Soluble compounds of chromium are widely used in industrial processes, including printing, photography, pyrotechnics, dyeing, electroplating, aircraft, shipbuilding, and leather tanning. Exposure in industry is generally via the inhalation of dusts and fumes. Ingestion of chromium (chromate or dichromate salt) has occurred accidentally in suicide attempts and during drug experimentation and may causes ulceration of the bowel, diarrhea, hemorrhagic diathesis, acute renal failure, and hepatic damage. Ingestion of hexavalent chromium com-pounds is considered to be one hundred times more toxic than the trivalent compounds. Chromium poisoning in children is an uncommon, potentially lethal form of poisoning which could possibly increase in incidence because of the resumed greater domestic distribution of dichromate in Korea. We report a case of ammonium dichromate inges-tion by a child that resulted in a healthy discharge.
Acute Kidney Injury ; Aircraft ; Ammonium Compounds* ; Child ; Chromates ; Chromium ; Diarrhea ; Dust ; Eating ; Electroplating ; Hemorrhagic Disorders ; Humans ; Incidence ; Inhalation ; Korea ; Photography ; Poisoning* ; Suicide ; Tanning ; Triacetoneamine-N-Oxyl ; Ulcer

In various autopsy series, overdiagnosis as well as underdiagnosis of pulmonary embolism has been reported. During the past decade, mortality rate has not declined despite advances in diagnostic methods. To evaluate the hypothesis that changes of hemodynamic parameters responded by mean pulmonary arterial pressure differences are of paramount importance to guide prognosis, experimental model of anesthetized dogs was used. Six dogs were anesthetized with 15 milligrams per kilogram of pentobarbital sodium, given intravenously and paralyzed with 2 milligrams of pancuronium bromide. 0.3 to 0.8 gram per kilogram of autologous blood clot was infused into the right atrium through a left external jugular vein. The dogs after embolization were divided into group A(mean pulmonary arterial pressure 33mmHg) and group B(mean pulmonary arterial pressure 43 mmHg). Each group of three dogs was monitored for a total of 4.5 hours. A 7F Swan-Ganz catheter was positioned and used to measure with fluid-filled transducer pulmonary capillary wedge pressure, mean pulmonary arterial pressure and mean right atrial pressure. Cardiac ouput was measured in triplicate by thermodilution and divided by weight to obtain the cardiac index. Blood gases, pH and saturation of arterial blood were measured. White blood cell and platerlets were counted in arterial blood. The results are as follows : 1) Changes in mean arterial pressure showed no significant differences between group A and group B following embolization. 2) Changes in mean pulmonary arterial pressure showed significant differences between group A and group B(p<0.05). 3) Changes in cardiac index showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 4) Changes in total pulmonary resistance showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 5) PaO2 showed significant differences between group A and group B after one hour following embolization(p<0.05), but arterial pH showed no significant difference. 6) Changes in mean pulmonary capillary wedge pressure, mean right atrial pressure and heart rates showed no significant differences between group A and group B following embolization. In conclusion, changes in mean pulmonary arterial pressure, cardiac index, total pulmonary resistance and PaO2 showed significant differences between group A and group B following embolization.
Animals ; Arterial Pressure ; Atrial Pressure ; Autopsy ; Catheters ; Dogs* ; Gases ; Heart Atria ; Heart Rate ; Hemodynamics ; Hydrogen-Ion Concentration ; Jugular Veins ; Leukocytes ; Models, Theoretical ; Mortality ; Pancuronium ; Pentobarbital ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism* ; Pulmonary Wedge Pressure ; Thermodilution ; Transducers

Primary segmental omental infarction in adults is very rare and occasionally occurs due to impaired perfusion to the greater omentum. Most authors believe that the condition results from an embryologic variant associated with anomalous and fragile blood supply of the right lower portion of the greater omentum, which is consequently susceptible to infarction. Since there are no characteristic clinical findings, the clinical presentation often mimics acute appendicitis or cholecystitis. However, in the proper clinical setting, the correct diagnosis can be established by the radiologist; therefore, unnecessary surgery can be avoided in many cases. Cross-sectional imaging by ultrasound or computed tomography will demonstrate characteristic findings in a location corresponding to the patient's point of maximal tenderness. These findings consist of an ovoid or cake-like mass in the omental fat with surrounding inflammatory changes. We report a case of primary segmental omental infarction in an adults who was treated conservatively after the diagnosis was established with clinical findings.
Abdominal Pain ; Adult ; Appendicitis ; Cholecystitis ; Diagnosis ; Humans ; Infarction* ; Omentum ; Perfusion ; Ultrasonography ; Unnecessary Procedures

