No abstract available.
Nocardia Infections*

A 69-year-old male patient presented with a 2 week history of left leg swelling. The past medical history was unremarkable. On physical examination, his left leg was swollen up to the thigh and Homan's sign was positive. Duplex ultrasound revealed a solid and cystic lesion localized only at the iliac vein. Surgical exploration was performed under the suspicion of adventitial cystic disease (ACD). The final pathologic diagnosis was ACD. Although ACD has usually been reported in arterial segments, venous involvement has been reported. In the majority of these reported patients, the common femoral vein is associated with venous ACD. According to a Medline search, there have been nine reports related with venous ACD. Only two cases of external iliac vein (EIV) involvement of ACD have been previously reported, including one Korean report. We report here on a case of recently experienced EIV ACD.
Aged ; Edema ; Femoral Vein ; Humans ; Iliac Vein ; Leg ; Male ; Physical Examination ; Thigh

No abstract available.

Purpose: To investigate the association of the preoperative fat-to-orbit ratio on the outcome of endoscopic orbital decompression in patients with thyroid-associated orbitopathy (TAO). Methods: Between January 2021 and December 2022, 36 patients with TAO, 72 eyes in total, underwent endoscopic orbital decompression at our hospital’s ophthalmology department. We calculated fat-to-orbit ratios using two-dimensional facial computed tomography scans, and conducted both preoperative and postoperative measurements of proptosis and the prism cover test. We used binominal logistic regression analysis to examine the correlation between the ratios and postoperative complications (diplopia, strabismus, lid retraction) following the surgery. Furthermore, simple linear regression analysis was used to assess the relationship between the ratios and change in exophthalmos. Results: The regression indicated significant associations between the ratio and the onset of postoperative complications such as new-onset postoperative diplopia (NOPD) (β = -0.098, p = 0.029), postoperative strabismus (β = -0.123, p = 0.009), and eyelid retraction (β = -0.188, p = 0.002), particularly in cases requiring subsequent strabismus or eyelid retraction surgery after the initial procedure. Conclusions The preoperative fat-to-orbit ratio is a significant predictor of postoperative complications such as NOPD, strabismus surgery and eyelid retraction surgery in patients undergoing endoscopic orbital decompression for thyroid eye disease. Therefore, it should be considered a valuable indicator of surgical outcomes and complications in such patients.

A 62-year-old male with a smoking history of 30 pack-years presented with a 1-year history of a periumbilical pulsating mass. He had been treated for hypertension for 2 years. Physical examination revealed a huge pulsating mass in the periumbilical abdomen. Femoral and popliteal arterial pulses were palpable. Computed tomography showed arterial dissection in the proximal segment of the superior mesenteric artery, a huge aneurysm (52×50 mm) with mural thrombus and two smaller aneurysms (20×20 mm) in the right ileocolic and ileal branches, along with atherosclerotic changes. Interposition using the great saphenous vein was performed after aneurysmal isolation and ligation of jejunal branches in the sac. Distal flow was reestablished by end-to-end and end-to-side anastomoses of the right ileocolic and ileal branches, respectively. No complications were observed at 1-year follow-up.
Abdomen ; Aneurysm* ; Aortic Aneurysm, Abdominal* ; Follow-Up Studies ; Humans ; Hypertension ; Ligation ; Male ; Mesenteric Artery, Superior* ; Middle Aged ; Physical Examination ; Saphenous Vein ; Smoke ; Smoking ; Thrombosis

No abstract available.
Intussusception*

Ludwig’s angina is a rapidly progressive and gangrenous cellulitis in the submandibular, sublingual spaces, and neck. It is characterized by an elevated tongue and laryngeal edema, resulting in airway compromise and, rarely, in sudden death. The most common cause is an odontogenic infection of a molar tooth. Infection can spread to the superior mediastinum and buccal area through anatomical structures. Herein, we report the sudden death of a 45-year-old male who was not diagnosed with Ludwig’s angina. He died in the emergency room 20 minutes after loss of consciousness. Intubation was impossible owing to severe laryngeal edema. The C-reactive protein level was 33.81 mg/dL. On autopsy, a diffuse light green abscess of the submandibular space was detected, along with severe edema of the epiglottis, aryepiglottic fold, and vocal cords. Subsequently, we confirmed that the airway obstruction was caused by Ludwig’s angina based on a literature review. In conclusion, this report emphasizes the need to identify the infection source and perform a detailed dissection according to the anatomical structure in the autopsy procedure for Ludwig’s angina.

