The most feared complication of left ventricular thrombus (LVT) is the occurrence of systemic thromboembolic events, especially in the brain. Herein, we report a patient with severe sepsis who suffered recurrent devastating embolic stroke. Transthoracic echocardiography revealed apical ballooning of the left ventricle with a huge LVT, which had not been observed in chest computed tomography before the stroke. This case emphasizes the importance of serial cardiac evaluation in patients with stroke and severe medical illness.
Brain ; Echocardiography ; Heart Ventricles ; Humans ; Sepsis ; Shock, Septic* ; Stroke* ; Thorax ; Thrombosis*

No abstract available.
Gangwon-do* ; Humans ; Norovirus* ; Sequence Analysis*

PURPOSE: A field investigation was done to evaluate the level of the epidemic of Shigellosis in Jeju Island during the first half of year 2000. METHODS: Confirming the Shigellosis was done by the structured questionnaire and the result of rectal swab for the residents having a diarrhea. RESULTS: As the confirmed patients with Shigella sonnei were 933 from 25 April to 14 August 2000, the crude incidence rate was 174 per 100,000 persons. The highest incidence rate was shown in 5-9 year-old group. Especially the south area of Jeju Island, called as Namjejugun, had the major epidemic occurrence. CONCLUSIONS: The huge and chronic epidemic of Shigellosis was confirmed. The nature of this epidemic suggested that the endemic occurrence had been existed in Jeju Island.
Diarrhea ; Disease Outbreaks ; Dysentery, Bacillary* ; Humans ; Incidence ; Shigella ; Shigella sonnei ; Surveys and Questionnaires

PURPOSE: Outbreaks of mumps continue to occur, even though the number of patients diagnosed of mumps has decreased considerably with the widespread use of vaccine. The accurate diagnosis of mumps is needed to understand the epidemiology of mumps and analyse the safety and effectiveness of vaccine. Therefore, we attempted to appraise the accuracy of provisional diagnosis of mumps in clinical practice by measuring mumps specific antibody. METHODS: Thirty-six patients with presumptive diagnosis of mumps were enrolled from four university hospitals. Medical history including MMR vaccination was obtained, and anti-mumps IgM antibody test(ELISA. Denka Seiken Co., Ltd., Tokyo, Japan), complete blood counts and amylase were measured. RESULTS: Among 36 patients presumptively diagnosed of mumps, anti-mumps IgM antibody was positive in 14 patients(38.8%), negative in 20(55.5%) and equivocal in 2(5.5%). In two patients who were not vaccinated against mumps, one had anti-mumps IgM antibody and the other did not. All four patients, vaccinated with MMR twice after their first birthday did not have anti-mumps IgM antibody. The sites of involved glands and the associated localized as well as systemic symptomatologies were not different between patients with anti-mumps antibody and those without. The proportion and degree of increment of serum amylase level were not different between the two groups. CONCLUSION: A significant number of patients with provisional diagnosis of mumps appear to be due to other causes. Amylase, commonly used in clinical practice, does not differentiate mumps from other illnesses involving the parotid glands. Mumps can be accurately diagnosed only by laboratory tests including anti-mumps antibody. The two-dose MMR vaccination program needs to be reinforced.
Amylases ; Blood Cell Count ; Child* ; Diagnosis ; Disease Outbreaks ; Epidemiology ; Hospitals, University ; Humans ; Immunoglobulin M* ; Mumps* ; Parotid Gland ; Vaccination

Disease Outbreaks* ; Epidemiologic Studies* ; Korea* ; Salmonella enterica* ; Salmonella*

The most feared complication of left ventricular thrombus (LVT) is the occurrence of systemic thromboembolic events, especially in the brain. Herein, we report a patient with severe sepsis who suffered recurrent devastating embolic stroke. Transthoracic echocardiography revealed apical ballooning of the left ventricle with a huge LVT, which had not been observed in chest computed tomography before the stroke. This case emphasizes the importance of serial cardiac evaluation in patients with stroke and severe medical illness.
Brain ; Echocardiography ; Heart Ventricles ; Humans ; Sepsis ; Shock, Septic ; Stroke ; Thorax ; Thrombosis

