Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixtture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequentlly in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb (T3N0M0). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.
Bronchi ; Carcinosarcoma* ; Humans ; Laparotomy ; Male ; Middle Aged ; Neoplasm Metastasis ; Pneumonectomy* ; Pulmonary Atelectasis ; Smoke ; Smoking

PURPOSE: Early diagnosis of congenital hearing loss through the neonatal hearing screening test minimizes language defect. This research intends to identify frequency of congenital hearing loss in infants through neonatal hearing screening test with the aim of communicating the importance of hearing test for infants. METHODS: From May 20, 2003 to May 19, 2004, infants were subjected to Automated Auditory Brainstem Response test during one month of birth to conduct the test with 35 dB sound. Infants who passed the 1st round of hearing test, were classified into 'pass' group whereas those who did not were classified into 'refer' group. Infants who did not 'pass' in the hearing test conducted within one month of birth were subjected to re-test one month later, and if classified as 'refer' during the re-test, they were subjected to the diagnosis for validation of hearing loss by requesting test to the hearing loss clinic. RESULTS: There was no difference among the 'pass' and 'refer' group in terms of form of childbirth, weight at birth and gestational age. In the 1st test, total of 45 infants were classified into 'refer' group. Six among 35 who were subjected to re-test (17%) did not pass the re-test, and all were diagnosed with congenital hearing loss. This corresponds to 0.35% (3.5 per 1, 000) among total number of 1, 718 subjects. CONCLUSION: In our study the congenital hearing loss tends to be considerably more frequently than congenital metabolic disorder. Accordingly, newly born infants are strongly recommended to undergo neonatal hearing screening test.
Diagnosis ; Early Diagnosis ; Evoked Potentials, Auditory, Brain Stem ; Gestational Age ; Hearing Loss* ; Hearing Tests ; Hearing* ; Humans ; Infant ; Mass Screening* ; Parturition

To evaluate the predisposing factors and characteristics of the steinstrasse after ESWL and to suggest the proper management of it, we analyzed 1,144 urolithiasis patients who were managed by ESWL with the second generation lithotripter, Siemens Lithostar, at Seoul National University Hospital from March 1989 to October 1995. Steinstrasse developed in 72 patients with the incidence of 6.3% after ESWL. As the risk factor for developing steinstrasse after ESWL, stone size and volume significantly influenced the development of steinstrasse (p<0.01, by student t-test), and multiple stones induced steinstrasse more frequently than single stones (p<0.05, by chi-square test). Stones located at renal pelvis induced more steinstrasse after ESWL than calyceal stones or ureter stones t<0.05, by chi-square test). Clinically, 61.1% of the patients who developed steinstrasse didn't have any symptoms or upper tract changes. Nineteen steinstrasse (26.4%) were resolved spontaneously without any intervention, with the median duration of 12 days after detection of the steinstrasse. In 51 steinstrasse which was not resolved spontaneously or with severe symptoms, ESWL was performed resulting in successful resolution in 94.1% of the patients. These results suggest that expectancy could be the first line strategy of the management of steinstrasse, and repeated ESWL could be recommended for patients refractory to expectancy and patients with severe symptoms.
Causality ; Humans ; Incidence ; Kidney Pelvis ; Risk Factors ; Seoul ; Ureter ; Urolithiasis

Background: Mobile applications (apps) on dietary supplements can increase consumers’ access to information. However, it can lead to indiscriminate use of dietary supplements. This study aims to systematically review dietary supplement apps released in English and Korean and evaluate the quality of those apps. Methods: Through the app stores, apps on dietary supplements were systemically searched and examined. Two independent evaluators evaluated the apps and presented a mean score using the Mobile App Rating Scale (MARS). The correlation between MARS scores, user and evaluator ratings, and the number of secondary features of the apps were analyzed. Results: Of the 2,772 dietary supplement apps identified, 17 apps were included according to the selection criteria. The mean MARS score was 3.28 (standard deviation: 0.29) out of 5. Apps had higher scores in aesthetics and functionality dimensions, while engagement and information dimensions had lower scores. There was a positive correlation between the number of app downloads and information among MARS dimensions. The subjective evaluation also correlated with the information dimension. There was a positive correlation between the secondary features of the apps and MARS total score as well as the engagement dimension. Conclusion The dietary supplement apps need to be managed at a higher level of quality to provide safe and reliable information to consumers. Especially, quality on information and engagement dimensions can be improved. Involvement of healthcare professionals in the app development, management with adequate referencing of information, and use of secondary features for enhanced user engagement can be helpful.

