PURPOSE: We compared the clinical manifestations of patients with tsutsugamushi disease between children and adults. METHODS: From January 2003 to December 2012, 768 patients diagnosed with tsutsugamushi disease were retrospectively reviewed, and the clinical characteristics, laboratory findings, and complications were compared between children and adults. RESULTS: No patterns of annual increases in the number of patients were noted in both children and adults. The higher incidences occurred in October and November respectively. By gender, male outnumbered female in children, but the opposite trend was seen in adults. By residential area, the urban distribution of children was higher than that of adults. Rashes (P=0.001) and eschar (P=0.004) were more common in children, while myalgia was more common in adults. Children had a high prevalence of anemia (P=0.041), and low incidence rates of thrombocytopenia, abnormal liver and renal function. Children yielded better results in the duration of their hospital stay and the incidence of complications (P<0.001). A comparison of the therapeutic effects of doxycycline and macrolide antibiotics, which was performed only on the children, did not reveal any significant differences. CONCLUSION: Compared to adults, children had higher incidence rates of male patients and more often suffered from rashes and eschar. Children yielded better results in the laboratory findings and duration of the hospital stay and complications. Therefore, when children are suspected to have tsutsugamushi disease, especially during its peak occurrence period, detailed physical examination and serological test should be performed to ensure a prompt diagnosis, and the use of macrolide antibiotics, which have fewer side effects, is expected to yield the same therapeutic effects.
Adult* ; Anemia ; Anti-Bacterial Agents ; Child* ; Diagnosis ; Doxycycline ; Exanthema ; Female ; Humans ; Incidence ; Length of Stay ; Liver ; Male ; Myalgia ; Physical Examination ; Prevalence ; Retrospective Studies ; Scrub Typhus* ; Serologic Tests ; Thrombocytopenia

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.
Basal Ganglia ; Brain ; Brain Stem* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging ; Pons ; Retrospective Studies

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

BACKGROUND: Diuretic agents are widely used in the treatment of variable diseases. Although some diuretics may cause photosensitive reactions, this has been a relatively neglwted area of investigation. OBJECTIVE: The study was undertaken to examine whether or not the diuretic agents could cause phototoxicity with the photohemolysis test and with the Candida albica as test. METHOD: Photohemolysis test: Fresh human red blood cells (RHC) were washed and diluted to 200 fold of original volume with TCM buffer. Test compound suspension, were added to the diluted blood at the final concentration of 10 M. Each sample was irradiated with 50 J/cm of UVA, and control samples were incubated in water bath with light shielding. After additional incubation in a dark water bath for 30 minutes the sarnples were centrifuged. After adding Drabkins reagent, measurement of absorbance of the supernatents by speetrophotometer at 420, 540, 550nm were performed. The degree of photohemolysis was determined by comparing the results wiith the control solution. Candide elbicens test wenty microliter of each solution of arious diuretics were applied to Sabourauds dextrose agar plate in which Candida albicanp had been diffusely applied previously. Four hours after the application, 80 J/cm of UVA was irradiated. The irraicated plates and nonirradiated controls were incubated in a darlI room for 48 hours, and were examined clearzones arround the drugs as the mean of positive results fcir the phototoxic potential of the drugs. RESULTS: The photohemolyeii; vaIues of azosemide, spironolaetonet, iamterene, and xipamide at 420, 540, and 550nm were 70.57%/28.36%/31.61%/83.65%/16.40%/15.21%/75.66%/25.40%/28.17%, and 14.02%/9.11%/8.99% respectively, which exceeds the mear,injful positive value of above 5 , With the Candida olbicans test all teat solution at concentration of 1% and 5% showed negstive results. CONCLUSION: A phototoxic reaction may be triggered by azosemide, spironolactone, triamterene, and xipamide, and the possible mechanism concerned may be directed to cellular membranes. However with the negative result of knowed photosensitizers like hydrochlorthiazid and furosemide, there may be other possibilities for the explenation of phototoxicity. Thus further stirdies may be necessary to investigate more details about the cliscrepancies in greates detail.
Agar ; Baths ; Candida albicans* ; Candida* ; Dermatitis, Phototoxic ; Dermis ; Diuretics ; Erythrocytes ; Furosemide ; Glucose ; Humans ; Membranes ; Photosensitizing Agents ; Spironolactone ; Triamterene ; Water ; Xipamide

