No abstract available.
Antiemetics* ; Cisplatin* ; Dexamethasone* ; Humans ; Lorazepam* ; Metoclopramide* ; Ondansetron*

Copper is an essential trace element for numerous vital enzymes. Recently, copper can be used clinically as assessing the disease activity, prognosis, therapeutic effect and early prediction of recurrence in patient with neoplasia. But overloading of copper can cause fatal outcome. Copper intoxication is usually encountered following accidental ingestion or suicidal intoxication. A 43-year old male was admitted because of epigastric pain and hematuria after ingestion of the copper hydroxide and organophosphate for suicidal purpose. The laboratory findings showed that the serum and urinary copper concentration are elevated, then the acute renal failure, hemolytic anemia and liver injury progressed. With conservative management, the hemolytic anemia was improved, but disseminated intravascular coagulation with sepsis and respiratory failure by pneumonia were developed, and then finally expired on the eighth hospital days. We experienced a case of a patient who presented with acute renal failure, hemolytic anemia and liver injury after ingestion of copper, and we reported with review of literature.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Copper* ; Disseminated Intravascular Coagulation ; Eating ; Fatal Outcome ; Hematuria ; Humans ; Liver ; Male ; Pneumonia ; Prognosis ; Recurrence ; Respiratory Insufficiency ; Sepsis

OBJECTIVES: Gastrectomy with lymph node dissec tion is the standard treatment for early gastric can cer(EGC). However, patients who have high risks demand modifications in surgical treatment for EGC. Recently, endoscopic mucosal resection(EMR) has become accepted in many institutions as a treatment for cancerous mucosal lesions of the stomach. Thus we investigated the efficacy and safety of EMR prospectively in the patients with EGC who have high risks in surgery and those with premalignant lesions. METHOD: Twenty-five patients were treated with EMR, thirteen were EGC and twelve were premalignant lesions such as tubular adenoma, severe dysplasia. We used standard snare method and endoscopic mucosal resection using a band ligation kits(EMRL). RESULTS: The complete resection rate at the first step of EMR was 100%(12/12) in premalignant lesions, 76.9%(10/13) in EGC. Of three EGC resected incomple tely at the first step, one patient was treated by surgery and two patients underwent the third step of EMR. The final complete resection rate was 92%(23/25) and it was 100%(12/12) in the premalignant lesions, 84.6%(11/13) in EGC. The final complete resection rate in according to the methods was 100%(5/5) by standard snare method, 75%(6/8) by EMRL. As pathologic results, all cases of EGC were limited to the mucosa. No serious complications such as perforation, major bleeding were encountered. CONCLUSION: We consider that EMR is effective and safe in treatment of the patients with EGC who have high risks in surgery and those with premalignant lesions.
Adenoma ; Gastrectomy ; Hemorrhage ; Humans ; Ligation ; Lymph Nodes ; Mucous Membrane ; Prospective Studies ; SNARE Proteins ; Stomach ; Stomach Neoplasms*

The association of Graves' disease and idiopathic thrombocytopenic purpura(ITP) is a rather rare, but well documented condition, and has also been reported a few times in Korea. At present, two main hypothetical mechanisms are used to explain the association of the two diseases; the presence of autoimmunity, which leads to both diseases, and activation of the reticuloendothelial system by thyroid hormone. A 33 year old female patient visited our hospital with mucosal bleeding and purpura over her entire body of 3 days duration. Her initial platelet count was 2x109/L, and the thyroid function tests showed a suppressed TSH level of 0.09 mU/L(0.4~3.1) and elevated levels of triiodothyronine and free thyroxine. The levels of anti-thyroglobulin Ab anti-TPO Ab, and anti-TSH receptor Ab were also elevated. The clinical, laboratory and bone marrow findings were compatible with Graves' disease associated with ITP. She was treated with methylprednisolone and propylthiouracil, after which her platelet count increased and thyroid function normalized. We report a case of Graves' disease associated with ITP, which was treated well by glucocorticoid and antithyroid medications
Adult ; Autoimmunity ; Bone Marrow ; Female ; Graves Disease* ; Hemorrhage ; Humans ; Korea ; Methylprednisolone ; Mononuclear Phagocyte System ; Platelet Count ; Propylthiouracil ; Purpura ; Purpura, Thrombocytopenic, Idiopathic* ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine ; Triiodothyronine

