No abstract available.

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

PURPOSE: To report two cases of acute and chronic intraorbital wooden foreign bodies. METHODS: We sutured an 11-year-old boy who had sustained forehead laceration with a pencil (Case 1) and sutured a 43-year-old man who had sustained lower eyelid laceration due to a wooden splinter embedded in the eyelid 1 month before (Case 2). We confirmed the presence of intraorbital wooden foreign bodies in both cases using radiological examinations and removed them. RESULTS: In Case 1, a pencil from the primary wound, and the patient obtained good visual acuity and full extraocular motility for six months. In Case 2, granulated wooden foreign bodies were removed and had limited extraocular motility and diplopia at post-operative three months. CONCLUSIONS: Unremoved intraorbital foreign bodies may lead to many ophthalmologic sequelae. If intraorbital foreign bodies intrude into the adjacent central nervous system, it may lead to fatal complications. The actual presence of intraorbital wooden foreign bodies should require radiological examinations; when confirmed, they should be removed surgically.
Adult ; Central Nervous System ; Child ; Diplopia ; Eyelids ; Forehead ; Foreign Bodies* ; Humans ; Lacerations ; Male ; Visual Acuity ; Wounds and Injuries

Hypertriglyceridemia (HTG) is a rare cause of pancreatitis. However, the relationship between acute pancreatitis and severe HTG is well recognized. We report a case of necrotizing pancreatitis due to severe HTG (type IV) in a patient with poorly controlled diabetes. It was of particular interest that serum pancreatic enzymes were normal even though the imaging studies indicated the presence of necrotizing pancreatitis. Our case clearly demonstrates the various indices of HTG-induced necrotizing pancreatitis with a normal pancreatic enzyme level despite there being a serum triglyceride level < or=1,000 mg/dL. We present this case with a review of literature for hyperlipidemic pancreatitis in Korea.
Adult ; Diabetes Mellitus, Type 2/complications/diagnosis ; Humans ; Hypertriglyceridemia/complications/*diagnosis ; Male ; Pancreatitis, Acute Necrotizing/*diagnosis/etiology ; Tomography, X-Ray Computed ; Triglycerides/blood

A 30-year-old woman who was diagnosed as peripheral neuroblastoma by fine needle aspiration of a soft mass of the right upper arm is described. She presented a slowly growing, soft mass of the right upper arm for 1 month. The right humerus revealed no abnormal finding on X-ray. Ultrasonogram of the right upper arm revealed a well demarcated, smooth marginated solid mass without invasion of adjacent structures. Fine needle aspiration was done under the impression of soft tissue tumor with undetermined biologic behavior. The aspirates were highly cellular and the tumor cells were dispersed both singly and in clusters of varying size. The clusters occasionally showed a central capillary core and rosette-like structures. The tumor cells were small in size and had a small to medium amount of cytoplasm. Some of them revealed slender cytoplasmic processes. The nuclei showed distinct nuclear membranes, finely clumped chromatin and small conspicuous nucleoli. Cellular pleomorphism or mitotic figure was not definite. These cytologic findings were interpreted as a malignant, non-lymphomatous, small round cell tumor, most likely representing peripheral neuroblastoma or Ewing's sarcoma. Final diagnosis was confirmed by simple excision as peripheral neuroblastoma.
Adult ; Arm ; Biopsy, Fine-Needle ; Capillaries ; Child* ; Chromatin ; Cyclosporine* ; Cytoplasm ; Diagnosis ; Female ; Humans ; Humerus ; Nephrotic Syndrome* ; Neuroblastoma ; Nuclear Envelope ; Pilomatrixoma ; Sarcoma, Ewing ; Ultrasonography

Multiple endocrine neoplasia (MEN) Ila is an inherited disease characterized by the development of medullary thyroid carcinoma, pheochromocytoma and hyperparathyroidism. It has been shown to be associated with germ-line mutatians in the RET proto-oncogene. Presymptomatic screening of medullary thyroid carcinoma in MEN IIa families enables the early diagnosis of this tumor with its significant morbidity, We describe a 19-year-old woman fmm a MEN IIa family who was founded by DNA analysis to be a gene carrier of MEN IIa and then was diagnosed, using a pentagastrin stimulation test, as having presymptomatie medullary thyroid carcinoma She underwent thyroidectomy and histologic examination confirmed medullary thyroid carcinoma. It is cancluded that direct genetic analysis for mutations in the RET proto-oncogene should be the diagnstlc test of choice for identifying family members at risk for MEN IIa and thyroidectomy on the basis of genetic analysis is a rational course of action.
DNA ; Early Diagnosis ; Female ; Genes, vif ; Humans ; Hyperparathyroidism ; Male ; Mass Screening* ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2a* ; Pentagastrin ; Pheochromocytoma ; Proto-Oncogenes ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Young Adult

