No abstract available.
Animals ; Mucous Membrane* ; Rats*

Influenza virus culture was performed in 149 patients with influenza-like illness who were admitted or visited to the Department of Pediatrics, Asan Medical Center from january, 1991 to March, 1991. The results were as follows; 1) Of the 149 patients, influenza virus were isolated in the 15 cases. 15 isolates were characterized by the WHO Collaborating Center for influenza: 7 cases were very similar to influenza A/Taiwan/1/86 (H1N1), 1 case was A/Beijing/353/89 (H3N2), 7 cases were B/Guangdon-g/55/89. 2) The age of 15 patients who were confirmed by viral isolation was between 11 months to 10 years. 3) The most common clinical symptoms were fever, vomiting, cough, nausea in deceasing order. 4) Of the total 149 patients, Reye syndrome occured in two patients and myositis occured in one: Influenza A/Taiwan/1/86 (H1N1) virus was isolated in one Reye syndrome patient.
Chungcheongnam-do ; Cough ; Fever ; Humans ; Influenza, Human* ; Myositis ; Nausea ; Orthomyxoviridae ; Pediatrics ; Reye Syndrome ; Seoul* ; Vomiting

To validate ventricular diastolic phase parameters of reconstructed transmitral flow rate curve by M-mode, 2-dimensional and pulsed Doppler Echocardiography, these parameters were compared with same parameters by left ventriculography. The study population was 22 patients who received both coronary arteriography and echocardiographic examination. Transmitral flow rate curve and left ventricular filling volume curve were reconstructed from transmitral flow velocity curve by pulsed Doppler, mitral annulus diameter by two diameter by two dimensional and diastolic motion of both mitral leafltes by M-mode echocardiography. From left ventriculography, left ventricular filling volume curve and transmitral flow rate curve were made using area-length method by Sandler and Dodge. From trasmitral flow fraction, 1/2 diastolic time filling fraction, normalized peak filling volume, 1/3 diastolic time filling fraction, 1/2 diastolic time fraction, normalized peak early filling rate and ratio of early to late peak filling rate were measured. Correlation between same parameters derived from echocardiography and left ventriculography were observed. 1) Total diastolic filling volume:correlation coefficient r=0.47, P<0.05. 2) 1/3 diastolic time filling fraction:correlation coefficient r=0.90, P<0.001. 3) 1/2 diastolic time filling fraction:correlation coefficient r=0.80, P<0.001. 4) Normalized peak early filling rate:correlation coefficient r=0.57, P<0.01. 5) Ratio of early to late peak filling rate:correlation coefficient r=0.85, P<0.001. Therefore, left ventricular diastolic phase parameters of reconstructed transmitral flow rate curve using, M-mode, 2-dimensional and pulsed Doppler echocardiography seems to be useful for the noninvasive evaluation of the left ventricular diastolic function.
Angiography ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Humans

Primary mucosa-associated with a lymphoid tissue (MALT) lymphoma is a rare distinct subtype of non-Hodgkin’s lymphoma that occurs in approximately 8% of all non-Hodgkin lymphomas. Primary gastrointestinal MALT lymphoma usually occurs in the stomach, but duodenal involvement is extremely rare. Therefore, the clinical manifestations, treatment, and prognosis of primary duodenal MALT lymphoma have not yet been validated because of its rarity. This paper reports a case of a 40-year-old male with primary duodenal MALT lymphoma who was treated successfully with radiation therapy alone. A 40-year-old male visited for a medical check-up.Esophagogastroduodenoscopy revealed whitish multi-nodular mucosal lesions in the second and third portions of the duodenum. Biopsy specimens from mucosal lesions in the duodenum were reported to be suspicious for MALT lymphoma of the duodenum. He received a total dose of 3,000 cGy in 15 fractions with external beam radiation therapy for three weeks. Three months after radiation therapy, an endoscopic examination revealed complete resolution of the duodenal lesions. The follow-up 12 months after radiation therapy showed no evidence of tumor recurrence.

