Recently, continuous epidural catheter insertion is common practice not only in anesthesia but also in pain clinic. Meningitis is rare but serious complication of epidural analgesia. Acute bacterial meningitis occurred in a 82-year-old female patient with thoracic herpes zoster after continuous thoracic epidural analgeia. An MRI of thoracic region did not show an epidural abscess or granulation tissue. Gram stain and culture of the epidural catheter tip and the CSF yielded Staphylococcus aureus. Immediate treatment with antibiotics and supportive therapy was instituted and then the patient discharged without neurologic sequalae.
Aged, 80 and over ; Analgesia, Epidural* ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Epidural Abscess ; Female ; Granulation Tissue ; Herpes Zoster ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Pain Clinics ; Staphylococcus aureus

PURPOSE: The purpose of this study was to study complementary and alternative medicines (CAM) used among cancer patients in Korea. METHOD: This study was a descriptive survey. Study participants were 1,150 cancer patients selected from 28 representative hospitals in Korea. Data were collected between December 1, 2004 and March 30, 2005. RESULTS: Their diagnosis were as follows : 20.0% for breast cancer, 15.6% for stomach cancer, 14.4% for liver cancer, 10.8% for lung cancer, 10.0% for colon cancer, and 10.0% for uterine cancer. 75.0% of cancer patients had used CAM. The most popular categories of CAM use were diet with 153.2%, non-prescription of oriental medical doctor 47.9% and mind-body control 20.3%. CAM use gender, age, cancer type, cancer treatment method, and current treatment type was significantly different in. CONCLUSION: CAM use among cancer patients in Korea was very popular (75.0%) and so systemic guidelines of CAM use are needed.
Breast Neoplasms ; Colonic Neoplasms ; Complementary Therapies* ; Diagnosis ; Diet ; Humans ; Korea* ; Liver Neoplasms ; Lung Neoplasms ; Stomach Neoplasms ; Uterine Neoplasms

The demand for rapid and broad clinical toxicology screens is on the rise. Recently, a new rapid toxicology screening test, the Triage TOX Drug Screen (Alere Inc., USA), which can simultaneously detect 11 drugs of abuse and therapeutic drugs with an instrument-read cartridge, was developed. In the present study, we evaluated the efficacy of this new on-site immunoassay using 105 urine specimens; the results were compared with those obtained by using ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-TMS). Precision was evaluated according to the CLSI EP12-A2 for analyte concentrations near the cutoff, including C₅₀ and±30% of C₅₀, for each drug using standard materials. The C₅₀ specimens yielded 35–65% positive results and the ±30% concentration range of all evaluated drugs encompassed the C₅–C₉₅ interval. The overall percent agreement of the Triage TOX Drug Screen was 92.4–100% compared with UPLC-TMS; however, the Triage TOX Drug Screen results showed some discordant cases including acetaminophen, amphetamine, benzodiazepine, opiates, and tricyclic antidepressants. The overall performance of the Triage TOX Drug Screen assay was comparable to that of UPLC-TMS for screening of drug intoxication in hospitals. This assay could constitute a useful screening method for drugs of abuse and therapeutic drugs in urine.
Acetaminophen ; Amphetamine ; Antidepressive Agents, Tricyclic ; Benzodiazepines ; Chromatography, Liquid ; Immunoassay ; Mass Screening ; Methods ; Street Drugs* ; Tandem Mass Spectrometry ; Toxicology ; Triage*

BACKGROUND: The surfactant protein A(SP-A) is important in the regulation of surfactant secretion, synthesis and recycling. Since the acute respiratory distress syndrome(ARDS) is usually viewed as the functional and morphological expression of a similar underlying lung injury caused by a variety of insults and since abnormalities in surfactant function have been described in ARDS, the authors investigated the different effects of endotoxin and thiourea on the accumulation of mRNA encoding SP-A. METHODS: Sprague-Dawley rats were given 5 mg/kg intraperitoneal endotoxin from Salmonella enteritidis and 3.5 mg/kg intraperitoneal thiourea and sacrified at different time periods. RESULTS: 1) SP-A mRNA was significantly increased 67.0% in 6 hours and 73.4% in 24 hours after 5 mg/kg endotoxin treatment respectively(P<0.005, P<0.005). 2)SP-A mRNA was significantly decreased 32.9% in 24 hours after 3.5 mg/kg thiourea treatment(P<0.05). CONCLUSIONS: These results indicate that the differential regulation of surfactant protein A in vivo is evident and suggest that surfactant protein A might be differentially regulated during different kind of insults of lung injury at different time periods without altering lung wet to dry ratios.
Animals ; Gene Expression* ; Lung Injury ; Lung* ; Pulmonary Surfactant-Associated Protein A* ; Rats* ; Rats, Sprague-Dawley ; Recycling ; RNA, Messenger* ; Salmonella enteritidis ; Thiourea*

Primary neoplasm of the heart is rare. Benign tumors, the majority of which are myxomas, comprise up to 50% of cardiac neoplasms. Although cardiac myxoma is a source of emboli to the central nervous system and elsewhere in the vascular tree, its clinical signs and symptoms may be nonspecific. These nonspecific systemic symptoms and minor embolic phenomena may be overlooked in patients without a previous history of cardiac problems. Thus, we need to recognize the signs of myxoma and begin treatment immediately. We encountered a case of left atrial myxoma, presenting as pulmonary interstitial edema of unknown cause, in a 50-year-old female patient. Excision of a mass located on the left atrium was scheduled but she developed a cerebral embolism that led to her death.
Central Nervous System ; Edema ; Female ; Heart ; Heart Atria ; Heart Neoplasms ; Humans ; Intracranial Embolism ; Middle Aged ; Myxoma ; Pulmonary Edema

