The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted ‘the clinical recommendation for hemodialysis facilities’ to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of ‘the clinical practice guideline for hemodialysis facilities dealing with MERS patients’ built upon our previous experience.
Advisory Committees ; Coronavirus Infections* ; Dialysis ; Infection Control ; Middle East Respiratory Syndrome Coronavirus ; Middle East* ; Nephrology ; Quarantine ; Renal Dialysis*

Tumoral calcinosis (TC) is a condition resulting from extensive calcium phosphate precipitation, primarily in the periarticular tissues around major joints. Calciphylaxis is a fatal ischemic vasculopathy mainly affecting dermal blood vessels and subcutaneous fat. This syndrome is rare and predominantly occurs in patients with end-stage renal disease. Here, we report on a rare case involving a patient with TC complicated with calciphylaxis. Our patient was a 31-year-old man undergoing hemodialysis who presented with masses on both shoulders and necrotic cutaneous ulcers, which were associated with secondary hyperparathyroidism, on his lower legs. He underwent subtotal parathyroidectomy, and sodium thiosulfate (STS) was administered for 27 weeks. Twenty months after beginning the STS treatment course, he experienced dramatic relief of his TC and calciphylaxis.
Adult ; Blood Vessels ; Calcinosis* ; Calciphylaxis* ; Calcium ; Humans ; Hyperparathyroidism, Secondary ; Joints ; Kidney Failure, Chronic ; Leg ; Parathyroidectomy* ; Renal Dialysis ; Shoulder ; Sodium* ; Subcutaneous Fat ; Ulcer

PURPOSE: High-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) have been used for the treatment of clinically aggressive non-Hodgkin's lymphoma (NHL). However, the superiority of specific conditioning regimens has not yet been established. The present study evaluated the efficacy and toxicity of a conditioning regimen involving fractionated total body irradiation (TBI), and the use of Ara-C and melphalan (TAM) for clinically aggressive NHL. MATERIALS AND METHODS: Between March 2002 and December 2004, 31 patients with aggressive NHL received fractionated TBI with a dose of 12 Gy over 3 days, and were administered 9 g/m2 Ara-C and 100 mg/m2 melphalan followed by autologous peripheral blood stem Cell Transplantation at the Catholic Hematopoietic Stem cell transplantation Center Korea. Patients that responded to first line chemotherapy and achieved complete remission (CR), or were in a first sensitive relapse were defined as having less advanced disease, while the other patients were defined as having more advanced disease. RESULTS: Objective responses were obtained in 24 of 31 patients (77.4%), comprising complete remission in 19 patients (61.3%) and partial remission in 5 (16.1%) patients. The median follow-up time was 28 months (range 1~62 months). At 3 years, the overall survival and event-free survival (EFS) rates were 62.3% and 47.3%, respectively. Patients with less advanced disease and more advanced disease showed 3-year EFS rates of 73.3% and 22.5 %, respectively (p=0.006). Early (within the first 100 days) treatment-related mortality occurred in 3 (9.7%) patients. Of the 31 total patients, 15 (48.4%) developed grade 3 mucositis, 22 (70.9%) developed neutropenic fever, and two (6.5%) developed interstitial pneumonia syndrome >grade 3. CONCLUSION: The modified TAM conditioning regimen and ASCT appear to be a feasible treatment regimen for clinically aggressive NHL, particularly for patients with less advanced disease.
Cytarabine ; Disease-Free Survival ; Drug Therapy ; Fever ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Korea ; Lung Diseases, Interstitial ; Lymphoma, Non-Hodgkin* ; Melphalan ; Mortality ; Mucositis ; Peripheral Blood Stem Cell Transplantation ; Recurrence ; Stem Cell Transplantation* ; Stem Cells* ; Whole-Body Irradiation

PURPOSE: Stomach cancer is the most prevalent extracolonic malignancy of the many primary cancers that occur together with colorectal cancer in Koreans. The purpose of this study was to evaluate the characteristics of patients who present with double primary cancer of the stomach and colorectum. METHODS: From Sep. 1994 to Dec. 2004, in 4,305 patients were diagnosed with colorectal cancer. Among these patients, 51 patients were diagnosed synchronously or metachronously as also having stomach cancer. The mean age these patients was 60.8 years and the median follow up duration was 31.0 months. RESULTS: The incidence of double primary cancer of the stomach and colorectum was 1.2% of the total colorecal cancer patients and they were 0.6% of the total stomach cancer patients. There were 17 (33.3%) metachronous cases and 34 (66.7%) synchronous cases. For the metachronous cases, the mean interval was 15 months (12~98) and detection methods were postoperative CT, symptom of second a cancer, and routine endoscopic examination. In synchronous cases, second cancer was detected by routine endoscopic examination, preoperative radiologic evaluation, and intraoperative exploration. Intraoperatively the detected cancers were all colorectal cancer during the operation for stomach cancer. The stage of the colorectal cancer was higher than that of the stomach cancer in 30 cases. Local or systemic recurrences were seen in 9 cases (17.6%), and 7 cases were recurrence of colorectal cancer. The 5-year disease free survival rates was 55.8%. CONCLUSION: The incidence of cancer arising from colorectum and stomach has been reported to be increasing. Careful attention should always be paid to the possible presence of a second cancer in preoperative or postoperative evaluation of cancer patients.
Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Neoplasms, Second Primary ; Recurrence ; Stomach Neoplasms ; Stomach*

