Angiosarcomas are extremely rare in the nasal cavity and para-nasal sinus. Upto the present only nineteen cases have been reported in the literature. A 31-year-old male presented with right facial swelling and large oral cavity mass. He was treated with wide excision of the tumor by radical maxillectomy. The tumor was diagnosed as angiosarcoma by immunohistochemical staining with factor VIII-reactive antigen. No adjuvant radiotherapy after surgery was done. After 9 montbs from surgery, the tumor recurred in the primary sites of oral cavity and right maxillary sinus and metastasized to the both lungs. He was treated with palliative chemotherapy and showed a stable disease in follow-up magnetic resonance image of para-nasal sinus and simple chest X-ray after second cycle of chemotherapy. He is undergoing further chemotherapy without any problems. We report first in Korea a case of primary angiosarcoma of the right maxillary sinus in a 31-year-old male.
Adult ; Drug Therapy ; Follow-Up Studies ; Hemangiosarcoma* ; Humans ; Korea ; Lung ; Male ; Maxillary Sinus* ; Mouth ; Nasal Cavity ; Radiotherapy, Adjuvant ; Thorax

PURPOSES: This study was to investigate the source of infection, mode of transmission and incidence of a measles outbreak among infants living in a Gwangju welfare institution in July 2000. METHODS: The information about 63 children was collected through the nurses interview and blood sampling and laryngopharyngeal swab were conducted to the children. In addition, an epidemiologic survey was performed to confirm the infection dissemination route. RESULTS: Before the outbreak, two children living at the institution were admitted to a university hospital for other health problems. These children shared a room with a 5 year old diagnosed with meningitis who was later diagnosed as having measles after rashes appeared. The two children developed measles after returning to their institution and the infection spread to other children in the institution. Among 63 children observed, 14 children(22.2%) developed measles, secondary attack rate of measles due to index cases was 19.7%. And 78.6% of the patients were between 4 and 8 months old. The room where the index case lived showed an attack rate of 81.8%, which is a much higher rate compared to other rooms. The attack rate among boys(26.0%) was higher than that of girls(12.5%), but it was not statistically significant. CONCLUSIONS: This outbreak was considered to be a nosocomial infection, where the index cases were admitted to a hospital, infected and the infection spread to children. Further studies are necessary to find out the maternal antibody levels of infants of post-vaccinated mothers and the optimal age for measles vaccination.
Child ; Child, Preschool ; Cross Infection* ; Exanthema ; Gwangju ; Humans ; Immunization ; Incidence ; Infant* ; Measles* ; Meningitis ; Mothers ; Vaccination

BACKGROUND: Medical treatments such as restriction of phosphate, phosphate binder use, and active vitamine D therapy have been widely used for hyperparathyroidism in ESRD patients, and surgical parathyroidectomy should be considered in patients with uncontrolled hyperparathyroidism. METHODS: A retrospective study was performed in 24 ESRD patients with severe and uncontrolled hyperparathyroidism despite of medical treatment who undertook surgical parathyroidectomy in Severance hospital from 1990 to 1999. RESULTS: Sixteen patients had total parathyroidectomy with immediate autotransplant, 7 patients had subtotal parathyroidectomy and only 1 patient had minimally invasive parathyroidectomy. An excellent short-term control of hyperparathyroidism was achieved in all patients after parathyroidectomy. Preoperative bone and joint pain improved in 16 of 19 patients. Muscle weakness and pain improved in 11 of 17 patiens, malaise improved in 8 of 10 patients and pruritus improved in 10 of 13 patients. In addition, clinical laboratory finding improved after parathyroidectomy. No clinical differences were seen between 16 patients who undertook total parathyroidectomy with immediate autotransplant and 7 patients who undertook subtotal parathyroidectomy. Recurrence of hyperparathyroidism ocurred in 5 of 24 patients with 4 nodular hyperplasia and 1 diffuse hyperplasia in pathologic finding. The less degree of attenuated response of intact PTH levels immediately after operation was observed in 5 recurrent cases. CONCLUSION: Good results were obtained after parathyroidectomy. We believe that histologic subtype and the attenuated response of intact PTH after surgical parathyroidectomy could be possible predictors of the recurrent hyperparathyroidism.
Arthralgia ; Autografts ; Humans ; Hyperparathyroidism* ; Hyperparathyroidism, Secondary ; Hyperplasia ; Kidney Failure, Chronic* ; Muscle Weakness ; Parathyroidectomy* ; Pruritus ; Recurrence ; Retrospective Studies ; Vitamins

BACKGROUND: According to previous studies on peritoneal membrane function, solute transport significantly increased 3 years after the begining of peritoneal dialysis. However, there were only few reports regarding the change of peritoneal membrane function in long-term CAPD patients in Korea. METHODS: Clinical factors affecting peritoneal membrane function were analyzed, in patients who maintained CAPD more than 5 years. 124 patients performed peritoneal equilibration test(PET) 5 years after CAPD were included. Cross sectional study was performed to know the differences of clinical characteristics among 4 types of peritoneal membrane transport characteristics based on PET. Also, clinical factors affecting peritoneal memebrane function were analyzed in 31 patients who had undertaken PET initially and 5 years after the beginning of CAPD. RESULTS: D/P Cr was the highest(p<0.001) and ultrafiltration was the lowest(p=0.011) in high transport group. Also, the number of hypertonic glucose exchanges(more than 2.5%) per day was the highest (p=0.02), and serum albumin was the lowest(p<0.001) in this group. 17 patients were included in ultrafiltraion failure group. D/P Cr and the number of hypertonic glucose exchanges was significantly higher (p<0.001, p<0.001, respectively) and the duration of peritoneal dialysis was significantly longer(p=0.033) in ultrafiltration failure group compared with the others. D/P Cr of 124 patients was well correlated with the number of peritonitis(gamma=0.246, p=0.006), and the number of hypertonic glucose exchanges(gamma=0.33, p<0.001), but inversely correlated with serum albumin(gamma=-0.452, p<0.001) with the statistical significance. In 31 patients who undertook PET within 1 year after the begining of CAPD, although not significant, D/P Cr increased and ultrafiltration decreased after 5 years. A significant increase in D/P Cr(p=0.014) was seen in patients who experienced more than 2 episodes of peritonitis(n=14), compared with patients who experienced either peritonitis free or single episode of peritonitis(n=17). The linear regression analysis showed that the number of peritonitis and the number of hypertonic glucose exchanges per day were significantly correlated with the increased D/P Cr after 5 years(p=0.001, p=0.003, respectively). CONCLUSION: Clinical factors affecting peritoneal membrane function were the number of peritonitis, the use of hypertonic glucose exchanges and the duration of peritoneal dialysis. To preserve peritoneal membrane function, it is recommended to avoid hypertonic glucose exchanges and to reduce the number of peritonitis.
Glucose ; Humans ; Korea ; Linear Models ; Membranes* ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Serum Albumin ; Ultrafiltration

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

BACKGROUND/OBJECTIVES: To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS: This first cross-sectional nationwide “Pediatric Nutrition Day (pNday)” survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS: At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively.During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.