Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.
Aged ; Cecum ; Colitis* ; Colon ; Colonoscopy ; Cytomegalovirus* ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Diarrhea ; Ganciclovir ; Humans ; Immunocompetence ; Polymerase Chain Reaction ; Rectum ; Ulcer

Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.
Aged ; Cecum ; Colitis ; Colon ; Colonoscopy ; Cytomegalovirus ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Diarrhea ; Ganciclovir ; Humans ; Immunocompetence ; Polymerase Chain Reaction ; Rectum ; Ulcer

The purpose of this study was to examine the characteristics of the dietary intake of Korean elderly according to chewing ability using data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted during 2007-2010. Among subjects aged 65 years and over, more than half, 54.3% of elderly people, were classified as the difficulty in chewing group (DC). The DC group had lower nutrients and food intakes than those of in the no difficulty in chewing group (NDC). Findings showed that subjects in the DC group consumed fewer foods, especially fruits and vegetables. In addition, the DC group had significantly lower intakes of pan-fried food, stir-fried food, braised food, and seasoned-cooked vegetables, which could not be easily cooked or chewed. On the other hand, the number of soups and stews included in the top 30 largely consumed dishes were higher in the DC group than in the NDC group. No difference in numbers of daily meal/snack intake was observed between the two groups, however, the DC group had lower numbers of side-dishes compared to the NDC group. Fewer side-dishes per meal could be related to lower intakes of nutrients in dietary quality. Findings of this study demonstrated that dietary intake was influenced by chewing ability of elderly Korean people. Therefore, study of factors affecting dietary intake such as convenient cooking methods to decrease cooking time and skills to extend preservation and storage time of foods will necessary. In addition, development of food products and new techniques of cooking considering health status, chewing, and swallowing ability is required for the elderly, followed by establishment of standards for senior-friendly food products.
Aged ; Cooking ; Deglutition ; Fruit ; Hand ; Humans ; Korea ; Mastication ; Meals ; Nutrition Surveys ; Vegetables

Primary T-cell lymphoma of the duodenum is uncommon, and peripheral T-cell lymphoma of the duodenum is extremely rare. Approximately 90% of primary gastrointestinal lymphomas originate from B-cells and fewer than 10% originate from T-cells. A peripheral T-cell lymphoma involved in the small intestine is usually detected by complications such as gastrointestinal bleeding, perforation, or obstruction. A 57-year-old man complained of postprandial discomfort and weight loss of 5 kg for 1 month. An esophagogastroduodenoscopy showed a deep ulcer with blood clots and whitish exudates. We conducted a Whipple's operation because of the high risk of ulcer perforation and difficulty in distinguishing the ulcer from malignancy. The resected tissue was confirmed as a peripheral T-cell lymphoma. We reported a case of peripheral T-cell lymphoma of the duodenum and jejunum that extended to the pancreatic head where a diffuse lesion was found without any complications or specific symptoms.
B-Lymphocytes ; Duodenum ; Endoscopy, Digestive System ; Exudates and Transudates ; Head ; Hemorrhage ; Humans ; Intestine, Small ; Jejunum ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Middle Aged ; T-Lymphocytes ; Ulcer ; Weight Loss

Menetrier's disease is a protein-losing hypertrophic gastropathy characterized by diffuse tremendous thickening of the gastric wall caused by excessive proliferation of the mucosa. Although the cause of Menetrier's disease is unknown, an association with Helicobacter pylori has been reported. A 42-year-old man was hospitalized for the evaluation of progressive body weight loss and indigestion for 6 months, with recently aggravated epigastric discomfort. Gastroscopy revealed prominent mucosal folds in the body and fundus. The histological findings revealed gastritis with erosions and foveolar hyperplasia. After eradicating the Helicobacter pylori and treatment with a proton pump inhibitor, clinical and endoscopic resolution ensued.
Adult ; Body Weight ; Dyspepsia ; Gastritis ; Gastritis, Hypertrophic ; Gastroscopy ; Helicobacter ; Helicobacter pylori ; Humans ; Hyperplasia ; Mucous Membrane ; Proton Pumps ; Protons

