The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.
Aged ; Auscultation ; Blood Pressure ; Body Temperature ; Carbon Monoxide ; Consciousness ; Dyspnea ; Eating* ; Emergencies ; Emergency Service, Hospital ; Esophagus ; Heart Rate ; Humans ; Inhalation ; Intensive Care Units ; Lung ; Male ; Methylene Chloride* ; Mouth ; Oxygen ; Paint ; Pulmonary Edema ; Pulmonary Fibrosis ; Pupil ; Rehabilitation ; Respiratory Distress Syndrome, Adult ; Respiratory Rate ; Respiratory Sounds ; Stomach ; Stupor ; Thorax ; Ulcer ; Ventilators, Mechanical ; Workplace

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

No abstract available.
Head* ; Orthognathic Surgery* ; Posture* ; Prognathism*

No abstract available.
Lipopolysaccharides* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis*

No abstract available.
Knee* ; Ligaments*

The effect of topically instilled autologous serum on the heang of endothelium and change of aqueous chemical properties following alkali wounds were evaluated, New Zealand white rabbits, weighing 2.5kg. total of 64(64 eyes), were used in this experiment, Standardized corneal alkali wounds were produced by applying a round filter paper of 5.5mm in diameter, soaked in 1N NaOH, to the central cornea for 60 seconds. Autologous serum in the treated group and balanced salt solution(BBS) in the control group were given 4 times per day for 3 week. Endothelial defect areas and the concentrations of ascorbic acid, glucose and minerals in the aqueous humor were measured. Endothelial defect area was not significantly different between autologous serum-treated and control groups. The concentrations of ascorbic acid in the aqueous humor were significantly increased n the autologous serum-treated groups compared to the control groups. However, the concentrations of glucose, Na+, K+, Ca++ and Mg++ in the aqueous humor were not statistically different between two groups
Alkalies* ; Aqueous Humor ; Ascorbic Acid ; Cornea ; Endothelium ; Glucose ; Minerals ; Rabbits ; Wounds and Injuries*

PURPOSE: Hashimoto's thyroiditis is the most common cause of thyroid disease in children and adolescents. It shows a wide spectrum of thyroid functions, ranging from hypothyroidism to hyperthyroidism, with variable clinical course. This study was undertaken to investigate the clinical course and outcome of Hashimoto's thyroiditis with long-term follow-up in children and adolescents. METHODS: We analyzed retrospectively clinical data in 85 girls diagnosed as Hashimoto's thyroiditis in the pediatric endocrinology clinic at Asan Medical Center from January 1996 to June 2006. Of 24 patients, who had been followed up for more than five years, we investigated age at diagnosis, family history, initial thyroid function, initial thyroid autoantibody titers, changes of thyroid function, and changes of positivity rate of thyroid autoantibody. RESULTS: The mean age at diagnosis was 10.9+/-2.6 years. Goiter was found in about 95% of patients, whereas 5 patients presented with short stature. Positive family history of autoimmune thyroid disease was documented in 27 out of 85 patients (31.8%). At diagnosis, 34 of 85 patients (40.0%) were in euthyroidal status, 43 (50.7%) in overt or compensated hypothyroidism, and 8 (9.4%) in hyperthyroidism. Among the 24 patients followed up for more than five years, 7 patients were in euthyroidal status, 16 in overt or compensated hypothyroidism, and 1 in hyperthyroidism at initial presentation. Four patients initially diagnosed with euthyroidism remained in euthyroidal status, while 7 patients with hypothyroidism were shifted to euthyroidism. Overall, 15 out of 24 patients were in remission status at the last follow-up. Initial TSH level was significantly higher in non-remission group (P=0.016). Initial thyroid autoantibody titers were not correlated with remission rate. CONCLUSION: The clinical course of children and adolescents with Hashimoto's thyroiditis varied widely. After more than five years follow-up, 62.5% of patients remained or became euthyroid. Initial TSH level can be a prognostic factor of Hashimoto's thyroiditis.
Adolescent ; Child ; Endocrinology ; Follow-Up Studies ; Goiter ; Humans ; Hyperthyroidism ; Hypothyroidism ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

