1.Brain Abscess After Hepatic Artery Chemoembolization for Hepatocellular Carcinoma: Case Report.
Tai Hyoung CHO ; Sin Hyuk KANG ; Jung Yul PARK ; Taek Hyun KWON ; Youg Gu CHUNG ; Hoon Kap LEE
Journal of Korean Neurosurgical Society 1998;27(4):511-515
We describe a case of brain abscess which developed in a 64-year-old man after hepatic artery chemoem-bolization(HACE) for hepatocellular carcinoma(HCC).On his first admission, percutaneous liver biopsy led to a diagnosis of type-C liver cirrhosis, he readmitted 5 years later and HCC was diagnosed. The patient underwent two HACE procedures, with a two-month interval. Three month later, he was readmitted to hospital with headache and brief loss of consciousness; brain magnetic resonance imaging(MRI) revealed a brain abscess. Stereotactic aspiration was performed and antibiotics sensitive to the klebsiella pneumonia bacteria cultured in the abscess were administrated intraveously. One month later, the abscess size became smaller and the patient was discharged. This report reviews the literature and discusses the pathogenesis of brain abscess after intra-arterial embolization.
Abscess
;
Anti-Bacterial Agents
;
Bacteria
;
Biopsy
;
Brain Abscess*
;
Brain*
;
Carcinoma, Hepatocellular*
;
Diagnosis
;
Headache
;
Hepatic Artery*
;
Humans
;
Klebsiella
;
Liver
;
Liver Cirrhosis
;
Middle Aged
;
Pneumonia
;
Unconsciousness
2.Nontraumatic Cerebrospinal Fluid Rhinorrhea(via the Middle Cranial Fossa and Sphenoid Sinus): A Case Report.
Seung Kweun SEO ; Jae Hyoo KIM ; Tae Sun KIM ; Jung Kil LEE ; Sin JUNG ; Soo Han KIM ; Sam Suk KANG ; Je Hyuk LEE
Journal of Korean Neurosurgical Society 1998;27(4):496-500
We describe a rare case of nontraumatic normal pressure cerebrospinal fluid rhinorrhea. A 33-year-old male was admitted to our hospital due to continuous rhinorrhea but without a history of specific trauma. We performed various radiological evaluations, and on bone-window CT, detected severe bilateral extension of the sphenoid sinus into the greater wing. MRI and CT cisternography revealed that contrast media and cerebrospinal fluid had leaked from the middle cranial fossa to the sphenoid sinus. Transethmoidal sphenoid approach and sphenoid sinus fat obliteration was successfully performed by an otolaryngologist. On postoperative day 2, however, the patient's mental condition deteriorated and CT showed the development of acute obstructive hydrocephalus. Ventriculo-peritoneal shunt was then successfully performed and the patient was discharged. Nontraumatic normal pressure cerebrospinal fluid rhinorrhea involving leakage through the middle cranial fossa is very rare, this report discussed the etiological, anatomical and surgical considerations of this case.
Adult
;
Cerebrospinal Fluid Rhinorrhea
;
Cerebrospinal Fluid*
;
Contrast Media
;
Cranial Fossa, Middle*
;
Humans
;
Hydrocephalus
;
Magnetic Resonance Imaging
;
Male
;
Sphenoid Sinus
;
Ventriculoperitoneal Shunt
3.Risk Factors for the Early Recognition of Cow's Milk Protein-induced Enterocolitis.
Sung Hyuk LEE ; Seon Yun CHOI ; Byung Cheol LEE ; Won Joung CHOI ; Byung Kyu CHOE ; Yeo Hyang KIM ; Una KANG ; Sin KAM ; Jin Bok HWANG
Korean Journal of Pediatrics 2005;48(9):991-997
PURPOSE: Cow's milk protein-induced enterocolitis (CMPIE) is a symptom complex of vomiting and/ or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE. METHODS: We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/ or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group. RESULTS: CMPIE was diagnosed in 11 patients (12.8%). On admission, failure to gain weight (P= 0.003), hypoalbuminemia (P=0.003), peripheral leukocytosis (P=0.015), and metabolic acidosis (P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight < 10 g/day (OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia < 3.5 g/dL (OR, 9.18[95% CI, 1.69- 49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting (81.8%), abnormal stool test (80.0%), peripheral leukocyte count and absolute neutrophil count (ANC) increase (100.0%) (P< 0.05), and enteropathy (100.0%). CONCLUSION: CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow: failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.
