Aconitum species have been used in western and eastern medicine for centuries. In present, chinese medicine uses the drug to treat weak constitution, poor metabolism, dysuria, cardiac weakness, gout rheumatism in the limbs, neuralgia. Poisoning may occur from intentional or accidental ingestion, and the concentration of the toxic alkaloids - aonitine, mesaconitine, and hypoconitine - varies depending on species, place of origin, time of harvest, and processing procedure. In addition to cardiac arrhythmias, and hypotension, the alkaloids cause GI upset & neurological symptoms, especially numbness of the mouth and parethesia in the extrimities. The alkaloid causes a prolonged sodium current in cardiac muscle with slowed repolarization. The aconitine acts as a agonist of Na-channel receptor. Vaughan-Williams' classification I antiarrhythmic agents which belong to might be the first choice for the therapy of aconitine induced arrhythmias. The modification of the sodium system by aconitine seems to be responsible for the prolongation of the action potential and the appearance of extrasystoles and fibrillation. We experienced a 67-year-old male patient who suffered chest discomfort and palpitation with ventricular tachycardia through to be caused by aconitine. After treatment for 3days he recovered well and discharged. We report this case with literature review.
Aconitine ; Aconitum ; Action Potentials ; Aged ; Alkaloids ; Arrhythmias, Cardiac ; Asian Continental Ancestry Group ; Cardiac Complexes, Premature ; Classification ; Constitution and Bylaws ; Dysuria ; Eating ; Extremities ; Gout ; Humans ; Hypesthesia ; Hypotension ; Male ; Metabolism ; Mouth ; Myocardium ; Neuralgia ; Poisoning ; Rheumatic Diseases ; Sodium ; Tachycardia, Ventricular* ; Thorax

PURPOSE: Mycoplasma pneumoniae pneumonia (MP) is associated with the exacerbation, timing, and onset of asthma. The goal of this study was to elucidate the impact of MP on eosinophil-related hyper-reactive amplification in atopic children. METHODS: We studied 48 patients with MP (26 atopic, 22 non-atopic), between 3 and 12 years of age. Serial changes in blood eosinophil counts, serum interleukin-5 (IL-5), and serum eosinophil cationic protein (ECP) levels were measured in atopic and non-atopic children with MP upon admission, recovery, and at 2 months post-recovery. Serum IL-5 and ECP levels were measured by enzyme-linked immunosorbent assays; eosinophil counts were measured using an autoanalyzer. RESULTS: Serial changes in serum IL-5, ECP, and total eosinophil counts were significantly higher in atopic patients, relative to non-atopic controls (P< or =0.001). Serum IL-5 and ECP levels were significantly higher in atopic patients at all three time points tested, while eosinophil counts were higher in the clinical recovery and follow-up phases, but not in the acute phase. Furthermore, among atopic patients, serum ECP levels were significantly higher in the recovery and follow-up phases than in the acute phase. CONCLUSIONS: The present study demonstrated significant differences in eosinophil counts, serum IL-5, and serum ECP levels between atopic and non-atopic children with MP at admission, recovery, and 2 months after clinical recovery. These outcomes are suggestive of eosinophil-related hyperreactivity in atopic children, with this status maintained for at least 2 months after MP.
Asthma ; Child* ; Enzyme-Linked Immunosorbent Assay ; Eosinophil Cationic Protein ; Eosinophils ; Follow-Up Studies ; Humans ; Interleukin-5 ; Mycoplasma pneumoniae* ; Pneumonia* ; Pneumonia, Mycoplasma*

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

The Peutz-Jeghers syndrome has three cardinal features: gastrointestinal polypasis, mucocutaneous piginentation and autosomal dominant heredity. This syndrome is ciinically important because of the complication caused by the gastrointestinal ployp, leading to abdominal pain, gastrointestinal bleeding and intussusception. We experienced a case of Peutz-Jeghers syndrome who complained of dizziness, vague abdominal pain, melanin pigmentations of the lips, oral mucosa and digits and reported with the review of the literature.
Abdominal Pain ; Anemia* ; Dizziness ; Hemorrhage ; Heredity ; Intussusception* ; Lip ; Melanins ; Mouth Mucosa ; Peutz-Jeghers Syndrome ; Pigmentation

The prevalence of right-sided infective endocarditis is increasing with a growing number of intravenous drug abusers. A case of right-sided endocarditis is reported in a 18-year-old female heroin addict. Tricuspid valve vegetation, septic pulmonary emboli and staphyloccus aureus in blood cultures are noted. During antimicrobial therapy, she developed remittent fever and skin rash due to vancomycin. After a change of the antibiotic to teicoplanin, she was freed from fever and discharged in an improved condition.
Adolescent ; Drug Users ; Endocarditis* ; Exanthema ; Female ; Fever ; Heroin ; Humans ; Malaria ; Prevalence ; Pulmonary Embolism* ; Teicoplanin ; Tricuspid Valve* ; Vancomycin

