No abstract available.
Hepatitis*

Intussusception in Schoenlein-Henoch Vasculitis is of interest because of its rarity & the importance of making what may be a difficult diagnosis. We recently experienced one case of Intussusception in Schoenlein-Henoch Vasculitis, who was a 3 year-old girl treated with mannual reduction following surgical operation & we reviewed some literature.
Child, Preschool ; Diagnosis ; Female ; Humans ; Intussusception ; Vasculitis*

Clinical and bacteriological studies were made on 168 cases of culture proved childhood shigellosis at Wallace Memorial Baptist Hospital in Busan between Aug. 1978 and July 1980. The following results were obtained. 1. Of 168 cases, 99 cases were male and 69 were female, the ratio being 1.4:1. The most frequently affected age group was between one three six years(57.7%) and the youngest was one month old infant(2 cases). 2. The peak incidence was in summer (34.5%), however it occurred throughout the year, even in winter(17.3%). 3. The most frequent symptoms on admission were diarrhea (86.9%), fever(77.4%), vomithing (36.9%), convulsion(38.7%) and abdominal pain(28.6%). 4. WBC count in peripheral blood was variable from leukocytosis to leukopenia and over 5% of band form was seen in 52.4%. 5. Sh. Flexneri was the most frequently isolated strain(86.3%) followed by Sh. Sonnei(6.5%), Sh. Boydii(4.8%) and Sh. Dysenteriae (2.4%). 6. The result of sensitivity test reveales that Oxolinic acid was the most sensitive drug(86.2%) followed by Gentamicin(83.9%) and Cefazolin(80.4%). It also revealed the high prevalence of resistance to Ampicillin(88.0%), Chloramphenicol(92.7%) and Tetracycline (95.6%). 7. 54 isolated shigellae strains were tested for Minimal Inhibitory Concentration in tube dilution method and inhibition zone diameter in single disc test (Rifampin disc 5g/ml). MIC were below 12.5g/ml in 77.7% and below 25g/ml in 90.7% and inhibition zone diameter was over 8mm in 88.7%. 8. Clinical response to antibiotic therapy revealed that clinical improvement was seen within 5 days of therapy in 48.1% of Ampicillin therapy group and 58.1% of Septrin therapy group and within 4 days of therapy in 95.7% of initial Rifampin therapy group and 97.2% of altrnative Rifampin therapy group. 9. Bacteriological response to antibiotic therapy revealed that within 4 days of Ampicillin and Septrin therapy the negative conversion rate was 49.1% and 54.4% respectively. The negative conversion within 3days of Rifampin therapy was observed in 93.4% of initial therapy group and 96.6% of alternative therapy group. 10. There was no untoward reaction of Rifampin during therapy except for the reddish discoloration of urine and stool.
Ampicillin ; Busan ; Diarrhea ; Dysentery, Bacillary* ; Female ; Humans ; Incidence ; Leukocytosis ; Leukopenia ; Male ; Oxolinic Acid ; Prevalence ; Protestantism ; Rifampin* ; Shigella ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

PURPOSE: To evaluate the effects of photodynamic therapy with verteporfin on visual acuity and fluorescein angiography in choroidal neovascularization (CNV) associated with pathologic myopia and to determine if this treatment could reproduce the results achieved in the Verteporfin in Photodynamic Therapy (VIP) Trial in Korean patients. METHODS: Forty-two eyes of 39 patients with CNV secondary to pathologic myopia were included. A retrospective review of their clinical records and fluorescein angiography was done. The patients underwent photodynamic therapy with verteporfin and were followed up for more than 6 months after the therapy. The change in best corrected visual acuity (BCVA) and leakage in fluorescein angiography were evaluated. RESULTS: The mean age of the patients was 39.6 and mean follow-up period was 23.5 months. The BCVA of the patients improved in 22 (52.4%) eyes, was unchanged in 13 (30.9%), and worsened in 7 (16.7%). The leakage in fluorescein angiography decreased in 25 (59.5%) eyes. CONCLUSIONS: Photodynamic therapy with verteporfin for myopic CNV in Korean patients appeared to be effective in stabilization of the lesions and improvement of visual acuity.
Choroidal Neovascularization ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Myopia ; Photochemotherapy* ; Retrospective Studies ; Visual Acuity

A 28-year-old female presented with a palpable mass lesion on the superonasal aspect of her right globe and she had a progressive diplopia. She had a scleral encircling surgery with a Miragel explant (MIRA, Waltham, Mass, USA) for the tractional retinal detachment associated with pars planitis 9 years previously. On examination, she revealed restricted eye movements of her right eye. The magnetic resonance imaging documented a swelling of the Miragel explant that mimicked a periorbital mass lesion. The Miragel explant was removed and fragmentation of the explant was found intraoperatively. The removed Miragel explant was examined by a scanning electron microscopy, and this demonstrated a disintergrated and swollen structural composition of the Miragel explant. Postoperatively, her extraocular movement was almost restored and the retina remained well attached. Alterations in the structural composition of the Miragel explant results in an excessive swelling that causes a restriction of the extraocular movement, and this can mimick a periorbital mass lesion.
Adult ; Diplopia/*etiology ; Female ; Granuloma, Plasma Cell, Orbital/*etiology ; Humans ; Magnetic Resonance Imaging ; Polyhydroxyethyl Methacrylate/*adverse effects/*analogs & derivatives ; Retinal Detachment/surgery ; Scleral Buckling/*adverse effects ; Visual Fields