Acidosis
;
Biopsy
;
Diarrhea
;
Enterocolitis*
;
Humans
;
Hypersensitivity, Delayed
;
Hypoalbuminemia
;
Leukocyte Count
;
Leukocytosis
;
Logistic Models
;
Milk*
;
Neutrophils
;
Risk Factors*
;
Vomiting
4.Indexes of Suspicion of Typical Cow's Milk Protein-Induced Enterocolitis.
Jin Bok HWANG ; Sung Hyuk LEE ; Yu Na KANG ; Sang Pyo KIM ; Seong Il SUH ; Sin KAM
Journal of Korean Medical Science 2007;22(6):993-997
This study was performed to identify clinical factors that facilitate the diagnosis of typical cow's milk protein-induced enterocolitis (CMPIE). Data from 142 consecutive patients (aged 15 to 45 days, cow's milk formula- or cow's milk and breast milk mixed-fed) admitted due to vomiting and/or diarrhea were retrospectively analyzed. These 142 subjects were divided into three groups: the CMPIE, infection, and non-infection group. Each group was composed of 16 (11.3%), 102 (71.8%), and 24 (16.9%) patients, respectively. On admission, poor weight gain (p=0.003), hypoalbuminemia (p=0.035), peripheral leukocytosis (p=0.012), and metabolic acidosis (p=0.015) were found to be more significant in the CMPIE group than those in other two groups. In CMPIE, serum albumin levels decreased from 3.3+/-0.9 g/dL on admission to 2.6+/-0.3 g/dL during admission (p<0.05), and methemoglobinemia was observed in 3 patients (18.8%) (p=0.012). Multiple logistic regression analysis showed that the independent predictors of CMPIE versus the infection group were failure to gain weight (OR, 10.75 [95% CI, 1.53-66.12]) (p= 0.014) and hypoalbuminemia (OR, 9.53 [95% CI, 1.62-49.01]) (p=0.010). The early recognition of indexes of suspicion for CMPIE may be of help in the diagnosis and treatment of this disorder.
Acidosis/etiology
;
Animals
;
Cattle
;
Enterocolitis/*diagnosis/etiology
;
Female
;
Humans
;
Infant
;
Infant, Newborn
;
Leukocyte Count
;
Logistic Models
;
Male
;
Methemoglobinemia/etiology
;
Milk Hypersensitivity/*diagnosis
;
Milk Proteins/*immunology
;
Serum Albumin/analysis
;
Weight Gain
5.Radiographic Progression of Osteoarthritis after Rotational Acetabular Osteotomy: Minimum 10-Year Follow-up Outcome According to the Tönnis Grade.
