Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

Although congenital nasolacrimal duct obstruction occurs commonly in infants, it rarely results in neonatal dacryocystitis. Recent reports have indicated a frequent association of neonatal dacryocystitis and nasolacrimal duct cysts. We experienced a case of bilateral nasolacrimal duct cysts in a neonate with dacryocystitis. Marsupialization of the cysts was safely accomplished under the direct endoscopic visualization using a microdebrider. The patient had an excellent postoperative course without recurrence. We report it with a review of the literature.
Dacryocystitis* ; Humans ; Infant ; Infant, Newborn ; Lacrimal Duct Obstruction ; Nasolacrimal Duct* ; Recurrence

Common complications after unicompartmental knee arthroplasty include infection, aseptic loosening, polyethylene wear, and progression of another compartmental arthritis. Complications caused by extruded cement and loose cement body are very rare, and have not been reported in Korea. This paper reports a case of femoral cartilage injury of the lateral compartment caused by a loose cement body after unicompartmental knee arthroplasty. The loose cement body was removed successfully by arthroscopic surgery.

PURPOSE: Respiratory motion is a considerable inhibiting factor for precise treatment with stereotactic radiosurgery using the CyberKnife (CK). In this study, we developed a moving phantom to simulate three-dimensional breathing movement and investigated the distortion of dose profiles between the use of a moving phantom and a static phantom. MATERIALS AND METHODS: The phantom consisted of four pieces of polyethylene; two sheets of Gafchromic film were inserted for dosimetry. Treatment was planned to deliver 30 Gy to virtual tumors of 20, 30, 40, and 50 mm diameters using 104 beams and a single center mode. A specially designed robot produced three-dimensional motion in the right-left, anterior-posterior, and craniocaudal directions of 5, 10 and 20 mm, respectively. Using the optical density of the films as a function of dose, the dose profiles of both static and moving phantoms were measured. RESULTS: The prescribed isodose to cover the virtual tumors on the static phantom were 80% for 20 mm, 84% for 30 mm, 83% for 40 mm and 80% for 50 mm tumors. However, to compensate for the respiratory motion, the minimum isodose levels to cover the moving target were 70% for the 30~50 mm diameter tumors and 60% for a 20 mm tumor. For the 20 mm tumor, the gaps between the isodose curves for the static and moving phantoms were 3.2, 3.3, 3.5 and 1.1 mm for the cranial, caudal, right, and left direction, respectively. In the case of the 30 mm tumor, the gaps were 3.9, 4.2, 2.8, 0 mm, respectively. In the case of the 40 mm tumor, the gaps were 4.0, 4.8, 1.1, and 0 mm, respectively. In the case of the 50 mm diameter tumor, the gaps were 3.9, 3.9, 0 and 0 mm, respectively. CONCLUSION: For a tumor of a 20 mm diameter, the 80% isodose curve can be planned to cover the tumor; a 60% isodose curve will have to be chosen due to the tumor motion. The gap between these 80% and 60% curves is 5 mm. In tumors with diameters of 30, 40 and 50 mm, the whole tumor will be covered if an isodose curve of about 70% is selected, equivalent of placing a respiratory margin of below 5 mm. It was confirmed that during CK treatment for a moving tumor, the range of distortion produced by motion was less than the range of motion itself.
Polyethylene ; Radiosurgery* ; Range of Motion, Articular ; Respiration

