Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was 2.5x3.0 cm sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.
Abdominal Pain ; Adult ; Emergencies ; Hamartoma ; Hepatitis ; Hepatitis A ; Humans ; Intussusception ; Laparotomy ; Physical Examination ; Rare Diseases ; Vomiting

A 60-year-old man undergoing maintenance hemodialysis presented with periodic fever, which resembled Pel-Ebstein fever of Hodgkin's lymphoma. Despite scores of diagnostic evaluations, origin of the fever remained obscure. On positron emission tomography/computed tomography scan, focal hot uptakes were seen in the mediastinum and mediastinoscopic biopsy showed many acid-fast bacilli with chronic granulomatous inflammation and necrosis. After a week of anti-tuberculosis medication, the patient remained afebrile without recourse to antipyretics.
Antipyretics ; Biopsy ; Electrons ; Fever ; Fever of Unknown Origin ; Hodgkin Disease ; Humans ; Inflammation ; Mediastinum ; Middle Aged ; Necrosis ; Renal Dialysis ; Tuberculosis, Lymph Node

A 60-year-old man undergoing maintenance hemodialysis presented with periodic fever, which resembled Pel-Ebstein fever of Hodgkin's lymphoma. Despite scores of diagnostic evaluations, origin of the fever remained obscure. On positron emission tomography/computed tomography scan, focal hot uptakes were seen in the mediastinum and mediastinoscopic biopsy showed many acid-fast bacilli with chronic granulomatous inflammation and necrosis. After a week of anti-tuberculosis medication, the patient remained afebrile without recourse to antipyretics.
Antipyretics ; Biopsy ; Electrons ; Fever ; Fever of Unknown Origin ; Hodgkin Disease ; Humans ; Inflammation ; Mediastinum ; Middle Aged ; Necrosis ; Renal Dialysis ; Tuberculosis, Lymph Node

BACKGROUND: There has been a lack of study on the structural changes of serum albumin in patients with minimal change disease (MCD). To determine whether glycation and/or conformational transitions of albumin are involved in the pathogenesis of albuminuria, nine patients with MCD were enrolled in a prospective follow-up study for comparison of these parameters in serum albumin during the remission and relapse of nephrotic syndrome. METHODS: Circular dichroism measurements were made with purified albumin. Ellipticities at each wavelength were transformed to mean residue ellipticity. Monosaccharide composition was analyzed by high-pH anion-exchange chromatography with pulsed amperometric detection. RESULTS: There was no difference in the proportions of alpha-helix, beta-conformation, and beta-turn of albumin between the sera of control patients and those with nephrotic syndrome. However, the proportion of the random configuration was slightly higher in the plasma albumin of patients in relapse than in those in remission. The proportion of the random configuration was lower in the albumin of the serum than in the urine of patients with nephrotic syndrome, but there was no difference in the proportions of alpha-helix, beta-conformation, and beta-turn of albumin between their plasma and urine. CONCLUSION: Our results suggest that conformational changes in albumin are involved in albuminuria in patients with MCD.
Adult ; Albuminuria/urine ; Case-Control Studies ; Female ; Follow-Up Studies ; Glycosylation ; Humans ; Male ; Middle Aged ; Nephrosis, Lipoid/*blood/urine ; Nephrotic Syndrome/blood/urine ; Prospective Studies ; Research Support, Non-U.S. Gov't ; Serum Albumin/*chemistry

Here we report two cases of isolated diffuse mesangial sclerosis (IDMS) with early onset end-stage renal failure. These female patients did not show abnormalities of the gonads or external genitalia. Direct sequencing of WT1 PCR products from genomic DNA identified WT1 mutations in exons 8 (366 Arg>His) and 9 (396 Asp>Tyr). These mutations have been reported previously in association with Denys-Drash syndrome (DDS) with early onset renal failure. Therefore we suggest that, at least in part, IDMS is a variant of DDS and that investigations for the WT1 mutations should be performed in IDMS patients. In cases with identified WT1 mutations, the same attention to tumor development should be required as in DDS patients, and karyotyping and serial abdominal ultrasonograms to evaluate the gonads and kidney are warranted.
Base Sequence ; DNA/chemistry/genetics ; DNA Mutational Analysis ; Fatal Outcome ; Female ; Glomerular Mesangium/*pathology ; Humans ; Infant ; Infant, Newborn ; *Mutation ; Nephrosclerosis/*genetics ; WT1 Proteins/*genetics

PURPOSE: This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. METHODS: We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. RESULTS: Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. CONCLUSION: Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.
Biopsy ; Denys-Drash Syndrome ; Dialysis ; Female ; Genetic Association Studies ; Glomerulosclerosis, Focal Segmental ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Parturition ; Prognosis ; Retrospective Studies ; Sclerosis ; Sepsis

