Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting

PURPOSE: The aim of the study was to evaluate the validity and reliability of the Korean version of the Liverpool Adverse Events Profile (K-LAEP).METHODS: An observational, cross-sectional study was performed in people with epilepsy (PWE) treated with a stable dose of antiepileptic drugs (AEDs). The scale was translated from the English version into a Korean version and was then back-translated to examine its accuracy. Patients completed the K-LAEP, Quality of Life in Epilepsy-31 (QOLIE-31), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).RESULTS: Three hundreds twelve patients were enrolled. The K-LAEP was completed in a short time, perceived as easy to comprehend, and there was no relevant information missing. Ceiling/floor effects were negligible. Internal consistency (Cronbach's alpha=0.9) and test-retest reliability (ICC=0.8) were satisfactory. The K-LAEP scores consistently correlated with QOLIE-31 (r= -0.528), BDI (r=0.526) and BAI (r=0.557) scores. When the K-LAEP was used to discriminate between patients with and without AED-related toxicity, the scores on the QOLIE, BDI and BAI corresponded. Anxiety symptoms were the strongest predictor to determine K-LAEP scores.CONCLUSIONS: The K-LAEP scale reveals highly acceptable parameters of the validity and reliability, suggesting that it is an appropriate instrument to measure adverse effects among Korean PWE.
Anticonvulsants ; Anxiety ; Cross-Sectional Studies ; Depression ; Epilepsy ; Humans ; Quality of Life ; Reproducibility of Results

BACKGROUND: Induction of anesthesia with a high dose of fentanyl and vecuronium decreases the heart rate and blood pressure. This study was designed to evaluate the effect of preinduction atropine on these hemodynamic changes in patients undergoing coronary artery bypass graft surgery (CABG). METHODS: Forty-one patients who underwent CABG were randomly divided into two groups. After insertion of a radial artery cannula and a Swan-Ganz catheter, normal saline 1 ml (control group, n = 20) or atropine 0.5 mg (atropine group, n = 21) was injected intravenously 1 min before the induction of anesthesia. Anesthesia was induced with a first dose of fentanyl (5-8 microgram/kg) and vecuronium (0.12 mg/kg) and a second dose of fentanyl (5-10 microgram/kg). The patient was then intubated. Hemodynamic variables were measured before the induction of anesthesia, 1 min after the administration of each drug during the induction of anesthesia and 5, 10, and 30 min after the intubation. RESULTS: There was no significant differences between the two groups in terms of demographic data except that the number of patients with diabetes mellitus was greater in the control group than in the atropine group. The number of patients treated for hypotension or bradycardia during the induction of anesthesia was greater in the control group than in the atropine group, but this was not statistically significant. Heart rates significantly decreased in the control group but were maintained in the atropine group without any significant tachycardia. Blood pressure significantly decreased in both groups. CONCLUSIONS: Intravenous injection of atropine before anesthetic induction in patients undergoing CABG attenuates the decrease in heart rate resulting from anesthetic induction with high dose fentanyl and vecuronium. However, it didn't prevent the decrease in blood pressure nor did it reduce the incidence of treatment for hypotension.
Anesthesia ; Atropine* ; Blood Pressure ; Bradycardia ; Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diabetes Mellitus ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Injections, Intravenous ; Intubation ; Radial Artery ; Tachycardia ; Transplants ; Vecuronium Bromide*

Intravenous immunoglobulin (IVIG) is widely used to treat various neurologic or autoimmune disorders in childhood. Aseptic meningitis has been reported as a rare complication of IVIG therapy. We describe two girls, aged 2 and 8 years, with myasthenia gravis who suffered from aseptic meningitis after an administration of high-dose IVIG. Any other etiologic agent were identified in neither case. Both patients recovered completely within a few days and left no sequelae. To our knowledge, these are the first such reported cases in children with myasthenia gravis.
Child ; Female ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Meningitis ; Meningitis, Aseptic* ; Myasthenia Gravis*

Disseminated Fusarium infection has rarely been encountered in neutropenic cancer patients. The clinical features include fever, positive blood cultures, severe myalgias, disseminated ecthyma gangrenosum-like skin lesions, ocular symptoms and multi-organ-system involvement. The mortality rate reported so far exceeded 70% despite antifungal treatments. We report here the first two cases of disseminated fusarial infections in Korea. The first patient contracted pneumonia during severe neutropenic period following consolidation chemotherapy for acute myelogenous leukemia(AML). Fusarium oxyshrum was cultured from bronchoalveolar lavage fluid. The patient remains free of fungemia after successful antifungal treatment of high-dose amphotericin B and terbinafine. The second patient had relapsed AML and suffered from disseminated fusarial infection involving lungs with characteristic skin lesions. The patient succumbed to refractory leukemia and the fungal infection. A brief review of the literature ensues with the case report.
Amphotericin B ; Bronchoalveolar Lavage Fluid ; Child* ; Consolidation Chemotherapy ; Ecthyma ; Fever ; Fungemia ; Fusariosis ; Fusarium ; Humans ; Korea ; Leukemia* ; Lung ; Mortality ; Myalgia ; Pneumonia ; Skin

No abstract available.
Protein-Losing Enteropathies

No abstract available.
Intestinal Pseudo-Obstruction*

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

No abstract available.
Embolism, Air* ; Humans ; Infant, Newborn*

PURPOSE: Fungal infections are an important cause of morbidity and mortality in patients with hematologic malignancies. The therapy of choice in documented or suspected invasive fungal infections has been intravenous Amphotericin B (AmB). Adverse effects such as fever, chils, thrombophlebitis, nausea or vomiting are common. A more serious adverse effect is potential renal impairment. As AmB administration mixed with Intralipid (AmB/Intralipid) was reported to decrease AmB toxicity without a concomitant loss of antifungal efficacy, we studied the efficacy and side effects of long-term administration of AmB/Intralipid in leukemic children with invasive fungal diseases. METHODS: AmB/Intralipid was administered in seven leukemic children (male, 3; female, 4) who had invasive fungal infections between July 1994 and March 1997. RESULTS: AmB/Intralipid was administered at a mean concentration of 1.45mg/kg/day for a mean of 58.1 days with cumulative dose of 3.01g. Excluding 2 patients who succumbed to the underlying leukemia, 4 out of 5 remaining patients remained free of both fungal infection and leukemia. Chills associated with AmB/Intralipid were found 13 times in 4 patients. One patient could not continue the administration because of the chills on the 45th day of AmB/Intralipid. Renal and hepatic impairment greater than Grade II toxicity was found in each case, respectively. The other 6 patients showed mild elevation from the baseline, but remained within the normal limits. CONCLUSION: Long-term, high-dose AmB/Intralipid therapy can be safely and effectively used in immunocompromised children with invasive fungal infections.
Amphotericin B* ; Child* ; Chills ; Female ; Fever ; Hematologic Neoplasms ; Humans ; Leukemia ; Mortality ; Nausea ; Thrombophlebitis ; Vomiting