OBJECTIVES: The purpose of this study was to examine the prevalence of allergic rhinitis between urban areas in the adjacent areas to a steel industrial complex and rural areas and the impact of pollutants in the industrialized city on allergic rhinitis. METHODS: From July 28 to August 9 of 2008, 1,043 residents of urban and rural areas in a local community had enrolled in health screening and questionnaire survey. One thousand thirty-three patients also underwent a skin prick test. Prevalence rates of allergic rhinitis were calculated according to residential areas, and the used statistical analysis were Fisher's exact test and chi-square test. RESULTS: In a survey, the fraction of adults, who complained of sneezing, nasal obstruction and rhinorrhea, during a recent 1 year period, showed the significant difference between urban (30.5%) and rural areas (22.4%). The fractions of positive skin prick tests were not different between two areas in each age group. The prevalence of allergic rhinitis was 8.4% in urban areas and 6.9% in rural areas. Considering the age groups, the adults group only showed the significantly higher prevalence of allergic rhinitis in urban areas (8.2% vs. 3.7%). CONCLUSIONS: Unlike the children and adolescents groups, the prevalence of allergic rhinitis in adults group was higher in the industrialized urban areas.
Adolescent ; Adult ; Child ; Humans ; Mass Screening ; Nasal Obstruction ; Prevalence* ; Rhinitis* ; Skin ; Skin Tests ; Sneezing ; Steel

No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

We report a recent case in which ciprofloxacin-resistant Shigella flexneri was isolated from a 23-yr-old female patient with a history of travel to India. Prior to her admission to our internal medicine department, she experienced symptoms of high fever and generalized weakness from continuous watery diarrhea that developed midway during the trip. S. flexneri was isolated from the stool culture. Despite initial treatment with ciprofloxacin, the stool cultures continued to show S. flexneri growth. In the susceptibility test for antibiotics of the quinolone family, the isolate showed resistance to ciprofloxacin (minimum inhibitory concentration [MIC], 8 microg/mL), norfloxacin (MIC, 32 microg/mL), ofloxacin (MIC, 8 microg/mL), nalidixic acid (MIC, 256 microg/mL), and intermediate resistance to levofloxacin (MIC, 4 microg/mL). In molecular studies for quinolone resistance related genes, plasmid borne-quinolone resistance genes such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB were not detected. Two mutations were observed in gyrA (248C-->T, 259G-->A) and 1 mutation in parC (239G-->T). The molecular characteristics of the isolated S. flexneri showed that the isolate was more similar to the strains isolated from the dysentery outbreak in India than those isolated from Korea.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics/metabolism ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/microbiology ; Feces/microbiology ; Female ; Humans ; India ; Mutation ; Quinolones/*pharmacology ; Shigella flexneri/drug effects/*isolation & purification/metabolism ; Travel ; Young Adult

The aortic inclusion technique is frequently used in the original Bentall's procedure for the control of excessive postoperative bleeding. Although this procedure has improved the outcome of patients with aortic root disease, there is a high incidence of both early and late complications, including coronary artery stenosis, kinking or pseudoaneurysm formation at the coronary suture lines. Pseudoaneurysm of the ascending aorta is a relatively rare, but fatal complication, which occurs after wrap-inclusion composite graft replacement. Herein, the case of a 45-year-old female, who developed a perigraft aortic pseudoaneurysm 10 years after a Bentall's procedure (wrap-inclusion technique), but was successfully managed using the Cabrol's method, is reported.
Aneurysm ; Aneurysm, False* ; Aorta ; Coronary Stenosis ; Coronary Vessels* ; Female ; Hemorrhage ; Humans ; Incidence ; Middle Aged ; Sutures ; Transplants

