We already achieved the goal of the elimination of leprosy that was recommended by WHO. But the amazing change of our country's situation of the economical & social conditions makes the need of the migrant worker. Especially, the portion of migrant workers form India, Nepal, Indonesia, Philippines, Bangladesh, & Vietnam, the countries of relatively high prevalence rate of Hansen's disease are increasing among them recently. It means the attention about the influx of Hansen's disease form the foreign countries. We perform the survey for Hansen's disease of the migrant worker. Total 603 workers were surveyed. We found only 4 persons, that had the high titer(above 500) of the result of PGL-1 ELISA, and only 3 persons, that had some findings, the suggestive finding of Hansen's disease, of cutaneous & neurological symptoms. In spite of the special study, we did not conform the diagnosis of Hansen's disease among them. During this survey, we did not find the conformed patients of Hansen's disease. But we think that we will be concerned about the influx of Hansen's disease from foreign countries, because of the recently significance change of the epidemiological situations of Hansen's disease in Korea.
Bangladesh ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; India ; Indonesia ; Korea ; Leprosy* ; Nepal ; Philippines ; Prevalence ; Social Conditions ; Transients and Migrants* ; Vietnam

PURPOSE: An outbreak of influenza virus is uncommon in neonatal intensive care unit (NICU). The clinical presentation of influenza virus infection in neonates is diverse. This study was aimed to report an outbreak of influenza A in a NICU and to investigate the clinical characteristics of influenza virus infection in neonates especially preterm infants during the 2011-2012 influenza season in Korea. METHODS: We reviewed the medical records of 29 patients who were evaluated by respiratory virus multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) at NICU of Kosin University Gospel Hospital during the 2011-2012 seasonal influenza outbreak in Korea. RESULTS: Eleven patients (37.9%) were influenza A virus RT-PCR positive during the survey periods. They were all preterm infants and three of them had no symptoms. Eight patients had symptoms and it was fever (18%, 2/11), respiratory difficulty (72.7%, 8/11) without symptoms of upper respiratory infection, and gastrointestinal symptoms (27.3%, 3/11). The median duration of symptom was 5 days. There were differences of duration of admission at the test of respiratory RT-PCR, Clinical Risk Index for Babies (CRIB) score, use of mechanical ventilation, and use of dexamethasone before infection between influenza A virus RT-PCR positive and negative group. All 11 patients with influenza A were discharged without any complications. CONCLUSIONS: The symptoms of influenza A virus infection in the preterm infants is nonspecific. Influenza A virus should be considered as a possible cause of infection in NICU during the influenza season in the community.
Dexamethasone ; Fever ; Humans ; Infant, Newborn ; Infant, Premature ; Influenza A virus ; Influenza, Human* ; Intensive Care Units ; Intensive Care, Neonatal* ; Korea* ; Medical Records ; Orthomyxoviridae ; Respiration, Artificial ; Seasons*

PURPOSE: Sclerotherapy for renal cysts was performed, using 50% acetic acid as new sclerosing agent. Wereport the methods and results of this procedure. MATERIALS AND METHODS: Fifteen patients underwent sclerotherapyfor renal cyst, using 50% acetic acid. Because four patients were lost to follow-up, only 11 of the 15 wereincluded in this study. The renal cysts, including one infected case, were diagnosed by ultrasonograpy (n=10) ormagnetic resonance imaging (n=1). The patient group consisted of four men and seven women (mean age, 59 years;range, 23-77). At first, the cyst was completely aspirated, and 25 volume% of aspirated volume was replaced with50% sterile acetic acid through the drainage catheter. During the following 20 minutes, the patient changedposition, and the acetic acid was then removed from the cyst. Finally, the drainage catheter was removed, aftercleaning the cyst with saline. After treatment of infection by antibiotics and catheter drainage for 7 days,sclerotherapy in the infected case followed the same procedure. In order to observe changes in the size of renalcysts and recurrence, all patients were followed up by ultrasound between 2 and 8 months. We defined response totherapy as follows: complete regression as under 5 volume%, partial regression as 5-50 volume% and no response asmore than 50 volume% of initial cyst volume. RESULTS: No clinically significant complication occured during theprocedures or follow-up periods. All cysts regressed completely during follow-up of 8 months. Complete regressionoccurred as follows : two cysts at 2 months, seven cysts at 4 months, two cysts at 6 months. Two cysts showedresidues at the last follow-up, at 4 and 6 months, respectiivery. The volume of residual cysts decreased to under5 volume% of initial volume, however. Completely regressed cysts did not recurr during follow-up. CONCLUSION: Acetic acid sclerotherapy for renal cysts showed good results, regardless of the dilntion of sclersoing agent withresidual cyst fluid, and no significant complications. the procedure, therefore, appears to provide effectivetherapy for renal cysts.
Acetic Acid* ; Anti-Bacterial Agents ; Catheters ; Cyst Fluid ; Drainage ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Male ; Recurrence ; Sclerotherapy ; Ultrasonography

