Twin-twin transfusion syndrome is attributed to an unbalanced blood flow between the donor and the recipient twin, but the exact pathophysiology remains incompletely understood. Despite active prenatal management, fetal twin-twin transfusion syndrome is still associated with a substantial residual perinatal mortality and morbidity. The donor twin progressively becomes anemic, growth restricted, oliguric and has oligohydramnios, where as the recipient becomes plethoric, polyuric and has polyhydramnios and in the most severe cases develops cardiomegaly, congestive heart failure and hypertension. We report a case of severe systemic hypertension developed in recipient twin.
Cardiomegaly ; Female ; Heart Failure ; Humans ; Hypertension* ; Oligohydramnios ; Perinatal Mortality ; Polyhydramnios ; Pregnancy ; Tissue Donors

Pulmonary vascular air embolism is a rare and, universally, almost a fatal complication of positive pressure ventilation in newborn infants. Here, we report a case of this unusual complication in a very-low-birth-weight infant who showed the clinical and radiological features of this complication along with pulmonary hypoplasia and massive hydrops. The possible pathogenesis has been discussed and a brief review of related literature has been presented.
Edema ; Embolism, Air ; Humans ; Hydrops Fetalis ; Infant, Newborn ; Infant, Very Low Birth Weight ; Positive-Pressure Respiration ; Pulmonary Embolism

Development of inhibitors is currently one of the most serious complications of hemophilia treatment. Typically, the propensity to develop an inhibitor is likely influenced by both genetic and non-genetic factors. Hemophilia patients with inhibitors are partially or completely refractory to traditional replacement of the deficient clotting factors and are at increased risk of bleeding as compared to patients without inhibitors. Several cases of infant hemophilia A with inhibitor have been reported in other countries, but no such patient has so far been reported in South Korea. We report two infants affected by hemophilia A with inhibitors, both of whom had bleeding episodes that were successfully treated with recombinant activated factor VII. Clinicians should remain aware of potential inhibitor development in infant hemophilia A patients and such patients should be carefully monitored.
Factor VIIa ; Hemophilia A ; Hemorrhage ; Humans ; Infant ; Korea

Alcoholic ketoacidosis is a serious metabolic abnormality that occurs in chronic alcoholics. We report a case of bilateral necrosis in the basal ganglia after alcoholic ketoacidosis in a 42-year-old female chronic alcoholics. Magnetic resonance imaging (MRI) of the patient suggested subacute infarction with subsequent necrosis of the basal ganglia, which matches with the patients neurological manifestations. Repeated alcoholic ketoacidosis in chronic alcoholics could be the cause of subacute infarction following necrotic changes in the basal ganglia.
Adult ; Alcoholics* ; Alcoholism ; Basal Ganglia* ; Female ; Humans ; Infarction ; Ketosis* ; Magnetic Resonance Imaging ; Necrosis ; Neurologic Manifestations

Stenotrophomonas maltophilia is a motile, non-fermentative, gram-negative rod. It is one of the important nosocomial pathogens associated with substantial morbidity and mortality such as pneumonia and bacteremia in immunocompromised patients. It should be carefully examined in the course of identification because it is frequently isolated together with other non-fermentative, gram-negative rods from clinical specimens. We report an isolate of S. maltophilia showing an oxidase-positive reaction, which is very rare for the species.
Bacteremia ; Humans ; Immunocompromised Host ; Indophenol ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stenotrophomonas ; Stenotrophomonas maltophilia

We describe below a case of Zellweger syndrome case with facial dysmorphism, profound hypotonia, and hepatomegaly. He died at the age of 2 months. Zellweger syndrome is a disease marked by the absence of hepatic and renal peroxisomes. Because peroxisomes have many vital anabolic and catabolic functions within the cell, their absence results in profound cellular dysfunction. A biochemical study of plasma revealed elevation of very long chains of fatty acids and pipecolic acid, consistent with peroxisomal disorder. The cultured skin fibroblasts showed a marked decrease in plasmalogen synthesis enzyme : dihydroxyacetonephosphate acyl transferase(DHAP-AT) The clinical characteristics and biochemical findings led to the diagnosis of Zellweger syndrome. The pattern of inheritance is autosomal recessive, hence genetic counseling can help the families. In infantile hypotonia patients with unknown cause, peroxisomal disorder should be included in the differential diagnosis. We report the first confirmed case of Zellweger syndrome by enzyme assay in Korea.
Cell Culture Techniques ; Diagnosis ; Diagnosis, Differential ; Enzyme Assays ; Fatty Acids ; Fibroblasts ; Genetic Counseling ; Hepatomegaly ; Humans ; Infant, Newborn ; Korea* ; Muscle Hypotonia ; Peroxisomal Disorders ; Peroxisomes ; Plasma ; Skin ; Wills ; Zellweger Syndrome*

Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.
Adult ; Case Management ; Female ; Humans ; Male ; Mental Disorders/diagnosis/*psychology ; Middle Aged ; Republic of Korea ; Suicide, Attempted/*prevention & control/*psychology ; Treatment Refusal/*psychology

No abstract available.
Polyarteritis Nodosa*

Gastric stump cancer is defined as cancers that develop in the gastric remnant after the gastric resection of nonmalignant lesions or malignant lesions. The interval between gastrectomy and the detection of gastric stump cancer must be over 5 years in nonmaligant lesions and 10 years in malignant lesions. Symptoms of gastric stump cancer are not specific, so, diagnosis is often delayed. Early detection and curative operation is very important in gasric stump cancer and follow-up endoscopic examination is the most importaint diagnostic tool to detect gastric stump cancer. Recently we experienced a case of early gastric stump cancer. We report review of the literature to remind the important of gastric stump cancer and the important of follow-up endoscopic examination.
Diagnosis ; Esophagus* ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Intestines* ; Stomach*

PURPOSE: A structural equation model was analysed to explore the determinants of health behaviors of university students in Korea. METNOD: Nine hundred sixty nine university students were selected by random cluster sampling from five universities located in the central area of Korea. DATA COLLECTION: The data was collected by questionnaires about demographic characteristics, stressful life events, perceived social support, perceived health status and health behaviors. RESULTS: 1. Gender showed indirect effect on health behaviors. 2. Living together with(out) family had a direct effecton health behaviors: students living with family showed more positive health behaviors. 3. Stressful life events had an indirect effect on health behaviors via perceived health status;a higher score of stressful life events was the predictor for negative health behaviors. 4. A higher score of perceived health status predicted positive health behaviors. RECOMMENDATION: Each university should be encouraged to develop a health behavior control program and health promotion program for their own university students. It would be more effective to develop health programs separately according to the demographic or social characteristics of the students. It is also necessary for the Ministry of Education to reform the School Health Act and school health policy to strengthen a health promotion program for university students. In conclusion, following studies should identify and promote the validity and reliability of perceived health status and health behaviors measurements.
Adult ; Attitude to Health ; Female ; *Health Behavior ; Health Status ; Humans ; Korea ; Life Change Events ; Male ; Social Support ; *Students/psychology ; Universities