Purpose: Human parvovirus B19 infection is widespread and has a heterogeneous clinical spectrum, ranging from asymptomatic infection to potentially life-threatening complications. We investigated the various clinical features of human parvovirus B19 infection during an outbreak of the virus in our community. Methods: A retrospective chart review study was conducted at the Pusan National University Children's Hospital from December 2017 to April 2019. We investigated the clinical features of children with parvovirus B19 immunoglobulin M or parvovirus B19 DNA detected using polymerase chain reaction. Results: A total of 24 children were diagnosed with parvovirus B19 infection. Twelve (50%) had lace form rashes, and four (16.7%) had petechial rashes. Two (8.3%) were diagnosed with fever without a focus. Six (25%) developed aplastic crisis as a complication of infection, of whom three were previously diagnosed with hereditary spherocytosis and three with acute lymphoblastic leukemia. Conclusions In addition to erythema infectiosum, the parvovirus B19 infection can present clinically with various types of rashes and fever without a focus. Furthermore, hematologic manifestations such as neutropenia and aplastic crisis can occur during infection.

The author's affiliation should be corrected. We apologize for any inconvenience that may have caused.

The author's affiliation should be corrected. We apologize for any inconvenience that may have caused.

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume*

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume

BACKGROUND/AIMS: Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry. METHODS: Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed. RESULTS: A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age. CONCLUSIONS: CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.
Aged ; Capsule Endoscopy* ; Child ; Crohn Disease ; Diagnosis ; Hemorrhage ; Humans ; Intestine, Small

BACKGROUND/AIMS: Natural orifice transluminal endoscopic surgery (NOTES) is a new era of minimally invasive surgery which has the potential to offer scarless surgery. So far, numerous reports on various routes to peritoneal organs in NOTES have been published. In case of transgastric approach, it is more inconvenient than transcolonic approach to access upper abdominal organs because of retroflexion. However, most data were subjective and there was no report examining the best access route for the exploration of peritoneal organs. The aim of this study was to evaluate the best access route according to the abdominal organs objectively. METHODS: Six female pigs weighing 30 to 35 kg were placed under general anesthesia. Incisions were made on both anterior wall of stomach body and rectosigmoid colon 15 to 20 cm above anal verge, respectively. Then, via each incision site, we evaluated the endoscopic visibility and checked the elapsed time to access abdominal organs in sequence (gallbladder (GB), spleen, bladder, uterus, and ovary). RESULTS: On comparison of the mean time to approach each organs, GB and ovary showed statistical difference in the mean time to approach between transgastric and transcolonic approaches. It took relatively shorter time to access GB via transcolonic route than transgastric route (352.3+/-80.1 sec vs. 222.2+/-82.0 sec, p=0.021). Next, we evaluated the time to access upper organs (GB and spleen) and lower organs (bladder, uterus and ovary). In case of lower organs, it showed no difference in time between transgastric and transcolonic approaches. However, to explore upper organs, transcolonic route was more favorable than transgastric route (351.8+/-80.7 sec vs. 273.3+/-110.3 sec, p=0.002). CONCLUSIONS: For exploration of lower organs, there is statistically no significant difference in time between transgastric and transcolonic approaches. But, in case of upper organs, transcolonic approach is superior to transgastric approach.
Animals ; Feasibility Studies ; Female ; *Laparoscopy ; Models, Animal ; Peritoneal Cavity/*surgery ; Statistics, Nonparametric ; Surgical Procedures, Minimally Invasive ; Swine ; Time

BACKGROUND/AIMS: Substantial time and attention are required to read and interpret the recordings of capsule endoscopic images. A suspected blood identification system (SBIS) has been developed to assist in the reading of capsule images. This software automatically marks "red tags" that correlate with suspected blood or red areas. However, the sensitivity and accuracy of the system have not been well characterized. We investigated the usefulness of the SBIS in capsule endoscopy according to various small bowel bleeding lesions. METHODS: Two expert endoscopists reviewed the capsule images. Angiodysplasias, ulcers and erosion were considered as significant lesions, and active bleeding lesions were considered when bleeding or blood clots were seen in the capsule images. The red tags that were automatically marked by the use of the rapid software were compared to the significant lesions reviewed by the endoscopists. RESULTS: A total of 95 patients were enrolled in the study. The endoscopists identified 159 significant lesions and 71 lesions marked by red tags were identified by the SBIS. Among the 71 lesions, 31 lesions correctly coincided with the significant lesions. The overall sensitivity and positive predictive value of the use of the SBIS were 20% and 44%, respectively. The sensitivities of active ulcers and active bleeding lesions were 83% and 93%, respectively. CONCLUSIONS: The SBIS should be considered as a rapid screening tool to identify active bleeding lesions, and a complete review of capsule images by a physician is still needed.
Angiodysplasia ; Capsule Endoscopy ; Hemorrhage ; Humans ; Mass Screening ; Ulcer

BACKGROUND/AIMS: Upper gastrointestinal (UGI) endoscopy is a necessary procedure for making the diagnosis of UGI diseases. However, it may evoke anxiety due to the procedural discomfort before endoscopy. There have been few detailed studies that have evaluated the anxiety of patients who undergo UGI endoscopy in Korea. The aim of this study is to evaluate the patient's anxiety associated with UGI endoscopy and to determine the methods to improve the tolerance of patients to UGI endoscopy. METHODS: From May to September 2004, we assessed 38 patients who received UGI endoscopy for the first time as outpatients at Korea University, Anam Hospital. One group was examined with UGI endoscopy after being sedated. The patient's anxiety was rated at baseline and immediately before the procedure. RESULTS: Endoscopy was associated with a significant increase in anxiety (prior to procedure, 48.53 vs. baseline, 43.58, p<0.001) but not trait anxiety (43.92 vs. 43.63, p=0.70). The procedural anxiety was not influenced by gender, age or the education level, but it was correlated with conscious sedation (without CS, 5.67+/-0.23 vs. with CS, 4.06+/-0.16, p<0.05). CONCLUSIONS: Sedating the patient during UGI endoscopy is an effective method to lower procedural anxiety.
Anxiety* ; Conscious Sedation ; Diagnosis ; Education ; Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Korea ; Outpatients

Carcinoid tumors originate from the enterochromaffin cells that are located in the gastrointestinal mucosa. Most of these tumors are asymptomatic and gastric carcinoid with massive gastrointestinal bleeding is found rarely. We experienced a case of gastric carcinoid admitted to our hospital due to melena and dizziness. The esophagogastroduodenoscopic examination revealed an ulcerofungating mass in the lower body which was thought to be a Borrmann type III adenocarcinoma. Microscopic examination of the biopsy specimens showed benign gastric ulcer without malignant cells. Repeated endoscopic biopsy revealed the same results. A computed tomographic scan of the abdomen showed a gastric mass with multiple perigastric enlarged lymph nodes. Histopathological examination of the operative specimen showed gastric carcinoid. We report a case of gastric carcinoid with massive bleeding mimicking advanced gastric cancer.
Abdomen ; Adenocarcinoma ; Biopsy ; Carcinoid Tumor* ; Dizziness ; Enterochromaffin Cells ; Hemorrhage* ; Lymph Nodes ; Melena ; Mucous Membrane ; Stomach Neoplasms ; Stomach Ulcer