We describe a case of infrarenal aortic hypoplasia in a 52-yr-old woman who presented with claudication. Computed tomographic angiography revealed an abrupt absence of the infrarenal aorta, with collateral flow reconstituting the iliofemoral systems. After a polytetrafluoroethylene graft was interposed between the aortic stump and the iliac bifurcation, the patient's claudication resolved.

Congenital central hypoventilation syndrome (CCHS) is a life-threatening disorder with apnea and cyanosis during sleep requiring immediate endotracheal intubation during the first day of life. The PHOX2B gene has been identified as the major gene involved in CCHS. This is the first report of a Korean neonate with CCHS confirmed to have a PHOX2B mutation with expanded alleles containing 20 polyalanine repeats that is a relatively small number compared to previous cases. The patient required intermittent ventilator support during sleep only and did not suffer from any other disorders of the autonomic nerve system. He consistently needs ventilator support during sleep and remains alive. Analysis of PHOX2B gene is useful for diagnosis and appropriate therapeutic intervention of CCHS patients.
Alleles ; Asian Continental Ancestry Group/*genetics ; Genotype ; Homeodomain Proteins/*genetics ; Humans ; Hypoventilation/congenital/*genetics ; Infant, Newborn ; Male ; Mutation ; Peptides/genetics ; Republic of Korea ; Sequence Analysis, DNA ; Transcription Factors/*genetics ; Ventilators, Mechanical

We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.
Aged ; Brachiocephalic Veins/*pathology/radiography ; *Central Venous Pressure ; Constriction, Pathologic/*etiology/pathology/therapy ; Edema/therapy ; Female ; Humans ; Jugular Veins/pathology/radiography ; Stents ; Tuberculosis, Pulmonary/*complications/pathology/radiography ; Vascular Diseases/*etiology/pathology/therapy

BACKGROUND: As life span is increasing, so is interest about adult disease. Especially the number of postmenopausal women has increased, and postmenopausal symptoms have become a important problem causing low quality of life. Hormone replacement therapy was introduced to overcome these problems. Authors investigated to evaluate the effect of hormone replacement therapy on the quality of life of postmenopausal women. METHODS: From April to June 1997, we surveyed 188 postmenopausal women (91 women were on hormone replacement therapy, and 97 women were in the controlled group in Sungnam Central Hospital) with COOP/WONCA chart Korean version. RESULTS: COOP/WONCA chart (Korean version) is composed of seven dimensions, among these four dimensions (change in health, overall health, daily activity and pain) were shown statistically significant difference between two groups. But three dimensions (social activity, physical fitness and feelings) were not shown to be statistically different. Total mean score of COOP/WONCA chart showed statistically significant difference. CONCLUSIONS: To improve the quality of life of postmenopausal women, primary care physician should consider hormone replacement therapy along with proper patient selection and periodic follow up.
Adult ; Female ; Follow-Up Studies ; Gyeonggi-do ; Hormone Replacement Therapy ; Humans ; Menopause* ; Motor Activity ; Patient Selection ; Physicians, Primary Care ; Quality of Life*

PURPOSE: Little research has been conducted on adverse drug reactions in neonates, particularly in Korea, where no studies have been reported. METHODS: We conducted a retrospectively study using medical records in a neonatal intensive care unit from August 1, 2013 to July 31, 2014. The adverse drug reactions were evaluated according to the Naranjo algorithm, World Health Organization-Uppsala Monitoring Centre, and the Korean adverse drug reaction algorithm. RESULTS: Of the 410 infants hospitalized during the study period, 57 cases of adverse drug reactions were reported in 40 infants (9.8%). The average gestational age was 28.4+/-4.3 weeks, the average birth weight was 1,184.1+/-622.0 g, and the adverse drug reactions were reported at an average of 21.0+/-29.7 days after birth. Causative agents were identified as electrolytes (36.8%), respiratory medication (14.0%), total parenteral nutrition (12.3%), lipid emulsion (10.5%), antibiotics (7.0%), non-steroidal anti-inflammatory drugs (NSAIDs, 7.0%), sedatives (7.0%), vaccine (3.5%), and an antiviral medication (1.8%). Of the 57 cases, 55 (96.5%) cases demonstrated meaningful adverse drug reactions, defined as those given a score of "possible or above" in all 3 adverse drug reaction algorithms. CONCLUSION: More emphasis is warranted in the field of neonatal adverse drug reactions.
Anti-Bacterial Agents ; Birth Weight ; Drug-Related Side Effects and Adverse Reactions* ; Electrolytes ; Gestational Age ; Humans ; Hypnotics and Sedatives ; Infant ; Infant, Newborn ; Intensive Care, Neonatal* ; Korea ; Medical Records ; Parenteral Nutrition, Total ; Parturition ; Retrospective Studies ; World Health

