Mediastinal fibrosis is pathologically characterized by chronic inflammation and fibrosis of mediastinal soft tissue. Mediastinal fibrosis is local expression of a family of systemic fibrosing syndroms. This can result in compression of adjacent mediastinal structures. Idiopathic fibrosing syndromes include retroperitoneal fibrosis, sclerosing cholangitis of the orbit and fibrosis of the thyroid gland(Riedel's struma). The cause of these disorders is obscure, in some instance there is an underlying malignancy, infection, history of drug ingestion, or trauma with retoperitoneal bleeding. Treatment of mediastinal fibrosis depends on structures involved by the fibrotic process. The disease is self limited in most case or improved by steroids uses. We experienced a case of idopathic solerosing mediastinitis with orbital fibrous dysplasia of unknown cause, which was confirmed by open lung biopsy, so reported it with a review of literature.
Biopsy ; Cholangitis, Sclerosing ; Eating ; Fibrosis* ; Hemorrhage ; Humans ; Inflammation ; Lung ; Mediastinitis ; Orbit ; Retroperitoneal Fibrosis ; Steroids ; Thyroid Gland

BACKGROUND: Despite widespread recognition of the hazardous health effects of smoking, adolescent smoking continues to increase, emerging as a public health problem. However few studies have focused on smoking cessation programs for adolescent smokers. The purpose of this study was to measure the short-term effects of the adolescent smoking cessation program performed by the Seoul School Health Center. METHODS: Four hundred and twenty adolescent smokers referred from their schools from March to December of 1996 were assessed before and immediately after the program with a self-questionnaire. The data acquired from these 420 students was analyzed. RESULTS: Males were found to have a higher rate of daily smoking as compared with females. Middle school students had a earlier starting age than those of high school students. About 70% of the students had tried to stop smoking and about 1/3 had a high level of self-efficacy in stop smoking. More than 80% of the students were current alcohol drinkers and 10% ever had experience with other drugs. Many showed poor academic performance and low degree of satisfaction with their schools. More than 50% had experienced punishment at school Middle and high economic status were more common than low status, 73.3% had smokers in their families and 43.3% showed severe dysfunction in family APGA-R. Smoking cessation rate immediately after the program was 37.4%, highest in female high school students and lowest in male high school students Factors shown to be significantly associated with smoking cessation in males were school age, FTQ scores, presence of peer smokers, smoking and alcohol status, self-efficacy in stop smoking and degree of satisfaction with their schools. School age, presence of peer smakers, smoking and other drug use status, self-efficacy in stop smoking, academic performance, degree of satisfaction with their schools, experienoe of runaway from home, economic status and presence of smokers in their families were significant factors in females. Stepwise logistic regression showed that current alcohol users were less likely to succeed in smoking cessation and those with a higher level of self-efficacy in stop smoking were more likely to succeed in males. In females, high school students with higher economic status were more likely to succeed while those with smokers in their families or experience of runaway from home were less likely to succeed. CONCLUSIONS: To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of adolescent smokers. For more effectiveness, programs will need to comprehensively include the school, the family, peers, alcohol and other drug issues as well as smoking problem itself.
Adolescent* ; Child ; Female ; Homeless Youth ; Humans ; Logistic Models ; Male ; Motivation ; Program Evaluation ; Public Health ; Punishment ; School Health Services ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking*

Purpose: We report two cases of tacrolimus-related transplant-associated thrombotic microangiopathy (TA-TMA) retinopathy in leukemia patients who had undergone allogenic peripheral blood stem cell transplantation (PBSCT).Case summary: (Case 1) A 58-year-old woman with a history of PBSCT due to acute myelocytic leukemia and taking tacrolimus was referred to the ophthalmology clinic with visual disturbance. Her visual acuity (VA) was 0.4 in the right eye and 0.5 in the left eye. Multiple cotton wool spots and retinal hemorrhages were found in both eyes on fundus examination. Multiple capillary non-perfusions were seen on fluorescein angiography (FA). Tacrolimus-related TA-TMA retinopathy was suspected. Tacrolimus was discontinued and plasmapheresis was performed. After 3 months, neovascular glaucoma developed and her VA became “counting fingers” at 20 cm in both eyes. (Case 2) A 20-year-old man with a history of PBSCT due to acute lymphocytic leukemia and taking tacrolimus was referred to our clinic because of decreased VA in both eyes. His VA was 0.05 in the right eye and 0.025 in the left eye. Fundus and FA findings were the same as in Case 1, and the patient was suspected to have tacrolimus-related TA-TMA retinopathy. Tacrolimus was discontinued and plasmapheresis was performed. His VA was 0.2 in the right eye and 0.4 in the left eye at 1 month after treatment. Conclusions It is necessary to consider TA-TMA retinopathy in leukemia patients taking calcineurin inhibitors, such as tacrolimus, who have decreased VA. Early diagnosis and treatment are important.

