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BACKGROUND: Immunoglobulin E (IgE) has traditionally been associated with anaphylaxis and atopic disease. Previous studies reported that serum IgE levels are elevated in nephrotic syndrome and suggested IgE levels as a prognostic indicator in glomerular diseases. The aim of this study was to explore the association between serum IgE levels and renal outcome in patients with immunoglobulin A nephropathy (IgAN). METHODS: We included 117 patients with biopsy-proven IgAN. Renal progression was defined if a patient meets one of these criteria: (1) a negative value of delta estimated glomerular filtration rate (mL/min/1.73 m²/mo) or (2) a rise in serum creatinine to an absolute level of ≥ 1.3 mg/dL (male) or 1.2 mg/dL (female). We defined delta changes in serum creatinine, estimated glomerular filtration rate, and proteinuria as a difference of values during the follow-up period. RESULTS: A total of 117 patients with IgAN were included. The serum IgE level was significantly high in the renal progressive group compared with the nonprogressive group. Sex and history of gross hematuria were significantly different between the high-IgE group and the low-IgE group. Regression analysis showed that a male sex, initial proteinuria, and change of proteinuria were significantly associated with serum IgE levels. CONCLUSION: The serum IgE level is potentially associated with disease progression and pathogenesis of IgAN.
Assuntos
Humanos , Masculino , Anafilaxia , Creatinina , Progressão da Doença , Seguimentos , Taxa de Filtração Glomerular , Glomerulonefrite , Glomerulonefrite por IGA , Hematúria , Imunoglobulina A , Imunoglobulina E , Imunoglobulinas , Síndrome Nefrótica , ProteinúriaRESUMO
BACKGROUND/AIMS: Several recent studies have reported that the early use of infliximab (IFX) improves the prognosis of Crohn's disease (CD). However, no data are available from Asian populations, as the forementioned studies have all been conducted in Western countries. The aim of the current study was to evaluate the impact of early use of IFX on the prognosis of Korean patients with CD. METHODS: Patients with a diagnosis of CD established between July 1987 and January 2012 were investigated in 12 university hospitals in Korea. Because insurance coverage for IFX treatment began in August 2005, patients were assigned to either of 2 groups based on diagnosis date. The first group included patients diagnosed from July 1987 to December 2005, and the second from January 2006 to January 2012. We compared the cumulative probabilities of operation and reoperation between the two groups using the Kaplan-Meier method and a log-rank test. RESULTS: Of the 721 patients investigated, 443 (61.4%) comprized the second group. Although the cumulative probabilities of immunosuppressant (P<0.001) and IFX use (P<0.001) after diagnosis were significantly higher in the second group, there were no significant differences in cumulative probabilities of operation (P=0.905) or reoperation (P=0.418) between two groups. CONCLUSIONS: The early use of IFX did not reduce CD-related surgery requirements in Korean patients with CD. These study results suggest that the early use of IFX may have little impact on the clinical outcome of CD in Korean patients in the setting of a conventional step-up algorithm.
Assuntos
Humanos , Povo Asiático , Doença de Crohn , Diagnóstico , Hospitais Universitários , Infliximab , Cobertura do Seguro , Coreia (Geográfico) , Prognóstico , ReoperaçãoRESUMO
PURPOSE: This study was designed to confirm whether the paracentric inversions of fetuses and parents may be harmless. MATERIALS AND METHODS: We report 10 cases (0.14%) with paracentric inversions among 7,181 prenatal cases observed during prenatal diagnosis performed at Cheil General Hospital between January 2009 and June 2013. We used cytogenetic GTL- and RBG-banding techniques. RESULTS: Of the 10 cases, nine cases were transmitted from each of the parents, and one case was de novo. Nine cases were phenotypically normal up to one month of age after birth. One case was lost to follow-up. We present prenatal diagnosis and follow-up examination of the fetuses with paracentric inversion. CONCLUSION: Based on our cases, most paracentric inversions are considered to be harmless. The precise identification of paracentric inversions might be clinically important and helpful for genetic counseling.
