No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND AND OBJECTIVES:Traditionally, down beat nystagmus is regarded as a sign of central nervous system dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior semicircular canal BPPV, and to propose the new treatment method. MATERIALS AND METHOD:From November 1999 to March 2004, we sampled the 103 patients with positional or positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous system dysfunction, nonspecific or artifact result, idiopathic origin. RESULTS:All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and reversibility was reported in 1 patient. Average latency was checked less than 2 seconds. CONCLUSION:Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Artifacts ; Central Nervous System ; Diagnosis ; Humans ; Semicircular Canals ; Vertigo*

No abstract available.
Spinal Muscular Atrophies of Childhood*

Milk-Alkali syndrome can be caused by ingesting large amount of calcium and absorbable alkali. Coincident with promotion of calcium therapy for the treatment of osteoporosis in postmenopausal women and secondary hyperparathyroidism in patients with chronic renal failure, the Milk-Alkali syndrome is now a common cause of hypercalcemia. We experienced a case of a woman who had took calcium for hypoparathyroidism after thyroidectomy (and incidental parathyroidectomy) for thyroid papillary adenocarcinoma. Recently she ingested unusually large amount of calcium (10.8 g/day) for a week mistakenly. She presented voiding difficulty, anorexia and irritability with the triad of hypercalcemia, metabolic alkalosis and acute renal failure. All the metabolic abnormalities were normalized and renal function was improved with fluid and diuretic therapies.
Acute Kidney Injury ; Adenocarcinoma, Papillary ; Alkalies ; Alkalosis ; Anorexia ; Calcium Carbonate* ; Calcium* ; Female ; Humans ; Hypercalcemia* ; Hyperparathyroidism, Secondary ; Hypoparathyroidism ; Kidney Failure, Chronic ; Osteoporosis ; Thyroid Gland ; Thyroidectomy

Dicamba is 3, 6-dichloro-2-methoxybenzoic acid and classified as a chemically related chlorophenoxy herbicide. This herbicide has been widely used for control of broad-leaved weeds. The poisoning is uncommon and of low toxicity, but massive self-ingestion may be fatal. We experienced a case of dicamba poisoning with rhabdomyolysis and acute renal failure in a 53-year-old male. This patient showed vomiting, confused mental status, and myotonia. Electrolyte abnormalities, rhabdomyolysis, and acute renal failure also developed together with fever, hepatotoxicity, pancreatic toxicity, hematologic abnormalities and cardiac ischemia. He was treated by 7 sessions of hemodialysis with supportive treatment and recovered.
Acute Kidney Injury* ; Dicamba* ; Fever ; Humans ; Ischemia ; Male ; Middle Aged ; Myotonia ; Poisoning* ; Renal Dialysis* ; Rhabdomyolysis* ; Vomiting

Arthroscopic repair of an isolated teres minor tendon tear without associated shoulder joint pathology has not been reported in the literature. We report on a case of isolated teres minor tendon tear after trauma. The patient complained of severe shoulder pain and progressive limited range of motion 4 months after the injury. Magnetic resonance imaging showed a full-thickness tear of the teres minor tendon at its musculotendinous junction and arthroscopic repair was performed. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. Here, the authors report this case and provide a review of literature.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pathology ; Range of Motion, Articular ; Shoulder Joint ; Shoulder Pain ; Tears* ; Tendons*

BACKGROUND: Thyroid hormones play an important role in regulating lipid and glucose metabolism. Thus this study was conducted to investigate the relationship between the thyroid hormone (FT4) or thyroid stimulating hormone (TSH) and the cardiovascular risk factors and metabolic syndrome in the individuals with subclinical thyroid dysfunction. METHODS: The female health examinee with normal range of FT4 were classified into three groups according to the level of TSH; euthyroid group (n=4,410), subclinical hypothyroidism group (n=438) and subclinical hyperthyroidism group (n=66). Age, blood pressure, BMI, fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, lipoprotein(a), and high-sensitivity C-reactive protein (hsCRP) levels of serum specimens were compared among the groups and association of FT4 or TSH with these parameters. RESULTS: Fasting glucose was significantly higher in subclinical hyperthyroidism than in euthyroid and subclinical hypothyroidism groups (P=0.031), and total cholesterol was higher in subclinical hypothyroidism than in subclinical hyperthyroidism (P=0.011). But the other factors showed no difference among the groups. The level of TSH increased as triglyceride increased, while FT4 decreased as BMI or triglyceride increased. The FT4 also lowered when fasting glucose was above 126 mg/dL. TSH was not related with the metabolic syndrome, but the possibility of the syndrome was 1.3 times higher in the lowest quartile of the normal range of FT4 than in its highest quartile. CONCLUSIONS: For the interpretation of FT4, its reference interval needs to be divided into 4 quartiles, which can be used as one of the predicting factors of the metabolic syndrome.
Adult ; Aged ; Blood Glucose/analysis ; Cardiovascular Diseases/*diagnosis ; Cholesterol/blood ; Female ; Humans ; Hyperthyroidism/complications/diagnosis ; Metabolic Syndrome X/diagnosis/etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Thyroid Gland/*physiology ; Thyroid Hormones/blood ; Thyrotropin/blood