OBJECTIVE: The importance of traumatic dural venous sinus injury lies in the probability of massive blood loss at the time of trauma or emergency operation resulting in a high mortality rate during the perioperative period. We considered the appropriate methods of treatment that are most essential in the overall management of traumatic dural venous sinus injuries. METHODS: We conducted a retrospective review of all cases involving patients with dural venous sinus injury who presented to our hospital between January 1999 and December 2014. RESULTS: Between January 1999 and December 2014, 20 patients with a dural venous sinus injury out of the 1,200 patients with severe head injuries who had been operated upon in our clinic were reviewed retrospectively. There were 17 male and 3 female patients. In 11 out of the 13 patients with a linear skull fracture crossing the dural venous sinus, massive blood loss from the injured sinus wall could be controlled by simple digital pressure using Gelfoam. All 5 patients with a linear skull fracture parallel to the sinus over the venous sinus developed massive sinus bleeding that could not be controlled by simple digital pressure. CONCLUSION: When there is a linear skull fracture parallel to the sinus over the dural venous sinus or a depressed skull fracture penetrating the sinus, the surgeon should be prepared for the possibility of potentially fatal venous sinus injury, even in the absence of a hematoma.
Craniocerebral Trauma ; Emergencies ; Female ; Gelatin Sponge, Absorbable ; Hematoma ; Hemorrhage ; Humans ; Male ; Mortality ; Perioperative Period ; Retrospective Studies ; Skull Fracture, Depressed ; Skull Fractures ; Superior Sagittal Sinus

Eosinophilic endomyocarditis is a manifestation of hypereosinophilic syndrome, characterized by prolonged (>6 months), unexplained peripheral blood eosinophilia (>1,500 cells/mm3) with end-organ damage in unknown causes. We report a case of a 42-year-old patient who developed eosinophilic endomyocarditis following upper respiratory tract symptoms for 2 months. Additionally, endomyocarditis was combined with massive pleural effusion and pericardial effusion, which have not been reported in Korea.
Adult ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome ; Korea ; Pericardial Effusion ; Pleural Effusion ; Respiratory System

BACKGROUND: Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO. METHODS: We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015. RESULTS: A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56). CONCLUSIONS: Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.
Adult* ; APACHE ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hematologic Neoplasms* ; Hemorrhage ; Humans ; Intensive Care Units ; Intracranial Hemorrhages ; Lung Injury ; Male ; Medical Records ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency* ; Retrospective Studies ; Tertiary Care Centers ; Weaning

BACKGROUND: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who underwent surgical revascularization under diagnosis of acute MI. MATERIAL AND METHOD: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. RESULT: WMSI decreased from 1.54+/-4.30 to 1.43+/-0.40 (p<0.001) and LVEF increased from 48.1+/-12.2% to 49.7+/-12.3% after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p= 0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). CONCLUSION: Coronary artery bypass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.
Coronary Artery Bypass ; Diagnosis ; Echocardiography ; Humans ; Myocardial Infarction ; Stroke Volume

Fanconi-Bickel syndrome is a rare autosomal recessive disorder of the carbohydrate metabolism recently demonstrated to be caused by mutations in GLUT2, the gene for the glucose transporter protein 2 expressed in the liver, pancreatic beta islet-cells, intestine and kidney. Typical clinical and laboratory findings of Fanconi-Bickel syndrome are hepatomegaly secondary to glycogen accumulation, glucose and galactose intolerance, fasting hypoglycemia, a characteristic proximal tubular nephropathy and severe short stature. Several cases have been reported in other countries after Fanconi and Bickel in Switzerland first reported this syndrome in 1949. We experienced the first Korean case of Fanconi-Bickel syndrome in a neonate presented with hyperglycemia and hypergalactosemia that was initially diagnosed as transient neonatal diabetes mellitus and galactosemia. We also identified a novel mutation(K5X) in the GLUT2 gene.
Carbohydrate Metabolism ; Diabetes Mellitus* ; Fanconi Syndrome* ; Galactose ; Galactosemias* ; Glucose ; Glucose Transport Proteins, Facilitative ; Glycogen ; Hepatomegaly ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant, Newborn ; Intestines ; Kidney ; Liver ; Switzerland

The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CABG). We present the case of a 57-year-old man who underwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation. The patient was successfully treated surgically. This report describes a patient who developed potentially fatal dehiscence of SVGs secondary to infection and outlines preventive and management strategies for this complication.
Catheters ; Containment of Biohazards ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Middle Aged ; Pericardium ; Renal Dialysis ; Rupture ; Saphenous Vein ; Sepsis* ; Transplants