Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a chronic respiratory condition with significant morbidity and mortality. Globally, the disease burden of NTM-PD is growing. This study reviews the current state of NTM-PD in Korea and worldwide, followed by a discussion of known risk factors.Current Concepts: In most countries, NTM-PD is not specified as a notifiable disease; thus, determining the actual incidence and prevalence has been challenging. When NTM-PD is defined using microbiological and diagnostic coding criteria, data consistently show a dramatic increase in the worldwide incidence and prevalence of NTM-PD. Although the cause of this increase is not completely understood, it is believed to result from a complex interplay of environmental and host-related factors that facilitates increased interactions between patients and the bacterium, as well as promoting mycobacterial survival within the hosts.Discussion and Conclusion: The global incidence, prevalence, and socioeconomic burden of NTM-PD is increasing, necessitating a comprehensive approach to understand this phenomenon. As a first step, the establishment of a coordinated system for identifying and managing patients with NTM-PD is imperative.

PURPOSE: To perform a cross-cultural adaptation and to test the measurement properties of the Korean version of International Knee Documentation Committee (K-IKDC) Subjective Knee Form. MATERIALS AND METHODS: According to the guidelines for cross-cultural adaptation, translation and backward translation of the English version of the IKDC Subjective Knee Form were performed. After translation into the Korean version, 150 patients who had knee-related problems were asked to complete the K-IKDC, Lysholm score, and Short Form-36 (SF-36). Of these patients, 126 were retested 2 weeks later to evaluate test-retest reliability, and 104 were recruited 3 months later to evaluate responsiveness. Construct validity was analyzed by investigating the correlation with Lysholm score and SF-36; content validity was also evaluated. Standardized mean response was calculated for evaluating responsiveness. RESULTS: The test-retest reliability proved excellent with a high value for the intraclass correlation coefficient (r=0.94). The internal consistency was strong (Cronbach's alpha=0.91). Good content validity with absence of floor not ceiling effects and good convergent and divergent validity were observed. Moderate responsiveness was shown (standardized mean response=0.689). CONCLUSIONS: The K-IKDC demonstrated good measurement properties. We suggest that this instrument is an excellent evaluation instrument that can be used for Korean patients with knee-related injuries.
Humans ; Knee ; Outcome Assessment (Health Care)

Hand tumors arise from the skin, subcutaneous tissue, tendons, nerves, blood vessels, and bones, and are of many different types. Most of them are benign but malignant lesions also occur, although only rarely. The authors have encountered 115 cases of tumors of the hand at Seoul National University Hospital between 1975 and 1984 and the following results were obtained; l. In our series of 115 cases of hand tumors (bone tumor; 47 cases, soft tissue tumor; 68 cases), most of them are benign (110 cases, 96%). 2. There are no demonstrable differences in the sex and distribution. 3. Of the bone tumors in the hand, enchondroma is most common (25 cases, 53%), followed by giant cell tumor (9 cases, 19%), and osteochondroma (7 cases, 15%). 4. Of the soft tissue tumors in the hand, ganglion is most common (28 cases, 41%), followed by hemangioma (16 cases, 24%), and xanthoma (8 cases, 12%). 5. Of the treatment modalities of bone tumors in the hand, the most frequent one is curettage and bone graft (26 cases, 53%), followed by excision, and en bloc resection and bone graft (8 cases, 16%, respectively). 6. Of the treatment modalities of soft tissue tumors in the hand, the most frequent one is excision (64 cases, 93%). 7. Although giant cell tumor, hemangioma, and lymphangioma are classified as benign histologically, their clinical course appears to be malignant, because of incomplete excision and recurrence.
Blood Vessels ; Chondroma ; Curettage ; Ganglion Cysts ; Giant Cell Tumors ; Hand ; Hemangioma ; Lymphangioma ; Osteochondroma ; Recurrence ; Seoul ; Skin ; Subcutaneous Tissue ; Tendons ; Transplants ; Xanthomatosis

We report a case of somatostatinoma, which manifested as insulinoma after liver metastasis. A 74-year-old man suffered from diabetes mellitus and jaundice. The abdominal CT scan of this patient showed a mass in the pancreas head, which obstructed biliary duct. He underwent Whipples procedure. Immunohistochemical staining of postoperative specimen disclosed that this tumor was strongly positive for somatostatin. After 4 months, follow up CT scan showed multiple metastatic lesions in the liver. We performed transarterial chemoinfusion two times, but the response was disappointing. After 2 months, he suffered from altered mentality, which was relieved by intake of sugar. Biochemical laboratory findings and immunohistochemical staining of liver biopsy disclosed that the metastatic lesion in this patient was insulinoma. We performed embolization of hepatic artery with gelform. The biochemical response was dramatic, but he died of septic shock, which was caused by gas forming liver abscess. In summary, we report a case of somatostatinoma which manifested as insulinoma after metastasis to the liver.
Aged ; Biopsy ; Diabetes Mellitus ; Follow-Up Studies ; Head ; Hepatic Artery ; Humans ; Insulinoma* ; Jaundice ; Liver Abscess ; Liver* ; Neoplasm Metastasis ; Pancreas ; Shock, Septic ; Somatostatin ; Somatostatinoma* ; Tomography, X-Ray Computed

