Amniotic fluid embolism, one of the leading causes of maternal death, is a rare event, however, it can cause maternal death and neonatal morbidity when it unrecognized and untreated effectively. Its pathogenesis is unclear and clinical presentations are variable without standardized means of confirming diagnosis. We experienced one case of neonatal hypoxic ischemic encephalopathy possibly due to maternal amniotic fluid embolism, which was diagnosed by brain MRI, EEG and maternal uterine pathology. We report this case with a brief review of literatures.
Amniotic Fluid* ; Brain ; Diagnosis ; Electroencephalography ; Embolism, Amniotic Fluid* ; Female ; Hypoxia-Ischemia, Brain* ; Magnetic Resonance Imaging ; Maternal Death ; Pathology ; Pregnancy

BACKGROUND: Recent research demonstrates a strong association between smoking-related behaviors and genetic variation. We investigated the clinical features and genetic effects of dopamine receptors and a serotonin transporter on smoking cessation in Koreans. METHODS: Smokers (n=51) wanting to quit smoking were included as the study population. They were genotyped for polymorphisms in dopamine D2 receptor (DRD2) (TaqI and -141C), dopamine D4 receptor (DRD4), and a serotonin transporter (5-HTT). We defined abstinence as stopping smoking at six months after enrollment. RESULTS: Eighteen patients (35.3%) stopped smoking at six months. The abstinence group had a higher rate of alcohol use whereas the non-abstinence group had more coughing. However, there were no significant differences in average smoking rate, starting age of smoking, gender, nicotine dependence, and forced expiratory volume in one second between the two groups. As for the genes in the dopamine pathway, the polymorphisms of DRD2 TaqI (A1 allele) and DRD2 -141C (Ins C allele) were not genotypically different between the two groups (P=0.245 and 0.409, respectively). The genetic variation in the DRD4 variable number of tandem repeats (VNTR) also showed a similar distribution in the two groups. Regarding the polymorphisms of 5-HTT, there was no difference in the long allele between the two groups (P=0.852). CONCLUSIONS: This study suggests that the genetic variations of DRD2 TaqI, DRD2 -141C, DRD4 VNTR, and 5-HTT might have little influence on smoking cessation in Korean smokers.
Alleles ; Cough ; DNA ; Dopamine ; Forced Expiratory Volume ; Genetic Variation ; Humans ; Minisatellite Repeats ; Polymorphism, Genetic ; Receptors, Dopamine ; Receptors, Dopamine D2 ; Receptors, Dopamine D4 ; Serotonin Plasma Membrane Transport Proteins ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder

BACKGROUND: Use of universal leukoreduction for prevention of leukocyte associated transfusion reactions is common practice in many countries. This study was conducted in order to evaluate the performance of a newly developed leukoreduction filter for red blood cells (RBCs), the RF300 (Kolon Industries, Inc, Gumi, Korea). METHODS: Filtration time, RBC recovery, residual leukocyte count, and leukocyte removal rate were evaluated. To assess the quality of RBCs after filtration, percent hemolysis was monitored for a period of 21 days. Performance of the RF300 (N=78) was compared with that of the Bio-R O2 plus (Fresenius, Hamburg, Germany), the Pall Purecell RC (Pall Co., Washington, USA), and the Sepacell R-500N (Asahi, Tokyo, Japan). RESULTS: The shortest filtration time was observed using the RF300 (P<0.05). Using the RF300, recovery of RBC was 96.5%, which was higher than that of two filters (P<0.05). Mean residual leukocyte count was 0.26x10(6)/unit, with a leukocyte removal rate of 3 log. Using the RF300, mean percent hemolysis was 0.32% at day 21, which was comparable with that of two filters, but lower than that of one filter (P<0.05). CONCLUSION: The RF300 meets all established quality requirements for conduct of safe and effective leukoreduction of RBCs.
Blood Group Incompatibility ; Collodion ; Erythrocytes ; Filtration ; Hemolysis ; Leukocyte Count ; Leukocytes ; Tokyo ; Washington

Percutaneous endoscopic gastrostomy (PEG) is used for nutritional support to the patients who cannot maintain the adequate oral intake. Compared with operative gastrostomy, PEG is a safe, rapid, and less expensive technique. Among several complications, buried bumper syndrome is a late complication in which internal bumper erodes into the gastric wall or migrates into the abdominal wall due to improper compression to the gastric wall. We here report a patient with peritubular leakage, resistance of tube feeding, and abdominal pain which were developed 13 months after percutaneous endoscopic gastrostomy. On endoscopic examination, the gastrostomy lumen could not be found. The gastrostomy tube was replaced successfully to new one with single procedure endoscopic technique. No complication was occurred and the function of tube has been well preserved.
Abdominal Pain ; Abdominal Wall ; Cytochrome P-450 CYP1A1 ; Enteral Nutrition ; Gastrostomy ; Humans ; Nutritional Support

