BACKGROUND AND OBJECTIVES: The Osborn wave is the name designated to the wave formation produced when there is a large, prominent deviation of the J point from the baseline. The wave has been reported in many countries, but only 2 cases have been reported in Korea. Thus, the purpose of our study was to evaluate the clinical characteristics and therapy of hypothermia employing the Osborn wave with Koreans. SUBJECTS AND METHODS: Between February 2001 and April 2001, five patients visiting our department with hypothermia were enrolled in this study. We analyzed these patients for their distribution, symptoms and signs, associated disorders, risk factors, electrocardiogram and laboratory findings. RESULTS: All 5 patients were male with an average age was 44.8+/-12.7 years. Three patients had a semi-comatose mentality and 2 cases had a comatose mentality. Their associated disorders were diabetes (2 cases), psychotic problems (1 case) and nutritional deficiency (1 case). Risk factors were alcohol abuse (3 cases) and drug in toxication (1 case). Laboratory abnormalities were acidosis (4 cases), increased serum glucose levels (all 5 cases) and increased serum potassium levels (3 cases). After active core rewarming by a line heat exchanger, 3 of the 5 patients completely recovered from hypothermia, 1 case immediately expired following admission and 1 case survived for 10 days, but later expired due to acute respiratory distress syndrome. The Osborn wave was persistent in 1 case and disappeared in 3 cases. CONCLUSION: We experienced 5 cases of hypothermia with an Osborn wave. The mortality of patients displaying an Osborn wave is expected to decrease if this anomaly is immediately found and treated by an appropriate method.
Acidosis ; Alcoholism ; Blood Glucose ; Coma ; Electrocardiography* ; Hot Temperature ; Humans ; Hypothermia* ; Korea ; Male ; Malnutrition ; Mortality ; Potassium ; Respiratory Distress Syndrome, Adult ; Rewarming ; Risk Factors

EDTA-dependent pseudothrombocytopenia (PTCP) is the phenomenon of a spurious low platelet count due to EDTA-induced aggregation of platelets. Since the failure to recognize EDTA-dependent PTCP may result in incorrect diagnosis and inappropriate treatment, the recognition of this phenomenon is very important. We report an insidious case of EDTA-dependent PTCP confirmed by supplementation of kanamycin to anticoagulant in a 53-year-old women. Although sodium citrate and heparin usually prevented the aggregation of platelets in EDTA-dependent PTCP patients, these anticoagulants failed in preventing PTCP in our case. EDTA-dependent PTCP was confirmed by the findings that the clumping of platelets on microscopic evaluation was found in EDTA-anticoagulated blood samples, whereas thrombocytopenia and platelet aggregation were not revealed in the sample supplemented with kanamycin.
Antibiotics, Aminoglycoside/*pharmacology ; Anticoagulants/*adverse effects/pharmacology ; Case Report ; Edetic Acid/*adverse effects ; Female ; Human ; Kanamycin/*pharmacology ; Middle Age ; Platelet Aggregation/*drug effects ; Platelet Aggregation Inhibitors/*therapeutic use ; Platelet Count ; Thrombocytopenia/*blood/chemically induced

Doxylamine succinate is an over-the-counter drug widely used for treating insomnia. We experienced a case of severe rhabdomyolysis complicating acute renal failure after doxylamine overdose in a 24-year- old male. The maximum values of creatine kinase and creatinine level during hospitalization were 264,141 IU/L and 8.4 mg/dL, respectively. Oliguria and severe dyspnea occurred on the sixth hospital day and were treated with hemodialysis. Then, he recovered without any sequelae. To the best of our knowledge, the maximum creatine kinase level of 264,141 IU/L in the present case is the highest value among the case reports on doxylamine-induced rhabdomyolysis and this is the first case report in Korea of doxylamine-induced severe rhabdomyolysis accompanying oliguric acute renal failure and requiring treatment with hemodialysis.
Acute Kidney Injury* ; Creatine Kinase ; Creatinine ; Doxylamine* ; Dyspnea ; Hospitalization ; Humans ; Korea ; Male ; Oliguria ; Renal Dialysis ; Rhabdomyolysis* ; Sleep Initiation and Maintenance Disorders ; Succinic Acid

Eosinophilic peritonitis is not uncommonly observed in patients on peritoneal dialysis. It typically occurs within the first 3 months after the initiation of peritoneal dialysis. Eosinophilic peritonitis is usually a benign and self-limiting process with the exception of fungal eosinophilic peritonitis. The use of oral or intraperitoneal steroids has been suggested only for patients with abdominal pain or with markedly turbid peritoneal effluent. We report a case of eosinophilic peritonitis with severe abdominal pain, which successfully resolved on treatment with single dose of oral prednisolone.
Abdominal Pain ; Eosinophils* ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Prednisolone* ; Steroids

PURPOSE: Papillary thyroid carcinomas (PTCs) frequently involve genetic alterations. The objective of this study was to investigate genetic alterations and further explore the relationships between these genetic alterations and clinicopathological characteristics in a high-recurrence risk (node positive, N1) PTC group. MATERIALS AND METHODS: Tumor tissue blocks were obtained from 240 surgically resected patients with histologically confirmed stage III/IV (pT3/4 or N1) PTCs. We screened gene fusions using NanoString’s nCounter technology and mutational analysis was performed by direct DNA sequencing. Data describing the clinicopathological characteristics and clinical courses were retrospectively collected. RESULTS: Of the 240 PTC patients, 207 (86.3%) had at least one genetic alteration, including BRAF mutation in 190 patients (79.2%), PIK3CA mutation in 25 patients (10.4%), NTRK1/3 fusion in six patients (2.5%), and RET fusion in 24 patients (10.0%). Concomitant presence of more than two genetic alterations was seen in 36 patients (15%). PTCs harboring BRAF mutation were associated with RET wild-type expression (p=0.001). RET fusion genes have been found to occur with significantly higher frequency in N1b stage patients (p=0.003) or groups of patients aged 45 years or older (p=0.031); however, no significant correlation was found between other genetic alterations. There was no trend toward favorable recurrence-free survival or overall survival among patients lacking genetic alterations. CONCLUSION: In the selected high-recurrence risk PTC group, most patients had more than one genetic alteration. However, these known alterations could not entirely account for clinicopathological features of high-recurrence risk PTC.
Gene Fusion ; Humans ; Retrospective Studies ; Sequence Analysis, DNA ; Thyroid Gland* ; Thyroid Neoplasms*