Though branchial cleft cysts (BCC) are common cause of congenital cyst formation in the neck, the prenatal cases have been reported very rarely. We discovered fetal neck cyst at 32 weeks of gestation and eventually diagnosed it as BCC by postnatal surgical excision and histologic findings. It is hard to establish differential diagnosis of BCC from other congenital neck cysts on fetal ultrasonography. The anatomic locations and clinical features of each cystic lesions are important to diagnose accurately and then to achieve complete surgical excision for recurrence-free treatment. We present a case of a BCC detected prenatally and survey the points of differential diagnosis of a BCC from other neck cystic lesions on fetal ultrasonography.
Branchial Region ; Branchioma ; Diagnosis, Differential ; Neck ; Pregnancy ; Ultrasonography, Prenatal

OBJECTIVE: The purpose of this study was to investigate the prognosis of pregnancy and perinatal outcomes of epileptic women used antiepileptic drugs. METHODS: A retrospective analysis of 66 consecutive pregnancies of 41 epileptic women from January 1989 through December 2005 was performed. The maternal and perinatal outcomes of pregnancies with epilepsy were compared with those of 1,000 normal pregnancies of similar age and parity occurred during the same period. We also compared the perinatal outcomes regarding protocol of antiepileptic drugs (monotherapy vs polytherapy), existence of gestational seizure, and duration of epileptic history. Statistical analyses with chi-square test and t-test were performed. RESULTS: In our comparison study between epilepsy and normal groups, with the exception of primigravida (43.8% vs 31.8%, p=0.009), induction of labor (43.1% vs 22.1%, p=0.001) and major congenital malformation (6.9% vs 2.0%, p=0.015), no other significant differences regarding maternal and perinatal outcomes were noted between two groups. There were no different obstetrical outcomes between monotherapy and polytherapy groups. In epileptic women with gestational seizure, the rate of fetal distress (20.0% vs 2.3%, p=0.02) was significantly increased. In longer epileptic history (> or =10 years), the rates of preterm birth, low birth weight, and major congenital malformation were increased, but there was no statistical significance. CONCLUSION: There are no increased maternal and perinatal complications in epileptic women used antiepileptic drugs, except for major congenital malformation.
Anticonvulsants* ; Epilepsy ; Female ; Fetal Distress ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Parity ; Pregnancy* ; Pregnant Women* ; Premature Birth ; Prognosis* ; Retrospective Studies ; Seizures

Goldenhar syndrome is a rare congenital disorder of hemicraniofacial and vertebral defects related to the abnormal development of the first and second branchial arches. In some infants, congenital heart disease, and pulmonary and renal defects are also present. Goldenhar syndrome commonly involves an airway which is difficult to manage. Tracheal intubation may be difficult due to a combination of retrognathia, micrognathia, mandibular hypoplasia, palatal defects and vertebral abnormities. We experienced the anesthetic management of an 8-month-old boy with Goldenhar syndrome who received excision and biopsy for conjunctival dermoid and ureteral reimplantation for vesicoureteral reflux under general anesthesia. Airway management, with thiopental, rocuronium and sevoflurane, and tracheal intubation were accomplished successfully in the patient. Surgery was performed uneventfully and the patient was discharged without complication.
Airway Management ; Anesthesia, General ; Biopsy ; Branchial Region ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Dermoid Cyst ; Goldenhar Syndrome* ; Heart Defects, Congenital ; Humans ; Infant ; Intubation ; Male ; Replantation ; Retrognathia ; Thiopental ; Ureter ; Vesico-Ureteral Reflux

