BACKGROUND: Acute drug intoxication has recently become an important issue in the social and clinical areas. There are various complications associated with acute drug intoxication such as pneumonia, but the process is was not fully understood. The aim of this study was to analyze our cases of pneumonia associated with acute drug intoxication and to determine the associated risk factors. METHOD: Forty four cases out of 237 patients, who were acute drug intoxicated from May 2000 to Feb. 2005, were diagnosed with pneumonia at the Konyang University hospital. These cases were analyzed by a retrospective review of their medical records. RESULTS: The incidence of pneumonia in acute drug intoxication was 18.6%. There was no gender difference in terms of the incidence, but the age group with the highest incidence was in the 5th decade (22.5%) followed by the 7th decade (17.9%). Most common drug of associated with pneumonia was organophosphate insecticides, and the others were herbicides. Suicidal attempts were the most common motive of intoxication. The incidence of pneumonia was increased in old age (beta=0.128, p<0.05). A drowsy or comatous mental status was an independent risk factors of pneumonia (beta=-0.209, p=0.006). A longer hospital duration was also a risk factor for pneumonia (beta=0.361, p<0.001). The intubated state, intensive care unit care and longer duration of admission correlated with the course of pneumonia in acute drug intoxicated patients (p<0.05). The culture study revealed MRSA to be most common pathogen. CONCLUSION: The incidence of pneumonia associated with acute drug intoxication was higher in the older aged patients, those with a decreased initial mental status and a longer hospital duration. The number of days in the intensive care unit and intubation were associated prognostic factors for pneumonia in acute drug intoxication patients.
Herbicides ; Humans ; Incidence ; Insecticides ; Intensive Care Units ; Intubation ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Retrospective Studies ; Risk Factors

BACKGROUND: Acute renal failure (ARF) due to acute pyelonephritis (APN) in patients in the absence of obstructive uropathy, diabetes, or chronic renal failure was reported rarely (12 cases in the last 25 yrs in Clin Inf Dis, 1992; 243-6 by SR Jones)2). Acute renal failure is a rare complication of acute pyelonephritis in patients who do not have urinary obstruction. Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure, and when clinicians weigh the possible consequences of bacteriuria, renal failure is not considered to be a reasonable possibility. METHODS: We observed 6 patients of acute pyelonephritis associated with acute renal failure as an initial manifestation on admission in the past 6 months. The analysis of clinical features of these 6 patients (APN+) compared to 7 patients of APN without ARF (APN-) revealed following data. RESULTS: All were female in both groups. The mean age was 331.7 years in APN+ and 48+6 years in APN-, respectively (p, ns). All in both APN- and APN+ were caused by E. coli. But, none in both groups except 1 in APN- had bacteremia. The previous history of UTI was present in 5 in APN-, but none in APN+. Duration of clinical symptoms before admission (8.4+/-0.5 vs. 4.4+/-1.0 days, P<0.05) and admission days (24.2+/-1.8 vs. 11.1+/-1.5 days, p=0.000) were significantly longer in APN+. On admission, HUN and serum creatinine was 45+/-2.7mg/dL and 3.5+/-0.2mg/dL in APN+, respectively. No one in APN+ required dialysis, and subsequently recovered renal function with prompt antibiotic therapy resulting in no significant difference compared to that of APN on discharge (serum creatinine, 1.0+/-0.1 vs. 0.9+/-0.1mg/dL). No differences in leukocytosis and serum electrolyte levels on admission were present. However, significant anemia was noted in APN+ (hemoglobin, 9.0+/-0.7 vs. 11.9+/-0.2gm/dL). The days of fever and leukocytosis before disappearance were not different in both groups, but those of flank pain (12.8+/-1.5 vs. 5.7+/-0.7 days, P=0.001) and pyuria (16+/-1.9 vs. 6.4+/-0.6 days, P=0.000) significantly longer in APN+. Upon ultrasonography, all in APN+ showed enhanced echogenicity, but I in APN . (P=P value, NS=not significant) CONCLUSION: Upon these data, we concluded that ARF associated with APN as an initial manifestation was accompanied by several distinct clinical characteristics, which could be used for the early recognition of its unusual occurrence and subsequent appropriate management including antibiotics leading to a favorable outcome.
Acute Kidney Injury* ; Adult ; Anemia ; Anti-Bacterial Agents ; Bacteremia ; Bacteriuria ; Creatinine ; Diagnosis, Differential ; Dialysis ; Female ; Fever ; Flank Pain ; Humans ; Kidney Failure, Chronic ; Leukocytosis ; Pyelonephritis* ; Pyuria ; Renal Insufficiency ; Ultrasonography ; Urinary Tract Infections

