ABSTRACT
Platyspondylic lethal skeletal dysplasia, Torrance type (PLSD-T), is one of the phenotypes of type II collagenopathy and is characteristic of severe bone growth disorder. This phenotype may limit the growth and expansion of the lungs, which is known to cause death from respiratory failure during or shortly after birth, but in few less severe cases, patients have been reported to have survived to adulthood. We have experienced a case of PLSD-T in a preterm infant who was delivered via cesarean section at the gestational age of 29 weeks 3 days, with a birth weight of 1.15 kg. Physical examination of the infant revealed characteristic findings of short arms and legs, small thorax, distended abdomen, and cleft palate. On the basis of the subsequent genetic testing, the patient had a heterozygous mutation in the encoded c-propeptide region of collagen, type II, alpha 1 (COL2A1), c.4335G>A (p.Trp1445*) in exon 52. This is the first case of PLSD-T diagnosed in Korea, and we hereby report the case.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Abdomen , Arm , Birth Weight , Bone Development , Cesarean Section , Cleft Palate , Collagen Type II , Exons , Genetic Testing , Gestational Age , Infant, Premature , Korea , Leg , Lung , Parturition , Phenotype , Physical Examination , Respiratory Insufficiency , ThoraxABSTRACT
In 2010, symptoms of leaf and stem rot were observed on potted plants (Peperomia quadrangularis) in a greenhouse in Yongin, Korea. The causative pathogen was identified as Myrothecium roridum based on morphological data, internal transcribed spacer sequence analysis, and pathogenicity test. To our knowledge, this is the first report of M. roridum causing leaf and stem rot disease on P. quadrangularis in Korea and elsewhere worldwide.
Subject(s)
Korea , Peperomia , Sequence Analysis , VirulenceABSTRACT
BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Subject(s)
Female , Humans , Male , Acute Kidney Injury , Doxycycline , Fever , Hypoalbuminemia , Incidence , Korea , Leukocytosis , Medical Records , Pneumonia , Renal Dialysis , Retrospective Studies , Scrub Typhus , Shock , Thrombocytopenia , Ventilators, MechanicalABSTRACT
BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Subject(s)
Female , Humans , Male , Acute Kidney Injury , Doxycycline , Fever , Hypoalbuminemia , Incidence , Korea , Leukocytosis , Medical Records , Pneumonia , Renal Dialysis , Retrospective Studies , Scrub Typhus , Shock , Thrombocytopenia , Ventilators, MechanicalABSTRACT
BACKGROUND AND METHODS: We have tried to analyze the clinical findings from a total of 2503 emergent explo-laparotomic cases which had been performed during ten years from March 1989 to February 1999 at the Deptartment of General Surgery of Inchon Medical Center, Public Corporation. RESULTS AND CONCLUSIONS: 1) The total 2503 emergent explo-laparotomic cases were composed of 1992 cases (79.6%, most common) of acute appendicitis, 235 cases (9.4%) of panperitonitis, 93 cases (3.7%) of intestinal obstruction, 62 cases (2.7%) of hemoperitoneum (more than 2000 cc, without panperitonitis), 40 cases (1.6%) of gall bladder empyema, 16 cases (0.6%) of upper gastrointestinal bleeding, 15 cases (0.6%) of wound evisceration, 10 cases (0.4%) of incarcerated inguinal hernia, 9 cases (0.4%) of intra- peritoneal abscess, 9 cases (0.4%) of pancreatic abscess, 7 cases (0.3%) of septic cholangitis, 6 cases (0.2%) of diverticulitis, 5 cases (0.2%) of intussusception, 2 cases (0.1%) of liver abscess and 2 cases (0.1%) of retroperitoneal abscess. 2) Of the 1992 emergent explo-laparotomic cases which had been performed due to acute appendicitis, there were 1826 cases (more than 90%) of simple appendicitis, 95 cases of perforated appendicitis, and 71 cases of periappendiceal abscess. 3) The 237 explo-laparotomic cases of panperitonitis contained 147 cases (62%) of non-traumatic (by disease) panperitonitis and 90 cases (38%) of traumatic panperitonitis. Of the 147 cases of non-traumatic panperitonitis, there were 91 cases (62%, most common) of duodenal ulcer perforation, 21 cases of stomach ulcer perforation, 6 cases of bile peritonitis, 5 cases of colon cancer perforation, etc. Of the 90 cases of traumatic panperitonitis, there were 42 cases of small bowel rupture, 12 cases of colon rupture, 9 cases of stomach rupture, 8 cases of duodenal rupture, etc. 4) The 97 explo-laparotomic cases of intestinal obstruction were composed of 34 cases (35%, most common) of adhesive ileus, 18 cases of duodenal obstruction (16 cases due to duodenal ulcer obstruction, 2 cases due to periampullary cancer invasion), 16 cases of colon cancer obstruction, 7 cases of cancer peritoneii, 6 cases of incarcerated inguinal hernia, 4 cases of small bowel ileus, 3 cases of intestinal tuberculosis, etc. 5) The 61 cases of hemoperitoneum contained 56 cases (92%) of traumatic hemoperitoneum and 5 cases (8%) of spontaneous hemoperitoneum. Of the 56 cases of traumatic hemoperitoneum, there were 20 cases of splenic rupture, 18 cases of mesenteric tearing, 11 cases of liver laceration, etc. 6) The 148 cases of emergent explo-laparotomy for trauma contained 114cases (77%) due to blunt trauma and 34 cases (23%) due to penetrating trauma. Of the 114 emergent explo-laparotomic cases due to blunt trauma, there were 37 cases (32%, most common) of small-bowel rupture, 19 cases (17%, 2nd common) of splenic rupture, 17 cases of mesenteric tearing, 12 cases of colon rupture, 8 cases of liver laceration, 8 cases of duodenal rupture, 3 cases of stomach rupture, 3 cases of pancreas rupture, etc. Of the explo-laparotomic cases due to penetrating trauma, there were abdominal wall only penetration (most common), stomach, small bowel, liver organ injury, etc, in decreasing order.
Subject(s)
Abdominal Wall , Abscess , Adhesives , Appendicitis , Bile , Cholangitis , Cholecystitis , Colon , Colonic Neoplasms , Diverticulitis , Duodenal Obstruction , Duodenal Ulcer , Hemoperitoneum , Hemorrhage , Hernia, Inguinal , Ileus , Intestinal Obstruction , Intussusception , Lacerations , Liver , Liver Abscess , Pancreas , Peritonitis , Rupture , Splenic Rupture , Stomach , Stomach Rupture , Stomach Ulcer , Tuberculosis , Wounds and InjuriesABSTRACT
BACKGROUND: Due to rapid economic growth and the development of medical science, the human life span is increasing nowadays. Due to this, old-aged people are increasing in number. However, the physiologic reserve power of old-aged people is lower than that of younger people. Therefore, it is necessary to be very careful about peri-operative care when doing surgery on old-aged people under general or spinal anesthesia. METHODS: We analyzed the medical records of 460 patients over 65 years of age who had undergone operations from August 1990 to July 1996 at the Department of General Surgery, Inchon Medical Center. RESULTS: (1) The ratio of geriatric surgical patients to all surgical patients during the same period was 14.7% (460/3122). Especially, the proportion of geriatric surgical patients increased to 17.0% during the last 2 years of this study compared to 16.2% for the previous 2 years, and 10.6% for the first 2 years. (2) The age distribution was 148 patients from 65 to 69 years (32.2%), 158 patients from 70 to 74 years (34.3%), 90 patients from 75 to 79 years (19.6%), and 64 patients over 80 years (13.9%). There was no significant difference between the number of men and women, there being 232 men and 228 women. (3) Among the 464 cases, 99 cases (21.3%) were malignant diseases compared to 365 cases (78.7%) of benign disease. Stomach cancer was the most common, 36 cases, colon cancer accounted for 31 cases and hepatobiliary cancer for 12 cases. Of the benign diseases, 103 cases (28.2%) were acute appendicitis, 85 (23.4%) were hepatobiliary diseases, 73 (20.1%) were hernias, and 35 (9.6%) were anal diseases. (4) Two hundred twenty-two (222) preoperative-associated diseases were found in 460 patients (48.3%). Cardiovascular disease was the most common (17.4%), and pulmonary disease was the 2nd most common (15.9%). (5) Of the total 133 cases of postoperative complication occurrence, wound infection was the most common, 43 cases, followed by pneumonia, 30 cases, respiratory failure, 11 cases, and renal failure, 7 cases. (6) The postoperative mortality rate was 5.0% and the most common cause was respiratory failure, 8 cases, followed by sepsis, 8 cases. CONCLUSION: The field of geriatric surgery must be pioneered and developed more by surgeons because the number of geriatric surgical patients is increasing more rapidly at present than in the past.
Subject(s)
Female , Humans , Male , Age Distribution , Anesthesia, Spinal , Appendicitis , Cardiovascular Diseases , Colonic Neoplasms , Economic Development , Hernia , Lung Diseases , Medical Records , Mortality , Pneumonia , Postoperative Complications , Renal Insufficiency , Respiratory Insufficiency , Sepsis , Stomach Neoplasms , Wound InfectionABSTRACT
There are many causes of the right lower quadrant(RLQ) abdominal pain. Although the most common underlying cause may be acute appendicitis, chronic constipation(or fecal impaction) is the cause in some portions. In review of 120 patients with chronic constipation between 1990 and 1996, we evaluated the clinical characteristics of the RLQ pain secondary to chronic constipation. In case of the RLQ pain secondary to chronic constipation, the key points in the DDx from the RLQ pain due to acute appendicitis are as follows. (1) RLQ pain in chronic constipation is characterized by dull pain and usually it has been complained for several weeks, several months or even several years in more than half. (2) The patients don't have accompanying G-I symptoms(such as anorexia, nausea, vomiting, and epigastric pain) in more than 90%. (3) The patient complains of mild tenderness in RLQ area in some cases but no rebound tenderness was found in any cases. (4) In almost all cases, WBC count in patient's blood is within normal limits and body temperature is under 37.0degrees C. (5) For the most part, simple abdomen X-ray finding shows large or moderate amount of fecal material in the colon. So I suggest that (a) DDx in the RLQ pain could be made between acute appendicitis & chronic constipation by above findings and (b) In case of chronic constipation we need not perform negative appendectomy and it could be managed by conservative management such as enema, laxatives, high fiber diet, etc. Conclusively, I mention that the rate of negative appendectomy would be able to be reduced a little by taking these points into consideration in the clinic.