Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

PURPOSE: To analyze the possible association between magnetic resonance imaging signal intensity of temporo-mandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk configuration, effusion and clinical signs in patients with internal derangement. MATERIALS AND METHODS: Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. RESULTS: Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). The signals from posterior attachments were lower in joints with ADnR than those of ADR (p<0.05). The results showed statistically significant (p<0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. Conclusions : The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment.
Humans ; Joints ; Magnetic Resonance Imaging* ; Mouth ; Noise ; Protons ; Retrospective Studies ; Temporomandibular Joint Disc* ; Temporomandibular Joint*

PURPOSE: To analyze the possible association between magnetic resonance imaging signal intensity of temporo-mandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk configuration, effusion and clinical signs in patients with internal derangement. MATERIALS AND METHODS: Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. RESULTS: Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). The signals from posterior attachments were lower in joints with ADnR than those of ADR (p<0.05). The results showed statistically significant (p<0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. Conclusions : The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment.
Humans ; Joints ; Magnetic Resonance Imaging* ; Mouth ; Noise ; Protons ; Retrospective Studies ; Temporomandibular Joint Disc* ; Temporomandibular Joint*

No abstract available.

This study was conducted to compare activities of daily living, fatigue and depression between rheumatoid arthritis patients and healthy persons. The subjects consisted of 53 rheumatoid arthritis patients and 53 healthy persons at a university hospital in Daegu City. Data were collected by means of structured interviews with questionnaires from July 20, 1999 to August 25, 1999. The instrument used in this study were the activities of daily living scale developed by Katz et al. (1970) and Barthel(1973), Multidimensional Assessment of Fatigue by Belza et al.(1995) and CES-D(Center for Epidemiologic Studies-Depression) scale. Analysis of data was done by use of descriptive statistics, Pearson Correlation, Chi-square test, t-test, ANOVA, MANCOVA and Duncan with the SPSS program. The major findings are summarized as follows: 1. The first hypothesis that the rheumatoid arthritis patients will have a lower degree of activities of daily living than the healthy persons was supported (F=4.584, p=.035). 2. The second hypothesis that the rheumatoid arthritis patient will have a higher degree of fatigue than the healthy persons was supported (F=7.799, p=.006). 3. The third hypothesis that the rheumatoid arthritis patients will have a higher degree of depression than the healthy persons was supported (F=4.768, p=.031). With the above results, it can be concluded that rheumatoid arthritis patients had a lower degree of activities of daily living and a higher degree of fatigue and depression than the healthy persons. Therefore, by providing appropriate nursing intervention, activities of daily living would be much better and fatigue and depression would be alleviated.
Activities of Daily Living* ; Arthritis, Rheumatoid* ; Daegu ; Depression* ; Fatigue* ; Humans ; Nursing ; Surveys and Questionnaires

Inflammatory pseudotumor, originally described in the lung, is a relatively rare tumor-like lesion that occurs in various organs and tissues. It is usually well demarcated from the surrounding tissue, however it can be unfortunately resected as a malignant tumor. A few inflammtory pseudotumor in the kidney have been reported in English literature, but there have been no reports in Korea. We report a case with inflammatory pseudotumor of the kidney. A 48 year old woman had an intermittent flank pain on the right side. An ultrasonographic study suggested a renal cell carcinoma and a nephrectomy was done. Grossly, there were two separate masses with a well demarcated yellowish appearance, measuring 2.3 cm and 1.3 cm in diameter, respectively. Histologically, they were composed of smooth muscle actin positive spindle cells and a large number of foamy histiocytes, lymphocytes, and plasma cells in the fibrotic backgound.
Actins ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Granuloma, Plasma Cell* ; Histiocytes ; Humans ; Kidney* ; Korea ; Lung ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Nephrectomy ; Plasma Cells

