Background: Several cases of pediatric acute hepatitis of unknown etiology related to adenoviral infections have been reported in Europe since January 2022. The aim of this study was to compare the incidence, severity, possible etiology, and prognosis of the disease with those in the past in Korea. Methods: The surveillance group collected data between May and November 2022 using a surveillance system. Acute hepatitis of unknown etiology was defined in patients aged < 16 years with a serum transaminase level > 500 IU/L, not due to hepatitis A-E or other underlying causes. For comparison, data from 18 university hospitals were retrospectively collected as a control group between January 2021 and April 2022. Results: We enrolled 270 patients (mean age, 5 years). The most common symptom was fever. However, the incidence was similar between 2021 and 2022. Liver function test results, number of patients with acute liver failure (ALF), liver transplantation (LT), death, and adenovirus detection rates did not differ between the two groups. None of the adenoviruspositive patients in either group experienced ALF, LT, or death. In the surveillance group, adenovirus-associated virus-2 was detected in four patients, one of whom underwent LT. Patients with an unknown etiology showed significantly higher bilirubin levels, a lower platelet count, and a higher LT rate than patients with a possible etiology. Conclusion The incidence of pediatric acute hepatitis of unknown etiology and adenovirus detection rate have not increased in Korea.

STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%–55% had NP. METHODS: Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups. RESULTS: A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP. CONCLUSIONS: NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.
Adult* ; Back Pain ; Cross-Sectional Studies ; Diagnosis ; Hospitals, General ; Humans ; Linear Models ; Low Back Pain* ; Male ; Neuralgia* ; Prevalence* ; Quality of Life ; Visual Analog Scale

It is well known that developmental delay or arrest occurs before implantation in mamals, which have undergone in vitro culture. Recently, these phenomena are being attributed to oxygen free radicals, and successful cell culture are being obtained by lowering the oxygen environment of in vitro culture. This is due to the fact that the oxygen concentration in the fallopian tube is around 5%, which is lower than the room air 20% concentraition for in vitro culture. Superoxide dismutase(SOD), which are free radical scavenger, were added to early embryo mice culture and compared the free radical level at each stage of development with that of culture in which free radical scavenging agent was not added. The highest free radical level in control group observed in the late 2-cell stage and was markedly decreased if SOD added to culture media. Blastulation rate, hatching rate, and blastomere count as the parameters of embryo development was significantly increased in the experimental group. This study suggests the possibility of improvement in in-vitro embryo culture with media including free radical scavengers.
Animals ; Blastomeres ; Cell Culture Techniques ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Fallopian Tubes ; Female ; Free Radical Scavengers ; Free Radicals ; Mice* ; Oxygen ; Pregnancy ; Superoxide Dismutase* ; Superoxides*

Dextrocardia with situs inversus is a rare congenital anomaly of development involving a left-handed malrotation of the visceral organs which affects approximately 1:10,000 patients. It is known that the prevalence of coronary atherosclerosis in patients with dextrocardia is similar to that of the general population. Successful coronary angiography and coronary angioplasty have previously been reported in patients with dextrocardia, but to our knowledge no report exist of a successful coronary angioplasty in a patient with dextrocardia with situs inversus in Korea. We performed a successful percutaneous transluminal coronary angioplasty of an infarct-related vessel in a acute myocardial infarction patient with dextrocardia with situs inversus.
Angioplasty* ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Artery Disease ; Dextrocardia* ; Humans ; Korea ; Myocardial Infarction ; Prevalence ; Situs Inversus*

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.
Adult ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Biopsy* ; Catheter Ablation ; Classification ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Female ; Heart Diseases ; Humans ; Pathology ; Tachycardia ; Tachycardia, Ventricular*

Primary tumors of the heart are rare and the most are benign. Malignant tumors constitute less than 25% of primary cardiac tumors and angiosarcomas are the most commonly reported histologic type. At least 160 cases have been reported in the world, but no previous report in Korea. We reported a case of primary cardiac angiosarcoma located in right atrium.
Heart ; Heart Atria ; Heart Neoplasms ; Hemangiosarcoma* ; Korea

Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.
Atrial Fibrillation ; Atrial Flutter* ; Female ; Humans ; Male

A 50 year old female presented unusual electrocardiographic changes including AV block, accelerated idioventricular rhythm, ventricular premature systole with severe fluctuation of blood pressure and clinical features of angina pectoris. Deep ST segment depression was demonstrated in spite of the normal coronary arteriogram and the negative coronary artery spasm study. Urinary excretion of catecholamines and their metabolites were elevated and a huge pheochromocytoma was found in the left adrenal glandd. After removal of the pheochromocytoma, the electrocardiographic abnormalities and the blood pressure were normalized and teh aptient became asymptomatic.
Accelerated Idioventricular Rhythm ; Angina Pectoris* ; Arrhythmias, Cardiac ; Atrioventricular Block ; Blood Pressure ; Catecholamines ; Coronary Vessels ; Depression ; Electrocardiography* ; Female ; Humans ; Middle Aged ; Pheochromocytoma* ; Spasm ; Systole

We report a rare case of cervical intradural extramedullary neurilemmoma associated with extradural cavernous angioma in adolescent male patient. This 19-year-old man complained of increasing weakness of left extremities with pain and numbness, starting upwards from the region of left leg since 2 months before, which has aggravated gradually and developed to right side. Neither the patient nor any family member displayed the stigmata of spinal tumor. Neurological examination showed spastic qudriparesis, more severe on left side, disclosed absent vibratory sense and diminution of pain and touch below level of cervico-thoracic junction. Myelogram demonstrated a large filling defect at the C4-6 vertebral level, which was interpreted as an intradural extramedullary or extradural mass. Laminectomy was performed 4 days after admission. At surgery, reddish, diffuse and well demarcated friable mass was found extradural space at the level of C4-6. But post-operative course was not improved for 2 weeks, so we are performed second operation after identified another intradural extramedullary mass by spinal CT. A total removal of tumor mass was accomplished at second procedure. Hostological examination confirmed the diagnosis of cavernous angioma at the extradural mass, neurilemmoma at the intradural extramedullary mass. The post-operative course was satisfactory.
Adolescent ; Christianity ; Diagnosis ; Extremities ; Hemangioma, Cavernous* ; Humans ; Hypesthesia ; Laminectomy ; Leg ; Male ; Muscle Spasticity ; Myelography ; Neurilemmoma* ; Neurologic Examination ; Young Adult

The cerebral contusion(necrotic brain tissue infiltrated with blood) is common post-traumatic lesion, In 851 consecutive C-T scan performed by 48 hours from injury, the contusion were present in 193(22.%) of the case. Comparing the midline shift, area, number, size of the lesions and their etiopathogenesis with the clinical course(assessed by Glasgow coma scale), it is possible to evaluate the early prognosis. The patient who showed 1) midline shift over 15mm, 2) the contusional lesion in basal ganglia, brain stem or corpus callosum, 3) multiple or large sized lesion took poor prognosis. Cortical contusion especially in the frontal region had relatively good prognosis. The pathogenetic mechanisms(angular acceleration of the brain) is the same in basal ganglia, brain stem and corpus callosum, but a direct impact of the In conclusion, the etiopathogenetic mechanism and consequent site of the cerebral contusion are the most important factors on the evaluation of the severity of the brain damage and their prognosis.
Acceleration ; Basal Ganglia ; Brain ; Brain Injuries ; Brain Stem ; Coma ; Contusions* ; Corpus Callosum ; Humans ; Prognosis