• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.26-35
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• 1994

Background: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. Methods: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, and survival retrospectively. Results: No correlation was found between patients' age, sex and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage IIIa diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of conclusion of this study. Conclusion: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.82-87
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• 2007

Purpose: In gastric cancer patients with gastric outlet obstruction, there are several complications such as malnutrition and vomiting. Palliative enteral stenting is a less invasive procedure as compared with a gastrojejunostomy. The aim of this study was to determine whether there was a significant difference between patients that undergone palliative enteral slanting and patients that had received a bypass gastrojejunostomy. Materials and Methods: One hundred patients underwent palliative entering stenting and 3f patients were subjected to a surgical bypass gastrojejunostomy. We reviewed the medical records of the patients with gastric outlet obstruction secondary to far advanced gastric cancer that were diagnosed using a gastrofibroscope, UGI and abdominal CT, and were admitted to our institution between January 2000 and August 2006. The outcome of stent placement for gastric outlet obstruction was compared with palliative gastrojejunostomy during the same period. We excluded patients with recurrent gastric cancer and double cancer from this study. Results: There were significant differences between the group of patients that underwent slanting and the group of patients that received a gastrojejunostomy regarding the age of patients ($67{\pm}12$ vs. $57{\pm}9$, P<0.001) but not between the sex of the patients (M : F, 2 : 1 vs. 2 :1, P=0.637). The most common complication of stenting was tumor ingrowth (16/100, 16%) and the second most common complication was stent migration (14/100). Failure of the procedure occurred in only three patients. Twenty-three patients underwent re-slanting and one patient required open conversion with a gastrojejunostomy. The median time to the first meal was $4{\pm}2$ days in the stent group of patients and $6{\pm}2$ days in the gastrojejunostomy group of patients (P=0.001). The median postoperative hospital stays were 9 days in the stent group of patients and 15 days in the gastrojejunostomy group of patients (P=0.003). The mean survival periods were 11 months in the stent group of patients and 10 months in the gastrojejunostomy group of patients (P=0.937). Conclusion: There were no significant differences In the mean survival rates. An earlier first meal and a shorter hospitalization stay were found in the slanting group of patients compared to the bypass gastrojejunostomy group of patients. However, re-slanting was a concern due to tumor ingrowth and stent migration.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.106-113
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• 1991

A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings : 1. The peak incidence was in 7th decade and male to female ratio was 1.8 : 1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group(SWOG) : plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III(84%) 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%. Kappa to Lambda ratio of 1.1 : 1. 6. Hematologic & biochemical fingins revealed anemia with <8.5% of hemoglobulin in 42%, hypercalcemia with < 10.6mg% of serum calcium in 22%, azotemia >2.0mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull(65%), rib(42%), L-spine(35%), pelvis(23%), T-spine(19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeoloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.

• Neonatal Medicine
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• v.18 no.1
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• pp.117-123
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• 2011

Purpose: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. Methods: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. Results: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. Conclusion: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.170-178
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• 2007

Background : The incidence of acute hepatitis A in adults has recently been increasing. This study was conducted to investigate the epidemiology and clinical characteristics of acute hepatitis A in Daegu province over the past 10 years. Materials and Methods : We reviewed the medical records of 55 patients (male/female: 34/21), who were diagnosed with acute hepatitis A by confirmation of the IgM anti-HAV between January 1998 and June 2007. Results : The mean age was $29.7{\pm}10.3$ years (range; 17-65 years). The incidence was most common between March and June (56.1%), in the third and fourth decades of life (78.2%) and 90.9% (50/55) of the patients were diagnosed from 2003 to present. The common symptoms included anorexia, nausea or vomiting (69.1%), fever and chills (49.1%), myalgia (47.3%), weight loss (47.3%), fatigue (40.0%), abdominal pain (36.4%), diarrhea (9.1%) and pruritus (5.5%). The mean duration of hospital stay was $8.6{\pm}3.4$ days (range; 3-20 days). The route of transmission was identified in only 11 patients (20.0%); 7 patients (12.7%) traveled (abroad or domestic), 2 patients (3.6%) ingested raw food and 2 patients (3.6%) had friends with acute hepatitis A. Fifty four patients recovered without complication; one patient developed fulminant hepatitis and recovered after a liver transplantation. Conclusion : The incidence of acute hepatitis A in adults is increasing. Because of the cost of treatment and potential for serious disease, persons, under 40 are recommened to have hepatitis A vaccination and confirmation of IgG anti-HAV.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.152-157
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• 2010

Purpose : Vitamin D deficiency rickets is a significant public health problem that results from insufficient exposure to sunlight and inadequate vitamin D supplementation. The purpose of this study is to identify the clinical characteristics of vitamin D deficiency rickets in infants. Methods : Data of 35 infants diagnosed as vitamin D deficiency rickets at Sanggye-Paik Hospital, Seoul, Korea, from March 2007 to May 2009 were reviewed. Children with plasma 25-hydroxyvitamin D levels <15 ng/mL and 15-30 ng/mL were considered to have vitamin D deficiency and vitamin D insufficiency, respectively. Results : Thirty-five infants (22 boys, 13 girls) were diagnosed with rickets. Mean age at diagnosis was $7.4{\pm}7.1$ months (range: 0.1-29.8 months). Eighteen infants (51%) were vitamin D deficient and seventeen infants (49%) were insufficient. Twenty-eight of all (80%) diagnosed as subclinical rickets. Twenty-nine infants (83%) were below the age of 12months. Twenty infants (57%) had breastfed and ten infants (29%) had iron deficiency anemia. Nine of breastfed infants (45%) were vitamin D deficient and ten of their mothers were vitamin D insufficient. Overall, radiographic evidence of rickets was present in 93% of the cases. Radiographic sign of rickets was evident even in vitamin D insufficient state. Conclusion : It is important for the clinician to screen for subclinical vitamin D deficiency rickets in inadequately supplemented infants by pairing 25-hydroxyvitamin D levels with wrist radiographs. A nationwide epidemiological study of vitamin D deficiency rickets must be conducted and evidence-based national guidelines must be defined to prevent rickets.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1172-1178
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• 2008

Purpose : Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment. Methods : We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007. The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding. Results : Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy. Conclusion : In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.136-143
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• 2000

Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.

• Childhood Kidney Diseases
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• v.12 no.1
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• pp.62-69
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• 2008

Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.5-12
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• 2004

I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.