1.A Case Report of Hypokalemic Periodic Paralysis with Arrhythmia.
Byoung Gue NA ; Dae Su KIM ; Sang Moo JUNG ; Sang Woo OH ; Jae Hong CHOE ; Ji Hyun LEE ; Gi Byoung NAM ; Dong Woon KIM ; Myeong Chan CHO
Korean Circulation Journal 1997;27(9):915-921
The hypokalemic periodic paralysis is characterized by intermittent falccid paralysis of extremities with spontaneous recovery. It is rarely accompanied by cardiac arrhythmia, especially fatal ventricular tachycardia or torsades de pointes. We observed a 29 year old man, who had suffered from intermittent periodic paralysis and fatal ventricular tachyarrhythmia. He had the first episode of muscle weakness in his low grade of elementary school, which lasted for 20 -30 hours. Similar episodes of muscle weakness occurred 1 -7 times per year, especially after carbohydrate rich food. On admission to emergency room, his chief complaints were generalized weakness and chest tightness, serum potassium level was 1.6mEq/l, and four extremities showed Grade 0 motor weakness. His electrocardiography(ECG) showed Atrioventricular dissociation due to sinus tachycardia and accelerated junctional rhythm, intraventricular conduction distrubance. During intravenous potassium administration, ECG showed sustained ventricular tachycardia and cardiovascular collapse occurred. So we carried out resuscitation and cardioversion. After resuscitation, he recovered from cardovascular collapse and ECG showed sinus tachycardia. But during continuous monitoring ECG showed torsades de pointes with cardiovascular collapse. We carried out resuscitation and defibrillation repeatedly. Serum potassium level was 1.7 - 1.8mEq/L at that time. After successful resuscitation, ECG showed sinus rhythm, and his mental status was fully recovered. After he admitted to intensive care unit, paralytic attack and cardiac arrhythmia did not occurred any more. Serum potassium level was maintained between 3.9 -6.1lmEq/L during his hospital days. He was fully recovered but could not take any medications(e.g. acetazolamide, potassium supplying agent and antiarrhythmic drugs) due to severe gastrointestinal disturbances. During the 30 months of postdischarge period, he experienced three mild paralysis attacks, but they were not accompanied by chest tightness, palpitation or syncope.
Acetazolamide
;
Adult
;
Arrhythmias, Cardiac*
;
Electric Countershock
;
Electrocardiography
;
Emergency Service, Hospital
;
Extremities
;
Heart Block
;
Humans
;
Hypokalemia
;
Hypokalemic Periodic Paralysis*
;
Intensive Care Units
;
Muscle Weakness
;
Paralysis
;
Potassium
;
Resuscitation
;
Syncope
;
Tachycardia
;
Tachycardia, Sinus
;
Tachycardia, Ventricular
;
Thorax
;
Torsades de Pointes
2.Effects of Tetrandrine on the Nitric Oxide Production by Vascular Smooth Muscle Cells of the Rat.
Gi Su OH ; Na Young KIM ; Hyun Ock BAE ; Youn Chul KIM ; Jong Hyun HAN ; Young Myung KIM ; Byoung Sun AHN ; Hun Taeg CHUNG
Korean Journal of Immunology 2000;22(4):247-252
No abstract available.
Animals
;
Muscle, Smooth, Vascular*
;
Nitric Oxide*
;
Rats*
3.Analysis of Prenatal and Postnatal Factors Associated with Complications and Prognosis in Premature Infants with Leukemoid Reaction.
Se Ho KWON ; Byoung Kook LEE ; Heun Ji LEE ; So Young NA ; Jung Ha LEE ; Su Yeon PARK ; Eun Kyeung KANG ; Do Hyeon KIM ; Kwan LEE ; Hee Sup KIM
Journal of the Korean Society of Neonatology 2008;15(2):151-159
PURPOSE: This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. METHODS: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/mm3. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. RESULTS: Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. CONCLUSION: Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.
