A 36-year-old woman was diagnosed with anaplastic large cell lymphoma (ALCL) by excisional biopsy of a left frontal skin lesion. During the first cycle of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient complained of right ocular pain and inflammation. Cytologic examination using aqueous humor revealed atypical lymphocytes, suggesting intraocular ALCL involvement. Acute angle closure developed in the anterior chamber due to rapid progression of ALCL, causing pupillary block. Laser and surgical interventions were attempted but failed to relieve the pupillary block. Finally, radiation therapy resolved the pupillary block to restore the anterior chamber and normalize intraocular pressure. This is the first case in the English literature of ALCL involving the iris to cause acute secondary angle closure.
Adult ; Anterior Eye Segment/*pathology ; Biopsy ; Diagnosis, Differential ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic/*diagnosis ; Magnetic Resonance Imaging ; *Neoplasm Invasiveness ; Positron-Emission Tomography

A 36-year-old woman was diagnosed with anaplastic large cell lymphoma (ALCL) by excisional biopsy of a left frontal skin lesion. During the first cycle of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient complained of right ocular pain and inflammation. Cytologic examination using aqueous humor revealed atypical lymphocytes, suggesting intraocular ALCL involvement. Acute angle closure developed in the anterior chamber due to rapid progression of ALCL, causing pupillary block. Laser and surgical interventions were attempted but failed to relieve the pupillary block. Finally, radiation therapy resolved the pupillary block to restore the anterior chamber and normalize intraocular pressure. This is the first case in the English literature of ALCL involving the iris to cause acute secondary angle closure.
Adult ; Anterior Eye Segment/*pathology ; Biopsy ; Diagnosis, Differential ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic/*diagnosis ; Magnetic Resonance Imaging ; *Neoplasm Invasiveness ; Positron-Emission Tomography

BACKGROUND: The number of cases of pertussis reported has increased gradually in the last decade. Pertussis vaccination is the most effective strategy for the prevention of infection. Despite the fact that young infants are at the highest risk for pertussis, the rate of tetanus-diphtheria-acellular pertussis (Tdap) vaccination is presumed to be very low among women of childbearing age in Korea. The purpose of this study was to investigate the perceptions of women of childbearing age regarding Tdap vaccination in Korea. MATERIALS AND METHODS: Women of childbearing age, who visited the Department of Obstetrics and Gynecology at 3 University hospitals in the Seoul and Gyeonggi-do provinces of Korea, were surveyed. Individual questionnaires were administered from April to May 2012. Demographic data, Tdap vaccination history, general knowledge about pertussis, and information on factors associated with decision on vaccination were collected. RESULTS: Of the 500 reproductive-age women enrolled, only 4 (0.8%) had received the Tdap. The most common reason for non-vaccination was the lack of awareness of pertussis and information about the Tdap. Totally, 171 (34.2%) responded that they would receive a Tdap vaccination in the future. By multivariate analysis, general confidence in the effectiveness of the vaccine (odds ratio [OR] = 1.88, 95% confidence interval [CI] 1.17 to 3.01) was indicated as an important factor for deciding whether to receive the Tdap vaccine (P < 0.01). CONCLUSIONS: The coverage of Tdap vaccination of women of childbearing age, including pregnant women, is very low because of the lack of awareness of pertussis and the Tdap. Education of women of childbearing age about pertussis is very important to increase Tdap vaccination rates among these women, particularly during the perinatal period.
Female ; Gynecology ; Hospitals, University ; Humans ; Infant ; Korea ; Multivariate Analysis ; Obstetrics ; Pregnant Women ; Vaccination ; Whooping Cough ; Surveys and Questionnaires

Bacillus (B.) anthracis is the pathogen that causes fatal anthrax. Strain-specific detection of this bacterium using molecular approaches has enhanced our knowledge of microbial population genetics. In the present study, we employed molecular approaches including multiple-locus variable-number tandem repeat analysis (MLVA) and canonical single-nucleotide polymorphism (canSNP) analysis to perform molecular typing of B. anthracis strains isolated in Korea. According to the MLVA, 17 B. anthracis isolates were classified into A3a, A3b, and B1 clusters. The canSNP analyses subdivided the B. anthracis isolates into two of the three previously recognized major lineages (A and B). B. anthracis isolates from Korea were found to belong to four canSNP sub-groups (B.Br.001/2, A.Br.005/006, A.Br.001/002, and A.Br.Ames). The A.Br.001/002 and A.Br.Ames sub-lineages are closely related genotypes frequently found in central Asia and most isolates were. On the other hand, B. anthracis CH isolates were analyzed that belonged to the B.Br.001/002 sub-group which found in southern Africa, Europe and California (USA). B.Br.001/002 genotype is new lineage of B. anthracis in Korea that was not found before. This discovery will be helpful for the creation of marker systems and might be the result of human activity through the development of agriculture and increased international trade in Korea.
Africa, Southern ; Agriculture ; Anthrax ; Asia ; Bacillus ; Bacillus anthracis ; California ; Europe ; Genetics, Population ; Genotype ; Hand ; Human Activities ; Molecular Typing ; Tandem Repeat Sequences

