Although hanging is the most common method of suicide in Korea, there are few reports of dysphagia following laryngeal injuries due to near-hanging. This is a case report of a patient who complained of dysphagia after a complex fracture of the neck structures caused due to attempted suicide by hanging. A 51-year-old male visited our hospital with neck injuries after a near-hanging episode. Laryngoscopy suspected dislocation of the right arytenoid cartilage. A computed tomography (CT) scan revealed fractures of the right hyoid bone and thyroid cartilage, as well as soft tissue emphysema. A closed reduction for the dislocation of the right arytenoid cartilage was performed. After surgery, oral feeding was attempted five days after surgery but stopped due to a large amount of aspiration. After two weeks, a videofluoroscopic swallowing study (VFSS) revealed a decreased laryngeal elevation and severe impairment of the upper esophageal sphincter opening. The patient was then given rehabilitation for oropharyngeal dysphagia to restore swallowing function. Four months after the injury, VFSS showed that the residue in the pyriform sinus after multiple swallowing attempts decreased compared to the previous studies. However, oral diet and enteral feeding were combined due to the patient experiencing early fatigue due to swallowing difficulties.Our observations, in this case, show that it was necessary to provide treatment through a multidisciplinary approach coupled with long-term follow-up for patients with dysphagia after complex fractures by near-hanging.

PURPOSE: In Korea, the incidence of breast cancer peaks in the fifth decade, which is younger than that observed in the Western world. We conducted this study to compare the clinical characteristics and prognostic factors of breast cancer in women < 35 and ≥35 years old.METHODS: The medical records of 969 patients treated for breast cancer at the Gil Medical Center from 2008 through 2012 were reviewed. Tumor characteristics, surgical methods, and adjuvant therapies were compared in two groups.RESULTS: Number of childbirths, family history, the proportion of postmenopausal women were lower among those aged < 35 years. However, tumor size, number of metastatic lymph nodes, and surgical procedures were similar in two groups. The rate of triple negative status in younger patients was higher than in older patients. Adjuvant chemotherapy was effective in patients positive for hormone receptors and no lymph nodal invasion, and it was effective in patients negative for hormone receptors and lymph nodal invasion in patients aged >35 years old. Postoperative radiotherapy was statistically effective in patients aged < 35 and ≥35 years old that underwent breast-conserving surgery. Pregnancy were significantly associated with survival in younger patients. While lymph node stage, presence of progesterone receptor, and triple negative status were significantly associated with survival on older patients.CONCLUSION: The prognostic factors of breast cancer in patients younger than 35 years old were pregnancy. Triple negative status rate was higher in younger patients than in older patients. Adjuvant therapy had similar effects in patients aged < 35 or ≥35 years old.
Breast Neoplasms ; Breast ; Chemotherapy, Adjuvant ; Female ; Humans ; Incidence ; Korea ; Lymph Nodes ; Mastectomy, Segmental ; Medical Records ; Parturition ; Pregnancy ; Prognosis ; Radiotherapy ; Receptors, Progesterone ; Western World ; Young Adult

The pathophysiology of glandular dysfunction in Sjögren's syndrome (SS) has not been fully elucidated. Previously, we reported the presence of autoantibodies to AQP-5 in patients with SS, which was associated with a low resting salivary flow. The purpose of this study was to investigate the presence of anti-AQP1 autoantibodies. To detect anti-AQP1 autoantibodies, cell-based indirect immunofluorescence assay was developed using MDCK cells that overexpressed human AQP1. By screening 112 SS and 52 control sera, anti-AQP1 autoantibodies were detected in 27.7% of the SS but in none of the control sera. Interestingly, the sera that were positive for anti-AQP1 autoantibodies also contained anti-AQP5 autoantibodies in the previous study. Different from anti-AQP5 autoantibodies, the presence of anti-AQP1 autoantibodies was not associated with the salivary flow rate. Although anti-AQP1 autoantibodies are not useful as a diagnostic marker, the presence of autoantibodies to AQP1 may be an obstacle to AQP1 gene therapy for SS.
Aquaporin 1 ; Autoantibodies* ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Genetic Therapy ; Humans ; Madin Darby Canine Kidney Cells ; Mass Screening

