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

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

Menetrier's disease is a rare, characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss, and edema due to gastric protem loss. A 64 year old male patient was admitted with the chief complaint of epigastric discomfort. Endoscopic, radiologic and histologic examination, revealed characteristic findings of Menetrier's disease. A case of Menetrier's disease is reported with a brief review of literature.
Edema ; Gastritis, Hypertrophic* ; Humans ; Male ; Middle Aged ; Stomach ; Weight Loss

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer (Zeiss Ibas 2000) using hematoxylin-eosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nu- clear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason's grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.
Adenocarcinoma ; Breast ; Fibroadenoma ; Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostatic Hyperplasia

Anterior glenohumeral instability is mainly due to the Bankart lesion and capsular stretch. The differentiation between the Bankart lesion and capsular laxity may not be readily apparent on clinical examination. So, increasing attention has been directed toward preoperative evaluation of the labral lesion and capsular laxity. MRI and MR Arthrogram of 55 shoulders, 40 stable shoulders and 15 unstable shoulders that were confirmed by arthroscopic surgery, were reviewed to evaluate the labral and capsular shapes, especially the lesions of labroligamentous complex. To evaluate and compare the capsular laxity, we measured the anterior capsular insertion type, capsular ballooning, capsular insertion angle and anterior band of inferior glenohumeral ligament. And the following results were obtained; 1) The shape of anterior labrum was varied in the superior, middle and inferior potions in 40 stable shoulders. The anterior labral lesions were shown as torn(eight cases), displaced(six cases) and no detectable labrum(one case), in 15 unstable shoulders. Also, there were a significant di fference in the evaluation of the anteior labrum shape between MRI and MR arthrography. 2) There were not a significant difference in the type III capsular insertion type, capsular ballooning and capsular insertion angle between the stable and unstable shoulders. However, it was found that the shape of the anterior band of the inferior glenohumeral ligament had definite difference between the two groups. And so, more experience and attention should be given for the accurate preoperative evaluation of the anterior labroligamentous complex in shoulder instability.
Arthrography* ; Arthroscopy ; Ligaments ; Magnetic Resonance Imaging ; Shoulder

There is a controversy in patella retention or resurfacing in total knee arthroplasty (TKA) till today. Authors studied 52 cases of 45 patients recieved total knee arthroplasty with patella retention (Group 1, twenty-five cases) or patella resurfacing (Group 2, twenty-seven cases) in patients with osteoarthritis. All operations were done by senior surgeon and the implants used were LCS type (33 cases), AMK type (12 cases), Genesis type (5 cases) and Tricon M type (2 cases). The indications of patella retention were small patella, nearly normal articular cartilage, minimal pre-operative patellofemoral pain, poor patellar bone quality and young patients. Patella retention were performed only with LCS prosthesis, which patella groove of the femoral component is deep and anatomical. The operative approaches used were medial parapatella approach in neutral or varus knee and lateral parapatella approch for severe valgus knee and tilting or lateral subluxation of the patella. The mean follow-up period was 24 months (range 12 months to 5 years). The method for clinical evaluation was Hospital for Special Surgery (HSS) knee scoring (consisted of pain, function, range of motion). The method for radiographical evaluation was Knee societys radiologic evaluation system for tibial and femoral alignment, and Keblishs method for patello-femoral congruence. The clinical HSS knee score was average 90.9 points in both groups, and 91.9 points in group 1, 90.0 points in group 2, and there was no statistically difference in HSS knee score between the two groups (P<0.05). The radiologic results had no significant difference in alignment and patello-femoral congruence between the two groups (P<0.05). But the complications were one case of patella fracture, one patella tendon rupture, one anterior instability and two cases of infection in group 2. In conclusion, the results of both groups were satisfactory. We think that it have relation to strict selection of the patients for patella retension and the use of prosthesis that the patella groove of femoral component is deep and anatomical.
Arthroplasty* ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Patella* ; Patellar Ligament ; Prostheses and Implants ; Rupture

The purpose of this study is to demonstrate the effectiveness of arthrocopic treatment for the avulsion fracture of intercondylar eminence of the tibia and of the technique of arthroscopically assisted reduction and fixation through pull-out suture method. Between January 1995 and May 1997, three patients were underwent arthroscopic reduction and suture fixation for type 0 of avulsion fracture of intercondylar eminence of tibia and were followed up. The result of two patients were graded as normal and one as nearly normal by the criteria of the International Knee Documentation Committee(IKDC) rating scale. The advantages of this technique include no retained hardware and ability to treat comminuted fracture(type g ). We describe technique of arthroscopic reduction and suture fixasion for displaced avulsion fractures, including those with comminution of intercondylar eminence of tibia.
Humans ; Knee ; Sutures* ; Tibia

No abstract available.
Animals ; Antlers* ; Lipid Peroxidation* ; Liver*

Ehlers-Danlos Syndrome(EDS) is an inherited disorder of the connective tissue disease that is usually transmitted as autosomal dominant trait. The defect in the biogenesis of collagen results in varying degree of skin hyperextensibility, joint hypermobility, skin fragility and bruising. There have been several reports of cardiac or great vessel abnormalities in patients with the EDS. A 45-year-old Woman was admitted to Maryknoll hospital because of orthopnea, palpitation and epigastric discomfort. Physical examination reveals multiple variable sized bruises and increased hyperelasticity on skin, and hypermobile joint in knee and proximal interphalanges of both hands. Mitral valvular prolapse and atrial septal defect were detected by echocardiography. We report a case of EDS accompanied by mitral valvular prolapse and ostium secundum atral septal defect with brief review of literature.
Organelle Biogenesis ; Collagen ; Connective Tissue Diseases ; Contusions ; Echocardiography ; Ehlers-Danlos Syndrome* ; Female ; Hand ; Heart Septal Defects, Atrial* ; Humans ; Joint Instability ; Joints ; Knee ; Middle Aged ; Physical Examination ; Prolapse* ; Skin