No abstract available.
Animal Experimentation* ; Animals* ; Botulism* ; Humans

No abstract available.
Humans ; Infant, Newborn* ; Respiration, Artificial*

BACKGROUND: The number of patients of doxylamine overdose has increased, but there were little clinical reports. The purpose of this study is review the patients of doxylamine overdose for aid clinical decision making of patients disposition. METHODS: We reviewed medical records of patients who ingested doxylamine succinate retrospectively from Jan. 1, 1996 to Dec. 31. 1996. Data that was recorded were followed: age, sex, psychiatric history, amounts of ingestion, time interval from ingestion to arrival to hospital, initial vital signs and symptoms, EKG, chest PA, Lab. findings, treatment, patients disposition, length of hospital stay, complication. RESULTS : 1) Total number of patients was ninety and average dosage of ingestion was 1062mg. 2) Tachycardia was the most frequent anticholinergic symptom(46%). 3) Routine lab. findings was not abnormal except one patient who was diagnosed as Rhabdomyolysis. 4) Gut decontamination was performed in patients who had arrived at hospital in 2-3 hours, and who had ingested large dose of drug. 5) Five patients were admitted to Psychiatric dept. and one patient was admitted to emergency dept. for treatment of rhabdomyolysis. 6) The mean duration of hospital stay was 6.5 hours. CONCLUSION: The patients who ingested overdose of doxylamine was managed safely in emergency department, but we should warn against the possibility of rhabdomyolysis.
Decision Making ; Decontamination ; Doxylamine* ; Eating ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Rhabdomyolysis ; Succinic Acid* ; Tachycardia ; Thorax ; Vital Signs

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

BACKGROUND: Urinalysis is a useful laboratory test in the diagnosis of various diseases. In sampling for the urinalysis, there is much concern about contamination that can lead to misdiagnosis in the mid-stream urine sampling method. We conducted this study to determine, in terms of concordance of results and contamination in culture, whether there was any superiority in mid-stream sampling methods with or without disinfection measures compared to the catheterization method. MATERIALS AND EMTHODS: We used three kinds of urine sampling methods sequentially, mid-stream non-clean catch, mid-stream clean catch, and catheterization, for ambulatory, non-pregnant, non-menstruating female patients who visited NHIC Ilsan Hospital emergency department during a one-week period in September 2001. Each sample was electrophotometrically analyzed for leukocyte esterase, nitrite, and blood by using a reagent strip and was cultured immediately or after overnight refrigeration. RESULTS: Of the 41 patients, 9 had culture-proven urinary tract infections. The concordance rates(kappa) for nitrite, blood, and leukocyte esterase were 0.875, 0.403, and 0.406 between non-clean catch and catheterized samples and 0.875, 0.481, and 0.560 between clean catch and catheterized samples, respectively. The contamination rate of the non-clean catch, the clean catch, and the catheterized samples were statistically different: 51.2%, 29.3% and 0%, respectively. CONCLUSION: We found that cleaning with disinfectant was effective for reducing the contamination rate, even though the best urine sampling method for zero contamination was catheterization. We recommend considering cost, patients' comfort, an acceptable threshold for contamination, and the necessity for a culture before choosing a urine sampling method for women who visit the emergency department.
Catheterization ; Catheters ; Diagnosis ; Diagnostic Errors ; Disinfection ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Leukocytes ; Reagent Strips ; Refrigeration ; Urinalysis ; Urinary Tract Infections

No abstract available.