BACKGROUND AND OBJECTIVES: The differences in plaque characteristics between non-culprit lesions (NCL) in acute coronary syndrome (ACS) patients (ACS-NCL) and target lesions (TL) in stable angina (SA) patients (SA-TL) are not well understood. We used a virtual histology-intravascular ultrasound (VH-IVUS) to compare the plaque components between ACS-NCL and SA-TL. SUBJECTS AND METHODS: We compared VH-IVUS findings between 290 ACS-NCL and 276 SA-TL. VH-IVUS classified the color-coded tissue into four major components: green (fibrotic); yellow-green (fibro-fatty); white {dense calcium (DC)}; and red {necrotic core (NC)}. Thin-cap fibroatheroma (TCFA) was defined as a NC > or =10% of the plaque area in at least 3 consecutive frames without overlying fibrous tissue in the presence of > or =40% plaque burden. RESULTS: Although the plaque burden was significantly smaller (52+/-13% vs. 54+/-14%, p=0.044), ACS-NCL had a greater %NC area (17.9+/-11.6% vs. 14.3+/-8.7%, p<0.001) and %DC area (9.7+/-9.8% vs. 8.1+/-8.0%, p=0.032) compared with SA-TL at the minimum lumen site. By volumetric analysis, ACS-NCL had a greater %NC volume (15.8+/-9.2% vs. 13.9+/-7.4%, p=0.006) compared with SA-TL. TCFA was observed more frequently in ACS-NCL compared with SA-TL (27.6% vs. 18.1%, p=0.032). Independent predictors of TCFA by multivariate analysis were ACS {odds ratio (OR): 2.204, 95% CI: 1.321-3.434, p=0.021} and high-sensitivity C-reactive protein (OR: 1.101; 95% CI 1.058-1.204, p=0.035). CONCLUSION: Although the plaque burden was significantly smaller, ACL-NCL had more vulnerable plaque components compared with SA-TL, and ACS and high-sensitivity C-reactive protein were the independent predictors of TCFA.
Acute Coronary Syndrome ; Angina, Stable ; C-Reactive Protein ; Calcium ; Humans ; Multivariate Analysis ; Plaque, Atherosclerotic ; Ultrasonography, Interventional

BACKGROUND: Use of universal leukoreduction for prevention of leukocyte associated transfusion reactions is common practice in many countries. This study was conducted in order to evaluate the performance of a newly developed leukoreduction filter for red blood cells (RBCs), the RF300 (Kolon Industries, Inc, Gumi, Korea). METHODS: Filtration time, RBC recovery, residual leukocyte count, and leukocyte removal rate were evaluated. To assess the quality of RBCs after filtration, percent hemolysis was monitored for a period of 21 days. Performance of the RF300 (N=78) was compared with that of the Bio-R O2 plus (Fresenius, Hamburg, Germany), the Pall Purecell RC (Pall Co., Washington, USA), and the Sepacell R-500N (Asahi, Tokyo, Japan). RESULTS: The shortest filtration time was observed using the RF300 (P<0.05). Using the RF300, recovery of RBC was 96.5%, which was higher than that of two filters (P<0.05). Mean residual leukocyte count was 0.26x10(6)/unit, with a leukocyte removal rate of 3 log. Using the RF300, mean percent hemolysis was 0.32% at day 21, which was comparable with that of two filters, but lower than that of one filter (P<0.05). CONCLUSION: The RF300 meets all established quality requirements for conduct of safe and effective leukoreduction of RBCs.
Blood Group Incompatibility ; Collodion ; Erythrocytes ; Filtration ; Hemolysis ; Leukocyte Count ; Leukocytes ; Tokyo ; Washington

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) transmission route is not yet clearly understood. Isolating H. pylori from stool, saliva, and vomitus is very difficult. However, H. pylori could be cultured from feces in the setting of rapid gastrointestinal tract transit. The aim of this study was to isolate H. pylori by culture and PCR in the rectum and terminal ileum during colonoscopy. METHODS: Twenty subjects with positive UBT (urea breath test) were included. We performed polymerase chain reaction (PCR) test and culture of H. pylori with the rectal fluid and terminal ileal fluid during colonoscopy. RESULTS: H. pylori was cultured with rectal fluid from 9 (45.0%) of 20 subjects and with ileal fluid from 11 (55.0%) of 20 subjects. H. pylori was a little more frequently cultured from the terminal ileal fluid than the rectal fluid without statistical significance (p>0.05). PCR test detected flaA (16/20, 80.0% and 17/20, 85.0%), 16S rRNA gene (16/20, 80.0% and 17/20, 85.0%), cagA (10/20, 50.0% and 12/20, 60.0%), and ureC (9/20, 45% and 11/20, 54.5%) from the rectal fluid and the terminal ileal fluid, respectively. The specificity and sensitivity of ureC were 100%. CONCLUSIONS: H. pylori could be cultured from the rectal fluid and terminal ileal fluid in the setting of rapid gastrointestinal tract transit. These results suggest of fecal-oral transmission of H. pylori.
Adult ; Antigens, Bacterial/genetics ; Bacterial Proteins/genetics ; Breath Tests ; Electrolytes/administration & dosage ; Feces/microbiology ; Female ; Helicobacter Infections/*diagnosis/transmission ; Helicobacter pylori/genetics/*isolation & purification ; Humans ; Ileum/*microbiology ; Male ; Middle Aged ; Polyethylene Glycols/administration & dosage ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/genetics ; Rectum/*microbiology ; Sensitivity and Specificity ; Urea/analysis ; Urease/genetics

Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large amounts of ructooligosaccharides. Traditionally, yacon tubers have been used as a source of natural sweetener and syrup for people suffering from various disorders. We report the case of a 55-year-old woman who developed syncope and generalized urticaria after ingesting yacon roots. The patient had positive skin prick and intradermal tests to yacon extract. An open food challenge test was performed to confirm food anaphylaxis and was positive 10 minutes after the consumption of yacon roots. To our knowledge, this is the first reported case of anaphylaxis after the ingestion of yacon roots.
Allergens ; Anaphylaxis ; Eating ; Female ; Flushing ; Humans ; Hypersensitivity ; Hypotension ; Intradermal Tests ; Middle Aged ; Outpatients ; Plants ; Skin ; Stress, Psychological ; Sweetening Agents ; Syncope ; Urticaria

Anaphylaxis is a potentially life-threatening systemic allergic reaction, often with an explosive onset; the symptoms range from mild flushing to upper respiratory obstruction, with or without vascular collapse. Foods are common offending allergens and remain the leading cause of outpatient anaphylaxis in most surveys. Yacon (Smallanthus sonchifolius) is a plant native to the Andes region, where its root is cultivated and consumed mainly as food. Unlike most edible roots, yacon contains large amounts of ructooligosaccharides. Traditionally, yacon tubers have been used as a source of natural sweetener and syrup for people suffering from various disorders. We report the case of a 55-year-old woman who developed syncope and generalized urticaria after ingesting yacon roots. The patient had positive skin prick and intradermal tests to yacon extract. An open food challenge test was performed to confirm food anaphylaxis and was positive 10 minutes after the consumption of yacon roots. To our knowledge, this is the first reported case of anaphylaxis after the ingestion of yacon roots.
Allergens ; Anaphylaxis ; Eating ; Female ; Flushing ; Humans ; Hypersensitivity ; Hypotension ; Intradermal Tests ; Middle Aged ; Outpatients ; Plants ; Skin ; Stress, Psychological ; Sweetening Agents ; Syncope ; Urticaria

Strongyloides stercoralis is an intestinal nematode that is a parasite to humans. The infecting filariform larvae of S. stercoralis enters the host body via the bloodstream, passes through the lungs, penetrates the alveoli, and then ascends the airway to transit down the esophagus into the small bowel. The infection can persist for decades without causing major symptoms and can elicit eosinophilia of varying magnitudes. Of note, this infection can also develop into a disseminated, often fatal, disease (hyperinfection) in patients receiving immunosuppressive corticosteroids. A 65-year-old man who was receiving corticosteroid therapy for the treatment of spinal stenosis was admitted to the emergency room with complaints of abdominal pain and severe dyspnea. We detected many S. stercoralis larvae in the sputum and in the bronchoalveolar-lavage sample collected by bronchoscopy. Here, we report a fatal case of strongyloidiasis with acute respiratory failure and intestinal perforation. In addition, we provide a brief review of the relevant medical literature.
Abdominal Pain ; Adrenal Cortex Hormones ; Aged ; Bronchoscopy ; Dyspnea ; Emergencies ; Eosinophilia ; Esophagus ; Humans ; Immunosuppression ; Intestinal Perforation ; Larva ; Lung ; Lung Neoplasms ; Parasites ; Respiratory Insufficiency ; Spinal Stenosis ; Sputum ; Strongyloides stercoralis ; Strongyloidiasis

BACKGROUND/AIMS: Hepatitis A is an acute infectious disease transmitted by fecal-oral route. As the incidence of hepatitis A has been increased in Gwangju and Chonnam province of Korea recently, the number of hepatitis A patients in hospital employees has also increased. Thus, we investigated the seroprevalence of IgG anti-HAV in hospital employees below 40 years old. METHODS: We analysed the seroprevalence of anti-HAV IgG from 1,002 Chonnam national university hospital empolyees (men: 190, women: 812) who were below 40 years old. The age group was divided by 5 years; 21-25 years old 199 (19.9%), 26-30 years old 426 (42.5%), 31-35 years old 215 (21.5%), 36-40 years old 162 (16.1%). RESULTS: Overall seropositive rate of IgG anti-HAV was 32.8% (329/1,002). The seropositive rate of men was 40.5% (77/190) and that of women was 31.0% (252/812). The seropositive rates of each age group were 1.5% (3/199) in 21-25 years old, 21.6% (92/426) in 26-30 years old, 48.4% (104/215) in 31-35 years old, and 80.2% (130/162) in 36-40 years old. The seropositivity rate of the high risk group (doctors, nurses, technicians) was 28.9% (234/809). CONCLUSIONS: The seropositive rate of IgG anti-HAV was the lowest in early twenties of hospital employees and below 50% in early thirties. Therefore, hepatitis A vaccination may be warranted in the hospital empolyees below the early thirties.
Adult ; Female ; Hepatitis A/*epidemiology ; Hepatitis A Antibodies/*blood ; Hepatitis A Virus, Human/immunology ; Hospitals ; Humans ; Immunoglobulin G/*blood ; Male ; Occupational Diseases/*epidemiology ; *Personnel, Hospital ; Seroepidemiologic Studies ; Young Adult