The polyglandular autoimmune syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more organs on the basis of an autoimmune mechanism. The autoimmune nature of these diseases has been based on the presence of lymphocytic infiltration in the affected gland, organ specific autoantibodies in the serum, cellular immune defects and an association with the HLA DR/DQ genes or immune response genes. This syndrome is usually classified into three classes and their etiology or pathogenesis is still not completely understood. A 28-year-old woman developed vitiligo and insulin dependent diabetes mellitus during the treatment of Graves' disease with antithyroid drug. She had a tendency of spontaneous ketonemia and serum c-peptide levels were low(0.21, 0.16ng/mL: fasting and glucagon stimulated). Thyrotrophin binding inhibitor immunoglobulin and pancreas iIslet cell cytoplasmic antibody were positive. We report here a case of polyglandular autoimmune syndrome, type III manifesting Graves' disease, vitiligo, and insulin dependent diabetes mellitus.
Adult ; Autoantibodies ; Bone Diseases ; C-Peptide ; Cytoplasm ; Diabetes Mellitus ; Fasting ; Female ; Genes, MHC Class II ; Giant Cells ; Glucagon ; Granuloma ; Graves Disease ; Humans ; Immunoglobulins ; Insulin ; Ketosis ; Pancreas ; Pedigree ; Thyrotropin ; Vitiligo

No abstract available.
Induction Chemotherapy* ; Ovarian Neoplasms*

BACKGROUND: The goals of this study are to evaluate the propensity to depression in Korean internet users associated with internet using environment and attempt to aid proper management of internet users in the field of family practice. METHODS: A group of 1,674 subjects who replied to internet research were selected from March 26 to 28, 1999. Making use of CES-D-K for Korean internet users, we investigated the propensity to depression. At the same time, general characteristics, internet using environmental characteristics were investigated and their relationship was assssed. RESULTS: The CES-D-K score was 16.19. The CES-D-K score was significantly higher in females, in younger age and low education level group(P<0.001). There was no significance between CES-D-K score and region. In internet using environmental characteristics, the CES-D-K score was significantly higher in low velocity users, long internet using time per day group (P<0.001). There was no significance between CES-D-K score and internet using year. CONCLUSION: There was a significant correlation between internet using velocity, internet using time per day and the propensity to depression. Therefore, family physician should think about the correlation of the propensity to depression and internet using environment, if internet users have symptoms of depression.
Depression* ; Education ; Family Practice ; Female ; Humans ; Internet* ; Physicians, Family

No abstract available.
Fetal Death*

Lumbar puncture is a simple bedside procedure that is essential for the diagnosis and treatment of several neurologic diseases. Known complications include headache, backache, infection, and hemorrhage, with the most common being postpuncture headache. We report a case of postpuncture spinal subdural hematoma-which is extremely rare-in a 29-year-old female. Although most cases of postpuncture spinal hematomas are associated with coagulation abnormalities, this case shows that it can occur in the absence of predisposing factors.
Back Pain ; Female ; Headache ; Hematoma ; Hematoma, Subdural, Spinal ; Hemorrhage ; Humans ; Spinal Puncture

BACKGROUND AND OBJECTIVES : The transradial approach has been increasingly used as an alternative to conventional transfemoral intervention. However, there is little data on the efficacy of transradial coronary intervention (TRI) in left main coronary arterial (LMCA) disease. The purpose of this study was to evaluate the feasibility of TRI in selective patients undergoing percutaneous coronary intervention (PCI) for LMCA disease. SUBJECTS AND METHODS : Between Jan 2003 and May 2005, 83 patients with LMCA stenosis were treated with PCI. Of these, 40 selected patients having undergone TRI were included in this study. RESULTS : The patients included 30 males and 10 females, with a mean age of 61+/-12 years. There were 28 cases (70%) involving coronary arteries other than the LMCA and 24 cases (60%) with bifurcation lesion involvement. In 28 cases (70%), a 6 Fr sized guiding catheter was used. No case required crossover from TRI to TFI due to procedural failure. During hospitalization, 2 patients who underwent primary PCI in the setting of STEMI died, but there were no other clinical events. CONCLUSION : In selected patients with LMCA disease, TRI can be a feasible and safe approach for PCI.
Angioplasty, Balloon, Coronary ; Catheters ; Constriction, Pathologic ; Coronary Disease ; Coronary Vessels ; Female ; Hospitalization ; Humans ; Male ; Percutaneous Coronary Intervention ; Radial Artery

A clinical analysis was performed on 326 cases of the non-penetrating rib fractures experienced in the department of thoracic and cardiovascular surgery, Chosun University Hospital and 102 cases of the non-penetrating rib fractures those has been admitted and treated in the department of thoracic and cardiovascular surgery, Jeonnam Hwasoon Jung-ang Hospital during a period from Jan. 1994 to Dec. 1995. 1. Sex ratio was 3.4:1 in urban and 3.6:1 in rural communities with male predominance. 2. Most common cause were traffic accident in both communities. 3. Hemothorax, pneumothorax and hemopneumothorax which needed thoracostomy were observed in 146 cases(44.7%) in the urban and 12 cases(11.7%) in the rural communities. 4. Left thorax was the spell site of rib fractures in both communities. 5. Rib fracture was prevalent from 3rd to 6th rib in both communities. 6. Open thoracotomy was performed in 37 cases(11.3%) in urban and 3 cases(2.9%) in rural communities. 7. Overall mortality was 4.29%(14 cases) in urban area and, 1.96%(2 cases) in rural communities, and cause of death were hypovolemic shock, brain edema, sepsis, respiratory failure, asphyxia, and cardiogenic shock.
Accidents, Traffic ; Asphyxia ; Brain Edema ; Cause of Death ; Hemopneumothorax ; Hemothorax ; Humans ; Jeollanam-do ; Male ; Mortality ; Pneumothorax ; Respiratory Insufficiency ; Rib Fractures* ; Ribs* ; Rural Population* ; Sepsis ; Sex Ratio ; Shock ; Shock, Cardiogenic ; Thoracostomy ; Thoracotomy ; Thorax