PURPOSE : To evaluate the frequency of urinary tract anomalies in male neonates less than 3months old who presented with urinary tract infection(UTI) and to evaluate a appropriate imaging approach after first UTI. MATERIALS AND METHODS : During a period of 5 years, from March 1994 to February 1999, 65 male infants less than 3months old(range: 4-92 days, mean: 43 days) with UTI were evaluated. Ultrasound(US) and Voiding cystourethrogram(VCUG) were done in 60 patients. Due to refusal and technological problem, 5 patients were missed. 99mTc-dimercaptosuccinic acid renal scan (99mTc-DMSA renal scan) was recommended to most patients but performed in 40 patients. Renal scan was performed at least 3 months later after urinary tract infection. RESULTS : Urinary tract anomalies were found in 26 of 65 infants. Twenty-six had vesicoureteral reflux(VUR), two had both VUR and double ureter, two had both VUR and posterior urethral valve. In patients with VUR, eight had renal scar or renal atrophies. In case of renal scar or atrophy, grades of VUR were III or above. CONCLUSION : We suggest that US and VCUG should be routinely performed in infants(<3months)with first UTI. 99mTc-DMSA renal scan should be performed only when renal parenchymal damage was observed in US and VUR grade III or above in VCUG.
Atrophy ; Cicatrix ; Disulfiram ; Humans ; Infant* ; Infant, Newborn ; Male* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ureter ; Urinary Tract Infections* ; Urinary Tract*

We report a case of unintentional intraoperative awareness during sevoflurane-remifentanil anesthesia in a 26 years old woman undergoing elective minimal invasive mitral valvuloplasty. Cardioprotective effects of sevoflurane were clinically most apparent when administered throughout the surgical procedure. Also use of sevoflurane during cardiopulmonary bypass decreases incidence of awareness. Although awareness during cardiac anesthesia has been previously described with sevoflurane, the implication of this case is that unexpected awareness can occur in patients with sevoflurane during cardiopulmonary bypass on cardiac surgery. Therefore, more attention is needed to use sevoflurane during cardiopulmonary bypass.
Anesthesia ; Cardiopulmonary Bypass ; Female ; Humans ; Incidence ; Intraoperative Awareness ; Methyl Ethers ; Piperidines ; Thoracic Surgery

BACKGROUND: The carotid intima-media thickness (IMT) have been known to be related to the degree of atherosclerosis and cardiovascular risk factors. The aim of this study was to elucidate the relationship of IMT and the hemodynamic changes during anesthetic induction. METHODS: Two hundred fourteen patients scheduled for general anesthesia were studied. The blood pressures and heart rates during anesthetic induction and endotracheal intubation were measured. IMT was measured at right common carotid artery using M-mode ultrasonography after anesthesia, RESULTS: Mean IMT of the patients was 0.611 +/- 0.146 (0.34-0.96) mm. IMT was significantly related with age, systolic blood pressure, the changes of blood pressure after induction, and the changes of blood pressure after intubation. IMT was not related for basal heart rate and the changes of heart rate during anesthetic induction and intubation. CONCLUSIONS: IMT is related with the magnitude of blood pressure decreasing during anesthetic induction and increasing during intubation. The further study is needed to evaluate the relationship of IMT and hemodynamic changes during other anesthetic practice.
Anesthesia ; Anesthesia, General ; Atherosclerosis ; Blood Pressure ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal ; Risk Factors

Purpose: A “Smart Cancer Care” platform that integrates patient-reported outcomes (PROs) with management has been established in Korea. This study focused on improving health behaviors and connecting patients to welfare services by introducing and assessing the feasibility of “Smart Cancer Care 2.0,” an enhanced version designed for monitoring complications post-cancer treatment. Materials and Methods: Smart Cancer Care 2.0 was developed by conducting a literature review and consulting with expert panels to identify symptoms or variables requiring monitoring and management guidelines based on the treatment type. Qualitative and quantitative surveys were conducted to assess the feasibility of the app and web system based on the experiences of patients with cancer and healthcare workers. Results: A total of 81 symptoms or variables (chemotherapy-, surgery-, radiotherapy-, rehabilitation-, and health management-related) were selected for management in Smart Cancer Care 2.0. PROs for these symptoms were basically categorized into three severity grades: preventive management, self-treatment, and consultation with a healthcare worker or visit to a healthcare institution. The overall mean scores in the feasibility evaluation by patients and healthcare workers were 3.83 and 3.90 points, respectively, indicating high usefulness. Conclusion Smart Cancer Care 2.0 leverages the existing information and communication technologies–based platform, Smart Cancer Care, and further includes health behaviors and welfare services. Smart Cancer Care 2.0 may play a crucial role in establishing a comprehensive post-discharge management system for patients with cancer as it provides suitable interventions based on patients’ responses and allows the regularly collected PROs to be easily viewed for streamlined care.

Pulmonary placental transmogrification (PT) is a rare lung disease that takes on the histologic appearance of placental chorionic villi. We herein report a case of PT in a 66-year-old woman who presented with a single nodule on chest radiography performed during a routine health examination. She had no complaints of any symptoms. Chest radiography showed a focal ill-defined nodular opacity in the right lower lobe; chest computed tomography revealed a 17-mm lobulated, focal irregular mass with fissural retraction in the right lower lobe, suggestive of lung cancer. Pathology of a percutaneous needle aspiration biopsy revealed papillary structures resembling placental villi. These were lined by cytotrophoblast-like cells and syncytiotrophoblasts. This characteristic pathologic finding led to a diagnosis of PT. PT of the lung is found mainly in bullous or cystic lesions. However, this patient presented with a single nodule on chest radiography.
Aged ; Biopsy, Needle ; Chorionic Villi ; Diagnosis ; Female ; Humans ; Lung Diseases ; Lung Neoplasms ; Lung* ; Needles ; Pathology ; Placenta ; Radiography ; Thorax ; Trophoblasts