No abstract available.
Lymphadenitis*

BACKGROUND: Hemodilution reduces the concentration of clotting factors in blood and this may induce some degree of impairment of coagulation. But there are some evidence that hemodilution may induce a hypercoagulable state. The goal of this study is to investigate the changes of coagulation status during progressive hemodilution. METHODS: Whole Blood was diluted by 10% increment to 80% with 0.9% normal saline. At each 10% dilution blood coagulation status was analysed using thrombelastography (TEG) and was compared with that of an undiluted control specimen obtained concurrently from the same patients. RESULTS: Hemodilutions up to 40% decrease r and K times and increase values of MA and angle. Hemodilutions more than 70% increase r and K times and decrease values of MA and angle. CONCLUSIONS: Hemodilutions up to 40% increase coagulability and hemodilutions more than 70% decrease coagulability of whole blood in vitro.
Blood Coagulation ; Hemodilution* ; Humans ; Thrombelastography

Purpose: To retrospectively evaluate the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in patients with mild clinical symptoms at a single hospital in South Korea. Materials and Methods: CT scans of 87 COVID-19 patients [43 men and 44 women; median age:41 years (interquartile range: 26.1–51.0 years)] with mild clinical symptoms (fever < 38℃ and no dyspnea) were evaluated. Results: CT findings were normal in 39 (44.8%) and abnormal in 48 (55.2%) patients. Among the 48 patients with lung opacities, 17 (35.4%) had unilateral disease and 31 (64.6%) had bilateral disease. One (2.1%) patient showed subpleural distribution, 9 (18.8%) showed peribronchovascular distribution, and 38 (79.2%) showed subpleural and peribronchovascular distributions.Twenty-two (45.8%) patients had pure ground-glass opacities (GGOs) with no consolidation, 17 (35.4%) had mixed opacities dominated by GGOs, and 9 (18.8%) had mixed opacities dominated by consolidation. No patients demonstrated consolidation without GGOs. Conclusion The most common CT finding of COVID-19 in patients with mild clinical symptoms was bilateral multiple GGO-dominant lesions with subpleural and peribronchovascular distribution and lower lung predilection. The initial chest CT of almost half of COVID-19 patients with mild clinical symptoms showed no lung parenchymal lesions. Compared to relatively severe cases, mild cases were more likely to manifest as unilateral disease with pure GGOs or GGOdominant mixed opacities and less likely to show air bronchogram.

Lymphangioma of the stomach is known to be extremely rare, benign tumor, reported only 13 cases now, worldwidely, The lesions are soft, sponge like, and pinkish colored and filled with watery fluid exudates. The histologic examination reveals that lymphangiomas are composed of endothelium-lined spaces that contain a eosinophilic protein-rich fluid. They usually present as polypoid lesions because they are originated from submucosal layer. By endoscopy, they appear as smooth, soft, polypoid submucosal mass. The endoscopic ultrasonographic findings of gastric lyrnphangioma were cystic mass with multi-septation originated from submucosal layer of the stomach. Recently, We experienced a case of lymphangioma associated with early gastric cancer of the stomach. So we report this case with brief review of world literature.
Endoscopy ; Eosinophils ; Exudates and Transudates ; Lymphangioma* ; Porifera ; Stomach ; Stomach Neoplasms

