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S-97 The Predictors of Follow up Loss in Patients with Inflammatory Bowel Disease
( Ji Yeon Koo ),( Kyeong Ok Kim ),( Da Eun Jeong ),( Byung Ik Jang ),( Chang Heon Yang ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
There were several studies about the predictors of non-adherence to inflammatory bowel disease (IBD) therapy. However, there were few studies about the predictors of stopping visiting clinics in patients with IBD. Our aims were to evaluate the predictors of follow up loss of visiting clinics in IBD patients. Methods: The medical record of 224 patients with IBD who were followed up between January 2010 and December 2013 were reviewed retrospectively. Follow up loss was defined that patients didn't visit clinics at least 6 months. Results: Among 224 patients with IBD, there were 94 patients with Crohn’s disease and 130 patients with ulcerative colitis. Mean follow up duration was 58.51 months. The follow up loss was noted in 32.1% of patients. The follow up loss rate in patients with CD and UC were 28.7% and 34.6 % respectively. Age, gender and disease severity index at the last visit before being absent the clinics could not show any difference according to the status of follow up. Mean follow up loss duration was 17.72 months. All of the patients who followed up loss revisited clinics and the most common cause of revisit was flare up of the diseas . Lower Education status and C reactive protein also increased the risk for follow up loss by 2.13 and 1.81 times, respectively. By multivariate analysis, risk factors of follow up loss were C reactive protein level below 1.2mg/dL and lower educational status. Conclusions: The follow up loss rate in patient of IBD was 32.1%. Lower educational status and low C reactive protein level increased the risk of follow up loss in IBD patients. Clinician takes an effort to help the patients with lower educational status or low C reactive protein level understand the disease and disease course to prevent follow up loss.
Ji Eun Kim,Mira Kang,Ok Soon Jeong,Poong-Lyul Rhee 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.2
Background/AimsMedian arcuate ligament syndrome (MALS) is known as chronic recurrent abdominal pain related to compression of the celiac artery by the median arcuate ligament. We aim to seek the specific mechanism of the pain by evaluating symptoms and radiological characteristics on abdominal CT scans. MethodsWe analyzed 35 patients who visited the emergency room for recurrent abdominal pain after cholecystectomy. We classified the characteristics of patients as 4 clinical components and 2 radiological components. We defined the sum of weighted clinical scores and weighted radiological scores as nutcracker ganglion abdominal pain syndrome (NCGAPS) scores. We categorized the patients into 3 groups classified by the degree of NCGAPS scores. The 3 patients with top-3 NCGAPS scores were recommended for CT angiography. ResultsWhen the suspicion was graded by NCGAPS scores, post stenotic dilatation was significantly different among all groups (P < 0.001). The clinical components of pain varied positional or respirational change and continuous pain were significantly different among all the groups (P < 0.01). NCGAPS scores can remarkably differentiate highly suspicious patients in comparison to simply combined scores. Only 1 patient in the highly suspicious group by NCGAPS scores took the CT angiography and was confirmed with NCGAPS. ConclusionsWe suggest renaming MALS as NCGAPS, nutcracker celiac ganglion abdominal pain syndrome, to better explain the mechanism of the recurrent abdominal pain. Further studies on the diagnostic cutoff of clinical and radiological scores of NCGAPS are needed not to miss the diagnosis of NCGAPS.
