No Abstract Available.
Glaucoma* ; Ligation* ; Silicones*

PURPOSE: Subperiosteal orbital hematoma is rare, and most cases occur in children or young adults after direct facial or orbital trauma. Nontraumatic subperiosteal hemorrhage has been reported in association with systemic disease associated with leukemia, scurvy, sudden elevation of cranial venous pressure or venous congestion, and paranasal sinusitis. To our best knowledge, this is the first case of subperiosteal orbital hematoma associated with von Willebrand disease in Korea. METHODS: A 30-year-old woman experienced a sudden onset of proptosis, diplopia and decreased visual acuity. Clinical features, orbital CT and MRI established the diagnosis of subperiosteal hematoma of the orbit. The patient was treated with superior orbitotomy with hematoma evacuation. RESULTS: After the surgery, the patient's visual acuity completely recovered and proptosis disappeared. During follow-up periods, she was diagnosed to have von Willebrand disease.
Adult ; Child ; Diagnosis ; Diplopia ; Exophthalmos ; Female ; Follow-Up Studies ; Hematoma* ; Hemorrhage ; Humans ; Hyperemia ; Korea ; Leukemia ; Magnetic Resonance Imaging ; Orbit* ; Scurvy ; Sinusitis ; Venous Pressure ; Visual Acuity ; von Willebrand Diseases* ; Young Adult

Female pelvic tuberculosis is almost invariably secondary to disease elsewhere, usually in the lungs. It is difficult to diagnose pelvic tuberculosis, because it is often a disease with absent or few non-specific symptoms. Pelvic tuberculosis should be considered in the differential diagnosis of all ovarian mass and pelvic malignancy. We report a case of retroperitoneal tuberculous lymphadenopathy that may be mistaken for pelvic malignancy, because of the nonspecific clinical features and radiologic findings. The diagnosis was made post-operatively by histopathology.
Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lung ; Lymphatic Diseases* ; Retroperitoneal Space ; Tuberculosis

Herpes zoster ophthalmicus sine herpete(HZSH), which means herpes zoster ophthalmicus(HZO)without skin eruption, is one of the atypical manifestations of varicella-oster virus(VZV)infection. Idiopathic iridocyclitis or acute retinal necrosis without skin lesion secondary to varicella-oster virus are good examples. Diagnosing zoster iridocyclitis without skin eruption is difficult because in the absence of typical skin eruption it is difficult to suspect varicella-zoster virus as the cause of inflammation in the absence of typical skin eruption. We describe here a rare case of a pediatric patient with severe iridocyclitis in a pediatric patient after penetration of keratoplasty in whom VZV DNA was detected using the DNA amplification and polymerase chain reaction(PCR)method. To our best knowledge, this is the first case report of varicella-zoster virus iridocyclitis in a pediatric patient after penetrating keratoplasty.
Corneal Transplantation ; DNA ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Inflammation ; Iridocyclitis ; Keratoplasty, Penetrating* ; Retinal Necrosis Syndrome, Acute ; Skin

No abstract available.
Death Certificates* ; Korea*

A right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm is a very rare condition. This requires surgical treatment because of the possibility of rupture of aneurysm, heart failure and infective endocarditis. A 47 years old male patient with dyspnea on exertion for 3 months was diagnosed as having a right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm according to the CT and coronary artery angiography. We resected the aneurysm and performed a coronary artery bypass graft.
Aneurysm ; Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Dyspnea ; Endocarditis ; Fistula ; Heart Aneurysm ; Humans ; Male ; Rupture ; Transplants

PURPOSE: Primary gastrointestinal lymphoma is the most common form of extranodal lymphoma. The clinical features, histological distributions, treatment results and prognosis of the primary intestinal lymphoma were evaluated. METHODS: A retrospective study was performed on 62 patients with primary intestinal lymphoma, as defined by Lewin's criteria, from May 1990 to February 2002. The WHO classification and Ann Arbor staging system were used for histological classification and staging, respectively. RESULTS: The sex ratio of the patients was 43: 19 (male: female), and the median age was 54 years. Abdominal pain, a palpable mass, and bleeding were the most frequent symptoms on presentation. The ileocecal area was the most frequent pathological site. Fifty-three cases were non- Hodgkin's lymphoma of B-cell origination; all of the remaining were T-cell originated. The mean survival period of B-cell and T-cell originated were 59.3 and 14.3 months, respectively (P<0.05). The 5 year survival rates of the patients in stage IE and IIE, and stage IIIE and IVE, were 52.4 and 32.6%, respectively (P=0.03). Six patients received surgery, 17 chemotherapy, and 39 surgery with adjuvant chemotherapy. Among the patients confined to stage IE and IIE, the 3 year survival rates of the surgery and surgery with adjuvant chemotherapy groups were 34 and 84%, respectively (P=0.0049). CONCLUSION: Primary gastrointestinal lymphoma of B-cell origination was predominant in relation to the WHO classification and revealed a better prognosis when compared to the T-cell originated lymphoma. For the patients with localized intestinal lymphoma, multimodality treatment (surgery with adjuvant chemotherapy) is preferred to the sole administration of chemotherapy.
Abdominal Pain ; B-Lymphocytes ; Chemotherapy, Adjuvant ; Classification ; Drug Therapy ; Hemorrhage ; Hodgkin Disease ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate ; T-Lymphocytes

