No abstract available.
Blood Group Incompatibility* ; Bromelains*

BACKGROUND/AIMS: Planned endoscopic submucosal dissection with snaring (ESD-S) is thought to shorten operating time spent on submucosal dissection, but may lead to uncertainty of en bloc resection or to a possible increase in tumor-positive margins. The purpose of the present study is to investigate the feasibility of ESD-S as a planned procedure for gastric adenoma. MATERIALS AND METHODS: The medical records of 99 patients who underwent ESD-S or ESD for gastric adenoma between May 2011 and May 2012 were retrospectively reviewed. We analyzed the differences between the ESD-S and the ESD groups, focusing on rates of en bloc resection and pathologic complete resection, mean operation time, and complications. RESULTS: The mean operation time was significantly lower in the ESD-S group than in the ESD group (19.9+/-11.2 vs. 33.8+/-19.9, P=0.012). Cases with an operation time under 30 minutes were more frequent in the ESD-S group (88.9% vs. 48.1%, OR=8.615, 95% CI=2.949~25.168). There were no significant differences in en bloc resection, histologic complete resection, or complication rates between the two groups. CONCLUSIONS: ESD-S has a time advantage over ESD with a comparable compete resection rate. ESD-S can be considered a planned method for available early gastric adenoma.
Adenoma* ; Endoscopy ; Focus Groups ; Humans ; Medical Records ; Retrospective Studies ; SNARE Proteins* ; Uncertainty

PURPOSE: Recently, the incidence of refractory Mycoplasma pneumoniae (MP) pneumonia has increased in Korea. Given that its early diagnosis is helpful in selection of the treatment, this study aimed at investigating the value of the antimycoplasma antibody (IgM) for early diagnosis of MP pneumonia. METHODS: A total of 315 children admitted with MP pneumonia from September 2015 to May 2016 were investigated with the IgM and polymerase chain reaction (PCR) for the diagnosis of MP pneumonia. Specifically, patients were grouped into nonrefractory respiratory MP and refractory MP groups according to their response to macrolide therapy. RESULTS: In the 44 PCR-negative seroconversed children, seroconversed IgM was more frequent in the refractory MP group compared with the nonrefractory respiratory MP group with statistical significance (P<0.001). In the 264 IgM-positive children, the time of antibody reaction was more delayed in the refractory MP group compared to the nonrefractory respiratory MP group with statistical significance (P<0.001). CONCLUSION: This study showed that there was a higher incidence of seroconversed IgM and delayed antibody reaction in the refractory MP group. In children with suspect MP pneumonia, follow-up studies of antibody are necessary, even through initial antibody and PCR showed negative findings. In addition, this result may suggest that the diagnosis of refractory MP pneunomia will be helpful in establishing the strategy of the treatment.
Child ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Incidence ; Korea ; Mycoplasma pneumoniae ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction

PURPOSE: The incidence of renal tuberculosis has decreased considerably in recent years, but the disease still threatens public health. Childhood genitourinary tuberculosis (GUTB) has been very rare. The aim of the study was to analyze the clinical aspects and characteristics of childhood GUTB. MATERIALS AND METHODS: A total of 145 cases of GUTB were diagnosed. We analyzed retrospectively the clinical manifestations of eight patients with GUTB younger than 15 years of age. RESULTS: The age of the patients, six boys and two girls, ranged from 5 to 14 years. Follow up period ranged from 12 to 145 months. Presenting features were diverse and included gross hematuria in five cases. Rarer presenting features included one case of epididymorchitis. All had had BCG vaccination at around 1 month old. Conclusive diagnosis was made on the basis of isolation of mycobacterium tuberculosis in five patients, whereas three patients were given a therapeutic trial based on clinical manifestations. The most common site of involvement was the kidney (7 cases). Temporary urinary diversional procedures were performed in two patients for relieving ureteral obstruction. Excisional surgery was needed in three patients, whereas one underwent ureteroneocystostomy for ureteric stricture. Response to antitubercular drug therapy was gratifying. No relapse was observed during follow-up period. CONCLUSIONS: Childhood GUTB is rare, but may become serious. The importance of early diagnosis is emphasized, and aggressive treatment is needed in advanced childhood tuberculosis for preservation of renal function.
Child* ; Constriction, Pathologic ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Incidence ; Infant, Newborn ; Kidney ; Mycobacterium bovis ; Mycobacterium tuberculosis ; Public Health ; Recurrence ; Retrospective Studies ; Tuberculosis* ; Tuberculosis, Renal ; Ureter ; Ureteral Obstruction ; Urinary Diversion ; Vaccination

