Isolated and severe left main coronary ostial stenosis is a rare case. In the majority of these patients ostial stenosis was associated with any of the conditions known to involve the coronary ostia. These conditions include syphilitic aortitis, Takayasu's aortitis, familial hypercholesterolemia, and aortic valve disease. A 34-year young female patient was presented with exertional and stabbing anterior chest pain. There was no history of syphilis, diabetes mellitus, hypertension, hyperlipidemia and smoking. Coronary angiogram showed isolated left main coronary ostial stenosis. Transesophageal echocardiography(TEE) showed acute angle takeoff of the left main coronary artery. She underwent surgical angioplasty of coronary ostia with a patch of autologous pericardium. After angioplasty, TEE showed dilatation of left main coronary ostium and her clinical symptom improved.
Angioplasty ; Aortic Valve ; Aortitis ; Chest Pain ; Constriction, Pathologic* ; Coronary Vessels ; Diabetes Mellitus ; Dilatation ; Female ; Humans ; Hyperlipidemias ; Hyperlipoproteinemia Type II ; Hypertension ; Pericardium ; Smoke ; Smoking ; Syphilis ; Syphilis, Cardiovascular

PURPOSE: To evaluate the MR imaging findings of liposarcomas of different histologic subtypes. MATERIALS AND METHODS: We evaluated MR images of 21 patients (5 men and 16 women, mean age, 55 years) with liposarcoma andcorrelated the findings with the results of histopathology. In the study group seven liposarcomas werewell-differentiated, seven were myxoid, three were mixed, two were pleomorphic, and one was round cell. RESULTS: On T1 -and T2 - weighted images, six of seven well-differentiated liposarcomas showed signal intensity equal tothe fat and hypointense septa, while the other showed low signal intensity on a T1 -weighted image, heterogeneoushigh signal intensity on a T2- weighted image, heterogeneous enhancement after the administration of contrastmedia and was dedifferentiate. Nine masses in seven patients with myxoid liposarcoma showed low signal intensityon T1-weighted images, six of the nine showed lace-like foci of high signal intensity. On T2 -weighted images, allmasses showed homogeneous high signal intensity. After administration of contrast media, five of seven massesshowed heterogeneous enhancement. Two of three mixed form were well-differentiated and myxoid types, and twosubtypes were separable on MR. Pleomorphic, round cell, mixed type myxoid and pleomorphic and unclassified casesshowed low signal intensity on T1-weighted images, heterogeneous high signal intensity on T2-weighted andheterogeneous enhancement. CONCLUSION: Using MR imaging, well-differentiated and myxoid liposcarcomas may bedifferentiated from other types.
Contrast Media ; Female ; Humans ; Liposarcoma* ; Liposarcoma, Myxoid ; Magnetic Resonance Imaging ; Male

Primary pulmonary malignant melanoma is an extremely rare type of melanoma. The radiologic features of primary pulmonary malignant melanoma are nonspecific; however, it almost always presents as a well-demarcated round or lobulated solitary solid nodule or mass. Herein, we report the case of a 78-year-old male with primary pulmonary malignant melanoma that was mistaken for primary pulmonary adenocarcinoma with lepidic growth and was seen as bilateral multiple subsolid nodules on CT.

PURPOSE: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. METHODS: A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2–5 of the PCT levels with the lowest quintile. RESULTS: The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ≤ 3 days after admission and hospital stay ≤ 6 days. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ≤ 3 days. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. CONCLUSION: Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.
Bronchopneumonia ; C-Reactive Protein ; Child* ; Diagnosis ; Drug Resistance ; Fever* ; Hospitalization ; Humans ; Immunoglobulin M ; Inflammation ; L-Lactate Dehydrogenase ; Length of Stay ; Leukocytes ; Logistic Models ; Mycoplasma pneumoniae ; Mycoplasma* ; Odds Ratio ; Pneumonia ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction ; Risk Factors*