As nucleocapsid protein of severe acute respiratory syndrome coronavirus 2 is immunogenic but not targeted in vaccines, it could be useful in distinguishing natural infection from vaccination. We aimed to investigate the clinical utility of sero-immunological responses against the nucleocapsid protein. Nucleocapsid antibody immunoassay study with 302 coronavirus disease 2019 (COVID-19) patients showed lower titers in immunocompromised patients (P < 0.001), higher titers in higher severity (P = 0.031), and different seroconversion rates and titers according to variants of concern. Longitudinal evaluation of nucleocapsid antibodies using 513 samples from 291 COVID-19 patients revealed that it could persist up to 556 days from symptom onset. Interferon gamma release assay against the nucleocapsid protein showed poor response, precluding the deduction of a cut-off for the nucleocapsid protein. In conclusion, nucleocapsid antibody provides instructive clues about the immunogenicity of nucleocapsid proteins by different seroconversion rates and titers according to the severity of infection, host immune status, and different variants of concern.

Purpose: Real-world experience with tocilizumab in combination with dexamethasone in patients with severe coronavirus disease (COVID-19) needs to be investigated. Materials and Methods: A retrospective cohort study was conducted to evaluate the effect of severity-adjusted dosing of dexamethasone in combination with tocilizumab for severe COVID-19 from August 2020 to August 2021. The primary endpoint was 30-day clinical recovery, which was defined as no oxygen requirement or referral after recovery. Results: A total of 66 patients were evaluated, including 33 patients in the dexamethasone (Dexa) group and 33 patients in the dexamethasone plus tocilizumab (DexaToci) group. The DexaToci group showed a statistically significant benefit in 30-day clinical recovery, compared to the Dexa group (p=0.024). In multivariable analyses, peak FiO2 within 3 days and tocilizumab combination were consistently significant for 30-day recovery (all p<0.05). The DexaToci group showed a significantly steeper decrease in FiO2 (-4.2±2.6) than the Dexa group (−2.7±2.6; p=0.021) by hospital day 15. The duration of oxygen requirement was significantly shorter in the DexaToci group than the Dexa group (median, 10.0 days vs. 17.0 days; p=0.006). Infectious complications and cellular and humoral immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the convalescence stage were not different between the two groups. Conclusion A combination of severity-adjusted dexamethasone and tocilizumab for the treatment of severe COVID-19 improved clinical recovery without increasing infectious complications or hindering the immune response against SARS-CoV-2.

As 16S ribosomal RNA (rRNA)-targeted sequencing can detect DNA from non-viable bacteria, it can be used to identify pathogens from clinical samples even in patients pretreated with antibiotics. We compared the results of 16S rRNA-targeted sequencing and culture for identifying bacterial species in normally sterile body fluid (NSBF): cerebrospinal, pericardial, peritoneal and pleural fluids. Over a 10-year period, a total of 312 NSBF samples were evaluated simultaneously using 16S rRNA-targeted sequencing and culture. Results were concordant in 287/312 (92.0%) samples, including 277 (88.8%) negative and 10 (3.2%) positive samples. Of the 16 sequencing-positive, culture-negative samples, eight showed clinically relevant isolates that included Fusobacterium nucleatum subsp. nucleatum, Streptococcus pneumoniae, and Staphylococcus spp. All these samples were obtained from the patients pretreated with antibiotics. The diagnostic yield of 16S rRNA-targeted sequencing combined with culture was 11.2%, while that of culture alone was 6.1%. 16S rRNA-targeted sequencing in conjunction with culture could be useful for identifying bacteria in NSBF samples, especially when patients have been pretreated with antibiotics and when anaerobic infection is suspected.