OBJECTIVES: The purpose of this study was to analyze the characteristics of workrelated musculoskeletal diseases, as listed by the Korea Labor Welfare Corporation (KLWC). METHODS: Using the database of the KLWC, we collected information from 410 approved occupational musculoskeletal disease cases, which occurred between 1 January and 31 December 1999 and were approved by 30 June in 2000. We investigated the characteristics of the disease using a mail survey and telephone interviews. The characteristics we investigated included : sex, age, disease-related working duration, process of disease occurrence, type of enterprises, etc. RESULTS: Men accounted for 75.6 % (310 workers) of the approved cases. The most common age group was 30-39 years (n=143, 34.9 %). The mean disease-related working duration was 5.7 years, and the most commonly had a work-duration of 1-5 years (n=108, 36.0 %). The major industrial types of enterprise were manufacturing (235 workers, 57.3 %), transportation (46 workers, 11.2 %), and construction (25 workers, 6.1 %). Within the manufacturing industry, the most common was motor vehicles and trailers manufacturing. Within the group, the most common jobs were plant or machine operators and assemblers (129 workers, 36.5 %), elementary occupations (90 workers, 25.5 %), and craft and related trades workers (63 workers, 17.8 %). The majority of the diseases involved lumbar problems (232 cases, 54.7 %), neck and upper extremity diseases (183 cases, 43.2 %) and lower extremity diseases (9 cases, 2.1 %). In the cases of lumbar disease, the mean age and working duration was 36.5 years and 4.7 years, respectively. Fifty-four cases of lumbar diseases were due to repetitive work and 89 due to non-repetitive work. Bad posture at work was the most common cause for those doing repetitive work(23 cases), and lifting the most common cause of problems in the non-repetitive work cases (27). CONCLUSIONS: We were able to elucidate the characteristics of workers with approved occupational musculoskeletal disease through this study. Many approved cases occurred in women, and workers performing repetitive work, of these herniated nucleus pulposus occurred in many workers performing simple repetitive works without serious external forces. This suggests that a prevention policy for occupational musculoskeletal disease must be established, to focusing on the above-mentioned high-risk groups.
Female ; Humans ; Interviews as Topic ; Korea* ; Lifting ; Lower Extremity ; Male ; Motor Vehicles ; Musculoskeletal Diseases* ; Neck ; Occupations ; Plants ; Postal Service ; Posture ; Transportation ; Upper Extremity

The major cause of pseudomembranous colitis is known to be Clostridium difficile (C. difficile). There are few reports that Clostridium species other than C. difficile has caused pseudomembranous colitis. We report a case of pseudomembranous colitis caused by clostridium glycolicum(C. glycolicum). A 47-year-old woman who had operational history for rectal cancer 3 months ago, was readmitted with diarrhea of 3 days duration. Seven weeks before admission, she had received ornidazole and ceftriaxone due to diarrhea and abdominal pain, and her symptoms were improved. She had received additional radiation therapy for rectal cancer during six weeks before the recent onset of diarrhea. On admission, she complained of watery diarrhea ten times a day and abdominal pain. She had tenderness on both lower abdomen. Pseudomembrane was observed by colonoscopic and histologic examination. VIDAS C. difficile toxin A II assay was positive and C. glycolicum was isolated in the stool. She recovered after receiving oral metronidazole treatment.
Abdomen ; Abdominal Pain ; Ceftriaxone ; Clostridium difficile ; Clostridium* ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Female ; Humans ; Metronidazole ; Middle Aged ; Ornidazole ; Rectal Neoplasms

PURPOSE: We investigated the clinical difference between single infection and coinfection with respiratory virus in hospitalized children with acute respiratory tract infections. METHODS: We reviewed 727 patients who were admitted with the diagnosis of acute respiratory infection at the Department of Pediatrics, Bundang Jesaeng Hospital between January and December of 2014. Diagnoses were made using the multiplex reverse transcriptase polymerase chain reaction (RT-PCR) assay targeting 16 viruses in nasopharyngeal swabs. Subjects were classified as the single virus infection and coinfection groups. RESULTS: A total of 439 patients were enrolled; 359 (77.2%) under 24 months. Single virus was detected in 279 (63.6%). Coinfection with multiple virus was detected in 160 (36.4%): 126 (28.7%) with 2 viruses, 30 (6.8%), and 4 (0.9%) with 3 to 4 viruses. Viral coinfection was detected in 28 samples (17.5%), with respiratory syncytial virus (RSV) A and rhinovirus being the most dominating combination. There were no clinical differences between the single infection and coinfection groups, except sputum and the frequency of high RSV load. Sputum was significantly more frequent in the coinfection group (P=0.043), and the frequency of high RSV load was significantly higher in the single infection group (P=0.029). Disease severity (high fever, the duration of fever [≥5 days], and the length of hospital stay [≥5 days], O₂ therapy) did not differ significantly between both groups. RSV was a frequent virus of single infection during winter. Coinfection was most common in winter. CONCLUSION: There were no clinical differences between single infection and coinfection, except sputum and the frequency of high RSV load.
Child ; Child, Hospitalized ; Coinfection* ; Diagnosis ; Fever ; Humans ; Length of Stay ; Multiplex Polymerase Chain Reaction ; Pediatrics ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Sputum

Since Folkman's novel hypothesis, it is well known that tumors depend on the angiogenesis for their growth, expansion, and possibly metastasis. Several angiogenic factors have been identified and shown to be produced by tumors. In some cancers, the angoigenic activity in the tumor is correlated with the clinical outcome. Clinically, the presence of macroscopic or colposcopic abnormal vascular patterns of the uterine cervical lesions would suggest that the angiogenic activities are associated with various cervical squamous epithelial lesions. This study was designed to look at the relationship between angiogenesis and squamous epithelial lesions of the uterine cervix and to determine whether squamous intraepithelial lesions are angiogenic as cervical cancers are. Tissue sections from 53 surgical specimens(6 normal cervix, 4 chronic cervictis, 9 low grade SII, 8 high grade SIL, 7 MIC, 19 squamous cell carcinoma) were immunohistochemically stained for CD 34 a specific marker for endothelial cels. Stained vessels in the most intense area on a X200 light microscopic field were selected and counted automatically using computer software for color-image analysis. Stained vessel counts were 19.7 +/- 9.1 in normal cervix, 33.5 +/-5.8 in chronic cervicitis, 38.8 +/- 10.9 in LGSIL, 67.0 +/- 23.6 in HGSIL, and 73.4 +/- 20.6 in microinvasive carcinoma, 77.8 +/- 28.7 in squamous cell carcinoma, respectively. Vessel counts showed a statistically increasing tendency in more advanced squamous epithelial lesins. Tumor angiogenesis is not related to inflammatory response. Also, the process of the angiogenic switching may begin from low grade SIL to high grade SIL. This study suggests that the angiogenic activity also involved in SILs as invasive cancer are and may be related to grade of SELs.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Female ; Neoplasm Metastasis ; Uterine Cervicitis

PURPOSE: There are various methods proposed for the evaluation of the hindfoot alignment. However, due to structural calcaneus variances between patients, it is hard to assess this alignment definitively. Thus, this study proposes a new method for evaluating of the hindfoot alignment and its comparisons to the existing current methods. MATERIALS AND METHODS: This study includes simple weight bearing hindfoot coronal view radiographs of 120 patients, taken between the time period of March 2008 to November 2009. Among the 120 patients, there was a 1:1 ratio of male to female with an average age of 40. The newly proposed method for evaluating this alignment is to draw a moment arm from the point where the sustentaculum tali meets the medial calcaneus border to the most prominent aspect of the lateral process of the calcaneal tuberosity. The angle produced via the intersection of this moment arm to the mid-longitudinal axis of the tibia is found and used to evaluate the hindfoot alignment. The inter and intra-observer reliability was evaluated using the coefficient of intraclass correlation. This study also investigates the comparisons between the newly proposed method to the traditionally used Saltzman et al hindfoot alignment evaluating technique. RESULTS: The newly proposed method has higher inter and intra-observer reliability than the existing traditional Saltzman et al technique. CONCLUSION: This new method is recommended over the traditionally used Saltzman et al technique as it has a stronger confidence level and is appropriate for assessing hindfoot alignment in simple radiographs.
Arm ; Axis, Cervical Vertebra ; Calcaneus ; Female ; Humans ; Male ; Tibia ; Weight-Bearing

BACKGROUND: The prognosis of syncope is related to the severity of the underlying disease, including cerebral disease, rather than of the syncope itself. The aim of this study was to identify the clinical factors related to the cerebral comorbidity confirmed on brain imaging of syncope patients. METHODS: We retrospectively reviewed the medical records of patients who were diagnosed as syncope and underwent brain magnetic resonance [MR] imaging between January 2011 and December 2014. An abnormal MR lesion was defined as the presence of one or more of the following: (1) ischemic lesion, (2) major cerebral artery occlusion or stenosis over 50%, (3) cerebral aneurysm or vascular abnormalities, and (4) other traumatic or parenchymal lesion. The findings of electroencephalography and clinical factors that might be related to abnormal lesions in brain MR images were investigated. RESULTS: Of 347 (mean age 50.5 years, 48.1% females) patients, abnormal imaging findings were observed in 48 (13.8%). The clinical factors related to abnormal findings were age, hypertension, diabetes mellitus, and coronary artery disease. Independent factors for an abnormal MR lesion were age (odds ratio=1.05, 95% confidence interval [CI] 1.03-1.08, p <0.001) and hypertension (odds ratio=2.73, 95% CI 1.34-5.60, p=0.006). Abnormal electroencephalography findings were noted in 52 (20.3%) of 256 investigated patients. Generalized or focal slowing was observed more frequently in elderly patients (p<0.001) and in the presence of abnormal brain MR lesions (p=0.013). CONCLUSIONS: In syncope patients with hypertension or who are elderly, a brain MR image may be helpful for detecting comorbid brain lesions.
Aged ; Brain ; Cerebral Arteries ; Comorbidity ; Constriction, Pathologic ; Coronary Artery Disease ; Diabetes Mellitus ; Electroencephalography ; Humans ; Hypertension ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Medical Records ; Neuroimaging ; Prognosis ; Retrospective Studies ; Syncope*