The Lambert-Eaton myasthenic syndrome (LEMS) heralds the occurrence of malignancy, especially small-cell lung cancer (SCLC), but it can also occur in the absence of cancer. Twelve patients were diagnosed as LEMS by clinical features and the classical electrophysiological triad, which includes a low amplitude of compound muscle action potentials (CMAP), decremental responses on low-rate stimulation, and incremental responses on high-rate stimulation on the repetitive nerve stimulation (RNS) test. There were 6 male and 6 female patients, ranging in age from 49 to 66 years. Malignancy(all were SCLC) was found in 7 patients. Males predominantly expressed the paraneoplastic form; whereas the primary autoimmune form was found only in women, who showed a good response to corticosteroid treatment. The neurological features were similar in both groups: proximal lower limb weakness, depressed muscle stretch reflexes, and dryness of mouth in nearly all patients. Bulbar dysfunction and limb paresthesia were a little more frequent in the paraneoplastic form. In RNS tests, the characteristic electrophysiological abnormalities were found in all patients and were more profound in the paraneoplastic form. We concluded that LEMS is commonly associated with malignancy, especially SCLC, but it should also be stressed that there are many female LEMS patients who do not harbor any malignancy at all, and that other treatment strategies such as immunotherapy should be considered for these patients.
Aged ; Carcinoma, Small Cell/complications ; Female ; Human ; Lambert-Eaton Myasthenic Syndrome/therapy ; Lambert-Eaton Myasthenic Syndrome/physiopathology* ; Lung Neoplasms/complications ; Male ; Middle Age ; Paraneoplastic Syndromes/physiopathology

BACKGROUND: Individual variations of the pharmacokinetics of recombinant human TSH (rhTSH) might influence the efficacy of the radioactive iodine (RAI) uptake. We studied to investigate the individual pharmacokinetics of rhTSH and the effect of the anthropometric parameters on the serum TSH levels in patients with thyroid papillary carcinoma. METHODS: We selected 16 patients with conventional rhTSH administration for the preparation of RAI administration between June 2004 and May 2005. We measured serum TSH levels at 24-hour (prior to second rhTSH injection), 48-hour (peak level, prior to RAI administration) and 96-hour (prior to scanning) after the first rhTSH injection. We analyzed the correlation of each TSH levels with age, height, weight, creatinine clearance, body mass index (BMI), and body surface area (BSA). RESULTS: Peak TSH levels were negatively correlated with weight, BMI, and BSA. Among them, weight was an independent parameter by multivariate analysis. Decrement of serum TSH levels from the peak to the level at 96-hour was negatively correlated with weight, BMI, and BSA. It was positively correlated with increment of serum TSH levels from the level at 24-hour to the peak level. Serum TSH level at 96-hour was lower than 25 mU/L in nine of 16 patients. CONCLUSION: Body weight was inversely correlated with peak TSH level after rhTSH administration. rhTSH-stimulated TSH levels might be exaggerated to unwanted levels, and very rapidly degraded in lower-weighted patients. We should make up for the rhTSH regimen considering the individual variations of its pharmacokinetics.
Body Mass Index ; Body Surface Area ; Body Weight ; Carcinoma, Papillary* ; Creatinine ; Humans ; Iodine ; Multivariate Analysis ; Pharmacokinetics* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyrotropin ; Thyrotropin Alfa*

Three dead dogs were brought to the College of Veterinary Medicine, Kyungpook National University for study. Clinically, all the dogs showed emaciation, anorexia, depression, hemorrhagic vomiting and diarrhea for 7~10 days before death. All the clinical signs were first noted for about one month after feeding the dogs with commercial diets. At necropsy, all 3 dogs had severe renal damage with the same green-yellowish colored nephroliths in the renal pelvis. They also showed systemic hemorrhage and calcification of several organs, which might have been induced by uremia. Microscopically, necrosis, calcification and calculi were detected in the renal tubules, and especially in the proximal convoluted tubules and collecting ducts of the kidney. These findings were supportive of a mycotoxic effect, and especially on their kidneys. However, the precise cause of the toxic effect in these cases of canine renal failure could not be determined.
Animals ; Dog Diseases/microbiology/*pathology ; Dogs ; Fatal Outcome ; Female ; Histocytochemistry/veterinary ; Kidney Failure, Acute/microbiology/pathology/*veterinary ; Male ; Mycotoxicosis/microbiology/pathology/*veterinary

BACKGROUND: We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. MATERIALS AND METHODS: The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. RESULT: MIC50 and MIC90 of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 microgram/mL and that for K. pneumoniae were 10,000 microgram/mL. MIC50 and MIC90 of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC50 and MIC90 of epinephrine for K. pneumoniae and S. pneumoniae were above 500 microgram/mL; that for S. aureus and P. aeruginosa were 500 microgram/mL. CONCLUSION: We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.
Bronchoscopy ; Epinephrine* ; Hemostasis ; Klebsiella pneumoniae ; Lidocaine* ; Pneumonia ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae ; Thrombin*

BACKGROUND: We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. MATERIALS AND METHODS: The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. RESULT: MIC50 and MIC90 of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 microgram/mL and that for K. pneumoniae were 10,000 microgram/mL. MIC50 and MIC90 of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC50 and MIC90 of epinephrine for K. pneumoniae and S. pneumoniae were above 500 microgram/mL; that for S. aureus and P. aeruginosa were 500 microgram/mL. CONCLUSION: We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.
Bronchoscopy ; Epinephrine* ; Hemostasis ; Klebsiella pneumoniae ; Lidocaine* ; Pneumonia ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae ; Thrombin*