BACKGROUND AND PURPOSE: Manganese could be toxic to the human nervous system. Therefore, it is important to detect the over-exposed patients in their early course of intoxication. The aim of this study is to find a valuable methods of clinical examination and applicable parameters for early detection of manganese intoxication. METHODS: we investigated the 35 men who had been exposed to manganese over 5 years. All the subjects were examined and video monitored by three physicians. We separated them into the two groups(Group A: clinically suspicious, Group B: clinically normal) in terms of their motor functions, gait, posture, expression. Motor functions(finger and foot tapping, rapid alternating movement, pegboard exam, writing and walking velocity etc.), MRIs, and biochemical data were measured and compared. RESULTS: No one showed significant effects of manganese intoxication . Also there were no significant differences between the two groups for their biochemical data except for elevated serum Adenosine deaminase(ADA) in clinically suspicious group. But there was a trend that motor functions were decreased especially for the finger and foot tapping, walking velocity and stride, writing velocity. A large number of subjects showed MRI changes in both groups. So MRI is not necessarily correlated with clinical findings and not a specific diagnostic tool for manganese intoxication but a sensitive one for the exposed subjects to manganese. CONCLUSION: From this study, the decreased motor functions were the only clinically significant neurologic manifestation in those who over-exposed subjects to manganese. The level of serum ADA and brain MRI could be a helpful supportive diagnostic tools for the over-exposure. Even if the subjects with these positive results do not show any significant sign of intoxication , we ought to modify their working environment to reduce further exposure.
Adenosine ; Brain ; Fingers ; Foot ; Gait ; Humans ; Magnetic Resonance Imaging ; Male ; Manganese* ; Nervous System ; Neurologic Manifestations ; Posture ; Walking ; Writing

No abstract available.
Adult* ; Humans ; Korea* ; Prevalence* ; Seoul* ; Urolithiasis*

PURPOSE: Presently laparoscopic urologic surgical procedures are being performed with increasing frequency. Despite the evolution of laparoscopic technique and instruments, the large set of physiologic alteration associated with laparoscopy are poorly understood. We have recently performed prospective study to evaluate the physiologic effects of pneumoperitoneum created during laparoscopic surgery. MATERIALS AND METHODS: Seventeen consecutive patients with various upper urinary tract diseases underwent laparoscopic surgeries at our institution. They were checked pre and postoperatively for such parameters as blood pressure, heart rate, arterial blood gas analysis(ABGA), end tidal CO2(ETCO2), peak airway pressure, temperature. Every patient was classified as ASA class 1 or 2 preoperatively. All insufflrated pressure was adjusted not to go over 14mmHg. All patients were positioned laterally for easier access to retroperitoneum. We evaluated the differences of various physiologic indices with statistical means. RESULTS: After 2hr insufflation, a marked hypercarbia and acidemia was observed intraoperatively suggesting that capnography may be an inadequate guide in controlling ventilation during the state of CO2 pneumoperitoneum in the upper urinary tract laparoscopic surgery. Eight patients suffered perioperative hypothermia(below 35.5degrees C). In the four of eight patients prolonged stay in recovery room were necessary due to their hypothermia. CONCLUSIONS: Because the upper urinary tract laparoscopic surgery causes many physiologic changes, surgeons should be aware of its meanings and clinical implications prior to achieving technical skillfulness in laparoscopic surgery.
Blood Pressure ; Capnography ; Heart Rate ; Humans ; Hypothermia ; Insufflation ; Laparoscopy* ; Physiology ; Pneumoperitoneum ; Prospective Studies ; Recovery Room ; Urinary Tract* ; Urologic Diseases ; Urologic Surgical Procedures ; Ventilation

