OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

Accidental ingestion of foreign body is a common problems in pediatric emergencies. The majority of such cases occur in children between 6 months and 3 years of age. 80% of ingested foreign bodies which reach the stomach will pass uneventfully through the gastrointestinal tract, however the remainder may cause obstruction, perforation or hemorrhage. When several magnets are ingested, they can be attracted to each other through the intestinal wall, causing necrosis and intestinal perforation or fistula, so they should be removed while they are still in the stomach. The authors experienced 2 cases of unusual small bowel complication caused by the ingestion of magnets. The first case was a 10-month-old male with ileal perforation due to 2 ingested magnetic beads, and the second case was a 22-month-old male with ileo-ileal fistula due to 7 ingested magnetic beads.
Child ; Eating* ; Emergencies ; Fistula ; Foreign Bodies* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Infant ; Intestinal Perforation ; Male ; Necrosis ; Stomach

We measured the anterior chamber depth and chamber angle to understand the biological structure of anterior segment and find a possible relation between cataract and angle closure glaucoma on 235 eyes over 40 years old divided into two groups: 111 cataract eyes and 124 normal control eyes using the Scheimpflug Camera(EAS-1000, Nidek, Japan) and image analysis technique. The values of the anterior chamber depth and angle of the eye of the young person were greater than those of older person, and the values in the male were deeper(p<0.01) and larger(p<0.05) than those in female in both groups. In cata ract eyes, the mean anterior chamber depth was 2.77mm and mean anterior chamber angle was 30.36 degrees. The mean anterior chamber depth and angle of normal control eye were 2.67mm and 29.10 degrees. The anterior chamber depth and angle in cataract group was deeper(p<0.05) and larger(p<0.05) than in normal control group.
Adult ; Anterior Chamber* ; Cataract* ; Female ; Glaucoma, Angle-Closure ; Humans ; Male

Liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68. 2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. CONCLUSION: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
Allopurinol* ; Follow-Up Studies ; Gout* ; Humans ; Liver Function Tests* ; Liver*

No abstract available.
Rhinoplasty*

Popliteal vein aneurysm is a very uncommon and rarely reported although potentially life-threatening disease because it can be a source of pulmonary embolism. A patient with recurrent pulmonary embolism must be checked for lower extremity venous abnormalities. Recently, newer techniques including duplex scanning, computerized tomography and magnetic resonance imaging are useful in detecting popliteal fossa venous abnormalities. However, venography is also mandatory before operating on a popliteal vein aneurysm. Several methods are useful for the surgical treatment of popliteal vein aneurysms, including aneurysmectomy with lateral venorrhaphy, aneurysmectomy with vein transposition, aneurysmectomy with vein patch, etc. Following surgery, anticoagulation therapy is widely accepted. Here in, we present a case of popliteal vein aneurysm with pulmonary embolism. This patient was a 67-year-old woman exhibiting chest pain and exertional dyspnea. Lung scan and chest CT revealed multiple pulmonary embolisms and lower extremity venography revealed a right popliteal vein aneurysm with thromboembolism. This patient underwent aneurysmectomy with lateral venorrhaphy.
Aged ; Aneurysm* ; Chest Pain ; Dyspnea ; Female ; Humans ; Lower Extremity ; Lung ; Magnetic Resonance Imaging ; Phlebography ; Popliteal Vein* ; Pulmonary Embolism* ; Thromboembolism ; Tomography, X-Ray Computed ; Veins

Intravascular papillary endothelial hyperplasia (Masson's hemangioma) is a disease characterized by exuberant endothelial proliferation within the lumen of medium-sized veins. In 1923, Masson regarded this disease as a neoplasm inducing endothelial proliferation, however, now it is considered to be a reactive vascular proliferation following traumatic vascular stasis. The lesion has a propensity to occur in the head, neck, fingers, and trunk. Occurrence within the abdominal cavity is known to be very rare, and especially in the liver, there has been no reported case up to date. The authors have experienced intravascular papillary endothelial hyperplasia of the liver in a 69-yr-old woman, and report the case with a review of the literature.
Aged ; Angiography ; Endothelium, Vascular/pathology ; Female ; Hemangioendothelioma/*pathology/surgery ; Human ; Liver/*blood supply/*pathology ; Necrosis ; Vascular Neoplasms/*pathology/surgery

