Drug-induced thrombocytopenia and purpura have boon developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects art fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.
Ciprofloxacin* ; Female ; Humans ; Purpura* ; Pyrazinamide* ; Rifampin ; Thrombocytopenia* ; Young Adult

Inflammatory pseudotumor is a rare benign lesion consisting of inflammatory cells and fibroblastic stroma, and is reported to have occurred. in various organs. Splenic involvement, however, is extremely rare. We report the spiral CT findings of pathologically proven inflammatory pseudotumor of the spleen. The CT scan shows delayed enhancement with central, stellate, low attenuation.
Fibroblasts ; Granuloma, Plasma Cell* ; Spleen* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

Congenital glioblastoma multiforme is relatively rare accounting for 2-9% of all congenital brain tumors. We deseribe a case of congenital glioblastoma multiforme which occurred in the lateral ventricle. T1-weighted images revealed high signal intensity, with areas of internal low signal intensity, while T2-weighted images showed low signal intensity with focal internal high-signal portions. Post-contrast T1-weighted images depicted a lateral ventricular mass which extended to adjacent brain parenchyme and had a serpentine signal void representing internal vessel.
Brain ; Brain Neoplasms ; Glioblastoma* ; Lateral Ventricles

OBJECTIVES: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. DESIGN : Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. MATERIALS AND METHODS: After blood sampling for basal FSH and estradiol (E2) on cycle day two, 0.5 ml (0.525 mg) GnRH agonist (Suprefact, Hoechst) was injected subcutaneously. Serum E2 was measured 24 hours later. Initial E2 difference (deltaE2) was defined as the change in E2 on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by deltaE2; group A (n=30):deltaE2<40 pg/ml, group B (n=52): 40 pg/ml< or =deltaE2<100 pg/ml, group C (n=20): deltaE2< or =100 pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-EF was followed. Ratio of E2 on day of hCG injection over the number of ampules of gonadotropins used (E2hCGday/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as E2 hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. RESULTS: Mean age (+/-SEM) in group A, B and C were 33.7+/-0.8*, 31.5 +/-0.6 and 30.6+/-0.5*, respectively (*: p<0.05). Mean basal FSH level of group A (11.1+/-1.1 mIU/ml) was significantly higher than those of B (7.4+/- 0.2 mIU/ml) and C (6.8+/-0.4 mIU/ml) 0<0.001). Mean E2hCGday of group A was significantly lower than those of group B or C, i.e., 1402.1+/-187.7 pg/ml, 3153.2+/- 240.0 pg/ml, 4078.8+/-306.4 pg/ml respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: 38.6+/-2.3, 24.2+/-1.1 and 18.5+/-1.0 (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: 6.4+/-1.1, 15.5+/-1.1 and 18.6+/-1.6, respectively (p<0.0001). By stepwise multiple regression, only deltaE2 showed a significant correlation (r=0.68, p<0.0001) with E2HCGday/Amp, while age or basal FSH level were not significant. Likewise, only deltaE2 correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). CONCLUSIONS: These data suggest that initial E2 difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial E2 difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.
Estradiol ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Oocytes ; Ovarian Cysts ; Ovary ; Ovulation Induction* ; Prospective Studies

No abstract available.
Brain* ; Choriocarcinoma* ; Female ; Neoplasm Metastasis* ; Pregnancy

PURPOSE: An accurate assessment of body fluid status is a significant challenge during every clinical examination. In many disorders, the therapy and its effectiveness depend on appropriate evaluation of body fluid state, especially in the trauma patient. The purpose of this study was to evaluate the clinical significance of the IVC/aorta diameter index on abdominal CT scans and to determine whether? The IVC/aorta diameter index was useful for predicting the outcome of trauma patients in the emergency department. METHODS: This study was a retrospective analysis of data acquired between December 2008 and April 2009. We included 108 trauma patients who received abdominal CT in the emergency department. Persons who had a major medical problem such as liver cirrhosis, or who were transferred from other hospitals for ICU care, or who were younger than 15 years, were excluded. IVC and aorta were measured below the infrarenal vein in the abdominal CT in an axial view. Clinical assessment included the patient's final diagnosis, blood pressure, heart rate, weight and whether he was dead or not. Receiver operating characteristic (ROC) curves were used to find the value of the IVC/aorta diameter index that maximized the sum of the sensitivity and specificity. Statistical analysis was performed using SPSS 17.0. RESULTS: We studied 135 patients (trauma 108 and non trauma 27). The mean IVC/aorta diameter index of nontrauma patients was 1.26+/-0.17; for trauma patients it was 0.80+/-0.33. The average IVC/aorta index in the shock group at arrival were significantly smaller than in the non shock group (0.57+/-0.27 versus 0.89+/-0.3). CONCLUSION: The inferior vena cava/aorta diameter index in trauma patients is useful in assessment of injury severity and prognosis.
Aorta ; Blood Pressure ; Body Fluids ; Emergencies ; Heart Rate ; Humans ; Liver Cirrhosis ; Prognosis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Shock ; Veins ; Vena Cava, Inferior

