A case of esophagopleural fistula after pleuropneumonectomy is reported. A 59 years old male underwent right pleuropneumonectomy due to tuberculous empyema. The postoperative small esophagopleural fistula was confirmed by esophagogram and was initially managed by a conservative treatment. There was a persistent fistula on follow up esophagogram, therefore we planned the next treatment modality for obstruction of the fistula. For poor general conditions and arrhythmia, an esophageal stent was applied as a non-surgical method. At first, a covered-form stent was inserted, but it migrated to the stomach after 3 months. By using an uncovered-form stent, a complete obstruction of the esophagopleural fistula was achieved.
Arrhythmias, Cardiac ; Empyema, Tuberculous ; Esophageal Fistula ; Fistula* ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Stents* ; Stomach

Partial anomalous pulmonary venous connection is frequently found in any ASD(atrial septal defect) patients. These patients are usually symptomatic, therefore, easily diagnosed as just simple ASD. We experienced a case of a 37-year-old female patient with ASD in which the left upper pulmonary vein was connected to SVC by the left inominate vein. The patient was diagnosed as simple ASD previously. During cardiac catheterization, we found a meaningful oxygen saturation step up between the SVC and its upper portion. Angiogram confirmed PAPVC. The surgical correction of anastomosis of PAPVC with left atrial appendage and direct closure of ASD were done. The patient was discharged 15 days later.
Adult ; Atrial Appendage ; Cardiac Catheterization ; Cardiac Catheters ; Female ; Heart Septal Defects, Atrial* ; Humans ; Oxygen ; Pulmonary Veins ; Veins

PURPOSE: The aim of this study was to evaluate the transfer of different occlusal forces in various skeletal malocclusions using finite element analysis (FEA). METHODS: Three representative human cone-beam computed tomography (CBCT) images of three skeletal malocclusions were obtained from the Department of Orthodontics, Yonsei University Dental Hospital, Seoul, South Korea. The CBCT scans were read into the visualization software after separating bones and muscles by uploading the CBCT images into Mimics (Materialise). Two separate three-dimensional (3D) files were exported to visualize the solid morphology of skeletal outlines without considering the inner structures. Individual dental impressions were taken and stone models were scanned with a 3D scanner. These images were integrated and occlusal motions were simulated. Displacement and Von Mises stress were measured at the nodes of the FEA models. The displacement and stress distribution were analyzed. FEA was performed to obtain the 3D deformation of the mandibles under loads of 100, 150, 200, and 225 kg. RESULTS: The distortion in all three skeletal malocclusions was comparable. Greater forces resulted in observing more distortion in FEA. CONCLUSIONS: Further studies are warranted to fully evaluate the impact of skeletal malocclusion on masticatory performance using information on muscle attachment and 3D temporomandibular joint movements.
Bite Force ; Computer Simulation ; Cone-Beam Computed Tomography ; Finite Element Analysis* ; Humans ; Korea ; Malocclusion* ; Mandible ; Muscles ; Orthodontics ; Seoul ; Temporomandibular Joint

Malignant neoplasm associated with long-standing pleuritis or empyema is rare but a critical complication. Among 67 cases which were reported in English and Japanese literatures the cause of empyema was considered tobe tuberculosis in 51 cases. The most common malignant disease associated with the long-standing pleural disease was non-Hodgkin lymphoma (NHL), and the majority of the malignant lymphomas were B-cell type. Detection of the malignancy combined with an empyema is difficult, however, chest radiograph or CT may show the evidence of malignant pleural disease. We report a case of pathologically proven T-cell type malignant NHL associated with chronic tuberculous empyema in a 66-year-old male patient.
Aged ; Asian Continental Ancestry Group ; B-Lymphocytes ; Empyema ; Empyema, Tuberculous* ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Male ; Pleural Diseases ; Pleurisy ; Radiography, Thoracic ; T-Lymphocytes* ; Tuberculosis

Malignant neoplasm associated with long-standing pleuritis or empyema is rare but a critical complication. Among 67 cases which were reported in English and Japanese literatures the cause of empyema was considered tobe tuberculosis in 51 cases. The most common malignant disease associated with the long-standing pleural disease was non-Hodgkin lymphoma (NHL), and the majority of the malignant lymphomas were B-cell type. Detection of the malignancy combined with an empyema is difficult, however, chest radiograph or CT may show the evidence of malignant pleural disease. We report a case of pathologically proven T-cell type malignant NHL associated with chronic tuberculous empyema in a 66-year-old male patient.
Aged ; Asian Continental Ancestry Group ; B-Lymphocytes ; Empyema ; Empyema, Tuberculous* ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Male ; Pleural Diseases ; Pleurisy ; Radiography, Thoracic ; T-Lymphocytes* ; Tuberculosis