Hemorrhagic cystitis (HC) is a common complication after allogeneic transplantation. Early posttransplant HC occurs in association with cyclophosphamide, while later on HC results from viral infections such as polyomavirus BK (BKV) and adenovirus. We report here the case of a 57-year-old woman who received an instillation of cidofovir into the bladder for the treatment of hemorrhagic cystitis after allogeneic peripheral stem cell transplantation for her acute myeloid leukemia. Cyclophosphamide and busulfan were used as conditioning treatments. Cyclosporin was administered daily. On the 71st day after transplantation, the patient developed acute severe hemorrhagic cystitis, and BK virus was demonstrated in the urine samples using polymerase chain reaction. Her urinary symptoms did not improve in spite of palliative treatment, but a response was evident after intravesical cidofovir treatment.
Adenoviridae ; BK Virus ; Busulfan ; Cyclophosphamide ; Cyclosporine ; Cystitis ; Cytosine ; Female ; Humans ; Leukemia, Myeloid, Acute ; Middle Aged ; Organophosphonates ; Palliative Care ; Peripheral Blood Stem Cell Transplantation ; Polymerase Chain Reaction ; Polyomavirus ; Stem Cell Transplantation ; Stem Cells ; Transplantation, Homologous ; Transplants ; Urinary Bladder

OBJECTIVES: We performed a time series analysis in order to identify the relationship between the occupational injury rate and socio-economic factors, and through this predict the occupational injury occurrence rate. METHODS: We reviewed 168 sets of monthly data. For the statistical analysis, we used the economic index data provided by Statics Korea and the occupational injury index provided by the Workers' Compensation & Welfare Service gathered from 1994 to 2007. We performed a correlation analysis to find relationship between the occupation injury rate and economic factors. Using the correlation analysis result, we used time series analysis for the data in order to find out the association between occupational injuries and socio-economic indicators. We performed time series analysis to find out association occupation injury rate with socio-economic factors. In addition we ran a prediction occupational injury rate for 2008 and compared the result to the actual value. RESULTS: The factors associated with occupational injuries were the daily worker index (b=0.394, p<0.0001), the mechanical index (b=-0.023, p=0.0043), the manufacturing operation index (b=0.152, p<0.0001), the workers compensation coverage expansion (b=1.189, p=0.015), the IMF index (b=-2.05, p<0.0001), and the after IMF index (b=-1.565, p=0.01). The daily worker index, manufacturing operation index, and workers compensation coverage expansion had an effect that increased the occupational injury rate. Conversely, the mechanical index and IMF variable tended to decrease the occupational injury rate. CONCLUSIONS: This study suggests that the daily worker index, manufacturing operation index, workers compensation coverage expansion, and IMF variables are related factors in regards to occupational injury.
Korea ; Occupational Injuries ; Occupations ; Workers' Compensation

BACKGROUND/AIMS: Benign intestinal strictures are common complications in patients with inflammatory bowel disease (IBD). This study aimed to assess the long-term prognosis of endoscopic balloon dilation (EBD) to treat benign strictures in IBD patients. METHODS: Patients with IBD who had benign strictures and who underwent EBD in four tertiary referral university hospitals between January 2004 and February 2014 were retrospectively reviewed. Technical success was defined as the ability to pass the scope through the stricture after balloon dilation, and clinical success was defined as improved obstructive symptoms. RESULTS: Forty-two benign strictures were identified in 30 patients (15 males and 15 females). Technical success was achieved in 26 patients (86.7%) at the first EBD attempt and in all 30 patients (100%) at the second EBD attempt. Clinical success was seen in 28 patients (93.3%). The median follow-up duration was 134.8 months (range, 10.2 to 252.0 months), and recurrence occurred in eight patients (26.7%), who required repeat EBD. The median duration to relapse was 1.7 months (range, 0.2 to 6.3 months). During repeat EBD, perforation occurred in two cases (6.7%), which were both clipped successfully. Finally, only one patient (3.3%) underwent surgery for the relief of recurrent obstructive symptoms during the follow-up period. CONCLUSIONS: The experience of 10 years shows that EBD is safe and effective for the treatment of benign strictures in IBD patients. Importantly, EBD may allow long-term effective palliation of the symptoms associated with benign intestinal strictures in IBD patients.
Colitis, Ulcerative ; Constriction, Pathologic* ; Crohn Disease ; Follow-Up Studies ; Hospitals, University ; Humans ; Inflammatory Bowel Diseases* ; Male ; Prognosis ; Recurrence ; Referral and Consultation ; Retrospective Studies