BACKGROUND:Acute vestibular neuronitis is the disease of which the etiology and pathophysiology are largely unknown . But the viral infection and ischemia of the labyrinth and the vestibular nerve are considered as general etiology. This study was performed to support the viral infection rather than the ischemic theory. MATERIALS & METHODS:We studied seventy years old female patient who showed painful vesicles on left auricle and vertigo with spontaneous nystagmus to the right side. We performed physical examination, serologic test, ENG test, pure tone audiogram, brain magnetic resonance imaging and polymerase chain reaction. RESULTS:We found small vesicles and vascular injection in left EAC, herpes zoster IgG positive, spontaneous right beating in electronystagmograpy, 54% left canal paresis in Caloric test , decreasing left side Tc in velocity step rotatory test, decresed gain, deviation to left in symmetry and phase lead in sinusoidal harmonic acceleration test, normal range hearing in pure tone audiogram, microangiopathy on cortex in brain MRI and negative PCR. CONCLUSION:This case supports viral infection etiology rather than ischemia in vestibular neuritis. But more studies to find the etiology of vestibular neuronitis are required.
Acceleration ; Brain ; Caloric Tests ; Ear, Inner ; Female ; Hearing ; Herpes Zoster ; Herpes Zoster Oticus ; Humans ; Immunoglobulin G ; Ischemia ; Magnetic Resonance Imaging ; Paresis ; Physical Examination ; Polymerase Chain Reaction ; Reference Values ; Serologic Tests ; Vertigo ; Vestibular Nerve ; Vestibular Neuronitis

In this study, the feasibility of identification and genotypic differentiation of enteroviruses was investigated by using nested reverse transcription-polymerase chain reaction (nested RT-PCR), single-stranded conformation polymorphism (SSCP), and restriction fragment length polymorphism (RFLP) techniques. Two hundred seventy-four clinical samples were assayed by both nested RT-PCR and tube culture method using MRC-5 and MK cells; 58 (86.6%) out of 67 enterovirus culture-positive samples contained enteroviral RNA. In addition, 114 (55.1%) of 207 samples from patients with suspected enteroviral CNS disease with negative viral cultures were positive by the nested RT-PCR. The nested RT-PCR products were genotyped by the SSCP method and the results were compared with serotypes. We could differentiate 6 subtypes, 3 of which are similar to coxsackievirus B3, B5, echovirus 11, plus 3 other subtypes. RFLP cleaved with Sty I, Bgl I, and Xmn I yielded characteristic patterns for each laboratory strains. This study demonstrates the usefulness of the RT-PCR for the rapid diagnosis of enterovirus infection and the potentials of the SSCP method for differentiation of enterovirus strains.
Central Nervous System Diseases ; Diagnosis ; Enterovirus B, Human ; Enterovirus Infections ; Enterovirus* ; Genotype* ; Humans ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single-Stranded Conformational ; RNA

PURPOSE: The purpose of the study is to develop education programs for improving medical school students' medical communication ability, and to provide basic information to help develop and operate medical communication education programs by analyzing the education programs and students satisfaction from the education effects. METHODS: The method was to survey 116 sophomores in C medical school in 2014 in order to research students' demands for the medical communication education, level differences of communication between before and after of the education, and students' satisfaction from the education program. Analysis of frequency, paired samples t-test, descriptive statistic analysis were used for the research. RESULTS: There were not only many students who did not get general communication educations before admission, but also many students who said they need medical communication education. On the whole, students' abilities of communication were improved. Building relationship, information gathering, sharing information, understanding one's perspectives factors was improved meaningfully in the statistics. However opening relationship, reach agreement, and providing closure were not improved meaningfully in the statistics. On the whole, the students were satisfied from the education programs. CONCLUSION: To develop education programs for medical communication ability, we need to construct the objectives of education and contents by researching students' demands and level of learning in communication area. Moreover we have to design curriculum to maintain the education effects consistently.
Communication ; Curriculum ; Education ; Education, Medical ; Health Communication ; Humans ; Learning ; Schools, Medical*