OBJECTIVE: Previous studies have suggested that hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR C677T) mutations are associated with increased risk of recurrent spontaneous abortion (RSA). Recently, a second site polymorphism in MTHFR, 1298A-->C, which changes a glutamic acid into an alanine residue, was shown to be associated with a decreased enzyme activity. We tested whether the variant alleles of MTHFR C677T and A1298C are risk factor (biomarker) for RSA. MATERIALS AND METHODS: We analyzed DNA from a case-control study in the Korean DNA was extracted from blood samples of 118 patients with RSA and 123 healthy fertile patients as the controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. RESULTS: We found no evidence for an association between 677TT genotype and risk of RSA (OR=1.95, 95% CI=0.84~4.50, p=0.12). However, the MTHFR 1298AC (OR=0.36, 95% CI=0.20~ 0.63, p=0.0004) and 1298AC+CC (OR=0.35, 95% CI=0.20~0.61, p=0.0002) genotypes were lower among 118 RSA cases compared with 123 controls, conferring a 2.8-fold decrease in risk of RSA, respectively. Moreover, the combined genotypes of MTHFR 677CC/1298AC (OR=0.30, 95% CI= 0.10~0.88, p=0.029) and 677CT/1298AC (OR=0.77, 95% CI=0.60~0.99, p=0.043) also showed significantly lower risk than those with MTHFR 677CC/1298AA type. CONCLUSION: MTHFR 1298AC, MTHFR 677CC/1298AC and 677CT/1298AC genotypes may represent genetic markers for the protection of RSA at least in Korean women.
Abortion, Spontaneous* ; Alanine ; Alleles ; Case-Control Studies ; DNA ; Female ; Genetic Markers ; Genotype ; Glutamic Acid ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases* ; Pregnancy ; Risk Factors ; Vascular Diseases

No abstract available.
Empyema, Tuberculous* ; Lymphoma, Non-Hodgkin* ; T-Lymphocytes*

Primary cutaneous follicular B cell lymphomas are rare entities of an unknown cause, except for those induced by Epstein-Barr virus (EBV) or Borrelia burgdorferi. Follicular B cell lymphoma has been thought to rarely occur primarily in the skin. The lesions are generally solitary plaques or nodules that are localized on the head and neck. It shows considerable variation in the clinical presentation, the histological features, the immunophenotype and the prognosis. In this case, a 79-year-old man presented with a 3-month history of lesions on his head. Clinical examination revealed two deep-seated subcutaneous tumors with uneven surfaces located on the both sides of the frontoparietal area of the scalp. Biopsy of the skin lesion disclosed a massive dermal lymphocytic infiltrate with a follicular pattern. On immunohistochemical staining, the lymphocytes strongly expressed CD20 and Ki-67, but not Bcl-2. He was diagnosed with primary cutaneous follicular B cell lymphoma. This case illustrates a rarely reported example of primary cutaneous follicular B cell lymphoma that arose on the scalp.
Aged ; Biopsy ; Borrelia burgdorferi ; Head ; Herpesvirus 4, Human ; Humans ; Lymphocytes ; Lymphoma, B-Cell ; Neck ; Prognosis ; Scalp ; Skin

OBJECTIVE: The number of Korean women of childbearing age who drink alcohol and binge drink has increased remarkably in recent years. In the present study, we examined self-reported rates of alcohol use before and during pregnancy and identified maternal characteristics associated with drinking in pregnancy. METHODS: One thousand pregnant Korean women who visited the Department of Obstetrics and Gynecology (OB/GYN) completed a self-administered questionnaire that sought information on their demographic characteristics and incorporated features of the Alcohol Use Disorder Identification Test (AUDIT)-C to investigate their use of alcohol, including binge drinking, during three time periods ("in the year before this pregnancy," "during this pregnancy," and "in the previous 30 days"). RESULTS: Of these participants, 16.4% reported using alcohol during their pregnancy, 12.2% had used alcohol in the previous 30 days, and 1.7% reported binge drinking during their pregnancy. In the year before pregnancy, 77.1% had used alcohol, and 22.3% had binge drunk. The group using any amount of any alcohol during pregnancy showed a lower educational level, a lower rate of planned pregnancy, a lower level of knowledge relating to the risks of drinking alcohol during pregnancy, and a higher frequency of alcohol drinking in the year before pregnancy when compared with the abstinent group. Low educational level and unplanned pregnancy were revealed to be significant risk factors for alcohol consumption in pregnant women. CONCLUSION: This is the first study to examine any alcohol and binge alcohol drinking during pregnancy in Korea. Clinical attention and monitoring system on alcohol use during pregnancy are necessary in Korea.
Alcohol Drinking ; Binge Drinking ; Drinking ; Family Planning Services ; Female ; Fetal Alcohol Syndrome ; Gynecology ; Humans ; Korea ; Obstetrics ; Pregnancy ; Pregnancy, Unplanned ; Pregnant Women ; Surveys and Questionnaires ; Risk Factors

Functional endoscopic sinus surgery(FESS) is now the surgical procedure of choice for treating chronic sinusitis in patients of all ages. We performed the olfactory threshold test after FESS and assessed its clinical value. From Feburary 1996 through July 1966, fifty bilateral sinusitis patients had received FESS and butanol threshold test and odor identification test were performed pre-operatively, at post-operative 1 month, and at post-operative 2 months. We analyzed preoperative computed tomography to determine the grade of sinusitis and status of olfactory fissure. The status of olfactory fissure significantly influenced the preoperative olfactory threshold score(p<0.001). At post-operative 2 months, the subjective symptoms of the patients were improved in 96% of patients and objective olfactory threshold were improve in 68% of patients. There was no correlation between subjective symptoms and olfactory threshold improvement. Our study suggests that the olfactory threshold test may predict the result of FESS, however for more accurate and reliable assessment, we should consider other objective methods like anterior rhinomanometry, acoustic rhinometry, ciliary beat frequency test, and post-operative endoscopic findings.
Humans ; Odors ; Rhinomanometry ; Rhinometry, Acoustic ; Sinusitis ; Smell