Since Combes' first description of hepatitis B virus associated membranous glomerulonephritis, many reports have shown a strong association of hepatitis B virus infection with various types of nephropathies, especially membranous glomerulonephritis and membranoproliferative glomerulonephritis. Recently, the authors experienced a case of membranoproliferative glomerulonephritis, type I in a 16-year-old male patient with persistent HBs and HBe antigenemia. One year prior to admission the patient was told of hepatitis at routine check, but he remained asymptomatic throughout. He was admitted to our hospital with chief complaints of proteinuria and microscopic hematuria found on routine urinalysis. Liver and kidney biopsy revealed chronic persistent hepatitis and membranoproliferative glomerulonephritis type I, respectively. We report a case of hepatitis B virus associated nephropathy with review of the literatures. Considering the endemic nature of hepatitis B virus infection in Korea, the incidence of hepatitis B virus associated nephropathy would be proportionally high in comparison with those of other countries. So, the importance of this entity merits special consideration in our country. Further study concerning pathogenesis, epidemiology, and treatment may be needed.
Adolescent ; Biopsy ; Epidemiology ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Hematuria ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Incidence ; Kidney ; Korea ; Liver ; Male ; Proteinuria ; Urinalysis

Behcet's disease was originally described as a triple symptom complex of oral aphthous ulceration, genital ulceration, and hypopyon iritis. It is now known to have a wide systemic manifestations. Among them, the central nervous system involvement should be diagnosed earlier because of it's lethal potential. Recently the authors experienced a case of Behcet's disease with CNS involvement. A 51-year-old female patient was admitted due to deterioration of mentality and generalized ache since 2 years prior to admission. The findings on physical examination were compatible with Behcet's disease, but without cerebrospinal pleocytosis. The manifestations were improved with medications of prednisolone, chlorambucil, colchicines, but relapsed relapsed 2 months later during subsequent tapering of prednisolone and chlorambucil. The patient is now on medication again. A case of Behcet's disease with CNS manifestations is reported with review of literature.
Behcet Syndrome ; Central Nervous System ; Chlorambucil ; Female ; Humans ; Iritis ; Leukocytosis ; Middle Aged ; Physical Examination ; Prednisolone ; Stomatitis, Aphthous ; Ulcer

Myasthenia gravis is a disorder characterized by fluctuating muscle weakness. This is frequently associated with thymoma or thymic hyperplasia, and thymectomy is an important step of treatment. We present one case of primary wquamous cell carcinoma of the thymus in myasthenia gravis. Review of literature indicate relative good prognosis.
Carcinoma, Squamous Cell* ; Muscle Weakness ; Myasthenia Gravis* ; Prognosis ; Thymectomy ; Thymoma ; Thymus Gland ; Thymus Hyperplasia

PURPOSE: To report a rare case of recurrent alveolar soft-part sarcoma (ASPS) with concurrent involvement of the orbit and multiple sites of the body that was removed successfully by surgery. CASE SUMMARY: A 37-year-old woman presented with diplopia at the left lateral gaze and proptosis of the left eye. Two years earlier, the patient had a mass excision of the right gluteus maximus and the left orbit, and ASPS was histopathologically diagnosed at that time. In addition, the patient had been treated with chemotherapy and radiation therapy. On radiologic examination, recurrent tumor of the left orbit was found and surgically removed. The histopathologic examination showed that tumor cells were arranged in an alveolar pattern divided by fibrous septa and contained abundant granules in the cytoplasm, typically consistent with ASPS. Postoperatively, the symptoms of diplopia and proptosis improved. CONCLUSIONS: ASPS can occur and recur in the orbit as well as systemically. In addition, at the time of surgical removal of ASPS in the orbit, the surgeon should be particularly cautious of massive bleeding.
Adult ; Cytoplasm ; Diplopia ; Exophthalmos ; Eye ; Female ; Hemorrhage ; Humans ; Orbit ; Sarcoma, Alveolar Soft Part ; Viperidae

We studied the incidence and results of treatment of secondary hypertension in Yeungnam University Hospital. Nineteen hundred fifty patients with hypertension were included from march 1990 to march 1994. We analysed the prevalence of secondary hypertension and results of treatment. The incidence of secondary hypertension in Yeungnam University Hospital was six percent. The most common underlying causes of secondary hypertension was renal parenchymal disease. Patients with three forms of potentially reversible secondary hypertension, namely, renovascular hypertension, endocrine disease, exogenous hormone, were assed to determine whether surgery or withdrawal of the exogenous hormane had led to an improvement in blood pressure control. The incidence of secondary hypertension in Yeungnam University Hospital was low(6%), but some of these are curable. Thus it is very inportant that evaluate the secondary hypertension.
Blood Pressure ; Endocrine System Diseases ; Equidae ; Humans ; Hypertension* ; Hypertension, Renovascular ; Incidence ; Prevalence

