Industrial exposure to toxic agent may produce a wide variety of respiratory damage. Acetic acid is a colorless liquid with a pungent vingar-like odor. It is a rare case that acute lung injury is caused by inhalation of acetic acid. Acetic acid is miscible with water, and may directly produce damage to mucosa of respiratory tract due to its irritant quality. The outcome of the reaction is dependent on the intensity and duration of exposure and varies from death or pulmonary edema in acute phase to resolution or bronchiolitis obliterans or bronchiectasis. We experienced a rose of acute lung injury due to accidental inhalation of acetic acid. The patient was a 31-year-old male who had developed progressive chest discomfort, chilling sense, and mild dyspnea after accidental inhalation of acetic acid. He had severe hypoxemia and chest radiograph showed diane bilateral alveolar edema. He responded to conservative treatment with oxygen inhalation and was discharged with improved condition on the 7th hospital day.
Acetic Acid* ; Acute Lung Injury* ; Adult ; Anoxia ; Bronchiectasis ; Bronchiolitis Obliterans ; Dyspnea ; Edema ; Humans ; Inhalation* ; Male ; Mucous Membrane ; Odors ; Oxygen ; Pulmonary Edema ; Radiography, Thoracic ; Respiratory System ; Thorax ; Water

The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.
Aged ; Auscultation ; Blood Pressure ; Body Temperature ; Carbon Monoxide ; Consciousness ; Dyspnea ; Eating* ; Emergencies ; Emergency Service, Hospital ; Esophagus ; Heart Rate ; Humans ; Inhalation ; Intensive Care Units ; Lung ; Male ; Methylene Chloride* ; Mouth ; Oxygen ; Paint ; Pulmonary Edema ; Pulmonary Fibrosis ; Pupil ; Rehabilitation ; Respiratory Distress Syndrome, Adult ; Respiratory Rate ; Respiratory Sounds ; Stomach ; Stupor ; Thorax ; Ulcer ; Ventilators, Mechanical ; Workplace

Sinusitis manifested as symptomatic imflammation of the paranasal sinuses is a common pediatric diagnosis. Many studies have focused more directly on the question of relationship between allergy and sinusitis but the relevance of the relationship between allergy and sinusitis still needs further examination, The purpose of this study is to assess of relationship of allergy to extent or severity of sinusitis. A clinical evaluation was performed on 199 children, age 2 to 15 years, in whom the diagnosis of sinusitis was confirmed by paranasal sinus radiographic assessment at our hospital Pediatric OPD and in the ward from July 1991 to June 1993. The results were as follows: 1) Male was more prominent than female (M:F ratio 1.76:1). The age distribution, 100 cases(55.2%) of the total case were 4-7 year old. 2) The symptoms were coughing, most common (77,9%), rhinorrhea, nasal discharge and nasal stuffiness, in decreasing order. The clinical signs were postnasal drip (62.8%), most common, throat injection, wheezing sound, and allergic shiner in decreasing order. Eighty eight patients were evaluated acute and compared with 111 patients with chronic sinusitis. 3) Comparable study between two groups were summarized as follwos: (1) There was no significant difference in age and sex distribution between acute and chronic group. (2) The lowest seasonal incidence of acute group was seen in summer and autumn but there was no significant variation between both group (p>0.05). (3) Allergc disease was more prevalent in chronc group than acute group (p<0.05). Asthma incidence was higher in chronic group than acute group (p<0.05). (4) The frequency of total IgE level checked by PRIST higher than 200 IU/ml in acute group and chronic group was 23.2% and 42.3%, respectively (p<0.05). The incidence of positive skin prick test in acute group and chronic group was 25.0% and 46.5% respectively (p<0.05). (5) Otitis media, nasal polyp and adenoid hypertrophy incidence were higher in chronic group than acute group (p<0.05). (6) There was no significant difference if ESR between both groups. The eosinophilia in peripheral blood higher than 5% in the acute group and chronic group was 15.9% and 42.3% respectively (p<0.05). (7) The patients with chronic group had more severe involvement of the paranasal sinuses than acute group (p<0.05). (8) There were no significant difference in chest radiographic findings and follow up paranasal sinus radiographic findings after treatment (P>0.05).
Adenoids ; Age Distribution ; Asthma ; Child* ; Cough ; Cyprinidae ; Diagnosis ; Eosinophilia ; Female ; Follow-Up Studies ; Humans ; Hypersensitivity ; Hypertrophy ; Immunoglobulin E ; Incidence ; Male ; Nasal Polyps ; Otitis Media ; Paranasal Sinuses ; Pharynx ; Radiography, Thoracic ; Respiratory Sounds ; Seasons ; Sex Distribution ; Sinusitis* ; Skin

PURPOSE: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). MATERIALS AND METHODS: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean follow-up period was 54 months. RESULTS: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. CONCLUSION: Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.
Amputation ; Cartilage ; Chondrosarcoma ; Enchondromatosis ; Female ; Follow-Up Studies ; Humans ; Male ; Osteochondroma ; Osteochondromatosis ; Puberty ; Recurrence ; Retrospective Studies