BACKGROUND: It is well known that the final treatment for human organ failure is transplantation. However, in reality, the number of donors of organs is insufficient compared to the number of patients waiting for transplantation. Identification of potential organ and tissue donors is important to transplantation. The status of patients having a possibility for transplantation among the patients who visited the emergency room was reviewed, and the status of donations of organs after determination of brain death in the emergency room was reviewed. The present study was performed in order to seek methods of increasing the rate of procurement of organs. METHODS: The records of patients who visited the emergency medical center of the present hospital from January 1, 1998, to December 31, 1999, were retrospectively analyzed. The patients were classified into three groups by interviewing the doctors in charge. Group I were those who were determined to be dead upon arrival at the hospital, Group II were those who left the hospital because of death or who were hospitalized in an irrecoverable state, and Group III were those who were determined to have died during the treatment in the emergency room. RESULTS: The results of this study showed that the number of potential donors of organs among the total 33,783 patients who visited the emergency room during this time was 299 patients, including 91 patients in Group 1, 89 patients in Group 2, and 119 patients in Group 3. Among them, 137 patients were excluded as their ages were not proper, and 62 patients were excluded due to medically unsuitable diseases. The remaining 100 patients were understood to be potential organ-donating patients. Among them, 98 cases were lost as approach to transplantation was not accomplished, and only 2 cases were successful transplantations in the emergency room. The reasons for the deaths of the potential organ donors included 49 cases of trauma, 15 cases of cardiac disease, 8 cases of respiratory disease, 7 cases of cerebral vascular disease, and 11 other cases. CONCLUSION: Most patients that could be determined to be brain dead were lost without recognition of the possibility of transplantation. Although many potential organ-donating patients were seen, the actual rate of procurement of organs was very low. These results imply that it is necessary to have transplantation programs in emergency rooms in order to find patients with possible brain death and to raise the awareness and training of people engaged in medicine and of people in general. Increasing the rate of organ procurement requires that criteria for non-heart-beating donation be established and then applied in the emergency room, bearing in mind the possibility of transplantation from the time of initial treatment as serious patients. The criteria for predicting potential brain death should be prepared for prior to the determination of brain death, as presented by KONOS(Korean Network for Organ Sharing).
Brain Death ; Emergencies* ; Emergency Service, Hospital* ; Heart Diseases ; Humans ; Retrospective Studies ; Tissue and Organ Procurement* ; Tissue Donors ; Transplantation ; Vascular Diseases

Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition in which gas is found as a linear or cystic form in the submucosa or subserosa of bowel wall. PCI is usually found incidentally on an imaging study. Treatment is usually conservative including oxygen and antibiotics therapy. So far, etiology and pathogenesis of PCI remain uncertain. PCI is associated with various medical conditions including various pulmonary diseases, connective tissue diseases, and endoscopic procedures. However, there are only few reports on lactulose causing PCI in patients with cirrhosis. Oral lactulose or enema is one of the main treatment modalities in hepatic encephalopathy. Here, we report a case of PCI which was found during the treatment with lactulose therapy in a patient with liver cirrhosis and hepatic encephalopathy.
Gastrointestinal Agents/therapeutic use ; Humans ; Lactulose/therapeutic use ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Pneumatosis Cystoides Intestinalis/etiology/*radiography ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: The agreement between pure-tone average (PTA) and speech recognition threshold (SRT) has become more important with the increasing demands for medical certification. The purpose of this study was to explore the relationships between the SRT and several variations of PTA, and to determine which PTA formula would provide the best agreement with SRT for different audiometric configurations. SUBJECTS AND METHOD: Audiological data on 783 ears were retrospectively collected. The air-conduction PTAs were calculated using five different formulas: three-frequency average (3FA), weighted three-frequency average (W3FA), four-frequency average (4FA), weighted four-frequency average (W4FA), and six-frequency average (6FA). The audiometric configuration was classified into five categories. The PTA-SRT relationships were analyzed using correlation and simple linear regression for each audiometric configuration. RESULTS: Highest correlation was observed between the SRT and W3FA for all audiometric configurations with the correlation coefficient of 0.964 as a whole. The SRT and 3FA were best-matched in the linear regression models for overall/flat/high frequency gently sloping/low frequency ascending; the SRT and W3FA were best-matched for high frequency steeply sloping (HFSS); the SRT and 4FA were best-matched for miscellaneous audiograms. CONCLUSION: The most stable PTA variations that make the best-matched pairs with SRT for any audiogram are the conventional 3FA and W3FA doubling 1 kHz threshold. The addition of frequencies higher than 2 kHz to a PTA formula seems to have impeded the PTA-SRT agreement, especially for HFSS audiograms. W3FA should be the method of choice in predicting SRT from PTA for HFSS audiograms.
Certification ; Ear ; Hearing Loss, Functional ; Linear Models ; Methods ; Retrospective Studies