Antibiotic Sensitivity Patterns in Children with Urinary Tract Infection: Retrospective Study Over 8 Years in a Single Center

PURPOSE: We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. METHODS: We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of ≥105 CFU/mL was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. RESULTS: During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli . Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P=0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P=1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P=0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P=0.003). The prevalence of extended-spectrum β-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P=0.000). CONCLUSION: This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria.

Risk Factors for Vancomycin-Associated Nephrotoxicity in Elderly Patients

OBJECTIVE: Infection is very common in the elderly, so there is a high prevalence of antibiotics use among this population. Especially, due to the emergence of resistant bacteria, the use of vancomycin is growing. The purpose of this study was to evaluate risk factors associated with vancomycin-induced nephrotoxicity in elderly patients. METHODS: The subjects of this study were patients over 18 years old who received intravenous vancomycin in a general hospital located in Gangneung-si, Korea between August 1, 2013 and July 31, 2015. Data collection regarding vancomycin use and baseline characteristics was conducted using computerized hospital database. Logistic regression analysis was used to identify risk factors associated with vancomycin-induced nephrotoxicity. RESULTS: A total of 290 patients were finally included, and 191(66%) out of these patients were age 65 or older. The incidence of vancomycin-induced nephrotoxicity was 11.0%, 12.6%, and 7.0% in the all adult patients, the elderly patients, and the non-elderly patients, respectively. There were significant differences in comorbidities between patients with nephrotoxicity and patients without nephrotoxicity in the all adult patients, and there were significant differences in vancomycin duration, comorbidities, and number of nephrotoxic agents between patients with nephrotoxicity and patients without nephrotoxicity in the elderly patients. However, according to the logistic regression analysis, there was no significant risk factor that increases the incidence of vancomycin-induced nephrotoxicity in all three age groups. CONCLUSION: There were no differences in risk factors that increase the incidence of vancomycin-induced nephrotoxicity between all adult patients, elderly patients, and non-elderly patients. Further studies with larger sample sizes to identify risk factors associated with vancomycin-induced nephrotoxicity in the elderly to improve the outcome of pharmacotherapy are required.

A novel mutation in the DAX1 gene in a newborn with adrenal hypoplasia congenita in Korea

Adrenal hypoplasia congenita (AHC) is a rare cause of adrenal insufficiency during neonatal period. Mutations in the gene coding for DAX1 cause X-linked adrenal hypoplasia. Most affected patients are shown to have salt wasting and hyperpigmentation on the skin during the neonatal period and require intensive medical care. In addition, it is usually associated with hypogonadotropic hypogonadism in adolescence. The DAX1 gene is expressed in the adrenal cortex, pituitary gland, hypothalamus, testis, and ovary. We report on a patient with genetically confirmed AHC whose initial clinical presentations were consistent with congenital adrenal hyperplasia. A point mutation in the DAX1 gene identified in this report resulted in a truncated DAX1 protein. Our patient was diagnosed with AHC.

Prognostic Factors of Renal Scarring on Follow-up DMSA Scan in Children with Acute Pyelonephritis

PURPOSE: Early diagnosis and treatment of urinary tract infection have been emphasized to prevent renal scarring. If untreated, acute pyelonephritis could cause renal injury, which leads to renal scarring, hypertension, proteinuria, and chronic renal failure. The purpose of this study was to assess risk factors of renal scarring after treatment of acute pyelonephritis (APN). METHODS: The medical records of 59 patients admitted at Daegu Fatima Hospital because of APN between March 2008 and April 2015 whose renal cortical defects were confirmed by using initial technetium-99m dimercaptosuccinic acid (DMSA) scans were reviewed retrospectively. We divided 59 patients into 2 groups according to the presence of renal scar and assessed risk factors of renal scar, including sex, age at diagnosis, feeding method, hydronephrosis, bacterial species, vesicoureteral reflux, and vesicoureteral reflux grade. RESULTS: Of 59 patients (41%), 24 showed renal scar on follow-up DMSA scan. No significant differences in sex, hydronephrosis, bacterial species, and fever duration were found between the renal-scarred and non-scarred groups. As for age at diagnosis, age of >12 months had 5.8 times higher incidence rate of renal scarring. Vesicoureteral reflux (VUR) affected renal scar formation. VUR grade III or IV had 14.7 times greater influence on renal scar formation than VUR grade I or II. CONCLUSION: Our data suggest that the presence of VUR and its grade and age at diagnosis are risk factors of renal scar on follow-up DMSA scan after APN.