Apgar Score
;
Birth Weight
;
Bronchopulmonary Dysplasia
;
C-Reactive Protein
;
Chorioamnionitis
;
Ductus Arteriosus, Patent
;
Enterocolitis, Necrotizing
;
Female
;
Gestational Age
;
Hemorrhage
;
Humans
;
Incidence
;
Infant
;
Infant, Low Birth Weight
;
Infant, Newborn
;
Infant, Premature
;
Inflammation
;
Intensive Care, Neonatal
;
Leukemoid Reaction
;
Medical Records
;
Mothers
;
Neutrophils
;
Parturition
;
Pregnancy
;
Prognosis
;
Retinopathy of Prematurity
;
Retrospective Studies
;
Steroids
;
Ventilators, Mechanical
4.A Case of Urinothorax in Autosomal Dominant Polycystic Kidney Disease Hemodialyzed.
Mi Jin SO ; Byoung Ju NA ; Jong Lyul KIM ; Jin Han LEE ; Jin Su KIM ; Yong Ho RHO ; Taehyo KIM ; Kyoung Hyoub MOON
Korean Journal of Nephrology 2001;20(1):161-165
Urinothorax is rare cause of pleural effusion. Urinothorax should be considered when pleural effusion occurs in patients with urinary tract obstruction accompanied by retroperitoneal urinoma. It has been reported in patients with trauma, malignancy, kidney biopsy and renal transplantation. Most cases are diagnosed retrospectively by promt resolution of symptoms after relief of urinary obstruction. But diagnosis can be made based on clinical suspicion, radiological findings and biochemical analysis of the effusion and most important finding is the pleural level of creatinine is higher than the serum level. We experienced right pleural effusion in autosomal dominant polycystic kidney disease hemodialyzed. The patient had right urinoma in the retroperitoneal space before pleural effusion developed. After 3month, he complained acute dyspnea. There was no effect in resolving effusion by lowering dry weight. We thought alternative diagnostic possibility, urinothorax and checked the pleural fluid to serum creatinine ratio. Finally concluded that pleural effusion was urinothorax secondary to remnant left polycystic kidney rupture and tried left nephrectomy. The patient showed reduction of pleural effusion. It is important to alert physician to this condition and to avoid the other invasive diagnostic study.
Biopsy
;
Creatinine
;
Diagnosis
;
Dyspnea
;
Humans
;
Kidney
;
Kidney Transplantation
;
Nephrectomy
;
Pleural Effusion
;
Polycystic Kidney Diseases
;
Polycystic Kidney, Autosomal Dominant*
;
Renal Dialysis
;
Retroperitoneal Space
;
Retrospective Studies
;
Rupture
;
Urinary Tract
;
Urinoma
5.Multicentric melanotic neuroectodermal tumor of infancy: a case report.
Byoung Hwan CHOI ; Su Won PARK ; Soo Mi JANG ; Bong Chan PARK ; Han Na SON ; Jang Ho SON ; Iel Yong SUNG ; Jong Ryoul KIM ; Yeong Cheol CHO
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2010;36(5):434-437
A melanotic neuroectodermal tumor of infancy (MNTI) is a uncommon osteolytic pigmented neoplasm that primarily affects the jaws of newborn infants. Most patients (> 90%) present with the tumor in the first year of life. Approximately 65% form in the maxilla, 11% in the mandible, 5% in the brain and elsewhere. MNTI is normally benign, but up to 15% may recur and a few have metastasized. Approximately 200 cases of MNTI have been reported but only 2 of them presented as multifocal. A case of MNTI in a 7 month old boy was encountered. The chief complaint was maxillary anterior ridge swelling. The incisional biopsy findings were MNTI. Two months after the first operation, mild swelling of another site was observed. The infant was examined periodically since undergoing two procedures with no recurrence. This case demonstrates the possibility of a multicentric MNTI. We report a multicentric MNTI with a review of the relevant literature.
