The urethral polyp is relatively unusual lesion but recently, has been reported more frequently Polyps of the anterior urethra are less common than those of the posterior urethra. The lesion is usually encountered in the young child but has occurred in the adult. Recently, we found two cases of urethral polyp. So, we report these with a brief review of the literature.
Adult ; Child ; Humans ; Polyps* ; Urethra

Anaphylactoid nephritis is a disease complicated by anaphylactoid purpura manifested by a non-thrombocytopenic purpura, abdominal pain. And joint pain The manifestation of nephritis may vary from microscopic hematuria to acute rapidly progressive nephritic and nephrotic syndrome. This paper reports on anaphylactoid nephritis in children. These cases were collected fromthe Department of Pediatrics, Yonsei university Medical College from January 1,1974 to may 31, 1979. The results are as follows; 1. Among 75 cases of anaphylactoid purpura, 25 cases developed nephritis(33%), 16 cases were male and 9female. The age distribution was from 3years 5months to 15years. The peak incidence occured between 5 and 7years ofage with 11 cases. 2. The evidence of renal invovement in 18 cases among 25 were detected within 4 weeks after onset of skin manifestation. 3. The clinical manifestations were skin rashes, abdominal pain, joint pain, pitting edema, gross hematuria, and melena in orders. 4. The clinical classification of renal involvement were transient hematuria 4 cases, acute nephritis, 7 cases recurrent hematuria 1 case, nephrotic syndrome 5 cases, and undetermined 8 cases. 5. In additionto the usual signs of renal involvement, serum levels of IgA were checked. The elevation of IgA was 4 cases among the tested 6 cases. 6. According to the pathologic findings and immunofluorescent technique, 8 cases out of 9 cases by kidney biopsy were focal proliferative glomerulonephritis and 1 case diffuse proliferative flomerulonephritis. The deposit of glomeruli by immunofluorescent technique was IgA, IgG, IgM, and fibrin 7. All the cases were treated with prednisone and only 4 cases were combined with immunosuppressant, azathioprine without benfit.
Abdominal Pain ; Age Distribution ; Arthralgia ; Azathioprine ; Biopsy ; Child* ; Classification ; Edema ; Exanthema ; Fibrin ; Glomerulonephritis ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Kidney ; Male ; Melena ; Nephritis ; Nephrotic Syndrome ; Pediatrics ; Prednisone ; Purpura ; Purpura, Schoenlein-Henoch ; Skin Manifestations

Chyle is the digestive product absorbed from intestinal lymphatics which the component have high concentration of triglyceride and protein. The various pathological circumstances which give rise to intrathoracic effusion of chyle are well documented and so the etiology is clearly defined in most instances. However, the occurrence of chylothorax in early infancy, in the absence of other demonstrable diseases and without apparent birth trauma, suggests the existence of congenital malformation of the thoracic ducts. We lately experienced a 20 day old new born who was proved to have congenital chylothorax by clinical history and laboratory findings. So we report the clinical findings and laboratory findings with the review of the literatures on congenital chylothorax.
Chyle ; Chylothorax* ; Parturition ; Thoracic Duct ; Triglycerides

OBJECTIVES : The aim of this study was to identify the characteristic symptoms for diagnosis of Hwabyung (HB), a culture-related anger syndrome in Korea; to construct a rating scale for HB and test its validity and reliability; and propose diagnostic criteria for HB. METHODS : Subjects were male and female Korean patients, who were diagnosed following Structured Clinical Interview (SCID) as having depressive disorders, anxiety disorders and somatoform disorders and who reported as having self-labeled HB. A HB Scale was constructed with 22 of the most common symptoms of HB as identified by previous studies. The HB scale's inter-rated reliability was tested with 60 subjects. Its validity was tested by comparison between a HB only group(n=47) and depressive disorder only group (n=44). Logistic regression analysis was conducted to make a predictive model of HB. Based on these results diagnostic criteria for HB was proposed. RESULTS : Inter-rated reliability in each of all the items and the total score of the HB Scale were statistically significant. The HB scale differentiated HB from depressive disorder with statistical significance. In logistic regression analysis, the ability of the HB model to predict symptoms of heat sensation, ukwool/boon (feeling of unfairness), and subjective anger was high with sensitivity of 80.0%, specificity of 88.4%, accuracy of 84.1% and area under ROC of 0.92. Based on these results and information from previous research, diagnostic criteria of HB were formulated. CONCLUSION : The HB Scale was found to be reliable and valid. Consequently, diagnostic criteria of HB were proposed, to include subject anger, "kwool/boon" (Feeling of unfairness), expressed anger, heat sensation, hostility, "haan", pushing-up in the chest, epigastric mass, respiratory stuffiness, palpitation, dry mouth, sighing, racing thoughts, and lamentation.
Anger ; Anxiety Disorders ; Continental Population Groups ; Depressive Disorder ; Female ; Hemoglobin, Sickle ; Hostility ; Hot Temperature ; Humans ; Logistic Models ; Male ; Mouth ; Sensation ; Sensitivity and Specificity ; Somatoform Disorders ; Thorax