PURPOSE: This is for analyzing the recent citations from papers enrolled in the Journal of Korean Academy of Nursing and understanding correct marking of references. METHOD: Targeted 2,334 references in 93 articles introduced from Feb. 2002 to Dec. 2002 which are applied current contribution rules of the Journal of Korean Academy of Nursing. RESULT: 1. 25 references are quoted per article and particularly foreign journals are most frequently quoted. Among foreign journals, Nursing Research is most frequently used. The Journal of Korean Academy of Nursing is also mostly referred material among national journals. 2. The retrieval rate is prove to be 1,539(83.8%) and 267(11.7%) are without errors and the other 2,022 have at least more than one error regardless of frequency. 3. Major error rate of periodical publication is 484(36.8%) and most occurred in the inconsistency of titles between articles and references. 4. Foreign journals have much more errors than national ones concerning periodical publications. CONCLUSION: Correct citation and marking of references can be achieved through strict reviewing process by authors, editors, publishers and paper investigators. In consequence, it is expected that these processes can cause improvement of quality in impact factor and papers.
Humans ; Nursing Research ; Nursing* ; Publications ; Research Personnel

PURPOSE: This is for analyzing the recent citations from papers enrolled in the Journal of Korean Academy of Nursing and understanding correct marking of references. METHOD: Targeted 2,334 references in 93 articles introduced from Feb. 2002 to Dec. 2002 which are applied current contribution rules of the Journal of Korean Academy of Nursing. RESULT: 1. 25 references are quoted per article and particularly foreign journals are most frequently quoted. Among foreign journals, Nursing Research is most frequently used. The Journal of Korean Academy of Nursing is also mostly referred material among national journals. 2. The retrieval rate is prove to be 1,539(83.8%) and 267(11.7%) are without errors and the other 2,022 have at least more than one error regardless of frequency. 3. Major error rate of periodical publication is 484(36.8%) and most occurred in the inconsistency of titles between articles and references. 4. Foreign journals have much more errors than national ones concerning periodical publications. CONCLUSION: Correct citation and marking of references can be achieved through strict reviewing process by authors, editors, publishers and paper investigators. In consequence, it is expected that these processes can cause improvement of quality in impact factor and papers.
Humans ; Nursing Research ; Nursing* ; Publications ; Research Personnel

BACKGROUND AND OBJECTIVES: Although Gore-Tex is popularly used in nasal augmentation in human, studies about the histological changes have been carried out only in animal models. The purpose of this study is to investigate histological changes of Gore-Tex used in nasal augmentation in human. SUBJECTS AND METHODS: Gore-Tex of 24 patients who underwent nasal augmentation using Gore-Tex (non-reinforced sheets) 2-36 months ago and had re-operated for the sole cosmetic problems was obtained. Histologic examination was performed from specimens including Gore-Tex and the surrounding soft tissue with light microscope and electromicroscope. RESULTS: Histologically, connective tissue ingrowth was observed in all specimen. But the degree of foreign body reaction and collagen deposit varied from specimen to specimen and had no relationship with the duration. Neovascularization was observed from specimen whose duration was longer than 12 months and degenerative calcification was observed from 36 month old specimen. CONCLUSION: Unlike the findings of previous reports, individual differences and partial degenerative lesions in Gore-Tex were observed. Additional studies are required to confirm the stability of Gore-Tex as an implant to be used in human.
Child, Preschool ; Collagen ; Connective Tissue ; Foreign-Body Reaction ; Humans* ; Individuality ; Models, Animal ; Polytetrafluoroethylene ; Rhinoplasty

