We report a case of primary cardiac angiosarcoma in a 35 year-old woman. She presented with dyspnea, facial edema and neck vein distension during 1 month. The oval round large mass(8x4 cm) filling the right atrium infiltrated into the entire thickness of the lateral wall and extended to the vena cava and ventricle. The interatrial septum and pericardium seemed to be intact. Despite the surgical excision and adjuvant chemo-and radiotherapy, the patient died 8 months later due to tumor recurrence. The histologic findings of tumor varied from benign looking capillary proliferation mimicking granulation tissue to sarcoma composed of spindle cells. But anastomosing vascular channels lined by anaplastic polygonal cells and intracytoplasmic lumen containing red blood cells were characteristic findings. These tumor cells showed positive reaction to endothelial cell antigen and factor VIII-related antigen. The intercellular junctional complex and vascular channels formed by cytoplasmic process of tumor cells were identified by the ultrastructural study.
Female ; Humans

PURPOSE: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. METHODS: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. RESULTS: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. CONCLUSION: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.
Ambulatory Care Facilities ; Child ; Eating ; Feeding Behavior ; Feeding Methods ; Humans ; Meals ; Parents ; Surveys and Questionnaires

PURPOSE: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. METHODS: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170girls and 205boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents'education and occupation using a modified Hollingshead index. RESULTS: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower class). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). CONCLUSION: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.
Adolescent* ; Crowding ; Education ; Enzyme-Linked Immunosorbent Assay ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Logistic Models ; Occupations ; Odds Ratio ; Parents ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Seroepidemiologic Studies ; Social Class*

An association between primary sclerosing cholangitis and ulcerative colitis is well known. But, primary sclerosing cholangitis with ulerative colitis has been rarely reported in children. The prevalence of primary sclerosing cholangitis among ulcerative colitis patiens is 3% in children. Primary sclerosing cholangitis is characterised by inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts. The diagnosis of primary sclerosing cholangitis based on biochemical, histologic and cholangiographic criteria. A twofold or greater elevation of serum alkaline phosphatase is required to suspect this diagnosis. The definitive diagnosis of primary sclerong cholangitis can usually made by cholangiography. The prognosis varies. No adequate treatment exists although a number of potential treatments have been evaluated. We experienced a case of primary sclerosing cholangitis with ulcerative colitis in a 14 year old girl. She was admitted with a history of intermittent bloody diarrhea and jaundice over a two year period. Hepatosplenomegaly and cholestasis had been noted. Abnormal liver function tests were noted. AST was 117U/l, ALT 179U/l, alkaline phosphatase 603U/l, gamma-GT 366U/l, total bilirubin 5.5mg/dl. An endoscopic retrograde cholecystopancreatography showed evidence of strictures, beading, and irregularities of intra and extrahepatic biliary system. Liver biopsy showed histologic findings compatible with a sclerosing cholangitis and evidence of periductular fibrosis. She sufferred from persistent cholestasis and sign of portal hypertension. She had developed recurrent episodes of variceal hemorrhages which had been successfully managed several times endoscopic variceal ligations.
Adolescent ; Alkaline Phosphatase ; Bile Ducts, Extrahepatic ; Bilirubin ; Biopsy ; Child ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing* ; Cholestasis ; Colitis ; Colitis, Ulcerative* ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Female ; Fibrosis ; Hemorrhage ; Humans ; Hypertension, Portal ; Inflammation ; Jaundice ; Ligation ; Liver ; Liver Function Tests ; Prevalence ; Prognosis ; Ulcer*

Mishaps related to valve malfunction in a self-inflating bag-valve unit can lead to fatal complications. We report a case of severe hypotension that resulted from the locking of the Laerdal valve in the inspiratory position during transport in the operating room. A 36 year old man had undergone an off-pump coronary artery bypass graft. Immediately before leaving the operating room, severe hypotension developed abruptly. But an EKG showed only a reduction of heart rate. We started closed cardiac massage with an intravenous bolus injection of epinephrine 0.5 microgram and reconnected the anesthesia breathing circuit. The patient was manually ventilated using the anesthesia reservoir bag. Vital signs immediately recovered. At that time, the patient's abdomen was distended and we suspected an expiratory abnormality. The self-inflating bag-valve unit was tested with an anesthesia reservoir bag as a test lung. Expiration did not occur. Another self-inflating bag-valve unit was substituted and normal ventilation was restored. It is essential that before use, a self-inflating bag-valve unit should be tested for proper function during both expiration and inspiration using a test lung such as, an anesthesia reservoir bag.
Abdomen ; Adult ; Anesthesia ; Coronary Artery Bypass, Off-Pump ; Electrocardiography ; Epinephrine ; Heart Massage ; Heart Rate ; Humans ; Hypotension* ; Lung ; Operating Rooms ; Respiration ; Resuscitation ; Transplants ; Ventilation ; Vital Signs

An 18-year-old man suffered heat stroke after continuous working for 26 hours on his first day in an aluminium utensil plant in August 1998. His job was to put a pressed aluminium utensil on the conveyer before the process of spray painting. The ranges of temperature and relative humidity measured at the local weather-station during the patient' s working period were 23.6-30.2 degrees C, 49-87 % respectively. On arrival the patient was comatose and suffered generalized seizure three times. His rectal temperature was 41.2 degrees C . blood pressure was 90/60 mmHg, pulse was 148 beats/minute and respiratory rate was 28 times/minute. The serum level of AST was 421 IU/L. ALT was 205 IU/L, LDH was 1,160 IU/L. myoglobin was higher than 500 ng/mL. OK was higher than 2,000 IU/L. He recovered consciousness 7th day of admission and discharged after 2 months but cerebellar dysarthria was remained. The patient felt himself several prodromal symptoms of heat stroke and he showed awkward behavior considered to be drowsiness, but the patient and his co-workers neglected them. This case report shows that heat stroke can be occurred in a condition that ambient temperature, humidity, and working load are not extreme. A thorough health education and management concerned with guidelines on salt and water intake, detection of early symptoms of heat-related illness, prompt body cooling and rapid transportation to a hospital is necessary.
Adolescent ; Blood Pressure ; Coma ; Consciousness ; Drinking ; Dysarthria ; Health Education ; Heat Stroke* ; Hot Temperature* ; Humans ; Humidity ; Myoglobin ; Paint ; Paintings ; Plants* ; Prodromal Symptoms ; Respiratory Rate ; Seizures ; Sleep Stages ; Transportation

