We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.
Acquired Immunodeficiency Syndrome ; Biopsy ; Cytomegalovirus ; Humans ; Lung ; Male ; Pneumocystis carinii ; Pneumonia ; Respiratory Insufficiency*

This study is a clinical review of two groups of patients. Group I was composed of 97 patients who were submitted to negative appendectomy under the impression of acute appendicitis and, group II was 45 patients who received conservative treatment with the same impression at the department of surgery, Dae Rim Saint Mary's Hospital, from January 1, 1994 to August 31, 1996.The purpose of this study is to identify possible factors for the decision of operation or conservative treatment in the patients with suspected appendicitis and so to decrease unnecessary operation. Clinical characteristics of the patients were compared between two groups by the method of comparison of means(X test). The following results were obtained; 1) The incidences of group I and group II among the patients in the state of suspicious appendicitis were 97 of 1,004 cases(9.7%) and 45 of 1,004 cases(4.5%) respectively. 2) The number of female patients was 1.5 times more than male in both groups(p<0.05). 3) In group I the number of patients under 30 years of age was more than that of patients above 30 years of age(p<0.05) and in group II the highest incidence was shown in the patients in forth decades. 4) Symptoms over 3 days were more frequent in group I(31%) and in group II those within 12 hours were prominent(42.2%). 5) Gastrointestinal symptoms of anorexia, nausea and vomiting were more frequent in group I than group II. 6) Body temperature over 37.5 degrees C appeared in 15% of patients in group I and 11% in group II, but this difference showed no statistical significance and there was no sex difference. 7) RLQ rebound tenderness was manifested in 60% of patients in group I and 37.7% in group II, this difference has statistical significance(p<0.05). Migration pain to RLQ appeared in 12% of patients in group I aand 17.7% in group II(p>0.05) 8) Leukocytosis above 10,000/mm3 appeared in 44% of patients in group I and 53.3% in group II(p>0.05). 9) In admission route, the patients via ER was 2 times more than those of OPD in group I and in group II that was 5 times more than this.
Anorexia ; Appendectomy* ; Appendicitis* ; Body Temperature ; Female ; Humans ; Incidence ; Leukocytosis ; Male ; Nausea ; Saints ; Sex Characteristics ; Vomiting

BACKGROUND: Mycoplasma is a common cause of respiratory infections and may require differential diagnosis from Kawasaki disease (KD). In this study, we investigated the frequency and clinical manifestations of mycoplasma infection in patients with KD. MATERIALS AND METHODS: Medical records of 375 in-patients admitted for treatment during the acute stage of KD, were collected, and reviewed retrospectively. Of these patients, 152 (40.5%) were also tested for recent mycoplasma infection. Patients with positive results (anti-mycoplasma IgM Ab >1:640 or cold agglutinin >1:64) were designated as the case group (n = 37, 24.3%) whereas those with negative results were designated as the control group (n = 115, 75.7%). Clinical findings of the two groups were compared. RESULTS: Patients in the case group were older than those in the control group (mean age, 48.2 ± 32.1 months, vs. 31.7 ± 21.7 months; P = 0.001). There were significant differences between the case and control groups in the changes in the extremities (78.3% vs. 57.4%, respectively; P = 0.031), and in fever duration (6.5 ± 2.5 days vs. 5.4 ± 1.5 days; P = 0.047). Of the 37 patients with positive mycoplasma testing, 7 (18.9%) had persistent fever even after the symptoms and signs of systemic inflammation (acute phase of KD) had been resolved. These patients were positive for mycoplasma infection during further evaluation of persistent fever, and all of them responded to macrolide antibiotics. CONCLUSIONS: We found that mycoplasma infection is somewhat related to KD. When fever persists after resolution of the acute stage of KD, mycoplasma infection may be considered as a possible cause of fever in preschool-aged children.
Anti-Bacterial Agents ; Child ; Diagnosis, Differential ; Extremities ; Fever* ; Humans ; Immunoglobulin M ; Immunoglobulins* ; Inflammation ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Mycoplasma Infections* ; Mycoplasma* ; Respiratory Tract Infections ; Retrospective Studies

Musculoskeletal conditions are common in patients with diabetes. Several musculoskeletal disorders are viewed as chronic complications of diabetes because epidemiological studies have revealed high correlations between such complications and diabetes, but the pathophysiological links with diabetes remains unclear. Genetic predispositions, shared risk factors, microvascular impairments, progressive accumulation of advanced glycation end-products, and diabetic neuropathy may underlie the development of musculoskeletal disorders. Musculoskeletal complications of diabetics have received less attention than life-threatening microvascular or macrovascular complications. Here, we review several diabetic musculoskeletal complications with a focus on the clinical importance of early recognition and management, which would improve quality of life and physical function.