STUDY DESIGN: A cross-section observational study. OBJECTIVES: To evaluate the current prescription patterns of non-steroidal anti-inflammatory drugs (NSAIDs) and gastrointestinal (GI) risk assessment in patients with lumbar spine disease. SUMMARY OF LITERATURE REVIEW: NSAIDs are commonly prescribed medications for lumbar spine disease patients. Since the rate of GI complication varies for each patient, identification of individual GI risks is a prerequisite to prevent such a complication. There are few reports about the GI risks in patients with lumbar spine disease who take NSAIDs. MATERIALS AND METHODS: 2264 patients with lumbar degenerative spondylopathy who were taking NSAIDs were enrolled from May 2010 to September 2010. The Standardized Calculator of Risk for Event (SCORE) was used to measure patients' GI risk factors. NSAID prescription patterns and GI protective agents were also investigated. RESULTS: Being aged over 65 (1098 patients; 48.5%) and the presence of GI side-effects from NSAIDs (896 patients; 39.6%) were the most common risk factors. 31.9% and 5.8% percent of patients belonged to each of the high risk and the very high risk groups in GI risk factor analysis. The total prescription rate of gastroprotectants was 91.7% for all patients. However, the prescription rate of selective COX-2 inhibitors in the high risk group was low, and in 54.8% of patients who took COX-2 inhibitors there was GI discomfort. CONCLUSIONS: The prescription pattern of GI protective agents was not correlated with GI symptoms. Therefore, physicians should consider NSAID prescription based on the GI risk factors of individual patients.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Cyclooxygenase 2 Inhibitors ; Humans ; Prescriptions ; Protective Agents ; Risk Assessment ; Risk Factors ; Spinal Diseases ; Spine

Surgery is the primary treatment for adenocarcinoma originating from the esophagogastric junction. However, many physicians attempt various endoscopic treatments for the cases of early adenocarcinoma and high-grade dysplasia of esophagogastric junction in order to avoid the high risk of complications associated with surgical resection. Recently, there is an increasing tendency to use endoscopic mucosal resection for the management of early esophageal cancer due to low morbidity and mortality rates. We report here on a case of early adenocarcinoma at esophagogastric junction successfully treated with endoscopic mucosal resection.
Adenocarcinoma ; Endoscopy ; Esophageal Neoplasms ; Esophagogastric Junction

Background: Hereditary hemolytic anemia (HHA) is a rare disease characterized by premature red blood cell (RBC) destruction due to intrinsic RBC defects. The RBC Disorder Working Party of the Korean Society of Hematology established and updated the standard operating procedure for making an accurate diagnosis of HHA since 2007. The aim of this study was to investigate a nationwide epidemiology of Korean HHA. Methods: We collected the data of a newly diagnosed pediatric HHA cohort (2007–2016) and compared this cohort's characteristics with those of a previously surveyed pediatric HHA cohort (1997–2006) in Korea. Each participant's information was retrospectively collected by a questionnaire survey. Results: A total of 369 children with HHA from 38 hospitals distributed in 16 of 17 districts of Korea were investigated. RBC membranopathies, hemoglobinopathies, RBC enzymopathies, and unknown etiologies accounted for 263 (71.3%), 59 (16.0%), 23 (6.2%), and 24 (6.5%) of the cases, respectively. Compared to the cohort from the previous decade, the proportions of hemoglobinopathies and RBC enzymopathies significantly increased (P < 0.001 and P = 0.008, respectively). Twenty-three of the 59 hemoglobinopathy patients had immigrant mothers, mostly from South-East Asia. Conclusion In Korea, thalassemia traits have increased over the past 10 years, reflecting both increased awareness of this disease and increased international marriages. The enhanced recognition of RBC enzymopathies is due to advances in diagnostic technique; however, 6.5% of HHA patients still do not have a clear diagnosis. It is necessary to improve accessibility of diagnosing HHA.