BACKGROUND: Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC), however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, arid survival of concurrent chemotherapy with etoposide and cisplatin(EP) arid radiation therapy for unresectable stage III NSCLC. METHODS: Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without, malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide arid cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. RESULTS: Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient The median survival was l2.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia(> or = grade 3,46%) Thrombocytopenia over grade 3 was found in 1%. Radiation pneumonitis occurred in 13 patients(46%). CONCLUSION: Concurrent chemotherapy(EP) pins radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Etoposide* ; Humans ; Lung Neoplasms ; Pleural Effusion, Malignant ; Radiation Pneumonitis ; Radiotherapy ; Survival Rate ; Thorax ; Thrombocytopenia

OBJECTIVE: To estimate the annual economic costs attributable to cigarette smoking in Korea. METHODS: The costs were classified as being direct medical and non-medical costs, indirect costs and others. We focused on those costs related that are incurred in the treatment of selected diseases (cardiovascular diseases, respiratory diseases, and cancers), which have been proven to be caused by smoking. In addition to the basic costs of treatment, the additional amount of costs occurred due to smoking was obtained by computing the population attributable risk (PAR%) caused by smoking. To compute the PAR%, relative risks of smoking to the number of outpatient visits, hospitalizations, and the death were estimated using the Cox proportional hazard model, respectively. Our major data source was the 'Korea Medical Insurance Corporation (KMIC) cohort study,' which was composed of a total of 115,682 male and 67,932 female beneficiaries who had complete records of their smoking histories in the year of 1992. RESULTS: The annual costs that could be attributable to smoking were estimated to be in the range of 2,847,500 million Won to 3,959,100 million Won. The maximum estimate of 3,959,100 million Won includes 233,100 million Won for medical costs, 5,100 million Won for transportation costs, 27,600 million Won for care giver's economic costs, 69,100 million Won in productivity loss, 3,435,000 million Won lost because of premature death, 172,100 million Won in costs resulting from passive smoke inhalation and 17,100 million Won for costs that resulted from fires that were caused by careless smoking. CONCLUSION: Our study confirms that the magnitude of the economic burden of smoking to Korean society is substantial. Therefore, this study provides strong evidence that there is a strong need for a national policy of tobacco control in Korea.
Cohort Studies ; Data Collection ; Efficiency ; Female ; Fires ; Hospitalization ; Humans ; Inhalation ; Insurance ; Korea* ; Male ; Mortality, Premature ; Outpatients ; Proportional Hazards Models ; Smoke* ; Smoking* ; Tobacco ; Transportation

OBJECTIVE: To analyse neonatal outcomes of the very low birthweight infants born to women who underwent an indicated preterm delivery and spontaneous preterm delivery. METHODS: We performed an observational study of 150 very low birthweight(<1500 grams) infants delivered at Samsung Medical Center. The study population was limited to singleton infants without major congenital anomalies. The primary reason for delivery was categorized as indicated preterm delivery or spontaneous preterm delivery. Selected neonatal outcomes were compared between infants born to women in each of these groups. RESULTS: Univariate analyses showed some survival benefits in infants born to women who underwent indicated preterm delivery. Selected neonatal outcomes, however, did not differ between the groups in the multiple logistic regression analysis. CONCLUSION: There was no survival advantage to the very low birthweight infants born to women who underwent an indicated preterm delivery compared to those born to women with spontaneous preterm delivery.
Female ; Humans ; Infant* ; Logistic Models ; Observational Study