A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Emergency Medical Technicians ; Erectile Dysfunction* ; Hemoptysis* ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate

BACKGROUND AND OBJECTIVES: Many expeerimental evidences have beensupported that the vestibulocerebellum involved in recovery of vestibular compensation. The purpose of this study was to investigate effect of unilateral ablation of uvula and nodular lobes on early stage of vestibular compensation. MATERIALS AND METHODS: Adult Sprague-Dawley rats weighing 250~300 g were used and divided into control (CON) group receiving sham operation, unilateral labyrinthectomy (ULX) group, ULX plus left uvulonodulectomy (ULX+Lt-UNLX) group, and ULX plus right uvulonodulectomy (ULX+Rt-UNLX) group. UNLX was performed 1 hour following ULX. Spontaneous nystagmus (SN) and roll head tilt (RHT) were recorded for 3 days following ULX. Temporal change of c-Fos protein expression in the medial vestibular nuclei (MVN) was measured for 2 days following ULX. RESULTS: There were observed SN with contralateral direction to injured labyrinth and RHT toward ipsilateral side with flexion of ipsilateral limb and extenstion of contralateral one just after ULX. There was significant increase in SN frequency of ULX+Rt-UNLX group compared with that of ULX group. In addition, ULX+Rt-UNLX group resulted in severe postural asymmetry. ULX elicited prominent expression of c-Fos protein in contralateral MVN 2 hours but in ipsilateral one 6, 24 hours after ULX, respectively. In contrast, number of c-Fos positive neurons was higher in contralateral MVN. 24 hours after ULX higher expression of c-Fos protein in contralteral MVN was still remained in ULX+Rt-UNLX group but that in ipsilateral MVN was observed in ULX+Lt-UNLX group. CONCLUSION: These results suggest that UNLX have a different effect on the early stage of vestibular compensatory process and the uvulonodulus serves the restoration of balance between intervestibular nuclear activities after ULX by inhibition of vestibular nuclear complex through nhibitory Purkinje system.
Adult ; Animals ; Compensation and Redress* ; Ear, Inner ; Extremities ; Head ; Humans ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Uvula ; Vestibular Nuclei

Behavior-modification approaches are among the most widely used methods for losing weight. The most important concern in these approaches is that the client is helped to achieve long-term weight loss. The purpose of this study was to determine the effectiveness of nutritional counseling for weight reduction in office workers. Sixteen overweight office workers (BMI=25.8+/-.5 age=34.1+/-.0) were selected from Poscohuls. Prior to nutritional counseling, their dietary intakes were assessed using the 24-hour recall method, and survey questionnaires for lifestyle and dietary habits were collected. Nutrient intakes were calculated using the Food Processor II program modified for Korean foods. Nutritional counseling sessions were conducted every 2-3 weeks for 5 months. Various techniques tailored to the individual participants were used to facilitate weight loss. After 5 to 6 counseling sessions, questionnaires for lifestyle and dietary habits were re-evaluated. Daily energy intake showed great individual differences. The energy intake of every client decreased by about 15% (p=0.08). Fat consumption was lowered by 39.3%, but consumption of carbohydrate and protein was not changed. The common dietary and lifestyles problems were overeating, binges, dinning out, snacking, and drinking alcohol. Before counseling began, clients ate out an average of 2.8 times per week, and they ate high-fat foods such as belly pork. After counseling, they consumed low-fat dishes such as fish and lean meat in fewer dinning-out sessions. Also, the number of binges decreased slightly, and clients consumed smaller meals. Similar changes occurred with respect to the consumption of alcohol. During the counseling sessions, 25 percent of clients lost weight by approximately 2kg, while 75 percent maintained their weight. In conclusion, multiple nutritional counseling sessions are an effective and efficient approach to change eating pattern to keep losing weight. Furthermore, through multiple nutritional counseling sessions, clients can gain good dietary habits and learn to control their weight through behavior modification. However, clients need to have patience and trust to lose weight since it takes longer periods to show losing weight multiple nutritional counseling sessions.
Behavior Therapy* ; Counseling* ; Drinking ; Eating ; Energy Intake ; Food Habits ; Hyperphagia ; Individuality ; Life Style ; Meals ; Meat ; Overweight ; Surveys and Questionnaires ; Snacks ; Weight Loss

No abstract available.
Abscess* ; Citrobacter koseri

No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine*

Ganglia are ubiquitous but periosteal ganglion is rare. This case is presented showing an unusual radiological picture. The radiological picture with honey combed appearance is striking. Previaus reports have stressed the concavity in the cortex. Histologically the structure is identical to that of soft tissue ganglia.
Animals ; Comb and Wattles ; Ganglia ; Ganglion Cysts ; Honey ; Strikes, Employee

Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min. Conclusions Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.

Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.
Alcohol Drinking ; Anticoagulants ; Diabetes Complications ; Diabetic Ketoacidosis* ; Heparin, Low-Molecular-Weight ; Humans ; Hypoglycemic Agents ; Insulin ; Male ; Middle Aged ; Pulmonary Embolism* ; Thrombophilia ; Warfarin