No abstract available.
Audiometry*

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

We experienced a case of aldosterone and cortisol secreting adrenal adenoma associated with pregnancy in a 23 year old female patient.The patient complained of severe thoraco-lumbar pain, weight gain, sweating, anxiety, and mild abdominal discomfort. On physical findings, hypertension, tachycardia, facial plethora, moon face, buffalo hump and truncal obesity were found.
Adenoma ; Aldosterone ; Anxiety ; Buffaloes ; Female ; Humans ; Hydrocortisone ; Hypertension ; Moon ; Obesity ; Pregnancy ; Sweat ; Sweating ; Tachycardia ; Weight Gain

The incidence of infrarenal aneurym is about 6 percent after the age 60 years. A primary aortocaval fistula is present in less than 1% of all abdominal aortic aneurysms. Atherosclerotic abdominal aortic aneurysm account for about 90% of spontanous aortocaval fistula. The most common site of fistulation is the inferior vena cava. Until recently, surgical repair was the only method of treatment and was associated high incidence of morbidity and motality. With rapid development of aortic stent-graft technique, endovascular stent-graft repair may offer an alterative to the management of this often fatal condition. We report a case of 72-years old male with aortocaval fistula in the abdominal aorta, which was treated with endovascular stent-graft implantation. About 30 days before procedure, the patient diagnosed inferior acute myocardial infarction with triple vessel disease and also suffered from chronic obstructive pulmonary disease. After the stent-graft inserting, no further communication from aorta to inferior vena cava and improving symptoms and sign of congestive heart failure. He was discharged without complication, about 2 months after admission.
Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Endovascular Procedures ; Fistula* ; Heart Failure ; Humans ; Incidence ; Male ; Myocardial Infarction ; Pulmonary Disease, Chronic Obstructive ; Rupture* ; Vena Cava, Inferior

No abstract available.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Vulva*

Recent reports have described an increasing incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in patients who do not exhibit established risk factors for healthcare exposure. We report two cases of CA-MRSA bacteremia complicated by vertebral osteomyelitis. Both of CA-MRSA isolates were resistant to beta-lactam agents, but susceptible to clindamycin, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and tetracycline. Both isolates carried staphylococcal cassette chromosome mec (SCCmec) type IVA, and were identified as sequence type (ST) 72 by mlultilocus sequence typing (MLST). However, the Panton-Valentine leukocidin (PVL) gene was not identified.
Bacteremia ; Bacterial Toxins ; Ciprofloxacin ; Clindamycin ; Delivery of Health Care ; Exotoxins ; Gentamicins ; Humans ; Incidence ; Leukocidins ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Risk Factors ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

Recent reports have described an increasing incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in patients who do not exhibit established risk factors for healthcare exposure. We report two cases of CA-MRSA bacteremia complicated by vertebral osteomyelitis. Both of CA-MRSA isolates were resistant to beta-lactam agents, but susceptible to clindamycin, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and tetracycline. Both isolates carried staphylococcal cassette chromosome mec (SCCmec) type IVA, and were identified as sequence type (ST) 72 by mlultilocus sequence typing (MLST). However, the Panton-Valentine leukocidin (PVL) gene was not identified.
Bacteremia ; Bacterial Toxins ; Ciprofloxacin ; Clindamycin ; Delivery of Health Care ; Exotoxins ; Gentamicins ; Humans ; Incidence ; Leukocidins ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Risk Factors ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: The myelodysplastic syndromes (MDS) can be categorized as a group of clonal hematopoietic disorders characterized by ineffective hematopoiesis and peripheral cytopenias. Although the natural history of MDS varies, traditional treatments are not curative and allogeneic marrow transplantation offers potentially curative treatment for MDS. METHODS: In our center, 10 patients underwent allogeneic bone marrow transplantation (BMT) between December 1989 and May 1997. The minimum follow-up of 3 months was possible in 10 patients, for whom treatment-related complications and clinical outcomes were assessed. RESULTS: The median age of the 10 patients was 33 (range 20~40) years. The median time from diagnosis to BMT was 34 (3~116) months. By morphology, 5 patients had advanced MDS (i.e., RAEB, RAEB-t, CMML) and 5 patients had less advanced MDS (RA). By Bournemouth score, 8 patients had a score 2~3 and two patients had a score 4. By IPSS, 5 patients were in intermediate-1 group, 3 patients in intermediate-2 group and 2 patients in high risk group. Patients were prepared for transplant with either a total body irradiation (TBI)+cyclophosphamide (n=7), busulfan+TBI (n=2) and busulfan+cyclophophamide (n=1). All patients received CsA+short course MTX for GVHD prophylaxis. Successful engraftment was confirmed in all patients. The overall incidence of acute GVHD was noted in 70% (7/10 patients) and grade IV acute GVHD developed in 2 patients (20%). Five patients were evaluable for the development of chronic GVHD and 2 patients (40%) developed limited chronic GVHD. The duration of median follow-up was 8.1 months. At present five patients are alive and disease-free 3 to 21 months (median survival duration : 8.2 months) post-transplantation resulting in a 2-year disease-free survival of 44%. 2-year disease free survival was 63% in less advanced MDS and 25% in advanced MDS. CONCLUSION: Allogeneic BMT should be considered when any clinical evidence of disease progression to a more advanced stage becomes apparent. International prognostic scoring system (IPSS) and Bournemouth score can also be used to gauge timing for BMT. For patients were in intermediate-1 or intermediate-2 group by IPSS, BMT can be justified if the patient is young and has an HLA matched sibling donor.
Anemia, Refractory, with Excess of Blasts ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Disease Progression ; Disease-Free Survival ; Follow-Up Studies ; Hematopoiesis ; Humans ; Incidence ; Myelodysplastic Syndromes* ; Natural History ; Siblings ; Tissue Donors ; Whole-Body Irradiation

