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

BACKGROUND: In spite of harmfulness of smoking, the rate of adult man's smoking is high in Korea and that of young people and women has risen recently. Although the number of hospitals operating smoking-cessation clinic has risen year by year, there is little research on smoking cessation. In this study, we tried to find the factors associated with successful smoking cessation and have attempted to contribute to developing effective smoking cessation strategy and help to continue cessation state. METHOD: Three hundred smokers, who had visited the Dankook Univ. Hospital from May 1999 to December 1999, were consulted. After doing a survey with a basic questionnaire and smoking cessation consultation, we asked them to revisit on the date of appointment with continued use of nicotine patch as much possible. Six months later, we selected 272 people and analyzed the factors of difference between the two groups ; one is the successful group and the other is the failure group. RESULT: The success group included 77 people (28.3%), and the failure group 195 people (71.7%). In view of demographic profiles such as age, sex, marital status, education, and job, there was no significant difference between the two groups. In view of smoking pattern and factors that can influence them such as age of starting to smoke, duration of smoking, motive of smoking, reason of failure to stop smoking, reason of trying to stop smoking, the presence of smoking family number, confidence in smoking cessation, dependence on nicotine and the number of alcohol drinking, there was no significant difference between the two groups. In the results of univariate analysis, daily mean smoking amount, the presence of smoking-associated disease, expiratory CO level at initial visit to hospital, period of using nicotine patch and total times of visiting clinic were significant difference between the two groups. Therefore, the total number of visits to the clinic was the only significant factor according to multivariate analysis. CONCLUSION: The results of multivariate analysis has shown that the factor that is most associated with success of smoking cessation is the total number of visits to smoking-cessation clinic. This means that the more people who smoke consult with doctor and the longer the period of utilizing the smoking-cessation clinic is, the more successful they in smoking cessation.
Adult ; Alcohol Drinking ; Education ; Female ; Humans ; Korea ; Marital Status ; Multivariate Analysis ; Nicotine ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Use Cessation Products ; Surveys and Questionnaires

In Korea, there are many kinds of functional foods to manage diabetes, however, they have not been evaluated or investigated systematically. The purpose of this study was to investigate the status of recognition and intake of functional foods among diabetic patients. The study subjects were 307 patients(male 135, female 172), who diagnosed with type 2 diabetes at Seoul National University of Bundang Hospital. Questionnaire survey was done from July to October, 2004 for the characteristics of patients and factors related to the use of functional foods. The mean age of the subjects was 64+/-10.2 years, and the mean duration of disease was 9.5+/-8.90 years. Approximately 49.8% of the subjects had experience to use functional foods at least once in past. Total number of functional foods used were 56 types. Red ginseng was used most frequently(27.9%), then followed by Silkworm powder(13.6%), Vitamin supplements(10.4%), Mulberry tree(7.1%), Cordyceps sinensis(6.8%) and Ginseng(4.2%). Functional foods were introduced by their friends.relatives(38.4%), family(29.1%), internet(13.9%), and the mass media(10.6%). Among respondents, 94.7% took functional foods with conventional diet therapies(diet, exercise and medication). The purpose of functional food use was to control blood glucose level(49.0%), to relieve fatigue and improve stamina(19.9%), to treat and prevent a disease(17.2%) and to help blood circulation(7.9%). Upon the question of further recommendation of functional foods to others, 74.8% of the subjects answered negative response. However, 12.6% of the subjects showed the further intention of using new product. Therefore, to guide the appropriate use of functional foods for diabetic patients, diabetic educator should provide the knowledge of the efficacy of functional foods and the desirable guidelines.
Blood Glucose ; Bombyx ; Cordyceps ; Surveys and Questionnaires ; Diabetes Mellitus ; Diet ; Fatigue ; Female ; Functional Food* ; Humans ; Intention ; Korea ; Morus ; Panax ; Seoul ; Vitamins

BACKGROUND: Family doctors are usually point of contact when the elderly think their death is imminent. To properly treat their disease and to provide good care of them and their families, family doctors must know the elderly's perception of a good death and dying. The purpose of this study was to investigate the components of a good death from the elderly. METHODS: We composed 9 questions focusing on good death and dying. A family medicine resident interviewed 35 people ages sixty five or over in Cheonan Welfare Center. The contents were recorded into audiotapes, and then translated and analyzed by quantitative method and coding technique. RESULTS: Among the total 35 respondents, many elders answered that they had thought about death and that the meaning of a death was the end of life, or transition from one world to another in religious belief. In their dying, they hoped that they would be with their offspring or spouse and that they would be in their home or hospital. Old people identified 8 major components of a good death: proper age, death without disease, death before death of their offspring and spouse, dying when whole family get together, death after seeing their family happy, death during sleep, and death without pain. They pointed out that the most meaningful event in their lives were related to their family, occupation and society. CONCLUSION: The elderly identified a good death in view of family as well as personal conditions such as proper age, a death without pain or disease. And most elderly pointed out that meaningful events in their lives were related to their family, occupation and society.
Aged* ; Chungcheongnam-do ; Clinical Coding ; Surveys and Questionnaires ; Euthanasia ; Hope ; Humans ; Occupations ; Religion ; Spouses ; Tape Recording

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