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Feminino , Humanos , Gravidez , Amniocentese , Amostra da Vilosidade Coriônica , Citogenética , Feto , Seguimentos , Aconselhamento Genético , Hospitais Gerais , Perda de Seguimento , Pais , Parto , Diagnóstico Pré-NatalRESUMO
BACKGROUND/AIMS: A subset of patients may develop colorectal cancer after a colonoscopy that was negative for carcinoma. These missed or de novo developed lesions were termed as interval cancers. Many studies regarding interval cancer have been conducted in Western countries, whereas very limited data are available in Asian populations. Therefore, the purpose of this study was to investigate prevalence, clinicopathologic features, and predictors of interval colorectal cancers in the Korean population. METHODS: Interval cancer was defined as a cancer that is diagnosed within 5 years of a negative colonoscopy result. Among the patients who were diagnosed colorectal cancers at Kangbuk Samsung Hospital from January 2007 to April 2012, clinicopathologic characteristics of interval cancers were compared with those of sporadic cancers. RESULTS: Among the 785 patients, 482 responded to telephone calls. Of these, 30 (6.2%) developed interval cancers. Finally, 28 patients who had interval cancers were compared with 415 patients who had sporadic cancers. Interval cancer group was significantly younger and more frequent in the right side colon than sporadic cancer group. There was no differences in sex, tumor size, differentiation, and staging between two groups. In multivariate analysis, young age and right side colon cancer were independent factors associated with an interval cancer. CONCLUSIONS: A significant proportion of Korean patients developed interval colorectal cancer, especially at the young age and in the proximal colon.
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Humanos , Povo Asiático , Colo , Neoplasias do Colo , Colonoscopia , Neoplasias Colorretais , Análise Multivariada , Prevalência , TelefoneRESUMO
PURPOSE: Early intervention is needed to treat patent ductus arteriosus (PDA) as it is a major cause of increased mortality in preterm infants. However, it is uncertain which is better, medical versus surgical management. We reviewed medical records to compare the treatment course and outcome between medically and surgically treated preterm PDA infants. METHODS: Thirth-two Mechanically ventilated pretem infants (gestational age<34 wks, birth weight<2,000gm) who survived beyond 30 days were studied. Treatment course and outcome were compared between indomethacin-treated (INDO, n=15) and surgically treated who have not responded to indomethacin (Surg, n=17). RESULTS: Volume of administered fluid and urine output during the first five days of life were similar, however, initial weight loss were lower in the SURG group than INDO group (p=0.031). Size of PDA on the echocardiogram were larger in SURG group (mean 3.4 mm) than INDO group (mean 2.5 mm) (p=0.046). Duration of hospitalization was longer in the SURG group (mean 46 days) than INDO group (mean 72 days) (p=0.033), however, time to start feeding, ventilator duration and weaning time were similar in both groups. Incidence of intraventricular hemorrhage was lower in the SURG group (47%) than INDO group (6%) (p=0.009). CONCLUSION: Preterm infants with poor initial weight loss and large size of PDA were likely to become surgical candidates and required longer periods of hospitalization and showed increased incidence of IVH. Although surgical treatment of PDA in preterm infants is definitive, fluid restriction and medical management at early postnatal period is recommended.
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Humanos , Lactente , Recém-Nascido , Permeabilidade do Canal Arterial , Intervenção Educacional Precoce , Hemorragia , Hospitalização , Incidência , Indometacina , Recém-Nascido Prematuro , Prontuários Médicos , Mortalidade , Parto , Ventiladores Mecânicos , Desmame , Redução de PesoRESUMO
Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4x5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.
