Acute eosinophilic pneumonia(AEP) was first described in 1989 and represents a clinical entity distinct from chronic eosinophilic pneumonia. AEP is characterized by acute respiratory insufficiency, hypoxemia, fever, diffuse radiographic infiltrates, and eosinophilia in bronchoalveolar lavage fluid or lung biopsies in the absence of infection, atopy, or asthma. Rapid response to corticosteroids is characteristic. We experienced a 47-year-old metal driller presenting typical clinical and radiological characteristics of AEP. We confirmed eosinophilic pneumonia with brochoalveolar lavage analysis and transbronchial lung biopsy. We report a case of AEP diagnosed by clinical, radiographic, and histologic findings with a brief review of the literature.
Adrenal Cortex Hormones ; Anoxia ; Asthma ; Biopsy ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils* ; Fever ; Humans ; Lung ; Middle Aged ; Pulmonary Eosinophilia* ; Respiratory Insufficiency ; Therapeutic Irrigation

BACKGROUND: Recently the clinical significance of several mycobacterial species has been increased and there is a growing need to identify mycobacteria to the species level. We evaluated multiplex polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assay for identification of mycobacterial isolates. METHODS: Reference strains of 6 species of mycobacteria and 88 clinical isolates were lysed by boiling method. The lysates were used for multiplex PCR reactions incorporating three pairs of PCR primers, which were expected to amplify fragments from the 65-kDa gene common to all mycobacteria, genes of M. tuberculosis complex and M. avium, respectively. The resultant amplicons were digested with the restric-tion enzymes PspEI and HaeIII. Multiplex PCR products and digested products were visualized by electrophoresis on agarose gels. RESULTS: Six reference strains yielded compatible results. Eighty-eight clinical isolates were identified as M. tuberculosis complex (81 strains), M. avium (2 strains), M. intracellulare (2 strains), M. fortuitum biovariant peregrinum (2 strains), and M. gordonae III (1 strain). CONCLUSION: Multiplex PCR-RFLP assay appears to be a reliable method for rapid identification of mycobacteria to species level.
Electrophoresis ; Gels ; Gordonia Bacterium ; Multiplex Polymerase Chain Reaction ; Mycobacterium* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sepharose ; Tuberculosis

PURPOSE: To report a case of macular hole after surgery in macular serous detachment associated with optic disc pit in a child, which was treated with silicone oil as an intraocular substitute. CASE SUMMARY: A 12-year-old boy was referred for examination due to visual disturbance in his left eye for the last 1 week. Corrected visual acuity at presentation was 0.08 in the left eye. The anterior part of the left eye was normal on slit lamp examination. Funduscopic examination revealed optic disc pit associated with macular detachment. The patient was treated with vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade. One week after treatment, the patient presented with central visual disturbance and showed a full thickness macular hole in the left eye. Extensive ILM peeling and silicone oil instillation were performed and after 2 months, silicone oil removal was performed. The macular hole appeared to be closed and visual acuity improved to 0.2. Recurrence was not observed until 20 months after treatment. CONCLUSIONS: After surgical treatment due to macular detachment associated with optic disc pit in a child, occurrence of a macular hole is possible. Regarding macular hole treatment, silicone oil instillation and fast removal could be a beneficial option.
Child ; Eye ; Humans ; Membranes ; Recurrence ; Retinal Perforations ; Silicone Oils ; Visual Acuity ; Vitrectomy

Neonatal listeriosis is not uncommon in Western developed countries, and has significant mortality and morbidity. However, its incidence in Asian countries is relatively low and it has rarely been reported in Korea. Once infected, Listeria monocytogenes (L. monocytogenes) can have high mortality and listeriosis in pregnancy may present serious hazards to the fetus and the newborn as sepsis and death through direct infection of the placenta and chorioamnionitis. Because early detection of L. monocytogenes infection is difficult, only high index of suspicion toward this disease can hopefully prompt treatment of this life-threatening perinatal infection. We experienced a case of L. monocytogenes yielded in cultures of blood and amniotic fluid of the newborn and the mother who delivered at 25+1 weeks of gestation because of preterm labor that developed without any specific evidence of infection. We report this case with a brief review of the literature.
Amniotic Fluid ; Asian Continental Ancestry Group ; Chorioamnionitis ; Developed Countries ; Female ; Fetus ; Humans ; Incidence ; Infant, Newborn ; Korea ; Listeria monocytogenes ; Listeriosis ; Mothers ; Obstetric Labor, Premature ; Placenta ; Pregnancy ; Sepsis

