No abstract available.
Diabetes Mellitus* ; Humans ; Neutrophils* ; Superoxides*

There are many predisposing factors for acute pulmonary edema, Pulmonary edema in well recognized complication of acute airway obstruction, especially in small children, but rarely seen in adults. We present a case of noncardiogenic pulmonary edema that developed in adult following removal of endotracheal intubation after esophagoscopy, The sequence of events suggest that laryngospasm precipitated the development of the pulmonary edema in this patient.
Adult ; Airway Obstruction ; Causality ; Child ; Esophagoscopy* ; Humans ; Intubation, Intratracheal ; Laryngismus ; Pulmonary Edema*

Electrocardiographic findings in 18 cases of hypertrophic obstructive cardiomyopathy(HOCM) were compared with those in 20 hypertensives with disproportinate septal hypertrophy(DSH) and in 20 normal controls. In conventional 12 leads electrocardiograms, abmormal Q waves were seen only in 6 cases of HOCM and none in the remadinder. The R waves were tallest in leads V4 in 6 cases(33%) of HOCM, 3(15%) hypertensives with DSH, and 4(20%) of the controls. The correlations of the QRS voltages with echocardiographically measured left ventricular dimension, interventricular septal thickness and left ventricular mass were significant in the hypertensives with DST and normal controls, but insignificant in patients with HOCM. We conclude that these electrocardiographic differences in patients with HOCM from the others would be caused by uneven distribution of hypertrophied muscle mass in the left ventricule and/or by the altered depolarization in hypertrophied cardiac muscles.
Cardiomyopathy, Hypertrophic* ; Electrocardiography* ; Humans ; Hypertension* ; Myocardium

Intracardiac metastasis as the initial presentation of malignant neoplasm is very rare. We report here on a 64-year-old man with non-small cell lung cancer (NSCLC) initially presenting with intracardiac metastasis which was identified with 18-F fluorodeoxyglucose positron emission tomography (FDG PET). The patient was admitted with complaints of exertional dyspnea and vague chest discomfort that had developed a few weeks ago. Two-dimensional echocardiography revealed a heart mass attached to its akinetic wall in the right ventricular chamber. CT and MRI demonstrated a large tumor involving the epicardium and myocardium in the right ventricle, and there was a mass in the right lower lobe of the lung along with multiple lymphadenopathies. Cytologic examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests, and this was strongly suggestive of squamous cell carcinoma. Subsequent FDG PET confirmed that the intracardiac mass had an abnormally increased FDG uptake, and again this was strongly suggestive of malignancy. By systemically considering these imaging studies, we were able to diagnose the mass as intracardiac metastasis of NSCLC.
Carcinoma, Non-Small-Cell Lung/*diagnosis ; Heart Neoplasms/diagnosis/*secondary ; Heart Ventricles/pathology ; Humans ; Lung Neoplasms/*diagnosis ; Male ; Middle Aged

BACKGROUND: The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. MATERIALS AND METHODS: Package inserts about antibiotics, only oral or parenteral agent, were perused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. RESULTS: Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases:15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases:8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases:10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases:13 oral and 7 parenteral agents) revealed no information for dose adjustment commens to indications or the severity of infection. CONCLUSION: This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.
Americas ; Anti-Bacterial Agents ; Anti-Infective Agents ; Asian Continental Ancestry Group ; Humans ; Japan ; Korea* ; Product Labeling* ; United States

BACKGROUND: The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. MATERIALS AND METHODS: Package inserts about antibiotics, only oral or parenteral agent, were perused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. RESULTS: Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases:15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases:8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases:10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases:13 oral and 7 parenteral agents) revealed no information for dose adjustment commens to indications or the severity of infection. CONCLUSION: This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.
Americas ; Anti-Bacterial Agents ; Anti-Infective Agents ; Asian Continental Ancestry Group ; Humans ; Japan ; Korea* ; Product Labeling* ; United States

PURPOSE: The purpose of our study is to describe the chest radiographic and CT findings of simple pulmonary eosinophilia. MATERIALS AND METHODS: Twenty-six patients with simple pulmonary eosinophilia under went chest radiography and CT scanning; the results were analyzed retrospectively by two chest radiologists, focusing on the patterns and distribution of the parenchymal abnormalities. RESULTS: The chest radiographs were normal in eight patients (31%), while among the remaining 18 patients, they showed subtle opacity (n=9), nodules (n=8), consolidation (n=2), and mass (n=1). Fo l l ow-up chest radiographs (n=18) demonstrated com-plete (n=16) or partial (n=1) resolution of parenchymal lesions or migratory lesions (n=1). On CT, nodule(s) (n=19) were most commonly seen, followed by ground-glass opacity (n=16), consolidation (n=3), and mass (n=1). A peripheral halo surrounding a nodule or an area of consolidation was seen in 18 patients. The nodules(s) (n=19) were subpleural (n=13) or random (n=6). Areas of ground-glass opacity (n=16) were subpleural (n=13), random (n=2), or central (n=1). All lesions were patchy ratherthan diffuse. Fo l l ow-up CT in nine patients showed complete (n=7) or partial (n=2) resolution of parenchymal lesions. CONCLUSION: Chest radiographs of patients with simple pulmonary eosinophilia often r eveal no abnormality. The most common finding is subtle opacity or nodule(s), while CT reveals transient nodule(s) with a surrounding halo or transient areas of ground-glass opacity.
Humans ; Pulmonary Eosinophilia* ; Radiography ; Radiography, Thoracic* ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed

BACKGROUND: TAn increased occurrence of morning time acute myocardial infarction(AMI) based on subjective self-reports and objective confirmation has been reported in the USA and Europe. We tried to see if the same circadian pattern is found among Korea patients in the regard. We have also studied how various modifying factors such as age, gender, history of congestive heart failure, previous angina pectoris, hypertension and smoking may affect the circadian pattern. METHODS: The onset of chest pain was studied in 471 patients with AMI admitted to four teaching hospitals in Taegu. Korea. We categorized the patients according to the modifying factors described above. RESULTS: The patients with AMI indeed showed bimodal variation at the onset of myocardial infarction with the primary peak between 6 A.M. and 12 noon. The frequency of the onset of pain occurred during this 6 hour period was 1.8 times higher than the average of the remaining period(p<0.001). The secondary peak occurring in the evening was barely noticeable. On the other hand. the sub-group(n=96) with a history of congestive heart failure demonstrated its peak(30%) in the evening(6 pm~12 midnight) and the sub-group with a history of hypertension(n=177) demonstrated its peak(37%) in the afternoon(12noon-6P.M.). However. the rest of the sub-groups smokers, patients with previous angina and patients over the age of 70 revealed typical circadian rhythm with a pronounced primary morning peak. CONCLUSIONS: This study clearly showed that Korean patients with AMI revealed a remarkably similar circadian pattern, primary morning peak of onset of myocardial infarction and that the marked differences in diurnal patterns of myocardial infarction onset occur in sub-groups of patients with modifying factors, particularly previous congestive heart failure and hypertension.
Angina Pectoris ; Chest Pain ; Circadian Rhythm ; Daegu ; Europe ; Hand ; Heart Failure ; Hospitals, Teaching ; Humans ; Hypertension ; Korea ; Myocardial Infarction* ; Smoke ; Smoking ; Triacetoneamine-N-Oxyl

OBJECTIVE: The authors analyzed clinical features, long-term treatment outcome, and prognostic factors of the olfactory neuroblastoma. METHODS: Twenty-one cases of olfactory neuroblastomas, treated from 1979 to 2000, were retrospectively reviewed with medical records and radiological findings. Mean follow-up periods are 28.7 months(range 4-178). Extent of tumor was classified by UCLA staging system. Statistical analysis for survival was done using Kaplan Meier method and log-lank test. RESULTS: Mean age was 27 years(13-62), and most common group are second decades(8/21, 38%). Male to female ratio was 13: 8. Common symptoms are nasal obstruction, epistaxis, exopthalmos and headache. There were three cases of T1, five T2, six T3, and seven T4 according to UCLA staging system. The 5-year survival rate was 21.3% and average time was 28.9 months in surgical resection group(n=14) as primary modality have higher survival rate than radiation and chemotherapy group(n=7)[2-year survival rate: 39.2% vs 14.3%, 5-year survival rate: 19.6% vs 14.3%(p=0.0274)]. Early stage(T1, T2) groups showed better survival rate than advanced(T3, T4) groups(38.1% vs 9.1% p=0.0336). The local and regional recurrences were observed in 6(27%) and 2(9%) cases. Mean recurrence free time was 7.8 months(range 1-25). CONCLUSION: Early detection and extent of resection are the important prognostic factors. Regular follow up is mandatary for the detection of recurrence or metastasis.
Drug Therapy ; Epistaxis ; Esthesioneuroblastoma, Olfactory* ; Female ; Follow-Up Studies ; Headache ; Humans ; Male ; Medical Records ; Nasal Obstruction ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

BACKGROUND: Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy and the RFP resistance is a marker of multi-drug resistant (MDR) tuberculosis. RpoB gene encodes the beta-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. And the mutations of rpoB gene have been found in about 96% of rifampicin resistant clinical isolates of M. tuberculosis. So in order to find a rapid and clinically useful diagnostic method in identifying the REP resistance, we compared the PCR-line probe method with PCR-SSCP for the detection of the rpoB gene mutation in cultured M. tuberculosis. METHODS: 45 clinical isoLates were collected from patients who visited Sung Kyun Kwan University Hospital. The REP susceptibility test was referred to the referral laboratory of the Korean Tuberculosis Institute. 33 were rifampicin resistant and 12 were rifampicin susceptible. The susceptibility results were compared with the results of the PCR-SSCF and PCR-line probe method. RESULTS: We could find rpoB mutations in 27/33(81.8%) RFP-resistant strains by PCR-line probe method, and in 23/33(69.7%) by PCR-SSCP and there was no significant difference between two methods. There was no mutation in rifampicinn susceptible strains by both methods.: Comparison of PCR-line probe and PCR-SSCP methods for detection rifampicin resistance CONCLUSION: PCR-Iine probe method would be a rapid, sensitive and specific method for the detection of rifampicin resistant Mycobacterium tuberculosis.
DNA-Directed RNA Polymerases ; Drug Resistance ; Drug Therapy ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Referral and Consultation ; Rifampin* ; Tuberculosis