Fulminant myocarditis is characterized by critical illness at presentation. However, if affected patients recover with pharmacologic therapy and mechanical circulatory support, they may have a better long-term prognosis than patients with other forms of myocarditis. A 31-year-old man was admitted due to chest pain associated with dyspnea. Electrocardiogram showed ST-segment elevation in all leads except for aVR and aVL. Non-sustained ventricular tachycardia developed 12 hours after admission. The echocardiography showed diffuse hypokinesia, concentric edematous thickening of the left ventricular wall, and pericardial effusion. Serum cardiac enzymes and absolute eosinophil count were elevated. Since the ELISA (Enzyme-Linked Immunosorbent Assay) against Paragonimus westermani was positive, the patient was treated with praziquantel for 2 days. Eosinophil count normalized after 10 days, with conversion to negativity on ELISA after 4 weeks. We concluded that his myocarditis was probably caused by allergic reaction secondary to Paragonimus westermani infection.
Adult ; Chest Pain ; Critical Illness ; Dyspnea ; Echocardiography ; Electrocardiography ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Hypersensitivity ; Hypokinesia ; Myocarditis ; Paragonimiasis ; Paragonimus westermani ; Pericardial Effusion ; Praziquantel ; Prognosis ; Tachycardia, Ventricular

OBJECTIVES: It was recently reported that the administration of T4 during antithyroid drug(ATD) therapy resulted in a significant decrease of antibodies to TSH receptors as well as the rate of recurrence of active Graves' disease following discontinuance of ATD treatment. But, there is still controversy whether combination therapy is efficient. Therefore, the present study was undertaken to evaluate the effect of T4 administration of patient with Graves' disease who were being treated with ATD. METHODS: We studied 56 patients received methimazole(MMI) alone(Group 1) and 48 patients received methimazole plus T4(Group 2), They are diagnosed active Graves' disease at department of internal medicine, Kwang ju Christian Hospital from January, 1994 to December, 1995. All the patients were treated initially with 30mg of methimazole daily for one month after then, in the Group 1(methimazole alone), the dose of methimazole was adjusted as necessary to achieve normal serum concentrations of T3, T4, and TSH. The patients of Group 2(methimazole plus T4) continue to receive the combination of T4 at a dose of 100 microgram daily. Simultaneously, we estimated the serum concentration of T3, T4, TSH and Thyroid-stimulating immunoglobulin(TSI) antibody at every three months. RESULTS: We obtained the following result. In the group 1, mean TSI values were 50.1%(first visit), 30.6%(6months), and 24.7%(1year). And, in the group 2 mean TSI values were 51.8%(first visit), 33.6%(6months), and 22.7% (1year). After 6 months of discontinuing of therapy, the recurrence rate was no significant difference in the two groups (the recurrence rate were 55.4%, 50.0%, respectively P>0.05). CONCLUSION: These results suggest that T4 administration in combination with MMI therapy have no significant effect in a decrease in levels of TSH receptors antibodies and recurrence rate within 6 months discontinuing MMI therapy as compared with MMI treatment alone.
Antibodies ; Graves Disease* ; Gwangju ; Humans ; Internal Medicine ; Methimazole ; Receptors, Thyrotropin ; Recurrence ; Thyroxine*

To evaluate the effect and untoward reaction of "Isocal(Mead-Johnson B.V., Netherlands), lactose free polymeric enteral nutrient, 32 surgical or malnourished patients were selected. The nutritional parameters and indices after feeding of Isocal were compared to the pretreatment states. Routes of intake were oral(N=17) or nasoduodenal tube feeding(N=15). The average duration of treatment were 14.3 days(8 to 30 days). Among the 6 trial failures, 4 cases were directly related with Isocal feeding, such as intolerable diarrhea(N=3), and abdominal pain with partial ileus of recurrent stomach cancer(N=1). Transient diarrheas were in 3 cases. All of the cases with diarrhea were in oral feeding group. Nutritional parameters such as anthropometric scales and serum albumin showed progressive improving tendencies after Isocal, and transferrin(p=0.017) and total lymphocyte counts(TLC, p=0.057) in transitional feeding group revealed significant improvements. Nitrogen balance improved within the first week(p=0.000) of feeding. The Instant Nutritional Score(INS) of 9 cases got better, but 3 became worse, which includes 2 cases of terminal recurrent cancers. CPK revealed a significant drop(p=0.021) in one week. Blood chemical parameters didn't show any untoward changes during the periods. In conclusion, Isocal, via oral as well as nasoduodenal tube feeding, was an effective and useful enteral nutrient with acceptable side effects. Nasoduodenal tube feeding was preferable to avoid unwanted diarrhea. Transferrin, TLC, nitrogen balance, INS and CPK were reliable nutritional parameters even in two weeks' short period of clinical study.
Abdominal Pain ; Diarrhea ; Enteral Nutrition* ; Humans ; Ileus ; Lactose ; Lymphocytes ; Nitrogen ; Polymers ; Serum Albumin ; Stomach ; Transferrin ; Weights and Measures

A 39-year-old woman with aplastic anemia suffered from progressive visual disturbance and headache. Funduscopic examination revealed pronounced bilateral papilledema. Lumbar puncture disclosed an elevated opening CSF pressure with normal biochemical and cellular findings. Brain MRI was normal. After transfusion of blood products, papilledema and her symptoms were improved. We conclude that the development of pseudotumor cerebri is related to aplastic anemia resulting from bone marrow failure.
Adult ; Anemia, Aplastic* ; Bone Marrow ; Brain ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Papilledema ; Pseudotumor Cerebri* ; Spinal Puncture

BACKGROUND/AIMS: The buttonhole technique, in which needle insertion during cannulation is always into the same site, confers advantages including ease of cannulation, ease of achieving hemostasis, and reduced pain compared with rope-ladder needling. We introduced the buttonhole technique in hemodialysis patients experiencing pain during needling. None of the disadvantages associated with the buttonhole technique, such as infection or access events, were observed, due to the short duration of the study. METHODS: Patients undergoing buttonhole needling were observed prospectively. Data were collected on the following parameters: infectious complications, hospitalizations and access events. We compared buttonhole and rope-ladder needling using baseline data. RESULTS: A total of 48 patients (34 males; mean age = 49.4 +/- 13.8 years) were enrolled. Seven patients were excluded: in three patients, the buttonhole technique failed to form a tract, three others underwent kidney transplantation, and one was lost to follow-up. The remaining 41 patients were followed for 15.7 +/- 4.7 months. Thirteen patients suffered infections, as follows: local infections (n = 5), pneumonia (n = 3), bacteremia (n = 2), cellulitis (n = 1), osteomyelitis (n = 1), and liver abscess (n = 1). There were no significant differences between the rope-ladder and buttonhole needling techniques in rates of infection, hospitalization or vascular access events. CONCLUSIONS: The infection rate and access event frequency associated with buttonhole needling did not differ in relation to that of rope-ladder needling.
Arteriovenous Fistula ; Bacteremia ; Catheterization ; Cellulitis ; Hemostasis ; Hospitalization ; Humans ; Kidney Transplantation ; Liver Abscess ; Lost to Follow-Up ; Male ; Needles ; Osteomyelitis ; Pneumonia ; Prospective Studies ; Renal Dialysis*

BACKGROUND/AIMS: The buttonhole technique, in which needle insertion during cannulation is always into the same site, confers advantages including ease of cannulation, ease of achieving hemostasis, and reduced pain compared with rope-ladder needling. We introduced the buttonhole technique in hemodialysis patients experiencing pain during needling. None of the disadvantages associated with the buttonhole technique, such as infection or access events, were observed, due to the short duration of the study. METHODS: Patients undergoing buttonhole needling were observed prospectively. Data were collected on the following parameters: infectious complications, hospitalizations and access events. We compared buttonhole and rope-ladder needling using baseline data. RESULTS: A total of 48 patients (34 males; mean age = 49.4 +/- 13.8 years) were enrolled. Seven patients were excluded: in three patients, the buttonhole technique failed to form a tract, three others underwent kidney transplantation, and one was lost to follow-up. The remaining 41 patients were followed for 15.7 +/- 4.7 months. Thirteen patients suffered infections, as follows: local infections (n = 5), pneumonia (n = 3), bacteremia (n = 2), cellulitis (n = 1), osteomyelitis (n = 1), and liver abscess (n = 1). There were no significant differences between the rope-ladder and buttonhole needling techniques in rates of infection, hospitalization or vascular access events. CONCLUSIONS: The infection rate and access event frequency associated with buttonhole needling did not differ in relation to that of rope-ladder needling.
Arteriovenous Fistula ; Bacteremia ; Catheterization ; Cellulitis ; Hemostasis ; Hospitalization ; Humans ; Kidney Transplantation ; Liver Abscess ; Lost to Follow-Up ; Male ; Needles ; Osteomyelitis ; Pneumonia ; Prospective Studies ; Renal Dialysis*