Myasthenia gravis is an autoimmune disorder, caused by the presence of anti-ac- etylcholine receptor antibody or acetylcholine-receptor deficiency and involved neuro- muscular endplate. The clinical course and outcome of myasthenia gravis are variable during pregnancy. The special caution and adequate management for myasthenic mother and myasthenia gravis occurred newborn of myasthenic mother are essential for good perinatal outcomes. We experienced a case of myasthenia gravis associated with pregnancy who underwent cesarean section. We present this case with a brief review of literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Mothers ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Pregnancy*

Pernicious anemia is a macrocytic anemia that is caused by vitamin B12 deficiency, itself a result of the absence of intrinsic factors due to autoimmune destruction of parietal cells. We report here the case of a 43-year-old female with spontaneous remission of pernicious anemia. The patient presented with fatigue. Her serum vitamin B12 level was low, hemoglobin level was 7.6 g/dL, and serologic tests for anti-intrinsic factor and anti-parietal cell antibodies were positive. We diagnosed her with pernicious anemia, but did not administer vitamin B12 because her hemoglobin level increased spontaneously. Since then, the patient's hemoglobin and serum vitamin B12 levels have been within the normal range.
Adult ; Anemia, Macrocytic ; Anemia, Pernicious* ; Antibodies ; Fatigue ; Female ; Humans ; Intrinsic Factor ; Rabeprazole ; Reference Values ; Remission, Spontaneous* ; Serologic Tests ; Vitamin B 12 ; Vitamin B 12 Deficiency

BACKGROUND: The determinants of intubation and the response to therapy in COPD patients with hypercapnic respiratory failure were retrospectively reviewed. METHODS: This study involved a review of 132 episodes of hypercapnic respiratory failure(PaCO2≥50mmHg and pH≤7.35). The time frame for resolution or the time to intubation of patients who were admitted between 1996 and 1999 was analyzed. RESULTS: Out of 132 hypercapnic episodes, 49(37%) required intubation. A comparison was made with the 83 cases that responded to treatment. Patients requiring intubation had greater severity of illness, which included a higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score (20±5 vs 14±4 ; p<0.01), a higher WBC, a higher serum BUM, and greater acidosis (pH, 7.23±0.11 vs 7.32±0.04 ; p<0.01). Those with the most severe acidosis(pH<7.20) had the highest intubation rate(87%) and shortest time to intubation (2±3 h). Conversely, those with an initial pH 7.31 to 7.35 were less likely to be intubated(20%), and had a longer time to intubation(97±121 h). The patients with a pH 7.21 to 7.25(4.1±2.9 day) required longer period of time to respond to medical treatment than patients with a pH of 7.31 to 7.35(2.2±3.1 day). Of those patients requiring intubation, half(55%) were intubated within 8 h of admission, and most (75%) within 24 h. Of those patients responding to treatment medical therapy, half(52%) recovered within 24 h and most (78%) recovered within 48 h. CONCLUSION: Respiratory acidosis at the initial presentation is associated with an increased likelihood of intubation. This shold assist in deciding help with the decision whether to treat patients medically, institute noninvasive ventilation, or proceed to intubation.
Acidosis ; Acidosis, Respiratory ; APACHE ; Humans ; Hydrogen-Ion Concentration ; Intubation* ; Noninvasive Ventilation ; Physiology ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Insufficiency* ; Retrospective Studies

No abstract available.
Leiomyoma* ; Trachea*

No abstract available.
Sleep Apnea, Obstructive*

No abstract available.
Budesonide* ; Humans

Leopard syndrome, a feature of a syndrome, is a acronym of Lentiginosis, Electrocardiographic conduction abnormalities, Ocular hypertelorism, Pulmonic stenosis, Abnormal genitalia, Retardation of growth, and Deafness. It is one of the autosomal dominant neurocutaneous traits accompanied by neurologic abnormality. We have experienced a case of Leopoard syndrome associated with 46,XX pure gonadal dysgenesis, which was diagnosed by laparoscopic biopsy, karyotyping, and dermatologic consultation. So we report this case with a brief review of literatures. In our knowledge, this very rare case is presented for the first time in Korea.
Biopsy ; Deafness ; Electrocardiography ; Genitalia ; Gonadal Dysgenesis* ; Gonads* ; Hypertelorism ; Karyotyping ; Korea ; Lentigo ; LEOPARD Syndrome* ; Panthera* ; Pulmonary Valve Stenosis

No abstract available.
Granuloma, Plasma Cell*

No abstract available.

BACKGROUND: Sarcoidosis is a systemic granulomatous disorder of unknown origin and characterized by accumulation of T cells and macrophages. Various cytokines may play crucial roles In the activation of T cells and macrophages, and thereby in the formation of granulomas. However, little is known about the balance between proinflammatory cytokines and antiinflamatory cytokines in the development of sarcoid granulomas and disease activities. In the present study, we measured IL-6, IL-8 and IL-10 in the bronchoalveolar lavage fluid(BALF) from patients with pulmonary sarcoidosis 13 find out whether there is an imbalance between proinflammatory cytokines and antiinflammatory cytokines in the lung. METHODS: Fourteen subjects with the diagnosis of sarcoidosis and six healthy volunteers were included. BALF was concentrated ten-fold by pressure ultrafiltration and each cytokine levels were measured by ELISA method. Active sarcoidosis was defined by major organ involvement or clinically progressive diseases. RESULTS: The mean IL-6 love]s in the BALF of the active sarcoidosis group were significantly increased than in controls or inactive sarcoidosis group(p < 0.05). Meanwhile, the IL-8 levels were increased and IL-10 levels were decreased in the active sarcoidosis group than in controls or inactive sarcoidosis group without significance(p>0.05). In active pulmonary sarcoidosis patients, the IL-6 love]s in BALF correlated with the BALF CD4/CD8 ratio(r=0.768, p < 0.05) and IL-8 levels(r=0.564, p < 0.05). CONCLUSIONS: The data presented showed that proinflammatory cytokine IL-6 is important in the pathogenesis of sarcoidosis and decreased tendency of anti-inflammatory cytokine IL-10 might also be involved in the development of granulomatous inflammation in sarcoidosis.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Cytokines ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Granuloma ; Healthy Volunteers ; Humans ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Interleukins* ; Lung ; Macrophages ; Sarcoidosis ; Sarcoidosis, Pulmonary* ; T-Lymphocytes ; Ultrafiltration