PURPOSE: The radioiodine ablation therapy is required for patients who underwent a total thyroidectomy. Through a comparative review of a low iodine diet (LID) and a restricted iodine diet (RID), the study aims to suggest guidelines that are suitable for the conditions of Korea. MATERIALS AND METHODS: The study was conducted with 101 patients. With 24-hour urine samples from the patients after a 2-week restricted diet and after a 4-week restricted diet, the amount of iodine in the urine was estimated. The consumed radioiodine amounts for 2 hours and 24 hours were calculated. RESULTS: This study was conducted with 47 LID patients and 54 RID patients. The amounts of iodine in urine, the 2-week case and 4-week case for each group showed no significant differences. The amounts of iodine in urine between the two groups were both included in the range of the criteria for radioiodine ablation therapy. Also, 2 hours and 24 hours radioiodine consumption measured after 4-week restrictive diet did not show statistical differences between two groups. CONCLUSION: A 2-week RID can be considered as a type of radioiodine ablation therapy after patients undergo a total thyroidectomy.
Ablation Techniques ; Adult ; Carcinoma/metabolism/*radiotherapy/surgery ; *Diet ; Female ; Humans ; Iodides/urine ; Iodine/administration & dosage/urine ; Iodine Radioisotopes/metabolism/*therapeutic use ; Male ; Middle Aged ; Republic of Korea ; Thyroid Neoplasms/metabolism/*radiotherapy/surgery ; Thyroidectomy ; Treatment Outcome

Nasotracheal intubation is often the method of choice in oral or maxillofacial operations. During the insertion of endotracheal tube (ETT) through nostril, a considerable damage can be inflicted on the nasal mucosa by forcing ETT into the nasal cavity, and epistaxis may occur as a result of mucosal damage even when vasoconstrictors, a lubricated tube, and careful manipulation are employed. This study was conducted to observe whether balloon dilation technique(BDT) can help to minimize the expected problems during nasotracheal tube insertion and was to tried to get a data for further studies. In 30 patients in whom the nasotracheal tube was placed, smooth passage into the nasal cavity without using BDT occurred in 9 patients(30.0%). Of 21 patients(70.0%) who were come into the use of BDT when resistance to tube insertion due to anatomical structures of the nasal cavity was encountered, epistaxis was not developed. By the above results, The BDT appers to prevent epistaxis during nasotracheal tube insertion and to make an easy and smooth passage of the tube and then it suggest that the BDT should provide a basic data and an alternative to conventional techniques for a safe and atraumatic nasotracheal intubation.
Epistaxis ; Humans ; Intubation ; Nasal Cavity ; Nasal Mucosa ; Vasoconstrictor Agents

BACKGROUND: Rubella is a viral infection of childhood. Its clinical manifestations are not serious, but rubella infection in early pregnancy can result. in congenital rubella syndrome. In Korea, there have been several rubella outbreaks in 1996. We performed an epidemiological study about a rubella outbreak in middle and high school students in an isolated small town. METHODS: This study was carried out from March 22, 1996 to April 29, 1996. The target populations were middle and high school students(middle school-1,369, high school-966 students) in Namseonri. They were given a questionnaire containing sociodemographic characteristics, past vaccination history and rubella-like symptoms. We selected 70 clinically diagnosed patients and 233 students with rubella-like symptoms from the questionnaires. Through IgM and IgG ELISA we analyzed the serum of selected students. All of the middle and high school students except those with clinical rubella were vaccinated on March 27. RESULTS: 1) The number of IgM positive students was 65 among 303 selected students. 58 students among the IgM positive group were diagnosed clinically, and 7 patients and subclincal infection. 2) Male patients were more predominant than female, especially in high school(M : F, 2 : 1 in middle school, 7 : 1 in high school). 3) Positive rates of IgG gradually increased by grade from 58.3% to 92.9% (1st grade of middle school to 3rd grade of high school). 4) IgG titer of the booster vaccinees(2nd and 3rd tirade female, high school) was significantly higher than younger female students(p<.05). 5) After mass vaccination, 3 more patients caught rubella in high school during 1 month follow-up. CONCLUSIONS: Among 2335 students, IgM positive patients were 65 with incidence rate of 2.8%. Mass vaccination of the studentg an effective preventive method in a rubella outbreak.
Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies* ; Female ; Follow-Up Studies ; Health Services Needs and Demand ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Korea ; Male ; Mass Vaccination ; Pregnancy ; Rubella Syndrome, Congenital ; Rubella* ; Vaccination ; Surveys and Questionnaires

The purpose of this study was to investigate nutritional risk factors, perceptions on nutrition and health, nutritional knowledge, flood habits and their correlation to supplement use in middle-aged and elderly Koreans. A nationwide survey was conducted in the metropolitan areas (6 cities) and middle-sized cities (8 cities) of Korea from October to December, 2000. Subjects were randomly selected based on population, and 2,188 non-institutionalized adults aged over 50, and elderly (male 765, female 1,423) were studied. Data were collected using a standardized questionnaire administered in personal interviews. Nutrition and health-related scores of nutritional risk factors, perceptions on nutrition and health, nutritional knowledge, and flood habits were significantly higher in supplement users as compared to non-users. There was a negative correlation between nutritional risk factors and other nutrition and health-related scores on perceptions on nutrition and health, nutritional knowledge, flood habits, and pocket money. Also there was a positive correlation between nutritional risk factors and age. Therefore, these results may provide basic information for proper supplement use by middle-aged and elderly Koreans.
Adult ; Aged* ; Female ; Food Habits* ; Humans ; Korea ; Risk Factors* ; Surveys and Questionnaires