Systemic primary carnitine deficiency with hypoglycemic encephalopathy

Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Carnitine is essential for long chain fatty acids transfer into mitochondria for oxidation. We present a case of systemic primary carnitine deficiency who presented with seizures due to hypoketotic hypoglycemia.

Systemic primary carnitine deficiency with hypoglycemic encephalopathy

Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Carnitine is essential for long chain fatty acids transfer into mitochondria for oxidation. We present a case of systemic primary carnitine deficiency who presented with seizures due to hypoketotic hypoglycemia.

Causes and Clinical Features of Transient Hypocalcemia in Newborn: A Single Center Study

PURPOSE: To review clinical symptoms, laboratory findings, and treatment of transient neonatal hypocalcemia. METHODS: Medical records of full-term (gestational age ≥37 weeks) neonates diagnosed with hypocalcemia, aged 8 mg/dL. Relative hypoparathyroidism was defined as hypocalcemia and hyperphosphatemia with parathyroid hormone level within the normal range (10–65 pg/mL). RESULTS: Of 68 included neonates, 62 were diagnosed with hypoparathyroidism with hypocalcemia and hyperphosphatemia, and 26 had seizures. Mean serum calcium level of the seizure group was 5.99 mg/dL, which was significantly lower than that of the non-seizure group (6.46 mg/dL, P=0.012). The recovery duration for calcium and phosphate levels was long, at 5.8 and 10.7 days, respectively. The calcium level recovery duration was significantly different between the seizure and non-seizure groups (P=0.034), but the phosphate level recovery period was not significantly different (P=0.194). Of 17 patients with diarrhea, 10 had confirmed rotavirus infection. Most patients with hypocalcemia responded well to oral calcium lactate and intravenous calcium gluconate, and the treatments could be discontinued after a certain period. CONCLUSION: Transient neonatal hypocalcemia is associated with hypoparathyroidism. The major symptom in late neonatal hypocalcemia was the occurrence of seizures. Serum calcium level was lower and the recovery period was longer in the seizure group, but most cases exhibited favorable progress.

A Case of Hashimoto's Thyroiditis Presented with Severe Hypertension and Thyrotoxicosis / 대한소아내분비학회지

Hashimoto's thyroiditis, also called chronic lymphocytic thyroiditis, is the most common cause of acquired hypothyroidism in children and adolescent. Children may present with an euthyroid goiter, subclinical hypothyroidism, overt hypothyroidism, and, rarely hyperthyroidism. A 14-year old girl presented with abrupt onset headache, nausea and vomiting. Her blood pressure was high. Laboratory studies demonstrated a high thyroid hormone level with elevated anti-thyroglobulin antibody and anti-microsomal antibody titer, but a normal thyrotropin receptor antibody. (123)I scan showed a normal uptake. The extensive investigations to exclude other causes of hypertension showed no abnormality. We report an unusual presentation of Hashimoto's thyroiditis with severe thyrotoxicosis.

A Case of Recurrent Bacterial Meningitis Associated with Lumbosacral Dermal Sinus during Early Infancy / 대한소아신경학회지

Acute bacterial meningitis is an uncommon, potentially life-threatening infection and recurrent episodes of bacterial meningitis are rarely seen. But when they occur, an exhaustive search for the mechanisms underlying the recurrent episodes must be pursued, especially some possible routes of migration of bacteria to the cerebrospinal fluid. Dermal sinus tracts are common skin manifestations seen with spinal dysraphism and may be associated with recurrent meningitis. Here, we present a case of a 2-month-old girl who had a small dimple on the lower lumbosacral area. She was attacked twice by purulent bacterial meningitis due to a dermal sinus tract and a tethered cord. She was treated with the excision of the tract, the removal of the dermoid and the detethering of the cord. Staphylococcus and Klebsiella were cultured separately and assumed to be causative agents. The lesion was suspected on the physical examination and demonstrated by lumbosacral magnetic resonance imaging.

Improved Reporting Rate of Notifiable Communicable Diseases through a Disease Code-Based Surveillance and In-House Electronic Reporting System / 병원감염관리

Background: Reporting rate of notifiable communicable diseases has been assumed to be low in Korea. To encourage timely reporting of notifiable communicable diseases and to improve the reporting process by the Infection Control Unit, a disease code-based electronic surveillance and in-house electronic reporting system was developed and implemented in February 2003. We evaluated the reporting rates of notifiable communicable diseases before and after the implementation of the electronic reporting- system. METHODS: The electronic reporting system, which was integrated to the computerized physician order entry system, was designed to monitor KCD-4 codes at the time of every order entry. Whenever the system recognized the predetermined codes of notifiable communicable diseases, it generated an alert box to recommend reporting: and then a physician could fill up an electronic report form, which was collected and faxed to the local public health authority by the Infection Control Unit. Reporting rate of notifiable communicable diseases in 2002, when the conventional paper-based reporting system was used, was assumed comparing the number of cases reported actually and that of cases identified to be reported by reviewing the medical records and electronic database. RESULTS: From March to July 2003, 181 cases with tuberculosis and 14 with other communicable diseases were reported whereas 106 and 9 cases were reported respectively for the same 5-month period in 2002. Reporting rate using the conventional reporting system in 2002 was assumed to be 61% and 39% respectively. Conclusions: Using a disease code-based electronic reporting system, reporting of notifiable communicable diseases could be improved compared with conventional paper-based reporting system.

Use of Undiluted Potassium Solution in Intermittent Antegrade Warm Blood Cardioplegia (IAWBC) / 대한흉부외과학회지

BACKGROUND: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. MATERIAL AND METHOD: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4:1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. RESULT: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346+/-597 mL in dilutedplegia (mean+/-standard deviation, and 28+/-9 mL in microplegia (p0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250+/-810 mL, 1689+/-548 mL) than in microplegia (959+/-410 mL, 1481+/-784 mL; p<0.05). CONCLUSION: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.

The Report for Genetic Analysis of Korean Families with Congenital Cataract

PURPOSE: To describe the clinical phenotype of congenital cataract in Korean families and to determine whether the cataract is causally related to other congenital cataract with known gene. METHODS: We examined total 21 patients with congenital cataract and their families. Peripheral blood samples were obtained from congenital cataract patients and their families who visited clinics. The phenotypes were characterized by slit lamp examination and photographs of digital camera. And genetic traits were discriminated by family pedigree analysis. And we performed known mutation specific enzyme digestion, cold - SSCP and sequencing analysis for identification of genetic defects. RESULTS: We found nuclear (42.8%), anterior polar (4.8%), cortical (4.8%), sutural (4.8%) cataract. And the families affected with coexisting cortical and posterior polar opacity, posterior polar and post-subcapsular opacity were two cases (9.4%) respectively. We identified and examined a three-generation family affected with coexisting autosomal dominant zonular cataract and sutural opacity (CCZS, 4.8%: Family Yun). Previously the CCZS had mapped to chromosome 17q11-q12 and reported mutation of the beta A3A1-crystallin (CRYBA1) gene. We had not identified any mutation in CRYAB1 gene. CONCLUSIONS: In conclusion, we reported that nuclear type is very frequent in Korean patients with congenital cataract. And we had not identified any defects in CRYAB1 gene. These results demonstrated another gene caused this congenital cataract with same phenotype. Furthermore it will be necessary to perform the linkage analysis with microsatellite marker.

Four Cases of Avellino Corneal Dystrophy Concurrent with Floppy Eyelid Syndrome

PURPOSE: Avellino corneal dystrophy (ACD) is the most common form of inherited corneal disorder in Korea. To report 4 cases of ACD concurrent with floppy eyelid syndrome (FES), which had not been previously reported, and to find an additional mutation. METHODS: Five patient in 2 families who were diagnosed as ACD patient were examined whether they had FES. PCR, cold-SSCP and sequencing analysis were performed for identification of genetic defect. RESULTS: Four of 5 ACD patients showed FES which characterized by easily everted eyelid and conjunctival papillary reaction. In one family, succeeding two generations had this feature. We identified R124H mutation in all 5 ACD patients, however, no additional mutation wsa identified in BIGH3 gene. CONCLUSIONS: One case series suggested that there may be some linkage between the genes responsible for ACD and FES.

Use of Intermittent Antegrade Warm Blood Cardioplegia in CABG / 대한흉부외과학회지

BACKGROUND: It has been reported that the recently developed intermittent antegrade warm blood cardioplegia (IAWBC) has better myocardial protective effects during coronary artery bypass surgery than cold blood cardioplegia or continuos retrograde cold blood cardioplegia. The aim of this study is to evaluate the safety and usefulness of IAWBC by comparing it retrospectively with intermittent retrograde cold blood cardioplegia (IRCBC). MATERIAL AND METHOD: From April 2001 to Feb. 2003, fifty seven patients who underwent isolated coronary surgery were divided into two groups (IAWBC vs. IRCBC). The two group had similar demographic and angiographic characteristics. There were no statistical differences in age, sex, Canadian Cardiovascular Society Functional Classification for angina, ejection fraction, and number of grafts. RESULT: Aortic cross clamping time and total pump time in IAWBC (99+/-23 and vs. 126+/-32 min) were shorter than those of IRCBC (118+/-32 min. and 185+/-48 min.)(p<0.05). The reperfusion time (13+/-7 min) in IAWBC was shorter than that of IRCBC (62+/-109 min.)(p<0.05). CKMB at 12 hours and 24 hours (16+/-15 and 9+/-13) in IAWBC was lower than that of IRCBC (33+/-47 and 17+/-26)(p<0.05). The awakening time in IAWBC (2+/-1 hour) was shorter than that of IRCBC (4+/-3)(p<0.05). The number of spontaneous heart beat recovery in IAWBC (85%) was more than that of IRCBC (35%)(p<0.05). The cardiac index after discontinuing cardio-pulmonary bypass was significantly elevated in the IAWBC group. The prevalence of perioperative myocardial infarction in IAWBC (4%) was lower than that of IRCBC group (20%)(p<0.05). CONCLUSION: Intermittent antegrade warm blood cardioplegia is a safe, reliable, and effective technique for myocardial protection. It can also provide simpler and economic way than the retrograde cold cardioplegia by shortening of cardio- pulmonary bypass time and avoiding retrograde cannulation for coronary sinus.

A 10 Year Follow-up of Childhood Asthma: Potential Risk Factors on Persistence of Nonspecific Bronchial Hyperresponsiveness / 소아알레르기및호흡기학회지

PURPOSE: We studied the change of bronchial hyperresponsiveness(BHR) from childhood to early adulthood and to know the risk factors which influence on the persistence of BHR. METHODS: Seventy two atopic asthma children with nonspecific BHR to methacholine were observed for about 10 years, longitudinally. They were divided into 3 groups depend on the degree of BHR; no BHR group(A group), asymptomatic BHR group(B group), symptomatic BHR group(C group) and compared clinical and atopic findings, inflammation degree of airway, and environmental factors between the groups. RESULTS: In the group A, B, C, the number of subjects were, respectively, 15(20.8%), 19 (26.4%), 38(52.8%). The frequency of group C was higher in the subjects with more severe asthma symptoms and higher BHR at diagnosis. The positive rates of skin prick test to Dp, Df, and pets, serum total IgE, sputum eosinophils, sputum ECP at the time of follow-up were significantly higher in group C. The frequency of subjects with carpets/sofa/bed, pets at home and smokers at the time of follow-up were higher in group B, C. CONCLUSION: Significant number of childhood asthma showed persistent nonspecific BHR in early adulthood. The persistence of nonspecific BHR in early adulthood was related with severity of asthma at diagnosis, laboratory findings and environmental factors at follow up.

IL-4, IFN-gamma, IL-5, IL-12 Production by Peripheral Blood Mononuclear Cells of Moderate Atopic Asthma and Its Relation with Clinical Findings / 소아알레르기및호흡기학회지

PURPOSE: Activation of T helper(Th) cells and secretion of cytokines play a pivotal role in the pathogenesis of asthma. Th2 cells secrete IL-4 and IL-5. IL-4 stimulates IgE production and IL-5 is related with hematopoiesis, chemotaxis and activation of eosinophils. IFN-gamma produced by Th1 cells and IL-12 produced by antigen presenting cells have an inhibitory action on IgE production. We examined the cytokine production by peripheral blood mononuclear cells(PBMCs) of atopic asthmatic children and its relation with clinical findings. METHODS: We measured IL-4, IFN-gamma, IL-5, IL-12 in serum and supernatants of stimulated PBMCs cultures in 32 children with moderate stable asthma and 17 healthy controls. They were compared with number of skin test positive allergens, serum total IgE, peak expiratory flow rate(PEFR), methacholine PD20, sputum eosinophils and eosinophil cationic protein(ECP). RESULTS: No difference in serum cytokines was found between patients and controls, except IL-5. In supernatants of stimulated PBMCs cultures, the concentration of IL-4, IL-5 was significantly increased and IFN-gamma, IL-12 was significantly decreased in patients compared with controls. IL-4 was related with total serum IgE and numbers of skin test positive allergens. IL-5 was related with sputum eosinophils and ECP. The serum total IgE was inversely and PEFR was directly related with IFN-gamma. CONCLUSION: In atopic asthmatics, Th1 cytokines were increased and Th2 were decreased in stimulated PBMCs cultures. IL-4 was related with atopy, IFN-gamma with lung function and IL-5 with airway inflammation.

Effect of Nasal Continuous Positive Airway Pressure after Early Surfactant Therapy in Moderate Respiratory Distress Syndrome

PURPOSE: Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. METHODS: The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm H2O within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. RESULTS: The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was 5.4+/-0.5 cm H2O. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(p>0.05). CONCLUSION: The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

Genetic Analysis of Korean Patients with Corneal Dystrophy

PURPOSE: We collected genomic DNAs of Korean patients with inherited corneal disorders, and identified mutations of the BIGH3 gene related corneal dystrophies in Korean patients: Lattice type I (CDLI), Avellino (ACD), Reis-Buckler's (CDRB). METHODS: Slit-lamp examination of 75 patients and their relatives was carried out to confirm the diagnosis of the disorders. We composed pedigree and extracted genomic DNAs from members of the CDaffected family and individual patients. Genomic DNAs of the patients with mutation in BIGH3 gene were identified using Polymerase chain reaction (PCR) and sequencing. RESULTS: The number of patients was ranked as follows: 30 patients (40.0%) with ACD, 24 patients (32.0%) with keratoconus, 7 patients (9.3%) with CDLI, 5 patients (6.7%) with Fuchs' dystrophy, 3 patients (4.0%) with CDRB. In the genetic examination, we identified R124H mutation in ACD, R124C mutation in CDLI and R555Q mutation in CDRB. During this study, we also identified a polymorphism (F540F) in exon 12. CONCLUSIONS: ACD associated with R124H mutation is the most common form of inherited corneal disorder in Korea. And in Korean patients with CDRB, this study is the first report about mutation R555Q.

Investigation of Espoused Theories in Nursing Practice / 성인간호학회지

As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

A case of aggressive angiomyxoma in female retroperitoneum / 대한내과학회지

Aggressive Angiomyxoma is a rare, benign but locally aggressive mesench ymal neoplasm, predominently involving the pelvis and perineum of young omen. We experienced a case of aggressive angiomyxoma in the retroperitoneum. A 47-year-old woman patient visited our hospital because of constipation and an abnormal intraabdominal mass in routine examination. Examination by abdominal ultrasonography and MR imaging indicated that it was a well capsulated large soft tissue tumor in the retroperitoneum. Thus, she underwent excision of the retroperitoneal tumor. A 15 x 10 x 2 cm yellow-whitish mass was noted. The cut surface was homogenous, tannish yellow and mucoid. Microscopic findings represent that a mass was composed of widely scattered spindle-shaped and stallate-shaped cells and variable sized vascular channels within a myxoid matrix. So we report this case with a review of literature.