A molecular study of intestinal samples from 21 broiler flocks with a history of enteritis revealed that 23.8% and 14.3% were positive for chicken astrovirus (CAstV) and avian rotavirus (ARV), respectively. CAstV and group A ARV were simultaneously detected in only one broiler flock. Birds in this group developed the significant intestinal lesions characterized by frothy contents, paleness, and thin intestinal walls. In this report we present an unusual case of runting stunting syndrome (RSS) with a history of high mortality and growth retardation in broiler chickens. We also make the first identification of CAstV and group A ARV in broiler chickens in Korea.
Animals ; Astroviridae Infections/diagnosis/epidemiology/*veterinary/virology ; Avastrovirus/classification/*genetics/isolation & purification/metabolism ; *Chickens/growth & development ; Enteritis/diagnosis/pathology/veterinary/virology ; Intestines/pathology/virology ; Molecular Sequence Data ; Phylogeny ; Poultry Diseases/*diagnosis/epidemiology/virology ; Republic of Korea/epidemiology ; Rotavirus/classification/*genetics/isolation & purification/metabolism ; Rotavirus Infections/diagnosis/epidemiology/*veterinary/virology

OBJECTIVES: This study was conducted in order to obtain information concerning the health hazards that may result from a 13 week inhalation exposure of n-pentane in Sprague-Dawley rats. METHODS: This study was conducted in accordance with the Organization for Economic Co-operation and Development (OECD) guidelines for the testing of chemicals No. 413 'Subchronic inhalation toxicity: 90-day study (as revised in 2009)'. The rats were divided into 4 groups (10 male and 10 female rats in each group), and were exposed to 0, 340, 1,530, and 6,885 ppm n-pentane in each exposure chamber for 6 hour/day, 5 days/week, for 13 weeks. All of the rats were sacrificed at the end of the treatment period. During the test period, clinical signs, mortality, body weights, food consumption, ophthalmoscopy, locomotion activity, urinalysis, hematology, serum biochemistry, gross findings, organ weights, and histopathology were assessed. RESULTS: During the period of testing, there were no treatment related effects on the clinical findings, body weight, food consumption, ophthalmoscopy, urinalysis, hematology, serum biochemistry, gross findings, relative organ weight, and histopathological findings. CONCLUSION: The no-observable-adverse-effect level (NOAEL) of n-pentane is evaluated as being more than 6,885 ppm (20.3 mg/L) in both male and female rats. n-pentane was not a classified specific target organ toxicity in the globally harmonized classification system (GHS).
Animals ; Biochemistry ; Body Weight ; Female ; Hazardous Substances ; Hematology ; Humans ; Inhalation ; Inhalation Exposure ; Locomotion ; Male ; Ophthalmoscopy ; Organ Size ; Pentanes ; Rats ; Rats, Sprague-Dawley ; Urinalysis

Systemic sclerosis is an autoimmune disease, characterized by inflammation, microangiopathy and fibrosis in the skin and various intestinal organs. Gastrointestinal involvement is one of the major causes of serious morbidity, and next to the skin, the gastrointestinal tract is the most commonly involved organ. While esophageal involvement is most common gastrointestinal manifestation, the involvement of the small intestine and colon is less common but may lead to life-threatening complications like chronic pesudoobstruction or pneumatosis cystoids intestinalis. Here, we describe a case of progressive systemic sclerosis associated with intestinal pseudoobstruction. 28 year-old male presented abdominal pain and vomiting and he was diagnosed as having intestinal pseudoobstruction. His symptoms were well managed using the combination of octreotide, a long-acting somatostatin analogue, and erythromycin.
Abdominal Pain ; Adult ; Autoimmune Diseases ; Colon ; Erythromycin* ; Fibrosis ; Gastrointestinal Tract ; Humans ; Inflammation ; Intestinal Pseudo-Obstruction* ; Intestine, Small ; Male ; Octreotide* ; Scleroderma, Diffuse ; Scleroderma, Systemic* ; Skin ; Somatostatin ; Vomiting

OBJECTIVES: We sought to establish a novel method to generate nano-sized carbon black particles (nano-CBPs) with an average size smaller than 100 nm for examining the inhalation exposure risks of experimental rats. We also tested the effect of nano-CBPs on the pulmonary and circulatory systems. METHODS: We used chemical vapor deposition (CVD) without the addition of any additives to generate nano-CBPs with a particle size (electrical mobility diameter) of less than 100nm to examine the effects of inhalation exposure. Nano-CBPs were applied to a nose-only inhalation chamber system for studying the inhalation toxicity in rats. The effect on the lungs and circulatory system was determined according to the degree of inflammation as quantified by bronchoalveolar lavage fluid (BALF). The functional alteration of the hemostatic and vasomotor activities was measured by plasma coagulation, platelet activity, contraction and relaxation of blood vessels. RESULTS: Nano-CBPs were generated in the range of 83.3-87.9 nm. Rats were exposed for 4 hour/day, 5 days/week for 4 weeks to 4.2 x 10(6), 6.2 x 10(5), and 1.3 x 10(5) particles/cm3. Exposure of nano-CBPs by inhalation resulted in minimal pulmonary inflammation and did not appear to damage the lung tissue. In addition, there was no significant effect on blood functions, such as plasma coagulation and platelet aggregation, or on vasomotor function. CONCLUSION: We successfully generated nano-CBPs in the range of 83.3-87.9 nm at a maximum concentration of 4.2 x 10(6) particles/cm3 in a nose-only inhalation chamber system. This reliable method can be useful to investigate the biological and toxicological effects of inhalation exposure to nano-CBPs on experimental rats.
Animals ; Blood Platelets ; Bronchoalveolar Lavage Fluid ; Carbon ; Contracts ; Inflammation ; Inhalation ; Inhalation Exposure ; Lung ; Particle Size ; Plasma ; Platelet Aggregation ; Pneumonia ; Rats ; Relaxation ; Soot