We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.
Chest Tubes ; Chylothorax* ; Drainage ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Parturition ; Pleural Effusion ; Thorax ; Ultrasonography

OBJECTIVE: To evaluate the accuracy of predicted birth weight percentile and large for gestational age(LGA) fetuses by the gestation-adjusted projection method using estimated fetal weight. METHODS: From 462 low-risk pregnancies with singleton fetus, fetal biometry including fetal biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC), and femur length(FL) was made from 30 weeks of gestation until term. Estimated fetal weight(EFW) by combinations of fetal biometry were made by Campbell, Hadlock1, Hadlock2, and Shepard formulas respectively. The diagnostic accuracy according to 4 formulas was assessed by correlation between EFW percentile and birth weight percentile, prediction of LGA fetuses, and prediction error(percentile difference between birth weight and EFW). RESULTS: The mean gestational age on ultrasound and on birth, and birth weight were 33.21 +/- 2.08(30-40) weeks, 38.43 +/- 1.72(30-42) weeks, and 3.14 +/- 0.47(0.99-4.38) Kg, respectively. The diagnostic accuracies of gestation-projection method using EFW were similar result to predict birth weight percentile and LGA fetuses according to 4 formulas. Correlation between EFW percentile and birth weight percentile(correlation coefficient, r) were Campbell: 0.644(p <0.001), Hadlock 1: 0.682(p <0.001), Hadlock 2: 0.681(p <0.001), Shepard: 0.638(p <0.001), respectively. Youden's index(sensitivity + specificity - 1) in prediction of LGA fetuses were Campbell: 0.532, Hadlock1: 0.525, Hadlock2: 0.520, Shepard: 0.549, respectively. Prediction error were Campbell: 18.14+/-16.56, Hadlock1: 16.19+/-14.35, Hadlock2: 16.10+/-14.29, Shepard: 19.68+/-17.00, respectively. The prediction error was increased according to increasing of lapse time(p <0.001), gestational weeks on ultrasound, and estimated fetal weight percentile, and decreasing birth weight percentile(p <0.001)(R square=0.411, (p <0.001). But, amniotic fluid index did not affect to prediction error(p=0.199). CONCLUSION: Our study presented relatively accurate prediction for birth weight percentile and LGA fetuses from remote sonographic examination. If LGA fetuses was suspected by antenatal ultrasound, adequate therapy and periodic observation are recommended for good perinatal outcome.
Amniotic Fluid ; Biometry ; Birth Weight* ; Female ; Femur ; Fetal Weight* ; Fetus* ; Gestational Age* ; Head ; Parturition* ; Pregnancy ; Sensitivity and Specificity ; Ultrasonography

Purpose: We investigated the clinical efficacy of immune checkpoint blocker (ICB) therapy for metastatic or advanced melanoma in Korean patients. As well, we assessed whether the effects of ICBs can be enhanced by combination therapy with palliative radiotherapy (RT). Materials and Methods: We retrospectively reviewed the records of 127 patients with metastatic melanoma who received ICB with or without palliative RT between 2014 and 2018. The melanoma subtypes were classified as follows: chronic sun-damaged (CSD), acral, mucosal, and uveal. The primary endpoint was the objective response rate (ORR). Results: The overall ORR was 15%, with 11 complete and eight partial responses. ORRs for CSD, acral/mucosal, and uveal melanomas were 50%, 16.5%, and 0%, respectively (p=0.009). In addition to the subtype, stage at treatment, total tumor burden at treatment, and ICB type were significantly associated with ORR (all p < 0.05). Palliative RT was administered in 44% of patients during the treatment, and it did not affect ORR. Clinical responders to ICB therapy exhibited significantly higher 1-year progression-free and overall survival rates than nonresponders. Conclusion ORR for ICB monotherapy in Korean patients with melanoma is relatively modest compared with that in Western patients because the non-CSD subtypes are predominant in the Korean population. Our findings regarding combination therapy with ICB provided a rationale for the initiation of our phase II study (NCT04017897).

OBJECTIVE: To compare the clinical outcomes between Day 2 and Day 3 embryo transfer(ET) groups in in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). METHODS: From May, 1997 to December, 1998, 174 cycles of IVF-ET with ICSI were performed and classified into two groups: Day 2 ET group(n=134) and Day 3 ET group (n=40). In Day 3 ET group, embryos fertilized after ICSI were cultured in vitro for further 24 hours in M3 media. RESULTS: There were no significant differences in the age and BMI of patients, basal serum FSH level, protocol of controlled ovarian hyperstimulation(COH), indication of ICSI, and source of sperm for ICSI between two groups. Only the number of the previous failed IVF-ET cycles was significantly higher in Day 3 ET group(p<0.05). Serum E2 level on hCG day, the numbers of oocytes retrieved after COH, oocytes fertilized after ICSI, and embryos transferred, and the rates of fertilization, cleavage, and implantation showed no significant differences. However, cumulative embryo score(CES) was significantly higher in Day 3 ET group(p<0.05). Although there were no significant differences in the rates of pregnancy per ET, spontaneous abortion, and live birth, the rates of biochemical and multiple pregnancy were significantly higher in Day 3 ET group(p<0.05). CONCLUSIONS: In IVF-ET with ICSI, the relatively higher CES may contribute to the higher risk of multiple pregnancy in Day 3 ET group, compared with the conventional Day 2 ET group.
Abortion, Spontaneous ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

Objective: : The effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). Methods: : We analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1–3 and 3–5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. Results: : After GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0–17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150–0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5–11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. Conclusion : The small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.