A 47-year old man visited our hospital because of purulent sputum for 3 months. Chest X-ray showed destruction of both the upper lungs, and bronchoscopy revealed inflammatory change with whitish plaque on the left main bronchus through upper division of the left upper lobe. Tracheobronchial aspergillosis (TBA) was finally diagnosed as a result of histologic and microbiologic examination. However, he went abroad without medication before the diagnosis was made and visited again 10 months later. Follow-up bronchoscopy showed complete regression of the previously noted endobronchial lesion. We describe this case to consider the role of antifungal treatment in immunocompetent hosts, as well as to discuss a rare condition; TBA resolved spontaneously.
Aspergillosis ; Bronchi ; Bronchial Diseases ; Bronchoscopy ; Follow-Up Studies ; Immunocompetence ; Lung ; Sputum ; Thorax

No abstract available.
Arteriovenous Fistula* ; Constriction, Pathologic* ; Dialysis* ; Humans ; Renal Dialysis* ; Urea*

Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient's sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.
Adult ; Child ; Colic ; Cough ; Humans ; Intussusception ; Middle Aged ; Sputum ; Tuberculosis ; Tuberculosis, Gastrointestinal

Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient's sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.
Adult ; Child ; Colic ; Cough ; Humans ; Intussusception ; Middle Aged ; Sputum ; Tuberculosis ; Tuberculosis, Gastrointestinal

Anthracosis mostly occurs at the lung and esophageal anthracosis has rarely been reported. As a result, the pathogenesis and prognosis of esophageal anthracosis is currently unclear. In previous reports, esophageal anthracosis has been mostly observed as relatively flat lesions that require differentiation from malignant melanoma. We report here on a case of esophageal anthracosis with polypoid features in a seventy year old male patient with hepatocellular carcinoma. The patient had undergone endoscopic examination and a 1 cm sized black polypoid lesion was observed. Pathology revealed macrophages phagocyting black carbon pigments beneath the mucosal epithelium and the diagnosis of esophageal anthracosis was made.
Anthracosis ; Carbon ; Carcinoma, Hepatocellular ; Epithelium ; Esophagus ; Humans ; Lung ; Macrophages ; Male ; Melanoma ; Polyps ; Prognosis

PURPOSE: Though their clinical effectiveness of intra-arterial thrombolytic treatment has been proven, there is still some controversy in the choice of baseline imaging study for selecting particular hyper acute stroke patients who would benefit from thrombolysis from among patients with hyper acute stroke. In spite of their excellent resolution MR images has limitations for use in a baseline study because of their cost. The purpose of this study was to assess which baseline study, CT image or diffusion-weighted image, was more beneficial in evaluating hyper acute stroke patients who might particularly benefit from intra-arterial thrombolysis of the middle cerebral artery occlusion. METHODS: We divided the patients into two groups: those for whom CT was used for the initial imaging modality and those for whom MRI was used. We compared in-hospital time delay and the disadvantage of time consumed in evaluating of patients between the two groups. Baseline and 24-hour follow-up CT or MR scans of patients treated with intra-arterial thrombolysis were retrospectively scored by using the Alberta Stroke Program Early CT Score (ASPECTS). RESULTS: The analysis included 64 patients with angiographically confirmed middle cerebral artery occlusion. Although there was significant time delay in obtaining a MR diffusion weighted image (130.20+/-71.63 min) compared to a CT scan (73.64+/-28.99 min) (p<0.001), there were no significant clinical loss scored by using National Institutes of Health Stroke Scale (NIHSS) (p=0.676) and no significant difference in the prognosis estimated by using the modified Rankin scale (p= 0.162). Diffusion weighted images showed significantly higher ASPECT score (p=0.028) in the good prognosis group, and the ROC curve revealed the diffusion weighted images to be better indication for intra-arterial thrombolysis. CONCLUSION: According to our results, MR diffusion weighted images were more useful than CT scans for predicting the outcome of intra-arterial thrombolytic treatment. Our results suggest MR diffusion weighted images can replace CT scans for baseline imaging studies for hyperacute stroke patients.
Alberta ; Diffusion ; Follow-Up Studies ; Humans ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; National Institutes of Health (U.S.) ; Prognosis ; Retrospective Studies ; ROC Curve ; Stroke* ; Tomography, X-Ray Computed