No abstract available.
Bronchoscopy ; Tuberculosis

PURPOSE: The aim of this study was to examine the volume differences of human brain 3-D MR images obtained by automatic segmentation methods depending on brain templates and image acquisition conditions, respectively. MATERIALS AND METHODS: 3D T1-weighted MR images oriented in coronal and sagittal plane were acquired from eight healthy subjects (29.5+/-5.66 years) using two identical 3T MR scanners at different sites. Caucasian brain template and Korean elderly brain template were applied for the same subject to segment brain structural region. Volumetric differences and variation of gray matter, white matter and hippocampus depending on scan orientations and brain template types were statistically evaluated. RESULTS: Volumetric measurements have some different results for the same subject images depending on scan orientation in identical MR scanners but not significantly. However, all segmented volumes relied upon brain templates were significantly different (p<0.05). Small variation of the volume in gray matter, white matter (coefficient of variation, CV< or =1%) and hippocampus (CV< or =3%) were obtained. Comparing the mean CV in all segmented regions, variation of scan orientation was not significantly different with inter scanner variation but variation relied upon brain templates were significantly different (p<0.001). CONCLUSION: Authors found that brain template regarding the specific properties of the subjects is required to reduce the errors of brain volumetry.
Aged ; Brain ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Orientation

PURPOSE: During the past decade, various endoscopic thyroid surgeries have been conducted, each with its own benefits. The incorporation of robotic systems to endoscopic thyroid surgery has improved the visualization and precision of endoscopic techniques. We previously reported our initial experience with robotic modified radical neck dissection (MRND) of papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM). The aim of this study was to compare surgical outcomes of robotic vs. conventional open MRND of PTC with LNM using propensity score matching. METHODS: From January 2008 to February 2011, 515 patients with PTC with LNM were enrolled. One hundred patients underwent robotic MRND, and 415 patients underwent conventional open MRND. These two groups were retrospectively compared with respect to their clinicopathological characteristics, surgical outcomes, and surgical completeness. Furthermore, to avoid selection bias, propensity score matching analysis was used to compare surgical outcomes of each group without any compounding factors. RESULTS: The operative time for the robotic MRND was longer than for the open MRND (297.9±60.2 min vs. 212.1±55.6 min, P=0.089). However, the mean numbers of retrieved lymph nodes and mean hospital stay after surgery were similar in the two groups (36.0±12.9 vs. 40.8±13.3, P=0.235), (6.1±1.6 days vs. 6.1±2.1 days, P=0.577). The complication rates were similar between the two groups, and there was no statistical difference in postoperative thyroglobulin levels between groups (0.51±0.83 ng/ml vs. 0.89±2.46 ng/ml, P=0.593). CONCLUSION: According to our study, robotic MRND shows similar surgical outcomes to conventional open MRND after case-matched analyses. We suggest that robotic MRND is an acceptable alternative as an operative method for PTC with LNM, resulting in excellent cosmesis and patient satisfaction.
Humans ; Length of Stay ; Lymph Nodes ; Methods ; Neck Dissection ; Neck* ; Neoplasm Metastasis* ; Operative Time ; Patient Satisfaction ; Propensity Score* ; Retrospective Studies ; Selection Bias ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

