetes and 30 without diabetes) were investigated between July and September 2015. Patients' general data were collected, and nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA) was evaluated. Nutrient intakes were assessed according to 3-day food records. There was no significant difference regarding body weight between the two groups. However, the non-diabetic group showed a better nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA) (5.2±4.4 vs. 8.0±4.3 score, non-diabetics vs. diabetics, P<0.05). There was no difference in daily calorie intake (1,473.9±370.5 vs. 1,503.8±397.5 kcal) and protein intake (60.3±19.7 vs. 65.6±20.5 g) in those with diabetes. Intakes of vegetables protein, sodium, potassium, vitamin C, folic acid and fiber were significantly higher in the diabetic group compared to those of the non-diabetic group. There was no difference in daily nutrient intake between the hemodialysis weekday and weekend groups. The non-diabetic group had higher calorie and sodium intakes per meal in the hemodialysis weekday group, but the difference was not significant. Based on these results, intervention should be performed to improve nutritional status in consideration of diabetes and dietary patterns.
Ascorbic Acid ; Body Weight ; Diabetes Mellitus ; Diabetic Nephropathies ; Folic Acid ; Humans ; Malnutrition ; Meals ; Mortality ; Nutritional Status* ; Outpatients ; Potassium ; Prospective Studies* ; Renal Dialysis* ; Sodium ; Vegetables

Aortic saddle embolus accounts for approximately 10% of all peripheral arterial emboli. The most common sources of emboli are left atrial thrombi associated with atrial fibrillation and vegetation. A 22-year-old male patient was admitted due to acute onset of orthopnea, tachypea and cough. Transthoracic and transeophageal echocardiography showed huge vegetation (3X2cm) of the posterior mitral valve leaflet which was associated with severe mitral regurgitation. On 14th hospital day, he suffered from sudden onset of weakness, pain, and coldness on both lower extremities. Follow-up echocardiography showed marked size reduction of the original mitral valve vegetation. Angiography showed aortic saddle embolus. The embolectomy of aortic saddle embolus was performed through the transfemoral approach with a Forgarty catheter. At the same time, removal of the infected mitral valve and mitral valve replacement were performed.
Angiography ; Atrial Fibrillation ; Catheters ; Cough ; Echocardiography ; Embolectomy ; Embolism* ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Young Adult

Background and Objectives: The objective of this study was to investigate the effect of an active transcutaneous bone conduction implant (BCI) of Bonebridge (MED-EL) on tinnitus patients with asymmetric hearing loss (AHL) or single-sided deafness (SSD).Subjects and Method Medical records and tinnitus questionnaires were reviewed retrospectively of patients with AHL or SSD, who received Bonebridge by a single surgeon at Seoul St. Mary’s Hospital from 2017 to 2021. Audiologic evaluation and tinnitus questionnaires were conducted before and after surgery. Results: Of the 17 patients, 8 patients had SSD and 9 patients had AHL, and 13 patients (76.47%) had tinnitus before surgery while 4 patients did not. No patient showed newly developed tinnitus after surgery. After implantation, three patients (23.08%) showed a complete resolution of tinnitus. All patients showed significant improvement in hearing level after surgery. The mean tinnitus handicap inventory (THI) score and visual analogue scale (VAS) score for effect on life showed a significant decrease after surgery, from 43.1±28.2 to 29.7±25.7 (p<0.05), and 4.7±2.9 to 3.2±3.3 (p<0.05), respectively. The mean THI scores of seven AHL patients and seven patients with tinnitus on the implanted ear were significantly decreased after implantation from 50.9±24.7 to 34.6±27.5 (p<0.05) and from 53.1±23.4 to 37.4±15.0 (p<0.05), respectively. Conclusion BCI seems to be effective in suppressing tinnitus in the patients with AHL but not with SSD. Along with directive counseling, sound therapy with Bonebridge can decrease tinnitus in some patients with AHL.