BACKGROUND/AIMS: The aim of this study was to determine whether the margin of early to be detected gastric cancer (EGC) and gastric adenoma is easier to be detected with autofluorescence imaging (AFI) than with white-light endoscopy (WLE). METHODS: A total of 102 lesions (48 EGCs and 54 gastric adenomas) found in 98 patients were removed endoscopically or surgically. The measured length of each pathology specimen was compared with the lengths estimated using WLE, AFI, and chromoendoscopy. RESULTS: The lesions could be discriminated from surrounding mucosa by AFI in 86 cases (84.3%). The detection rates were similar for elevated lesions (85.1%) and flat/depressed lesions (82.9%, p=0.770). In terms of histology, the detection rate was slightly higher for adenomas (90.7%) than for cancer (77.1%, p=0.058). The estimated length was shorter than the pathologic length in 31.4% of cases when using WLE and 22.1% of cases when using AFI (p=0.168). The resection range was larger for EMR than for AFI in 24 of 80 cases (30.0%). CONCLUSIONS: WLE tends to underestimate the size of EGCs, whereas AFI tends to overestimate their size.
Adenoma ; Endoscopy ; Fluorescence ; Humans ; Mucous Membrane ; Optical Imaging ; Prospective Studies ; Stomach Neoplasms

Hematopoietic stem cell transplantation (HSCT) recipients have a risk of post-transplant lymphoproliferative disorder (PTLD), which normally develops in Epstein-Barr virus (EBV) transformed donor B lymphocytes. The incidence of Hodgkin's lymphoma (HL) ranges from 1.8% to 3.4% of PTLD after HSCT. There are no case reports of early onset HL-like PTLD that developed less than one year after HSCT. We encountered a case of early onset PTLD after an unrelated HSCT following reduced-intensity conditioning with cyclophosphamide/fludarabine/thymoglobulin. A 24 year old patient with severe aplastic anemia developed multiple lymphadenopathies at day 95 after HSCT. The excisional biopsy revealed HL-like PTLD, which tested positive to immunohistochemical staining for the EBV. The Ann Arbor stage was IIA. Immunosuppressive agents were discontinued for 2 weeks in order to induce a graft-versus-lymphoma effect without a response. A total 4 cycles of chemotherapy with doxorubicin (adriamycin)/bleomycin/ vinblastine/dacarbazine (ABVD) and radiotherapy (total dosage 3,400 cGy) were then carried out. The response to salvage treatment was complete remission. The patient showed no evidence of the disease at the follow-up performed 32 months after HSCT.
Anemia, Aplastic ; B-Lymphocytes ; Biopsy ; Doxorubicin ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Herpesvirus 4, Human ; Hodgkin Disease ; Humans ; Immunosuppressive Agents ; Incidence ; Lymphoproliferative Disorders ; Tissue Donors

Plasmodium vivax malaria, which used to be endemic in the past, re-emerged in 1993 and the number of cases has increased annually. Though there has been no proven endemic drug-resistant malaria case reported, widespread use of anti-malarial chemoprophylaxis for the military personnel could cause emergence of resistance. We herein report a case of tertian malaria, which recurred three times despite the standard chloroquine-primaquine therapy. The patient is 40-year-old male, lives in Dongducheon city, Gyeonggy province, and has never been abroad. He visited hospital in September 2000, because of fever. His blood smear revealed ring forms and trophozoites of P. vivax. He took hydroxychloroquine for 3 days and primaquine for 14 days. His symptoms disappeared then. After 7 months he got fever for 2 days and his blood smear revealed schizonts of P. vivax. He took the same medicines and got well next day. Fever recurred 4 month later, and trophozoites were observed on the blood smear. Hydroxychloroquine and primaquine were prescribed in the same way and fever disappeared. Forty three days later, he had fever and positive blood smear of P. vivax trophozoite. Fever disappeared on the day drug was administered and no malaria was detected in follow up smear of 7 and 14 days. He was free of fever in follow up at 3 months later.
Adult ; Chemoprevention ; Chloroquine ; Fever ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Hydroxychloroquine ; Malaria* ; Malaria, Vivax ; Male ; Military Personnel ; Plasmodium vivax ; Primaquine ; Recurrence ; Schizonts ; Trophozoites