BACKGROUND/AIMS: To evaluate the role of hepatitis B virus(HBV) and hepatitis C virus(HCV) in the development of hepatocellular carcinoma(HCC) in Korea, we investigated the status of HBV and HCV infection in Korean patients with HCC. METHODS: HBV DNA and HCV DNA were detected in the scrum from 45 unseiected patients with HCC.' by polymerase chain reaction. RESULTS: Among 45 patients with HCC, 31 paticnts(68.9%) were positive for serum HBsAg. HBV DNA was detected in 24(77.4%) ot 31 HBsAg-positive patients and 6(42.8%) of 14 HBsAg-negative patients. Thirty-three patients(82.2'%) were positive for HBsAg and/or HBV DNA. Among 45 patients, anti-HCV was positive in 7 patients(15.5%) by first generation enzyme-linked immunoassay(EIA) and in 11 patients(24.4%) by second generation EIA. Anti-HCV positive patients by first generation EIA were all positive for anti-HCV by second generation EIA. HCV RNA was detected in 4 of ll anti-HCV-positive patients and 4 patients of 34 anti-HCV-negative patients. Among 45 patients, tifteen patients(33.3%) were positive for anti-HCV and/or HCV RNA. HCV infection was evident for 9(24.3%) of 37 patients with HBV infection and 6(75%) of 8 patients without HBV intection. Among 45 patients with HCC, only two patients(4.5%) were all negative for HBsAg, anti-HCV, HBV DNA and HCV RNA. CONCLUSIONS: These data suggest that HBV is thc main etiologic factor for HCC and HCV is considered another risk factor in some patients without evidence of HBV infection. HBV and HCV could be detected in spite of the absence of serological marker tor viral iinfection.
Carcinoma, Hepatocellular* ; DNA ; Dronabinol ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis C ; Hepatitis* ; Humans ; Korea ; Polymerase Chain Reaction ; Risk Factors ; RNA

The coronavirus disease 2019 (COVID-19) has been a major public health emergency worldwide. Vaccines were rapidly developed and approved to prevent the spread of viral infection. However, various side effects of the COVID-19 messenger RNA (mRNA) vaccines have been reported after their commercialization. A 24-year-old man visited our emergency department with polyuria and polydipsia that occurred after he received a COVID-19 mRNA vaccine 10 days beforehand. The initial laboratory findings showed very low urine osmolality with hyperosmolar hypernatremia. Based on these findings, diabetes insipidus was suspected, and sella magnetic resonance imaging showed an enlarged pituitary gland and the absence of posterior pituitary higher intensity. After 12 hours of using oral desmopressin acetate, urine volume decreased, and after 5 days of administration, serum electrolyte and serum osmolality improved. This case report of diabetes insipidus occurring after vaccination with the BNT162b2 mRNA COVID-19 vaccine is presented as a reminder that close monitoring is necessary for patients with polyuria and polydipsia after vaccination.

BACKGROUND: Stenotrophomonas maltophilia is a gram-negative bacillus that has become increasingly recognized as an important nosocomial pathogen, particularly in individuals with severe debilitation or immunosuppression. S. maltophilia is also characterized by its resistance to multiple antibiotics. S. maltophilia peritonitis in CAPD (continuous ambulatory peritoneal dialysis) patients is associated with a poor prognosis and loss of CAPD catheter. No report concerning this entity has been presented in Korea. Therefore, we describe and discuss five cases of the S. maltophilia infection associated with CAPD in three patients with peritonitis and two with exit-site infections. METHODS: We performed a retrospective search for episodes of S. maltophilia infections related to CAPD in our renal unit. The baseline levels of hemoglobin, albumin, cholesterol, BUN and creatinine were compared with age, sex and, if possible, the underlying disease-matched controls. RESULTS: All the patients with S. maltophilia peritonitis had diabetes mellitus as the underlying disease. The individual patients also had other significant combined morbidities, such as panhypopituitarism, COPD chronic obstructive pulmonary disease, cerebrovascular accident and myocardial infarction. The level of hemoglobin in these patients was significantly lower than in the controls, and the mean values of serum albumin, creatinine and BUN were also low. CONCLUSION: Immune dysfunction due to uremia, anemia, malnutrition, other comorbidities (e.g. diabetes mellitus), and also, an indwelling peritoneal catheter may be predisposing factors for the S. maltophilia infection in CAPD patients. Once the S. maltophilia infection is diagnosed in CAPD patient, the patient should be treated based on the understanding of this particular organism.
Adult ; Anti-Bacterial Agents/therapeutic use ; Biological Markers/blood ; Diabetes Complications/therapy ; Drug Resistance, Microbial ; Female ; Gram-Negative Bacterial Infections/blood/drug therapy/etiology/*microbiology ; Humans ; Korea ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects ; Peritonitis/blood/drug therapy/etiology/*microbiology ; Retrospective Studies ; Risk Factors ; *Stenotrophomonas maltophilia ; Treatment Failure