BACKGROUND: The therapeutic effects of surfactant on acute lung injury derive not only from its recruiting action on collapsed alveoli but also from its anti-inflammatory effects. Pro-apoptotic action on alveolar neutrophils represents one of the important anti-inflammatory mechanisms of surfactant. In the present study, we evaluated the effects of surfactant on the apoptosis of human peripheral and rat alveolar neutrophils. METHODS: In the (Ed- the article is not definitely needed but it helps to separate the two prepositions 'in') in vitro study, human neutrophils were collected from healthy volunteers. An equal number of neutrophils (1X10(6)) (Ed-confirm) was treated with LPS (10, 100, 1000ng/ml), surfactant (10, 100, 1000micro gram/ml), or a combination of LPS (1000ng/ml) and surfactant (10, 100, 1000micro gram/ml). After incubation for 24 hours, the apoptosis of neutrophils was evaluated by Annexin V method. In the in vivo study, induction of acute lung injury in SD rats by intra-tracheal instillation of LPS (5mg/kg) was followed by intra-tracheal administration of either surfactant (30mg/kg) or normal saline (5ml/kg). Twenty-four hours after LPS instillation, alveolar neutrophils were collected and the apoptotic rate was evaluated by Annexin V method. In addition, changes of the respiratory mechanics of rats (respiratory rate, tidal volume, and airway resistance) were evaluated with one chamber body plethysmography before, and 23 hours after, LPS instillation. RESULTS: In the in vitro study, LPS treatment decreased the apoptosis of human peripheral blood neutrophils (control; 47.4+/-5.0%, LPS 10ng/ml; 30.6+/-10.8%, LPS 100ng/ml; 27.5+/-9.5%, LPS 1000ng/ml; 24.4+/-7.7%). The combination of low to moderate doses of surfactant with LPS promoted apoptosis (LPS 1000ng/ml + Surf 10micro gram/ml; 36.6+/-11.3%, LPS 1000ng/ml + Surf 100micro gram/ml; 41.3+/-11.2%). The high dose of surfactant (1000micro gram/ml) decreased apoptosis (24.4+/-7.7%) and augmented the anti-apoptotic effect of LPS (LPS 1000ng/ml + Surf 1000micro gram/ml; 19.8+/-5.4%). In the in vivo study, the apoptotic rate of alveolar neutrophils of surfactant-treated rats was higher than that of normal saline-treated rats (6.03+/-3.36% vs. 2.95+/-0.58%). The airway resistance (represented by Penh) of surfactant-treated rats was lower than that of normal saline-treated rats at 23 hours after LPS injury (2.64+/-0.69 vs. 4.51+/-2.24, p<0.05). CONCLUSIONS: Surfactant promotes the apoptosis of human peripheral blood and rat alveolar neutrophils. Pro-apoptotic action on neutrophils represents one of the important anti-inflammatory mechanisms of surfactant.
Acute Lung Injury* ; Airway Resistance ; Animals ; Annexin A5 ; Apoptosis* ; Healthy Volunteers ; Humans ; Neutrophils* ; Plethysmography ; Rats* ; Respiratory Mechanics ; Tidal Volume

To evaluate the effect of allergic parameters, such as serum IgE, eosinophil, and skin test on the bronchial hyperresponsiveness (BHR) in patients with chronic airflow obstruction, we performed methacholine bronchial provocation test, pulmonary function test, skin prick test, and measured blood eosinophil counts and serum IgE level from seventy-nine patients who showed persistent fixed airflow obstruction, less than 75% of predicted value in FEV~ and FEV1/FVC, despite of conventional treatment without steroid therapy for more than 3 months. The results were as follows 1) There were 53 patients with BHR and 26 patients without BHR. There were no statistically significant differences in sex, age, and smoking duration between positive BHR group and negative BHR group (p>0.05). 2) There was no statistically significant difference in absolute and predicted value of FVC(p>0.05). But there were significantly lower absolute, predicted value of FEV1 and FEV1/FVC% in positive group compared with negative group (p<0.05). 3) There was somewhat higher trend of serum IgE level in positive group. Skin test was not significantly different between two groups (p > 0.05 ). 4) Blood eosinophil count was significantly higher in positive group than in negative group(p<0.05). Conclusion of this study is that increased bronchial responsiveness in patients with chronic airflow obstruction is inversely related to the level of pulmonary function and significantly associated with blood eosinophilia.
Bronchial Provocation Tests ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Skin ; Skin Tests ; Smoke ; Smoking

BACKGROUND: To evaluate airway responses and inflammation to antigen in Sprague-Dawley rat asthma model, we examined airway responses, serial histologic changes of the lung, and the relationship between airway responses and airway inflammation after antigen airway challenge. METHODS: Sprague-Dawley rats were sensitized with subcutaneous injection of 10 microgram ovalbumin(OA). Antigen airway challenges were done 14 ~16 days after sensitization and the sensitized rats were sacrificed 1h(AE), 6 ~8h(AL) and 1day(AD) after airway challenge, to examine the histologic changes of the lung. Airway responses were measured by body plethysmograph and recorded by enhanced pause(Penh) as an index of airway obstruction 6 ~8h after antigen challenges. Nonsensitized controls(10 rats) were also challenged with antigen and sacrificed 1 day later. Histopathologic examination of two trachea, large bronchi, small bronchi, and vessels was performed to evaluate the severity of inflammation and eosinophilic infiltration with H&E stain. RESULTS: In 17 of 20 rats(85%) in both groups, we observed airway responses. Among them, an early response(ER) in 15 rats(75%), an dual response in 5(25%), and an late response(LR) only in 2 rats(10%) displayed. There were no significant differences in the severity of inflammation among the trachea, large bronchi, small bronchi and vessels in all groups after antigen challenge(p>0.05) and between early and late responders. The significant eosinophil infiltration was observed in 5 rats(50%) of AL(p<0.05) compared with in AE and controls. Also, eosinophil infiltration was observed in higher trend in LR(57.1%) compared to ER(40%)(p>0.05). CONCLUSION: Sprague-Dawley rats sensitized with subcutaneous injection of OA showed a significant airway responses to antigen challenge. But antigen challenges caused a little eosinophil infiltration and no significant airway inflammation. Asthma model of Sprague-Dawley rats could be useful for antigen-induced airway responses, but this model has a limitation for the study of human asthma because of no significant pathologic change.
Airway Obstruction ; Animals ; Asthma* ; Bronchi ; Eosinophils ; Humans ; Inflammation* ; Injections, Subcutaneous ; Lung ; Ovalbumin* ; Rats ; Rats, Sprague-Dawley* ; Trachea