Biopsy
;
Brain
;
Humans
;
Infant
;
Infant, Newborn
;
Jaw
;
Mandible
;
Maxilla
;
Neuroectodermal Tumor, Melanotic
;
Polyenes
;
Recurrence
6.The study of stability of absorbable internal fixation after mandibular bilateral sagittal split ramal osteotomy.
Byoung Hwan CHOI ; Su Won PARK ; Soo Mi JANG ; Han Na SON ; Bong Chan PARK ; Jang Ho SON ; Yeong Cheol CHO ; Iel Yong SUNG
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2010;36(4):255-261
INTRODUCTION: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. MATERIALS AND METHODS: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. RESULTS: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) CONCLUSION: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.
Humans
;
Internal Fixators
;
Mandible
;
Osteotomy
;
Osteotomy, Sagittal Split Ramus
;
Recurrence
;
Sitosterols
8.Inflammatory Reactions after Subdermal Injection of Thiopental and Propofol in Rabbits.
Je Hwan OH ; Byoung Su NA ; Bo Ryoung LEE ; Jung Won PARK ; Yong Hun JUNG ; Chong Wha BAEK ; Su Won OH ; Young Cheol WOO ; Jin Yun KIM ; Sun Gyoo PARK ; Gill Hoi KOO
Korean Journal of Anesthesiology 2002;43(4):485-493
BACKGROUND: Thiopental and propofol are the most widely used intravenous anesthetics as induction agents in general anesthesia. Thiopental is a very strong alkaline drug, and when it is extravasated, it can cause pain and skin necrosis. Propofol also can cause pain on injection in many populations. Therefore, we planed this study to compare inflammatory reactions of skin tissues after subdermal injections of thiopental and propofol in rabbits. METHODS: Four rabbits were divided into 2 groups: Standard dose (S) group and double dose (D) group. In the S group, thiopental 0.4 ml and propofol 0.4 ml were injected subcutaneously on each side of the posterior proximal ear. In the D group, the dose was doubled to 0.8 ml of each drug and injection was done in the same manner. Skin tissue at the injection sites were excised after 1 day, 3 days, and 7 days. Then each skin tissue slide was examined under an optical microsccpe. RESULTS: In the S group, the inflammatory reaction after the subdermal injection of 2.5% thiopental revealed a more progressed and more severe pattern than 1% propofol. In the D group, the inflammatory reaction after a subdermal injection of 2.5% thiopental revealed a more progressed and more severe pattern than 1% propofol at 3 days, but there was no significant difference in the degree of progression and severity between the 2 drugs at 7 days. CONCLUSIONS: When propofol is extravasated during continuous infusion for maintenance of anesthesia, it can cause distinct inflammatory reaction; though the inflammatory reaction is milder and the possibility of complications is lower than with thiopental.
Anesthesia
;
Anesthesia, General
;
Anesthetics, Intravenous
;
Ear
;
Inflammation
;
Necrosis
;
Propofol*
;
Rabbits*
;
Skin
;
Thiopental*
9.Neutralizing Antibodies Against Interferon-Beta in Korean Patients with Multiple Sclerosis.
