BACKGROUND: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. METHODS: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. RESULTS: Mean age of the patients was 40.0 years and the ratio of male to female was 1 : 0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea. except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1%). CONCLUSION: The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are discharged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.
Abdominal Pain ; Agaricales* ; Amanita ; Diarrhea ; Eating ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver Failure, Acute ; Male ; Mushroom Poisoning* ; Nausea ; Seasons ; Vomiting

The diagnosis of internal jugular vein thrombosis (IJVT), a vascular disorder, can be easily overlooked. Disruption of blood flow through the internal jugular vein can take place in a variety of clinical settings. CT and ultrasonography are useful diagnostic tools. Recently, we experienced a case of IJVT after deep neck infection. This case showed sore throat, odynophagia and swelling of right submandibular area. CT scan revealed diffuse neck swelling and incomplete occlusion of the right internal jugular vein at the thyroid level. Treatment began with antibiotics and hydration. We present a case of IJVT after deep neck infection with literature review.
Anti-Bacterial Agents ; Diagnosis ; Jugular Veins* ; Neck* ; Pharyngitis ; Thrombosis* ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography

A lesion that is hyperintense on diffusion-weighted imaging (DWI) and hypointense on the apparent diffusion coefficient (ADC) map is a characteristic magnetic resonance imaging (MRI) finding in acute ischemic infarction. In some cases, however, these findings can persist for a few months after infarct onset. It is thought that these finding reflect the different evolution speeds of the infarcted tissue. We report a patient with a right middle cerebral artery territory infarction with persistent hyperintensity on DWI and hypointensity on the ADC map for over 8 months. To our knowledge, this is the most persistent case of hyperintensity lesion on DWI and the serial MRI images of this patient provide important information on the evolution of infarcted tissue.
Cerebral Infarction ; Diffusion ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Middle Cerebral Artery

No abstract available.
Ventriculoperitoneal Shunt

BACKGROUND: It has been reported that Mentha arvensis water extract (MAWE) inhibited systemic anaphylaxis and histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80. OBJECTIVE AND METHOD: This study was undertaken to determine the inhibitory effects of immunoglobulin E (IgE)-mediated anaphylactic reaction by MAWE. This paper deals with an evaluation of the effect of MAWE on the anti-dinitrophenyl (DNP) IgE antibody induced anaphylactic reaction in rats. We also investigated the influence of MAWE on anti-DNP IgE antibody-induced tumor necrosis factor-alpha (TNF-alpha) production. RESULTS: MAWE inhibited passive cutaneous anaphylaxis (PCA) when intravenously, intrap- eritoneally, and orally administered. MAWE dose-dependently inhibited histamine release from RPMC activated by anti-DNP IgE antibody. Moreover, MAWE had an inhibitory effect on anti-DNP IgE antibody induced TNF-alphaproduction from RPMC. CONCLUSION: These results suggest that MAWE inhibits the IgE-mediated anaphylactic reaction in rats.
Anaphylaxis* ; Animals ; Histamine Release ; Immunoglobulin E ; Immunoglobulins ; Mast Cells ; Mentha* ; Passive Cutaneous Anaphylaxis ; Rats* ; Tumor Necrosis Factor-alpha ; Water

Small cell carcinoma of the cervix has been traditionally considered a rare subtype ofsquamous cell carcinoma characterized by a highly malignant behavior. However, it has becomeobvious that the majority of small cell carcinomas of the cervix expresses neuroendocrine,not squamous, differentiation. One case of intermediate cell neuroendocrine carinoma andthree cases of small cell undifferentiated carcinoma were reported. Patients ranged in age from37 to 50 (median, 44years) and presental as stages Ib(two patients), IIa(one patient), andIIb(one patient). One cases of intermediate cell neuroendocrine carinoma was combined with-endocervical adenocarcinoma and one case of small cell undifferentiated carcinoma was combinedwith adenocarcinoma in situ. All 4 tumors expressed one or more epithelial markers andneuroendocrine markers. Electron microscopically, neuroendocrine granules were observed inall 4 cases but large amount in intermediate cell neuroendocrine carinoma. A variety of treatmentregimens was employed. One patient with intermediate cell neuroendocrine carinoma isalive now for 60 months after starting of treatment. But two of three patients with small cellundifferentiated carcinoma died of disease (34, 45 months) and one of them is alive now for20 months. One patient had spinal metastasis and paraplegia which were treated twice withsurgery and irradiation on tumor bed and the other patient was comatose with multiple livermetastasis. Small cell undifferentiated carcinoma of the cervix was more aggressive thanintermediate cell neuroendocrine carcinoma of the cervix. We can differentiate small cellundifferentiated carcinoma of the cervix from intermediate cell neuroendocrine carcinoma of thecervix, pathologically, ultrastructurally and immunocytochemically.
Adenocarcinoma ; Carcinoma ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell* ; Cervix Uteri* ; Coma ; Female ; Humans ; Neoplasm Metastasis ; Paraplegia