Recently, we experienced two advanced gastric cancer (AGC) patients younger than 17 years of age. The first case was a 15-year, 2-month-old male who had suffered from epigastric soreness for 5 weeks. His grandfather died of gastric cancer at 39 years of age. Under the diagnosis of AGC, he underwent a total gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 4.5x4 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 42 regional lymph nodes (T2bN2M0). The second case was a 17-year, 11-month-old male who had suffered from epigastric pain for 2 years without familial clustering. Under the diagnosis of AGC, he underwent a distal subtotal gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 3x2 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 45 regional lymph nodes (T2bN2M0). The two patients have been alive without recurrence for 27 months and 4 months, respectively. Even among teenagers, patients with abdominal complaints should be subjected to a thorough examination of the gastrointestinal tract.
Adenocarcinoma ; Adolescent ; Diagnosis ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Infant ; Lymph Node Excision ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms*

A gastric duplication cyst is an extremely rare developmental anomaly, comprising 2~8% of all alimentary duplication cysts with most being reported in children. However, this condition should be included in a differential diagnosis of partially obstructing cystic masses of the stomach. Moreover, the possibility of a malignancy within it should be considered particularly in adults. The excision of duplication cysts has become feasible with the introduction of laparoscopic gastric surgery. We report a 17-year-old female suffering from postprandial abdominal discomfort and nausea. Two cystic lesions in her stomach were found by preoperatively endoscopic ultrasonography (EUS) and the computed tomography (CT). Laparoscopic wedge resections of the gastric lesions were performed, and the postoperative pathologic examination disclosed multiple gastric duplication cysts with no evidence of a malignancy. The patient made an uneventful postoperative recovery and has remained a asymptomatic for 8 months after surgery.
Adolescent ; Adult* ; Child ; Diagnosis, Differential ; Endosonography ; Female ; Humans ; Laparoscopy ; Nausea ; Stomach

Primary lymphoma of the thyroid is a relatively rare malignant tumor of the thyroid. It is known to be frequently associated with Hashimoto's thyroiditis. In Korea, a few cases of primary lymphoma of the thyroid have been reported and most of these cases were in the stage I E or II E. Recently, we experienced a case of the primary thyroid lymphoma, stage IV E associated with Hashimoto's thyroiditis in a 70-year-old woman who presented with dysphagia and dyspnea due to rapidly enlarging neck mass.She was treated with combination chemotherapy(cyclophosphamide, adriamycin, vincristine and methylprednisolone) and local radiotherapy and achieved partial response with resolution of dysphagia and dyspnea.
Aged ; Bone Marrow ; Deglutition Disorders ; Doxorubicin ; Dyspnea ; Female ; Humans ; Korea ; Lymphoma ; Neck ; Radiotherapy ; Thyroid Gland ; Thyroiditis ; Vincristine

OBJECTIVE: To develop a simplified functional scale and classification system to evaluate the functional abilities of patients with Duchenne muscular dystrophy (DMD). METHODS: A Comprehensive Functional Scale for DMD (CFSD) was developed using the modified Delphi method. The accompanying Ambulatory Functional Classification System for DMD (AFCSD) was developed based on previously published classification systems. RESULTS: The CFSD consists of 21 items and 78 sub-items, assessing body structure and function, activities, and participation. Inter-rater intraclass correlation coefficient values were above 0.7 for 17 items. The overall limits of agreement between the two examiners ranged from -6.21 to 3.11. The Spearman correlation coefficient between the total score on the AFCSD and the Vignos Functional Scale was 0.833, and 0.714 between the total score of the AFCSD and the Brooke scale. Significant negative correlations existed between the total score for each functional level of the AFCSD and each functional grade of the Vignos and Brooke scales. The total scores of the CFSD varied significantly between the functional grades of the Vignos scale, and specific grades of the Brooke scale. For the AFCSD, total scores of the CFSD varied significantly between the functional levels. CONCLUSION: We have developed a new scale and the associated classification system, to assess the functional ability of children diagnosed with DMD. Preliminary evaluation of the psychometric properties of the functional scale and classification systems indicate sufficient reliability and concurrent validity.
Child ; Classification* ; Humans ; Methods ; Muscular Dystrophy, Duchenne* ; Psychometrics ; Reproducibility of Results* ; Weights and Measures

Very virulent infectious bursal disease virus (vvIBDV) causes high mortality in chickens but measures to reduce the mortality have not been explored. Chickens (8–9 weeks) were treated with 3 agents before and during vvIBDV inoculation. Dexamethasone treatment reduced the mortality of infected chickens (40.7% vs. 3.7%; p < 0.001), but treatment with aspirin or vitamin E plus selenium did not affect the mortality. The bursa of Fabricius appeared to have shrunk in both dead and surviving chickens (p < 0.01). The results indicate that dexamethasone can reduce mortality in vvIBDV-infected chickens and may provide therapeutic clues for saving individual birds infected by the virus.

Objective: To evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs. Materials and Methods: Nine patients (8 females and 1 male; age range, 23–65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics. Results: Feeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions).TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers. Conclusion Single-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.