The importance of the ticks in medical field has been emphasized because of their association with and transmission of various diseases. We report herein a case of tick bite in a 55-year-old male farmer, who visited our hospital on July 2, 1981 with a parasite attached on right lower flank and rice to small pea sized, pruritic erythematous papular skin eruptions on chest and right lower flank. The skin lesions disappeared completely with.in five days after removal of the parasite, which was identified with an adult female tick which belongs to Genus Ixodes.
Adult ; Female ; Humans ; Ixodes* ; Male ; Middle Aged ; Parasites ; Peas ; Skin ; Thorax ; Tick Bites* ; Ticks*

BACKGROUND: The statistical analysis is an essential procedure ensuring that the results of researches are based on evidences rather than opinion. The purpose of this study is to evaluate which statistical techniques are used and whether these statistical methods are used appropriately or not in the journal of Tuberculosis and Respiratory Diseases. MATERIALS AND METHODS: We reviewed 185 articles reported in the journal of Tuberculosis and Respiratory Diseases in 1999. We evaluated the validity of used statistical methods based upon the checklist that was developed on the basis of the guideline for statistical reporting in articles for medical journals by International Committee of Medical Journal Editors. RESULTS: Among 185 articles, original articles and case reports were 110 (59.5%) and 61 (33.0%) respectively. In 112 articles excluding case reports and reviews, statistical techniques were used in 107 articles (95.5%). In 94 articles (83.9%) descriptive and inferential methods were used, while in 13 (11.6%) articles only descriptive methods were used. With the types of inferential statistical techniques, comparison of means was most commonly used (64/94, 68.1%), followed by contingency table (43/94, 45.7%) and correlation or regression (18/94, 19.1%). Among the articles in which descriptive methods were used, 83.2% (89/107) showed inappropriate central tendency and dispersion. In the articles in which inferential methods were used, improper methods were applied in 88.8% (79/89) and the most frequent misuse of statistical methods was inappropriate use of parametric methods (35/89, 39.3%). Only 14 articles (13.1%) were satisfactory in utilization of statistical methodology. CONCLUSION: Most of the statistical errors found in the journal were misuses of statistical methods related to basic statistics. This study suggests that researchers should be more careful when they describe and apply statistical methods and more extensive statistical refereeing system would be needed.
Checklist ; Journalism, Medical ; Korea ; Lung Diseases ; Tuberculosis*

Toothbrush swallowing is a rare event. Because no cases of spontaneous passage have been reported, prompt removal is recommended to prevent the development of complications. Most swallowed toothbrushes have been found in the esophagus or the stomach of affected patients, and there has been no previously reported case of a toothbrush in the colon. Here, we report a case of a swallowed toothbrush found in the ascending colon that caused a fistula between the right colon and the liver, with a complicating small hepatic abscess. This patient was successfully managed using exploratory laparotomy. To our knowledge, this is the first documented case of a swallowed toothbrush found in the colon.
Adult ; Colon/*injuries ; Colonic Diseases/*diagnosis/etiology/surgery ; *Deglutition ; Fistula/*diagnosis/etiology ; Foreign-Body Migration/*surgery ; Humans ; Laparotomy ; Male ; Toothbrushing/*instrumentation

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. As the clinical manifestations are very diverse and associated with nonspecific symptoms, research seeking to identify organic causes to rule out IBS and to enable differential diagnosis is required. A 24-year-old man was referred to our hospital for specialized management of IBS. He had a 7-month history of intermittent epigastric and lower abdominal pain. On the basis of clinical examination, he was diagnosed with IBS and administered medication at a primary clinic. However, his symptoms did not improve after treatment. We performed capsule endoscopy at our hospital and identified a parasite (Ancylostoma duodenale) in the proximal jejunum. We therefore report a case of parasitic infection found by additional examination while evaluating symptoms associated with a previous diagnosis of refractory IBS.
Abdominal Pain ; Ancylostoma ; Ancylostomatoidea ; Capsule Endoscopy ; Diagnosis* ; Diagnosis, Differential ; Humans ; Irritable Bowel Syndrome* ; Jejunum ; Parasites* ; Young Adult

A Sengstaken-Blakemore (S-B) tube has been widely used to treatment of bleeding esophageal varices. It controls bleeding in 50~92% of cases and provide more time to plan future management. However, there are a number of complications with its use, some of which are lethal. We recently observed a very unusual complication of a S-B tube, namely an impaction of the gastric balloon at the gastroesophageal junction, which could not be deflated by removing the clamps and suctioning the air with a syringe. The gastric balloon was punctured endoscopically with needle knife and deflated. The S-B tube was then be easily removed.
Esophageal and Gastric Varices ; Esophagogastric Junction ; Gastric Balloon ; Hemorrhage ; Needles ; Suction ; Syringes