Byung Woo MIN ; Chang Soo KANG ; Kyung Jae LEE ; Ki Cheor BAE ; Chul Hyun CHO ; Jung Hoon CHOI ; Hyuk Joon SOHN ; Hong Kwan SIN
Clinics in Orthopedic Surgery 2018;10(3):299-306
BACKGROUND: Although satisfactory mid- to long-term results of rotational acetabular osteotomy for early osteoarthritis secondary to acetabular dysplasia have been reported, there is still controversy about the long-term effects of this surgery in more advanced osteoarthritis. The purpose of this study was to investigate the radiographic progression of osteoarthritic changes after rotational acetabular osteotomy in acetabular dysplasia according to the preoperative Tönnis grade and evaluate its effects after minimum 10-year follow-up. METHODS: We performed 71 consecutive rotational acetabular osteotomies in 64 patients with symptomatic acetabular dysplasia between November 1984 and April 2005. Of these, 46 hips (four hips with Tönnis grade 0, 30 with grade 1, and 12 with grade 2) whose clinical and radiographic findings were available after minimum 10-year follow-up were evaluated in this study. The mean age at the time of surgery was 39.0 years (range, 18 to 62 years) and the average follow-up duration was 17.3 years (range, 10.0 to 27.7 years). Clinical and radiographic evaluations were performed according to the preoperative Tönnis grade. RESULTS: The average Harris hip score improved from 71.8 (range, 58 to 89) to 85.1 (range, 62 to 98). The radiographic parameters also improved in all Tönnis grades after the index surgery. Although the improvement of radiographic parameters was not different between preoperative Tönnis grades, the incidence of osteoarthritic progression was significantly different between grades (zero in Tönnis grade 0, four in Tönnis grade 1, and 10 in Tönnis grade 2; p < 0.001). The mean age at the time of surgery was also significantly older in osteoarthritic progression patients (p < 0.002). Kaplan-Meier survivorship analysis, with radiographic progression of osteoarthritis as the endpoint, predicted a 10-year survival rate of 100% in Tönnis grade 0, 85.7% in Tönnis grade 1, and 14.3% in Tönnis grade 2 (p < 0.001). CONCLUSIONS: The outcome of rotational acetabular osteotomy in most hips with Tönnis grade 0 and 1 was satisfactory after an average of 17 years of follow-up. The incidence of osteoarthritic progression was higher in Tönnis grade 2 and older age. Our results support that early joint preserving procedure is essential in the case of symptomatic dysplastic hips.
Acetabulum*
;
Follow-Up Studies*
;
Hip
;
Humans
;
Incidence
;
Joints
;
Osteoarthritis*
;
Osteotomy*
;
Survival Rate
6.2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease
Hye-Kyung JUNG ; Chung Hyun TAE ; Kyung Ho SONG ; Seung Joo KANG ; Jong Kyu PARK ; Eun Jeong GONG ; Jeong Eun SHIN ; Hyun Chul LIM ; Sang Kil LEE ; Da Hyun JUNG ; Yoon Jin CHOI ; Seung In SEO ; Joon Sung KIM ; Jung Min LEE ; Beom Jin KIM ; Sun Hyung KANG ; Chan Hyuk PARK ; Suck Chei CHOI ; Joong Goo KWON ; Kyung Sik PARK ; Moo In PARK ; Tae Hee LEE ; Seung Young KIM ; Young Sin CHO ; Han Hong LEE ; Kee Wook JUNG ; Do Hoon KIM ; Hee Seok MOON ; Mi-Young CHOI ; Kwang Jae LEE ;
Korean Journal of Medicine 2022;97(2):70-92
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.
7.Buerger's Disease in Korea.
Jang Sang PARK ; Geun Eun KIM ; Seong Ki MIN ; Sun cheol PARK ; In Sung MOON ; Sung HEO ; Ho Chul PARK ; Won Hyun JO ; Hyung Tae KIM ; Do Kyun KIM ; Jong Kwon PARK ; Ki Hyuk PARK ; Jeong An LEE ; Joong Ki JUNG ; Sang Joon KIM ; Jong Won HA ; Young Wook KIM ; Dong Ik KIM ; Yong Sin KIM ; Seok Yul LEE ; Koing Bo KWUN ; Bo Yang SEO ; Tae Won KWON ; Hong Rae JO ; Byung Jun SO ; Hee Jae JUN ; Sang Yeong JUNG ; Oh Jeong KWON ; Hyun Chul KIM
Journal of the Korean Society for Vascular Surgery 2005;21(2):105-112
