Atrial fibrillation is the most common cardiac arrhythmia, and electrical cardioversion for atrial fibrillation contributes to the formation of systemic thromboembolism. In particular, the increase in the occurrence of thromboembolic events is associated with postcardioversion atrial and atrial appendage "stunning". Most thromboembolic events after cardioversion were found in the cerebral artery. In this case, the patient had a thromboembolism in the brachial artery region, which has not been reported in literature reviews. We describe the first case of brachial arterial thromboembolism which occurred 3 days after cardioversion of atrial fibrillation, and was completely resolved by thrombolytic therapy.

Left ventricular (LV) thrombi may be caused by various conditions, particularly myocardial infarction. In most cases, LV thrombus occurs in patients with a significantly reduced ejection fraction. A LV thrombus is extremely rare in patients with normal LV function. We report a case of LV thrombus initially detected on transthoracic echocardiography and confirmed using cardiac magnetic resonance imaging in a patient with normal LV wall motion. We highlight the rarity of this condition and the usefulness of cardiac magnetic resonance imaging in the diagnosis of LV thrombus.

Acute tubular necrosis (ATN) is a syndrome of intrinsic renal injury secondary to ischemic or toxic causes without parenchymal damages and usually non-oliguria. A 20-year old man presented with acute renal failure preceded by 2 days of watery diarrhea. He had been anuria for 48hr with intravenous fluid therapy. Oliguria persisted for 10 days and he required hemodialysis support for 6 days before renal recovery. He denied the use of any regular medication and any intravenous drug use. Renal biopsy revealed severe ATN. Histopathologic findings were marked desquamation of proximal tubular epithelial cells with intact distal tubules and normal glomeruli. We report an unusual case of ATN with anuria and clinically severe features.

Acute myocardial infarction (AMI) involving two simultaneous vascular territories of acute transmural ischemia is known as a double or combined myocardial infarction. This well described but extremely rare phenomenon may be related to the fact that AMI with multiple vessel obstruction often causes extensive myocardial injury and death before hospitalization. We reported the first case of 45-year-old man with AMI occluded left anterior descending artery and right coronary artery simultaneously in Korea.

Prognosis of the patients with lung cancer with lung-to-lung metastasis are known to be poor and frequently old aged persons with multiple nodules on imaging study abandon more invasive procedure including bronchoscopy and VATS (Videoassisted thoracoscopic surgery) to get tissue confirmation. Sjogren’s syndrome (SS) associated lung lesion mimicking lung cancer has a chance to have more favorable diseases including lymphoma. A 78-year-old woman with SS was admitted due to slowly progressive exertional dyspnea and multiple nodules on imaging study. She and her family gave up invasive diagnostic procedures at first due to old age but short term rapid change of dyspnea and nodules on chest CT brought out invasive procedures and diffuse large B-cell lymphoma was diagnosed. Dyspnea and nodules on imaging were improved after R-CHOP chemotherapy.

The aim of this study was to investigate the clinical relations of eating behaviors to body mass index (BMI) and obesity in girls with idiopathic central precocious puberty. This study included 30 precocious puberty patients who were diagnosed at Chosun University Hospital between February and December 2013. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors. We rechecked their BMI and questionnaire after 12 months to identify the changes. Six (20%) of the 30 patients children were overweight and obesity at diagnosis. Overweight and obesity group tended to overeat. Normal weight group ate an unbalanced diet more than overweight and obesity group, particularly lack of fruit and vegetable (p=0.010). Eight (27%) of the 30 patients children were overweight and obesity and 24 (80%) of the 30 patients children showed increased BMI after 12 months follow up. BMI-decreased group ate breakfast with whole family members more frequent than BMI-increased group (p=0.006). This study showed the importance of healthy diet during treatment of precocious puberty. Children with precocious puberty should avoid overeating and make a balanced diet with preferable eating behaviors from the family meals.

The lumbar discectomy is the surgery with low morbidity itself and need the prone position, which is essential for this surgery. However, the increased intra-abdominal pressure after changing supine to prone position may lead intra-abdominal hypertension or abdominal compartment syndrome, consequently acute mesenteric ischemia. Acute mesenteric ischemia is one of the fatal conditions of acute abdomen with overall mortality of 60% to 100%. Unfortunately, the early detection of mesenteric ischemia in perioperative period of spinal surgery is difficult. We herein report an experience of acute mesenteric ischemia after lumbar discectomy in prone position, and review the relative literatures.