BACKGROUND: Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. METHODS: All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL RESULTS: 1) CTL is most prevalent in young women between the age of 20 30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6% (p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%),other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%),fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). CONCLUISON: CTL is prevalent in women between the age of 20 ~ 40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.
Drug Therapy ; Female ; Fistula ; Humans ; Incidence ; Lymph Nodes ; Male ; Needles ; Prognosis ; Tuberculosis ; Tuberculosis, Lymph Node* ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

PURPOSE: We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux (VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex. METHODS: We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection (UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate (ESR), and C- reactive protein (CRP) were performed initially. Voiding cystourethrography (VCUG) was performed 1 to 3 weeks after treatment with UTI. (99m) Tc-dimercaptosuccinic acid (DMSA) scan was performed 4 to 6 months after treatment. RESULTS: Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys (P< 0.05). The severity of VUR was significantly correlated with renal scar formation (P< 0.05). The duration of fever before treatmen (5.0+/-1.3 vs 2.6+/-1.3) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group (P< 0.05). ESR (56.3+/-23.8 vs 27.9+/-18.1 mm/hr, P< 0.05) and CRP (12.8+/-7.3 vs 3.9+/-3.8 mg/dL, P< 0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups. CONCLUSION: The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.
Blood Sedimentation ; Child* ; Cicatrix* ; Diagnosis ; Fever ; Humans ; Kidney ; Protestantism ; Retrospective Studies ; Risk Factors ; Ultrasonography ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: This study was done to identify the relationship of malnutrition, social network and health-related quality of life and to investigate the main factors influencing health-related quality of life in elders. METHODS: The research design was a descriptive survey design using a convenience sampling. Data were collected by self-report questionnaires from 196 elders. Data analysis was done using SPSS 18.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. RESULTS: The average score for health related quality of life was 3.33 (SD=0.86). Differences in health-related quality of life were statistically significant according to age, gender, occupation, presence of spouse, monthly income, source of income, economic status, medicine, and existence of chronic disease. Health-related quality of life was significantly correlated with malnutrition and social network. Major factors affecting health related quality of life for elders were malnutrition, occupation, age, social network, and economic status which explained 52.0% of the variance in health related quality of life. CONCLUSION: Findings provide a basis for developing nursing interventions to improve health-related quality of life. Future studies are needed a wide variety of variables that might influence health-related quality of life in elders.
Aged ; Chronic Disease ; Humans ; Malnutrition ; Occupations ; Quality of Life ; Surveys and Questionnaires ; Research Design ; Spouses ; Statistics as Topic

PURPOSE: Caffeine shows wide interindividual pharmacokinetic (PK) variation, and therapeutic drug monitoring (TDM) may be needed. The PK profile of caffeine in Korean preterm neonates was investigated, and factors influencing the clearance of caffeine were analyzed. METHODS: Fifty-nine preterm neonates receiving caffeine for apnea of prematurity were enrolled in the study (gestational age, 29.5±2.2 weeks and birth weight [BW], 1,318±358 g). Caffeine (20 mg/kg) was intravenously administered to each neonate as a loading dose, followed by a maintenance dose of 5-10 mg/kg/d. A total of 190 serum concentrations were measured for population PK analysis and modeling using nonlinear mixed-effects model (NONMEM®) software. RESULTS: The mean serum concentration of caffeine was 15.4±4.5 mg/L (range 7.8-33.0 mg/L). High serum concentrations (>20 mg/L) were noted in 36 samples (29%). At the first measurement of serum caffeine, the mean postmenstrual age was 33.9±2.3 weeks, mean BW was 1,802±471 g, mean duration of treatment was 7.4±9.4 days, and mean sampling time after the last dose was 21.8±2.1 hours. In the population PK analysis, the clearance was 0.033 L/h and volume of distribution was 0.371 L. Typical clearance was calculated as 0.0293×(BW/70)1.33. Among the subjects receiving 5 mg/kg/d caffeine, the most significant risk factor associated with high serum concentrations (>20 mg/L) was low BW (P=0.024). CONCLUSION: BW was the only covariate that influenced caffeine clearance in preterm neonates. Preterm neonates with low BW should be carefully monitored for apnea and adverse reactions in addition to undergoing TDM.
Apnea* ; Birth Weight ; Caffeine* ; Drug Monitoring ; Humans ; Infant, Newborn ; Infant, Premature* ; Pharmacokinetics* ; Risk Factors