Syndrome of inappropriate antidiuretic hormone secretion (SIADH), the most common cause of euvolemic hyponatremia, results from the inappropriate release of antidiuretic hormone. SIADH may be caused by a variety of malignant tumors, central nervous system (CNS) disorders, intrathoracic disorders, and pharmacological agents. We experienced a case of SIADH associated with sarcoidosis that involved the lungs and mediastinal lymph nodes. A 72-year-old male was admitted to hospital with epigastric and back pain. Laboratory tests showed hyponatremia and low serum osmolality, while the urine sodium concentration and urine osmolality were inappropriately high. A chest x-ray and computed tomography showed mediastinal lymph node enlargement, and a mediastinoscopic lymph node biopsy revealed a noncaseating granuloma. Brain magnetic resonance imaging showed no evidence of CNS sarcoidosis. Systemic corticosteroid therapy improved the observed mediastinal lymph node involvement, and tolvaptan as an SIADH treatment corrected the patient's abnormal sodium level and restored the laboratory findings to normal.
Aged ; Back Pain ; Biopsy ; Brain ; Central Nervous System Neoplasms ; Granuloma ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Male ; Osmolar Concentration ; Sarcoidosis ; Sodium ; Thorax

OBJECTIVES: We evaluated the effect of the aircraft noise on the behavior and affect status of the local elementary school students. METHODS: The daytime noise levels of the exposed and control areas were compared and the self answered questionnaires from 272 students and their parents of the exposed area and 91 of the control area were collected. The questionnaires are regarding the noise sensitivity and the psychosocial status of the students, noise sensitivity of the parents and the parents' behavioral evaluation for their children. RESULTS: The mean noise level of the exposed area (67.6 dB(A)) showed higher level than the control area (57.1 dB(A), 58.2 dB(A), 60.2 dB(A)) and it was statistically significant. The mean score for noise sensitivity and the mean score for brief mental exam. in the exposed students were lower than the mean scores in the control group but they were not statistically significant (p=0.056 & 0.165). The mean score for behavioral evaluation of students by their parents in the exposed area(15.5) was higher than the mean score in the control group(13.2) and it was statistically significant(p=0.043). The mean score for noise sensitivity in the exposed parent(27.5) was higher than the mean score in the control group(24.1) and it was statistically significant(p=0.045). CONCLUSIONS: This study revealed that the noise sensitivity of the parents affected the behavioral evaluation of the students than noise-exposure itself. The further study is needed to evaluate relationship between aircraft noise and it's effect on children's health.
Aircraft ; Child ; Humans ; Noise ; Parents ; Surveys and Questionnaires