Recently, techniques of magnetic resonance angiography(MRA) have been developed that permit a three dimensional display of vessel without infusion of a contrast agent. However, to be competitive with conventional angiography(CA). MRA should show not only morphology of vessel but should also provide functional inforrnation, as selective delineation of specific vascular territories. Selective presaturation of individual vessels causes signal loss within the territory supplied by the presaturated artery, without affecting vessels not crossing the presaturation slab. We applied the selective MRA to the study of blood flow dynamics in five patients wiih ischemic stroke, showing patent middle cerebral arteIy in spite of obstruction or severe stenosis of the ipsilateral internal carotid artery on MRA. Selective MRA was able to demonstrate the direction of blood flow and presence of collateral blood flow. Findings of selective MRA were correlated with those from CA. Selective MRA can be used as a noninvasive and useful means for imaging the blood supply of the major intracranial arteries.
Arteries ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; Magnetic Resonance Angiography* ; Stroke*

PURPOSE: To investigate the relationship between the smart devices usage-related factors and self-regulation ability development in early childhood. METHODS: Parental questionnaires of 187 children aged 3–6 years were analyzed. The metrics included smart device usage frequency (times/week, scored as uFreq), smart device usage time (hours/day, scored as uTime), parental scale for appropriate smart device usage level (scored as uLevel), the Korean-developmental screening test (K-DST), and the scale for self-regulation ability in young children (scored as SRS, and including four sub-categories: self-appraisal, self-determination, behavior inhibition, and emotionality). The correlations were analyzed by total age group and by each age. RESULTS: In the total age group analysis, uFreq and uTime were negatively correlated with mean SRS (rs =−0.366, −0.330; P < 0.001) and sub-category SRS (rs =−0.186 to −0.370; P < 0.05). Mean uLevel score was positively correlated with mean SRS (rs =0.406; P < 0.001) and most of the mean sub-category SRS (rs =0.174 to 0.362; P < 0.05). In 3-year-old children, the mean SRS was strongly negatively correlated with uFreq (rs =−0.751; P < 0.001), negatively correlated with uTime (rs =−0.518; P < 0.001), and positively correlated with mean uLevel score (rs =0.533; P=0.013). Such correlations seemed to decrease at the age of 4–6 years. CONCLUSION: Self-regulation ability was significantly correlated with smart device-related factors and was the highest in the 3-year-old children. Encouraging appropriate smart device usage will be helpful for self-regulation development of young children.
Child ; Child, Preschool ; Diagnostic Self Evaluation ; Humans ; Mass Screening ; Parents ; Self-Control* ; Smartphone

A 68 year old male with diabetes mellitus visited our hospital due to general weakness and abdominal pain. Patient was in severe septic condition, abdominal X-ray and CT revealed gas shadow on left kidney and bladder. E-coli grew on urine culture. Thus we were able to diagnose the patient as the emphysematous pyelonephritis with emphysematous cystitis. The patient was treated with antibiotics and bilateral bladder catheter drainage. However the patient expired due to severe sepsis. Although the emphysematous pyelonephritis and emphysematous cystitis are rare disease, they result in life threatening complication in diabetic patients. Because of rarity of these diseases, the clinical and radiological classifications, the treatment and the progress are not established. These two diseases have the same causes such as diabetes mellitus or urinary tract obstruction and can be expanded due to anatomical relationships resulting in increased mortality. The authors report 68 year old male diabetic patient with emphysematous pyelonephritis with emphysematous cystitis with literature review.
Abdominal Pain ; Aged ; Anti-Bacterial Agents ; Catheters ; Classification ; Cystitis* ; Diabetes Mellitus ; Drainage ; Humans ; Kidney ; Male ; Mortality ; Pyelonephritis* ; Rare Diseases ; Sepsis ; Urinary Bladder ; Urinary Tract

PURPOSE: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution. MATERIALS AND METHODS: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy). RESULTS: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age > or =66 years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis. CONCLUSION: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.
Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy* ; Disease-Free Survival ; Drug Therapy ; Humans ; Multivariate Analysis ; Radiation Pneumonitis ; Radiotherapy* ; Treatment Failure

