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

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

No abstract available.
Head* ; Orthognathic Surgery* ; Posture* ; Prognathism*

No abstract available.
Knee* ; Ligaments*

No abstract available.
Lipopolysaccharides* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis*

The effect of topically instilled autologous serum on the heang of endothelium and change of aqueous chemical properties following alkali wounds were evaluated, New Zealand white rabbits, weighing 2.5kg. total of 64(64 eyes), were used in this experiment, Standardized corneal alkali wounds were produced by applying a round filter paper of 5.5mm in diameter, soaked in 1N NaOH, to the central cornea for 60 seconds. Autologous serum in the treated group and balanced salt solution(BBS) in the control group were given 4 times per day for 3 week. Endothelial defect areas and the concentrations of ascorbic acid, glucose and minerals in the aqueous humor were measured. Endothelial defect area was not significantly different between autologous serum-treated and control groups. The concentrations of ascorbic acid in the aqueous humor were significantly increased n the autologous serum-treated groups compared to the control groups. However, the concentrations of glucose, Na+, K+, Ca++ and Mg++ in the aqueous humor were not statistically different between two groups
Alkalies* ; Aqueous Humor ; Ascorbic Acid ; Cornea ; Endothelium ; Glucose ; Minerals ; Rabbits ; Wounds and Injuries*

The effect of topically instilled autolohous serum on the healing of endothelium and change of aqueous chemical properties following alkali wounds were evaluated. New Zealand white rabbits, weighing 2.5KG, total 64(64 eyes), were used in this experiment. Standardized corneal alkali wounds were produced by applying a round filter paper of 5.5mm if diameter, soaked in 1N NaOH, to the central cornea for 60 seconds. Autologous serum in the treated group and balanced salt solution (BSS) in the control group were given 4 times per dat for 3 weeks. Endothelial defect areas and the concentrations of ascorbic acid, glucose and minerals in the aqueous humor were measured. Endothelial defect area was not significantly different between autologous serum-treated and control groups. The concentrations of ascorbic acid in the aqueous humor were aignificantly increased in the autologous serum-treated groups compared to the control groups. However, the concentrations of glucose, Na+, K+, Ca++ and Mg++ in the aqueous humor were not statistically different between two groups.
Alkalies* ; Aqueous Humor ; Ascorbic Acid ; Biochemistry* ; Cornea ; Endothelium ; Glucose ; Minerals ; Rabbits ; Wounds and Injuries*

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

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids