No abstract available.
Rhinoplasty*

We report here on a rare case of adrenal paragonimiasis that presented with an adrenal incidentaloma. A 52-year-old male presented with fatigue and weight loss. The laboratory findings revealed eosinophilia (8.5%) and an increased eosinophil count (910/microL). The computed tomography scan showed 6.5 x 5 cm sized multilocular cystic mass in the right adrenal gland, which was non-functioning, and cystic lesions with variable sizes were also noted in the abdominal cavity. On the surgical field, whitish patches were spread out in the peritoneum, the omentum, the dome of the liver and the diaphragm. The right adrenal gland was replaced by a cystic mass filled with mucopurulent creamy materials. The pathologic findings revealed numerous eggs of Paragonimus spp. Also, the ELISA was positive for IgG paragonimus antibody. The adrenal gland can become infected by various microbial pathogens, including parasites, although it is relatively uncommon. However, in the case of a cystic adrenal mass with accompanying eosinophilia in an endemic area, clinicians should consider the possibility of parasitic infection.
Abdominal Cavity ; Adrenal Gland Neoplasms ; Adrenal Glands ; Diaphragm ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Fatigue ; Humans ; Immunoglobulin G ; Liver ; Male ; Middle Aged ; Omentum ; Ovum ; Paragonimiasis ; Paragonimus ; Parasites ; Peritoneum ; Weight Loss

Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases.
Amnesia ; Brain ; Brain Diseases ; Central Nervous System ; Follow-Up Studies ; Humans ; Spinal Cord ; Spinal Cord Diseases ; Spine ; Steroids ; Tuberculosis ; Tuberculosis, Central Nervous System ; Tuberculosis, Miliary

OBJECTIVE: This study was to determine whether aquaporin-4, which plays role as a transcellular water channel, is expressed in human placenta, and to compare the degree of its expression between preeclamptic women and normal pregnant women. METHODS: Placentas were obtained from severely preeclamptic women and normal pregnant women who were delivered neonates by cesarean section before the onset of labor in the Chungbuk National University Hospital. Immunohistochemistry with aquaporin-4 antibody was performed using paraffin-embedded tissue section. Signal of aquaporin-4 expression was observed with light microscope. RESULTS: Immunohistochemistry demonstrated expression of aquaporin-4 in the placentas of both preeclamptic women and normal pregnant women. The degree of expression was not different in both group. CONCLUSION: Aquaporin-4 was expressed in the human placenta, but may not be related to the pathogenesis of preeclampsia.
Cesarean Section ; Chungcheongbuk-do ; Female ; Humans ; Immunohistochemistry ; Infant, Newborn ; Placenta* ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women

OBJECTIVE: The purpose of this study was to compare the efficacy of intravaginal misoprostol and that of intravenous sulprostone for termination of second-trimester pregnancy. METHODS: Fouty-six patients were randomly assigned to misoprostol and sulprostone group, and the misoprostol group was further divided into two groups according to gestational age. In the misoprostol group, the patients at or before 20 weeks of gestation received 400 microgram of intravaginal misoprostol every 4 hours until labor pain was established, 200 microgram every 6 hours after 20 weeks of gestation. In the sulprostone group, intravenous sulprostone was infused at the speed of 100 microgram/hr regardless of gestational age. RESULTS: At or before 20 weeks of gestation, the mean time from induction to completion of termination was shorter, and the success rate within 24 hours was higher in the misoprostol group than in the sulprostone group (9.0 vs. 20.2 hours; 86% vs 50%). After 20 weeks, the mean induction time was longer at misoprostol group than sulprostol group but, there was no significant difference in success rate within 24 hours (14.7 vs. 7.1 hours; 83% vs. 86%). There was no significant difference in the prevalence of complication between two groups. CONCLUSION: Misoprostol is superior to sulprostone for termination of pregnancy at or before 20 weeks of gestation, but both have almost equal effectiveness after 20 weeks of gestation. Considering less cost and complication, the efficacy of misoprostol should be further investigated for termination of second-trimester pregnancy.
Female ; Gestational Age ; Humans ; Labor Pain ; Misoprostol* ; Pregnancy* ; Prevalence

OBJECTIVES: This study aimed to assess the relationship between musculoskeletal symptoms and non-fatal injuries in construction workers. METHODS: This was a cross-sectional study involving 1,836 male construction workers in petrochemical plants in Korea. For this study, a structured self-reported questionnaire(KOSHA CODE H-30-2003) was used. Musculoskeletal symptoms were defined as symptoms that affect the operation of the musculoskeletal system, for longer than one week or a frequency of more than once per month. To evaluate the association between musculoskeletal symptoms and non-fatal occupatioanl injuries, multiple logistic-regressions were used after adjusting for age, exercise, smoking status, alcohol consumption, work time, work duration, and income. RESULTS: A total of 140 workers were involved in non-fatal injuries cases, representing 7.6% prevalence. After adjusting for confounding variables, the logistic regression analyses indicated the group with musculoskeletal symptoms(OR 1.73 95% CI:1.21~2.47) and intensity criteria of musculoskeletal symptoms as related to 'moderate' criteria(OR 1.82 95% CI:1.18~2.81) or 'severe' criteria(OR 2.57 95% CI:1.43~4.63). This identified group was more likely to experience non-fatal occupational injuries. However, a 'mild' criteria(OR 1.00 95% CI:0.51~1.99) was not associated with non-fatal occupational injuries. CONCLUSIONS: The results indicated a possible association between musculoskeletal symptoms and non-fatal injuries. Hence, strengthening of laws and regulations, effective ergonomic programs and training is necessary to prevent musculoskeletal symptoms.
Alcohol Drinking ; Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Humans ; Jurisprudence ; Korea ; Logistic Models ; Male ; Multiple Trauma ; Musculoskeletal System ; Occupational Injuries ; Prevalence ; Smoke ; Smoking ; Social Control, Formal