Jae Won HYUN ; Gayoung KIM ; Yeseul KIM ; Byungsoo KONG ; AeRan JOUNG ; Na Young PARK ; Hyunmin JANG ; Hyun June SHIN ; Su Hyun KIM ; Suk Won AHN ; Ha Young SHIN ; So Young HUH ; Woojun KIM ; Min Su PARK ; Byung Jo KIM ; Byoung Joon KIM ; Jeeyoung OH ; Ho Jin KIM
Journal of Clinical Neurology 2018;14(2):186-190
BACKGROUND AND PURPOSE: Patients treated with interferon-beta (IFN-β) can develop neutralizing antibodies (NAbs) against IFN-β that can negatively affect the therapeutic response. This study assessed the prevalence of NAbs and the impact of NAb positivity on the therapeutic response to IFN-β in Korean patients with multiple sclerosis (MS). METHODS: This was a multicenter study involving 150 MS patients from 9 Korean medical centers who were treated with IFN-β for at least 6 months. Sera that had not been influenced by acute treatment were assessed for NAbs using a luciferase reporter gene assay. To evaluate the association between persistent positivity for NAbs and disease activity, NAbs were tested at 2 different time points in 75 of the 150 patients. Disease activity was defined as the presence of clinical exacerbations and/or active MRI lesions during a 1-year follow-up after NAb positivity was confirmed. RESULTS: NAbs were found in 39 of the 150 (26%) MS patients: 30 of the 85 (35%) who were treated with subcutaneous IFN-β-1b, 9 of the 60 (15%) who were treated with subcutaneous IFN-β-1a, and 0 of the 5 (0%) who were treated with intramuscular IFN-β-1a. Thirty of the 39 patients exhibiting NAb positivity were tested at different time points, and 20 of them exhibited persistent NAb positivity. Disease activity was observed more frequently in patients with persistent NAb positivity than in those with transient positivity or persistent negativity [16/20 (80%) vs. 4/55 (7%), respectively; p < 0.001]. When disease activity was compared between patients with persistent and transient NAb positivity, the difference was unchanged and remained statistically significant [16/20 (80%) vs. 2/10 (20%), p=0.004]. CONCLUSIONS: These results further support that persistent NAb positivity is associated with disease activity in MS patients treated with IFN-β.
Antibodies, Neutralizing*
;
Follow-Up Studies
;
Genes, Reporter
;
Humans
;
Interferon-beta*
;
Luciferases
;
Magnetic Resonance Imaging
;
Multiple Sclerosis*
;
Prevalence
10.Objective Measurement of Cosmetic Outcomes of Breast Conserving Therapy Using BCCT.core.
Tosol YU ; Keun Yong EOM ; Na Young JANG ; Kyung Su KIM ; Tae Ryool KOO ; Jeanny KWON ; Byoung Hyuck KIM ; Eunyoung KANG ; Sung Won KIM ; Jae Sung KIM ; In Ah KIM
Cancer Research and Treatment 2016;48(2):491-498
PURPOSE: The purpose of this study is to evaluate objective cosmetic outcomes and factors related to breast-conserving therapy (BCT) using the BCCT.core software. MATERIALS AND METHODS: Fifty-one patients who received BCT with informed consent were evaluated using the BCCT.core software. Patients were divided into two groups based on the BCCT score: excellent or good (n=42) vs. fair or poor (n=9). Analysis of clinical factors was performed to determine factors affecting cosmetic outcomes. RESULTS: The objective cosmetic outcome of BCT measured using the BCCT.core software was excellent in 10% of patients, good in 72%, and fair in 18%. None of the patients were classified as poor outcome. Tumor characteristics, systemic adjuvant therapy (chemotherapy and hormonal therapy), and radiation dose or energy of electron boost did not show correlation with the score measured by the BCCT.core program (p > 0.05). In univariate analysis, maximum dose within the breast (Dmax), width of tangential field, and excised tumor volume were smaller in patients with excellent or good by the BCCT.core compared to those with fair or poor (Dmax, 110.2±1.5% vs. 111.6±1.7%, p=0.019; width of tangential field, 8.0±1.1 cm vs. 8.6±0.7 cm, p=0.034; excised tumor volume, 64.0±35.8 cm3 vs. 95.3±54.4 cm3, p=0.067). In multivariate analysis, only Dmax was a significant factor for breast cosmetic outcome with a risk ratio of 1.697 (95% confidence interval, 1.006 to 2.863; p=0.047). CONCLUSION: Objective measurement of cosmetic outcome of BCT using the BCCT.core software was feasible. The cosmetic outcome of BCT may be affected by the maximum dose within the breast.
Breast Neoplasms
;
Breast*
;
Esthetics
;
Humans
;
Informed Consent
;
Multivariate Analysis
;
Odds Ratio
;
Quality of Life
;
Tumor Burden