No abstract available.
Humans ; Pregnancy, Twin*

OBJECTIVE: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. METHODS: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. RESULTS: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. CONCLUSIONS: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.
Addison Disease ; Adrenocorticotropic Hormone ; Amenorrhea ; Antibodies ; Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases* ; Diabetes Mellitus, Type 1 ; Electrolytes ; Endocrine System Diseases ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Mass Screening ; Primary Ovarian Insufficiency* ; Thyroid Gland ; Thyroiditis ; Thyrotropin ; Thyroxine

OBJECT: This study was performed in order to examine the correlation between acute neuroleptic-induced dystonic reactions and serum iron level. METHOD: Serum iron levels were measured in psychiatric inpatients who had developed acute neuroleptic-induced dystonia(N=41) and in control patients with no history of acute dystonic reactions(N=37). Serum iron levels were compared in acute dystonic inpatients before starting treatment with neuroleptics and after acute dystonic reaction. RESULTS: The patients exhibiting acute dystonic reactions had significantly lower serum iron levels than the patients without acute dystonic reactions. CONCLUSION: This result supports an association between low serum iron and the occurrence of neuroleptic-induced acute dystonic reactions.
Antipsychotic Agents ; Dystonia* ; Humans ; Inpatients ; Iron*

Background: Reversal of neuromuscular blockade (NMB) at the end of surgery is important for reducing postoperative residual NMB; this is associated with an increased risk of postoperative pulmonary complications (PPCs). Moreover, PPCs are associated with poor prognosis after video-assisted thoracoscopic surgery (VATS) for lobectomy. We compared the effects of two reversal agents, sugammadex and neostigmine, on the incidence of PPCs and duration of hospital stay in patients undergoing VATS lobectomy. Methods: After VATS lobectomy was completed under neuromuscular monitoring, the sugammadex group (n = 46) received sugammadex 2 mg/kg, while the neostigmine group (n = 47) received neostigmine 0.05 mg/kg with atropine 0.02 mg/kg after at least the third twitch in response to the train of four stimulation. The primary outcome was incidence of PPCs. The secondary outcomes were duration of hospital stay and intensive care unit (ICU) admission. Results: There was no significant difference in the incidence of PPCs for both the sugammadex and neostigmine groups (32.6% and 40.4%, respectively; risk difference = 0.08; 95% confidence interval = [−0.12, 0.27]; P = 0.434). The lengths of hospital (P = 0.431) and ICU (P = 0.964) stays were not significantly different between the two groups. Conclusions The clinical use of sugammadex and neostigmine in NMB reversal for patients undergoing VATS lobectomy was not significantly different in the incidence of PPCs and duration of hospital and ICU stay.

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting

The surgical technique of renal transplantation has been well established, but surgical complications are not uncommon and still be important factors in postoperative mortality and morbidity. From August 1990 to May 1998, we performed 250 consecutive renal transplantations at Maryknoll hospital. The authors analyzed the kinds and incidences of surgical complications in a single center by using information from hospital records. The results were as follows: 1. The overall surgical complication rate was 9.6% (24 episodes in 250 cases). 2. These were composed of 6 vascular, 8 urologic, 4 lymphatic, and 6 wound complications. 3. Vascular complication included renal artery stenosis in 1 case and bleeding and hematoma in 5 cases. 4. Urologic complication included urine leakage in 4 cases, ureter stenosis in 2 cases and bladder stone in 2 cases. 5. Lymphatic complication was all lymphoceles. 6. One case in which renal artery stenosis had occured progressed to graft loss after 4 years later. There was no complication related mortality. 7. 1 year, 3 year and 5 year graft survival rate was 97.2%, 94.8% and 90.0%, respectively. and patient survival rate was 98.0%, 95.6% and 94.7%, respectively.
Constriction, Pathologic ; Graft Survival ; Hematoma ; Hemorrhage ; Hospital Records ; Humans ; Incidence ; Kidney Transplantation ; Lymphocele ; Mortality ; Renal Artery Obstruction ; Survival Rate ; Transplants ; Ureter ; Urinary Bladder Calculi ; Wounds and Injuries

We herein report a case of subcutaneous panniculitic T-cell lymphoma which occurred in a 48-year-old Korean woman. Her disease presented as multiple subcutaneous nodules on the arms, legs, and abdomen, with systemic symptoms and signs. From the results of immunophenotypic studies, we suggest her disease may originate from cytotoxic T-lymphocytes. The patient had a protracted course of multiple dark-red-colored subcutaneous nodules on both arms, legs, and abdomen for 1 year, often with fever, chills, and malaise. Histopathologic findings for the subcutaneous nodule in the lower abdomen revealed diffuse infiltration of atypical lymphocytes in the subcutis, with extensive fat necrosis and karyorrhexis and a bean-bag cell appearance with engulfed lymphocytes in some histiocytes. The immunophenotypic studies showed a cytotoxic T-lymphocyte profile, i. e., LCA+, lysozyme+, UCHL1+, CD8+, CD20-, CD30-, and CD56-. In situ hybridization studies for the Epstein-Barr virus genome resulted in a negative finding. A lymphadenopathy was found in the right upper paratracheal area on the chest CT associated with pancytopenia and abnormal LFT findings. She received high-dose chemotherapy with autologous blood stem cell transplantation, but died after 6 months.
Abdomen ; Arm ; Chills ; Drug Therapy ; Fat Necrosis ; Female ; Fever ; Genome ; Glycogen Storage Disease Type VI ; Herpesvirus 4, Human ; Histiocytes ; Humans ; In Situ Hybridization ; Leg ; Lymphatic Diseases ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Middle Aged ; Pancytopenia ; Stem Cell Transplantation ; T-Lymphocytes* ; T-Lymphocytes, Cytotoxic ; Tomography, X-Ray Computed

No abstract available.
Pulmonary Atelectasis*

No abstract available.
Esophagitis*

We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult