No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

Clinical observarions were done on 616 cases of cerebrovasculae accidents treated as inpatients at the Sung-Sim hospital, Chung-Ang university over a period of 8 years, from January, 1981 to Agust, 1988. The results were as follows; 1) Of 616 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 56.82%, cerebral thrombosis in 28.57%, subarachnoid hemorrhage in 12.66%, cerebral embolism in 1.95%. 2) The ratio of male to female was 1.01:1. 3) The cerebrovascular accidents were most common in the sixth decade and followed by the fifth and fourth in turn. 4) The seasonal incidence was in order of frequency of Spring, Winter, Autumn and Summer. 5) Among disease preceding the onset of cerebrovascular accidents, hypertension was noted at 75% in cases of cerebral hemorrhge, 61% in cerebral thrombosis and 73% in subarachnoid hemorrhge. 6) The mean duration of underlying hypertension was 13.7 years in cerebral emorrhge, 15.3 years in cerebral thrombosis, 12.2 years in subarachnoid hemorrhage and 14.8 years in cerebral embolism. 7) Major precipitating factor in cerebral hemorrhage and subarachnoid hemorrhage was thought to be physical activity, whereas cerebral thrombosis and cerebral embolism frequently occured during sleeping or resting state. 8) The mean cholesterol level were 204.1mg% in cerebral hemorrhage, 214.9mg% in cerebral thrombosis, 211.7mg% in subaraachnoid hemorrhage and 217.0mg% in cerebral embolism. 9) The mortality rate was 12.2% in total, 16.6% in cerebral hemorrhage 2.3% in cerebral thrombosis, 15.45 in subarachnoid hemorrhage and 25% in cerebral embolism.
Cerebral Hemorrhage ; Cholesterol ; Female ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Inpatients ; Intracranial Embolism ; Intracranial Thrombosis ; Male ; Mortality ; Motor Activity ; Precipitating Factors ; Seasons ; Stroke* ; Subarachnoid Hemorrhage

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed

BACKGROUND: The myelodysplastic syndromes (MDS) can be categorized as a group of clonal hematopoietic disorders characterized by ineffective hematopoiesis and peripheral cytopenias. Although the natural history of MDS varies, traditional treatments are not curative and allogeneic marrow transplantation offers potentially curative treatment for MDS. METHODS: In our center, 10 patients underwent allogeneic bone marrow transplantation (BMT) between December 1989 and May 1997. The minimum follow-up of 3 months was possible in 10 patients, for whom treatment-related complications and clinical outcomes were assessed. RESULTS: The median age of the 10 patients was 33 (range 20~40) years. The median time from diagnosis to BMT was 34 (3~116) months. By morphology, 5 patients had advanced MDS (i.e., RAEB, RAEB-t, CMML) and 5 patients had less advanced MDS (RA). By Bournemouth score, 8 patients had a score 2~3 and two patients had a score 4. By IPSS, 5 patients were in intermediate-1 group, 3 patients in intermediate-2 group and 2 patients in high risk group. Patients were prepared for transplant with either a total body irradiation (TBI)+cyclophosphamide (n=7), busulfan+TBI (n=2) and busulfan+cyclophophamide (n=1). All patients received CsA+short course MTX for GVHD prophylaxis. Successful engraftment was confirmed in all patients. The overall incidence of acute GVHD was noted in 70% (7/10 patients) and grade IV acute GVHD developed in 2 patients (20%). Five patients were evaluable for the development of chronic GVHD and 2 patients (40%) developed limited chronic GVHD. The duration of median follow-up was 8.1 months. At present five patients are alive and disease-free 3 to 21 months (median survival duration : 8.2 months) post-transplantation resulting in a 2-year disease-free survival of 44%. 2-year disease free survival was 63% in less advanced MDS and 25% in advanced MDS. CONCLUSION: Allogeneic BMT should be considered when any clinical evidence of disease progression to a more advanced stage becomes apparent. International prognostic scoring system (IPSS) and Bournemouth score can also be used to gauge timing for BMT. For patients were in intermediate-1 or intermediate-2 group by IPSS, BMT can be justified if the patient is young and has an HLA matched sibling donor.
Anemia, Refractory, with Excess of Blasts ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Disease Progression ; Disease-Free Survival ; Follow-Up Studies ; Hematopoiesis ; Humans ; Incidence ; Myelodysplastic Syndromes* ; Natural History ; Siblings ; Tissue Donors ; Whole-Body Irradiation

Background: This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice. Methods: This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit. Results: Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula. Conclusion A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

BACKGROUND/AIMS: The delay between the onset of myocardial infarction symptoms and primary percutaneous coronary intervention (PCI) is an important prognostic factor in patients with ST-segment elevation acute myocardial infarction (STEMI). We reviewed this delay in patients with STEMI and analyzed clinical outcomes. METHODS: The study enrolled 3,399 patients (age, 61.4 +/- 12.8 years; 25.6% women) with STEMI who underwent primary PCI within 12 hours of symptom onset between October 2005 and February 2008 from the Korea Acute Myocardial Infarction Registry. The patients were divided into two groups according to the symptom-to-balloon time: group I (< or = 3 hours, n = 955) and group II (> 3 hours, n = 2444). The in-hospital mortality rates and 1-year mortality and major adverse cardiac event (MACE) rates were compared between the two groups. RESULTS: The mean time interval from the onset of symptoms to arrival at the emergency room (ER) was 188.0 +/- 133.6 minutes (median, 152 minutes). The mean time interval from the ER to reperfusion (door-to-balloon time) was 97.8 +/- 67.9 minutes (median, 80 minutes). The mean time interval from the onset of symptoms to reperfusion (symptom-to-balloon time) was 285.8 +/- 146.2 minutes (median 250 minutes). The in-hospital mortality rate was significantly lower in group I as compared with group II (3.6% versus 5.2%, p = 0.044). The 1-year mortality rate was also significantly lower in group I (4.7% versus 7.2%, p = 0.012), while the 1-year MACE rate was not significantly different between groups (17.9% versus 20.4%, p = 0.179). CONCLUSIONS: This study demonstrates that there is a significant pre-hospital time delay in patients with STEMI in Korea and this time delay is associated with increased 1-year mortality.
Angioplasty ; Emergencies ; Hospital Mortality ; Humans ; Korea ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Reperfusion ; Time Factors