Kaposi sarcoma is the most common malignancy in aquired immunodeficiency syndrome (AIDS), and when disseminated may involve any organ system. Pulmonary involvement of Kaposi sarcoma in AIDS patients has not been previously reported in Korea and we report one such case, confirmed pathologically at autopsy.
Autopsy ; Humans ; Korea ; Lung Neoplasms ; Sarcoma, Kaposi*

BACKGROUND: Atherosclerotic vascular disease is major cause of morbidity and mortality in dialysis patients. C-reactive protein(CRP) as a marker of inflammmation appears to be clinically useful in prediction of coronary heart disease and mortality. This study is designed to test whether plasma concentration of CRP correlates with coronary heart disease and mortality in CAPD patients. METHODS: A total of 137 end-stage-renal disease patients undergoing CAPD were included. The measurement of baseline CRP and stress thallium SPECT were performed in all patients. Patients were followed prospectively from initiation of dialysis to June 1999 for analysis of survival rate and cause of death. Coronary angiography performed in 16 of 32 patients showed all positive results. RESULTS: 32 patients showed positive results in thallium SPECT. The baseline CRP concentration were higher among patients with positive results in thallium SPECT than those with negative results(1.05 g/L vs 1.30mg/dL, p<0.001). The survival rate was significantly lower in lower CRP group than higher CRP group (44months vs 26 months, p<0.001). However, There was no difference in cause of death according to serum CRP level. Death from cardiac cause is significantly higher among patients with positive thallium SPECT than negative results. The most common cause of death are, in descending order of frequency, cardiac disease including acute MI, sepsis, cerebrovascular disease. CONCLUSION: The baseline level of inflammation as assessed by the plasma concentration of CRP independently predicts the risk of coronary heart disease and survival in CAPD patients.
C-Reactive Protein* ; Cause of Death ; Coronary Angiography ; Coronary Disease* ; Dialysis ; Heart Diseases ; Humans ; Inflammation ; Mortality* ; Peritoneal Dialysis, Continuous Ambulatory* ; Plasma ; Prospective Studies ; Sepsis ; Survival Rate ; Thallium ; Tomography, Emission-Computed, Single-Photon ; Vascular Diseases

Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy, is caused by emotional or physical stressors and mimics acute myocardial infarction. Stress-induced cardiomyopathy is characterized by acute, reversible left ventricular apical ballooning without significant coronary artery stenosis. New variants of stress-induced cardiomyo pathy with localized wall motion abnormalities or an inverted pattern with a hyperdynamic apex have been reported. We present a rare case of a sudden cardiac arrest due to atypical stress-induced cardiomyopathy (mucosal packing and the injection of epinephrine) in an elderly male patient during elective endoscopic sinus surgery with septoplasty under local anesthesia. In this case, only the basal and midportions of the left ventricle were affected, whereas the apex was completely spared. The patient rapidly and completely recovered without sequelae.
Aged* ; Anesthesia, Local ; Cardiomyopathies* ; Coronary Stenosis ; Death, Sudden, Cardiac ; Epinephrine ; Heart Ventricles ; Humans ; Male* ; Myocardial Infarction ; Takotsubo Cardiomyopathy

OBJECTIVE: This study assessed whether characteristics of ruptured hepatocellular carcinoma (HCC) at presentation to the emergency department (ED) affect patient outcomes, and evaluated factors prognostic of HCC, particularly treatment modalities. METHODS: This retrospective study between 2008 and 2017 evaluated patients presenting to an ED with ruptured HCC. Parameters associated with 30- and 90-day mortality were investigated, and clinical characteristics and treatments were analyzed. RESULTS: In total, 121 patients presented to the ED with ruptured HCC. Of these, 29 died within 30 days. Multivariate logistic regression analysis showed that platelet count (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.976–0.995) and prothrombin time (OR, 16.20; 95% CI, 1.91–137.23) were associated with a 30-day mortality rate, whereas presence or absence of acute abdominal pain and shock at presentation to the ED was not significant. Patients who underwent embolization had a lower 30-day mortality rate than those treated conservatively (OR, 0.04; 95% CI, 0.001-0.20). Sixtyone patients died within 90 days after presentation to the ED. Serum albumin concentration (OR, 0.25; 95% CI, 0.09–0.71) was associated with 90-day mortality. Moreover, patients who underwent embolization (OR, 0.19; 95% CI, 0.06–0.60) and emergency hepatectomy (OR 0.09; 95% CI, 0.01–0.99) had lower 90-day mortality rates as compared to patients treated conservatively. CONCLUSION Presence of acute abdominal pain at presentation to the ED does not affect patient outcomes. Early aggressive treatments, such as embolization or emergency hepatectomy, were observed to improve outcomes in patients with ruptured HCC.