BACKGROUND: Dizziness due to brain lesions manifests mainly in infratentorial lesions, with few cases related to supratentorial lesions having been reported. This study aimed to elucidate the clinical characteristics and demographic factors of patients with dizziness caused by cerebral infarction and to determine the site of the brain where supratentorial lesions are most prevalent. METHODS: Patients with prominent dizziness who visited the emergency room of Gachon University Gil Hospital between July 2006 and July 2007 were included. Among them, 101 patients with acute cerebral infarction were categorized into supratentorial (n=51) and infratentorial (n=50) groups based on brain MRI. Demographics and clinical characteristics of dizziness in each group were compared, and common brain sites of the supratentorial group were assessed. RESULTS: The nature of the dizziness differed between the supratentorial group (vertigo, 27.4%; presyncope, 5.9%; disequilibrium, 29.4%; ocular, 11.8%; and nonspecific, 25.5%) and the infratentorial group (vertigo, 50.0%; presyncope, 6.0%; disequilibrium, 32.0%; ocular, 0%; and nonspecific, 12.0%; p=0.02). The duration of dizziness was shorter in the supratentorial than the infratentorial group (p<0.01). In the supratentorial group, common sites of the lesion were the thalamus (19.6%) and frontoparietal lobe (15.7%). The lesion usually appeared in the left hemisphere (60.8%). CONCLUSIONS: Dizziness from supratentorial lesions manifests in different ways, and its duration is shorter than that from infratentorial lesions. The central vestibular pathway may be located in the thalamus and frontoparietal lobe.
Brain ; Cerebral Infarction ; Demography ; Dizziness ; Emergencies ; Humans ; Infarction ; Syncope ; Thalamus

OBJECTIVE: Recent neuroimaging studies have shown a strong involvement of the cortex as well as brainstem locomotor center in locomotion. In the present study, cortical activity during constant stepping was investigated using electroencephalography (EEG). METHOD: Five healthy volunteers participated in this study. Sixty-four channel EEG was measured for 10 min while the participants performed constant stepping on a cadence of 100 rpm (50 cycles per 1 min) using a recumbent stepper. Surface electromyography (EMG) was also measured at the bilateral vastus medialis muscles. Each stepping cycle was epoched from the onset of EMG signal of the right vastus medialis muscle. Averaged event-related potentials (ERP) and event-related spectral perturbations (ERSP) of all subjects were calculated at all EEG channels. RESULTS: Periodic change of ERP was centered on the CZ and FPZ electrodes. While ERP at the CZ started to increase at 200 and 800 ms, ERP at the FPZ started to increase at -50 and 600 ms. ERSP was remarkable at the CZ during stepping cycles. According to the stepping cycle, power increases were pronounced at low-gamma frequency band and also observed at beta band. CONCLUSION: This study showed cortical activity during constant stepping using EEG in healthy participants. Periodic cortical activities were remarkable at the sensorimotor cortex area, and precedent activities were observed at the prefrontal area. EEG measurement during stepping on a recumbent stepper may be a valuable tool in investigating cortical activates related to walking in patients with gait disorders.
Brain Stem ; Electrodes ; Electroencephalography* ; Electromyography ; Evoked Potentials ; Gait ; Healthy Volunteers ; Humans ; Locomotion ; Muscles ; Neuroimaging ; Quadriceps Muscle ; Walking

BACKGROUND: Anesthesia and surgery may exacerbate liver function in patients with pre-existing liver disease so it is important to choose less hepatotoxic anesthetics in patients with chronic liver disease. METHODS: This study was designed to examine the postoperative liver function test in 150 patients after hepatectomy with portal triad clamping through retrospective chart review. Patients were divided into an isoflurane group (group I, n = 56) and a propofol group (group P, n = 57) by used anesthetics for maintaining anesthesia. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, alkaline phosphatase, total bilirubin, albumin, and prothrombin time were checked at preoperation, and postoperatively at 1, 3, 7 and 14 days in the two groups. Indocyanine retention rate (ICG-R15) was measured at preoperation, and postoperatively at 1 and 7 days. RESULTS: AST values increased postoperatively at 1, 3, 7, and 14 days compared with preoperation. ALT values increased postoperatively at 1, 3 and 7 days compared with preoperation and there was difference between group I (443.8 +/- 52.1 U/L) and group P (202.7 +/- 24.7 U/L) at postoperative 1 day. Other values had no significant difference between the two groups. CONCLUSIONS: Though it might need a well controlled study to find the differences in effect between isoflurane and propofol on the postoperative liver function test, we concluded that total intravenous anesthesia using propofol is also one of the safest anesthetic methods for hepatic resection with minimal hepatotoxicity.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Aspartate Aminotransferases ; Bilirubin ; Constriction* ; Hepatectomy ; Humans ; Isoflurane* ; L-Lactate Dehydrogenase ; Liver Diseases ; Liver Function Tests* ; Liver* ; Propofol* ; Prothrombin Time ; Retrospective Studies