OBJECTIVES: Pathogenic Vibrio species are widely distributed in warm estuarine and coastal environments, and can infect humans through the consumption of raw or mishandled contaminated seafood and seawater. For this reason, the distribution of these bacteria in South Korea was investigated.METHODS: Seawater samples were collected from 145 coastal area points in the aquatic environment in which Vibrio species live. Environmental data (i.e., water temperature, salinity, turbidity, and atmospheric temperature) was collected which may help predict the distribution of the species (data not shown). Seawater samples were filtered, and incubated overnight in alkaline peptone water, at 37°C. Using species-specific polymerase chain reaction methods, screening tests were performed for the hlyA, ctxA, vvhA, and tlh genes. Clones of pathogenic Vibrio species were isolated using 3 selective plating media.RESULTS: In 2017, total seawater isolation rates for Vibrio vulnificus, Vibrio cholerae (non-pathogenic, non-O1, non-O139 serogroups), and Vibrio parahaemolyticus were 15.82%, 13.18%, 65.80%, respectively. However, in 2018 isolation rates for each were 21.81%, 19.40%, and 70.05%, respectively.CONCLUSION: The isolation rates of pathogenic Vibrio species positively correlated with the temperature of seawater and atmosphere, but negatively correlated with salinity and turbidity. From 2017 to 2018, the most frequent seawater-isolated Vibrio species were V. parahaemolyticus (68.10 %), V. vulnificus (16.54%), and non-toxigenic V. cholerae (19.58%). Comprehensive monitoring, prevention, and control efforts are needed to protect the public from pathogenic Vibrio species.
Atmosphere ; Bacteria ; Cholera ; Clone Cells ; Humans ; Korea ; Mass Screening ; Peptones ; Polymerase Chain Reaction ; Salinity ; Seafood ; Seawater ; Vibrio cholerae ; Vibrio parahaemolyticus ; Vibrio vulnificus ; Vibrio ; Water

Background: This study aimed to examine the occupational stress and quality of life of mental health welfare center workers and to identify the impact of occupational stress on compassion satisfaction, burnout, and secondary traumatic stress. Methods: This study included 588 employees working at 15 provincial/municipal/regional mental health welfare centers. Demographic and psychosocial factors were surveyed. Data were analyzed using independent t-test, Pearson’s correlation test, and multiple regression analysis. Results: The high-risk group for occupational stress showed low compassion satisfaction, high burnout, and high secondary traumatic stress. Compassion satisfaction showed a significant negative correlation with occupational stress. Burnout and secondary traumatic stress showed a significant positive correlation with occupational stress.Occupational stress factors affecting compassion satisfaction included lack of reward (β=−0.155, p<0.001), whereas those affecting burnout included physical environment (β=0.028, p<0.01), job demand (β=0.042, p<0.001), relationship conflict (β=0.033, p<0.01), job instability (β=0.016, p<0.01), lack of reward (β=0.051, p<0.001), and occupational climate (β=0.024, p<0.01). Additionally, occupational stress factors affecting secondary traumatic stress included physical environment (β=0.063, p<0.001) and job instability (β=0.020, p<0.05). Conclusion Occupational stress had a significant impact on compassion satisfaction, burnout, and secondary traumatic stress. Therefore, active interventions against occupational stress factors are necessary to improve the quality of life of mental health welfare center workers.

The aim of the study is to investigate the association between cerebral white matter hyperintensity (WMH) and the functional improvement using the Korean version of Modified Barthel Index (K-MBI) score during inpatient stroke rehabilitation. One hundred sixty participants were divided into 2 groups based on the severity of WMH according to Fazekas scale: Mild WMH group was defined as patients with Fazekas scale 0 and 1, and severe WMH group was defined as Fazekas scale 2 and 3. Functional status was assessed using the K-MBI score, and functional gains were calculated from the K-MBI score. The absolute functional gain in mild WMH group was significantly higher compared to severe WMH group (p < 0.05). In addition, patients in mild WMH had higher absolute functional efficiency, rehabilitation effectiveness, and relative functional efficiency. In the generalized linear model analyses, there was an association between functional outcomes and severity of WMH. In this study, the severity and extent of WMH are significantly correlated with poor functional improvement in patients with ischemic stroke. The WMH could be considered as one of many factors that can influence functional recovery during rehabilitation of stroke.
Humans ; Inpatients ; Linear Models ; Recovery of Function ; Rehabilitation ; Stroke ; White Matter

