Thyrotoxicosis (thyroid crisis) is a known cause of sudden death; however, only a few cases of death resulting from thyrotoxicosis have been reported. Histopathologic examination and postmortem thyroid function tests may be helpful in postmortem diagnosis, but their usefulness seems to be limited. We report three autopsy cases associated with thyrotoxicosis.
Autopsy ; Death, Sudden ; Thyroid Crisis ; Thyroid Function Tests ; Thyrotoxicosis

Giant cell arteritis is a focal granulomatous inflammation of arteries of medium and small size that affects principally the cranial vessels, especially the temporal arteries, in older individuals. It appears to be a localized process; its significance apparantly depends on the organ affected. A 67-year-old man was admitted to hospital because of the left scrotal mass and pain lasting for 1 month. On physical examination, the hard masses were palpated at the superior part of the left epididymis without tenderness. Histologically, the spermatic cord showed granulomatous arteritis involving the small and medium sized arteries with a transmural inflammatory infiltrates centered on the inner media, and composed of lymphocytes, histiocytes, some eosinophils and multinucleated giant cells. The elastic tissue stain revealed the fragmentation of the internal elastic lamina along with numerous epithelioid histiocytes and giant cells.
Male ; Humans

No abstract available.
Fosinopril* ; Humans ; Hypertension*

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO. METHODS: We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups. RESULTS: There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 - 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 - 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups. CONCLUSIONS: The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.
Atrial Fibrillation ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Humans ; Incidence ; Intensive Care Units ; Lung Transplantation ; Lung* ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Risk Factors* ; Tracheostomy ; Transplants ; Weaning

BACKGROUND: Recently, according to many studies, variable factors have been known to be associated with physical fitness. The factors such as obesity and inactivity are associated with poor physical fitness, but regular exercise is associated with good physical fitness. In our country, these studies are not yet reported. And so, this study was designed to investigate the factors associat,ed with physical fitness. METHODS: From May 1st, until July 30th 1996, we recruited the 411 subjects who visited the Health Promotion Center at Seoul National University Hospital. Data related to sex, age, exercise, job, cigarette smoking, alcohol consumption were obtained by self-administered Questionnaire. Obesity index was calculated by the percentage of standard body weight. And VO2max were obtained by submaximal bicycle ergometer test. High level exercise group was defined as the persons who had taken exercise more than 3 times a week and 20 minutes per session, and moderate exercise group was defined as the persons who had taken exercise one or two times a week and 20 minutes per session, and sedentary group was defined as the persons who had taken exercise more than 20 minutes less than one time per week. RESULTS: The subjects were 230 males(56%), total numbers were 411. The results were as follows. Compaired to women and nonexercise group, men and exercise group had high VO2max(p<0.005). The relationship between VO2max and age showed negative, and the VO2max of obese group(obesity index>_120) was greater than that of nonobese group. Any significant relationships between VO2max and job, disease were not found. In multiple regression analysis, significant relationships between VO2max and age, sex, exercise type, and obesity index were observed(p<0.01). CONCLUSIONS: We concluded that there were significant relationships between VO2max and obesity index, exercise group.
Alcohol Drinking ; Body Weight ; Female ; Health Promotion ; Humans ; Male ; Obesity ; Physical Fitness* ; Seoul ; Smoking ; Surveys and Questionnaires

Crohn's disease (CD) is a chronic, idiopathic, inflammatory disorder of the gastrointestinal tract. In rare cases, CD has been associated with Hirschsprung's disease (HD); however, the underlying pathophysiology of this and other comorbidities is not yet fully understood. In this report, we describe the case of a 17-year-old patient who was diagnosed with both CD and ankylosing spondylitis (AS), having undergone a long ileo-colonic anastomosis to treat HD at 12 months of age. To our knowledge, this is the first documented case of CD combined with AS in a patient with HD.
Adolescent* ; Comorbidity ; Crohn Disease* ; Gastrointestinal Tract ; Hirschsprung Disease* ; Humans ; Infant* ; Inflammatory Bowel Diseases ; Spondylitis, Ankylosing*