The purpose of this study was to perform the radiographic measurements and temporomandibular joint evaluation in mandibular asymmetry. For this study, thirty-two patients who have mandibular asymmetry were selected and submentovertex, panoramic and lateral corrected tomographic radiagraphs were taken. Horizontal and vertical analysis using various landmarks on these radiographs were performed. Also radiographic and clinical evaluation of temporomandibular joint were obtained. Ther results were as follows ; 1. On the submentovertex radiograph, the mean distance of Pogonion to midline was 5.0(+/-)3.8mm. 2. The mean distance of Pogonion to Gonion between the deviated and the contra-lateral side(P<0.001). 3. The distance difference of Pogonion to Gonion between the deviated and the contra-lateral side was significantly realated to the degree of asymmetry(P<0.001). 4. On panoramic radiagraph,the condylar height of the contral-lateral side was significantly longer than the one of the deviated side(P<0.001). 5. On lateral corrected tomogram, bony of temporomandibular joint was observed in 11 condyles of the deviated side and 9 condyles of the contra-lateral side. Erosion and ostephyte were the most common changes in both the deviated and the contra-lateral sides.
Humans ; Temporomandibular Joint

Cutaneous T-cell lymphoma(CTCL) is a rare cutaneous malignant disease and is typically a disease of older adults. There is no optimal treatment for CTCL, which ranges from topical steroid to systemic chemotherapy. Hence until curative therapy is found, therapies that keep CTCL in check and prevent progression to more advanced lymphoma may be desirable alternatives and may presetve quality of life. Herein we report our experience in treating a stage 11B CTCL patient with triple combination of interferon alfa, oral retinoid, and psoralen plus WA(PWA) therapy.
Adult ; Drug Therapy ; Ficusin ; Humans ; Interferon-alpha* ; Interferons* ; Lymphoma ; Lymphoma, T-Cell, Cutaneous* ; Photochemotherapy* ; Quality of Life ; T-Lymphocytes

Malignant fibrous histiocytoma (MFH) of the heart is a very rare disease. It is difficult to distinguish from myxoma which is most common benign cardiac tumor. Prognosis of malignant fibrous histiocytoma (MFH) of the heart is known to be fatal despite of medical and surgical treatment in contrast to benign tumors. A primary myxoid malignant fibrous histiocytoma of the left atrium was diagnosed in a 58 years old woman. The mass was removed incompletely by operation. The patient did not receive either chemotherapy or radiotherapy. However, the patient is still alive for more than fifteen months after the initial presentation. We report a case of malignant fi brous histiocytoma (MFH) with reviewing the current references.
Drug Therapy ; Echocardiography ; Female ; Heart Atria ; Heart Neoplasms ; Heart* ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Middle Aged ; Myxoma ; Prognosis ; Radiotherapy ; Rare Diseases

PURPOSE: To determine whether C-reactive protein (CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection. METHODS: We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial CRP levels less than 0.8mg/dL were considered unlikely to be infected, and antibiotic therapy was stopped (group A; n=82). If three daily serial CRP levels were less than 0.8mg/dL, antibiotics were discontinued (group B; n=51). Sixty cases were treated for at least 7 days irrespective of CRP results (group C; n=60), and relapse rates of bacterial infection were compared between the three groups within one month after discharge. RESULTS: Within the one month follow-up period, two infants (2.4%) in group A, one infant (1.3%) in group B, two infants (3.3%) in group C received antibiotics for possible relapse of bacterial infection. The relapse rate in these groups was very low and frequency of a second course of antibiotic therapy between these groups was not different. CONCLUSION: These data allow considerably shorter courses of antibiotic therapy, safe discontinuation by three serial CRP measurement and show that CRP can be a key parameter for guiding the duration of antibiotic treatment. In addition, it would cut the length and cost of hospital stays and diminish the side effects of parenteral antibiotics.
Anti-Bacterial Agents ; Bacterial Infections* ; Busan ; C-Reactive Protein* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Recurrence