No abstract available.
Asthma* ; Child* ; Emergencies* ; Emergency Service, Hospital* ; Epidemiologic Studies* ; Humans

No abstract available.
Asthma* ; Child* ; Emergencies* ; Emergency Service, Hospital* ; Epidemiologic Studies* ; Humans

BACKGROUND: Notified tuberculosis (TB) cases in Korea have not decreased over the last decade (2001-2010). METHODS: To clarify the reasons, we analyzed an annual report on notified tuberculosis patients and age-specific population drift in Korea. RESULTS: Compared to the age-specific notified TB cases between 2001 and 2010, distinctive features in notified TB cases and new cases increased markedly in people aged 45-54 years and in patients over 65 years old, whereas those between 15-34 years in 2010 decreased drastically. In particular, notified TB individuals over 65 years old occupied 29.6% of the cases in 2010, which was 1.5 times higher than that in 2001. The main reason not to decrease in notified TB patients for the last decade (2001-2010) was due to the increasing elderly population as well as the aging of baby boomers, which have a higher risk of TB development. CONCLUSION: Korea needs to pay attention to the older population in order to successfully decrease the burden of TB in the future.
Aged ; Aging ; Humans ; Korea ; Population Dynamics ; Population Growth ; Tuberculosis

Emphysematous pyelonephritis is an uncommon and, but life-threatening necrotizing inflammation of renal parenchyme and perinephric tissue by gas-forming organisms. This disease is encountered mainly in patients with uncontrolled diabetes mellitus and/or urinary tract obstruction etc. Clinically, it appears as an acute severe clinical pyelonephritis that needs emergency care with poor prognosis. Though the pathogenesis of this disease is still pooly understood, radiographic demonstration of gas shadow in renal parenchyme and peri- nephritic tissue establishes the diagnosis of emphysematous pyelonephritis. The identification of this finding has been believed to consider incision and drainage or nephrectomy in addition to medical treatment, because of high mortality rate of this disease in spite of vigorous medical management. We herein present 1 diabetic patient with emphysematous pyelonephritis who responded to medical treatment alone. The patient was treated with antibiotics alone, the clinical signs and laboratory findings were improved, CT scan 1 month after medical treatment revealed absence of gas in the renal pelvis.
Anti-Bacterial Agents ; Diabetes Mellitus ; Diagnosis ; Drainage ; Emergency Medical Services ; Humans ; Inflammation ; Kidney Pelvis* ; Mortality ; Nephrectomy ; Prognosis ; Pyelonephritis* ; Tomography, X-Ray Computed ; Urinary Tract

Leigh Disease, or subacute necrotizing encephalopathy (SNE), is a degenerative disorder characterized by lesions of the gray and white matter in the bran and spinal cord. The pathogenesis was known as mitochondrial enzyme defect of the respiratory chain system. We experienced 2 cases of Leigh disease. The first case, a seven-month old girl who was presented with weak respiration and failure to thrive, showed lactic acidemia and increased lactic acid in CSF fluid, high signal intensity in the bilateral putamen and head of caudate of nucleus at T2 weighted MR imaging. The second case, a 3-year-old girl with ataxic gait and bilateral ptosis also showed lactic acidemia, increased lactic acid in CSF fluid and high signal intensity in the bilateral basal ganglia. Respiratory difficuly developed in both cases and died within 1 month after visiting our hospital. The diagnosis was made by lactic acidosis and specific MRI finding. We report these cases with a brief review of its related literature.
Acidosis, Lactic ; Basal Ganglia ; Child, Preschool ; Diagnosis ; Electron Transport ; Failure to Thrive ; Female ; Gait ; Head ; Humans ; Lactic Acid ; Leigh Disease* ; Magnetic Resonance Imaging ; Putamen ; Respiration ; Spinal Cord

There are many kinds of treatments for hepatocellular carcinoma (HCC) such as surgical resection, liver transplantation, chemotherapy, interventional therapy [TACE, ethanol embolization, Immuno -chemoembolization, I131 -lipiodol embolization], thermal therapy, cryotherapy, and radiation therapy. Generally spontaneous remission is not common in HCC, however underlying mechanism of spontaneous remission is uncertain. We report a case of complete remission after one time TACE in ruptured HCC with review of literature about the effect of TACE and spontaneous remission. We conclude that arterial embolization is an effective alternative to surgery for hepatic hemostasis in patients with spontaneous rupture of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Cryotherapy ; Drug Therapy ; Ethanol ; Hemostasis ; Humans ; Liver Transplantation ; Remission, Spontaneous ; Rupture, Spontaneous