BACKGROUND: In this study, we retrospectively analyzed the outcomes of aortic valvuloplasty in pediatric age. MATERIAL AND METHOD: Between January 1993 and March 2004, 35 patients underwent aortic valvuloplasty for aortic stenosis (AS) or aortic regurgitation (AR). The mean age was 81.1+/-61.5 (1~223) months. The mean follow up was 50.8+/-30.2 (3~121) months. Nine patients had AS, 21 had AR, and 6 had AS and AR. Valve morphology was tricuspid in 24 patients, bicuspid in 9, quadricuspid in 1, and unicuspid in 1. The mean peak pressure gradients of AS were 72.0+/-33.0 mmHg, and the mean grades of AR were 3.1+/-0.9. RESULT: There was one late mortality without early mortality. After operation, AS improved with mean peak pressure gradients of 23.5+/-21.0 mmHg (p<0.05), and AR improved with mean grades of 1.9+/-0.8 (p<0.05). At mean follow up of 35.0+/-23.0 months, AS maintained with mean peak pressure gradients of 31.5+/-24.0 mmHg, but AR progressed with mean grades of 2.8+/-1.3 (p<0.05). Reoperation was required in 6 patients 38.3+/-21.8 months after the original operation. The actuarial figures for freedom from reoperation at 2, 5 and 8 years were 96.9+/-3.1%, 79.5+/-5.5%, and 56.8+/-11.4%, respectively. Age at operation, presence of AS, preoperative severity of AS or AR, and morphology of aortic valve were not significant risk factors for reoperation, and improvement of AS or AR. CONCLUSION: Aortic valvuloplasty showed good immediate postoperative valve function. Aortic valvuloplasty offers children many years with tolerable valve function and allows to postpone aortic valve replacement or Ross procedure in pediatric patients.
Aortic Valve ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Bicuspid ; Child ; Follow-Up Studies ; Freedom ; Humans ; Mortality ; Reoperation ; Retrospective Studies ; Risk Factors

BACKGROUND: In this study, we analyzed the long-term surgical outcome of partial atrioventricular septal defects during the past 17 years at Seoul National University Hospital. MATERIAL AND METHOD: A retrospective analysis on mortality, survival, and reoperation and their risk factors was done in 93 patients who underwent surgical correction of partial atrioventricular septal defects between April 1986 and December 2002. 32 patients were male and 61 were female with a median age of 68 months (3~818 months) and a mean follow-up period of 108 months (1~200 months). RESULT: There were 4 operative deaths (4.3%) and one mortality during the follow-up period. 3, 5, 10, and 15 year actuarial survival rates were 95.7%, 94.3%, 94.3%, and 94.3%, respectively. After the surgical correction, left atrioventricular valve incompetence was improved in 61patients (67.7%), remained same as the preoperative status in 14 patients (15.1%), and was aggravated in 12 patients (12.9%). Reoperation was performed in 8 patients (9.0%) after a mean interval of 38.6 months (3~136 months). Freedom from reoperation rates at 3, 5, 10, and 15 years after surgical correction were 94.0%, 91.4%, 91.4%, and 88.2%, respectively. Reasons for reoperation were 7 left atrioventricular valve incompetence, 2 left ventricular outflow tract obstruction, a residual atrial septal defect, a left atrioventricular valve stenosis, and a right ventricular failure. Left ventricular outflow tract obstruction was the only statistically significant factor. In ten patients, significant arrhythmia was developed and three of them were supraventricular arrhythmia. Complete atrioventricular block occurred in 7 patients and permanent pacemakers were implanted in six of them. CONCLUSION: Surgical corrections of partial atrioventricular septal defects were performed with low operative mortality. Sicnce left atrioventricular valve incompetence was the most common cause of reoperation and left ventricular outflow tract obstruction was the only risk factor for reoperation, a precise estimation of the left atrioventricular valve morphology and the structure of left ventricular outflow tract are needed. Although left ventricular outflow tract obstruction rarely developed, reoperation was frequently required and resection of subaortic tissue could be performed but the possibility of recurrence was high, so modified Konno operation could be performed with satisfactory results. Complete atrioventricular block developed frequently in early periods, but was overcome with a precise anatomical understanding of conduction system and experience.
Arrhythmias, Cardiac ; Atrioventricular Block ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Freedom ; Heart Septal Defects, Atrial ; Humans ; Male ; Mortality ; Recurrence ; Reoperation ; Retrospective Studies ; Risk Factors ; Seoul ; Survival Rate

Neurofibroma in gastrointestinal tract are presented as localized forms or in associated with neurofibromatosis. Previous reported cases were presented as relatively large sized esophageal mass and treated by surgical resection. However, a neurofibroma was found incidentally during endoscopy in this case. It was presented as palisade like solitary nodules with or without connecting mucosal bridges in lower esophagus. It was treated by mucosectomy and followed up without recurrence.
Endoscopy ; Esophagus* ; Gastrointestinal Tract ; Neurofibroma* ; Neurofibromatoses ; Recurrence