BACKGROUND: Recent studies demonstrated that volatile anesthetics suppress the NO-cGMP system in the vascular system. It has been known that the hemodynamic changes produced by volatile anesthetics in septic patients are mediated by upregulation of iNOS leading to excessive release of NO. The mechanisms underlying suppression of the NO-cGMP system by anesthetics are still controversial. It has been elucidated that nitric oxide synthase (NOS) plays a major role in the regulatory function in the L-arginine-NO system. So we examined the effects of NOS inhibitor (L-NAME, aminoguanidine) and NO scavenger (hydroxocobalamin) on vascular smooth muscle contractile function in lipopolysaccharide (LPS)-treated rat aorta during halothane administration. METHODS: Aortic ring preparations were obtained from LPS-treated (1.5 mg/kg, ip, for 18 h) rats. We evaluated the effects of hydroxocobalamin, L-NAME and aminoguanidine on contractile responses to phenylephrine during halothane (1 & 2 MAC) administration respectively. Statistical significances (P<0.05) were analyzed according to data characterictics by repeated measures ANOVA test and student's t-test. RESULTS: The contractile responses to phenylephrine in LPS-treated rats aorta were significantly (P<0.05) increased in the presence of hydroxocobalamin and L-NAME. During the halothane (1 and 2 MAC) administration, the contractile responses to phenylephrine in LPS-treated rats aorta were increased significantly (P<0.05) in the presence of hydroxocobalamin and L-NAME. CONCLUSIONS: From these results, it is suggested that hydroxocobalamin and L-NAME may be useful in the therapy of septic shock.
Anesthetics ; Animals ; Aorta ; Halothane* ; Hemodynamics ; Humans ; Hydroxocobalamin* ; Muscle, Smooth, Vascular ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide Synthase ; Phenylephrine ; Rats* ; Shock, Septic ; Up-Regulation

PURPOSE: To determine the major reasons that diabetics decide to undergo their first fundus examination, and the factors influencing such reasons. METHODS: Of the patients with type II diabetes who presented to the Department of Ophthalmology in Gachon University Gil Medical Center, 164 patients who underwent their first fundus examination after being diagnosed with diabetes were included in the study. Face-to-face and phone interviews with these patients were conducted. RESULTS: The average prevalence period from the diagnosis of diabetes to the first fundus examination was 8.3 ± 7.5 years. Of the diabetics who underwent their first fundus examination, 52.4% had diabetic retinopathy, with no significant difference in prevalence between the male and female patients (p = 0.118). The most common reason for deciding to undergo the first fundus examination was recommendation by a doctor (53.7%). For those patients who received their first fundus examination after recommendation by a doctor, the prevalence period from diabetes was the shortest among all patients (p < 0.001), and the prevalence and severity of diabetic retinopathy were the lowest (p < 0.001 and p = 0.017, respectively). The number of fundus examinations conducted following recommendation by a doctor was significantly higher in secondary and tertiary hospitals than in primary hospitals (p < 0.001). Education on diabetes and knowledge of diabetic ocular complications were found to be significantly correlated (p < 0.001). CONCLUSIONS: For patients who are diagnosed with diabetes and treated in primary hospitals, who are older, or who did not receive education on diabetes, recommendation by a doctor for early fundus examination is particularly important regardless of subjective visual disturbance. Moreover, patient education should be offered and ophthalmic examination should be recommended in primary hospitals.
Diabetic Retinopathy ; Diagnosis ; Education ; Female ; Humans ; Male ; Ophthalmology ; Patient Education as Topic ; Prevalence ; Tertiary Care Centers

Complete or partial agenesis of dorsal pancreas has been reported in a small number of pediatric and adult patients. A case of partial agenesis of dorsal pancreas was reported. This case was not associated with diabetes mellitus and pancreatic exocrine dysfunction, or abdominal pain. A 37-year-old man with chronic hepatitis B visited to our hospital due to further examination for chronic hepatitis B. Abdominal ultrasonography showed enlarged pancreatic head. Diagnosis was made by endoscopic retrograde cholangiopancreatography and computed tomography. Explor-laparotomy was not done.
Abdominal Pain ; Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Diagnosis ; Head ; Hepatitis B, Chronic ; Humans ; Pancreas ; Ultrasonography