Perihepatic capsulitis is associated with various diseases, such as Fitz-Hugh-Curtis syndrome, systemic lupus erythematosus, perforated cholecystitis, perforated hepatic abscess, and tuberculous peritonitis. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and is characterized by the widespread millet-like hematogenous dissemination of Mycobacterium tuberculosis. We describe a 24-year-old virgin patient presenting with right upper quadrant and costovertebral angle pain. Diffuse perihepatic capsular enhancement was observed in abdominal computed tomography scans. Chest radiography showed miliary tuberculosis, and a polymerase chain reaction hybridization assay of sputum revealed the presence of M. tuberculosis. Symptoms improved after administering anti-tuberculosis medications. This report describes a rare case of miliary tuberculosis accompanying perihepatitis.
Cholecystitis ; Humans ; Liver Abscess ; Lupus Erythematosus, Systemic ; Mycobacterium tuberculosis ; Peritonitis, Tuberculous ; Polymerase Chain Reaction ; Radiography ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Miliary ; Young Adult

No abstract available.
Extracorporeal Membrane Oxygenation ; Stents

The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.
Biopsy ; Body Weight ; Cyclosporine ; Edema ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Leg ; Oliguria ; Porphyrins ; Prednisolone ; Weight Gain

OBJECTIVE: Cerebral vasospasm still remains a major cause of the morbidity and mortality, despite the developments in treatment of aneurysmal subarachnoid hemorrhage. The authors measured the utility and benefits of external lumbar cerebrospinal fluid (CSF) drainage to prevent the clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage in this randomized study. METHODS: Between January 2004 and March 2006, 280 patients with aneurysmal subarachnoid hemorrhage were treated at our institution. Among them, 107 patients met our study criteria. The treatment group consisted of 47 patients who underwent lumbar CSF drainage during vasospasm risk period (about for 14 days after SAH), whereas the control group consisted of 60 patients who received the management according to conventional protocol without lumbar CSF drainage. We created our new modified Fisher grade on the basis of initial brain computed tomography (CT) scan at admission. The authors established five outcome criteria as follows : 1) clinical vasospasm; 2) GOS score at 1-month to 6-month follow-up; 3) shunt procedures for hydrocephalus; 4) the duration of stay in the ICU and total hospital stay; 5) mortality rate. RESULTS: The incidence of clinical vasospasm in the lumbar drain group showed 23.4% compared with 63.3% of individuals in the control group. Moreover, the risk of death in the lumbar drain group showed 2.1% compared with 15% of individuals in the control group. Within individual modified Fisher grade, there were similar favorable results. Also, lumbar drain group had twice more patients than the control group in good GOS score of 5. However, there were no statistical significances in mean hospital stay and shunt procedures between the two groups. IVH was an important factor for delayed hydrocephalus regardless of lumbar drain. CONCLUSION: Lumbar CSF drainage remains to play a prominent role to prevent clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage. Also, this technique shows favorable effects on numerous neurological outcomes and prognosis. The results of this study warrant clinical trials after endovascular treatment in patients with aneurysmal SAH.
Aneurysm ; Brain ; Drainage ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Length of Stay ; Prognosis ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial

Synovial sarcomas are rare soft tissue malignancies arising from tendons, tendon sheaths, and bursal structures. These tumors usually develop in the extremities of adolescents and young adults. Uncommonly, these tumors may arise in the head and neck approximately 9% of all synovial sarcomas. Most common sites of head and neck synovial sarcomas are hypopharynx and surrounding structures of paranasal sinuses. However, frontal bone without involving paranasal sinus is extremely rare. We report a case of biphasic synovial sarcoma of the frontal bone discuss the clinical and pathologic features of this case with the literature review.
Adolescent ; Aged* ; Extremities ; Frontal Bone* ; Head ; Humans ; Hypopharynx ; Neck ; Paranasal Sinuses ; Sarcoma, Synovial* ; Tendons ; Young Adult

