We observed the change of serum cholinesterase and clinical symptoms of acute parathion intoxication in I.C.U. of N.M.C. from 1975 Sep. to 1976 Oct. The results were as follows; 1. Serum choinesterase level of control group (55 cases) was l00. 53+/-13. 8 and range was 74~125 unit. 2. Serum cholinesterase level were reduced markedly below 10 units in 10 cases of severe parathion intoxication. 3. With adequate treatment PAM & atropine, serum cholinesteraee level rose steadly from 3 rd hospital day to 7 th hospital day and thereafter marked rising was noted remarkable improvement of respiratory symptoms. 4. In cases of low serum cholinestrsse level, sudden aggravation of general symptoms even death occurred and the symptoms & signs were correlated serum cholinesterase level.
Atropine ; Cholinesterases* ; Clinical Study* ; Parathion*

A low grade endometrial stromal sarcoma is a rare malignant tumor in woman. We experienced this infrequent malignant tumor in a 36 years old woman showing metas- tasis to both ovaries, omentum, rectum and mesenteric lymph nodes, and she was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by VAC(vincristi n, actinomycin, cyclophoshamide) chemotherapy. The authors report this case with the clinicopathologic findings and brief review of literature.
Adult ; Dactinomycin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Omentum ; Ovary ; Rectum ; Sarcoma, Endometrial Stromal*

Brunner's gland hamartomas are rare, benign duodenal tumors. But, they are the commonest hamartomas in the small intestine and believed to represent hyperplasia of Brunner's glands, perhaps in response to excessive gastric acid secretion. Brunner's gland hamartomas are usually smaller than 1cm and asymptomatic, incidental finding during endoscopy or radiographic examination. We report a case of large Brunner's gland hamartoma which prolapsed into gastric antrum and caused gastric outlet obstruction, and was resected by endoscopic polypectomy.
Brunner Glands ; Endoscopy ; Gastric Acid ; Gastric Outlet Obstruction* ; Hamartoma* ; Hyperplasia ; Incidental Findings ; Intestine, Small ; Pyloric Antrum

Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor.
Candidiasis ; Child* ; Cough ; Deglutition Disorders ; Dilatation ; Electric Impedance ; Endoscopy ; Esophageal Achalasia* ; Esophageal pH Monitoring ; Esophagus ; Failure to Thrive ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Lost to Follow-Up ; Male ; Manometry* ; Vomiting

We report a case in which routine chest roentgenograms of an 840 g infant led to the belief that the peripherally inserted central catheter (PICC) was appropriately positioned within the superior vena cava when, in actuality, it was within the azygous arch. Although many cases of pleural effusions have been reported to be caused by a central venous catheter, a right-sided hydrothorax caused by azygous vein rupture from the use of a PICC is an extremely rare complication. Sudden changes in the condition of a preterm infant with PICC should raise the suspicion of a catheter- related problem.
Azygos Vein* ; Catheterization, Central Venous ; Catheters* ; Central Venous Catheters ; Humans ; Hydrothorax* ; Infant ; Infant, Extremely Low Birth Weight* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Pleural Effusion ; Rupture ; Thorax ; Veins ; Vena Cava, Superior

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

BACKGROUND: Chlamydia trachomatis is most common sexually transmitted pathogen in the world, and a common cause of urethritis and cervicitis. Also it is common cause of preterm premature rupture of membranes and premature labor in pregnant women, and pneumonitis and conjunctivitis in neonate. A rapid and sensitive polymerase chain reaction(PCR)-based assay for detection of C. trachomatis is recently introduced. OBJECTIVES: We studied to determine whether a PCR assay is useful to detect Chlamydial infection in pregnant women. We also studied to compare its prevalence rate according to maternal age, trimester and parity, respectively. Study Design: Specimens were collected from 149 pregnant women by transcervical swab or endocervical lavage. If a specific band was detected in PCR assay, we considered as Chlamydial infection. RESULTS: In general, the positive bands were detected in the 45 of 149 pregnant women(30.2%). The positive bands were detected the 6 of 55(10.9%), 16 of 49(32.7%), and 23 of 45(51.1%) pregnant women in each trimester, respectively. Therefore, there was significantly increased according to the gestational age(p<0.05). However, there were not significantly different according to maternal age and parity(p> 0.05). CONCLUSION: We concluded that the PCR assay is a fast and useful test for the detection of C. trachomatis in transcevical cells from the pregnant women. This study suggested that Chlamydial infection seems to be increased according to the gestational age.
Chlamydia trachomatis* ; Chlamydia* ; Conjunctivitis ; Diagnosis* ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Parity ; Pneumonia ; Polymerase Chain Reaction* ; Pregnancy ; Pregnant Women* ; Prevalence ; Rupture ; Therapeutic Irrigation ; Urethritis ; Uterine Cervicitis

Metachronous double cancer of primary early esophageal squamous cell carcinoma and invasive thymoma is a very rare condition. The invasive thymoma had been detected during the myathenia gravis evaluation and treated by radiation therapy 5 years ago. The esophageal lesion had a nodular-surfaced flat elevation at the mid-esophagus that was found by esophagoscopy. Radical resection for the lesions was undertaken after histologic confirmation. Postoperative pathologic examination documented that the esophageal squamous cell carcinoma was in the "early" stage involving the mucosal and submucosal layer only. We report a case of early esophageal cancer associated with invasive thyrnoma with literatures review.
Carcinoma, Squamous Cell ; Esophageal Neoplasms* ; Esophagoscopy ; Thymoma*

No abstract available.
Acidosis, Renal Tubular* ; Lupus Erythematosus, Systemic*

Background/Aims: Periampuilary diverticulum has been known to be associated with various bilio-pancreatic diseases such as choledocholithiasis and disturbs performing selective cannuiation of ERCP and EST. This present study aims to investigate anatomical morphology of periampullary diverticulum and to determine whether periampullary diverticulurn influences difficulty and complication performing of ERCP and to analyse the relationship between periampullary diverticulum and choledocholithiasis. Methods: We reviewed records of chart and diverticular pictures in 1389 cases of underwent ERCP and evaluated the incidence, size, direction, location of periampullary diverticulum and its influence against performing of ERCP and investigated its relationship with bilio-pancreatic diseases such as choledocholithiasis.(continue..)
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Diverticulum* ; Incidence