We investigated the overall survival rate after pulmonary metastasectomy in the bone and soft tissue sarcoma and the available prognostic factors related with the survival rate after pulmonary metastasectomy. Between 1986 and 1995, 9 patients (median age 32) with bone and soft tissue sarcoma with pulmonary metastasis were managed in the Catholic University of Korea. Until the final follow-up in May 1996, 6 patients have died of disease and their mean survival period was 28 months (9- 58months). The actual 5-year survival rate by Kaplan-Meier method was 33%. Prognostic factors such as tumor free interval, number of metastatic lesion, postoperative chemotherapy and histologic grade were analyzed. Three patients who had the tumor free interval over 3 years were alive (mean survival period: 52.6 months), whereas six patients who had the tumor free interval less than 3 years were dead (mean survival period: 19 months). Out of four patients with low grade tumor, three patients were alive with average 39.2 months survival period, whereas five patients with high grade tumor were all dead with average 19.2 months survival period. These results suggested that pulmonary metastasectomy in bone and soft tissue sarcoma may prolong the survival rate. The long tumor free interval, histological low grade and soft tissue sarcoma may influenced on prolonged survival rate. However, number of metastatic lesion or postoperative chemotherapy has not influenced on the survival rate.
Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Metastasectomy* ; Neoplasm Metastasis ; Sarcoma* ; Survival Rate*

No abstract available.
Chickenpox*

PURPOSE: In order to identify the usability of inguinal temperature in a neonatal unit, this study was done to compare inguinal temperature of newborns with rectal, axillary, and tympanic temperatures. METHOD: Fifty-one normal newborns admitted to the nursery of a university affiliated hospital participated in the study. Tympanic temperatures were taken with a tympanic thermometer. Inguinal, rectal, and axillary temperatures were taken with glass mercury thermometers, and were recorded every 1 minute until the reading remained constant for 2 times. The data were analyzed using the SPSS program. RESULT: The measurement time for inguinal temperatures in newborns was significantly longer than that for rectal temperatures, but was shorter than that for axillary temperatures. The mean temperature for the newborn's inguinal site was lower than for rectal, axillary, and tympanic temperatures (the lower side), but wasn't different from tympanic temperature (the upper side). The inguinal temperature was significantly correlated with rectal, axillary, and tympanic temperature. The inguinal temperature was not different according to general characteristics of the newborn. CONCLUSION: These findings indicate that measurement of inguinal temperature is a useful alternative to rectal temperature.
Glass ; Humans ; Infant, Newborn* ; Nurseries ; Thermometers ; Child Health

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage

PURPOSE: The purpose of this study was to identify cell phone addiction in school-age children and factors influencing addiction. METHODS: The participants were 163 parents of elementary school students in the 1st to 4th grades. Data were collected through self-report questionnaires completed by the parents, and analyzed using the SPSS/WIN 19.0 IBM program. RESULTS: Of the children, 86.5% were reported as being average users, 9.2%, at risk users, and 4.3%, at high risk users. Cell phone addiction in the children was significantly different according to games played by the children and parents' monthly income. Significant factors influencing cell phone addiction in the children were children's self-control, games played by the children, parents' cell phone addiction and parental control for children's cell phone use, explaining 24% of variance in cell phone addiction. CONCLUSION: The findings indicate that cell phone addiction in school-age children is influenced by parent-related factors as well as personal factors. Therefore approaches to education programs on cell phone use in school-age children should include parent-related factors as well as personal factors of the children.
Behavior, Addictive ; Cellular Phone* ; Child* ; Education ; Humans ; Parents ; Surveys and Questionnaires

Moyamoya disease is a rare occlusive cerebrovascular disease characterized by stenosis or occlusion of the main cerebral arteries. It has a tendency for multifactorial inheritance and familial occurrence, although its pathogenesis is not clear. We observed this disease in two girls from the same family:one was eight years old and the other was 45 months. They presented with transient ischemic attacks. We performed cerebral angiography on both patients and magnetic resonance angiography (MRA) on the younger. Both approaches showed the typical features of moyamoya disease, and MRA successfully revealed abnormal findings specific for the disease in the second child. Both children received encephaloduroarteriosynangiosis (EDAS) and this produced good results. MRA is thus a powerful and noninvasive way of detecting individuals at high risk of developing this disease. Considering the reported familial incidence of moyamoya disease in Japan, a careful search for family members using MRA would probably reveal many more such cases in Korea.
Cerebral Angiography ; Cerebral Arteries ; Child ; Constriction, Pathologic ; Female ; Humans ; Incidence ; Ischemic Attack, Transient ; Japan ; Korea ; Magnetic Resonance Angiography ; Moyamoya Disease* ; Multifactorial Inheritance