A 32-year-old pregnant woman (34 + 5 weeks) was admitted with dizziness, nausea, and vomiting. Previously, she was diagnosed with gestational diabetes mellitus at 28 weeks with 100 g-OGTT and insulin therapy was started. Her average fasting glucose level was 97 mg/dL and postprandial 1-hour glucose level was 130 mg/dL with basal-bolus insulin therapy (total dose of 28-30 IU/day). At 34 + 0 weeks of gestational age, polyuria and unexpected weight loss (2 kg/week) with hyperglycemia occurred, and total dose of daily insulin requirement was increased up to 50 IU/day. At admission, her serum glucose level was high (502 mg/dL), and urinalysis revealed ketonuria +3. Arterial blood gas analysis revealed pH of 6.83, pCO2 of 9 mmHg, and bicarbonate of 2 mmol/L with an anion gap of 23.5 mmol/L. The diagnosis of diabetic ketoacidosis was established and emergency caesarean section was conducted due to fetal distress. She was finally diagnosed with fulminant type 1 diabetes mellitus, and multiple daily insulin injection therapy was continued after delivery.
Acid-Base Equilibrium ; Adult ; Blood Gas Analysis ; Blood Glucose ; Cesarean Section ; Diabetes Mellitus, Type 1 ; Diabetes, Gestational* ; Diabetic Ketoacidosis ; Diagnosis ; Dizziness ; Emergencies ; Fasting ; Female ; Fetal Distress ; Gestational Age ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hyperglycemia ; Insulin ; Ketosis ; Nausea ; Polyuria ; Pregnancy* ; Pregnant Women ; Urinalysis ; Vomiting ; Weight Loss

OBJECTIVES: The purpose of this study was to compare the differences in bone mineral density (BMD), T-scores, and the prevalence of osteopenia and osteoporosis between mountain villagers and seaside villagers. MATERIALS & METHODS: Four hundred fifty-one postmenopausal women (138 women in mountain villagers and 313 women in seaside villagers) were examined, including women > 50 years of age. The study subjects were recruited from the women who had received care at the health examination center of our hospital between January 2005 and September 2009. The BMD was measured at lumbar 1-4 by dual-energy X-ray absorptiometry.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic ; Female ; Humans ; Osteoporosis ; Prevalence ; Spine

We compared the glycemic efficacy of treatment intensification between quadruple oral antidiabetic drug therapy and once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus refractory to triple oral therapy. For 24 weeks, changes in glycosylated hemoglobin (HbA1c) from baseline were compared between the two treatment groups. Of all 96 patients, 50 patients were treated with quadruple therapy, and 46 were treated with GLP-1RA therapy. Reductions in HbA1c for 24 weeks were comparable (in both, 1.1% reduction from baseline; P=0.59). Meanwhile, lower C-peptide level was associated with a lower glucose-lowering response of GLP-1RA therapy (R=0.3, P=0.04) but not with quadruple therapy (R=–0.13, P=0.40). HbA1c reduction by GLP-1RA therapy was inferior to that by quadruple therapy in the low C-peptide subgroup (mean, –0.1% vs. –1.3%; P=0.04). Treatment intensification by switching to quadruple oral therapy showed similar glucose-lowering efficacy to weekly GLP-1RA-based triple therapy. Meanwhile, the therapeutic response was affected by C-peptide levels in the GLP-1RA therapy group but not in the quadruple therapy group.