PURPOSE: Buerger's disease (Thromboangiitis obliterans, TAO) is characterized by non- atheromatous inflammatory disease, and segmental inflammatory thrombotic occlusions of the small & middle-sized arteries and veins of the upper or lower extremities. Any epidemiological study of Buerger's disease in Korea has not been carried out until now. This study was undertaken to investigate the incidence of Buerger's disease in Korea among the patients suffering with arterial disease. METHODS: We collected and analyzed the data on 11,128 patients who were admitted to or visited the participating 22 hospitals for chronic arterial diseases throughout the major region of the South Korea from January 1986 to December 2003. The clinical diagnostic inclusion criteria for Buerger's disease were the followings: (1) a history of smoking or tobacco abuse; (2) an age of onset less than 50 years; (3) infrapopliteal, segmental arterial occlusions with sparing of the proximal vasculature; (4) frequent distal upper extremity arterial involvement (Raynaud's syndrome or digital ulceration) or-superficial phlebitis; and (5) the absence of arteriosclerotic risk factors other than smoking. RESULTS: The incidence rate of Buerger's disease among the arterial disease (11,128 patients) was 93 patients (0.83%) when the strict criteria of Shionoya was applied. 699 male-patients (6.55%) and 30 female patients (4.12%) who met the less strict criteria (the extended clinical diagnostic criteria group) were also reviewed. The 4th and 5th decades were the most common ages with-249 patients (34.2%) and 222 patients (30.5%) respectively, being found at these ages. The mean age was 40.4+/-1.6 years (age range: 16~83 years) and this was similar in both the strict criteria group and the less strict criteria group. CONCLUSIONS: This study suggests there was a low incidence of Buerger's disease in Korea among the patients who visited the participating hospitals when the strict diagnostic criteria were used. The incidence was lower than expected even when the less strict criteria were used. The more accurate incidence of Buerger's disease among the general population can be obtained by performing careful prospective study that is participated in by not only vascular surgeons, but also the other medical specialists with utilizing the strict diagnostic criteria.
Age of Onset
;
Arteries
;
Epidemiologic Studies
;
Female
;
Humans
;
Incidence
;
Korea*
;
Lower Extremity
;
Phlebitis
;
Risk Factors
;
Smoke
;
Smoking
;
Specialization
;
Thromboangiitis Obliterans*
;
Tobacco
;
Upper Extremity
;
Veins
8.2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease
Hye-Kyung JUNG ; Chung Hyun TAE ; Kyung Ho SONG ; Seung Joo KANG ; Jong Kyu PARK ; Eun Jeong GONG ; Jeong Eun SHIN ; Hyun Chul LIM ; Sang Kil LEE ; Da Hyun JUNG ; Yoon Jin CHOI ; Seung In SEO ; Joon Sung KIM ; Jung Min LEE ; Beom Jin KIM ; Sun Hyung KANG ; Chan Hyuk PARK ; Suck Chei CHOI ; Joong Goo KWON ; Kyung Sik PARK ; Moo In PARK ; Tae Hee LEE ; Seung Young KIM ; Young Sin CHO ; Han Hong LEE ; Kee Wook JUNG ; Do Hoon KIM ; Hee Seok MOON ; Hirota MIWA ; Chien-Lin CHEN ; Sutep GONLACHANVIT ; Uday C GHOSHAL ; Justin C Y WU ; Kewin T H SIAH ; Xiaohua HOU ; Tadayuki OSHIMA ; Mi-Young CHOI ; Kwang Jae LEE ; The Korean Society of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility 2021;27(4):453-481
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.
9.2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease
Hye-Kyung JUNG ; Chung Hyun TAE ; Kyung Ho SONG ; Seung Joo KANG ; Jong Kyu PARK ; Eun Jeong GONG ; Jeong Eun SHIN ; Hyun Chul LIM ; Sang Kil LEE ; Da Hyun JUNG ; Yoon Jin CHOI ; Seung In SEO ; Joon Sung KIM ; Jung Min LEE ; Beom Jin KIM ; Sun Hyung KANG ; Chan Hyuk PARK ; Suck Chei CHOI ; Joong Goo KWON ; Kyung Sik PARK ; Moo In PARK ; Tae Hee LEE ; Seung Young KIM ; Young Sin CHO ; Han Hong LEE ; Kee Wook JUNG ; Do Hoon KIM ; Hee Seok MOON ; Hirota MIWA ; Chien-Lin CHEN ; Sutep GONLACHANVIT ; Uday C GHOSHAL ; Justin C Y WU ; Kewin T H SIAH ; Xiaohua HOU ; Tadayuki OSHIMA ; Mi-Young CHOI ; Kwang Jae LEE ; The Korean Society of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility 2021;27(4):453-481
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.