We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.
Adenocarcinoma ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Central Nervous System ; Cerebrospinal Fluid ; Cisplatin ; Drug Therapy ; Epidermal Growth Factor* ; Erlotinib Hydrochloride ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Methotrexate ; Middle Aged ; Nausea ; Neoplasm Metastasis* ; Paclitaxel ; Phosphotransferases* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor* ; Recurrence ; Thorax ; Vomiting

PURPOSE: The study was conducted to examine the usefulness of somatosensory evoked potentials (SEP) and proton magnetic resonance spectroscopy (1H-MRS) in predicting poor outcomes for comatose survivors after cardiopulmonary resuscitation. METHODS: We investigated 36 patients who were comatose after cardiac arrest. Among them, 35 had short latency SEP, and 27 had 1H-MRS. Both tests were performed in 26 patients. To estimate the cerebral outcome, we used the cerebral performance category (CPC) to classify the outcomes for our patients as good (CPC 1-2) or poor (CPC 3-5). RESULTS: Of the 36 patients, 11(31%) presented with good outcomes (CPC 1-2). A bilaterally absent N20 peak (n=35) predicted poor outcomes with a sensitivity of 54.2% and a specificity of 100%. A lactate-positive resonance (n=27) predicted poor outcomes with a sensitivity of 78.9% and a specificity of 100%. Using a combination of a bilaterally absent N20 peak and a lactate-positive resonance (n=26) predicted poor outcomes with a sensitivity of 94.4% and a specificity of 100%. CONCLUSION: The combination of a bilaterally absent N20 peak and a lactate-positive resonance is better than either alone in predicting poor outcomes in patients who are comatose after cardiac arrest.
Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Magnetic Resonance Spectroscopy* ; Protons* ; Sensitivity and Specificity ; Survivors*

PURPOSE: The aim of this study was to investigate the causes of stridor with respiratory distress and their clinical courses in children. METHODS: Children who were hospitalized in Samsung Medical Center due to stridor with respiratory distress without infectious causes were studied retrospectively. The causes of stridor, sex, age at onset, symptoms, combined diseases, treatment, and clinical courses were investigated. Fisher's exact test was used to assessing the association of risk factors with the severity of post-intubation subglottic stenosis. RESULTS: Of 75 cases, 15 (20 percent) were congenital and 60 (80 percent) were acquired. The prevalence in males was higher than in females. Common causes of congenital stridor were laryngomalacia, tracheomalacia, pulmonary artery sling and complete tracheal ring. Acquired stridor is usually due to subglottic stenosis secondary to endotracheal intubation. Risk factors such as frequency and duration of intubation, age at first intubation, birth weight and gestational age were not associated with the developement of post-intubation subglottic stenosis. (P> 0.05) More complicated surgical treatment was required according to the severity of subglottic stenosis. CONCLUSION: Congenital malformation of the airway requiring urgent surgical correction should be differentiated in children with stridor and respiratory distress. Post-intubation subglottic stenosis accounts for most cases of acquired stridor. Evaluation of it's severity, and careful airway care, is required in children with subglottic stenosis.
Airway Obstruction ; Birth Weight ; Child* ; Constriction, Pathologic ; Female ; Gestational Age ; Humans ; Infant* ; Intubation ; Intubation, Intratracheal ; Laryngomalacia ; Male ; Prevalence ; Pulmonary Artery ; Respiratory Sounds* ; Retrospective Studies ; Risk Factors ; Tracheomalacia

Anaplastic lymphoma kinase (ALK) rearrangement, is a kind of driver mutation, accounts for 3%-5% of non-small cell lung cancer (NSCLC). NSCLC patients harboring ALK fusion genes have distinct clinical features and good response to ALK inhibitors. Metastasis from lung cancer to the ovary has rarely been known. We report a case of a 54-year-old woman with bilateral ovarian metastases from ALK rearranged NSCLC. She underwent bilateral salpingo-oophorectomy for ovary masses, which were progressed after cytotoxic chemotherapy although primary lung mass was decreased. Histopathological examination of the ovary tumor showed characteristic adenocarcinoma patterns of the lung and ALK rearrangement.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Female ; Humans ; Lung ; Lung Neoplasms ; Lymphoma ; Middle Aged ; Neoplasm Metastasis* ; Ovary ; Phosphotransferases