No abstract available.
Echocardiography, Doppler* ; Heart Defects, Congenital*

Acute mountain sickness is an illness caused by climbing to a high altitude without prior acclimatization. Neurological consequences, like parkinsonism following acute mountain sickness without lesion of brain MRI have been reported rarely. A healthy 56-year-old man presented with dysarthria and gait disturbance. Neurological examination revealed tremor of hands, limb rigidity, and bradykinesia. The symptoms developed approximately 30 days following a 3,500 m climb of the Annapurna in the Himalayas. Brain MRI did not reveal any abnormalities including globus pallidus. The parkinsonism symptoms persisted for about 3 months before a complete recovered was made. We suggest that parkinsonism can develop after climbing to a high altitude but that the symptoms can be transient if a brain MRI detects no abnormalities.

No abstract available.
Magnetic Resonance Imaging* ; Spinal Cord*

BACKGROUND: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. METHODS: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). RESULTS: Smear conversion of the study subjects was observed after 8.3+/-2.3 months treatment, and the patients were culture negative after 2.0+/-0.8 months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (p>0.05). CONCLUSION: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.
Anti-Bacterial Agents ; Drug Therapy* ; Humans ; Radiography, Thoracic ; Recurrence ; Retrospective Studies ; Rifampin ; Risk Factors ; Sputum* ; Tuberculosis ; Tuberculosis, Pulmonary

Calcific tendinitis of the longus colli is an inflammatory disease caused by calcium hydroxyapatite crystal deposition in the longus colli tendon of the prevertebral space. It is also known as retropharyngeal calcific tendinitis or prevertebral tendinitis. The typical imaging characteristics of this entity are calcifications on the superior insertion of the longus colli tendons at the C1-2 level and fluid collection in the retropharyngeal space. However, we introduce a case of acute longus colli tendinitis without definite calcification deposition on image findings.
Durapatite ; Tendinopathy* ; Tendons

We describe a case of congenital nephrogenic diabetes insipidus with severe dilatation of bilateral urinary tracts without anatomical obstructions. Functional obstruction can be occurred when polyuria surpasses the transporting ability of urine in the urinary tract. The patient was admitted to our hospital due to decreased mentality developed after traffic accident. On radiologic study, bilateral hydronephrosis and hydroureter were noted. Because the patient excreted copious dilute urine, we performed water deprivation test and the result was consistent with nephrogenic diabetes insipidus. We are presenting this case in an attempt to describe strong association between congenital diabetes insipidus and nonobstructive hydronephrosis in which polyuria is responsible for the hydronephrosis.
Accidents, Traffic ; Diabetes Insipidus ; Diabetes Insipidus, Nephrogenic* ; Dilatation ; Humans ; Hydronephrosis* ; Polyuria ; Urinary Tract ; Water Deprivation

There has been a mistake, claimed and confirmed by all the authors of Vol 49(4), 2011, p. 333-340 issue, that first author should have been Hyun-Du Won instead of Ahran Pae.

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

Primary omental torsion is a rare condition and its etiology and pathogenesis remain unknown. It is very difficult even for general surgeon to differentiate this from other acute abdominal diseases, and so the most common preoperative diagnosis is acute appendicitis and the treatment of choice is resection of the affected organ. The authors experienced 7 cases of primary omental torsion at Holy Family Hospital since 1990 and review them retrospectively with other literatures. We conclude that omental torsion must be tried to find if there is serosanguious fluid or undescended omentum without pathology in peritoneal cavity during the emergency operation.
Appendicitis ; Diagnosis ; Emergencies ; Humans ; Omentum ; Pathology ; Peritoneal Cavity ; Retrospective Studies

We report of a successfully treated case of fatal bronchospasm, which developed after N-acetylcysteine bolus intratracheal instillation in a 49-year-old female patient with bronchial asthma undergoing laparoscopic cholecystectomy. N-acetylcysteine has been widely used as a potent mucolytic agent since 1963, with few reported adverse reactions. Its mucolytic action is due to the breakage of disulfide bonds in mucus mucoproteins. Most adverse reactions to N-acetylcysteine are usually mild and respond to the termination of the medication and symptomatic treatment with antihistamine. However, several cases of fatal bronchospasm have been reported in asthmatic patients after inhaled or intravenous N-acetylcysteine. N-acetylcysteine induced bronchospasm could be avoided in most asthmatic patients if its concentration is not allowed to exceed 10%, and concomitant beta2-selective bronchodilators are utilized. Nevertheless, asthma is still a potent risk factor and requires special precautions, including careful risk-versus-benefit assessment, close observation and the immediate availability of resuscitation equipment and staff in the event of life-threatening bronchospasm.
Acetylcysteine* ; Asthma* ; Bronchial Spasm* ; Bronchodilator Agents ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Middle Aged ; Mucoproteins ; Mucus ; Resuscitation ; Risk Factors