Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Autoimmune Graves' disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). And Graves' disease associated with idiopathic thrornbocytopenic purpura (ITP) has been reported many times in Korea. There is a special relationship between SLE and ITP, both of which are autoimmune diseases. Some patients with thrombocytopenic purpura, labeled as idiopathic at the onset, later develop a classical course of SLE, suggesting that ITP may be an early manifestation of SLE. The relationships among these three conditions and their pathogenesis are poorly undemtood, and the coexistence of these diseases at the same time has been reported very rarely, but it may be very probable that there are some relationships among them. We report a case of SLE associated with Graves' disease and ITP treated well by imunosup-pressive agent who had been suffering from recurrence by conventional treatments (antithyroid medication, corticosteroid, subtotal thyroidectomy and splenectomy).
Autoimmune Diseases ; Graves Disease ; Humans ; Korea ; Lupus Erythematosus, Systemic ; Purpura ; Purpura, Thrombocytopenic ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Rheumatic Diseases ; Thyroidectomy

BACKGROUND: In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of FEV1 in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of FEV1 especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and FEV1 in healthy children. METHOD: PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children (age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of FEV1 by PEF were derived. RESULTS: 1. The regression equation for PEF(L/min) was:12.6×age(year)+3.4×height(cm)-263(R2=0.85) in boys, and 6×age(year)+3.9×height(cm)-293(R2=0.82) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for FEV1(ml) by PEF(L/min) was:7×PEF-550(R2=0.82) in boys, and 5.8×PEF-146(R2=0.81) in girls, respectively. CONCLUSION: This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for FEV1, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.
Airway Obstruction ; Asthma ; Child* ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Reference Values

PURPOSE: To determine the clinical effect of radial optic neurotomy (RON) in central retinal vein occlusion (CRVO). METHODS: The retinal findings, visual acuity and complications were analyzed in patients who had undergone RON for the treatment of CRVO and were followed up 10 months or more after surgery. RESULTS: Of all 16 patients (16 eyes), the mean age was 55 years and the follow-up period was 14 months. Preoperative anterior segment and retinal neovascularization was observed in each three eyes. All eyes showed improvement in the retinal findings within two weeks after RON. The postoperative complications included vitreous hemorrhage in 1 eye, chorioretinal collateral circulation in 1 eye, neovascular glaucoma in 1 eye, vitreous hemorrhage and neovascular glaucoma in 1 eye. The visual acuity was counting fingers or less in 8 eyes preoperatively and in 2 eyes finally, and was less than 0.1 in 13 eyes preoperatively and in 10 eyes finally. The mean visual improvement in the 3.8 lines was in 11 eyes and a loss of 2.5 lines in 2 eyes. The maximum velocity of the blood flow of CRV improved with 1.95 +/- 0.93 cm/sec on the average in the 7 eyes examined by color doppler. CONCLUSIONS: RON appears to be safe and effective for improving the retinal findings, visual acuity and blood flow of CRV in CRVO. However, the visual recovery is limited.
Collateral Circulation ; Fingers ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Postoperative Complications ; Retinal Neovascularization ; Retinal Vein* ; Retinaldehyde ; Visual Acuity ; Vitreous Hemorrhage

Isolated ACTH deficiency is a rare disorder, and usually characterized by its chronic course. The 59 year-old woman patient who had been healthy until 2 months ago, admitted because of abdomial pain, general weakness and loss of weight about 12kg for 2 months. She looked a little pallor but color of skin was not remarkable. Blood pressure, serum electrolyte, and glucose on admission were within normal range. Serum calcium was elevated with the value of 12.6mg/dL, which was normalized after hydration. Cortisol response to RI induced hypoglycemia did not show any response. Anterior pituitary hormone except ACTH showed normal response during combined pituitary hormone stimulation test. These clinical and laboratory finding reveals that isolated ACTH deficiency was developed in a short term period. There were no abnormalities in sellar MRI except pineal cyst. Her complaints were disappeared dramatically after hydroccetisone replacement at 4th. hospital day. Here we report a case of isolated ACTH deficiency, which was rapidly developed, with hypercalcemia, abdominal pain, and loss of weight about 12kg for 2 months.
Abdominal Pain ; Adrenocorticotropic Hormone* ; Blood Pressure ; Calcium ; Female ; Glucose ; Humans ; Hydrocortisone ; Hypercalcemia ; Hypoglycemia ; Magnetic Resonance Imaging ; Middle Aged ; Pallor ; Reference Values ; Skin ; Weight Loss

A healthy 72-year-old male was referred to the emergency department (ED) for removal of a foreign body (FB) in the right bronchi from a local medical clinic. The FB was a dental part measuring 5×15 mm in size, which had been accidently aspirated into the lung during a dental procedure. On arrival at the ED, he only complained of mild chest discomfort, and there were no abnormal findings in on physical examination. ED physicians prepared bronchoscopic FB removal while the patient rested in bed. During the wait for bronchoscopy, the patient felt discomfort in the chest and epigastric area, and then he coughed forcefully and at the same time, epigastric thrust was performed with his fist. After several strong coughs with epigastric thrusts, the FB was expelled from his mouth. Chest roentgenogram showed no FB, and the patient was discharged from the ED with no complications. Bronchoscopy has been the only treatment option for bronchoscopic FB, and self-removal of FB is rare. This case report may be helpful to understanding a possible mechanism of self-clearance of FB in some healthy adult patients with a small-sized endobronchial FB.
Adult ; Aged ; Bronchi ; Bronchoscopy* ; Cough* ; Emergencies* ; Emergency Service, Hospital* ; Foreign Bodies* ; Humans ; Lung ; Male ; Mouth ; Physical Examination ; Thorax

