Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre-and post- procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drain efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were lower than than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we though that it will be very helpful to the treatment of patients as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.
Abscess ; Catheters* ; Drainage ; Humans ; Viscosity

Authors analyzed the findings of findings of chest radiographs and high-resolution CT(HRCT) of chronic mercury vapor poisoning in 12 patients who were diagnosed by previous working history for mercury-thermometer and high level of mercury in blood and urine. The purpose of this paper is to introduce the HRCT findings of chronic mercury vapor poisoning. Duration of mercury exposure was ranged from 10 to 41 months(mean, 21.8 months). Estimated value of serum mercury was ranged from 3.6 to 8.7µg/dl(mean, 5.3 µg/dl: normal value is less than 0.5µg/dl). Estimated value of mercury in urine was ranged from 104 to 482µg/1(mean, 291.4µg/1: normal value is less than 20µg/1). Chest radiographs showed positive findings such as ground-glass opacities and peribronchial cuffings in only 2 out of 12 patients, but HRCT showed positive findings such as ground-glass opacities in 8 patients, peribronchial cuffings in 7 patients, centrilobular abnormalities in 5 patients, interface sign in 4 patients, interlobular septal thickening with intralobular lines in 2 patients and lobular consolidation in one patient. In conclusion, chest HRCT is superior to chest radiograph to show the pulmonary manifestation of chronic mercury vapor poisoning. In patients with chronic mercury vapor poisoning, HRCT findings of centrilobular distributed ground-glass opacities and peribronchial cuffinges are characteristic.
Humans ; Lung* ; Poisoning* ; Radiography, Thoracic ; Reference Values ; Thorax

PURPOSE:To identify the main toxic gas released from salted radish in rice bran(Dan-Mu-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. MATERIALS AND METHODS: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. RESULTS: The radiographic examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headspace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. CONCLUSION: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.
Anoxia* ; Carbon Dioxide ; Chromatography, Gas ; Ethanol ; Humans ; Hydrogen Sulfide ; Inhalation ; Lung ; Male ; Pulmonary Edema ; Radiography, Thoracic ; Raphanus* ; Survivors ; Tomography, X-Ray Computed

The Fanconi's syndrome is characterized by generalized disturbance of proximal tubular function. It leads to excessive losses of amino acids, glucose, phosphate, bicarbonate, and other substrates handled by the proximal tubules. The metabolic consequences are acidosis, hypophosphatemia, hypocalcemia, osteomalacia, osteoporosis, and growth retardation. Adult Fanconi's syndrome is mostly secondary form caused by multiple myeloma, primary amyloidosis, light chain nephropathy, and heavy metal poisoning. We experienced 50-year-old woman with kappa light chain disease whose chief complaints were weakness of both lower extremities and multiple bone pain. This patient had renal glycosuria, hypercalciuria, normal anion gap type metabolic acidosis, osteomalacia and normal distal tubule acidification. Her bone marrow biopsy showed inappropriate proliferation of plasma cell. The patient underwent percutaneous renal biopsy in which was exceptionally observed focal effacement of podocyte foot process. So we report a case of osteomalacia caused by adult Fanconi's syndrome and foot process effacement by kappa -light chain disease.
Acid-Base Equilibrium ; Acidosis ; Adult* ; Amino Acids ; Amyloidosis ; Biopsy ; Bone Marrow ; Female ; Foot* ; Glucose ; Glycosuria, Renal ; Humans ; Hypercalciuria ; Hypocalcemia ; Hypophosphatemia ; Lower Extremity ; Middle Aged ; Multiple Myeloma ; Osteomalacia* ; Osteoporosis ; Plasma Cells ; Podocytes* ; Poisoning

