• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.242-246
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• 2009

The clinical features of ring chromosome 13 include mental and growth retardation, CNS anomalies, facial dysmorphism, cardiac defects, genital malformations, limb anomalies, skeletal deformities and anal malformations. Although many cases of ring chromosome 13 have been reported worldwide, only 6 cases have been reported in Korea, and the latter cases were not mosaic but pure ring chromosome 13. Here we report a case with mosaic ring chromosome 13. The baby boy was born at 37 weeks of gestation by induced vaginal delivery due to intrauterine growth restriction (IUGR). He was the second baby of a 28-year-old hepatitis B carrier mother and a 32-year-old father. There was no family history of chromosomal anomalies. The baby was a symmetric IUGR with a birth weight of 1,860 g, length of 44.8 cm, and head circumference of 29.4 cm. The physical examination revealed microcephaly, trigonocephaly, flat occiput, large ears, short neck and dysmorphic facial features, including microophthalmia, hypertelorism, antimongoloid slanting palpebral fissures, a flat nasal bridge, and micrognathia. The karyotype of this patient performed by peripheral blood lymphocytes was 46,XY,r(13)(p13q34)/45,XY,-13/46,XY,dic r(13;13)(p13q34;p13q34). The baby showed failure to thrive, hypotonia, and developmental delay. We report the first case of mosaic ring chromosome 13 in a male baby in Korea and compare this case with other Korean cases of non-mosaic ring chromosome 13.

• Childhood Kidney Diseases
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• v.21 no.1
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• pp.21-25
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• 2017

Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.109-113
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• 2018

A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

• Journal of agricultural medicine and community health
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• v.32 no.3
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• pp.125-138
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• 2007

Objectives: This retrospective study is to identify related factors of treatment success of patients with tuberculosis at community health centers. Methods: The subjects of this study were 1,417 patients with tuberculosis treated in 28 community health centers. The predictors of tuberculosis treatment success were analyzed in terms of 2 areas, which were characteristics of patients and health centers(TB control program). The characteristics of patients consist of 2 factors, such as demographic & diagnosis and treatment. The present conditions of health centers consist of 3 factors, location of centers, resources, and community activities. Data were analysed using X2- test and logistic regression methods. Results: The significant differences between success group and failure group were sex(p=0.003), age(p=0.013), job(p=0.000), type of patients(p=0.001), past history(p=0.029), BCG injection(p=0.009), sputum culture examination(p=0.017), period of treatment(p=0.000), location of center(p=0.001), population per staff(p=0.015), FTE(p=0.027), education days of staff(p=0.005), BCG injection rate(p=0.001), case detection rate (p=0.003), and health education provision rate(p=0.044). Then these variables were analysed using logistic regression analysis. Significant positive factors of treatment success were occupation(95% CI:1.3-6.1), periods of treatment(95% CI:1.5-2.2), center in large city(95% CI:1.2-16.7), center in middle city(95% CI:2.1-24.3), job education related TB(95% CI:1.02-1.3), and BCG injection rate(95% CI:1.1-303.4). Significant negative factors of treatment success were male(95% CI:0.1-0.5) and treatment after default(95% CI:0.005-0.5). Conclusions: Tuberculosis is still one of serious diseases in Korea, because it causes highest mortality rate among OECD countries. This study may provide information to improve treatment effectiveness of tuberculosis at community health centers.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.250-255
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• 1995

Diffuse tracheobronchial amyloidosis is an uncommon form of pulmonary involvement, and causes prolonged cough, dyspnea, wheezing and repeated development of pneumonia. We report a case of diffuse tracheobronchial amyloidosis in 58-year-old woman that was traeted by repeated electrocautry under flexible fiberoptic bronchoscopy. The patient had a long-standing history of dyspnea and was admitted due to resting dyspnea, which was aggravated to impending respiratory failure after diagnostic procedures. We applied repeated electrocautry to the endobronchial amyloid tumors and successfully reduced bronchial stenosis and the pateint didn't feel dyspnea. We suppose that, in certain cases of tracheobronchial amyloidosis patients, endobronchial electrocautry would be a helpful procedure.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.98-102
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• 2004

The terrible triad of the shoulder, a combination of anterior shoulder dislocation, massive rotator cuff tear and neurologic injury, is rare. We experienced 4 patients with this condition who were treated with a rotator cuff repair. The mean age was 65 years. Follow-up averaged 27 months. All patients had a history of redislocation after initial traumatic shoulder dislocation and were evaluated with electromyography and magnetic resonance imaging. At the operation, massive rotator cuff tear and hypertrophy of the long head of the biceps were found in all patients. Clinically, 3 patients achieved recovery of their nerve injury by 3 months postoperatively and the final results were fair. In one patient, there was no recovery of deltoid function and this case was rated as a failure. For this injury pattern, the prognosis appears to be dependent on eventual nerve recovery when the rotator cuff has been repaired early.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.644-651
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• 1999

It is a relatively common clinical experience to see an unerupted maxillary central incisor. This phenomenon is apparent at the dental age of almost eight years and over. Among the possible cause for failure of eruption, ectopic development of the tooth germ is mentioned. This is not fully understood but trauma or periapical imflammation of primary predecessors is accepted. The case with no history of trauma may be impacted by the periapical imflammation of primary predecessors. For bringing into the tooth eruption and the continued normal root developement by the Hertwig's epithelial root sheath, there are early considered of surgical invention and orthodontic traction with removable appliance. We reported successful treatment for inverted maxillary central incisor with proper eruption and normal root developement by forced eruption using removable appliance. But further observation will be required to evaluate the final root developement state and amount of keratinized attachment gingiva.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.21-27
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• 2001

Objectives : To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the perfermance of hospitals. Methods : Data from 564 CABGs peformed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic repression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, $R^2$, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. Results : The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission. acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and $R^2$ were 0.791 and 0.001, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were net significantly different. Conclusion : Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may He an indicator for evaluating hospital performance in Korea.

• The Korean Journal of Medicine
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• v.99 no.4
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• pp.219-223
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• 2024

Emphysematous prostatitis with an abscess is an extremely rare but lethal infection, characterized by the accumulation of gas and purulent exudates. Due to its rarity, severity, and nonspecific presentation, prompt diagnosis and treatment are crucial to achieve favorable clinical outcomes. This report presents a 43-year-old male with hemodialysis-dependent end-stage kidney disease who reported a 3-day history of fever, urinary incontinence, dysuria, and dyspnea. His condition rapidly deteriorated due to septic shock caused by emphysematous prostatitis with an abscess. Following extensive treatment including long-term parenteral antibiotics, polymyxin B hemoperfusion filter treatment, abscess drainage via transurethral resection of the prostate, and suprapubic cystostomy, the patient successfully recovered.