STUDY DESIGN: Retrospective study. PURPOSE: To more accurately determine the incidence and clarify risk factors. OVERVIEW OF LITERATURE: Superior mesenteric artery syndrome is one of the possible complications following correctional operation for scoliosis. However, when preliminary symptoms are vague, the diagnosis of superior mesenteric artery syndrome may be easily missed. METHODS: We conducted a retrospective study using clinical data from 118 patients (43 men and 75 women) who underwent correctional operations for scoliosis between September 2001 and August 2007. The mean patient age was 15.9 years (range 9~24 years). The risk factors under scrutiny were the patient body mass index (BMI), change in Cobb's angle, and trunk length. RESULTS: The incidence of subjects confirmed to have obstruction was 2.5%. However, the rate increased to 7.6% with the inclusion of the 6 subjects who only showed clinical symptoms of obstruction without confirmative study. The BMI for the asymptomatic and symptomatic groups were 18.4+/-3.4 and 14.6+/-3, respectively. The change in Cobb's angle for the asymptomatic and symptomatic groups were 24.8+/-13.6degrees and 23.4+/-9.1degrees, respectively. The change in trunk length for the asymptomatic and symptomatic groups were 2.3+/-2.1 cm and 4.5+/-4.8 cm, respectively. Differences in Cobb's angle and the change in trunk length between the two groups did not reach statistical significance, although there was a greater increase in trunk length for the symptomatic group than for the asymptomatic group. CONCLUSIONS: Our study shows that the incidence of superior mesenteric artery syndrome may be greater than the previously accepted rate of 4.7%. Therefore, in the face of any early signs or symptoms of superior mesenteric artery syndrome, prompt recognition and treatment are necessary.
Body Mass Index ; Humans ; Incidence ; Male ; Mesenteric Artery, Superior ; Retrospective Studies ; Risk Factors ; Scoliosis ; Superior Mesenteric Artery Syndrome

BACKGROUND: Since May 2009, a pandemic influenza A (H1N1) virus has emerged and spread nationwide. We describe the epidemiological characteristics of the confirmed deaths related with the 2009 H1N1 influenza pandemic in Korea from May 2009 to mid December 2009. METHODS: This study was based on an analysis of the reports from the deaths of confirmed cases pandemic H1N1 virus until 7 December 2009 in Korea. These reports were compiled by the epidemic intelligence team at the Korea Centers for Disease Control & Prevention (KCDC) or at the provinces. The epidemic intelligence team used an identical, well-defined investigate form for reviewing the medical records and for interviewing the physicians in charge of the cases. RESULTS: The first confirmed death occurred on August 15, 2009. Until December 7, 2009, 139 deaths had been reported. Eighty cases (57.6%) were individuals more than 60 years old. Sixty two cases (47.0%) were dead within 7 days from the onset of symptoms. One hundred three cases (74%) had underlying diseases, and cancer was the most common underlying disease. The proportion of patients using antivial medications before confirmation among the patients with underlying diseases was greater than the proportion of patients using antivial medications among the patients with no underlying diseases. CONCLUSIONS: During the evaluation period, serious underlying diseases were present in nearly three quarters of the cases of confirmed death. We suggest that health providers consider using antiviral drugs before confirmation of pandemic H1N1 in hospitalized patients, and especially in those with underlying diseases.
Antiviral Agents ; Centers for Disease Control and Prevention (U.S.) ; Fees and Charges ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Intelligence ; Korea ; Medical Records ; Pandemics ; Viruses

Drug-eluting stents (DES) dramatically reduce the rate of restenosis and the need for repeat revascularization. Despite these promising results, stent thrombosis seems to occur more frequently with DES and often seems to be associated with premature discontinuation of antiplatelet agents. We experienced a case of recurrent stent thrombosis with separate lesions. Recurrent stent thrombosis is a very rare event, and simultaneous stent thrombosis is also rare. Here, we report a case of recurrently developing stent thrombosis involving separate lesions.
Coronary Thrombosis ; Coronary Vessels ; Drug-Eluting Stents ; Platelet Aggregation Inhibitors ; Stents ; Thrombosis

BACKGROUND: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. METHODS: On the evening of October 30, 1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims. RESULTS: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. CONCLUSION: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.
Adolescent ; Burns ; Cicatrix ; Contracture ; Contusions ; Disasters ; Emergency Medical Services ; Fires* ; Humans ; Hypoxia, Brain ; Inhalation ; Lacerations ; Laryngeal Edema ; Medical Records ; Mortality ; Pulmonary Edema ; Restaurants* ; Retrospective Studies ; Sepsis ; Smoke ; Survivors ; Triage