Diffuse gastroesophageal leiomyomatosis is a rare, benign neoplastic condition characterized by thickening of the esophageal wall as a result ofaberrant smooth muscle proliferation. Gastroesophageal leiomyomatosis may occur in isolation or as a familial disorder and has been associated with other conditions, such as Alport syndrome. Alport syndrome is a hereditary disorder of basement membrane type IV collagen, characterized by progressive nephritis, sensorineural deafness and ocular abnormalities. In this article, we present an interesting case of gastroesophageal leiomyomatosis occurring in a single family in whichthe mother and her son had Alport syndrome. This case is the first report in Korea that gastroesophageal leiomyomatosis is associated with two generations of Alport syndrome.
Basement Membrane ; Collagen Type IV ; Deafness ; Family Characteristics ; Humans ; Korea ; Leiomyomatosis ; Mothers ; Muscle, Smooth ; Nephritis ; Nephritis, Hereditary

No abstract available.
Bone Marrow/pathology ; Chromosomes, Human, Pair 12 ; Chromosomes, Human, Pair 9 ; Core Binding Factor Alpha 2 Subunit/*genetics ; DNA/metabolism ; Gene Rearrangement ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/*genetics ; Male ; Middle Aged ; Oncogene Proteins, Fusion/*genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Translocation, Genetic

Human epididymis protein 4 (HE4) has been suggested as a useful new biomarker of lung cancer; however, few relevant large-scale studies have been published. In this study, we evaluated the utility of serum HE4 for lung cancer detection. HE4 levels were measured in serum samples from 100 lung cancer patients, 57 patients with benign lung diseases, and 274 healthy controls by using a chemiluminescent immunoassay, and variations in HE4 levels were analyzed by clinical status such as lung cancer, benign lung disease, and healthy condition, Tumor, Lymph Nodes, Metastasis (TNM) stage, tumor score, and histological cancer type. Lung cancer patients had significantly higher serum HE4 levels than patients with benign lung diseases and healthy controls (P<0.0001). The area under the ROC curve for HE4 was 0.84 (95% confidence interval, 0.78–0.89; P<0.0001) between lung cancer patients and healthy controls. Serum HE4 levels were significantly higher in patients with advanced disease (according to TNM stage) than in healthy controls (P<0.0001). HE4 levels were significantly elevated in patients with tumors of all types, those of different histological subgroups, and those with the smallest tumors (P=0.002). This report supports the potential of serum HE4 as an ancillary diagnostic marker for lung cancer detection.
Biomarkers, Tumor ; Epididymal Secretory Proteins ; Humans* ; Immunoassay ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Male ; Neoplasm Metastasis ; ROC Curve

A patient who underwent a transfusion due to an aplastic anemia subsequently experienced secondary hemochromatosis, which is very rare in Korea. The 56 year old female was admitted to our hospital with complaints of general weakness, fatigue, a brown-colored facial complexion, dyspnea upon exertion, and abdominal distension. Laboratory examination disclosed functional impairment of the liver and echocardiography revealed a congestive heart failure pattern. Gastrofiberscopy revealed brown colored gastric mucosa, and a fundal mucosa biopsy revealed a hemosidt pigment in iron stain.
Anemia, Aplastic ; Biopsy ; Dyspnea ; Echocardiography ; Fatigue ; Female ; Gastric Mucosa ; Heart Failure ; Hemochromatosis* ; Humans ; Iron ; Korea ; Liver ; Middle Aged ; Mucous Membrane

OBJECTIVE: Trisomy 21 (Down syndrome) is the most common chromosomal anomaly which occurs 1 out of 700-1000 birth. Current techniques such as amniocentesis, chorionic villi sampling (CVS), require lengthy laboratory culture procedures and high costs. This study was undertaken to establish a rapid prenatal diagnosis of trisomy 21 using real-time quantitative polymerase chain reaction of fetal DNA from amniotic fluid. METHODS: Real-time quantitative PCR was performed with DNA template obtained from 14 normal serum, 10 normal amniotic fluid samples, 14 Down syndrome serum, and 7 Down syndrome amniotic fluid samples. Primers for D21S167 and S100B of chromosome 21 were used. Primers that direct amplification of 165-bp fragment of the IGFI (Insulin-like growth factor-1) gene on chromosome 12 are included to generate an internal standard for quantitation. RESULTS: The relative levels of D21S167 and S100B were 2.6 and 2.4 times higher in the serum of Down syndrome patients compared to the control group. The difference between these two groups was statistically significant (P-value: 0.0012 and 0.0016). The relative levels of D21S167 and S100B were 2.1 and 2.7 times higher in the amniotic fluid of Down syndrome fetuses compared to control group. The difference between these two groups was statistically significant (P-value 0.0379 respectively). CONCLUSION: Prenatal diagnosis of trisomy 21 by real-time quantitative PCR-associated STR (small tandem repeats) analysis of D21S167 and S100B is useful, accurate and rapid diagnostic method and also can be employed in diagnosis of trisomy 13, 18. Furthermore, it may also be useful for prenatal diagnosis with fetal DNA from maternal blood and for preimplantation genetic diagnosis.
Amniocentesis ; Amniotic Fluid ; Chorionic Villi Sampling ; Chromosomes, Human, Pair 12 ; Chromosomes, Human, Pair 21 ; Diagnosis ; DNA ; Down Syndrome* ; Female ; Fetus ; Humans ; Parturition ; Polymerase Chain Reaction* ; Pregnancy ; Preimplantation Diagnosis ; Prenatal Diagnosis* ; Trisomy*