Three cases of milia-like idiopathic calcinosis cutis occuring in infants
( Ji Hoon Kim ),( Jeong Soo Kim ),( Ha Ryeong Ryu ),( Chyl Hyun Yoon ),( Jong Rok Lee ),( Joo Young Roh ),( Jin Ok Baek ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Milia-like idiopathic calcinosis cutis (MICC) is a rare disorder and about 6 cases have been reported in Korean literature so far. The lesions appear as multiple whitish papules resembling milia primarily on the hands and feet, with mean ages of 9.9 years old. The majority of cases suggest an association between MICC and Down syndrome. We were presented by a 16-month-old girl with numerous papules on her right sole, a 23-month-old girl with several papules on her right foot and both hands dorsum, and a 30-months-old girl with a papule on her right sole. They reported that skin lesion appeared at 2, 3, and 6 months old, respectively. Second and third patients were born premature at 26 weeks’ gestation and have been spasticity of their lower and upper extremities, both affected and unaffected by skin lesions. Patients were otherwise well with no significant past medical history. Histological analysis demonstrated a subepidermal nodule filled with amorphous basophilic materials surrounded by a mild lymphocytic infiltrate. Von-kossa stain confirmed the materials as calcium particles. Serum calcium, phosphorus and parathyroid hormone levels were unremarkable. We herein report three unusual cases of MICC. There was no evidence of Down syndrome from patients, and one of lesion occurred as early as 2 months old. These are 2nd and 3rd cases of MICC occurring in a toddler born prematurely in Korean literature.
A case of lymphangioma circumscriptum on anus
( Jeong Soo Kim ),( Ha Ryeong Ryu ),( Chul Hyun Yun ),( Ji Hoon Kim ),( Jin Ok Baek ),( Joo Young Roh ),( Jong Rok Lee ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Lymphangioma circumscriptum is a rare, benign hamartomatous malformation histopathologically composed of numerous dilated lymphatic vessels lined by normal endothelia and clear fluid. Most lesions develop in infancy, but they may arise at any age. A typical lesion consists of grouped and translucent vesicles. It predominantly occurs at the thigh, buttock, upper arm, axilla, and tongue. Surgical treatment is usually performed, but recurrences are common. A 17-year-old female patient presented with grouped multiple verrucous papules on her anus and coccygeal area that had appeared one year earlier. The skin lesions were suspected and treated as multiple genital warts with no improvement at local clinic. Skin biopsy from the papule on the anus revealed lymphatic dilatation in papillary dermis with superficial dermal lymphocytic, neutrophilic and plasmocytic infiltration. The dilated lymphatics were positive for CD34 and D2-40 immunostains. We diagnosed the lesion as lymphangioma circumscriptum based on clinical and histopathological data. Surgical excision and electrocauterization were done without any complication. Herein, we report a rare case of lymphangioma circumscriptum on anus that was initially misdiagnosed as multiple genital warts because of the location and morphological similarity of the lesion.
A case of atypical Spitz nevus in a child
( Ji Hoon Kim ),( Jeong Soo Kim ),( Ha Ryeong Ryu ),( Chyl Hyun Yoon ),( Jin Ok Baek ),( Jong Rok Lee ),( Joo Young Roh ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1
Atypical Spitz nevus shares histologic features with the classic Spitz nevus, but it may have one or more atypicalfeatures, which can be characteristics of malignancy. Atypical Spitz nevus has unpredictable biological potential dependent on degree of atypia. Therefore, there have been controversies on the diagnosis of atypical Spitz nevus. A 5-year-old boy presented with slowly-growing, black pigmented papule on his right shoulder. On physical examination, the papule was 0.7 cm in diameter with asymmetric, irregular border and no ulcer. Histologically, the lesion showed variable sized nests of spindle cells and epithelioid cells from epidermis to the reticular dermis with a few epidermal pagetoid spread. Melanocytic cells were uniform side to side and showed low nuclear to cytoplasmic ratio. Some Kamino bodies were identified. Mitoses were found only superficially with 1.2 mitoses per high power field. Immunohistochemically, HMB-45 and Cyclin D1 showed absence of maturation. P16 and P53 showed positivity. The lesion had Ki index of 10-20 %. The diagnosis of atypical Spitz nevus with lower risk of metastasis was made because of age of patient younger than 10 years, diameter of the lesion smaller than 10 mm, no fat involvement, no ulceration, and mitotic activity less than five per high power field. We recommended wide excision with sentinel lymph node biopsy since the thickness of mass was more than 1 mm and showed features of atypia.