BACKGROUND: Acute pulmonary injury by paraquat are caused by multiple mechanisms including direct injury with oxygen free radicals and several mediators released from inflammatory cells. In order to clarify whether vitamin E could reduce tissue damages induced by intraperitoneal administaration of paraquat and to investigate the pathogenetic mechanisms of paraquat-induced pulmonary injury, vitamin E as a free radical scavenger was administered. METHODS: Rats were divided into three groups (group 1: control, group 2 : paraquat treated group, group 3 : paraquat and vitamin E treated group). Animals were sacrificed on day 1, day 2, day 3, and day 8 after the administration of saline, paraquat, or paraquat/vitamin E. RESULTS: Treatment with vitamin E decreased the death rate of rats treated with paraquat. Comparing with control group (1.37 x 106/ml), mean total cell counts recovered from the lavage fluid from animals treated with paraquat (1.65 x 106/ml) were increased(p=0.06). Magnitudes of increament of the total cell counts on the Day 8 in the vitamin E treated group were smaller than those of the animals treated with paraquat alone. The neutrophils began to appear in significant amounts in the lavage fluid on Day 8 after the administration of paraquat(37.0 + 12.7%). A significant decreasing neutrophil concentration at Day 8 was observed in the paraquat/vitamin E treated group(20.6 + 13.4 %). Histologically the degree of pulmonary fibrosis was most prominent in the paraquat treated group while diffuse alveolar damage was continuously observed in the paraquat/vitamin E treated group and extensive interstitial lymphocytic infiltration was seen in the paraquat/vitamin E treated group. The paraquat/vitamin E treated group showed the less histologic changes. CONCLUISON: In this study vitamin E acting as a scavenger of neutrophil-derived free radicals and suppressant of lipid peroxidation, seemed to be the effective antioxidant in the inhibition of paraquat-induced pulmonary injury.
Acute Lung Injury ; Animals ; Bronchoalveolar Lavage ; Cell Count ; Free Radicals ; Lipid Peroxidation ; Lung Injury ; Mortality ; Neutrophils ; Oxygen ; Paraquat* ; Pulmonary Fibrosis ; Rats* ; Therapeutic Irrigation ; Vitamin E* ; Vitamins*

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.
Aged ; Ascites ; Chemistry ; Chylothorax* ; Chylous Ascites* ; Female ; Hepatic Encephalopathy ; Hepatitis B ; Humans ; Liver Cirrhosis ; Pleural Effusion ; Pleurodesis ; Thoracic Duct

No abstract available.
Lymphoma*

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.
Aged ; Ascites ; Chemistry ; Chylothorax ; Chylous Ascites ; Female ; Hepatic Encephalopathy ; Hepatitis B ; Humans ; Liver Cirrhosis ; Pleural Effusion ; Pleurodesis ; Thoracic Duct

Purpose: We compared corneal higher-order aberration (HOA) measurements between the Pentacam® HR (PC), which uses the Scheimpflug principle, and the iTraceTM aberrometer (IT), which evaluates Placido disc topography. Methods: We retrospectively analyzed 109 eyes of 87 patients without a history of ocular surface disease during the period from January 2021 to December 2022; both devices were used on the same day. We calculated the root mean square values (μm) of corneal total HOA and of the corneal 3rd- and 4th-order HOA at a pupil diameter of 4 mm. Data were compared by Bland-Altman plots for agreement analysis and Pearson correlation coefficient for correlation analysis. Results: There was no significant difference in the total HOA (p = 0.145), coma (p = 0.309), or secondary astigmatism (p = 0.080) between the PC and IT measurements; all other HOAs significantly differed between devices (p < 0.001). In the correlation analysis, the total HOA (r = 0.605, p < 0.001) and coma (r = 0.634, p < 0.001) were moderately correlated between the two devices; the other HOAs showed low degree of correlations. In the Bland-Altman plot analysis, all HOAs showed low agreement between the two devices. Conclusions Corneal total HOA and coma measured by the two devices were significantly correlated between the two devices, but other HOAs showed significant differences in measurement and low correlations. Therefore, corneal HOA measurements cannot be interpreted interchangeably between the two devices.