A 45-year-old woman with a prior history of hysterectomy due to adenomyosis and leiomyomas was presented at our outpatient gynecology clinic 13 months later with sudden lower pelvic discomfort and vaginal bleeding symptoms. The patient underwent vaginal vault biopsy however diagnosis was still uncertain. Additional evaluation was required due to massive rebleeding incidents. After an emergent explorative laparoscopic operation with total excision of the vault, a diagnosis of vaginal vault endometriosis was made. Our theory is that a possible transplantation of endometrial cells during morcellation of the adenomyotic uterus which then may have progressed to iatrogenic endometriosis of the vaginal vault. Therefore, vault endometriosis must be considered in incidences of delayed massive bleeding occurring in post-hysterectomy patients when other diagnoses have been excluded.
Adenomyosis ; Biopsy ; Diagnosis ; Endometriosis* ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Leiomyoma ; Middle Aged ; Outpatients ; Uterine Hemorrhage ; Uterus

BACKGROUND: Several recent studies have demonstrated that left ventricular diastolic dysfunction is major cause of congestive heart failure and may precede systolic dysfunction or without left ventricular hypertrophy in most patients with systemic arterial hypertension. The purpose of this study is to evaluate left ventricular diastolic function in patients with systemic arterial hypertension compared with normal control group using color M-mode Doppler and Doppler echocardiographic studies. METHODS: From October 1994 to August 1995. 53 patients(18 men and 35 women, mean age : 56.1±12.6 years) with essential hypertension and 30 subjects age-matched nomal controls(13 men and 17 women, mean age 55.9±12.3 years) were included in this study. We measured the early propagation slope of LV inflow by color M-mode Doppler Echocadiography and the peak velocities of E and A wave, E/A tatio, deceleration time of E wave, isovolumic relaxation time by Doppler echocardiography. We also studied left ventricular diastolic function in patients with hypertension who were divided two group(Group I : hypertension with left ventricular hypertrophy, Group II : hypertension without left vetricular hypertrophy). RESULTS: 1) Early propagation slope of LV inflow was significantly decreased in patients with hypertension compared with normal control group(57.43±17.15m/secs vs 69.87±12.71m/secs, p < 0.05). 2) Peak velocity of A wave and isovolumic relaxation time were significantly increased in patients with hypertension compared with normal control group(0.79±0.2m/sec vs 0.69±0.17m/sec, 132.96±36.98m/secs vs 108.67±23.30m/secs, p < 0.05), whereas E/A ratio was significantly decreased in patients with hypertension compared with normal control group(0.96±0.42 vs 1.18±0.43, p < 0.05). Peak velocity of E wave and deceleration time of E wave were not significantly different between in patiens with hypertension and normal contral group, but peak velocity of E wave was showed decreasing tendency in patients with hypertension compared with normal contral group(0.75±0.38m/sec vs 0.77±0.17m/sec, p>0.05), whereas deceleration time of E wave was showed increasing tendency in patients with hypertension empared with normal control group(196.57±37.07m/secs vs 189.33±41.35m/secs, p>0.05). 3) Early propagation slope of LV inflow was not significantly different between Group I and Group II, but showing decreasing tendency in Group I compared with Group II(54.72±14.65m/sec vs 60.16±18.96m/sec, p>0.05). Peak velocity of E wave and peak velocity of A wave and E/A ratio and deceleration time were not significantly different between Group I and Group II but peak velocity of E wave and E/A ratio were showed decreasing tendency in Group I(0.65±0.19m/sec vs 0.73±0.22m/sec, 0.86±040 vs 1.04±0.44, p>0.05), whereas peak velocity of A wave and deceleration time of E wave were showed increasing tendency in Group I(0.80±0.20m/sec vs 0.74±0.18m/sec, 199.38±46.45m/secs vs 196.89±24.76m/secs, p>0.05). Only isovolumic relaxation time was significatly increased in Group I compared with Group II(150.63±44.75m/secs vs 120.34±19.77m/secs, p < 0.05). CONCLUSION: Left ventricular diastolic dysfunction may precrede systolic or without left ventricular hypertrophy in patients with systemic arterial hypertension. An early diagnosis of left ventricular diastolic dysfunction, color M-mode Doppler echocardiography and Doppler echocardiography were useful diagnostic stools.
Deceleration ; Early Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Female ; Heart Failure ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Relaxation

Objective: The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. Methods: The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. Results: Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. Conclusion Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

Objective: The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. Methods: The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. Results: Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. Conclusion Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

Among complications of choledochal cysts, malignant transformation is most concerning and management of choledochal cyst now includes complete cyst excision, whenever possible. In cases of choledochal cyst associated with pancreaticobiliary maljunction like our case, cholecystectomy along with the resection of dilatated bile duct and the biliary diversion are generally performed. However, incomplete cyst excision can result in malignant transformation within the remnant cyst. We present the case of cholangiocarcinoma arising from remnant intrapancreatic cyst 15 years after choledochal cyst excision in a patient with Todani type 1 choledochal cyst associated with pancreaticobiliary maljunction. We learn from the case that a careful long-term follow-up is needed in patients with choledochal cysts if residual cyst is remained after excision.
Bile Ducts ; Cholangiocarcinoma* ; Cholecystectomy ; Choledochal Cyst* ; Follow-Up Studies ; Humans ; Pancreatic Cyst