Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).
Blood Pressure ; Consciousness ; Emergency Service, Hospital ; Female ; Glycosuria ; Herbicides ; Humans ; Hypnotics and Sedatives ; Incidence ; Intention ; Leukocytosis ; Male ; Miosis ; Mortality ; Nausea ; Pesticides ; Physical Examination ; Pneumonia ; Pulmonary Edema ; Pupil ; Respiratory Insufficiency ; Rodenticides ; Seasons ; Seizures ; Suicide ; Sweat ; Sweating ; Vomiting

A lymphangioma is comparatively rare in the elimentary tract, and is a benign tumor of the lymphatic system. A duodenal lymphangioma is especially rare, and has an obscure etiology. Clinically, and in the laboratory the are non-specific, and are incidentally found by endoscopy, and their treatment is total excision. Recently, the authors experienced a 45 year-old woman, who had a duodenal lymphangioma, but with no symptom. An endoscopic examination revealed a single, about 2 cm, polypoid lesion below the ampulla. The lesion was successfully excised after a duodenotomy.
Duodenum ; Endoscopy ; Female ; Humans ; Lymphangioma* ; Lymphatic System ; Middle Aged

A 77-year old woman was referred to hospital with dyspnea and chest dull pain for 5 months. The chest radiograph showed a mass located in the mediastinum. Trachea was deviated to right side. Chest computed tomography showed an enhancing large mass at the middle mediastinum. Endobronchial ultrasonography showed hyperechoic mediastinal mass. We performed endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). Histologic finding was thyroid tissue with a benign looking papilla. Ectopic thyroid is an uncommon embryological aberration characterized by the presence of thyroid tissue in a site other than in its usual pretracheal region. It occurs along the path of descent of the developing thyroid primodium from the foramen cecum. It is extremely rare for mediastinal ectopic thyroid tissue diagnosised by EBUS-TBNA, so we report here on a case of mediastinal ectopic thyroid and we review the relevant medical literature.
Biopsy, Needle ; Bronchoscopy ; Cecum ; Dyspnea ; Female ; Humans ; Mediastinal Neoplasms ; Mediastinum ; Needles ; Thorax ; Thyroid Dysgenesis ; Thyroid Gland ; Trachea

Since the entity of postmastectomy lymphangiosarcoma was first reported by Stewart and Traves in 1948, postmastectomy lymphangiosarcoma has become a well recognized, uncommon malignant tumor which occurs in the upper extremity following mastectomy for mammary carcinoma. The postmastectomy lymphangiosarcoma occurred at an average age of 63.9 years and at an average of 10 years and 3 months following mastectomy. The lymphangiosarcoma raised from blood and lymphatic vessel. The histologic appearance has been observed edematous dermis and dilated lymphatics lining with malignant cells. Most authors recommend radical amputation for treatment, either shoulder disarticulation or forequarter amputation. Other modalities of treatment including radiotherapy were considered as ineffective. The present report provides a case of the regression of postmastectomy lymphangiosarcoma with chronic lymphedima by external irradiation. Radiation therapy was used as primary therapy. Total tumor dose of 6500 cgy in 9 weeks was delivered using 6 MV x-ray and 8 MeV electron.
Amputation ; Dermis ; Disarticulation ; Lymphangiosarcoma* ; Lymphatic Vessels ; Lymphedema ; Mastectomy ; Radiotherapy ; Shoulder ; Upper Extremity

