No abstract available.
Tuberculosis, Renal*

PURPOSE: To report 2 cases of bilateral endogenous endophthalmitis in patients with Klebsiella pneumoniae primary liver abscess. CASE SUMMARY: A 78-year-old woman and a 76-year-old woman presented with bilateral blurred vision for 2 to 3 days. The women had fever, cough, and chills for 5 to 10 days. Abdominal computed tomography revealed liver abscess and ophthalmologic examination results suggested bilateral endophthalmitis. In both patients, Klebsiella pneumoniae was identified from the liver abscess aspirate. In one patient, Klebsiella pneumoniae was also identified from a vitreous sample. Both patients lost their vision despite intravitreal and intravenous antibiotics injection.
Aged ; Anti-Bacterial Agents ; Chills ; Cough ; Endophthalmitis ; Female ; Fever ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Liver ; Liver Abscess ; Vision, Ocular

There has been so much controversies about the position of upper and lower jaws, and their first permanent molars in normal occlusion and Angle's class I,II,III malocclusions. So, the purpose of this study is to compare the position of upper and lower jaws, and their first molars in normal occlusion and Angle's class IIIIII malocclusions by lateral cephalometric analysis. The sample consisted of one hundred and twenty girls(thirty in each group) who had completed growth. The findings of this study were as follows: 1. In class I malocclusion, both maxilla and mandible were slightly posterior position than normal occlusion, but they showed harmonious relationship. 2. In class II malocclusion, the mandible was greatly retruded, and the maxilla was also slightly retruded to the cranial base as compared with normal occlusion. 3. In class III malocclusion, the maxilla was significantly retruded to the cranial base, but no significant difference was found in mandibular position as compared with normal occlusion. 4. The maxillary first molar was located at posterior position in class II malocclusion, and anterior position in class III malocclusion to the cranium, so that the rotation of mandible was influenced by that. 5. The mandibular first molar showed constant relationship to the mandible in all four groups, but different position to the cranial base in direct proportion to the mandibular position. 6. On the treatment planning of class II malocclusion, it seems to be better to promote the mandibular horizontal growth by inhibiting the vertical growth of maxillary molar area, and on the treatment planning of class III malocclusion, it seems to be better to promote the antero-inferior growth of maxilla and to promote the mandibular vertical growth by inducing the vertical growth of maxillary molar area.
Jaw* ; Malocclusion* ; Mandible ; Maxilla ; Molar* ; Skull ; Skull Base

Bone marrow necrosis is infrequently diagnosed during life, and its presence often signifies a poor prognosis. It has been associated with a variety of disease, including acute and chronic leukemia, carcinoma, malignant lymph oma, infection and sickle cell disease. About 5-26% of acute myeloid leukemia has been reported to express lymphoid differentiation markers, of which CD7 is ex pressed very early during T-cell ontogeny. A 46-year-old male complaining severe bone pain had pancytopenia, leukoerythroblastosis and bone marrow necrosis. Peripheral blood immature cells expressed CD7 as well as myeloid markers such as CD13 and CD33 on immunophenotypic studies. We report a case of CD7 positive acute myeloid leu kemia associated with bone marrow necrosis, confirmed by bone marrow biopsy and immunophenotypic study.
Anemia, Sickle Cell ; Antigens, Differentiation ; Biopsy ; Bone Marrow* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Male ; Middle Aged ; Necrosis* ; Pancytopenia ; Prognosis ; T-Lymphocytes

Obstructive sleep apnea is characterized by repeated episodes of obstructive apnea and hypopnea. Lingual tonsillar hypertrophy causing obstructive symptoms is a rare disease in adults. Recently, we experienced a case of obstructive sleep apnea due to massive lingual tonsillar hypertrophy. The patient had tonsillectomy as a child and underwent adenoidectomy three years prior to the current presentation due to snoring and sleep apnea. However, symptoms did not improve and were recently aggravated. The upper airway evaluation and polysomnography revealed excessive lingual tonsillar hypertrophy and severe obstructive sleep apnea. An enlarged lingual tonsil was successfully removed using a Coblator. No recurrence was observed, and the obstructive sleep apnea was resolved postoperatively.
Adenoidectomy ; Adult* ; Apnea ; Child ; Humans ; Hypertrophy* ; Palatine Tonsil ; Polysomnography ; Rare Diseases ; Recurrence ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy

BACKGROUND: The purpose of this study was to determine whether the injection rate affects the spread of spinal anesthesia in cesarean sections. METHODS: Spinal anesthesia was performed on 45 parturients in a cesaren section. Dural puncture was performed in the sitting position with a 27-gauge Whitacre needle. All patients received a mixture of 10 mg hyperbaric bupivacaine and 15 microgram fentanyl. Twenty five (Group I) patients received rapid injections (about 0.2-0.3 ml/sec) and twenty (Group II) received slow injections (about 0.1 ml/sec). Anesthetic levels, time to T4 sensory block, maximal height sensory block and incidence of hypotension were measured. RESULTS: There was significantly rapid T4 sensory block in group I but no differences in maximal height of sensory block and incidence of hypotension between the two groups. CONCLSIONS: We conclude that injection rate (about 0.1-0.3 ml/sec) has a statistically insignificant influence on the maximal height sensory block and incidence of hypotension.
Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section* ; Female ; Fentanyl ; Humans ; Hypotension ; Incidence ; Needles ; Pregnancy ; Punctures