Assuntos
Feminino , Humanos , Diagnóstico , Hemangioma , Hemangioma Cavernoso , Neoplasias do Mediastino , Radiografia , Tórax , Veia Cava SuperiorRESUMO
BACKGROUND: Recently thoracoscopic surgery is widely applied in thoracic surgical field and hyperhidrosis is one of the most frequently operated diseases. MATERIAL AND METHOD: From June 1997 to February 1998, 30 patients with hyperhidrosis underwent bilateral thoracic sympathectomy under thoracoscopy at Inje University Sanggye Paik Hospital. There were 10 males and 20 females whose mean age was 22.42+/-6.84 years ranging from 17 to 51. All patients underwent bilateral thoracic sympathectomy under semi-sitting position and two 5 mm sized trocars were inserted. RESULT: Mean operation time was 52.32+/-11.72 minutes and the mean elevation of palmar temperature after sympathectomy was 2.17+/-0.47degree C. Eighteen patients (60%) complained compensatory hyperhidrosis. All patients except one were able to discharge at the operation day or postoperative one day. There were no recurrence during follow up from 2 to 8 months (mean 5.30+/-2.17 months). CONCLUSION: Thoracoscopic sympathectomy is simple and effective technique in hyperhidrosis and widely applied indication will be necessary. We conclude that further discussion should be made about the resection area and method to get maximal effect and minimal side effect.
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Feminino , Humanos , Masculino , Seguimentos , Hiperidrose , Recidiva , Instrumentos Cirúrgicos , Simpatectomia , ToracoscopiaRESUMO
Tracheobronchial injuries are uncommon. Except for the cervical region, most tracheobronchial injuries are due to blunt chest trauma in Korea. The depth of the tracheobronchial trees renders these structures relatively safe from stab wound. We experienced a case of left main bronchial laceration with azygos vein tear following stab wound in the back of right chest firstly in Korea. The patient was a 24 years old male. A routine chest radiography showed a knife in chest at emergency room. We didn't remove the knife at emergency room. This patient was carried to operation room in 30 minutes after arrival of our hospital without computed tomography and bronchoscopy. The operation was performed through standard right posterolateral thoracotomy and then the knife was removed. The left main bronchus and azyos vein were lacerated obliquely. The penetrated azygos vein was ligated and the laceration of the left main bronchus was repaired. Postoperative course was uneventful.
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Humanos , Masculino , Adulto Jovem , Veia Ázigos , Brônquios , Broncoscopia , Serviço Hospitalar de Emergência , Coreia (Geográfico) , Lacerações , Radiografia , Toracotomia , Tórax , Veias , Ferimentos e Lesões , Ferimentos PerfurantesRESUMO
Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Paik Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon in 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform sinus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed. There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in 3 patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.
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Feminino , Humanos , Masculino , Adesivos , Álcalis , Colo , Constrição Patológica , Deglutição , Transtornos de Deglutição , Estenose Esofágica , Esôfago , Gastrostomia , Hipofaringe , Músculos , Pescoço , Necrose , Seio Piriforme , Seul , Cartilagem Tireóidea , Traqueia , TransplantesRESUMO
We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%), and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed in 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's lymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.
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Feminino , Humanos , Masculino , Diagnóstico , Células Germinativas , Neoplasias do Mediastino , Mediastino , Mortalidade , Pescoço , Agulhas , Complicações Pós-Operatórias , Radiografia , Seul , TóraxRESUMO
The common cause of tracheoesophageal fistula(T-E fistula) after tracheal intubation is ulceration and necrosis of the posterior wall of trachea by compression pressure generated by cuff. We experienced a young woman sustaining a T-E fistula which was found on the 12th day of intubation for cardiopulmonary resuscitation. Because spontaneous closure of the fistula is far uncommon, operative closure should be aimed for and should be done as soon as diagnosis is conformed. We delayed operative closure because of poor general condition of the patient. In spite of delayed reconstruction, the tracheal reconstruction itself was successful, but the patient died of peritonitis induced sepsis on the postoperative 41th day.
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Feminino , Humanos , Reanimação Cardiopulmonar , Diagnóstico , Fístula , Intubação , Intubação Intratraqueal , Necrose , Peritonite , Sepse , Traqueia , Fístula Traqueoesofágica , ÚlceraRESUMO
No abstract available.
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No abstract available.