OBJECTIVES: To compare the quality improvement of the abstracts of original articles, according to the revised manuscript format, of the Korean Journal of Preventive Medicine (Korean J Pre Med) was adopted in 1999. METHODS: A total 63 abstracts for 1997, and 49 for 2001, were selected as the original articles from the Kor J Pre Med. This study was carried out by the separate-sample pretest-posttest design. The quality of the abstracts was measured by a checklist of Narine' evaluation criteria, and the other information related to the articles were also surveyed by e-mail and fax or telephone using a self-made questionnaire. From the response rate, a total of 62 abstracts for 1997 and 49 for 2001 were finally analyzed. RESULTS: The mean number of words in an abstract decreased from 285 in 1997, to 250 by 2001. The mean number of key words per abstract decreased from 3.9 in 1997, to 3.6 by 2001. The mean number of inappropriate usage of key words per abstract, by the MeSH standard, decreased from 1.9 in 1997, to 0.4 by 2001. Also, the overall mean score of abstract quality increased from 0.54 in 1997 to 0.61 by 2001. The range of scores for the abstract quality was better in 2001 (0.40~0.77) than in 1997 (0.20~0.81). From the multiple regression analyses of the 1997 and 2001 databases, the intervention of the manuscript format's revision, and the number of English words to the quality score of the abstract, were the only statistically significant factors. CONCLUSIONS: In conclusion, the quality of abstracts in the Kor J Pre Med has improved since the revised manuscript format was adopted in 1999. The Korean Society for Preventive Medicine will continuously recommend proposals for more informative abstracts in their journal, and will evaluate the abstracts' content with quality criteria. Future studies should address these issues, and compare the quality of abstracts between different international and domestic journals.
Checklist ; Electronic Mail ; Preventive Medicine* ; Quality Improvement* ; Telephone

BACKGROUND: Recent research has reported that high sugar diets increase insulin resistance, without abdominal obesity, in male, but not female Wister rats. Whether a high sucrose (SU) diet increased insulin resistance in ovariectomized (OVX) rats was determined. METHODS: Female Sprague Dawley rats, weighing 273 +/- 20 g, had either an ovariectomy or a sham operation (sham). OVX and sham rats were divided into two groups: one group had a 68 En% SU diet and the other a 68 En% starch (ST) diet for 8 weeks. RESULTS: The body weight was higher in the OVX than the sham rats, regardless of dietary carbohydrate subtype. The fasting serum glucose levels did not differ according to diet and ovariectomy. However, the fasting serum insulin levels were higher in the OVX than the sham rats, and in the OVX rats, a high SU diet increased the serum insulin levels more than a high ST diet. The whole body glucose disposal rates, which referred to the state of insulin sensitivity, were lower in the OVX rats fed both the high SU and ST diets, compared to sham rats. Glycogen deposits in the soleus and quadriceps muscles were lower in the OVX rats fed high SU and ST diets than in sham rats. The glucose transporter 4 content and fraction velocity of glycogen synthase in muscles showed similar glucose disposal rates. However, the triacylglycerol content in the muscles were higher in the OVX rats with a high SU diet than those with a high ST diet. CONCLUSION: These results suggested that an OVX increased the weight gain due to higher food intakes, regardless of dietary carbohydrate subtypes. OVX-induced obesity may be involved in the induction of insulin resistance from an increased triacylglycerol content, decreased glucose uptake and glycogen synthesis in skeletal muscles, regardless of dietary carbohydrate subtypes.
Animals ; Blood Glucose/*drug effects/*metabolism ; Body Weight/drug effects ; Dietary Carbohydrates/*administration & dosage ; Energy Intake/drug effects ; Estradiol/blood ; Female ; Glucose Clamp Technique ; Glucose Transporter Type 4/drug effects/metabolism ; Glycogen/metabolism ; Glycogen Synthase/drug effects/metabolism ; Insulin/blood ; *Insulin Resistance ; Leptin/blood ; Models, Animal ; Muscle, Skeletal/metabolism ; *Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Triglycerides/metabolism

BACKGROUND: Twelve patients with acyanotic tetralogy of Fallot (TOF), characterized by the combination of a malaligned ventricular septal defect (VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. MATERIALS AND METHODS: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months (mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. RESULTS: The preoperative mean right ventricle to pulmonary artery (RV-PA) pressure gradients were 52.3 mmHg on 2D-echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients (50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients (mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. CONCLUSIONS: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.
Cardiac Catheterization ; Cardiac Catheters ; Cardiopulmonary Bypass ; Chylothorax ; Diagnosis ; Heart ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemorrhage ; Humans ; Oxygen ; Postoperative Complications ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Tetralogy of Fallot*

