Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
Acid-Base Equilibrium ; Acidosis* ; Aged* ; Coma ; Female ; Humans ; Isoniazid* ; Parents ; Pyridoxine ; Seizures*

We report oliguric mannitol-induced acute kidney injury (AKI) early treated by continuous renal replacement therapy. A 70-year-old woman was admitted to the Department of Neurology with diagnosis of acute intracranial hemorrhage. Mannitol was infused for intracranial pressure control. At admission third day, urine output was abruptly decreased to 57 ml during first 6 hours and blood urea nitrogen (BUN) and serum creatinine was increased to 54.2 mg/dL and 5.3 mg/dL respectively. Plasma osmolality was 340 mOsm/kg and osmolar gap was 70. Mannitol was immediately withdrawn and continuous renal replacement therapy (CRRT) was performed to remove mannitol rapidly. Urine output was increased 6 hours later after continuous veno-veno hemodiafiltration (CVVHDF) start. BUN and creatinine was decreased to 21.4 and 1.2 mg/dL at admission ninth day. Mannitol can develop oliguric AKI and CRRT may be of more benefit than conventional hemodialysis in the case of increased intracranial pressure.
Acute Kidney Injury* ; Aged ; Blood Urea Nitrogen ; Creatinine ; Diagnosis ; Female ; Hemodiafiltration ; Humans ; Intracranial Hemorrhages ; Intracranial Pressure ; Mannitol* ; Neurology ; Oliguria ; Osmolar Concentration ; Plasma ; Renal Dialysis ; Renal Replacement Therapy*

BACKGROUND: Composite grafts are frequently used for facial reconstruction. However, the unpredictability of the results and difficulties with large defects are disadvantages. Adipose-derived stem cells (ADSCs) express several cytokines, and increase the survival of random flaps and fat grafts owing to their angiogenic potential. METHODS: This study investigated composite graft survival after ADSC injection. Circular chondrocutaneous composite tissues, 2 cm in diameter, from 15 New Zealand white rabbits were used. Thirty ears were randomly divided into 3 groups. In the experimental groups (1 and 2), ADSCs were subcutaneously injected 7 days and immediately before the operation, respectively. Similarly, phosphate-buffered saline was injected in the control group just before surgery in the same manner as in group 2. In all groups, chondrocutaneous composite tissue was elevated, rotated 90 degrees, and repaired in its original position. Skin flow was assessed using laser Doppler 1, 3, 6, 9, and 12 days after surgery. At 1 and 12 days after surgery, the viable area was assessed using digital photography; the rabbits were euthanized, and immunohistochemical staining for CD31 was performed to assess neovascularization. RESULTS: The survival of composite grafts increased significantly with the injection of ADSCs (P<0.05). ADSC injection significantly improved neovascularization based on anti-CD31 immunohistochemical analysis and vascular endothelial growth factor expression (P<0.05) in both group 1 and group 2 compared to the control group. No statistically significant differences in graft survival, anti-CD31 neovascularization, or microcirculation were found between groups 1 and 2. CONCLUSIONS: Treatment with ADSCs improved the composite graft survival, as confirmed by the survival area and histological evaluation. The differences according to the injection timing were not significant.
Adult Stem Cells ; Cytokines ; Ear* ; Graft Survival ; Humans* ; Microcirculation ; Photography ; Rabbits ; Skin ; Stem Cell Transplantation ; Stem Cells* ; Transplants* ; Vascular Endothelial Growth Factor A

BACKGROUND: Composite grafts are frequently used for facial reconstruction. However, the unpredictability of the results and difficulties with large defects are disadvantages. Adipose-derived stem cells (ADSCs) express several cytokines, and increase the survival of random flaps and fat grafts owing to their angiogenic potential. METHODS: This study investigated composite graft survival after ADSC injection. Circular chondrocutaneous composite tissues, 2 cm in diameter, from 15 New Zealand white rabbits were used. Thirty ears were randomly divided into 3 groups. In the experimental groups (1 and 2), ADSCs were subcutaneously injected 7 days and immediately before the operation, respectively. Similarly, phosphate-buffered saline was injected in the control group just before surgery in the same manner as in group 2. In all groups, chondrocutaneous composite tissue was elevated, rotated 90 degrees, and repaired in its original position. Skin flow was assessed using laser Doppler 1, 3, 6, 9, and 12 days after surgery. At 1 and 12 days after surgery, the viable area was assessed using digital photography; the rabbits were euthanized, and immunohistochemical staining for CD31 was performed to assess neovascularization. RESULTS: The survival of composite grafts increased significantly with the injection of ADSCs (P<0.05). ADSC injection significantly improved neovascularization based on anti-CD31 immunohistochemical analysis and vascular endothelial growth factor expression (P<0.05) in both group 1 and group 2 compared to the control group. No statistically significant differences in graft survival, anti-CD31 neovascularization, or microcirculation were found between groups 1 and 2. CONCLUSIONS: Treatment with ADSCs improved the composite graft survival, as confirmed by the survival area and histological evaluation. The differences according to the injection timing were not significant.
Adult Stem Cells ; Cytokines ; Ear* ; Graft Survival ; Humans* ; Microcirculation ; Photography ; Rabbits ; Skin ; Stem Cell Transplantation ; Stem Cells* ; Transplants* ; Vascular Endothelial Growth Factor A

