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

PURPOSE: The purpose of this study was to examine the academic achievement of the first year medical students at Gachon University of Medicine and Science based on their characteristics (i.e. age, gender, and academic degree types (bachelors/masters), field of major (biology/ non-biology), and admission variables (i.e. MEET, GPA, attitude, interview, and English test). METHODS: The admission scores and demographic information were obtained from 39 students who had entered the university in 2005. T-test was used to examine the differences in academic achievement according to the students' characteristics. Correlations between admission variables and academic achievements were examined while multiple regression analysis was used to decipher the influence of students' characteristics and admission variables on the academic achievements. RESULTS: This study showed that the academic achievements differed significantly depending on degree level, age, and field of study, but not gender. It was also found that both the Nature Science Reasoning (NSR) of MEET subscale score and GPA score correlated significantly with academic achievement in the first year students. Attitude, interview, and English test scores did not correlate significantly. The result of the multiple regression analysis revealed that NSR 1 and 2, field of major, and age accounted for a substantial amount of the variance in academic achievement. CONCLUSION: Students with higher scores in NSR 1 and 2 who majored in biology-related fieldsand who are younger tend to do better academically in their first year of medical school. The results of this study may be helpful to graduate medical schools in designing effective admissions strategies for recruiting students, as well as, in planning the curriculum to improve the academic achievements of medical students.
Curriculum ; Humans ; Schools, Medical* ; Students, Medical

PURPOSE: Successful treatment of bladder cancer greatly depend upon the regular surveillance for early detection of persistent or recurrent cancer. We assessed the efficacy of urinary NMP22 test in screening and post-trearment follow-up for bladder cancer. MATERIALS AND METHODS: Urinary NMP22 test kit, which is based on an enzyme-linked immunosorbent assays, were used to measure the values of urinary NMP22 in 30 patients of transitional cell carcinoma of the bladder, 32 healthy volunteers, 12 patients of urinary tract infection and 13 patients of other urinary malignancy. RESULTS: Median values of urinary NMP22 in patients with bladder cancer were significantly greater than in healthy volunteers(p<0.05). With a cutoff value of 15units/ml, urinary NMP22 test had a 90.0% of sensitivity and a 90.6% of specificity in predicting bladder cancer. There was significant postoperative decrease of urinary NMP22 values in all patients with bladder cancer(p<0.05). CONCLUSIONS: These results suggest that urinary NMP22 test is useful for screening and postoperative surveillance of patients with transitional cell carcinoma of urinary bladder. Further comparative studies of urinary NMP22 test with the results of postoperative cystoscopy or cold cup biopsies are requested to enhance the practical utility of urinary NMP22 test.
Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies* ; Healthy Volunteers ; Humans ; Mass Screening* ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

Localized scleroderma is a disease of unknown origin and is characterized by circumscribed sclerotic skin changes. When occurring in a linear pattern, it is called linear scleroderma. 'En coup de sabre' is a subtype of linear scleroderma which is characterized by band-like, ivory-colored depressions on the frontoparietal scalp region. Several treatment modalities have been used. However, they have not been effective or safe. We report our experience of two patients with 'en coup de sabre' on the forehead, who were treated successfully with polymethylmethacrylate microspheres (PMMA-NewPlastic(R)).
Depression ; Forehead ; Humans ; Microspheres* ; Polymethyl Methacrylate* ; Scalp ; Scleroderma, Localized* ; Skin

We report of a successfully treated case of fatal bronchospasm, which developed after N-acetylcysteine bolus intratracheal instillation in a 49-year-old female patient with bronchial asthma undergoing laparoscopic cholecystectomy. N-acetylcysteine has been widely used as a potent mucolytic agent since 1963, with few reported adverse reactions. Its mucolytic action is due to the breakage of disulfide bonds in mucus mucoproteins. Most adverse reactions to N-acetylcysteine are usually mild and respond to the termination of the medication and symptomatic treatment with antihistamine. However, several cases of fatal bronchospasm have been reported in asthmatic patients after inhaled or intravenous N-acetylcysteine. N-acetylcysteine induced bronchospasm could be avoided in most asthmatic patients if its concentration is not allowed to exceed 10%, and concomitant beta2-selective bronchodilators are utilized. Nevertheless, asthma is still a potent risk factor and requires special precautions, including careful risk-versus-benefit assessment, close observation and the immediate availability of resuscitation equipment and staff in the event of life-threatening bronchospasm.
Acetylcysteine* ; Asthma* ; Bronchial Spasm* ; Bronchodilator Agents ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Middle Aged ; Mucoproteins ; Mucus ; Resuscitation ; Risk Factors

PURPOSE: The present study was done to define the degree of intravesical prostatic protrusion (IPP) causing bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms. MATERIALS AND METHODS: We retrospectively evaluated 239 patients with BPH, analyzing age, IPP, prostate volume, International Prostate Symptom Score (IPSS), and the results from a pressure-flow study. Urethral resistance was quantified by using the BOO index (BOOI), according to the formula BOOI=PdetQmax-2xQmax (where Pdet is detrusor pressure at the peak flow rate and Qmax is peak flow rate). BOO was defined by a BOOI above 40. Patients with a BOOI below 20 were excluded. Patients were classified into two groups (obstructed and unobstructed groups) by the BOOI. Correlations were determined by logistic regression analysis, and receiver operating characteristic curves were plotted to estimate the optimal cutoff for IPP. RESULTS: There were significant differences in total prostate volume, postvoiding residual urine (PVR), IPP, and Qmax (p<0.001, p<0.001, p<0.001, and p=0.026, respectively) between the obstructed and unobstructed groups, but there were no significant differences in age (p=0.653), IPSS total score (p=0.624), or quality of life score (p=0.138). IPP had a significant prognosis (p<0.001) but was weakly correlated with prostate volume (p=0.026). The correlation coefficients between IPP and Qmax, PVR, prostate volume, and BOO were 0.551, -0.159, 0.225, and 0.391, respectively. For IPP, the area under the curve was 0.759 (95% confidence interval, 0.657 to 0.861) and the cutoff to indicate BOO was 5.5 mm with 66.7% sensitivity and 80.5% specificity. CONCLUSIONS: An IPP exceeding 5.5 mm was significantly associated with BOO.
Humans ; Indoles ; Logistic Models ; Prognosis ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; ROC Curve ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Tract

Nuclear protein-1 (NUPR1) is a small nuclear protein that is responsive to various stress stimuli. Although NUPR1 has been associated with cancer development, its expression and roles in cholangiocarcinoma have not yet been described. In the present study, we found that NUPR1 was over-expressed in human cholangiocarcinoma tissues, using immunohistochemistry. The role of NUPR1 in cholangiocarcinoma was examined by its specific siRNA. NUPR1 siRNA decreased proliferation, migration and invasion of human cholangiocarcinoma cell lines (HuCCT1 and SNU1196 cells). From these results, we conclude that NUPR1 is over-expressed in cholangiocarcinoma and regulates the proliferation and motility of cancer cells.
Cell Line ; Cholangiocarcinoma ; Humans ; Immunohistochemistry ; Nuclear Proteins ; RNA, Small Interfering

Takayasu's arteritis is a chronic inflammatory disease of unknown etiology involving the thoracic and abdominal aorta and its major branches. In some cases other vessel such as renal arteries, coronary arteries, and even pulmonary arteries may be involved. Total aortography is very important, because the clinical features are determined by the extent and severity of the specific artery involved in the occlusive phase of the disease. We report a case of Takayasu's arteritis type IV in a 38 year man with pulmonary arterial involvement and pulmo-nary hypertension.
Aorta, Abdominal ; Aortography ; Arteries ; Arteritis* ; Coronary Vessels ; Hypertension ; Hypertension, Pulmonary* ; Pulmonary Artery ; Renal Artery ; Takayasu Arteritis*

PURPOSE: In the endoscopic treatment of vesicoureteral reflux, the relatively high rate of success, the simplicity of the procedure, high patient compliance, and a lack of complications has led to the increased development of injection materials and techniques. We report a method of identifying and maintaining a clear visual field during ureteral and bladder submucosal wall injection of a dextranomer/hyaluronic acid copolymer (Deflux, Oceana, Therapeutics Inc.) by use of the hydrodistention implantation technique (HIT) with the aid of temporary ureteral catheter insertion. MATERIALS AND METHODS: We prospectively reviewed patients with grade IV or V reflux who received an endoscopic injection of Deflux. Reflux grade was evaluated before and after treatment (3 months) by use of voiding cystourethrograms. Conventional sub-trigonal injection (STING) was performed with injection of Deflux underneath the bladder mucosa at the 6 o'clock position. HIT was performed either with hydrodistention or with guidewire insertion. These techniques increase visualization of the intramural portion of the distal ureteral wall. Patients with treatment failures were offered reinjection up to three times. RESULTS: Sixty-three patients completed endoscopic injection and follow-up of 3 months. The overall resolution rate for conventional STING was 58%, i.e., 67% for grade IV and 43% for grade V. The overall resolution rate for HIT was 80%, i.e., 93% for grade IV and 66% for grade V. The modified methods showed higher resolution rates for overall cure owing to the success in patients with grade IV reflux (p=0.026). Although the success of grade V treatment was higher with the modified method, the success rate was not statistically significant (p=0.27). CONCLUSIONS: HIT with the use of either hydrodistention or a guidewire to aid in visualization of the intramural portion of the distal ureter is an effective treatment for high-grade vesico-ureteral reflux.
Bites and Stings ; Dextrans ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Mucous Membrane ; Patient Compliance ; Prospective Studies ; Treatment Failure ; Ureter ; Urinary Bladder ; Urinary Catheters ; Vesico-Ureteral Reflux ; Visual Fields

Renal lymphangiomatosis is a rare developmental malformation of the perirenal lymphatic system, and this can result in the development of cystic masses in the peri-pelvic or peri-renal areas. This is difficult to differentiate from other cystic renal disease on imaging studies. We present here a case of metachronous bilateral renal lymphangiomatosis that was falsely diagnosed as a simple renal cyst. A 47 year-old man was referred for a large amount of drainage after right renal cyst marsupialization. The abdominal computed tomography(CT) findings and fluid analysis were compatible with a lymphangiomatosis. After 6 month, he presented with flank pain on his left side and CT showed intracystic hemorrhage on the left renal lymphangiomatosis. Percutaneus drainage and conservative management were done.
Male ; Humans ; Cysts