Behcet's syndrome has been known as multisystemic disease caused by nonspecific immune mediated vasculitis, but it's precise etiology is not yet identified. Among the various systemic manifestations, pericardial effusion is extremely rare, and pericardial tamponade caused by massive pericardial effusion in Behcet'sydrome has not been reported in the literature. We report a case of Behcet's syndrome manifested as SVC syndrome due to SVC and right atrial thrombus with massive pericardial effusion resulting cardiac tamponade with the review of the literature.
Behcet Syndrome* ; Cardiac Tamponade ; Pericardial Effusion* ; Superior Vena Cava Syndrome* ; Thrombosis ; Vasculitis ; Vena Cava, Superior*

OBJECTIVE: To assess the effect of vitamin K2 in addition to risedronate on postmenopausal osteoporosis METHOD: We enrolled 21 postmenopausal osteoporosis women (age: 65.2+/-7.8 years). Ten subjects received risedronate (35 mg, weekly) and vitamin K2 (45 mg, daily) and eleven subjects only received risedronate. They all received calcium citrate 2,130 mg and vitamin D 600 IU daily. The duration of treatment was 7.7+/-1.4 months. Bone mineral density (BMD) of lumbar spine and both femurs, serum osteocalcin and urine deoxypyridinoline were examined at baseline and after treatment. RESULTS: After treatment, BMD, serum osteocalcin and urine deoxypyridinoline were improved in each group but there was no statistical difference between the groups. CONCLUSION: There was no evidence of the benefit of vitamin K2 in addition to risedronate in bone metabolism on postmenopausal osteoporosis.
Bone Density ; Calcium Citrate ; Female ; Femur ; Humans ; Metabolism ; Osteocalcin ; Osteoporosis, Postmenopausal* ; Risedronate Sodium ; Spine ; Vitamin D ; Vitamin K 2* ; Vitamins*

OBJECTIVE: To evaluate effects of short stretch bandage and electrical stimulation therapy (EST) for the complex regional pain syndrome (CRPS) in hemiplegic patients METHOD: 10 hemiplegic CRPS patients after stroke or traumatic brain injury were included in the study. We established CRPS from clinical symptoms and triphasic bone scan. Short stretch bandage was applied on affected limb and changed every 24 hours for 2 weeks. EST was tried for 10 minutes twice per day. It was applied at finger and wrist flexor muscles. We measured hand volume of pre-and posttreatment using hand volumeter. Also compared pre-and posttreatment pain-free range of motion (ROM) of metacarpophalangeal (MCP) joint and third proximal interphalangeal (PIP) joint circumference. RESULTS: Mean difference of hand volume between the affected and the unaffected prior to treatment was 20.5+/-4.9 ml (7.9+/-2.3%). After treatment, mean volume change was 15.5+/-4.9 ml (5.5+/-1.8%) (p<0.05). Mean change of pain-free ROM was 8.0+/-4.8 degree (10.9+/-7.1%), mean change of PIP joint circumference was 3.1+/-1.4 mm (5.9+/-2.4%) (p<0.05). CONCLUSION: Short stretch bandage and EST complex therapy is effective for the reduction of paralyzed hand edema and pain in hemiplegic CRPS patients. However further control study is required.
Bandages* ; Brain Injuries ; Edema ; Electric Stimulation Therapy* ; Electric Stimulation* ; Extremities ; Fingers ; Hand ; Humans ; Joints ; Muscles ; Range of Motion, Articular ; Stroke ; Wrist

OBJECTIVE: There is increasing interest in growth hormone (GH) replacement therapy to improve quality of life (QoL) of elderly with age-related decline in GH level (somatopause). The aim of this study was to evaluate the effect of GH replacement on the QoL in patients with somatopause. METHOD: A prospective study of 56 adults with somatopause was conducted. They were replaced with a GH over a 6-month period. QoL was assessed by using three self-rating questionnaires: the Nottingham Health Profile (NHP), the Psychological General Well-Being Index (PGWBI) and theAssessment of Growth Hormone Deficiency in Adults (AGHDA). RESULTS: Significant impairment in QoL as measured by NHP, PGWBI and AGHDA were noted in patients with somatopause compared with age and sex matched normal population (p<0.05). There was significant improvement in QoL after 6-month of GH replacement (p<0.05). CONCLUSION: Six months GH replacement induced an improvement in the QoL of patients with somatopause.
Adult ; Aged ; Growth Hormone* ; Humans ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires

PURPOSE: Ocular injury is a significant problem in pediatric patients. The aim of this investigation was to evaluate clinical characteristics of pediatric eye injury for the purpose of offering preventive strategies. METHODS: This retrospective study was carried out by evaluating the records of patients under the age of 15 years who were treated for ocular injury at the Kyungpook National University Hospital emergency medical center, from January 2003 to December 2008. A total of 477 patients were included in the study. Age, sex, date of injury, location where injury occurred, cause of injury, diagnosis, any effects on visual acuity, and any complications, were analyzed. RESULTS: Ocular injury occurred more frequently in boys (72.3%) than in girls, and the highest incidence was seen in ages 11 to 15 years (37.3%). Ocular injury frequently occurred in the home or at school. The most common cause of injury was due to instruments (51.6%). Surgery was necessary in 71 patients (14.9%), complication developed in 48 patients (10.1%), and 40 patients (8.4%) suffered from decreased visual acuity. CONCLUSION: It's important to monitor boys, in particular, who are engaged in physical activities in the home and at school. Appropriate education and application of personal protective equipment are important methods to aid in prevention of pediatric ocular trauma, especially with children in the home and with adolescents engaged in sporting activities.
Adolescent ; Child ; Emergencies ; Eye ; Eye Injuries ; Humans ; Incidence ; Motor Activity ; Organothiophosphorus Compounds ; Pediatrics ; Retrospective Studies ; Sports ; Visual Acuity

PURPOSE: We have examined the expression of c-erbB-2 oncogene in sera and tissues of non-small cell lung cancer patients. MATERIALS AND METHODS: Serum levels of c-erbB-2 protein were measured by an enzyme im munoassay in 55 patients with non-small cell lung cancer. Sera from patients with surgical therapy were evaluated again after surgery. Immunohistochemical staining was performed in 47 of these tumors. RESULTS: Elevated levels (> or =45 U/mL, control mean 2SD) were observed in 15% of 55 non-small cell lung cancer patients, as compared with none of control subjects (p<0.05). The incidence of elevated level was higher in the adenocarcinoma than squamous cell carcinoma (22% vs 4%, p<0.01). The serum levels of c-erbB-2 protein decreased significantly after surgical tumor ablation (p<0.01). Tissue overexpression was obtained in 23/47 cases (49%). The incidence of c-erbB-2 overexpression was higher in the adenocarcinoma (73% vs 29%, p<0.005). No relationship was found between c-erbB-2 protein expression in serum and tumor tissue and clinicopathologic feature. Elevated serum c-erbB-2 levels predicted tissue overexpression with sensitivity 30% and specificity 96%. There was relationship between serum level and expression in tumor tissue of c-erbB-2 protein. CONCLUSION: Serum and tissue levels of c-erbB-2 correlate in patients with non-small cell carcinoma. Serum c-erbB-2 protein may be a useful indicator of tumor burden in patients with non-small cell lung cancer.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Incidence ; Oncogenes ; Receptor, erbB-2* ; Sensitivity and Specificity ; Tumor Burden

PURPOSE: Ingestion of puffer fish can be poisonous due to the presence of potent neurotoxins such as tetrodotoxin (TTX) found in its tissues. There are few clinical reports related to TTX. We performed this study to evaluate the clinical characteristics of TTX poisoning. METHODS: We conducted a retrospective study of the 41 patients diagnosed with TTX poisoning who visited the Seoul Asan medical center from July 2004 and December 2010. A review of patients'electronic medical records and patient telephone interviews were conducted. Diagnosis of TTX poisoning was confirmed by observing the casual link between puffer fish consumption and the development of typical TTX intoxication symptoms. RESULTS: The mean age of the patients included in the study was 46.6 years. The highest incidence of intoxication was observed in patients in their 50s (10 patients). Seasonal distribution of intoxication events included 10 in spring, 7 in summer, 10 in fall, and 14 in winter. In most cases, symptoms occurred within 1 hour of ingestion. A wide range of symptoms were associated with puffer fish ingestion affecting multiple body systems including neuromuscular (27 patients), gastrointestinal (19 patients), and cardiopulmonary/vascular (19 patients). All patients were treated with symptomatic and supportive therapy and recovered completely, without sequelae, within 48 hours. In three cases, ventilator support was required. CONCLUSION: TTX poisoning is not seasonally related, and patients admitted to the emergency room were observed with a wide range of symptoms. Where TTX poisoning is diagnosed, supportive therapy should be performed. Early intubation and ventilation is important, especially is cases of respiratory failure.
Aluminum Hydroxide ; Carbonates ; Eating ; Emergencies ; Humans ; Incidence ; Interviews as Topic ; Intubation ; Medical Records ; Neurotoxins ; Respiratory Insufficiency ; Retrospective Studies ; Seasons ; Tetraodontiformes ; Tetrodotoxin ; Ventilation ; Ventilators, Mechanical