BACKGROUND: Ski injuries depend on many factors which involve the skier's skill, the skiing environment, and skier's equipment. The purpose of this study was to determine the factors associated with fractures by skiing accident. SUBJECT: We evaluated 566 patients with ski injuries who visited to the emergency post located in the YongPyong Ski Resorts from Nov. 1996 to Feb. 1997. Among the patients,379 patients had no fracture(group I) and 187 patients had fracture(group II). RESULT: There was no differences in mean age and sex ratio between two groups. Fractures of the lower extremities were more common than the upper extremities. Slipping was the most common injury mechanism. arming-up was done in 40% of group I and in 17% of group II. The fracture injuries were more common in the skier with intermediate(45%) skill than the beginner(29%) and the ones with advanced skill(12%). The slope with intermediate difficulty was the most frequent site of fracture accidents. The fracture group tended to choose the slope beyond their skiing ability. CONCLUSION: Our results suggest that fracture during skiing can be prevented if skiers do warming-up prior to skiing and choose slope appropriate to their skiing skill.
Emergencies ; Health Resorts ; Humans ; Lower Extremity ; Sex Ratio ; Skiing ; Upper Extremity

An 81-year-old woman with a raised pigmented nodule over her left cornea for 7 months duration was examined. Dark conjunctival pigmentation was observed in the upper bulbar fornix conjunctiva. She had previously undergone primary surgical excision of a malignant conjunctival melanoma four years earlier. The tumor separated easily from the corneal surface, but remained slightly attached to the corneoscleral surface. A corneoscleral lamellar dissection of 3 mm in width and 2 mm in depth as well as a corneoscleral lamellar keratoplasty for the reconstruction of the corneoscleral defect were performed. The wide upper bulbar and fornix conjunctiva were excised, and an amniotic membrane transplantation was performed. Biopsy revealed an invasive melanoma with a depth of 1 mm. Left, right, and inferior tumor margins of the corneoscleral lesion and the pigmentary lesion in the conjunctiva were free of the tumor. After surgery, 0.04% mitomycin was administered topically 4 times daily for 4 weeks. There was no recurrence 2 years after surgery, and systemic evaluation revealed no metastasis.
Aged, 80 and over ; Amnion/*transplantation ; Conjunctival Neoplasms/*surgery ; *Corneal Transplantation ; Female ; Humans ; Melanoma/*surgery ; Neoplasm Recurrence, Local ; Recurrence

Myxedema coma is a severe life-threatening form of hypothyroidism that is associated with a high mortality rate. It is known to be common in the elderly, and is mainly accompanied with cardiogenic shock, respiratory failure, central nervous system dysfunction, and body temperature regulation defects. Thus, immediate management is required in order to prevent fatal complications in myxedema coma. However, early detection is difficult and further, it is easily misdiagnosed due to its low incidence rate and nonspecific symptoms. We report a case of myxedema coma which was misdiagnosed for heart failure. The patient was successfully treated with intensive care and oral low dose levothyroxine.
Aged ; Body Temperature Regulation ; Central Nervous System ; Coma* ; Heart Failure ; Humans ; Hypothyroidism ; Hypoventilation ; Incidence ; Critical Care ; Mortality ; Myxedema* ; Respiratory Insufficiency ; Shock, Cardiogenic ; Thyroxine*

No abstract available.
Brain* ; Glucose* ; Metabolism* ; Vomiting*

OBJECTIVE: The cognitive, Affective, and Somatic Empathy Scale (CASES) suggests novel three components structure of empathy. Although CASES developed to assess the trait empathy of both children and adult, the validation in adult sample is not yet conducted. This study developed Korean version of CASES (CASES-K) and examined the psychometric properties in young adult for first time. METHODS: Confirmatory factor analysis was conducted to test whether the factor structure suggested in initial development study is valid in Korean young adult population. 350 young adults participated, and 44 of them also answered to other empathy scales for validation. The construct validity was ascertained through a series of correlational analysis with widely used trait empathy scales. RESULTS: The result of confirmatory factor analysis supports the three-factor model of empathy consists of affective, cognitive and somatic facets. The construct validity was ascertained through a series of correlational analysis with widely used trait empathy scales. The result of correlational analysis supports the validity of CASES-K, and especially the separation of somatic empathy from affective empathy. CONCLUSION: The current study provides the first evidence of the validity and utility of the CASES-K in young adult population. The result also supports the commonality of three factor structure of empathy in both East Asian and Caucasian, from the children to adults.
Adult ; Asian Continental Ancestry Group ; Child ; Empathy ; Humans ; Psychometrics ; Weights and Measures ; Young Adult

Purpose: To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. Methods: A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. Results: Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. Conclusions In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.