The purpose of this study was to investigate the dietary habits, nutritional status, and serum copper and zinc concentrations of adolescent athletes. 50 high school adolescent athletes (29 male, 21 female) took part in physical education high school and 47 high school adolescent non-athletes (21 male, 26 female) in general high school. Questionnaires, anthropometric measurements, 24-hour dietary recalls and blood analysis were conducted. In the males, the mean height, weight and body fat percents of athletes and non-athletes were 174.0/172.9 cm, 67.4/68.3 kg, and 8.9/20.0% (p < 0.001) respectively. In the females, the mean height, weight and body fat percents of athletes and non-athletes were 163.7/159.3 cm (p < 0.01), 58.7/55.7 kg (p < 0.05), and 18.6/30.1% (p < 0.001) respectively. In both male and female athletes, intakes of animal fat were significantly higher and intakes of vitamin C were significantly lower than those of non-athletes. There was no significantly difference in zinc and copper intakes between athlete and non-athlete groups. The average serum zinc level of male athletes was significantly lower than that of male non-athlete. The average serum copper levels of male and female athletes were significantly lower than those of male and female non-athletes. Based on these results, exercise may effect on zinc and copper utilization of adolescent. Further studies on zinc and copper nutrition of adolescent athletes were needed to understand more mineral nutrition and exercise.
Adipose Tissue ; Adolescent* ; Animals ; Ascorbic Acid ; Athletes* ; Copper* ; Female ; Food Habits* ; Humans ; Male ; Nutritional Status ; Physical Education and Training ; Surveys and Questionnaires ; Zinc*

Turcot syndrome is characterized by the concurrence of a primary neuroepithelial brain tumor and multiple colorectal polyposis. We report a case of a 24-year-old woman diagnosed with Turcot syndrome. At first, the patient was diagnosed as having a medulloblastoma after a tumorectomy of the 4th ventricle mass. The patient underwent radiotherapy and chemotherapy. After high-dose chemotherapy, neutropenic fever and severe mucositis developed. For an evaluation of the persistent hematochezia and diarrhea, a colonoscopy was performed. It revealed pseudomembranous colitis and multiple polyps in the entire colon. According to the family history, her father had undergone a total colectomy due to colon cancer and polyposis of the entire colon. Her brother also was found to have multiple polyps in the colon by a colonoscopy. The patient was diagnosed with Turcot syndrome.
Adenomatous Polyposis Coli* ; Brain Neoplasms ; Colectomy ; Colon ; Colonic Neoplasms ; Colonoscopy ; Diarrhea ; Drug Therapy ; Enterocolitis, Pseudomembranous ; Fathers ; Female* ; Fever ; Gastrointestinal Hemorrhage ; Humans ; Medulloblastoma* ; Mucositis ; Polyps ; Radiotherapy ; Siblings ; Young Adult*

Abscess ; Adolescent ; Body Mass Index ; Child ; Classification ; Colonic Diseases ; Crohn Disease ; Diagnosis ; Europe ; Fistula ; Humans ; Inflammatory Bowel Diseases ; Korea ; Male ; Pediatrics ; Phenotype ; Retrospective Studies

PURPOSE: To determine the prevalence and degree of CAC (coronary artery calcification) in appearently healthy middle-aged Koreans, and the relation of CAC to risk factors for atherosclerosis. MATERIALS AND METHODS: A total of 289 apparently healthy personnel at Yonsei University (male: 170, female: 119, age: mean(SD=54.9 +/-7.1 years) underwent EBT (electron bean tomography). The risk factors for atherosclerosis, which included diabetes mellitus, hypertension, smoking, a family history of precocious onset, obesity, hyperlipidemia, and high intraperitoneal fat, were scrutinized. One hundred and sixty-eight subjects (58 % ) had at least one risk factor. The CAC score was calculated for all subjects and for each coronary artery separately and was then analyzed by age and sex and in relation to the risk factors. RESULTS: The prevalence of CAC was 40% in men and 18.5% in women (mean score: 29.7 vs. 9.9). The number of individuals who had one, two, or more than two risk factors was 141, 41, and 19, respectively. The number of risk factors and the prevalence and score of CAC were significantly correlated (p=0.01, 0.02 respectively). The number of individuals with no risk factor, with without CAC, was 58(20.1%) and 103(35.6% ) , respectively, while the number with some risk factor, with or without CAC, was 38(13.1%) and 90(31.1%), respectively. The CAC score was significantly higher in the presence of hypertension, low HDL, or obesity (p=0.001, 0.049, and 0.068, respectively). Smoking appeared to have a borderline effect on the calcium score (p=0.118). CONCLUSION: This study should provide useful information for interpreting CAC scores and establishing a treatment strategy for Koreans. The comparison of our results with other studies will enable a better understanding of the process and risk factors of atherosclerosis in Koreans.
Arteries ; Atherosclerosis ; Calcium* ; Coronary Vessels ; Diabetes Mellitus ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Obesity ; Prevalence ; Risk Factors ; Smoke ; Smoking