PURPOSE: Standard chest compression is useful for cardiopulmonary resuscitation of victims but may be difficult to perform in a confined space if the victim is lying on his side. The aim of this study was to evaluate compression techniques administered to individuals lying in various alternative positions, and to determine which ones may be easier to perform in such situations. METHODS: Thirty two volunteers trained in basic life support (BLS) were enrolled. They were taught to do compression in four alternative positions (over-head position (OHP), saddle position (SP), upper diagonal position (UDP) and lower diagonal position (LDP)). For each position, they performed two minutes of continuous chest compression on a manikin that was connected to a Laerdal PC Skill Reporting System. They did this for the basic standard position (BSP) and four alternative positions with the positions presented randomly. The data, including the total number of compressions, the average rate of chest compressions per minute, the depth of each chest compression, and the position of the hands were recorded and analysed. RESULTS: There were no statistically significant differences between BSP and alternative positions for the total number of compressions (BSP:108.8 min-1; OHP:109.5 min-1; SP:107.8 min-1; UDP:108.5 min-1; LDP:107.7 min-1) of chest compressions. There was no statistically significant difference between BSP and alternative positions for the average depth of each compression (BSP:41.9 mm; OHP:44.4 mm; SP:41.8 mm; UDP:42.9 mm; LDP:41.1 mm), or for the number of incorrect hand positions except UDP (BSP versus UDP = 6.4 versus 32.5). p<0.054 is not normally considered significant. The p value has to be 0.050 or smaller. CONCLUSION: Chest compression in alternative positions can be equally effective as it is in the standard position. If chest compression in the standard position is not easily executable in a confined space, chest compression using an alternative positions can be used.
Cardiopulmonary Resuscitation ; Chest Wall Oscillation ; Confined Spaces ; Deception ; Hand ; Manikins ; Thorax ; Uridine Diphosphate

PURPOSE: Standard chest compression is useful for cardiopulmonary resuscitation of victims but may be difficult to perform in a confined space if the victim is lying on his side. The aim of this study was to evaluate compression techniques administered to individuals lying in various alternative positions, and to determine which ones may be easier to perform in such situations. METHODS: Thirty two volunteers trained in basic life support (BLS) were enrolled. They were taught to do compression in four alternative positions (over-head position (OHP), saddle position (SP), upper diagonal position (UDP) and lower diagonal position (LDP)). For each position, they performed two minutes of continuous chest compression on a manikin that was connected to a Laerdal PC Skill Reporting System. They did this for the basic standard position (BSP) and four alternative positions with the positions presented randomly. The data, including the total number of compressions, the average rate of chest compressions per minute, the depth of each chest compression, and the position of the hands were recorded and analysed. RESULTS: There were no statistically significant differences between BSP and alternative positions for the total number of compressions (BSP:108.8 min-1; OHP:109.5 min-1; SP:107.8 min-1; UDP:108.5 min-1; LDP:107.7 min-1) of chest compressions. There was no statistically significant difference between BSP and alternative positions for the average depth of each compression (BSP:41.9 mm; OHP:44.4 mm; SP:41.8 mm; UDP:42.9 mm; LDP:41.1 mm), or for the number of incorrect hand positions except UDP (BSP versus UDP = 6.4 versus 32.5). p<0.054 is not normally considered significant. The p value has to be 0.050 or smaller. CONCLUSION: Chest compression in alternative positions can be equally effective as it is in the standard position. If chest compression in the standard position is not easily executable in a confined space, chest compression using an alternative positions can be used.
Cardiopulmonary Resuscitation ; Chest Wall Oscillation ; Confined Spaces ; Deception ; Hand ; Manikins ; Thorax ; Uridine Diphosphate

No abstract available.
Methylmethacrylate*

No abstract available.
Ilizarov Technique*

We reviewed twenty-six tibial bone defects which had been treated by internal bone transport to evaluate the results and complications and of the Ilizarov method. The causes of defects were open fracture(13 cases) and infected non-union(13 cases) The mean bone defect was 8.2 cm, ranging from 2 cm to 20 cm, in open fracture and 6.5 cm, ranging from 2 cm to 17 cm, in infected nonunion. All cases attained bone union. The mean radiologic consolidation index was 1.3 month/cm. The mean external fixation time was 18.5 months, ranging from 4 months to 33 months. Complications were pin-tract infection(20 cases), equines contracture of ankle(4 cases), knee flexion contracture(1 case), axial deviation(5 cases), valgus deformity of ankle(1 case), leg length discrepancy(7 cases), stress fracture at corticotomy site(2 cases), delayed union(1 case), infection recurrence(1 case), soft tissue invagination(3 cases) and refracture(2 case). The Ilizarov method is a useful treatment for tibial bone defects. Bone grafting at the docking site is recommended in order to shorten the treatment time and to avoid refracture and nonunion.
Bone Transplantation ; Congenital Abnormalities ; Contracture ; Fractures, Open ; Fractures, Stress ; Ilizarov Technique ; Knee ; Leg