A 35 year old woman, gravid 5, multiparous, was admitted to our department at 6 weeks and 5 days of gestation after being diagnosed with cervical pregnancy. Before the evacuation, the uterine arteries were embolized using angiographic techniques. As a result, dilatation and curettage were performed with minimal hemorrhage. We report one case of cervical pregnancy managed, successfully with preoperative uterine artery embolization and evacuation.
Adult ; Dilatation and Curettage ; Female ; Hemorrhage ; Humans ; Pregnancy* ; Uterine Artery Embolization* ; Uterine Artery*

Differential diagnosis of cavitary lung lesions is frequently problematic. We studied 35 patients with cavitary lung lesions, consisting of lung cancer (17 patients). Pulmonary tuberculosis(11 patients), and lung abscess (7 patients). We analysed CT scans in terms of irregularities of the cavity wall, maximum wall thickness, the presence of air-fluid level, location of the cavity within the mass, number of cavities within the mass, size of the cavity and the presence of calcification within the mass. Cancer cavity showed irregular inner (100%) and outer margins(100%), and thick wall (mean, 1.94cm), eccentrical location(94%) and multiplicity within a mass(38%). Tuberculous cavity showed smooth inner (56%) and irregular outer margins(75%), thin wall (mean 0.96cm), central location (62%), and multiplicity in one patient (36%). Abscess cavity showed irregular inner (57%) and outer margins(91%), relatively thin wall (mean 1.0cm), central location (57%), and air-fluid level (86%). CT scan could differentiate malignant lesions from benign condition such as tuberculosis and lung abscess by observing characteristics of the cavities.
Abscess* ; Diagnosis, Differential ; Humans ; Lung Abscess ; Lung Neoplasms* ; Lung* ; Tomography, X-Ray Computed ; Tuberculosis*

BACKGROUND: The Cobas(R) Integra is a new automated chemistry analyzer with continuous and random-access features for routine chemistries, specific proteins, electrolytes, therapeutic drugs and drugs of abuse. The system maintains 68 test-specific reagent cassettes on board and have test principles of absorbance photometry, immunoturbidometry, fluorescence polarization and ISE measurements. We evaluated the usefulness of Cobas(R) Integra in the aspect of accuracy, precision, linearity, comparison study, test speed and general performance. METHODS: We evaluated the analytical performance of the Cobas(R) Integra for T. bilirubin, CRP, BUN, creatinine, sodium, potassium, chloride, valproic acid, phenytoin and carbamazepine according to NCCLS guidelines (EP5-T2, EP6-P, EP9-T and GP10-T). RESULTS: In accuracy study, error ranges(%) of most test items, except sodium and chloride, were within analytic goals. In within-run and between-run precision study, Coefficient of variation (CV, %) of most items, except sodium, were lower than limits suggested by College of American Pathologists Survey 1991. The linearities were maintained well in the range of medically significant levels and were statistically acceptable (p<0.001). The comparison study for most items, except sodium and chloride, indicated good correlation with Hitachi 747 and TDx FLx(TM) and correlation coefficients (r) were above 0.98. Throughput was about 450 tests/hr. CONCLUSIONS: Cobas(R) Integra showed satisfactory accuracy, precision, linearity, good correlation with other analyzers and high throughput. So, we concluded that Cobas(R) integra is highly suitable for not only routine use but also emergency tests in medium to large-sized hospitals because of its high productivity and reliability.
Bilirubin ; Carbamazepine ; Chemistry* ; Creatinine ; Efficiency ; Electrolytes ; Emergencies ; Fluorescence Polarization ; Phenytoin ; Photometry ; Potassium ; Sodium ; Street Drugs ; Valproic Acid