No abstract available.
Nevus, Blue* ; Nose*

No abstract available.

No abstract available.
Hyperlipoproteinemia Type IV* ; Hyperlipoproteinemias ; Xanthomatosis*

Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.
Anoxia ; Anti-Bacterial Agents ; Autopsy* ; Bacterial Infections ; Biopsy ; Collagen ; Cough ; Dust ; Dyspnea ; Fibroblasts ; Hospitalization ; Humans ; Hyalin ; Hyperplasia ; Keratins ; Lung ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Pathology ; Pneumocytes ; Pulmonary Fibrosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency

Mauriac syndrome consists of a triad of poorly controlled diabetes, profound growth retardation and hepatomegaly. We experienced a case of Mauriac syndrome in an 18-year-old girl who had poorly controlled diabetes mellitus, short stature, hepatomegaly and central obesity. Also at the time of examination, she had complications of diabetic cataract and nephropathy. Fourteen years prior to admission, she was diagnosed as diabetes mellitus at a hospital. Thereafter, she had been managed with irregular insulin injection. On physical examination at admission, her height was 135cm(<3 percentile) and her weight was 39kg(<3 percetile). She was short and obese. The liver was 5 cm palpable below the right subcostal margin. Her sexual maturation was Tanner stage I. On ophthalmologic examination, the cataracts were observed on both eyes and diabetic retinopathy was absent. Diabetic nephropathy could not be confirrned by kidney biopsy due to her mother's refusal. We studied the hormonal, radiographic and histological abnormalities. The hormonal study was normal and the bone age was by delayed as much as 10 years. The liver biopsy revealed glycogen accumulation in hepatocyte. She was consistent with Mauriac syndrome. She was managed by strict diabetic control with insulin therapy, diabetic diet and intensive education. She was discharged with well controlled blood glucose. Five months later, growth acceleration and sexual maturation have not been observed, but hepatomegaly subsided. (J Korean Pediatr Soc 2000;43-837-841)
Acceleration ; Adolescent ; Biopsy ; Blood Glucose ; Cataract ; Diabetes Mellitus* ; Diet, Diabetic ; Diabetic Nephropathies ; Diabetic Retinopathy ; Disulfiram ; Education ; Female ; Glycogen ; Hepatocytes ; Hepatomegaly ; Humans ; Insulin ; Kidney ; Liver ; Obesity, Abdominal ; Physical Examination ; Sexual Maturation

PURPOSE: To evaluate the accuracy of ultrasonography(USG) and abdominal computerized tomography(CT) and the possibility of reducing unnecessary appendectomy rate with improvement of diagnostic accuracy using optional CT with USG. METHODS: From January 1999 to May 2003, 496 patients younger than 14 years received surgical intervention with preoperative impression of acute appendicitis. They were devided into three groups no preoperative imaging study; preoperative abdominal USG only; and USG with optional abdominal CT. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated in each group, and percentage of unnecessary appendectomy was also obtained. RESULTS: Sensitivity and unnecessary appendectomy rate of group was 78.4% and 21% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and unnecessary appendectomy rates of group were 96.5%, 42.8%, 85.4%, 78% and 12.2%. Sensitivity and positive predictive value of group was 100% and 98%, and no unnecessary appendectomy was performed in this group. CONCLUSION: With consideration of radiation exposure, cost, and in-hospital delay time, using optional CT with USG under optimal indication can decrease the frequency of complications and unnecessary appendectomy rates.
Appendectomy ; Appendicitis* ; Diagnosis* ; Diagnostic Errors ; Humans ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography

Purpose: This study aimed to identify the risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition to build a nomogram for CRE acquisition risk prediction and evaluate its performance. Methods: This unmatched case-control study included 352 adult patients (55 patients and 297 controls) admitted to the intensive care unit (ICU) of a 453-bed secondary referral hospital between January 1, 2018, and September 31, 2019, in Busan, South Korea. The nomogram was built with the identified risk factors using multiple logistic regression analysis. Its performance was analyzed using calibration-in-the-large, the slope of the calibration plot, concordance statistic (c-statistic), and the sensitivity and specificity of the training set, subsets, and a new test set. Results: The risk factors of CRE acquisition among ICU patients at a secondary referral hospital were Acute Physiology and Chronic Health Evaluation II score at the time of admission, use of a central venous catheter and a nasogastric tube, as well as use of cephalosporin antibiotics. At 20.0% of the predicted CRE acquisition risk in the training set, the calibration-in-the-large was 0, slope of the calibration plot was 1, c-statistic was .93, sensitivity was 85.5%, and specificity was 84.8%. The performance was relatively good in the subsets and new test set. Conclusion The nomogram can be used to monitor the CRE acquisition risk for ICU patients who have a similar case mix to patients in the study hospitals. Future studies need to involve more rigorous methodology and larger samples.