From January 1998 to December 2002, 3,259 cases of uterine myoma were treated at the department of Obstetrics and Gynecology, Chunbuk National University Hospital. A clinico-stastical study of uterine myoma was perfomed to analyse the clinical characteristics. The results were as follows. 1. The incidence of uterine myoma was 9.8%. 2. The most frequent age group was 40 to 49 years, and the mean age was 44.6 years. 3. The average parity was 2.29, the infertility was 163 cases (5.0%), while the primary infertility, 2.4%, the secondary, 2.6% respectively. 4. The most frequent chief complaint was pain which was observed in 2,648 cases (81.2%), abnormal bleeding in 1,775 cases (53.8%). dizziness in 270 cases (8.3%). 5. The corporeal myomas were observed in 2,879 cases (95.9%). Intramural type was observed in 1,687 cases (58.2%), subserous in 529 cases (18.2%), submucous in 191 cases (6.5%), mixed type in 483 cases (17.0%). 6. The mean value of preoperative hemoglobin was 11.1 gm/dL, and the anemia (Hb<10.0 gm/dL) was observed in 481 cases (11.7%). Transfusion was necessary in 215 cases (6.5%). 7. The mean weight of the uterine myoma operated was 335.0 gm. 8. The secondary change of myoma was found in 54 cases (1.7%) and hyaline degeneration was the most common (0.7%). 9. The most common associated condition was chronic cervicitis, which was observed in 784 cases (24.1%). 10. The gynecologic surgery were performed in 1,456 cases (44.7%), medical therapy in 25 cases (0.8%), observation in 1,792 cases (55.0%). 11. Total abdominal hysterectomy was performed in 607 cases (41.7%), total abdominal hysterectomy with unilateral adnexectomy in 115 cases (7.9%), total abdominal hysterectomy with both adnexectomy in 164 cases (11.3%), subtotal hysterectomy in 304 cases (20.9%), myomectomy in 153 cases (10.5%), total laparoscopic hysterectomy in 103 cases (7.0%), laparoscopy assisted vaginal hysterectomy in 8 cases (0.5%), diagnostic laparoscopy in 2 cases (0.1%) respectively. 12. The postoperative complication were found in 113 cases (3.5%) and the wound infection was the most common (1.6%). 13. The mean period of hospitalization was 8 days, and the period less than 10 days in 1,177 cases (80.9%).
Anemia ; Dizziness ; Female ; Gynecologic Surgical Procedures ; Gynecology ; Hemorrhage ; Hospitalization ; Humans ; Hyalin ; Hysterectomy ; Hysterectomy, Vaginal ; Incidence ; Infertility ; Laparoscopy ; Leiomyoma* ; Myoma ; Obstetrics ; Parity ; Postoperative Complications ; Uterine Cervicitis ; Wound Infection

OBJECTIVE: To compare the effectiveness of oral misoprostol with vaginal misoprostol administration in mid-trimester pregnancy termination after pretreatment with serial laminarias tenting. METHODS: This study was made in 50 patients for mid-trimester pregnancy termination at Department of Obstetrics and Gynecology, Chonbuk National University Hospital from January 1999 through December 2002. Twenty five women received misoprostol orally in a dose of 200 micro gram every hour for 3 doses followed by 400 micro gram every 4 hours after serial laminarias tenting. Twenty five women received misoprostol vaginally in a dose of 400 micro gram every 4 hours after serial laminarias tenting. Side effects of drug, induction to delivery interval, delivery numbers within 24 hours, curettage numbers for retained placenta, and the length of hospital stay were compared. RESULTS: The mean time of induction to delivery interval was significantly shorter in the vaginal group (15.5 +/- 12.7 vs 24.2 +/- 14.3 hours, p<0.01). The length of hospital stay was also shorter in the vaginal group (38.9 +/- 13.1 vs 47.2 +/- 14.5 hours, p<0.01). The number of patients delivered within 24 hours was more in the vaginal group (92 vs 72%, p<0.05). The side effects of misoprostol were slightly more common in the oral group than the vaginal group without statistical significance. CONCLUSION: We suspect that after serial tenting of laminarias, intravaginal misoprostol appears to be more safe and effective than oral misoprostol for mid-trimester termination.
Curettage ; Female ; Gynecology ; Humans ; Jeollabuk-do ; Laminaria ; Length of Stay ; Misoprostol* ; Obstetrics ; Placenta, Retained ; Pregnancy*