PURPOSE: Women who are pregnant, planning to become pregnant in the influenza season or caring for infant 6-59 months of age are identified as priority groups for influenza vaccination. Vaccination rate is presumed to be low in those women. The purpose of this study was to investigate perceptions of childbearing age women about influenza vaccination. MATERIALS AND METHODS: Childbearing age women visiting the department of Obstetrics and Gynecology in 3 University hospitals in Seoul and Gyeonggi-do province were surveyed. Individual interviews were performed to them with questionnaire for 2 months from April to May 2012. Demographic data, Immunization history, general understanding and factors associated with vaccination were asked. RESULTS: Three hundred fifty-five (71.0%) of total 500 reproductive age women had the experience of influenza vaccination. Among 343 women who has been pregnant at least once, 48 women (16.4%) had vaccination during pregnancy, and 46 of them got vaccination since 2009. One hundred ninety women of total 500 women responded that they would get vaccination if pregnant in the next influenza season (38.0%). In multivariate analysis, statistically significant factors associated with plans of influenza vaccination in pregnancy were as follows: experience of childbirth (odds ratio [OR], 1.97; 95% CI, 1.32 to 2.93), high level of education (OR, 1.96; 95% CI, 1.22 to 3.15), previous influenza vaccination (OR, 1.88; 95% CI, 1.17 to 3.01). CONCLUSION: Influenza vaccine coverage on childbearing age women including pregnant women is low because of misperception of vaccination during pregnancy. It is necessary for healthcare provider to correct misunderstanding and to recommend vaccination actively.
Female ; Gynecology ; Health Personnel ; Hospitals, University ; Humans ; Immunization ; Infant ; Influenza Vaccines ; Influenza, Human ; Multivariate Analysis ; Obstetrics ; Parturition ; Pregnancy ; Pregnant Women ; Seasons ; Vaccination ; Surveys and Questionnaires

Obstructive jaundice associated with hepatocellular carcinoma (HCC) is an uncommon symptom caused by intraductal tumor growth, the migration of tumor necrosis, blood clots within the biliary tract, or compression of the biliary tract by the tumor. Most cases of icteric-type HCC involve a main tumor in the liver parenchyma. Bile duct HCC without a primary hepatic tumor is extremely rare, but because it shows similar clinical manifestations and imaging results to extrahepatic bile duct cancer, it is possible to misdiagnose this condition as a primary bile duct tumor or choldocholithiasis. Recently, we experienced a case of obstructive jaundice associated with an extrahepatic bile duct tumor in a 69-year-old woman. Upon radiologic studies and endoscopic cholangiography, the cause of obstructive jaundice was initially attributed to the bile duct tumor itself. However, subsequent analysis indicated that the condition was, in fact, due to bile duct thrombi associated with extrahepatic bile duct HCC.
Aged ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Female ; Humans ; Jaundice ; Jaundice, Obstructive ; Liver ; Necrosis ; Thrombosis

BACKGROUND: The occurrence of an outbreak of food-borne infectious disease requires a hospital to do extended role. There has been no report of an outbreak and an outbreak management of food-borne infectious diseases in a hospital. Therefore, this report of an outbreak and management of Shigellosis in the hospital would help others to manage further cases. METHODS: This was a descriptive study for an infection control program for food-borne infectious diseases in a hospital. RESULTS: There was a shigellosis outbreak at a university hospital in Seoul between December 3 and 30, 2001, Five hundred eighty four were affected, of which 81 cases were suspected and 86 cases were confirmed Shigella sonnei in fetal culture. The source of infection was identified as a lunch box or seaweed rolled rice that was contaminated and was supplied from the S-catering facility. The infection control team had developed the various strategies to control the outbreak and implemented them. The strategies included an epidemiology investigation, the removal of infection sources, medical treatment and isolation of patients, education and management of public relationship, environmental control, withdrawal of medical students' training, prevention and control of asymptomatic cases, intensive care unit strong financial support, analysis and management various data and the construction of cooperation and reporting system with the public health system CONCLUSION: This outbreak was controlled by effective team approach. The effective management of an outbreak of food-borne infectious diseases requires a systematic infection control, public relationship strategies for the reputation of the hospital, and the cooperation with a public health system.
Communicable Diseases ; Dysentery, Bacillary* ; Education ; Epidemiology ; Financial Support ; Humans ; Infection Control* ; Intensive Care Units ; Lunch ; Public Health ; Seaweed ; Seoul ; Shigella sonnei