PURPOSE: The endoscopic surgery has been widely used and developed in operations of the thyroid and parathyroid gland because of the cosmetic advantage and the development of laparoscopic instrument. Since the first endoscopic thyroid surgery in late 1990's, many endoscopic operations for thyroid tumors have been performed in Korea. The authors analyzed the current status of endoscopic thyroid surgery performed in Korea. METHODS: We have collected and analyzed the data of endoscopic thyroid operations using survey. RESULTS: The surgeons working in 16 hospitals answered the questions in survey. The total endoscopic thyroid operations were performed over 1,200 cases until the end of 2004. In the pathologic diagnosis, nodular hyperplasia was most frequent in 64.5%. The axillary approach was most frequently applied in 9 hospitals (56.2%). Most of endoscopic thyroid operations were performed in 2~3 hours. The operation time was decreased according to the experience. The endoscopic surgery for malignant tumors were also performed in 11 hospitals, The hospital stay was usually 3~4 days. The most common complications in endoscopic thyroid surgery were temporary recurrent laryngeal nerve paralysis and anteior chest wall discomfort or paresthesia. The most common reason for conversion to conventional surgery was the intraoperative diagnosis as for a malignancy. CONCLUSION: Endoscopic thyroid surgery has been perfomed in many hospitals not only special thyroid clinic in Korea. The operation cases are increasing rapidly in these days. According to the development of technique and instrument, the endoscopic surgery are applied to various neck disease involving malignancy. The safety and efficacy of endoscopic surgery for malignancy should be further evaluated with accumulation of experience of endoscopic operation and long term follow-up of thyroid cancer patients.
Diagnosis ; Follow-Up Studies ; Humans ; Hyperplasia ; Korea* ; Length of Stay ; Neck ; Paralysis ; Parathyroid Glands ; Paresthesia ; Recurrent Laryngeal Nerve ; Surgeons ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*

Background/Aims: The risk for colonoscopic postpolypec-tomy bleeding (PPB) in patients with chronic liver disease (CLD) remains unclear. We determined the incidence and risk factors for colonoscopic PPB in patients with CLD, espe-cially those with liver cirrhosis. Methods: We retrospectively reviewed the medical records of patients with CLD who un-derwent colonoscopic polypectomy at Seoul National Univer-sity Hospital between 2011 and 2014. The study endpoints were immediate and delayed PPB. Results: A total of 1,267 consecutive patients with CLD were included in the study. Im-mediate PPB occurred significantly more often in the ChildPugh (CP) B or C cirrhosis group (17.5%) than in the CP-A (6.3%) and chronic hepatitis (4.6%) groups (p<0.001). More-over, the incidence of delayed PPB in the CP-B or C cirrhosis group (4.4%) was significantly higher than that in the CP-A (0.7%) and chronic hepatitis (0.2%) groups (p<0.001). The independent risk factors for immediate PPB were CP-B or C cirrhosis (p=0.011), a platelet count <50,000/μL (p<0.001), 3 or more polyps (p=0.017), endoscopic mucosal resection or submucosal dissection (p<0.001), and polypectomy per-formed by trainees (p<0.001). The independent risk factors for delayed PPB were CP-B or C cirrhosis (p=0.009), and pol-yps >10 mm in size (p=0.010). Conclusions Patients with CP-B or C cirrhosis had an increased risk for bleeding fol-lowing colonoscopic polypectomy.