PURPOSE: In 2000, the American Heart Association and International Liaison Committee on Resuscitation published guidelines for CPR (Cardiopulmonary Resuscitation), and these guidelines were revised in 2005. Many physicians perform CPR differently than suggested by these guidelines. We investigated guideline conformation rates for CPR by non-emergency physicians. METHODS: From January 1st, 2005, to December 31st, 2005, and from January 1st, 2007, to September 30th, 2007, 103 in-hospital CPR cases were enrolled. We separated the 103 cases into two groups: 2005 patients and 2007 patients. Fifty-two cases in the 2005 group and 51 cases in the 2007 group were enrolled. The defibrillation method, defibrillation energy, epinephrine use, and atropine use were analyzed. RESULTS: Nineteen cases (82.6%) in the 2005 group and three cases (21.4%) in the 2007 group were performed using the appropriate defibrillation method (p=0.0002). Seventeen cases (73.9%) in the 2005 group and four cases (28.6%) in the 2007 group received the appropriate defibrillation energy (p=0.0069). Seven cases (14.0%) in the 2005 group and 16 cases (32.0%) in the 2007 group used the appropriate epinephrine dose (p=0.0325). Fourteen cases (28.0%) in the 2005 patient group and 14 cases (29.2%) in the 2007 patient group used the appropriate atropine dose (p=0.8983). CONCLUSION: Although CPR guidelines were renewed in 2005, many physicians do not follow these guidelines. We suggest that adequate information, education, feedback, and further study are needed for guideline conformation.
American Heart Association ; Atropine ; Cardiopulmonary Resuscitation ; Electric Countershock ; Epinephrine ; Humans ; Resuscitation

OBJECTIVE: Cytopenia is a common hematologic complication of viral infections. However, information regarding hematologic effects of common respiratory virus infections is scarce. This study aimed to evaluate hematologic complications and the clinical course of patients infected with common respiratory viruses. METHODS: We retrospectively analyzed 496 patients with respiratory tract infections admitted to the Department of Pediatrics, Wonkwang University Hospital from November 2011 to March 2012 using multiplex real-time polymerase chain reaction to detect the presence of respiratory viruses and hematologic abnormalities. RESULTS: Respiratory viruses were identified in 379 patients. Respiratory syncytial virus (RSV) was most frequently detected (55.7%), followed by influenza A (Flu-A, 23.0%). Further, cytopenia was observed in 35.5% of RSV-infected patients, 25.0% of Flu-A-infected patients, and 34% of patients infected by other viruses. Each virus caused a decrease in 3 blood cell component values, which corresponded with cytopenia frequency. Of the 379 infected patients, 83 had anemia (9.71+/-1.09 g/dL); 46 had neutropenia (803.70+/-263.09 cells/mm3); and 23 had transient thrombocytopenia (142,434.78+/-86,835.18 cells/mm3). However, no patient required treatment. A comparison of clinical characteristics between RSV- and Flu-A-positive patients with anemia revealed that RSV-infected patients had significantly longer duration of hospitalization. RSV was detected more commonly in young neutropenic patients, who had a shorter duration of fever. CONCLUSIONS: Our findings suggest that infections, particularly RSV and Flu-A, result in varying degrees of cytopenia, which usually improves without treatment and does not affect the clinical course of the infection.
Anemia ; Blood Cells ; Fever ; Hospitalization ; Humans ; Influenza, Human ; Neutropenia ; Pediatrics ; Real-Time Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Retrospective Studies ; Thrombocytopenia ; Viruses*

Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis.
Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Gait ; Granuloma ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Nervous System ; Sarcoidosis* ; Spinal Cord Diseases* ; Spinal Cord* ; Upper Extremity

Loeffler's endocarditis is a recognized complication of diseases associated with eosinophilia. This disease is considered to be a part of the idiopathic hypereosinophilic syndrome, which is characterized by persistently elevated blood eosinohil counts with symptoms and signs of organ involvement especially in the heart, nervous system, and bone marrow. We have experienced a case of Loeffler's endocarditis in a 51 years old man who complained of leg pain due to acute closure of left iliac artery by emboli. We found left ventricular mural thrombus by echocardiography and confirmed Loeffler's endocarditis by endomyocardial biopsy. We present a case with the review of literatures.
Biopsy ; Bone Marrow ; Echocardiography ; Eosinophilia ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Iliac Artery* ; Leg ; Middle Aged ; Nervous System ; Thromboembolism ; Thrombosis