Background: In Korea, the safety culture is led by national policy. How the policy ensures a patient safety culture needs to be investigated. This study aimed to examine the way in which physicians and nurses regard, understand, or interpret the patient safety-related policy in the hospital setting. Methods: In this qualitative study, we conducted four focus group interviews (FGIs) with 25 physicians and nurses from tertiary and general hospitals in South Korea. FGIs data were analyzed using thematic analysis, which was conducted in an inductive and interpretative way. Results: Three themes were identified. The healthcare providers recognized its benefits in the forms of knowledge, information and training at least although the policy implemented by the law forcibly and temporarily. The second theme was about the interaction of the policy and the Korean context of healthcare, which makes a “turning point” in the safety culture.The final theme was about some strains and conflicts resulting from patient safety policy. Conclusion To provide a patient safety culture, it is necessary to develop a plan to improve the voluntary participation of healthcare professionals and their commitment to safety.Hospitals should provide more resources and support for healthcare professionals.

Patients with NIDDM are at increased risk for the development of coronary atherosclerosis and experience more silent myocardial infarction than non-diabetic subjects. The screening tools for early detection of coronary artery disease without significant narrowing has been requested in diabetic patients. Coronary artery calcification (CAC) score, quantified by electron beam computed tomography (EBT), have been reported to correlate with the amount of atherosclerotic plaque and vascular luminal narrowing. We investigated the distribution of CAC score and associated risk factors in asymptomatic NIDDM patients and patients with ischemic heart disease to estimate the usefulness of CAC as a screenig tool for ischemic heart disease in asymptomatic diabetes. METHOD: 136 NIDDM patients without any symptom of coronary artery disease and 37 patients with significant coronary artery stenosis were included. CAC were measured by electron bean tomography (ultrafast CT). Forty contiguous 3-mm thickness transverse two-dimensional sections were obtained through root of aorta and heart. Coronary calcification were defined as the presense of at least two adjacent pixel within the border of visualized coronary artery with CT number of at least 130 HU. Body mass index, waist-hip ratio were measured and body fat components were counted by impedence method. Visceral fat versus subcutaneous fat ratio were calculated by abdominal computed tomography. Plasma lipid profile, fasting insulin, C-peptide level, HbA1c concentration were measured. Correlations between natural log of CAC score and clinical parameters were evaluated and multiple regression analysis with natural log of CAC score as a independent variable was performed. Coronary angiography were performed in 17 asymptomatic NIDDM patients.. RESULT: CAC score was significantly higher in male than female subjects and increased significantly with aging (p<0.01). In patients with hypertension, previous history of cerebrovascular or peripheral vascular disease (p<0.05), CAC score was significantly increased. The CAC score showed significant positive correlations with smoking amount, duration of diabetes and a negative correlation with HDL-cholesterol (p<0.05). There were no association between CAC score and total cholesterol, LDL-cholesterol, waist to hip circumference ratio, or fasting insulin levels. After adjustment of compounding variables (age, sex), duration of diabetes, amount of smoking and previous history of atherosclerotic vascular disease were shown to be associated with CAC score. In multiple logistic regression analysis with natural log of CAC score as dependent variable, age, HDL-cholesterol, duration of diabetes, male gender were found to be significant independent variables. Seventeen diabetic patients with high CAC score, were taken coronary angiography and significant luminal narrowings (more than 50%) of coronary artery were documented in 16 patients. But, In 7 out of 17 patients with coronary one-vessel disease, coronary calcification were not detected by EBT. CONCLUSION: coronary artery calcium score quantified by electron beam computed tomography may be useful for screening of preclinical or asymptomatic coronary artery disease in asymptomatic NIDDM patients.
Adipose Tissue ; Aging ; Aorta ; Body Mass Index ; C-Peptide ; Calcium ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Fasting ; Female ; Heart ; Hip ; Humans ; Hypertension ; Insulin ; Intra-Abdominal Fat ; Logistic Models ; Male ; Mass Screening* ; Myocardial Infarction ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Phenobarbital ; Plaque, Atherosclerotic ; Plasma ; Risk Factors ; Smoke ; Smoking ; Subcutaneous Fat ; Tomography, X-Ray Computed* ; Vascular Diseases ; Waist-Hip Ratio