PURPOSE: The purpose of this study was to explore the level of occupational stress and emotional intelligence in hospice volunteers. METHODS: Participants were 158 hospice volunteers at hospitals in B city. Occupational stress, emotional intelligence, and general characteristics of hospice volunteers were measured. The data were analyzed with descriptive statistics, t-tests, ANOVA, and Pearson's correlation coefficients. RESULTS: The mean score for occupational stress was 2.16 points out of 4 and 4.65 out of 7 for emotional intelligence. The scores for occupational stress and emotional intelligence were significantly different by educational level and monthly income in hospice volunteers. Occupational stress was negatively correlated with emotional intelligence (r=-0.196, P=0.013). CONCLUSION: A continuous educational program is needed to offer volunteers with new hospice-related trends. To ensure quality care for patients and their families, it should be helpful to encourage hospice volunteers to build a social network to enhance their emotional intelligence.
Emotional Intelligence* ; Hospice Care ; Hospices* ; Humans ; Intelligence ; Stress, Psychological ; Volunteers*

The total energy expenditure (TEE) consists of the basal energy expenditure (BEE), physical activity energy expenditure (PAEE) and the thermic effect of food. The PAEE accounts for a significant portion of the TEE and can be changed according to individual efforts, and the difference between individuals of PAEE is large. Even for the same physical activity, there is a difference in energy expenditure between adults and children. Therefore, a physical activity classification table for youth is needed to classify the physical activity recorded in the physical activity diary prepared to evaluate children's energy expenditure. It is also necessary to calculate the physical activity level required to set the estimated energy requirement in the Dietary Reference Intakes for children and adolescents in Korea. This paper reports a physical activity classification table for Korean youth using the 2017 Youth Compendium of Physical Activities in the United States. This physical activity classification table includes 110 specific activities classified into 14 major categories by four age groups (6–9, 10–12, 13–15, and 16–18 years old) and their metabolic equivalent values. Of these, 87 physical activities were selected from the 2017 Youth Compendium reported in the United States. Nine physical activities such as washing and going to the bathroom, which are daily activities of children and adolescents not included among them, were selected from the another list (2008) of physical activities in America. The remaining 15 physical activities were selected from the research results, which measured the energy expenditure of Korean children and adolescents. Activity categories were divided into 4 areas: daily activity (A), movement (B), school work (C), exercise and sports (D).This physical activity classification table will help standardize the interpretation and scoring process of physical activity of youth in related studies and community health surveys.

Purpose: Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. Materials and Methods: Forty-eight patients aged ≤6 years who were scheduled to undergo surgery under general anesthesia with an arterial line were randomly allocated to receive 1:1 (group 1:1) or 1:2 (group 1:2) I:E ratio ventilation. Airway pressure, respiratory system compliance, and arterial blood gas analyses were compared between groups immediately after induction (T0), 30 min after induction (T1), 60 min after induction (T2), immediately after surgery (T3), and on arrival at the post-anesthesia care unit (T4). Results: Peak and plateau airway pressures were significantly lower in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.048, respectively). The dynamic and static compliances were significantly higher in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.045, respectively). However, the partial pressure of oxygen did not significantly differ between groups. Conclusion Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.

Purpose: Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. Materials and Methods: Forty-eight patients aged ≤6 years who were scheduled to undergo surgery under general anesthesia with an arterial line were randomly allocated to receive 1:1 (group 1:1) or 1:2 (group 1:2) I:E ratio ventilation. Airway pressure, respiratory system compliance, and arterial blood gas analyses were compared between groups immediately after induction (T0), 30 min after induction (T1), 60 min after induction (T2), immediately after surgery (T3), and on arrival at the post-anesthesia care unit (T4). Results: Peak and plateau airway pressures were significantly lower in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.048, respectively). The dynamic and static compliances were significantly higher in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.045, respectively). However, the partial pressure of oxygen did not significantly differ between groups. Conclusion Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.