The present study aimed to identify the factors that can clinically predict responses to macrolides treatment in patients with Mycoplasma pneumoniae pneumonia. Of the patients admitted to the pediatrics department of Kwangju Christian Hospital during December 2012 to March 2015, 195 patients who had pneumonia according to findings of chest radiography, positive Mycoplasma IgM, and fever at the time of admission were selected as study subjects. Patients were divided into one group wherein the duration of fever after macrolides treatment was 3 days or less and another group wherein the duration of fever was 4 days or more (169 patients [86.7%] vs 26 patients [13.3%]). In the group with fever duration of 4 days or more, a greater number of patients had a history of atopic dermatitis (3.6% vs 15.4%, p=0.11), and the symptom duration before admission was longer (cough: 4.04 days vs 6.38 days, p<0.001; fever: 3.96 days vs 6.08 days, p<0.001). Moreover, according to laboratory test results in the group with fever duration of 4 days or more, LDH levels were high (648.16 IU/L vs 829.92 IU/L, p=0.001), and there was a significant correlation between LDH levels and the duration of fever after macrolides treatment.

Guillain-Barré syndrome can be classified with several subtypes along with the union of each symptom. Autoimmune mechanism is accepted for pathogenesis. It is often difficult to predict the causative antibodies of the various types of Guillain- Barré syndrome, because there are considerable mismatches of causative antibody to clinical phenotype as well as phenotype or antibody heterogeneities. We investigated the clinical characteristics of the patients with positivity of anti-gangliosides antibody in the serum. Nineteen patients were enrolled who showed the positivity of anti-GM1 antibody, anti-GQ1b antibody and anti-GD1b antibody, who had visited the department of neurology of Chosun University Hospital. We classified the three patient groups; 8 patients had positivity for anti-GM1 antibody, 10 patients for anti-GQ1b antibody and 8 patients for GD1b antibody. The result of statistical analysis showed no clinical difference within the groups. Therefore, prediction of causative autoantibody can be risky when we considered only the symptoms and course of disease of Guillain-Barré syndrome.

Severe maternal morbidity is frequently associated with catastrophic complications of pregnancy such as amniotic fluid embolism (AFE) or sepsis due to chorioamnionitis. The authors report a case of postpartum maternal hypoxic encephalopathy that might be attributed to AFE or sepsis due to chorioamnionitis with Escherichia coli bacteremia, and review the relevant literature. The patient presented with preterm labor, underwent Cesarean section for intrauterine fetal demise, and experienced postpartum cardiopulmonary collapse and disseminated intravascular coagulation, which led to catastrophic postpartum maternal encephalopathy.

For patients suffering from acute ischemic stroke from cerebral artery occlusion, reperfusion is necessary to save the ischemic penumbra. Therefore, early and complete recanalization of an occluded artery is the main therapeutic goal of acute ischemic stroke. Among the many advances in management of acute ischemic stroke, thrombolysis with intravenous (IV) tissue plasminogen activator (t-PA) within 4.5 hours after symptom onset has been the only approved pharmacological therapy. However, IV t-PA has many limitations in clinical practice, low eligible patients and low recanalization rates, particularly in cases of larger proximal artery occlusions. In addition, there are many complications, including symptomatic intracranial hemorrhage (approximately 6%). In contrast, higher recanalization rates and an extended therapeutic time window have been reported for intra-arterial (IA) thrombolysis. According to studies until 2013, no studies proving the advantages of IA thrombolysis have been reported. However it was reported that studies in 2015 showed its possibility. Therefore, the purpose of this article is to cast a light on failures of previous studies, and try to assess the differences with studies in 2015. In addition, crucial points for successful IA thrombolysis will be discussed.

Calcifying fibrous tumor (CFT) is a rare benign soft tissue mass consisted of abundant densely hyalinized collagen with calcifications and patchy infiltration of lymphocytes and plasma cells. The etiology and pathogenesis of this entity are unknown. Recently we experienced a case of CFT of the peritoneum in 37-year-old man. Complete removal of this lesion was performed.

The intussusception recurs in approximately 10 percent of children after successful nonoperative reduction. The main objective was to determine the clinical and sonographic findings that could be used to predict recurrence of ileocolic intussusception in children that had been successfully reduced by enema. A retrospective search was performed on 66 children, at age of 3 months to 7 years, with successful enema reduction of intussusception during a 2.5-year period from January 2013 to July 2015. The clinical, laboratory records, and sonographic findings were compared between recurrence of intussusceptions group (ROI) and non-recurrence group (NROI). Statistical significances were found in age (median, 26.0 vs 18.5 months; P =0.022) and terminal ileal wall thickening (mean, 10.23 vs 7.8 mm; p=0.002); in contrast, there was no significance considering gender, irritability (p=0.074), currant jelly stool (p=1.0), or C-reactive protein (p=0.908). Recurrence is associated with age and the thickening of terminal ileal wall, but clinical or laboratory findings. Given the small number of cases, further studies should be conducted.

Enterobius vermicularis is one of the most common parasites in the world and the infection rate is higher in children than adults. Although the most common clinical manifestation is perianal pruritus, it may cause other gastrointestinal manifestations. We report one case of appendicitis caused by Enterobius vermicularis. The clinical difference between typical appendicitis and the appendicitis due to Enterobius vermicularis is unclear. The patient had a repetitive Enterobius vermicularis infection for a past year, which was treated with occasional vermicides only. It is considered that the appendicitis is developed from the intractable Enterobius vermicularis infection.