Purpose: This study aimed to identify the risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition to build a nomogram for CRE acquisition risk prediction and evaluate its performance. Methods: This unmatched case-control study included 352 adult patients (55 patients and 297 controls) admitted to the intensive care unit (ICU) of a 453-bed secondary referral hospital between January 1, 2018, and September 31, 2019, in Busan, South Korea. The nomogram was built with the identified risk factors using multiple logistic regression analysis. Its performance was analyzed using calibration-in-the-large, the slope of the calibration plot, concordance statistic (c-statistic), and the sensitivity and specificity of the training set, subsets, and a new test set. Results: The risk factors of CRE acquisition among ICU patients at a secondary referral hospital were Acute Physiology and Chronic Health Evaluation II score at the time of admission, use of a central venous catheter and a nasogastric tube, as well as use of cephalosporin antibiotics. At 20.0% of the predicted CRE acquisition risk in the training set, the calibration-in-the-large was 0, slope of the calibration plot was 1, c-statistic was .93, sensitivity was 85.5%, and specificity was 84.8%. The performance was relatively good in the subsets and new test set. Conclusion The nomogram can be used to monitor the CRE acquisition risk for ICU patients who have a similar case mix to patients in the study hospitals. Future studies need to involve more rigorous methodology and larger samples.

PURPOSE: The purpose of this study was to evaluate the dietary potassium intake, Na/K intake molar ratio, consumption of 18 food groups, and foods contributing to potassium intake of Korean adults as well as the relationships among quartile of potassium intake level and blood pressure, blood biochemical index. METHODS: This study was conducted using the Korea National Health and Nutrition Examination Survey, 2007~2010. The total number of subjects was 20,291. All analyses were conducted using a survey weighting to account for the complex survey design. RESULTS: Overall average intakes of potassium were 2,934.7, 3,070.6, 3,078.1, and 3,232.0 mg/day, and they significantly increased by year in Korean adults. The average dietary potassium intake was close to adequate intake (AI), whereas that of women was considerably lower than the AI. The Na/K intake molar ratio in males (2.89~3.23) was higher than in females (2.62~2.95). The major food groups contributing to potassium intake were vegetables, cereals, and fruits/meats. The two major foods contributing to potassium intake were polished rice and cabbage kimchi. The rankings of food source were as follows; polished rice > cabbage kimchi > potato > oriental melon > sweet potato > seaweed > radish > apple > black soybean. In 50~64 year old females, systolic blood pressure (SBP) significantly decreased (p < 0.01) and HDL-cholesterol significantly increased (p < 0.05) as potassium intake increased. Triglyceride (TG) was significantly higher in the other quartile of potassium intake level than in the first quartile (p < 0.05). CONCLUSION: In conclusion, our study suggests the need for an appropriate set of dietary reference intakes according to caloric intake by sex and age groups and for development of eating patterns to increase potassium intake and decrease sodium intake.
Adult* ; Blood Pressure ; Brassica ; Cucurbitaceae ; Eating ; Edible Grain ; Energy Intake ; Female ; Humans ; Ipomoea batatas ; Korea* ; Male ; Molar ; Nutrition Surveys* ; Potassium* ; Potassium, Dietary ; Raphanus ; Recommended Dietary Allowances ; Seaweed ; Sodium ; Solanum tuberosum ; Soybeans ; Triglycerides ; Vegetables

Apert syndrome is an uncommon congenital disorder characterized by malformation of the skull in association with symmetrical syndactyly of both hands and feet. This syndrome is autosornal dominant. The original description was presented by Apert in 1906. Since then more than 200 cases have been reported in the world. Recently, we experienced a case of newhorn male infant with congenital anomalies of the skull and extremities. Molecular biologically, he was found to have Ser252Try mutation in the FGFR2 exonIIIa. A brief review of literature was made.
Acrocephalosyndactylia ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Extremities ; Fibroblast Growth Factors* ; Fibroblasts* ; Foot ; Hand ; Humans ; Infant ; Male ; Receptor, Fibroblast Growth Factor, Type 2* ; Receptors, Fibroblast Growth Factor* ; Skull ; Syndactyly