Cerebral Venous Sinus Thrombosis (CVST) in children is rare and its cause is multifactorial. The clinical manifestations of CVST vary and may cause long-term neurological sequelae and even death on rare occasion. In this case, a 15 year old boy presented with severe headache and vomiting for 1 day. Brain MRI with venography revealed multiple lesions of CVST in superior sagittal sinus and the left transverse sinus. Anticoagulation therapy was performed for 3 months, which led to the complete resolution in superior sagittal sinus and partial resolution in left transverse sinus.
Adolescent ; Brain ; Child ; Headache ; Humans ; Phlebography ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus ; Vomiting

PURPOSE: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. METHODS: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. RESULTS: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. CONCLUSION: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.
Bile ; Bile Ducts, Intrahepatic ; Biliary Atresia* ; Biliary Tract ; Cholestasis ; Chungcheongnam-do ; Diagnosis* ; Early Intervention (Education) ; Hepatitis ; Humans ; Infant, Newborn ; Parenteral Nutrition, Total ; Radioactivity ; Radionuclide Imaging* ; Sensitivity and Specificity

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by overproduction of myeloid white blood cells. Philadelphia chromosome is an essential finding for CML diagnosis. Generally, a clinical diagnosis of essential thrombocythemia (ET) can be established from isolated marked thrombocytosis in peripheral blood. However, Philadelphia chromosome-positivity or bcr/abl rearrangement with isolated thrombocytosis should be diagnosed as CML, not ET, according to World Health Organization diagnostic criteria. Therefore, CML should not be excluded before confirming the presence of the Philadelphia chromosome or bcr/abl rearrangement in cases of isolated thrombocytosis in peripheral blood. We report a case of CML with clinical features of ET in a patient successfully treated with imatinib.
Bone Marrow* ; Diagnosis ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytes ; Philadelphia Chromosome ; Thrombocythemia, Essential* ; Thrombocytosis ; World Health Organization ; Imatinib Mesylate

Background: In some patients, coronavirus disease 2019 (COVID-19) is accompanied by loss of smell and taste, and this has been reportedly associated with exposure to air pollutants. This study investigated the relationship between the occurrence of chemosensory dysfunction in COVID-19 patients and air pollutant concentrations in Korea. Methods: Information on the clinical symptom of chemosensory dysfunction, the date of diagnosis, residential area, age, and sex of 60,194 confirmed COVID-19 cases reported to the Korea Disease Control and Prevention Agency from January 20 to December 31, 2020 was collected. In addition, the daily average concentration of air pollutants for a week in the patients’ residential area was collected from the Ministry of Environment based on the date of diagnosis of COVID-19. A binomial logistic regression model, using age and gender, standardized smoking rate, number of outpatient visits, 24-hour mean temperature and relative humidity at the regional level as covariates, was used to determine the effect of air pollution on chemosensory dysfunction. Results: Symptoms of chemosensory dysfunction were most frequent among patients in their 20s and 30s, and occurred more frequently in large cities. The logistic analysis showed that the concentration of particulate matter 10 (PM 10 ) and 2.5 (PM 2.5 ) up to 2 days before the diagnosis of COVID-19 and the concentration of sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon monoxide (CO), and ozone (O 3) at least 7 days before the diagnosis of COVID-19 affected the development of chemosensory dysfunction. In the logistic regression model adjusted for age, sex, standardized smoking rate, number of outpatient visits, and daily average temperature and relative humidity, it was found that an increase in the interquartile range of PM 10 , PM 2.5 , SO 2 , NO 2 , and CO on the day of diagnosis increased the incidence of chemosensory dysfunction 1.10, 1.10, 1.17, 1.31, and 1.19-fold, respectively. In contrast, the O 3 concentration had a negative association with chemosensory dysfunction. Conclusion High concentrations of air pollutants such as PM 10 , PM 2.5 , SO 2 , NO 2 , and CO on the day of diagnosis increased the risk of developing chemosensory dysfunction from COVID-19 infection. This result underscores the need to actively prevent exposure to air pollution and prevent COVID-19 infection. In addition, policies that regulate activities and products that create high amounts of harmful environmental wastes may help in promoting better health for all during COVID-19 pandemic.