PURPOSE: The aim of this study is to investigate the association between elevated alanine aminotransferase (ALT) and urosepsis in children with acute pyelonephritis (APN). METHODS: We retrospectively identified all children who were managed in our hospital with APN during a decade period. In our study a diagnosis of APN was defined as having a positive urine culture and a positive (99m)Tc-dimercaptosuccinic acid scintigraphy. We compared those with elevated ALT and those with normal ALT according to the following variables: age, gender, duration of fever prior to admission, presence of hypotension, C-reactive protein (CRP), creatinine, presence of anemia, white blood cells count, platelet count, blood culture result, and grades of vesicoureteral reflux. In addition, the correlation between elevated ALT and positive blood culture was analyzed in detail. RESULTS: A total of 996 children were diagnosed with APN, of which 883 were included in the study. ALT was elevated in 81 children (9.2%). In the analysis of demographic characteristics, the number of children with elevated ALT was higher in children between 0 to 3 months, boys, and in those with positive blood culture (p=0.002, 0.036, and 0.010, respectively). In multivariate analysis of variables associated with positive blood culture, age younger than 3 months, elevated ALT, elevated CRP, and elevated creatinine showed statistical significance (p=0.004, 0.030, 0.043, and 0.044, respectively). CONCLUSION: Our study demonstrates the association between elevated ALT and increased prevalence of urosepsis in addition to elevated CRP, elevated creatinine, and age younger than 3 months in children with APN.
Alanine Transaminase* ; Alanine* ; Anemia ; C-Reactive Protein ; Child* ; Creatinine ; Diagnosis ; Fever ; Humans ; Hypotension ; Infant ; Leukocytes ; Multivariate Analysis ; Platelet Count ; Prevalence ; Pyelonephritis* ; Radionuclide Imaging ; Retrospective Studies ; Vesico-Ureteral Reflux

Renal cell carcinoma is well known for its tendency to metastasize early to the lung, bone, and liver, but skeletal muscle is an extremely unusual site of metastasis. We report here on an unusual case with numerous skeletal muscle metastases in the posterior abdominal wall and buttock 2 years after radical nephrectomy for renal cell carcinoma.
Abdominal Wall ; Buttocks ; Carcinoma, Renal Cell* ; Liver ; Lung ; Muscle, Skeletal* ; Neoplasm Metastasis* ; Nephrectomy*

Insulin resistance (IR) plays a significant role in the development and progression of non-alcoholic fatty liver disease (NAFLD). However, the natural course of insulin sensitivity under NAFLD remained unclear. Accordingly, this study was designed to investigate the effect of NAFLD on insulin resistance. A total of 20,628 Korean men without homeostasis model assessment of insulin resistance (HOMA-IR < 2.7) were followed-up for 5 years. They were serially checked for HOMA-IR to monitor the development of IR (HOMA-IR ≥ 2.7). The incidence rate of IR increased according to the degree of NAFLD (normal: 11.6%, mild: 28.8%, moderate to severe: 40.5%, P < 0.001). Cox proportional hazards model showed that HRs (95% CI) for IR increased proportionally to the degree of NAFLD (mild: 1.19 [1.02–1.39], moderate to severe: 1.32 [1.08–1.57]). IR was more potentially associated with the more progressive NAFLD than normal and milder state. In addition, NAFLD was the independent risk factor of the development of IR. These results suggest the potential availability of NAFLD as a predictor of IR.
Homeostasis ; Humans ; Incidence ; Insulin Resistance* ; Insulin* ; Male ; Non-alcoholic Fatty Liver Disease* ; Proportional Hazards Models ; Risk Factors