Childhood Burkitt lymphoma is most often diagnosed in the abdomen, with the majority of intra-abdominal cases arising from the small or large intestines. Involvement of the gastric mucosa is rare. Here, we present a six-year-old boy who was found to have gastric Burkitt lymphoma through biopsy obtained by esophagogastroduodenoscopy. The child was treated with six cycles of chemotherapy without surgery, and he remains free of disease fourteen months since initial diagnosis. Early definitive diagnosis through endoscopic biopsy and appropriate treatment are necessary for rare instances where children present with upper gastrointestinal tract tumors.
Abdomen ; Biopsy ; Burkitt Lymphoma ; Child ; Diagnosis ; Drug Therapy ; Endoscopy ; Endoscopy, Digestive System ; Gastric Mucosa ; Hematemesis ; Hemorrhage ; Humans ; Intestines ; Lymphoma, Non-Hodgkin ; Male ; Stomach Neoplasms ; Upper Gastrointestinal Tract

Intraosseous lipomas are extremely rare and this incidence has been reported to be less than one per 1,000 primary bone tumors. Because of its rarity, information of this tumor is obtained from case reports. We report a case of intraosseous lipoma that developed in the proximal humerus. The patient was a 69-year-old male who had experienced night pain and intermittent pain at the proximal humerus for 10 years. Simple x-ray revealed a well demarcated osteolytic lesion, which was measured 4 cm in width with a central calcific lesion. There was no cortical destruction in the proximal humerus. He was treated by currettage without bone graft, thereafter his symptoms were relieved.
Aged ; Humans ; Humerus* ; Incidence ; Lipoma* ; Male ; Transplants

The efficacy of tandem high-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was investigated in patients with high-risk neuroblastoma. Patients over 1 yr of age who were newly diagnosed with stage 4 neuroblastoma from January 2000 to December 2005 were enrolled in The Korean Society of Pediatric Hematology-Oncology registry. All patients who were assigned to receive HDCT/ASCR at diagnosis were retrospectively analyzed to investigate the efficacy of single or tandem HDCT/ASCR. Seventy and 71 patients were assigned to receive single or tandem HDCT/ASCR at diagnosis. Fifty-seven and 59 patients in the single or tandem HDCT group underwent single or tandem HDCT/ASCR as scheduled. Twenty-four and 38 patients in the single or tandem HDCT group remained event free with a median follow-up of 56 (24-88) months. When the survival rate was analyzed according to intent-to-treat at diagnosis, the probability of the 5-yr event-free survival+/-95% confidence intervals was higher in the tandem HDCT group than in the single HDCT group (51.2+/-12.4% vs. 31.3+/-11.5%, P=0.030). The results of the present study demonstrate that the tandem HDCT/ASCR strategy is significantly better than the single HDCT/ASCR strategy for improved survival in the treatment of high-risk neuroblastoma patients.
Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy/mortality ; Drug Therapy/*mortality ; Female ; Humans ; Infant ; Korea/epidemiology ; Longitudinal Studies ; Male ; Neuroblastoma/*mortality/*therapy ; Prevalence ; Risk Assessment/methods ; Risk Factors ; Stem Cell Transplantation/*mortality ; Survival Analysis ; Survival Rate ; Treatment Outcome

BACKGROUND: Since its reemergence in 1993, a number of cases of Plasmodium vivax malaria have been reported in Korea. We analyzed the cases of malaria patients living in Chuncheon and its neighboring communities, to characterize its clinical manifestations and laboratory findings, and to identify any differences between our clinical findings and those of previous studies. METHODS: We reviewed the clinical records of cases that were confirmed as malaria by peripheral blood smear at Chuncheon Sacred Heart Hospital from July 1998 to September 2001. RESULTS: Forty-four cases were included in the study. All patients were infected with Plasmodium vivax, and presented with high fever; however, tertian fever developed in only 15 patients (35.7%). A number of cases showed various symptoms, which included headache, abdominal pain, nausea and vomiting. Of the 44 cases identified, 41 (93.2%) developed malaria between June and September. Thrombocytopenia was a prominent finding in 75% of the cases at diagnosis, but resolved during or after therapy. Other laboratory abnormalities such as, anemia, elevated transamines, coagulopathies, and elevated lactose dehydrogenase (LDH) were also noted. Cerebrospinal fluid (CSF) studies were performed in five cases, one of which showed pleocytosis in the CSF. CONCLUSION: We noted only 15 patients (35.7%) with tertian fever; the other patients showed variable fever patterns. Thrombocytopenia was the most prominent laboratory finding. Therefore, we suggest that malaria should be included in the differential diagnosis of febrile diseases with an onset between June to and September, regardless of the pattern of the fever.
Adult ; Animals ; Comparative Study ; Diagnosis, Differential ; Female ; Human ; Malaria/blood/cerebrospinal fluid/*diagnosis/*microbiology ; Male ; Plasmodium vivax/*isolation & purification ; Retrospective Studies ; Thrombocytopenia/diagnosis