Background: This study aimed to investigate the incidence and clinical significance of segmental chromosomal aberrations (SCAs) in Korean patients with neuroblastoma. Methods: Patients diagnosed with neuroblastoma from 2012 to 2018 were included for retrospective review. Fluorescence in situ hybridization (FISH) was used to analyze four SCAs (MYCN amplification, 1p deletion, 11q deletion, and 17q gain). Clinical characteristics at diagnosis, early tumor response (reduction in primary tumor volume and neuron-specific enolase level after the first three cycles of chemotherapy), and survival rates were compared according to SCAs. Results: Among 173 patients with FISH results, 92 (53.2%) had at least one of the four SCAs, while 25 (14.5%) had two co-aberrations, and eight (4.6%) had three co-aberrations. SCAs detected in our study were MYCN amplification (n = 17, 9.8%), 1p deletion (n = 26, 15.2%), 11q deletion (n = 44, 25.6%), and 17q gain (n = 46, 27.1%). Patients with MYCN amplification showed a better early response but a worse survival than those without (5-year overall survival: 46.2% ± 13.1% vs. 88.6% ± 3.4%). Furthermore, 1p deletion was associated with a better early response but a worse survival; however, it was not an independent factor for survival. We could not find any prognostic significance associated with 11q deletion or 17q gain. Conclusion This is the first study investigating SCAs in Korean neuroblastoma patients. Prognostic significance of SCAs other than MYCN amplification was different from those reported in western countries. Further study with a larger cohort and longer follow-up is needed to confirm our findings.

A 62-year-old man with a chronic cough presented with atelectasis of the left upper lobe on chest X-ray. Chest computed tomography showed an atelectasis in the left upper lobe with bronchial wall thickening, stenosis, dilatation, and mucoid impaction. We performed bronchoscopy and found a well-circumscribed mass on the left upper lobe bronchus. The mass was removed by flexible bronchoscopy using an electrosurgical snare and diagnosed with lipoma. An endobronchial lipoma is a rare benign tumor that can be treated by a surgical or endoscopic approach. We report the successful removal of endobronchial lipoma via flexible bronchoscopic electrosurgical snare.
Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Cough ; Dilatation ; Electrocoagulation ; Lipoma ; Pulmonary Atelectasis ; SNARE Proteins ; Thorax

Tuberous sclerosis is an autosomal dominant disorder characterized by facial skin lesions, epilepsy, and mental retardation. Pulmonary involvement in tuberous sclerosis is rare and shows characteristic reticulonodular infiltration and cystic changes. Lymphangioleiomyomatosis is characterized by the progressive proliferation of smooth muscle cells and occurs in 0.1-1% of patients with tuberous sclerosis. We encountered a case of pulmonary lymphangioleiomyomatosis associated with tuberous sclerosis and bilateral renal angiomyolipoma in a 31-year-old female patient. This case is reported here along with a brief review of the literature.
Adult ; Angiomyolipoma ; Epilepsy ; Female ; Humans ; Intellectual Disability ; Lymphangioleiomyomatosis ; Myocytes, Smooth Muscle ; Skin ; Tuberous Sclerosis

Tuberous sclerosis is an autosomal dominant disorder characterized by facial skin lesions, epilepsy, and mental retardation. Pulmonary involvement in tuberous sclerosis is rare and shows characteristic reticulonodular infiltration and cystic changes. Lymphangioleiomyomatosis is characterized by the progressive proliferation of smooth muscle cells and occurs in 0.1-1% of patients with tuberous sclerosis. We encountered a case of pulmonary lymphangioleiomyomatosis associated with tuberous sclerosis and bilateral renal angiomyolipoma in a 31-year-old female patient. This case is reported here along with a brief review of the literature.
Adult ; Angiomyolipoma ; Epilepsy ; Female ; Humans ; Intellectual Disability ; Lymphangioleiomyomatosis ; Myocytes, Smooth Muscle ; Skin ; Tuberous Sclerosis

A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.
Adenocarcinoma* ; Biopsy ; Constriction ; Diagnosis, Differential ; Epidermal Growth Factor* ; Female ; Genetic Testing ; Humans ; Lung Neoplasms ; Lung* ; Middle Aged ; Radiography, Thoracic ; Receptor, Epidermal Growth Factor* ; Sequence Analysis, DNA ; Thorax