The purpose of this study was to investigate a possibility of chronic or intermittent bacteremia in patients undergoing orthodontic treatment with fixed orthodontic appliance. Orthodontic patients who had been injured by orthodontic appliances and/or suffered from gingivitis were selected. They had not taken any antibiotics for 1 month. The number of subjects were 21 including 7 males and 14 females. Blood samples of the subjects were cultured and, IgG, IgA and IgM levels in the serum were quantified. The author found following results. 1. No bacterial growth was found in 7-day culture of all the samples. 2. The immunoglobulin levels in serum were confined in normal range. 3. This study could not deny the possibility of transient bacteremia episode undergoing orthodontic treatment.
Anti-Bacterial Agents ; Bacteremia* ; Female ; Gingivitis ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Male ; Orthodontic Appliances ; Reference Values

OBJECTIVE: To investigate the proportion of aspiration pneumonia cases among patients with community-acquired pneumonia in Korea. METHODS: This retrospective study included patients with community-acquired pneumonia who had been admitted to the emergency department of a university-affiliated tertiary hospital in Gyeonggi Province, Korea between January 1, 2016 and December 31, 2016. Among these patients, those with aspiration pneumonia were identified using ICD-10 codes (J69.*). Patients with recurrent pneumonia were excluded, as were those who were immunocompromised. The proportion of cases of aspiration pneumonia was calculated, and the characteristics and clinical outcomes of patients with aspiration pneumonia and non-aspiration pneumonia were compared. RESULTS: The proportion of aspiration pneumonia cases among patients with community-acquired pneumonia was 14.2%. Patients with aspiration pneumonia were significantly more likely to be older (p<0.001) and male (p<0.001), and to have a higher confusion, uremia, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score (p<0.001) as compared to patients with non-aspiration pneumonia. They were also more likely to require admission to the intensive care unit (p<0.001) and a longer hospital stay (p<0.001). CONCLUSION: Aspiration pneumonia accounts for 14.2% of all cases of community-acquired pneumonia in Korea. These data may contribute to the establishment of healthcare strategies for managing aspiration pneumonia among Korean adults.
Adult ; Blood Pressure ; Community-Acquired Infections ; Delivery of Health Care ; Emergency Service, Hospital ; Gyeonggi-do ; Humans ; Intensive Care Units ; International Classification of Diseases ; Korea ; Length of Stay ; Male ; Pneumonia ; Pneumonia, Aspiration ; Respiratory Rate ; Retrospective Studies ; Tertiary Care Centers ; Uremia

Hemolytic uremic syndrome (HUS) is a rare disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. These characteristics are related to the formation of platelet-rich microthrombi in the microvasculature. HUS is associated with a variety of etiologies, including cisplatin. Previously reported HUS cases after cisplatin administration were almost always related to systemic combination chemotherapy that included cisplatin. Transarterial chemoembolization (TACE) is commonly used in treatment of hepatocellular carcinoma, and most centers in Korea use cisplatin. A 70-year-old female with hepatocellular carcinoma was treated with TACE including cisplatin and subsequently developed clinical and laboratory findings compatible with HUS.
Acute Kidney Injury ; Anemia, Hemolytic ; Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Cisplatin ; Drug Therapy, Combination ; Female ; Hemolytic-Uremic Syndrome ; Humans ; Korea ; Microvessels ; Thrombocytopenia

BACKGROUND: It has been speculated that many factors including age, hemoglobin serum albumin level and socioeconomic factors are closely related with the mortality and morbidity of patients with end-stage renal disease (ESRD). Optimal management of the patients with pre-dialysis chronic kidney disease has been thought to be very important for the prognosis of end-stage renal disease patients on dialysis. METHODS: In order to evaluate the clinical impact of referral pattern of chronic renal failure patients to nephrologist, 217 patients (male 129, female 88) who initiated hemodialysis from Jan. 1998 to Jul. 2002 in Chungnam National University Hospital were included in this retrospective analysis. Patients were defined as early referral (n=129) when hemodialysis was initiated at least 90 days after the first visit to nephrologist and as late referral (n=88) when hemodialysis was performed within 90 days after the first visit to nephrologist. RESULTS: Male gender and medical aid coverage were significantly more prevalent in late referral than early referral group (p<0.05, p<0.05, respectively). Late referral group had more combined medical problems than those of early referral group (p<0.05). Serum albumin level of early referral group was significantly higher than that of late referral group at the initiation of hemodialysis (p<0.001). At the initiation of hemodialysis, temporary central catheter for the blood access was needed in 85.2 % of late referral group. However, only 41.6% of early referral group needed such temporary catheter (p<0.001). One year after initiation of hemodialysis treatment, early referral group showed significantly lower mortality rate than that of late referral group (p<0.001). CONCLUSION: The early referral of chronic renal failure patients to nephrologist has beneficial effects including higher one-year survival after beginning of hemodialysis.
Catheters ; Chungcheongnam-do ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic* ; Male ; Mortality ; Prognosis ; Referral and Consultation* ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Serum Albumin ; Socioeconomic Factors