Esophageal intramural pseudodiverticulosis is a rare disease characterized by multiple, flask-shaped outpouchings in the esophageal wall. These pseudodiverticula represent abnormally dilated excretory ducts of esophageal submucosal gland, which cause is unknown. The most common symptom is dysphagia associated with esophageal stricture. Frequently associated diseases were gastroesophageal reflux disease, diabetes mellitus, candida esophagitis, and chronic alcoholism. We have experienced a patient with dysphagia and anemia, who was diagnosed as esophageal stricture with intramural pseudodiverticulosis and pancreatic pseudoaneurysm. He was treated with esophageal bougienage for the esophageal stricture and transcatheter embolization for pancreatic pseudoaneurysm. This may be the first case of esophageal intramural pseudodiverticulosis reported in Korea.
Alcoholism ; Anemia ; Aneurysm, False ; Candida ; Deglutition Disorders ; Diabetes Mellitus ; Esophageal Stenosis ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Korea ; Rare Diseases

Adenocarcinoma is the most common type of malignant tumor arising in the stomach, accounting for approximately 95% of malignant gastric neoplasms. The majority of remainder is lymphoma. Although H. pylori infection has been implicated as a common cause of both adenocarcinoma and lymphoma of the stomach, synchronous occurrence of both tumors is very rare. We present a case of a 23- year-old-female who presented with epigastric discomfort and was found to have synchronous low-grade B-cell MALT lymphoma and adenocarcinoma of the stomach in association with H. pylori infection.
Adenocarcinoma ; B-Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Stomach ; Stomach Neoplasms*

In this study we present a case of an angiocentric T-cell lymphoma (ACTL) which involve the esophagus. A 37-year-old male was admitted with dysphagia, odynophagia, and weight loss for 3 months. Two months before his admission, he had undergone on endoscopy with a biopsy. The first endoscopic findings revealed a large ulcerative lesion on the esophagus, although there had been no evidence of lymphoma upon microscopic examination. On the follow up endoscopic examination, this ulcerative lesion revealed progressive and destructive change. Histopathology of the third biopsied specimens showed large atypical lymphocyte infiltrates with angiocentric and angioinvasive features. Immunohistochemical studies revealed that the atypical (large) lymphocytes had T-cell phenotypes (CD3+, CD5+, and CD43+) and contained few reactive B-cells (CD20+), We assume that this is the first case of ACTL involving the esophagus and larynx.
Adult ; B-Lymphocytes ; Biopsy ; Deglutition Disorders ; Endoscopy ; Esophagus* ; Follow-Up Studies ; Humans ; Larynx ; Lymphocytes ; Lymphoma ; Lymphoma, T-Cell* ; Male ; Phenotype ; T-Lymphocytes* ; Ulcer ; Weight Loss

BACKGROUND: Infections and vascular disorders are the two most widely accepted probable causes of sudden hearing loss. Tumor necrosis factor alpha (TNF-alpha) is major pro-inflammatory cytokine that is thought to be important in the pathogenesis of sudden deafness. However, the functions of genetic polymorphism in this cytokine have not been throughly examined in the context of sudden deafness pathology. In an effort to discover polymorphism in genes whose variants have been implicated in sudden deafness phenotypes, we examined the genetic effects of TNF-alpha polymorphisms in Koreans with sudden deafness. METHODS: Two common single nucleotide polymorphism (SNP) in TNF-alpha gene were genotyped in a Korean sudden deafness. Ninety nine patients with sudden deafness (45 males and 54 females) were selected from Keimyung University Dongsan Medical Center. The control subjects consisted of healthy 285 males and 319 females. RESULTS: Human genomic DNA was extracted from peripheral blood sample. The SNP at position -863 C/A and -857 C/T of TNF-alpha promoter were analyzed by PCR and pyrosequencing. Genotype distribution and allele frquencies in subjects were in Hardy-Weinberg equilibrium (p>0.05). No significant association was found between TNF-alpha -863 C/A and -857 C/T polymorphism and sudden deafness. We examined whether the relation between TNF-alpha polymorphism and sudden deafness varied according to tinnitus. Statistical analysis of TNF-alpha polymorphism at -857 C/T showed that there was a significant difference between SD without tinnitus and the control in both genotype distribution (p<0.05) and allele frequency [OR (95% CI)=2.63 (1.29-5.34)], but not between SD with tinnitus. CONCLUSION: These findings suggest TNF-alpha polymorphisms at -863C/A, -857 C/T are likely to play a role in SD.
Alleles ; DNA ; Female ; Gene Frequency ; Genotype ; Hearing Loss, Sudden* ; Humans ; Male ; Pathology ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide* ; Tinnitus ; Tumor Necrosis Factor-alpha*