OBJECTIVE: We studied the effect of Hyu-Sig-Gong-Gan and Hye-Ah-Rim on several evaluations and compared the two programs. We then investigated factors associated with the difference between pre- and post-ratings. METHODS: Thirty-six patients were randomized to Hyu-Sig-Gong-Gan (n=23) or Hye-Ah-Rim (n=13). We tested for the effect of each program on several evaluations and compared the two programs through Zarit Burden Interview (ZBI), Center for Epidemiologic Studies-Depression Scale, Dementia Attitude Scale (DAS)-intelligence, DAS-comfort and DAS-total. We then investigated whether the difference between pre- and post-rating depends on other factors. RESULTS: We observed significant positive effect of Hyu-Sig-Gong-Gan on DAS-comfort (t=1.843, p=0.039) and significant positive effect of Hye-Ah-Rim on ZBI (t=-2.327, p=0.019), DAS-comfort (t=2.241, p=0.022), and EuroQol-5 Dimensions-Visual Analogue Scale (t=2.537, p=0.013). For comparing the two programs, we found a lack of evidence for the difference in any of the five commonly observed evaluations. In the secondary analysis, we observed a strong trend that the two programs were particularly effective for caregivers with negative pre-ratings. CONCLUSION: The two programs showed positive effects on the various evaluations, but some evaluations could not reach statistical significance. The programs appear to be particularly helpful for those who are in need before the program participation.
Aged* ; Caregivers* ; Dementia* ; Humans ; Program Evaluation

BACKGROUND AND OBJECTIVES: Standard unfractionated heparin (UFH) has long been used to prevent death and myocardial infarction in patients with acute coronary syndrome and acute occlusion undergoing percutaneous revascularization. However, UFH binds to several plasma proteins, platelets, and endothelial cells producing a highly variable anticoagulant response. In contrast, Low molecular weight heparin (LMWH) exhibits less protein binding and provides more predictable anticoagulant response with reduced need for patient monitoring and dosage adjustment. The purpose of this study was to assess the anti-Xa activities of LMWH in Korean patients with acute coronary syndrome after recommended dose for caucasians and to determine an optimal method of administration of LMWH. MATERIALS AND METHODS: Twenty five patients with acute coronary syndrome were enrolled and allocated to five separate groups (5 patients in each group) by types according to molecular weight (LMWH (A): (molecular weight of 4500 daltons, LMWH (B): molecular weight of 6400 daltons) and methods of administration (Group 1A and 1B: Subcutaneous and subcutaneous injections (SC-SC), Group 2: Intravenous and subcutaneous injections (IV-SC), Group 3A and 3B: Intravenous, subcutaneous and subcutaneous injections (IV-SC-SC). Five groups were as follows: Group 1A: LMWH (A) 1 mg/kg SC every 12 hours, Group 1B: LMWH (B) 100 IU/kg SC every 12 hours, Group 2: LMWH (A) 1 mg/kg IV bolus and 1 mg/kg SC 12 hours later, Group 3A: LMWH (A) 0.5 mg/kg IV bolus, 3 hours later 1 mg/kg SC every 12 hours, Group 3B: LMWH (B) 50 IU/kg IV bolus, 3 hours later 100 IU/kg SC every 12 hours. Anti-Xa activity was measured by amidolytic assay method (Rotachrome, Stago, France) in 555 samples from 25 patients. All the data of anti-Xa activity in each group were plotted along the sequential time and mean values of them were analyzed by Wilcoxon signed rank test. RESULTS: 1)The anti-Xa activity (mean 0.6216+/-0.238 IU/mL) of LMWH (A) was greater than that of LMWH (B)(mean 0.2587+/-0.1709 IU/mL) in the conventional SC-SC method (p<0.001). 2) The anti-Xa activity of LMWH (A) (mean 0.6203+/-0.2383 IU/mL) was also greater than that of LMWH (B)(mean 0.468+/-0.2428 IU/mL) in the IV-SC-SC method (p<0.001). 3) More rapid and effective anti-Xa activities were achieved by IV-SC-SC method compared with conventional SC-SC method. CONCLUSION: This study suggests that immediate achievement and optimum maintenance of anticoagulant activity can be accomplished by IV-SC-SC method rather than conventional SC-SC method in patients of acute coronary syndrome.
Acute Coronary Syndrome* ; Blood Proteins ; Endothelial Cells ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Injections, Subcutaneous ; Molecular Weight ; Monitoring, Physiologic ; Myocardial Infarction ; Protein Binding