Enlargement of the thyroid gland is the most frequently encountered disorder of the endocrine system. A clinical evaluation is helpful in diagnosis but has its limitation. Until recently, surgical excision has been the only means by which a precise diagnosis of thyroid nodule is made, based upon the histopathologic evaluation. Authors studied 117 cases of thyroid nodule operated at Department of Surgery, College of Medicine, Hallym University, from January 1985 to July 1994. The results were analyzed with X2-test and summarized as follows. 1. The thyroid nodules were most frequently seen in third and fourth decades (57.3%), and more in female (5.9:1). 2. The most common symptoms and duration were palpable mass (97.4%) and within 3 months (41.1%). 3. Most cases of thyroid nodules were treated with lobectomy (41.0%). 4. On the radioisotope scanning, the incidence of malignant nodule with cold nodules was 17.9% and the incidence of benign nodule with hot nodule was 91.7%. 5. The overall postoperative and specific complications were only related to the histopathologic finding (P=0.0026, P=0.0207), and not related to the type of operation and size of the thyroid nodules.
Diagnosis ; Endocrine System ; Female ; Humans ; Incidence ; Radionuclide Imaging ; Thyroid Gland* ; Thyroid Nodule*

The toxic effect of azalea extract, especially on cardiovascular system, in relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups: In group as preliminary study; 4 cc of normal saline was administered intravenously (N); 0.7 gm/kg and 1.0 gm/kg of azalea extract was administered respectively in the same route, volume (A1, A2); atropine was administered intravenously (A); after pretreatment with atropine (0.04 mg/kg) to block parasympathetic system, azalea extract was injected like the above groups (AA1, AA2); normal saline, 0.7 gm/kg and 1.0 gm/kg of azalea extract were administered respectively with 0.2 cc (1:1000) epinephrine (E0, E1, E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes: RR interval, QTc interval, maximal systolic and diastolic pressure drop with occurring time and presence of significant arrhythmia. The results were as follows: 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epinephrine and Azalea extract was not noted by the effect of epinephrine itself. 5. The ST change by 0.7 gm/kg, 1.0 gm/kg of Azalea extract was revealed in 1 case (14.0%), 7 case (100%), respectively. 6. Most of all cases with arrhythmia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epinephrine, except on case by Azalea extract (1.0 gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we can't be absolutely exclusive of actions of autonomic nervous system, especially parasympathetic nervous system.
Arrhythmias, Cardiac ; Atropine ; Autonomic Nervous System ; Blood Pressure ; Cardiovascular System* ; Epinephrine ; Myocardial Ischemia ; Parasympathetic Nervous System ; Rabbits ; Tachycardia, Ventricular ; Ventricular Fibrillation

BACKGROUND/AIMS: Several studies have reported an association between antiphospholipid antibodies (APA) and major adverse cardiovascular events (MACE) following acute myocardial infarction (AMI). However, the relationship between APA and the prognosis after drug-eluting stent (DES) implantation in patients with AMI is not known. METHODS: Thus, we investigated the relationship between the incidence of MACE and APA levels in patients with AMI who underwent successful DES implantation. RESULTS: Of 182 patients, 78 (42.9%) tested positive for APA. Lupus anticoagulant was positive in 37.6% (68 of 181) patients, anticardiolipin antibody IgM was positive in 8.3% (15 of 180), and anticardiolipin antibody IgG was positive in 1.7% (3 of 180) patients. At follow up, a MACE had occurred in 11 (14.1%) patients in the APA-positive group and in seven (6.7%) patients in the APA-negative group (p = 0.099). CONCLUSIONS: No significant association was found between the incidence of MACE and the presence of APA in patients with AMI who underwent successful DES implantation.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Lupus Coagulation Inhibitor ; Myocardial Infarction ; Prognosis