Atresia of larynx is a rare fatal anomaly that should bring an immediate medical attention for proper managenent. We reported a case who died in neonatal period because of respiratory difficulty. His first problem was difficulty of inserting tracheal tube through the larynx. It was of interest in this case that he was presented with generalized edema and also massive lung edema. The lung was characterized by total absence of squamous and amniotic debris in the alveolar spaces and massive inflation of the alveoli by clear fluid that was thought to be amniotic fouid produced by the lung per se. Because there was no connection between oral cavity and the lungs, there would be no way the amniotic fluid outside the fetus. The laryngeal atresia was of infraglottic type and was complete with dispalced cricoid cartilage. Associated anomalies were left persistent supperior vena cava, perimembranous ventricular septal defect, spina bifida and focal cerebellar heterotopia.
Infant, Newborn ; Humans

Congenital obstuction of pulmonary vein without anomalous drainage can cause long-standing pulmonary congestion and pulmonary arterial hypertension, and it may include stenosis of individual pulmonary veinsor total pulmonary vein atresia. We reviewed seven cases of pulmonary vein obstruction, five of which accompanied other cardiac anomalies. Right pulmonary veins were involved in all seven cases including one bilateral case. Pulmonary veins were occluded totally in five and partially in three lungs. Pumonary catheterization and angiography were done for diagnosis. Chest radiographs of total occlusion cases showed decreased lung volume, features of pulmonary edema, interstitial lesions, and pleural thickening, which were quite specific, whereas pulmonry venous dilatation was dominant findings in partial obstruction cases. Pulmonary perfusion scans (n=3) showed total perfusion defects in the cases of total occlusion of veins. MR imaging (n=2) demonstrated total occlusion of pulmonary veins in the venoatrial junction in two, and membranous focal obstruction in one lung. Two patients had pneumonectomy and histological confirmation, Although catheterization and angiography are essential for the diagnosis, MR imaging is thought to be useful for the diagnosis of pulmonary vein obstruction.
Angiography ; Catheterization ; Catheters ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Drainage ; Estrogens, Conjugated (USP) ; Humans ; Hypertension ; Lung ; Magnetic Resonance Imaging ; Perfusion ; Pneumonectomy ; Pulmonary Edema ; Pulmonary Veins* ; Radiography, Thoracic ; Veins

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

Objectives: ：Screening of male depression is important since their symptoms differ from females, such as more common suicide attempts and aggression. Rutz et al. designed the Gotland Male Depression Scale (GMDS) to understand male depression and prevent suicide. The aim of this study is to translate the GMDS into Korean and assess the factor structure of K-GMDS. Methods: ：The K-GMDS was administered to 213 male office workers in one public institution. The current study used exploratory factor analysis to validate the factor structure and used confirmatory factor analysis to test the construct validity of five factor models from prior research. Results: ：The result indicated that the K-GMDS is characterized by a two-factor structure, different from originally proposed GMDS factor structure and other prior models. Fit indices demonstrated the prior five models to be a poor fit to the data. The internal consistency was demonstrated by a Cronbach’s α of 0.921. Conclusions ：This study can be used as a basis study of male depression, which has not been studied much in Korea. Though factor structure of GMDS reported discrepant findings with prior studies, it would help further development of the scale.

OBJECTIVES: The current Korean Mental Health Act (KMHA) indicates that a patient, who voluntarily gave their permission for admission into a mental health facility, has the right to be discharged upon personal request. However, there is no clause in the KMHA that allows a change in a patient's voluntary status under special circumstances. The purpose of this study was to investigate problems that may arise from the lack of such a clause ; problems that can result in misinterpretation and lead to the prohibition of voluntary admission status conversion. METHODS: Previous cases presented to the National Human Rights Commission of Korea were investigated in order to determine the current state in Korean psychiatric practice regarding the conversion from voluntary to involuntary admission status. In addition, examples of similar mental health legislation in use by the United Nations (UN), World Health Organization (WHO), and several advanced countries pertaining to such conversions were investigated. These examples were used as models for making recommendations for possible changes to the KMHA. RESULTS: From 2010 to 2014, more than 220 petitions were filed with the National Human Right Commission of Korea. The petitions involved voluntarily institutionalized patients who had their requests for discharge rejected. Based on mental health regulations of the UN, WHO, and such countries as the United States, England, Canada, Australia, and Japan, the KMHA should include a provision that, upon receiving a discharge request, allows for discharge refusal if the voluntarily admitted patient is considered not mentally fit. CONCLUSION: The results suggest that the absence of a regulation allowing admission status conversion in the current KMHA is inappropriate. Rectification of this absence is urgently needed.
Australia ; Canada ; England ; Human Rights ; Humans ; Japan ; Korea ; Mental Health ; Patient Admission ; Social Control, Formal ; United Nations ; United States ; World Health Organization

Cutaneous polyarteritis nodosa (PAN) is a benign form of vasculitis of small and medium-sized arteries with chronic benign course without systemic involvement. Corticosteroids are the mainstay of treatment for cutaneous PAN but aspirin and non steroidal anti-inflammatory drugs (NSAIDs) are also used for conservative treatment. We treated five patients with cutaneous PAN using oral dapsone. All patients initially showed good response to dapsone, but exacerbation occurred once the dose of dapsone was tapered or stopped. Patients had mild side effects of dapsone which were hemolytic anemia (4 cases) and abnormal liver function (2 cases). No patient has developed major organ system involvement during 1 to 13 years of follow-up. Instead of using oral Corticosteroid, oral dapsone may be an effective and relatively safe alternative therapy for chronic benign cutaneous PAN.
Adrenal Cortex Hormones ; Anemia, Hemolytic ; Arteries ; Aspirin ; Dapsone ; Follow-Up Studies ; Humans ; Liver ; Polyarteritis Nodosa ; Vasculitis

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency. The clinical presentation can be similar to that of primary adrenal insufficiency, but most of them may be nonspecific. A female patient of 25 months of age, complainig short stature, showed hypocortisolemia without ACTH & cortisol stimulation by insulin-induced hypoglycemia test. All the other hormone state was normal. Left hand AP view revealed delayed bone age(3 month) compared with chronological age. No radiologic abnormality was found in sella MRI and adrenal CT. Here we report a case of isolated ACTH deficiency presented by short stature.
Addison Disease ; Adrenocorticotropic Hormone ; Female ; Hand ; Humans ; Hydrocortisone ; Hypoglycemia ; Magnetic Resonance Imaging

The incidence of hypoxic-ischemic encephalopathy (HIE) is not well known, however, the common causes of hypoxic-ischemic encephalopathy are sudden cardiac arrest, acute respiratory failure and carbon monoxide poisoning. Due to high metabolic demand, the brain is very susceptible to damage from deprivation of blood supply and oxygen delivery. When patients recover from comatose after HIE, there are various spectrums of neurological outcomes, ranging from vegetative state to good recovery. Various methods including neurologic examination, neurophysiologic and biochemical tools, neuroimaging technique have been proposed for the prognostic evaluation of HIE. This article reviews the pathophysiology of HIE and predictive methods for neurological recovery after HIE.
Brain ; Carbon Monoxide Poisoning ; Coma ; Death, Sudden, Cardiac ; Humans ; Hypoxia-Ischemia, Brain* ; Incidence ; Neuroimaging ; Neurologic Examination ; Oxygen ; Persistent Vegetative State ; Respiratory Insufficiency