BACKGROUND: Bile examination is believed to be the most precise method for detecting Clonorchis sinensis (CS) eggs. We carried out bile examination to evaluate infestation state of CS in patients with pancreatobiliary diseases in Ulsan, known as an endemic area of CS infestation. METHODS: We examined CS eggs in bile in three hundreds and nine patients with pancreatobiliary diseases. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes. RESULTS: The overall egg positive rate was 27.5% (35.3% in male, 17.6% in female). The egg positive rate was not significantly different according to the age group: 20.0% in thirties, 26.7% in forties, 24.2% in fifties, 29.9% in sixties, 36.2% in seventies and 16.7% in eighties or more. The egg positive rate according to the disease, except CS cholangitis, was not also statistically different: 32.6% in bile duct cancer, 38.5% in gallbladder cancer, 11.1% in ampulla of Vater cancer, 24.0% in pancreatic cancer, 26.4% in gallstone diseases and 12.5% in the reminder. The location of gallstone and whether CS related diseases or CS unrelated diseases did not affect the egg positive rates. The egg positive rate in patients with normal radiological findings including cholangiography was 17.0%. CONCLUSION: This result shows that regardless of age, sex, and sorts of diseases, the infestation rate of CS was very high. On the basis of our results, it is therefore presumes that clonorchiasis is still endemic disease in Korea.
Ampulla of Vater ; Bile Duct Neoplasms ; Bile* ; Biliary Tract Diseases ; Cholangiography ; Cholangitis ; Clonorchiasis ; Clonorchis sinensis* ; Drainage ; Eggs ; Endemic Diseases ; Gallbladder Neoplasms ; Gallstones ; Humans ; Korea ; Male ; Ovum ; Pancreatic Diseases ; Pancreatic Neoplasms ; Ulsan*

INTRODUCTION: Chest radiographs (CXRs) are widely used for the screening and management of COVID-19. This article describes the radiographic features of COVID-19 based on an initial national cohort of patients. METHODS: This is a retrospective review of swab-positive patients with COVID-19 who were admitted to four different hospitals in Singapore between 22 January and 9 March 2020. Initial and follow-up CXRs were reviewed by three experienced radiologists to identify the predominant pattern and distribution of lung parenchymal abnormalities. RESULTS: In total, 347 CXRs of 96 patients were reviewed. Initial CXRs were abnormal in 41 (42.7%) out of 96 patients. The mean time from onset of symptoms to CXR abnormality was 5.3 ± 4.7 days. The predominant pattern of lung abnormality was ground-glass opacity on initial CXRs (51.2%) and consolidation on follow-up CXRs (51.0%). Multifocal bilateral abnormalities in mixed central and peripheral distribution were observed in 63.4% and 59.2% of abnormal initial and follow-up CXRs, respectively. The lower zones were involved in 90.2% of initial CXRs and 93.9% of follow-up CXRs. CONCLUSION In a cohort of swab-positive patients, including those identified from contact tracing, we found a lower incidence of CXR abnormalities than was previously reported. The most common pattern was ground-glass opacity or consolidation, but mixed central and peripheral involvement was more common than peripheral involvement alone.
COVID-19 ; Humans ; Lung/diagnostic imaging* ; Radiography, Thoracic ; Retrospective Studies ; SARS-CoV-2 ; Singapore