BACKGROUND: A management protocol for hepatitis C virus (HCV) after liver transplantation (LT) has not been established in Korea. We therefore investigated HCV transplant protocols and post-transplant results from liver transplant centers in Korea. METHODS: The HCV protocol and medical data of individual cases from eight major liver transplant centers were compiled and analyzed. RESULTS: A post-transplant protocol biopsy was performed in only three centers. In these centers, HCV treatment was considered when pathological abnormalities were confirmed on the protocol biopsy (irrespective of liver function). In the other five centers, biopsies were performed when biochemical parameters were aggravated. Only two out of the eight centers performed preemptive or prophylactic therapy. A total of 5,663 adult LTs were performed between 2000 and 2010. HCV-related liver disease was responsible for 277 LTs (4.9%). Pre-transplant data were not available in many patients, including HCV genotype and serum HCV RNA level. Tacrolimus was more frequently used for initial maintenance immunosuppression than cyclosporine A (61.7% vs. 36.8%). Post-transplant HCV treatment was performed in 135 patients (48.7%). Sixty-seven recipients (24.2%) died during follow-up after LT and 11 HCV-related graft loss (4.0%) developed. The cumulative patient survival rate was 74.7% at 5 years and 67.9% at 10 years after LT. CONCLUSIONS: The HCV management protocol after LT varied markedly between the eight Korean transplant centers and a standard protocol did not exist. A nationwide multicenter study is required to investigate the most effective treatment for HCV after LT, with the goal of establishing the most effective standard protocol.
Adult ; Biopsy ; Cyclosporine ; Follow-Up Studies ; Genotype ; Hepacivirus ; Hepatitis ; Hepatitis C ; Humans ; Immunosuppression ; Korea ; Liver ; Liver Diseases ; Liver Transplantation ; RNA ; Survival Rate ; Tacrolimus ; Transplants

BACKGROUND: Current guidelines of advanced trauma life support recommend open thoracotomy when pericardiocentesis reveals bloody pericardial effusion in patients with blunt chest trauma. However, open thoracotomy may not be always required for treating patients alive until arriving emergency department, because rapid accumulation of the blood into pericardial space results in immediate death at scene. We report our experiences of treating traumatic pericardial effusion, and discuss the therapeutic modality in patients with traumatic pericardial effusion. METHODS: The study consisted of 37 patients(20 males and 17 females with the mean age 42) sustaining traumatic pericardial effusion. The patients were divided according to treatment modality into 3 groups(group I : patients receiving conservative management, group II : patients treated with pericardiocentesis, group III : patients required emergency thoracotomy). We compared clinical presentations, hemodynamic profiles and echocardiographic findings among three groups. RESULTS: Cardiac tamponade was present in 14 of 37 patients. Pericardiocentesis was performed in 13 patients, and open thoracotomy in 4 patients. Pericardiocentesis was curative in 9 patients. Thoracotomy was performed in only 3(24%) of 13 patients required pericardiocentesis. 3(75%) of 4 patients having moderate or severe pericardial effusion from penetrating injury were required open thoracotomy. CONCLUSION: In selected patients who have traumatic pericardial effusion by blunt chest injury, pericardiocentesis may be curative, and thoracotomy may not be inquired as long as bleeding via indwelling pericardial catheter is not sustained after pericardiocentesis.
Advanced Trauma Life Support Care ; Cardiac Tamponade ; Catheters ; Echocardiography ; Emergencies ; Emergency Service, Hospital ; Female ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Pericardial Effusion* ; Pericardiocentesis ; Thoracic Injuries ; Thoracotomy ; Thorax

No abstract available.
Dinoprostone*