In diabetic patients who were being treated with hemodialysis, coma and other neurological deficits did not occur in spite of extremely elevated serum glucose levels. In this report, we compared diabetic patients with renal failure in severe hyperglycemia with nonketotic hyperosmolar coma patients with normal renal function to know what affect mental changes. Mental changes were not present in diabetic patients with renal failure. These patients with renal failure showed more severe hyperglycemia, but corrected serum sodium concentration and calculated effective serum osmolality were low. So it is suggested that corrected serum sodium concentration and effective serum osmolality are more important factor affecting mental changes than high blood glucose levels in diabetic patients with renal failure, due to absence of osmotic diuresis.
Blood Glucose ; Coma ; Diuresis ; Humans ; Hyperglycemia* ; Osmolar Concentration ; Renal Dialysis ; Renal Insufficiency* ; Sodium

BACKGROUND: The purpose of this study was to examine the relationship between cardiovascular disease risk and alcohol consumption according to facial flushing after drinking among Korean men. METHODS: The subjects were 1,817 Korean men (non-drinker group, 283 men; drinking-related facial flushing group, 662 men; non-flushing group, 872 men) >30 years who had undergone comprehensive health examinations at the health promotion center of a Chungnam National University Hospital between 2007 and 2009. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. Cardiovascular disease risk was investigated based on the 2008 Framingham Heart Study. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and cardiovascular disease risk within 10 years for the flushing and non-flushing groups, with adjustment for confounding factors such as body mass index, diastolic blood pressure, low density lipoprotein cholesterol, triglycerides, and exercise patterns. RESULTS: Individuals in the non-flushing group with alcohol consumption of < or =4 standard drinks (1 standard drink = 14 g of alcohol) per week had significantly lower moderate or high cardiovascular disease risk than individuals in the nondrinker group (adjusted odds ratio, 0.51; 95% confidence interval, 0.37 to 0.71). However, no significant relationship between the drinking amount and cardiovascular disease risk was observed in the flushing group. CONCLUSION: Cardiovascular disease risk is likely lowered by alcohol consumption among non-flushers, and the relationship between the drinking amount and cardiovascular disease risk may differ according to facial flushing after drinking, representing an individual's vulnerability.
Alcohol Drinking* ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Chungcheongnam-do ; Drinking ; Flushing* ; Health Promotion ; Heart ; Humans ; Hypotension ; Lipoproteins ; Logistic Models ; Male ; Odds Ratio ; Surveys and Questionnaires ; Triglycerides

PURPOSE: Biofeedback treatment is thought to be appropriate for patients with nonrelaxing puborectalis syndrome (NRPR). The aim of this study is to analyze the physiologic characteristics and to assess the outcomes of biofeedback treatment for patients with NRPR. METHODS: Forty-six (46) patients with NRPR were evaluated with anorectal physiologic studies, including colonic transit time (n=26), anorectal manometry (n=41), defecography (n=46), anal sphincter EMG (n=28), and colonoscopy or barium enema (n=33). The treatment consisted of a training program with EMG-based biofeedback for 30 minutes once a week and routine supportive care, including Kegel practice. RESULTS: The mean age was 52.8 years, and the sex ratio was 1 male to 0.6 female. A delayed colonic transit time was noted in 5 patients (19.26%). In the NRPR group, the maximal voluntary contraction and the mean squeezing pressure were higher than they were for other patients with pelvic outlet obstructive disease. Also, the perineal descents and the dynamic change of anorectal angle were shorter. Polyps were observed in 6 patients (18.2%), melanosis coli in 4 patients (12.1%), and diverticula in 3 patients (9.1%). The rectoanal inhibitory reflex (RAIR) was negative in 3 patients (7.3%). The patients underwent a mean of 4.0 sessions, and the mean follow-up was 7.4 months. Twenty-three (23) patients (82.1%) experienced improved of symptoms or EMG findings. The patients (17.9%) who did not improve had several abnormal findings: neuro-psychologic disease with delayed colonic transit time in 2 cases, negative RAIR in 2 cases, and melanosis coli in one case. CONCLUSIONS: We think that biofeedback training is an effective treatment for patients with NRPR. In addition, several factors, such as neuro-psychologic diseases, delayed colonic transit time, negative RAIR, or melanosis coli may influence the prognosis for biofeedback treatment, so further large-scaled studies will be needed to confirm these findings.
Anal Canal ; Barium ; Biofeedback, Psychology* ; Colon ; Colonoscopy ; Defecography ; Diverticulum ; Education ; Enema ; Female ; Follow-Up Studies ; Humans ; Male ; Manometry ; Melanosis ; Polyps ; Prognosis ; Reflex ; Sex Ratio

Endometrial carcinoma is predominantly a disease of postmenopausal women, so we don't have to consider fertility. But in case of young women who want to preserve their fertility, it is very difficult to approach. We experienced one case of treatment using high-dose Megestrol Acetate (Megace(R)) combined with PDT (Photodynamic Therapy) on early stage of endometrial carcinoma, in young aged woman who wanted to preserve her fertility. And, we described briefly clinicopathologic findings, reviews of literatures and possibility of combined therapy with Megestrol and PDT.
Endometrial Neoplasms* ; Female ; Fertility ; Humans ; Megestrol Acetate* ; Megestrol*

Progressive dysphagia in a 53 year old man was caused by a giant polypoid tumor in the lower intrathoracic esophagus. Radical transthoracic esophagectomy and esophagogastrostomy were carried out. Microscopic examination of the tumor revealed a true carcinosarcoma, composed of a mixture of basaloid squamous cell carcinoma and chondrosarcoma with multiple cartilagenous productions. Carcinoma metastases were found in the subcarinal and perigastric lymph nodes. Immunohistochemically, squamous area displayed strong positive to cytokeratin, and basaloid area showed positive immunoreaction to high molecular weight cytokeratin (34beta E12). Spindle cell sarcoma reacted to vimentin and smooth muscle actin. Chondrosarcomatous area reacted to vimentin and S-100 protein. He received postoperative chemotherpy and radiotherapy. He has been free of disease for 11 months.
Actins ; Carcinoma, Squamous Cell ; Carcinosarcoma* ; Chondrosarcoma ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Keratins ; Lymph Nodes ; Middle Aged ; Molecular Weight ; Muscle, Smooth ; Neoplasm Metastasis ; Radiotherapy ; S100 Proteins ; Sarcoma ; Vimentin

PURPOSE: With recent anorectal physiologic studies, functional etiologies of pelvic outlet obstructive disease were evaluated in detail. The current study was designed to assess the clinical and the physiologic characteristics of patients with pelvic outlet obstructive disease. METHODS: one hundred two (102) patients with pelvic outlet obstructive disease were evaluated with anorectal physiologic studies, including the colonic transit time (n=66), anorectal manometry (n=88), defecography (n=102), anal sphincter EMG (n=50), and colonoscopy or barium enema (n=77). The patients were categorized as group I (nonrelaxing puborectalis syndrome), group II (rectocele), group III (sigmoidocele), and group IV (rectoanal intussusception). The clinical and the physiologic characteristics were compared between the groups. RESULTS: The mean age was 51.9 years, and the sex ratio was 1:1.9. the populations of the groups were group I 45.1% (n=46), group II 36.3% (n=37), group III 5.9% (n=6), and group IV 9.8% (n=10). In group II and group III, co-existing etiologies were more, and the incidences of female patients was higher (P<0.05). Delayed colonic transit time was noted in 11 patients (17%). Diverticula was observed in 6 patients (8%), polyps in 12 patients (16%), and melanosis coli in 14 patients (18%). On anorectal manometry, group I showed higher maximal voluntary contraction and mean squeezing pressure than the other groups (P<0.05). On defecography, group I had a shorter perineal descent at rest and a smaller anorectal angle at push (P<0.05). CONCLUSIONS: The current study showed the clinical and the physiologic characteristics of the each functional etiology in patients with pelvic outlet obstructive disease. These results provide fundamental data for diagnosis of and tailored therapy for pelvic outlet obstructive disease.
Anal Canal ; Barium ; Colon ; Colonoscopy ; Defecography ; Diagnosis ; Diverticulum ; Enema ; Female ; Humans ; Incidence ; Manometry ; Melanosis ; Polyps ; Rectocele ; Sex Ratio