OBJECTIVES: Left ventricular hypertrophy (LVH) is one of the most common echocardiographic findings and an important prognostic factor for cardiovascular mortality in hypertensives and chronic renal failure patients. To evaluate the prevalence and the types of LVH, and left ventricular systolic and diastolic functions as worsening of renal function, and to elucidate the risk factors for LVH, we performed this study retrospectively in normal populations, hypertensives, and renal failure with or without hemodialysis. METHODS AND SUBJECTS: We recruited the study population among the patients who had taken echocardiography at Pun-Dang CHA Hospital from July, 1995 to June, 1997. They are consisted of 54 patients for normal control, 53 patients of hypertensives, 31 patients of mild renal failure with less than 4.5 mg/dl of serum creatinine (Group I), 29 patients of moderate renal failure with more than 4.5 mg/dl of serum creatinine (Group II), and 47 patients of end stage renal disease with hemodialysis (Group III). The echocardiography was performed with all standard strategies including 2 dimension, M mode, and Doppler signals. RESULTS: 1) Among the baseline characteristics, the body mass index only significantly increased in hypertensives compared with group II and III.2) The prevalences of LVH in each groups were 5.6% in control group, 49.1% in hypertensives, 83.8% in group I, 89.7% in group II, and 100% in group III respectively. And the pevalences of concentric LVH were 5.6%, 43.3%, 41.9%, 34.5%, and 25.5% and those of the eccentric hypertrophy were 0.0%, 5.7%, 41.9%, 55.2%, and 74.5% respectively. The prevalence of eccentric hypertrophy increased according to deterioration of renal function.3) The left ventricular mass index was significantly higher in hypertensives, Group I, Group II, and Group III than normal control and the left ventricular volume index was greater in all renal failure patients compared with controls and hypertensives.4) In pre-hemodialysis renal failure patients, the types of LVH were consisted of 8 of normal heart (Group A), 23 of concentric LVH (Group B), and 29 of eccentric LVH (Group C). The systolic blood pressure and mean arterial pressure were significantly higher in group C than group A but there was no significant difference between group C and B. The RBC volume was significantly decreased in group B and C compared with group A. The echocardiographic end diastolic interventricular septal thickness and posterior wall thickness were significantly thicker in group B than others but end diastolic LV dimension, LV mass index, and LV volume index were significantly increased in group C than group B and A. The LV ejection fraction and fractional shortening as markers of LV systolic function in group C revealed the lowest level among three groups. The E velocity among the Doppler study profiles was significantly higher in group C than others.5) In hemodialysis group, all the patients had any types of LV hypertrophic changes. The concentric LVH group (group B) had significantly higher systolic blood pressure and mean arterial pressure than eccentric LVH (group C) but there was no difference in diastolic blood pressure between two groups. The echocardiographic interventricular septum and posterior wall were thicker in group B than group C but end diastolic LV dimension and LV volume were significantly higher in group C than group B.6) The LV mass index in pre-hemodialysis group had positive relationship with blood pressure and serum urea nitrogen level and the LV volume index was positively correlated with systolic blood pressure and mean blood pressure.7) The LV mass index in hemodialysis group had positive relationship with age and systolic blood pressure and LV volume index was positively correlated with serum urea nitrogen level but negatively correlated with blood pressure. CONCLUSION: The prevalence of LVH was much higher in renal failure group than hypertenssives and the proportion of eccentric LVH was increased with worsening of renal function. Although the arterial hypertension is the most important risk factor for LVH, this finding suggested existence of other contributing risk factors for LVH in chronic renal failure, which included uremia, anemia, and age.
Anemia ; Arterial Pressure ; Blood Pressure ; Body Mass Index ; Creatinine ; Echocardiography* ; Heart ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic ; Mortality ; Nitrogen ; Prevalence ; Renal Dialysis ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Retrospective Studies ; Risk Factors ; Urea ; Uremia

The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases.

The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases.

The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases.