Endoscopic Resection for Synchronous Esophageal Squamous Cell Carcinoma and Gastric Adenocarcinoma in Early Stage Is a Possible Alternative to Surgery

BACKGROUND/AIMS: We investigated the clinical outcomes according to the method of treatment in synchronous esophageal and gastric cancer. METHODS: Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma were diagnosed in 79 patients between 1996 and 2010. We divided the patients into four groups according to treatment; Group 1 received surgical resection for both cancers or surgery for gastric cancer with chemoradiotherapy for esophageal cancer (n=27); Group 2 was treated by endoscopic resection with or without additional treatment (n=14); Group 3 received chemoradiotherapy only (n=18); and Group 4 received supportive care only (n=20). RESULTS: The median survival times in groups 1 and 2 were 86 and 60 months, respectively. The recurrence rate and mortality were 23% and 48%, respectively, in group 1 and 21% and 4%, respectively, in group 2. The median survival time was 12 months in group 3 and 9 months in group 4. Multivariate analysis showed that age (p<0.001) and treatment group (p=0.019) were significantly associated with death. Compared with group 1, treatment in the intensive care unit (p=0.003), loss of body weight (p=0.042), and decrease in hemoglobin (p=0.033) were worse in group 1. CONCLUSIONS: Endoscopic resection for synchronous esophageal and gastric cancer could be considered as a possible alternative to surgery for early-stage cancer.

Clinical Outcomes Associated with Treatment Modalities for Gastrointestinal Bezoars

BACKGROUND/AIMS: With technical and instrumental advances, the endoscopic removal of bezoars is now more common than conventional surgical removal. We investigated the clinical outcomes in a patient cohort with gastrointestinal bezoars removed using different treatment modalities. METHODS: Between June 1989 and March 2012, 93 patients with gastrointestinal bezoars underwent endoscopic or surgical procedures at the Asan Medical Center. These patients were divided into endoscopic (n=39) and surgical (n=54) treatment groups in accordance with the initial treatment modality. The clinical feature and outcomes of these two groups were analyzed retrospectively. RESULTS: The median follow-up period was 13 months (interquartile range [IQR], 0 to 77 months) in 93 patients with a median age of 60 years (IQR, 50 to 73 years). Among the initial symptoms, abdominal pain was the most common chief complaint (72.1%). The bezoars were commonly located in the stomach (82.1%) in the endoscopic treatment group and in the small bowel (66.7%) in the surgical treatment group. The success rates of endoscopic and surgical treatment were 89.7% and 98.1%, and the complication rates were 12.8% and 33.3%, respectively. CONCLUSIONS: Endoscopic removal of a gastrointestinal bezoar is an effective treatment modality; however, surgical removal is needed in some cases.

Isolated Right Pulmonary Artery Hypoplasia with Retrograde Blood Flow in a 68-Year Old Man / 결핵및호흡기질환

Unilateral pulmonary artery hypoplasia (UPAH) is a rare disease in adults and is frequently accompanied by a congenital cardiac anomaly at a young age. The diagnosis is usually based on computed tomography (CT), angiography, and magnetic resonance imaging (MRI). However, no reports are available on retrograde flow in patients with UPAH. We describe a 68-year-old man with isolated UPAH and retrograde blood flow. He was admitted for dyspnea on exertion for the past 23 years. His diagnosis was delayed, as his symptoms and signs mimicked his underlying pulmonary diseases, such as emphysema and previous tuberculous pleurisy sequelae. A discrepancy was detected between the results of a ventilation-perfusion scan and the CT image. This was resolved by MRI, which showed retrograde blood flow from the right to the left pulmonary artery. Using MRI, we diagnosed this patient with isolated pulmonary artery hypoplasia and retrograde flow.

Clinical characteristics and outcomes among pediatric patients hospitalized with pandemic influenza A/H1N1 2009 infection / 소아과

PURPOSE: The purpose of this article is to describe the clinical and epidemiologic features and outcomes among children hospitalized with pandemic influenza A/H1N1 2009 infection. METHODS: We retrospectively reviewed the charts of hospitalized pediatric patients (<18 years) diagnosed with pandemic influenza A/H1N1 2009 infection by reverse-transcriptase polymerase chain reaction at a tertiary hospital in Seoul, Korea, between September 2009 and February 2010. RESULTS: A total of 72 children were hospitalized with pandemic influenza A/H1N1 2009 infection (median age, 6.0 years; range, 2 months to 18 years). A total of 40% had at least 1 underlying medical condition, including asthma (17%), malignancies (19%), and heart diseases (17%). Of the 72 patients, 54 (76%) children admitted with H1N1 infection showed radiographic alterations compatible with pneumonia. There was no significant difference in pre-existing conditions between pandemic influenza A/H1N1 infected patients with or without pneumonia. Children with pandemic influenza A/H1N1 pneumonia were more likely to have a lower lymphocyte ratio (P=0.02), higher platelet count (P=0.02), and higher level of serum glucose (P=0.003), and more commonly presented with dyspnea than did those without pneumonia (P=0.04). CONCLUSION: No significant differences in age, sex, or presence of preexisting conditions were found between children hospitalized with pandemic influenza A/H1N1 H1N1 influenza infection with pneumonia and those without pneumonia. Higher leukocyte count, higher glucose level, and a lower lymphocyte ratio were associated with the development of pandemic A/H1N1 2009 influenza pneumonia.

A Septic Abortion Caused by Campylobacter jejuni bacteremia / 대한내과학회지

Campylobacter jejuni was isolated from the blood of a 31-year-old woman who suffered a mid-trimester septic abortion with fever and headache. Histologically, evidence of septic abortion was found, with an intervillous abscess and acute villitis. Complete clinical recovery followed termination of the pregnancy and the use of antibiotics. C. jejuni is an unusual cause of septic abortion in humans. To our knowledge, no case has been reported in Korea.

Red Blood Cell Indices and Iron Status in Infants and Young Children with Iron Deficiency Anemia / 대한소아혈액종양학회지

PURPOSE: Iron deficiency anemia (IDA) is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause serious effects on mental and psychomotor development. We analyzed the hematologic profiles of infants and young children with IDA, comparing them with control group. METHODS: The feeding practices and the iron batteries investigated in 198 anemic patients aged 5 to 36 months who had been brought to Inha General & University Hospital. Control group were 129 healthy infants and children who visited DongBu Municipal Hospital and the local health center for immunizations. They also had hemoglobin concentration (Hb), hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin and red cell distribution width (RDW) tested by the electron counters. Patients with hemoglobin level <11 g/dL who had serum ferritin <10 ng/mL or transferrin saturation <15% were classified as having IDA. RESULTS: Out of the 198 subjects (M:F=1.6:1) with IDA, 81.8% (n=162) was breast feeding more than 6 months. The main causes which they were brought to the clinic were infectious or inflammatory illness, and only 13.1% with IDA were visited for evaluation of pallor or anemia. Correlation between Hb and MCV was much more in IDA group than control group (r=0.709, r=0.368; P<0.001). CONCLUSION: By combining Hb with MCV and RDW as well as iron batteries in screening for iron deficiency and IDA, the accuracy of diagnosis can be increased. We support the use of appropriately iron-fortified formulas or weaning foods, or the routine iron supplement starting at 6 months of age in exclusively breast-fed infants to prevent the iron deficiency.

Iron Deficiency and Feeding Practices in Infants and Young Children

PURPOSE: Iron deficiency anemia is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause seroius effects on mental and psychomotor development. The object of this study is to determine the prevalence of iron deficiency and evaluate its relationship with diet during the weaning period. METHODS: We conducted blood tests on 247 healthy, 5-24 months olds, who visited DongBu Municipal Hospital and the local health center for immunizations. One hundred and fifty-two children also had serum iron, TIBC, transferrin-saturation and serum ferritin tested. Mothers of 129 children answered a questionnaire about feeding practices and their children were divided into 3 groups according to age; groupl (5-11 mon.), groupll (12-17 mon.), grouplll (18-24 mon.). RESULTS: Out of the total number of subjects 7.3% (n=18) was anemic (Hbg<11g/dl) and the highest 9.4% was in groupl (5-11 mon.). Among 152, 32.2% (n=49) were in an iron deficient state (ferritin<10ng/ml). In group lll, 57.5% (23/40) were iron deficient. Transferrin saturation<10% was 13.8% (21/152) and ferritin<10ng/ml and/or TS<10% was 37.5%. Analysis of questionnaires is as follows : Total daily caloric intake was 771.9 +/- 264.0 Cal on average. Average daily iron intake was 5.5 +/- 2.7 mg, about half the recommended dietary allowance of 10mg. CONCLUSION: The prevalence of iron deficiency was high (32.9%) in 5-24 months olds. Because iron deficiency without anemia was 27.0%, we recommend to add serum ferritin to routine Hb indices test for iron deficiency evaluation. As average iron intake in weaning period was much less than recommended, it seems appropriate to emphasize feeding iron rich weaning foods.

Iron Deficiency and Feeding Practices in Infants and Young Children

PURPOSE: Iron deficiency anemia is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause seroius effects on mental and psychomotor development. The object of this study is to determine the prevalence of iron deficiency and evaluate its relationship with diet during the weaning period. METHODS: We conducted blood tests on 247 healthy, 5-24 months olds, who visited DongBu Municipal Hospital and the local health center for immunizations. One hundred and fifty-two children also had serum iron, TIBC, transferrin-saturation and serum ferritin tested. Mothers of 129 children answered a questionnaire about feeding practices and their children were divided into 3 groups according to age; groupl (5-11 mon.), groupll (12-17 mon.), grouplll (18-24 mon.). RESULTS: Out of the total number of subjects 7.3% (n=18) was anemic (Hbg<11g/dl) and the highest 9.4% was in groupl (5-11 mon.). Among 152, 32.2% (n=49) were in an iron deficient state (ferritin<10ng/ml). In group lll, 57.5% (23/40) were iron deficient. Transferrin saturation<10% was 13.8% (21/152) and ferritin<10ng/ml and/or TS<10% was 37.5%. Analysis of questionnaires is as follows : Total daily caloric intake was 771.9 +/- 264.0 Cal on average. Average daily iron intake was 5.5 +/- 2.7 mg, about half the recommended dietary allowance of 10mg. CONCLUSION: The prevalence of iron deficiency was high (32.9%) in 5-24 months olds. Because iron deficiency without anemia was 27.0%, we recommend to add serum ferritin to routine Hb indices test for iron deficiency evaluation. As average iron intake in weaning period was much less than recommended, it seems appropriate to emphasize feeding iron rich weaning foods.

Iron Deficiency Anemia in Infants

No abstract available.

Study on Mean Birth Weight and Medical Care System at City Hospital

Since Dongboo City Hospital cares patients with medicaid and poor socio-economic status in large percentage, we analized all the newborns delivered at the hospital from 1984 to 1992 by their birth weights, gender, gestational age and their Medical Care System. We found our babies?mean birth weight was lower than National standard mean birth weight of 1975 and 1985 (published by KPA) and also lower than other reported studies. But the fact than mean birth weight has been increasing since 1990 is encouraging.

Tuberculin skin test and measles vaccination

Although the incidence of tuberculosis in Korea in general has declined in recent years, it remains an importat health problem, especially in children. Inspite of the recent controversy over the necessity of tuberculin skin test prior to measles vaccination, this brief report shows 13.8% of positive skin test at 9 and 15 months of age at the time of measles vaccination. We feel, in Korea, practicing tuberculin skin test prior to measles vaccination is good way of detecting asymptomatic infection in young age who needs preventive therapy.

Nonimmune hydrops fetalis; an autopsy case / 대한주산의학회잡지

No abstract available.

Clinical and Statistical Studies on Pediatric Emergency Room Patients

No abstract available.