BACKGROUND: Diuretic agents are widely used in the treatment of variable diseases. Although some diuretics may cause photosensitive reactions, this has been a relatively neglwted area of investigation. OBJECTIVE: The study was undertaken to examine whether or not the diuretic agents could cause phototoxicity with the photohemolysis test and with the Candida albica as test. METHOD: Photohemolysis test: Fresh human red blood cells (RHC) were washed and diluted to 200 fold of original volume with TCM buffer. Test compound suspension, were added to the diluted blood at the final concentration of 10 M. Each sample was irradiated with 50 J/cm of UVA, and control samples were incubated in water bath with light shielding. After additional incubation in a dark water bath for 30 minutes the sarnples were centrifuged. After adding Drabkins reagent, measurement of absorbance of the supernatents by speetrophotometer at 420, 540, 550nm were performed. The degree of photohemolysis was determined by comparing the results wiith the control solution. Candide elbicens test wenty microliter of each solution of arious diuretics were applied to Sabourauds dextrose agar plate in which Candida albicanp had been diffusely applied previously. Four hours after the application, 80 J/cm of UVA was irradiated. The irraicated plates and nonirradiated controls were incubated in a darlI room for 48 hours, and were examined clearzones arround the drugs as the mean of positive results fcir the phototoxic potential of the drugs. RESULTS: The photohemolyeii; vaIues of azosemide, spironolaetonet, iamterene, and xipamide at 420, 540, and 550nm were 70.57%/28.36%/31.61%/83.65%/16.40%/15.21%/75.66%/25.40%/28.17%, and 14.02%/9.11%/8.99% respectively, which exceeds the mear,injful positive value of above 5 , With the Candida olbicans test all teat solution at concentration of 1% and 5% showed negstive results. CONCLUSION: A phototoxic reaction may be triggered by azosemide, spironolactone, triamterene, and xipamide, and the possible mechanism concerned may be directed to cellular membranes. However with the negative result of knowed photosensitizers like hydrochlorthiazid and furosemide, there may be other possibilities for the explenation of phototoxicity. Thus further stirdies may be necessary to investigate more details about the cliscrepancies in greates detail.
Agar ; Baths ; Candida albicans* ; Candida* ; Dermatitis, Phototoxic ; Dermis ; Diuretics ; Erythrocytes ; Furosemide ; Glucose ; Humans ; Membranes ; Photosensitizing Agents ; Spironolactone ; Triamterene ; Water ; Xipamide

No abstract available.
Thromboangiitis Obliterans

PURPOSE:To identify the main toxic gas released from salted radish in rice bran(Dan-Mu-Ji) and to introduce the radiological findings of the patient who was exposed to the gas. MATERIALS AND METHODS: Chest radiographs and CT scans of one survivor among three men who were exposed to the gas from Dan-Mu-Ji were reviewed. Gas obtained from the closed bottle containing Dan-Mu-Ji was analized by using the gas chromatography. RESULTS: The radiographic examinations of the survivor were suggestive of pulmonary edema with it's rapidly improving consolidations in both lung. The headspace gas within the bottle containing Dan-Mu-Ji was mainly composed with carbon dioxide, ethyl alcohol and hydrogen sulfide, of which hydrogen sulfide was considered the main toxic gas released. CONCLUSION: Under the anaerobic condition, Dan-Mu-Ji released toxic hydrogen sulfide. Inhalation of hydrogen sulfide might produce non-cardiogenic pulmonary edema.
Anoxia* ; Carbon Dioxide ; Chromatography, Gas ; Ethanol ; Humans ; Hydrogen Sulfide ; Inhalation ; Lung ; Male ; Pulmonary Edema ; Radiography, Thoracic ; Raphanus* ; Survivors ; Tomography, X-Ray Computed

Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre-and post- procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drain efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were lower than than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we though that it will be very helpful to the treatment of patients as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.
Abscess ; Catheters* ; Drainage ; Humans ; Viscosity

Authors analyzed the findings of findings of chest radiographs and high-resolution CT(HRCT) of chronic mercury vapor poisoning in 12 patients who were diagnosed by previous working history for mercury-thermometer and high level of mercury in blood and urine. The purpose of this paper is to introduce the HRCT findings of chronic mercury vapor poisoning. Duration of mercury exposure was ranged from 10 to 41 months(mean, 21.8 months). Estimated value of serum mercury was ranged from 3.6 to 8.7µg/dl(mean, 5.3 µg/dl: normal value is less than 0.5µg/dl). Estimated value of mercury in urine was ranged from 104 to 482µg/1(mean, 291.4µg/1: normal value is less than 20µg/1). Chest radiographs showed positive findings such as ground-glass opacities and peribronchial cuffings in only 2 out of 12 patients, but HRCT showed positive findings such as ground-glass opacities in 8 patients, peribronchial cuffings in 7 patients, centrilobular abnormalities in 5 patients, interface sign in 4 patients, interlobular septal thickening with intralobular lines in 2 patients and lobular consolidation in one patient. In conclusion, chest HRCT is superior to chest radiograph to show the pulmonary manifestation of chronic mercury vapor poisoning. In patients with chronic mercury vapor poisoning, HRCT findings of centrilobular distributed ground-glass opacities and peribronchial cuffinges are characteristic.
Humans ; Lung* ; Poisoning* ; Radiography, Thoracic ; Reference Values ; Thorax

Neurocristopathy is characterized as having a common origin in aberrant neural crest development. Congenital central hypoventilation syndrome (Ondine's curse) is characterized by marked depression of respiratory drive during sleep and normal ventilation while awake because of no response to both hypercapnea and hypoxia. The girl was full-term, weighing 3020 grams. The girl had poor respiratory effort at birth, but improved with oxygen supply and stimulation. abdominal distention and calcification were noted. During laparotomy transitional zone was found at distal jejunum; a jejunostomy was constructed. Numerous attempts at extubation failed because of apnea. The results of an apnea work-up, including brain sonography, echocardiogram, were normal. The girl died of sepsis at 37 days of age. para-aortic ganglioneuroblastoma was found on autopsy. We experienced a newborn with congenital central hypoventilation syndrome, Hirschsprung's disease and congenital ganglioneuroblastoma representative of neurocristopathy.
Anoxia ; Apnea ; Autopsy ; Brain ; Depression ; Female ; Ganglioneuroblastoma* ; Hirschsprung Disease* ; Humans ; Hypoventilation* ; Infant, Newborn* ; Jejunostomy ; Jejunum ; Laparotomy ; Neural Crest ; Oxygen ; Parturition ; Sepsis ; Ventilation