Two-point mutations (V419L and L925I) on the voltage-sensitive sodium channel of bed bugs (Cimex lectularius) are known to confer pyrethroid resistance. To determine the status of pyrethroid resistance in bed bugs in Korea, resistance allele frequencies of bed bug strains collected from several US military installations in Korea and Mokpo, Jeollanamdo, from 2009-2019 were monitored using a quantitative sequencing. Most bed bugs were determined to have both of the point mutations except a few specimens, collected in 2009, 2012 and 2014, having only a single point mutation (L925I). No susceptible allele was observed in any of the bed bugs examined, suggesting that pyrethroid resistance in bed bug populations in Korea has reached a serious level. Large scale monitoring is required to increase our knowledge on the distribution and prevalence of pyrethroid resistance in bed bug populations in Korea. Based on present study, it is urgent to restrict the use of pyrethroids and to introduce effective alternative insecticides. A nation-wide monitoring program to determine the pyrethroid resistance level in bed bugs and to select alternative insecticides should be implemented.

PURPOSE: The purpose of this study was to investigate the prevalence rate of HBsAg and the epidemiological characteristics of hepatitis B virus (HBV) infection from 1998 to 2005. National Health and Nutrition Examination Survey (NHANES) data of 1998, 2001 and 2005 were analyzed. METHOD: Study population was consisted of 24,093, aged 10 year or over who performed NHANES self reported surveys and blood tests. Statistical analysis was performed by age, sex, and the year of survey. Also the prevalence of HBsAg was compared by self reported family history of liver disease. RESULTS: The prevalence rate of HBsAg was reduced from 4.5% in 1998 to 3.7% in 2005. Also age-specific prevalence rate of HBsAg was significantly decreased in persons born after introduction of the hepatitis B virus vaccination. HBsAg seropositivity was slightly higher in male than in female. Among the people with the family history of liver diseases, the risk of HBsAg seropositive was much higher than those without. Study subjects with mother's liver disease history showed much higher HBsAg serepositive rate. Although after the implementation of hepatitis B virus vaccination program prevalence of HBsAg decreased, but persons with history of liver disease showed still higher rate Of HBsAg seropositive rate. CONCLUSION: Although the introduction of the HBV vaccination program has resulted in a decline of HBV infection, the family history of liver diseases was still an important factor for transmission of HBV in Korea. In addition to the mother-to-child transmission prevention program from 2002, it might be advisable to introduce a screening program for persons with family history of liver diseases for further reduction of HBV infection.
Aged ; Female ; Hematologic Tests ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Korea ; Liver ; Liver Diseases ; Male ; Mass Screening ; Nutrition Surveys ; Prevalence ; Self Report ; Vaccination

We report a species of diplostomid fluke recovered from 3 carcasses of wild Korean raccoon dog, Nyctereutes procyonoides koreensis, in Korea. A total of 107 diplostomid flukes were recovered from the small intestines of Korean raccoon dogs, which were obtained from the Gangwon Wildlife Medical Rescue Center. Worms fixed with 10% neutral formalin were subjected to microscopic observation and those fixed in 70% ethanol were used for molecular genomic analysis. The worm was divided into 2 separate parts, forebody and hindbody, with a total length of 3,020-4,090 (3,855) µm and a width of 1,210-1,770 (1,562) µm. The boat-shaped forebody has a pair of characteristic tentacular appendage, 2 suckers, holdfast organ, and vitelline follicles. The oval to cylindrical hindbody has reproductive organs. The ovary was round or elliptical and located in the anterior of the testes. Two large testes were slightly segmented and tandemly arranged, occupying almost half of hindbody. The short uterus contained a relatively small number of unembryonated eggs sized 130-140×85-96 µm. The partial sequence of 18S rRNA of this fluke was consistent with Alaria alata. Based on the morphological and molecular characteristics, the diplostomid flukes recovered from the small intestine of Korean raccoon dogs were identified as A. alata (Digenea: Diplostomidae).