BACKGROUND AND OBJECTIVES: The coronary sinus (CS) is a small tubular structure just below the tricuspid valve. The dilatation of the coronary sinus as well as the inferior vena cava and the hepatic vein may provide echocardiographic signs of systemic congestion. The aim of this study was to evaluate the correlation of size of coronary sinus that had abnormal echocardiographic findings with or without congestive heart failure. SUBJECTS AND METHODS: Echocardiographic examinations of coronary sinus were performed on 58 patients (M : F=20 : 38) who had abnormal echocardiographic findings with current or previous symptoms or signs of congestive heart failure (group 1), and on 63 patients (M:F=27:36) who had abnormal echocardiographic findings but that had never had symptoms or signs of heart failure(group 2) and 94 healthy volunteers (control group, M:F=52:42). The CS was mesured using a two-dimensional echocardiogram in the right ventricular inflow view (5-10 mm below the Thebesian valve at end-systolic phase). RESULTS: In the normal control group, the median size of the CS was 6.2+/-1.2 mm, and showed no difference between gender and age. The sizes of the CS in groups 1 and 2 were 9.0+/-2.3 and 6.4+/-1.3 mm, respectively. There were differences between groups 1 and the normal control group (p<0.001), and between groups 1 and 2 (p<0.001), but a slight change between group 2 and the normal control group. In group 1, the size of the coronary sinus was related with the duration of heart failure (r=0.32, p=0.016), but no correlations to body surface area, left ventricle dimension and TR peak velocity were shown. In the presence of heart failure, as diagnosed according to the size of the CS, the predictive value was high when the size of the CS exceeded 8.0 mm, with an accuracy of 84%. In heart failure, the median size of the IVC was 16.6+/-5.4 mm, the variation rate of the IVC during the respiratory cycle was 0.40+/-0.13, and the variation rate of the CS during cardiac cycle was 0.31+/-0.20. The size of the CS was not related with the size of the IVC, but there was an inverse correlation between the size of the IVC and its variation rate (r=-0.434, p=0.037). The size of the IVC was inversely correlated with the variation rate of the CS (r=-0.490, p=0.024). There was a correlation between the variation rate of the CS and that of the IVC (r=0.411, p=0.021). Comparing the groups with and without systolic flow reversal into the CS in congestive heart failure patients with tricuspid regurgitation, in the former there wrer distensions of the CS, IVC and LA dimensions and reductions in the variation rates of the CS. CONCLUSION: The measurement of the size of the CS and the variation rate of CS may provide valuable information concerning the presence and duration of congestive heart failure.
Body Surface Area ; Coronary Sinus* ; Dilatation ; Echocardiography ; Estrogens, Conjugated (USP) ; Healthy Volunteers ; Heart Failure* ; Heart Ventricles ; Heart* ; Hepatic Veins ; Humans ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Vena Cava, Inferior

BACKGROUND: One of the characteristics of hypoglycemic encephalopathy (HE) is selective vulnerability of different brain regions. CASE REPORT: We observed a patient with unilateral HE affecting the right internal capsule and the subcortical white matter. The patient had a preexisting stroke in the opposite hemisphere. The hemisphere that was affected by HE exhibited greater regional blood flow (single positron-emission tomography) and higher fractional anisotropy (diffusion-tensor imaging) than the unaffected hemisphere. CONCLUSIONS: This case suggests that the degree of metabolism required to maintain the function of brain structures and neuronal integrity is an important factor determining the selective vulnerability in HE.
Anisotropy ; Brain ; Humans ; Internal Capsule ; Neurons ; Regional Blood Flow ; Stroke

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.
Aged ; B-Lymphocytes ; Biopsy, Large-Core Needle ; Empyema ; Empyema, Pleural ; Herpesvirus 4, Human ; Humans ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Male ; Thoracic Wall ; Tuberculosis, Pleural

Pyothorax-associated lymphoma is a distinct type of malignant lymphoma composed of lymphocytes, mostly of a B-cell nature. It occurs in patients with a long history of pyothorax and is strongly associated with Epstein-Barr virus infection. We experienced a case of pyothorax-associated lymphoma in a 66-year-old male. The patient had chronic pyothorax after tuberculous pleurisy was treated about 37 years earlier and was hospitalized for a recently occurring chest wall mass. A core needle biopsy of the chest wall mass led to a diagnosis of diffuse large B-cell lymphoma. Pyothorax-associated lymphoma is rare in Korea, but should be considered in patients with chronic pyothorax and a recently occurring pleural mass.
Aged ; B-Lymphocytes ; Biopsy, Large-Core Needle ; Empyema ; Empyema, Pleural ; Herpesvirus 4, Human ; Humans ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Male ; Thoracic Wall ; Tuberculosis, Pleural

OBJECTIVE: This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. MATERIALS AND METHODS: We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. RESULTS: Sixteen patients received thrombectomy. The mean age was 67.8 +/- 11 years and the mean NIHSS score was 12.3 +/- 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. CONCLUSION: Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset.
Basilar Artery ; Cerebral Infarction ; Endovascular Procedures ; Humans ; National Institutes of Health (U.S.) ; Retrospective Studies ; Stents ; Stroke ; Suction ; Thrombectomy ; Thrombosis