PURPOSE: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. METHODS: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. RESULTS: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). CONCLUSION: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.
Charcoal ; Emergency Service, Hospital ; Epidemiology ; Gastric Lavage ; Hospitalization ; Hospitals, Teaching ; Humans ; Hypnotics and Sedatives ; Pesticides ; Poisoning* ; Public Health ; Retrospective Studies* ; Suicide

PURPOSE: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. METHODS: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. RESULTS: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). CONCLUSION: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.
Charcoal ; Emergency Service, Hospital ; Epidemiology ; Gastric Lavage ; Hospitalization ; Hospitals, Teaching ; Humans ; Hypnotics and Sedatives ; Pesticides ; Poisoning* ; Public Health ; Retrospective Studies* ; Suicide

Objectives: . Balloon Eustachian tuboplasty (BET) is a novel treatment method for Eustachian tube dilatory dysfunction (ETD). However, surgeons cannot identify the insertion depth of the catheter during BET, resulting in potential risks such as internal carotid artery (ICA) injury. Therefore, we developed an image-guided navigation balloon catheter to identify the insertion depth of the catheter and to establish awareness of the proximity of the ICA. This study aimed to evaluate the technical feasibility of this image-guided navigation balloon catheter system in patients with ETD. Methods: . Twenty-nine patients (38 ears; nine bilateral; 21 right ears, and 17 left ears) diagnosed with ETD were assessed. All patients who showed no improvement despite medical therapy with topical steroids, anti-reflux medication, and the Valsalva maneuver for a minimum of 6 weeks received image-guided navigation-assisted BET. The 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score and Valsalva maneuver were used to evaluate patients’ symptoms preoperatively and at the postoperative follow-up. Results: . Image-guided navigation-assisted BET was safely performed in all patients. The mean total ETDQ-7 score was 25.4±7.1 preoperatively, 17.5±6.2 at 1 month, and 15.2±7.0 at 6 months (P<0.001). In total, a Valsalva maneuver was possible for 28 of 38 ears (73.7%) at the time of the patient’s final visit at 6 months post-procedure. Conclusion . Image-guided navigation balloon catheters are a potentially valuable tool in patients with ETD. Their use is also technically feasible and safe when performing BET to treat ETD.

Bilateral internal auditory canal (IAC) tumors are usually pathognomonic for vestibular schwannomas in the setting of neurofibromatosis type 2 (NF2). Descriptions of bilateral nonschwannomatous IAC tumors, such as metastasis that may mimic NF2, are limited to case reports. Here, we report a case of unusual metastatic bilateral IAC tumor originating from the ovary with a rapidly progressive pattern, which we initially suspected to be NF2.

Paragangliomas, a term used for tumors of extra-adrenal origin, are chromaffin cell tumors that secrete catecholamines. Approximately one in three patients with paraganglioma has a gene mutation associated with familial paraganglioma syndromes (FPGLs), resulting from mutations in one of the subunits of the succinate dehydrogenase (SDH) gene. Most extraadrenal paragangliomas involve the head and neck, and only 2% of paragangliomas are found in the mediastinum. We report the case of a 37-year-old woman with a posterior mediastinal paraganglioma attached to the heart and recurrent glomus jugulare who underwent glomus tumor resection at the age of 17 years. Genetic testing revealed a mutation in the SDH subunit B gene associated with FPGL type 4 (FPGL4). This case report describes the features of multimodal imaging of a posterior mediastinal paraganglioma and explain how a multidisciplinary approach led to the diagnosis of FPGL4.

We investigated the potential association between ketonuria during treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors and its renoprotective effect in patients with type 2 diabetes. We included 192 patients who had received SGLT2 inhibitors for more than 6 months. After propensity score matching, 52 patients each were allocated into groups with or without ketonuria, respectively. The estimated glomerular filtration rate exhibited a significant improvement only in subjects with ketonuria (without ketonuria: mean difference, –0.02 mL/min/1.73 m2 [95% confidence interval (CI), –3.87 to 3.83 mL/min/1.73 m2] vs. with ketonuria: mean difference, 6.81 mL/min/1.73 m2 [95% CI, 3.16 to 10.46 mL/min/1.73 m2]; P<0.001). Improvement in estimated glomerular filtration rate at 6 months was associated with female sex and lower baseline body weight, blood pressure, and triglyceride levels in patients with ketonuria. In conclusion, the presence of ketonuria was associated with the renoprotective effect of SGLT2 inhibitors, and female sex and the absence of metabolic syndrome components may serve as additional indicators of these medications’ substantial renoprotective effects in individuals with ketonuria.