PURPOSE: We estimated the incidence of cancer in Korea. MATERIALS AND METHODS: The indicence of cancer was estimated using national mortality data, and the incidence data from four frontier regional cancer registries, including Kangwha, Seoul, Busan and Deagu. These four registries served a population about seventeen million, which is almost 38% of entire population in Korea. RESULTS: The overall age-standardized incidence rates (ASR) were 287.0 and 163.1 per 100,000 for males and females, respectively. Among males, stomach cancer was the most frequent (ASR 69.6), followed by lung cancers, including bronchus cancer (ASR 54.5), liver cancer (ASR 47.0) and colo-rectal cancer (ASR 25.2). The most frequent sites of cancer in females, by rank order, were stomach (ASR 26.8), breast (ASR 20.1), uterine cervix (ASR 18.0), colo-rectum (ASR 15.9), lung (ASR 13.0) and liver (ASR 12.0). CONCLUSION: It is hoped that these results will provide valuable leads for cancer research and cancer control in Korea.
Breast ; Bronchi ; Busan ; Cervix Uteri ; Daegu ; Female ; Hope ; Humans ; Incidence* ; Korea* ; Liver ; Liver Neoplasms ; Lung ; Lung Neoplasms ; Male ; Mortality ; Registries ; Seoul ; Stomach ; Stomach Neoplasms

PURPOSES: To investigate the viral etiology of community-acquired pneumonia in Korean adults, we have detected respiratory viruses (Respiatory syncytial virus, adenovirus, influenza virus and parainfluenza virus) in the way of prospective, multi-center study. METHODS: From July 1997 to April 2000, nasal aspirates or sputum were obtained from adults patients with community pneumonia admitted to the participating hospitals and transferred immediately to the central laboratory in the Seoul National University Children's Hospital. The specimens were divided into three parts. One part was used for indirect immunofluorescent test for respiratory viruses, the other part for the culture of RSV and adenovirus in HEp-2 cell monolayer. Another part was used for the culture of influenza virus and parainfluenza virus in MDCK or LLC- MK2 cell monolayers. RESULTS: Of 317 samples, 32 (10.1%) specimens were positive for viral isolation by indirect IF staining or culture, including one dual-infected specimen (adenovirus and parainfluenza virus). Influenza virus was most commonly detected (16 specimens). Parainfluenza virus, adenovirus and RSV were detected in 10, 4 and 3 patients, respectively. All isolated influenza viruses were type A (H3N2 in 9 patients, H1N1 in 2 and unspecified in 5), and 8 out of 10 parainfluenza virus isolates were type 3. CONCLUSION: Similar to previous foreign reports, a significant portion of community-acquired pneumonia in Korean adult is caused by respiratory viruses. Our data empathized the need of referral system for viral diagnosis and of nationwide investigation on respiratory virus infections.
Adenoviridae ; Adult* ; Diagnosis ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia* ; Prospective Studies ; Referral and Consultation ; Seoul ; Sputum

The objective of this study is to differentiate the mild dementia of Alzheimer type from the questionable dementia and non-demented elderly using the neurocognitive assessment. Subjects of 28 women who were registered to kwangju Community Mental Health Center were as follows: 14 non-demented, 9 questionable dementia, 5 mild dementia of Alzheimer type. The diagnosis were made using DSM-IV, Clinical Dementia Rating Scale. The neurocognitive functions were assessed with following test tools 1) attention: Digit span, Visual span, Continuous attention; 2) memory: Logical memroy, Verbal paired associates-easy/hard 3) visual perception and visuospatial ability: Visual recognition test, Construction; and 4) language: Comprehension and Aphasia severity rating scale; 5) higher cortical function: Hypothesis formation, Perseveration, Similarity, Judgment, and Go-No-Go test. Group differences were analyzed with one way ANOVA test in SPSS 8.0 for win and LSD method as post-hoc analysis. The questionable dementia group showed significant difference in Verbal paired associateseasy pair, Construction, Aphasia severity rating scale and Similarity from the non-demented normal control group but showed no difference from the mildly demented group. These results suggest that the questionable dementia is actually very early or very mild stage of dementia of the Alzheimer type.
Aged* ; Aphasia ; Comprehension ; Dementia* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Gwangju ; Humans ; Judgment ; Logic ; Lysergic Acid Diethylamide ; Memory ; Mental Health ; Visual Perception