OBJECTIVE: It is widely known that the menopausal complication in the surgical menopause is to proceed rather than that of natural menopause. But, it has not obviously been proven so far. In this study, we surveyed whether BMD between surgical and natural menopausal group, in terms of decrease of the BMD of the menopausal complication would have a difference. METHOD: By using dual energy X-ray absorptiometry, we compared 2nd-4th Lumbar spine BMD in 28 of surgical menopause with that of 187 of natural menopause. RESULT: There is no obvious distinction in FSH and estradiol concentration between two groups. Surgical and natural menopausal groups showed the BMD -1.046+/-0.175 g/cm2, -0.942+/-0.124 g/cm2, respectively. Also, there is no statistical significance. CONCLUSION: Although there is no statistical significance in the BMD of the surgical menopausal group was lower than that of the natural menopausal group. Prevention of the menopausal complication as well as decrease of the BMD in the surgical menopausal group needs to be required more active attitude.
Absorptiometry, Photon ; Bone Density* ; Estradiol ; Female ; Humans ; Menopause ; Spine

OBJECTIVE: We focused the objective of this study on the obstetrical and statistical aspects of the unmarried mother, especially teenage pregnancy and 20's pregnancy. METHODS: The 112 well-documented records in the 130 unmarried mothers who delivered at Gangnam general hospital public corporation from 1998 to 2000, were enrolled in our study. Unmarried mothers were divided into three age groups; teenage group, 20's group and 30's group, then, each group was analyzed by liable methods, SPSS (Version 10.0.7) and data were processed by Student's t-test and accepted as the significant meaning within p-value less than 0.05, 95% significant level. RESULTS: In this study, teenage mothers were delivered lower birth weight babies than those of other groups (p=0.000001). Sex partners of teenage mothers, most school boy friends, were similar age to those mothers and low economic state. Despite desire of bringing up children (teenage 11% versus 20's 36%), they gave up their babies because of monetary matters and social bias. And teenage mothers felt stronger affection for babies than 20's. Teenagers' and 20's unmarried mothers have poor information about contraception (teenage group 42%, 20's 31%). CONCLUSION: The unmarried mothers have been constituting many social problems. Fortunately, the absolute number of the unmarried mothers have not increased but the teenage pregnancy has the majority of unmarried mothers (> OR =50%). It is necessary for unmarried mothers to take the education of contraceptive measures, the social systems of bringing up the boarder babies and the retraining courses of unmarried mothers.
Bias (Epidemiology) ; Birth Weight ; Child ; Contraception ; Education ; Female ; Friends ; Hospitals, General ; Humans ; Illegitimacy* ; Male ; Mothers ; Pregnancy ; Pregnancy in Adolescence ; Single Person* ; Social Problems

OBJECTIVE: We focused the objective of this study on the obstetrical and statistical aspects of the unmarried mother, especially teenage pregnancy and 20's pregnancy. METHODS: The 112 well-documented records in the 130 unmarried mothers who delivered at Gangnam general hospital public corporation from 1998 to 2000, were enrolled in our study. Unmarried mothers were divided into three age groups; teenage group, 20's group and 30's group, then, each group was analyzed by liable methods, SPSS (Version 10.0.7) and data were processed by Student's t-test and accepted as the significant meaning within p-value less than 0.05, 95% significant level. RESULTS: In this study, teenage mothers were delivered lower birth weight babies than those of other groups (p=0.000001). Sex partners of teenage mothers, most school boy friends, were similar age to those mothers and low economic state. Despite desire of bringing up children (teenage 11% versus 20's 36%), they gave up their babies because of monetary matters and social bias. And teenage mothers felt stronger affection for babies than 20's. Teenagers' and 20's unmarried mothers have poor information about contraception (teenage group 42%, 20's 31%). CONCLUSION: The unmarried mothers have been constituting many social problems. Fortunately, the absolute number of the unmarried mothers have not increased but the teenage pregnancy has the majority of unmarried mothers (> OR =50%). It is necessary for unmarried mothers to take the education of contraceptive measures, the social systems of bringing up the boarder babies and the retraining courses of unmarried mothers.
Bias (Epidemiology) ; Birth Weight ; Child ; Contraception ; Education ; Female ; Friends ; Hospitals, General ; Humans ; Illegitimacy* ; Male ; Mothers ; Pregnancy ; Pregnancy in Adolescence ; Single Person* ; Social Problems