BACKGROUND: Obesity has been generally diagnosed by 'Body Mass Index (BMI)' in primary care. Recently the use of Bioelectrical Impedance Analyzer' has become popular in Korea to evaluate body fat rate (BFR), as cost is inexpensive and the method to use is simple. As a result, the opposed finding of normal BMI and elevated BFR vice versa in same individuals are being encountered frequently. We designed this study to find out the characteristics and cardiovascular risk of people in these groups. METHODS: The medical records of health promotion center were obtained and 22,704 applicants visitor who undeerwent health risk questionnaire, screening tests and physical examination for cardiovascular disease were reviewed. RESULTS: After adjusting for age, sex, exercise and education level, cardiovascular risk such as hypertension, DM, and hypercholesterolemia, LDL tended to increase linearly and HDL tended to decrease linearly with increase of BFR or BMI. In comparison with normal BMI and BFR group, the odds ratios of normal BMI and elevated BFR group or vice versa were increased. CONCLUSION: If either one of BMI or BFR of a person was elevated, even though the other was within normal range, the cardiovascular risk of that person was shown to be high.
Adipose Tissue* ; Body Mass Index* ; Cardiovascular Diseases ; Education ; Electric Impedance ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Mass Screening ; Medical Records ; Obesity ; Odds Ratio ; Physical Examination ; Primary Health Care ; Reference Values ; Risk Factors* ; Surveys and Questionnaires

BACKGROUND: The purpose of this study was to evaluate the applicability of the Korean version of Fall Efficacy scale(FES) and Activities-specific Balance Confidence Scale(ABC) to Korean older adult through an examination of instrument`s internal consistency and validity METHOD: A sample of 90 Korean older adults who lived in a community completed a survey instrument which included Korean version of FES and ABC. Because of comparable data derived from each scale, fear of falling and quality of life, activity daily living were included. Concurrent validity, criterion validity and correlational validity were tested. Reliability was tested by internal consistency, test-retest method. RESULTS: Cronbach`s alpha was 0.9043 in FES, and 0.99623 in ABC. Test-retest correlations in all scales were higher than 7.0. Statistically significant association was found between fear of falling and both scales. Correlation coefficient between Quality of life(SF-8) and ABC was -0.142(p=0.049). Both FES and ABC are correlated significantly each other. CONCLUSION: The Korean version of FES and ABC appears to be a reliable and valid method for meas- uring fear of falling. These instruments may be useful in assessing the independent contribution of fear of falling. ABC scale may be more useful to detect loss of balance confidence in more highly functioning seniors.
Adult ; Humans ; Quality of Life ; Reproducibility of Results* ; Weights and Measures

BACKGROUND: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone. METHODS: We screened adults over 20 years who were visited the health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression. RESULTS: Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P<0.05). Multiple logistic regression showed that prevalence of asymptomatic gallstones was increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose. CONCLUSION: Associated factors of prevalence of asymptomatic gallstone were increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose, and were not different from those in West countries. further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to asymptomatic gallstone.
Adult ; Blood Glucose ; Cholesterol ; Eating ; Fasting ; Gallbladder ; Gallstones* ; Health Promotion ; Humans ; Korea ; Logistic Models ; Prevalence* ; Smoke ; Smoking ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

