Hemodynamics in 60 normal, 15 simple goiter and 40 hyperthyroid subjects were determined from non-invasive Wezler's method. Hemodynamic changes in hyperthyroid patients were compared with those of normal subjects. The relationships of the cardiac output, aging,131I uptake rate and PEP/LVET to the hemodynamic changes in Hyperthyroid patients were also discussed. 1) The hemodynamics of normal subjects were same as those of simple goiter. 2) The heart rate and cardiac output were increased very significantly in hyperthyroid patients but they appeared to decrease with age. The stroke volume was increased slightly in the hyperthyroid patients, but remained unlateerd even with aging. Peripheral arterial resistance in hyperthyroid patients was decreased but appeared to increase with age. 3) As the131I uptake rate increased, the heart rate, cardiac output also increased, but PEP/LVET as an index of myocardial contractility and the peripheral arterial resistance decreased. 4) PEP/LVET as an index of myocardial contractility in hyperthyroid patients was markedly reduced. 5) The relationship of stroke volume and the rate of the heart to cardiac output in normal subjects were reasonably linear, and peripheral arterial resistance has negative relation to cardiac output. However the heart rate, though increased in most patients with thyrotoxicosis, bears no close relations to the level of cardiac output increment. The relationshop of stroke volume to cardiac output in hyperthyroid patients is reasonably linear and peripheral arterial resistance has negative correlation with the cardiac output.
Aging ; Cardiac Output ; Goiter ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Stroke Volume ; Thyrotoxicosis

OBJECTIVES: The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. METHODS: A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. RESULTS: More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. CONCLUSION: The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.
Adolescent Psychiatry ; Adolescent* ; Child* ; Cognitive Therapy ; Consultants ; Cooperative Behavior ; Counseling ; Education ; Fellowships and Scholarships ; Female ; Group Practice ; Humans ; Korea ; Mental Health ; Parents ; Play Therapy ; Private Practice ; Psychiatry* ; Public Sector ; Seoul

Lymphocytic ascites with low serum-ascites albumin gradient (SAAG) are observed mainly in tuberculous peritonitis, peritoneal carcinomatosis, and pancreatic disease. However, pelvic inflammatory disease (PID) induced generalized peritonitis causing diffuse ascites has been rarely described. We report a 26-year old female patient, who was diagnosed as generalized peritonitis with diffuse ascites due to Chlamydia trachomatis infection. Gynecologic examination did not show the clue of PID and in the analysis of ascites, low SAAG, predominant lymphocyte count and high level of adenosine deaminase were noted. Although the best impression was tuberculous peritonitis on the base of these findings, the laparoscopic finding was consistent with PID and the PCR for C. trachomatis infection in cervical swab was positive. This case suggests that C. trachomatis peritonitis should be considered as a rare cause of low SAAG and lymphocytic ascites in sexually active women and should be intensively evaluated including laparoscopic examination.
Adult ; Anti-Bacterial Agents/therapeutic use ; Ascites/diagnosis/metabolism/therapy ; Ascitic Fluid/chemistry ; Cephalosporins/therapeutic use ; Chlamydia Infections/complications/*diagnosis/drug therapy ; Chlamydia trachomatis/genetics/*isolation & purification ; Diagnosis, Differential ; Female ; Humans ; Laparoscopy ; Peritonitis/*diagnosis/etiology/radiography ; Peritonitis, Tuberculous/diagnosis ; Serum Albumin/metabolism ; Tomography, X-Ray Computed

IgA nephropathy is the most common glomerulonephritis in all parts of the world. It presents as asymptomatic microscopic hematuria or proteinuria or as episodic gross hematuria after upper respiratory infection or excercise. Pulmonary hemorrhage is both a rare complication and presentation of IgA nephropathy. We report a case of pulmonary hemorrhage associated with IgA nephropathy in adult. A 29-year-old woman was transferred because of gross hematuria and hemoptysis after hysterectomy. Chest X-ray showed bilateral pulmonary infiltrates in lower lobes. Renal biopsy showed mesangial expansion by mesangial cellular proliferation with mesangial staining of IgA. Her repiratory symptom and pathcy opacities on the chest X-ray disappeared spontaneously. Normal renal function of the patient maintained but she had persistent hematuria.
Adult* ; Biopsy ; Cell Proliferation ; Female ; Glomerulonephritis ; Glomerulonephritis, IGA ; Hematuria ; Hemoptysis ; Hemorrhage* ; Humans ; Hysterectomy ; Immunoglobulin A* ; Proteinuria ; Thorax

OBJECTIVETo analyze the incidence and profile of mutations in epidermal growth factor receptor (EGFR) in Chinese patients with non-small cell lung cancer (NSCLC).

METHODSA total of 176 cases of NSCLC tissue was enrolled in this study, among which 123 normal lung samples were also included. The tissue DNA was extracted and the EGFR gene in exon 19 to 21 was subjected for PCR amplification and direct sequencing.

RESULTSThe EGFR gene in exon 19-21 was of wild type in all normal lung tissues detected. Mutations were found in 57 cases of 176 lung cancer samples, with an incidence of 32. 4%. Mutations were mainly detected in the exon 19 (37/57 cases, 64. 9% ) and exon 21 (18/57 cases, 31. 6% ) , while that in the exon 20 was rare (2/57 cases, 3. 5% ). There were 7 types of EGFR mutation in the exon 19, resulting in the deletion of codon 746 to 753. A missense mutation was detected in exon 20, dealing with codon 789 to 793. The mutation in exon 21 belonged to the single missense substitution in codon 858. The EGFR mutations were more frequent in female patients than male ones, in adenocarcinoma and adenosquamous cell carcinoma versus cancer of other histologies.

CONCLUSIONEGFR mutation is a tumor-specific somatic abnormality. Some one third of Chinese NSCLC tumors harbor EGFR mutations, especially in exons 19 and 21. These mutations are more frequently detected in female, adenocarcinoma and adenosquamous cell carcinoma.

Adenocarcinoma ; genetics ; Adult ; Aged ; Amino Acid Sequence ; Base Sequence ; Carcinoma, Non-Small-Cell Lung ; genetics ; Carcinoma, Squamous Cell ; genetics ; Codon ; DNA Mutational Analysis ; Exons ; Female ; Gene Deletion ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Mutation ; Mutation, Missense ; Receptor, Epidermal Growth Factor ; genetics ; Sex Factors