Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease.
Chyle ; Chylous Ascites ; Humans ; Pancreatic Neoplasms ; Pancreatitis ; Parenteral Nutrition, Total ; Peritoneum ; Portal Vein ; Rare Diseases ; Rupture ; Thrombosis

No abstract available.
Hand* ; Neutrophils* ; Skin Diseases* ; Sweet Syndrome

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.
Aneurysm ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Cardiovascular Diseases ; Death, Sudden ; Education ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Heart Ventricles ; Humans ; Korea ; Male ; Myocardium

BACKGROUND: Decreased heart rate variability(HRV) has been shown to be an independent predictor of poor outcome after acute myocardial infarction, Spectral analysis of HRV has recently been shown to be a reliable noninvasive test for quantiative assessment of cardiovascular autonomic regulatory response. We estimated the reproducibility and circadian rhythm of HRV parameters in patients with acute myocardial infarction. METHODS: Three consecutive 24-hour ambulatory electrocardiographic recordings were made in 24 patients with acute myocardial infarction, with 10~14 days after the acute attack, and analyzed for HRV parameters of both frequency and time domains. Parameters of frequency domain include low frequency(LF) and high frequency(HF) components. Parameters of time domain include sdRR, SDANN, SD, pNN50, rMSSD, HRV index. RESULTS: Mean total, low frequency and high frequency amplitude spectral densities were 33msec, 19msec and 11msec, respectively. Mean values of sdRR, SDANN, SD, rMSSD, pNN50 and HRV index were 103msec, 90msec, 47msec, 28msec, 7% and 32, respectively. Coefficients of variation(CV) of total amplitude spectral density, and low and high frequency components were 7%, 9% and 12%, respectively. CV of most HRV parameters of time domain were also around 10% except rMSSD and pNN50. Heart rate increased in the morning to be sustained during the day time and decreased in the night. Heart rate variability of high frequency component decreased in the early morning to be sustained during day time with increase in the night. CONCLUSIONS: We conclude that in the predischarge period of acute myocardial infarction, HRV parameters of frequency and time domains are reproducible and there are some morning fall of cardiac vagal activity.
Circadian Rhythm ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Myocardial Infarction*

Recent studies suggest that apolipoproteins may be better predictor of ischemic heart disease than are plasma lipids, such as total cholesterol and high density lipoprotein cholesterol(HDL-C). To examine this hypothesis, plasma levels of major lipids and major apolipo-proteins were measured and their derivatives were calculated in 30 male patients with ischemic heart disease(16 angina pectoris and 14 old myocardial infarction) and 30 age-matched male healthy controls. Plasma levels of lipids were obtained by conventional methods and apolipoproteins by Rocket immunoelectrophoresis. Levels of HDL-C, HDL2-cholesterol(HDL2-C), and apolipoprotein-AII, and ratios of HDL-C/total cholesterol, HDL2-C/total cholesterol, and apolipoprotein-AI/apolipoprotein-B were lower in the group of patients than in controls. Levels of low density lipoprotein cholesterol(LDL-C) and apolipoprotein-B, and ratios of lDL-C/HDL-C and apolipoprotein-AI/apolipoprotein-AII were higher in the group of patients. There were no statistically significant differences in the levels of total cholesterol and apolipoprotein-AI between the two groups. Stepwise discriminators analysis showed that apolipoprotein-B and apolipoprotein-AII were better discriminators than plasma lipids for identifying those with ischemic heart disease. One could correctly classify 78% of the cases by using the levels of the two apolipoproteins. By using the level of apolipoprotein-B, one could correctly classify 73% of the cases. There were no correlations between the levels of total cholesterol and HDL-C in the controls whereas there were positive correlations between the levels in the group of patients. In conclusion, this study showed that apolipoprotein-B was the best single discriminator for identifying the patients with ischemic heart disease, followed by apolipoprotein-AII.
Angina Pectoris ; Apolipoproteins A* ; Apolipoproteins* ; Cholesterol ; Heart ; Humans ; Immunoelectrophoresis ; Lipoproteins ; Male ; Myocardial Ischemia* ; Plasma* ; Risk Factors*

BACKGROUND: Much of the recent understanding of hypertensive has focused on the importance of concomitant atherosclerotic risk factors in addition to the blood pressure itself and has created new therapeutic challenges. METHODS AND RESULTS: We conducted a prospective study to determine the prevalence rates of hyperlipidemia, smoking, diabetes, obesity and left ventricular hypertrophy(LVH) in 185 hypertensive subjects. Serum levels of total cholesterol, triglyceride and HDL-cholesterol were measured by enzymatic method. 1) Mean values of serum total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and atherogenic index were not significantly different between sex and resident area. 2) The most frequent risk factor in hypertensive subjects was overweight, followed by M-mode echocardiographic LVH, hypertriglyceridemia, high LDL-cholesterol levels, low HDL-cholesterol levels, hypertriglyceridemia, electrocardiographic LVH, and diabetes. 3) The prevalence rates of both total cholesterol levels over 240mg/dl and LDL-cholesterol over 160mg/dl were about 20%, regardless of sex and resident area. CONCLUSION: These results indicate that hypertensive subjects have many concomitant risk factors of atherosclerosis. Hypercholesterolemia(> or =200 mg/dl), M-mode echocardiographic LVH and overweight among the selected risk factors were observed in more than a half of the hypertensive subjects, regardless of sex and resident area. These findings suggest that for the effective management of hypertensive subjects, physician should not only treat hypertension itself, but also control the concomitant risk factors.
Atherosclerosis* ; Blood Pressure ; Cholesterol ; Echocardiography ; Electrocardiography ; Hyperlipidemias ; Hypertension ; Hypertriglyceridemia ; Obesity ; Overweight ; Prevalence ; Prospective Studies ; Risk Factors* ; Smoke ; Smoking ; Triglycerides

No abstract available.
Fluconazole* ; Tinea Capitis* ; Tinea*

From January, 1972 to August 1983, 12 cases of ovarian pregnancy out of 1202 total ectopic pregnancy were studied and the incidence constituted 0.9%. The gross and microscopic findings were reviewed according to gross description and gross photographs, and microscopic description and reviewing all microscopic slides. All cases were shown to meet Spiegelberg's criteria for primary ovarian pregnancy.
Pregnancy ; Female ; Humans ; Incidence

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

PURPOSE: This study has been carried out in order to develop and verify the effects of self-leadership reinforcement program for hospital nurses. METHODS: The research design was a non-equivalent control group pre-posttest design. Participants were 64 individuals (32 in each group), all of whom were nurses working at a university hospital, with less than five years of job experience. Experimental group was provided with two hours of self-leadership reinforcement program, once per week, for four weeks. The questionnaire for pre and post test included general characteristics, transfer motivation for learning, self-leadership, communication ability, clinical nursing competency, organizational commitment, and turnover intentions. RESULTS: There was a significant difference in self-leadership scores between experimental group and control group (F=15.10, p < .001). There was also a significant difference between the experimental group and the control group in terms of transfer motivation for learning (t=−5.44 p < .001), communication ability (F=15.29, p < .001), clinical nursing competency (F=15.23, p < .001), and organizational commitment scores (F=7.21, p=.009). CONCLUSION: The self-leadership reinforcement program developed in this study was effective in improving self-leadership, communication ability, clinical nursing competency, and organizational commitment. Thus, by implementing the program at clinical levels, it will be a basis for nursing personnel resource administration.
Communication ; Intention ; Learning ; Motivation ; Nursing ; Research Design