OBJECTIVES: The evaluations of the pathogenetic roles of cell mediated immunity and of the preventive effect for disease progression with interferon(IFN) treatment in patients with chronic active hepatitis-B(CAH-B) are the objectives of this study. METHODS: Thirty-two patients with CAH-B were treated with interferon alpha-2b(IFN alpha-2b) with prednisolone withdrawal and 30 control patients were treated with conventional hepatotonics for 6 months. Peripheral total T cell fractions and T cell subsets of the patients with CAH-B, treated with IFN alpha-2b with prednisolone withdrawal, were examined 1 month before administration of prednisolone, and compared with 12 normal controls for assessing the potential role of cellular immunity in the development of CAH-B. To estimate the effectiveness of IFN therapy for the patients with CAH-B, levels of various liver function tests, HBsAg, anti-HBs, HBeAg, anti-HBe, HBV DNA, anti-HCV and others were assessed for the treatment group and compared with control patients at pre- and post-treatment period each. RESULTS: The value of CD4 was significantly lower in patients with CAH-B than normal controls (36.3 +/- 7.7% vs 42.1 +/- 5.7%, p < 0.05) and the value of CD8 was significantly higher in patients with CAH-B than normal controls (30.6 +/- 10.3% vs 24.3 +/- 5.2%, p < 0.05) before prednisolone administration. The patients in responder group (n = 26) had significantly lower CD4 cells compared with normal controls, but non-responders (n = 6) did not have. The levels of liver function test(LFT) in the patients with IFN alpha-2b treatment with prednisolone withdrawal were not different from the control patient group at pretreatment, but significantly lower than control patient group's after treatment, regardless of response to IFN alpha-2b treatment with prednisolone withdrawal. CONCLUSIONS: The cellular immunity of the host may have a potential role in the pathogenesis of chronicity of hepatitis B infection. IFN alpha-2b treatment with prednisolone withdrawal may be regarded as one of the effective treatment modalities for the inhibition of disease progression in patients with CAH-B.
Adult ; DNA, Viral/blood ; Female ; Hepatitis B Antibodies/blood ; Hepatitis B e Antigens/blood ; Hepatitis B, Chronic/therapy* ; Hepatitis B, Chronic/physiopathology ; Hepatitis B, Chronic/immunology* ; Human ; Interferon Alfa-2b/therapeutic use* ; Male ; Middle Age ; Prednisolone/administration & dosage ; T-Lymphocyte Subsets/immunology*

BACKGROUND/AIMS: The purpose of this study was to examine the clinical observations of patients with hematochezia in attempt to determine the appropriate evaluation and treatment of this group of patients. METHODS: Seventy patients with hematochezia were admitted to Intemal medicine (IM) Department of Chungnam National University Hospital from January 1990 to August 1997. The clinical observations of patients with hematochezia were reviewed and the results are as follows. RESULTS: 1) The causes of the hematochezia were ischemic colitis (18.6%), hemorrhoids (15.7%), ulcerative colitis (14.3%), unknown (12.8%), rectal cancer (7.1%), nonspecific ulcers (rectum; 4.3%, colon; 1.4%), diverticulosis (5.7% ), colon cancer (4.3%.), mdiation colitis (2.9%), angiodysplasia (2.9%), polyps (2.9%), Samonella colitis (2.9%), rectal varix (1.4%), ileitis(1.4%) and ileal ulceration (1.4%). 2) The average hemoglobin of the patients with hematochezia was 9.6 g/dl. Forty percent of the patients with hematochezia required a transfusion and the average transfusion amount was 4.4 packs (Pack Red Cell). Patients with nonspecific ulcers (recutum, colon), angiodysplasia, colon cancer, ilieal lesion and rectal varix required more transfusions (average transfusion amount, 5.7 packs). 3) Patients who improved with eonservative treatment only were 85.7%, and 11.4% required surgical intervention. Also 2.9% required endoscopic intervention. 4) Confirmative modalities of hematochezia included colonoscopy (80%), and others (angiography, barium enema, and operation etc.). CONCLUSIONS: In patients with hematochezia admitted to the IM Department, the cause of hematochezia was confirmed by colonoscopy and patients with hematochezia were mainly managed using conservative treatment.
Angiodysplasia ; Barium ; Chungcheongnam-do ; Colitis ; Colitis, Ischemic ; Colitis, Ulcerative ; Colon ; Colonic Neoplasms ; Colonoscopy ; Diverticulum ; Enema ; Gastrointestinal Hemorrhage* ; Hemorrhoids ; Humans ; Polyps ; Rectal Neoplasms ; Ulcer ; Varicose Veins