Spontaneous pneumomediastinum(SPM) is an uncommon disease that is defined as the nontraumatic presence of free air in the mediastinum without any apparent underlying disease. We report a case of recurrent spontaneous pneumomediastinum without any direct precipitating cause. A 21-year-old woman was admitted to hospital suffering from chest pain that occurred during walking(?). She had previously been well. She did not complain of cough or vomiting prior to this presentation. Upon admission, the physical examination and Electrocardiogram findings were normal. The chest x-ray and chest computed-tomography showed a pneumomediastinum. She was successfully managed conservatively. Twenty seven months later, she was readmitted with chest pain, which again occurred during the same activity. The recurrent SPM was confirmed by the chest x-ray and chest computed-tomography. She was managed in the same manner as before and made an uneventful recovery. This is the first case of recurrent SPM in Korea.
Chest Pain ; Cough ; Electrocardiography ; Female ; Humans ; Korea ; Mediastinal Emphysema* ; Mediastinum ; Physical Examination ; Thorax ; Vomiting ; Young Adult

BACKGROUND: Psoas abscess is a rare condition with vague clinical presentations, therefore misdiagnosis or delayed diagnosis is often made. We have reviewed the characteristics of the clinical presentation, microbiology, and treatment of 24 patients with psoas abscess. METHODS: The records of all patients treated with psoas abscess at Ajou University Hospital between March, 1996 and May, 2001 were retrospectively reviewed. RESULTS: A total of 24 cases of psoas abscess were reviewed: among these 17 cases were due to secondary cases and seven cases were diagnosed as primary psoas abscess. The right side was affected in 11 cases, the left side in nine, and both sides in four. Methicillin-susceptible Staphylococcus aureus was the most frequent (7/24 cases) pathogen, which were detected in cultures from five of seven patients with primary abscesses, whereas Mycobacterium tuberculosis (6/17 cases) and mixed enteric flora were detected in secondary abscesses. Three of the patients with primary psoas abscess expired from septic shock. The mortality rate was 12.5%. CONCLUSION: A psoas abscess should be considered when any patient presents with nonspecific abdominal pain, back pain and fever. This condition may be diagnosed promptly with computed tomography. Treatment involves use of appropriate antibiotics, as well as drainage of the abscess. Antibiotic coverage must include S. aureus and enteric bacteria. However, in endemic areas (such as Korea), tuberculous infection should be also considered.
Abdominal Pain ; Abscess ; Anti-Bacterial Agents ; Back Pain ; Delayed Diagnosis ; Diagnostic Errors ; Drainage ; Enterobacteriaceae ; Fever ; Humans ; Mortality ; Mycobacterium tuberculosis ; Psoas Abscess* ; Retrospective Studies ; Shock, Septic ; Staphylococcal Infections ; Staphylococcus aureus ; Tuberculosis

Neonatal hydrometrocolpos is the cystic dilatation of the vagina and uterus, which is caused by the combination of vaginal obstruction such as imperforate hymen, transverse vaginal septum, or vaginal atresia, and glandular secretion by maternal estrogenic stimulation. Although hydrometrocolpos is a rare congenital abnormality unlike pubertal hematocolpos, it is one of the relatively common abdominal masses in neonates. In typical cases the diagnosis may be determined easily by the combination of a pelvic mass, upper urinary tract dilatation and a bulging membrane in the vaginal introitus. The presense of a lower abdominal mass in a female infant should always arouse suspicion of hydrometrocolpos and lead to careful examination of the vagina. We report a case of neonatal hydrometrocolpos due to imperforate hymen which was initially presented as a large abdominal mass and a bulging membrane in the vaginal introitus. For 72 hrs, the abdominal mass increased rapidly, accompanied by urinary tract obstruction. It was relieved by a simple incision of the imperforate hymen and drainage of 300 cc of whitish mucoid vaginal fluid, and by Foley catheter drainage of 750 cc urine. No other anomaly was observed.
Catheters ; Congenital Abnormalities ; Diagnosis ; Dilatation ; Drainage ; Estrogens ; Female ; Hematocolpos ; Humans ; Hymen ; Infant ; Infant, Newborn ; Membranes ; Urinary Tract* ; Uterus ; Vagina

BACKGROUND: Surgical site infection (SSI) is prominent among the total incidence of healthcare-associated infections, and is a major contributing factor in the trend of increasing medical costs. There have been numerous efforts to analyze the conditions and causes of SSI for the purpose of prevention. In this study of SSI development after gastric surgery, we evaluated the prevalence of specific pathogens and compared the clinical characteristics observed between gram-positive (GPB) and gram-negative bacteria (GNB). MATERIALS AND METHODS: We conducted a retrospective study of patients who developed SSI within 30 days after gastric surgery at 13 clinics in Korea, between January 2007 and December 2008. Only those cases of SSI which included confirmed pathogen were included in this study. RESULTS: Among the 121 patients who developed SSI, GPB were observed in 32 patients and 36 cases, and GNB were isolated in 32 patients and 36 cases. Methicillin resistant Staphylococcus aureus (MRSA) was the most frequently isolated pathogen in this analysis. There were no differences observed between the GPB and GNB group in terms of baseline characteristics, patient or procedure related risk factors, or factors associated with prophylactic antibiotics. CONCLUSIONS: In the previous studies of the occurrence of SSI after gastric surgery, it was reported that the majority of observed pathogens were enteric GNB. Further studies of the incidence of SSI after gastric surgery, particularly those related to MRSA infection, are necessary.
Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Incidence ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus