Endosulfan is an agricultural chemical of organic chlorine, is toxic in both the central nervous system and the cardiovascular system, and causes respiratory system disorder and deaths by status epilepticus, respiratory distress, and so on. The use of this agricultural chemical of organic chlorine is limited by its toxicity. However, it is still used as a common insecticide, so it is readily to available. Four elderly people were admitted with depression of consciousness and convulsions after eating pan-fried food. During their treatment, the patients were diagnosed with endosulfan intoxication, completely by accident. We are reporting these cases of endosulfan intoxication that showed variable clinical findings from mild sequelae to death.
Aged ; Cardiovascular System ; Central Nervous System ; Chlorine ; Consciousness ; Depression ; Eating ; Endosulfan* ; Humans ; Respiratory System ; Seizures ; Status Epilepticus

PURPOSE: As a sedative hypnotic agent, etomidate has a little side effect like respiratory depression and has an excellent pharmacokinetics and hemodynamics. The objective of this study is comparison of etomidate effect in the two groups, only lidocaine injection group and combinational administration group, during closed thoracostomy in the emergency department. METHODS: The patients with respiratory problems, which needed a closed thoracostomy, from March 1, 2003 to February 29, 2004 were enrolled in this prospective study. Thus, we were enrolled 68 patients. etomidate were used for 34 patients and only lidocaine local injection was used for 34 patients. Patients of combinational administration were randomized to receive intravenous boluses of etomidate (0.2 mg/kg) prior to fentanyl (1.0 ug/kg) during PSA (procedural sedation anesthesia). We recorded pre-administration and interval of 5 minute, 10 minute, 15 minute and transcutaneous oxygen saturation, heart rate, respiratory rate, blood pressure, degree of sedation, satisfaction of sedation, and side effects after administration. RESULTS: Of all combinational administration group, significant hemodynamic, as hypotension or bradycardia etc. and respiratory depression, as apnea or tachypnea etc. were absent. With comparison of two groups, significant clinical problems and statistics were not different and degree of sedation was fast and impaired conscious was effective in the combinational administration group. CONCLUSION: We conclude combinational administration with etomidate and fentanyl during procedural sedation is safty and excellent effectiveness. Therefore we recommened the use of etomidate for emergency procedural sedation in emergency department.
Apnea ; Blood Pressure ; Bradycardia ; Emergencies ; Emergency Service, Hospital ; Etomidate* ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Hypnotics and Sedatives* ; Hypotension ; Lidocaine ; Oxygen ; Pharmacokinetics ; Prospective Studies ; Respiratory Insufficiency ; Respiratory Rate ; Tachypnea ; Thoracostomy*

Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.
Atrial Septum ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Child ; Echocardiography ; Heart Atria ; Heart Murmurs ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Korea ; Pulmonary Veins ; Thorax

PURPOSE: A general analysis of patients in the Emergency Department (ED) and the Intensive Care Unit (ICU) was performed to evaluate the effectiveness of a noninvasive ventilator (NIV) for the effective treatment of patients in respiratory distress without using endotracheal intubation. METHODS: The 38 patients who were treated with a NIV from December 1, 2001, to September 31, 2002, were studied. The ER doctors investigated prospectively sex, age, the causes of disease, the main symptoms, the duration of treatment, the mode of ventilation, the vital signs and the arterial blood gas analysis at the time of admission and after 30 minutes of NIV use, adaptation of patients, complications, and the success or failure of the treatment. RESULTS: 1) General features: Out of 38 cases, 25 males and 13 females, the average age was 60.61 years old. In group X (treatment success), the average age was significantly lower than it was in group Y (treatment failures). 2) The causes of disease and symptoms: The causes of disease were as follows: asthma and chronic obstructive pulmonary disease, 13 patients; drug intoxication, 8 patients; pulmonary edema, 8 patients; respiratory failure, 2 patients; lung contusion, 3 patients; pneumonia, 2 patients. 3) Adaptation and complications: 11 patients adapted well, 18 patients adapted normally, and 11 patients failed. Complications were minimal and included gastric distension in 2 patients and xerophthalmia in another 2. 4)Vital signs and arterial blood gas analysis results: The arterial blood gas analysis performed after 30 minutes in treatment showed improved results, but only the pH had any effect on success or failure. CONCLUSION: NIV had a success rate of 72%. The factors influencing success were surveyed according age, pH level before treatment, pH P a C O2 S a O2 30 minutes after treatment, and adaptation.
Asthma ; Blood Gas Analysis ; Contusions ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Intubation, Intratracheal ; Lung ; Male ; Pneumonia ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema ; Respiratory Insufficiency ; Ventilation ; Ventilators, Mechanical* ; Vital Signs ; Xerophthalmia

PURPOSE: To find the factors influencing the immediate and late outcome of replantation and revascularization of the digits, we carried out a prospective study from 1998 to 1999 with at least a 1-year followup. Traumatic total and subtotal amputations with inadequate circulation of the digits distal to the metacarpal head were included in the study. METHODS: This study was carried out as a prospective study from 1998 to 1999 with at least a 1- year followup. The relationship between age, sex, extent of injury, type of injury, ischemic time, regular smoking, level of injury, and survival rate were analyzed. There were 234 patients with 155 males (254 digits) and 79 females (129 digits). RESULTS: Successful operation was found in 203 patients (86.3%), 314 digits (82%). Although male patients seemed to have poorer survival rates than female, it should be noted that male patients had more severe injuries than female patients. All patients who were regular cigarette smokers were males. Cigarette smoking has been shown to cause cutaneous vasoconstriction, decrease the digital blood flow, and impair the wound healing. These two reasons might explain the lower survival rate in males than in females. Type of injury significantly affected the survival rate. The survival rate was very low in extensive crushed amputation (11.1% survival rate), followed by degloving (21.1% survival rate) and avulsion (64.7% survival rate) amputation. The level of injury also seemed to determine the survival rate as injury at Zone I (65% survival rate) resulted in a poor survival rate compared to the injury at Zone II, III, or IV (92%, 97.6%, or 90.9% survival rate). Ischemic time longer than 8 hours might lessen the survival rate. CONCLUSION: All patients who had successful replantation and revascularization were satisfied with the results even though they had rather poor hand movement. In single digital replantation, no patients needed reamputation, but all preferred to have their finger replanted than udergo a primary amputation. All could accommodate and adapt their injured digits to their work.
Amputation ; Female ; Fingers ; Follow-Up Studies ; Hand ; Head ; Humans ; Male ; Prospective Studies ; Replantation* ; Smoke ; Smoking ; Survival Rate ; Tobacco Products ; Vasoconstriction ; Wound Healing

The incidence of skull tuberculosis is very rare, with only a few cases reported as a result of a simple radiography and computed tomographic findings. In this study, we report the magnetic resonance image (MRI) findings of a case of skull tuberculosis, which was confirmed histologically.
Frontal Bone ; Incidence ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Skull ; Tuberculosis ; Tuberculosis, Osteoarticular

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.
Adult* ; Anesthesia ; Eating* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Risk Factors ; Water*

BACKGROUND AND OBJECTIVES: The idiopathic sudden sensorineural hearing loss is a disease that develops within several hours to several days. Its etiology is not verified yet, but disturbance of blood circulation in the inner ear, intracochlear membrane break, inner ear hydrops and viral infection are considered as possible causes of disease. The herpes virus family is one of the possible viral pathogens that can cause a sudden hearing loss. The purpose of this study was to evaluate the effect of antiviral agent (Vacrovir, 200 mg/T, acyclovir) on sudden sensorineural hearing loss. MATERIALS AND METHOD: Fifty-eight ears were studied from 56 patients who were admitted to Konkuk University Medical Center Minjoong Hospital from December 1993 to August 1999. Fifty eight ears were divided into experimental (30 ears) and control (28 ears) groups. Acyclovir (3000 mg/ day) was added to the therapeutic regimen in the experimental group. The effect of antiviral agent therapy was analyzed according to the factors relating to the prognosis. RESULT: 1) Total recovery rate of the experimental group(76.7%) was significantly (p<0.05) better than that of the control group (46.4%). 2) In the patients whose age was less than fifty, the recovery rate of experimental group (84.2%) was significantly better than that of the control group (50,0%). 3) The patients who had been treated within 2 weeks after symptoms had developed had a better recovery rate in the experimental group (80.8%) as compared with the control group (48.0%) significantly(p<0.05). 4) If the initial hearing loss was in the mild to severe range, the recovery rate of experimental group (77.8%) was better than that of the control group (41.7%) with the significance of p<0. 05. 5) In the patients who had tinnitus as a accompanying symptom, the recovery rate of experimental group (76.0%) was better than that of the control group (43.5%) significantly (p<0.05). 6) In the patients who had no dizziness, the recovery rate of experimental group (80.0%) was better than that of the control group (47.4%) significantly (p<0.05). 7) In the cases associated with URI (upper respiratory infection), the recovery rate of experimental group (100.0%) was better than that of the control group (66.7%), but this was not statistically significant (p>0.05). CONCLUSION: These results suggest that the antiviral agent therapy seems to be effective on the recovery of sudden sensorineural hearing loss. The factors which affect good prognosis in the antiviral agent therapy were age (less than fifty years), early initial treatment that began within 2 weeks, mild to severe hearing loss, accompanying symptom of tinnitus and no dizziness.
Academic Medical Centers ; Acyclovir ; Blood Circulation ; Dizziness ; Ear ; Ear, Inner ; Edema ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Membranes ; Prognosis ; Tinnitus

The Tian Shan mountain system is one of the large mountain ranges located in Central Asia. This region is globally recognized as mountain ranges, offering inestimable wealth in fauna and flora with significant biodiversity values. We surveyed macrofungal diversity of Tian Shan in Kyrgyzstan from 2016 to 2018. A collection of macrofungi was made, and these were subjected to sequence comparisons and phylogenetic analysis to ensure the identity of the collected macrofungi. Of those collected, 95 out of 100 specimens were successfully sequenced and compared with those of other related species retrieved from GenBank. The sequenced specimens were classified into 2 phyla, 8 orders, 24 families, 47 genera, and 57 species, based on current taxonomic concepts (combining morphology and phylogeny). To the best of our knowledge, this study provides the first well-documented checklist and phylogenetic analysis of macrofungi recovered from the Tian Shan mountains in Kyrgyzstan.

PURPOSE: We wanted to analyze the mammographic and clinical findings of the non-mass image-forming low echoic areas seen on breast ultrasonography (US) and investigate their pathologic results. MATERIALS AND METHODS: Sixty-nine patients with 72 non-mass image-forming low echoic areas seen on breast US and who had undergone mammography and biopsy were included in this study. The mammographic findings were divided into 2 groups: 1) the negative or probably benign group and 2) the suspicious for malignancy group. The US findings were divided into 3 groups: focal, segmental and diffuse distributions. The clinical findings were divided into 2 groups: the non-palpable and palpable groups. We investigated the pathologic results according to each group. RESULTS: Of the 72 lesions, 49 (68.1%) were benign and 23 (31.9%) were malignant. On the mammography, 42 (93.3%) of the 45 negative or probably benign findings and 7 (25.9%) of 27 suspicious for malignancy findings were pathologically benign (p < 0.001). On the US, 38 (76%) of the 50 focal distributions and 11 (52.4%) of 21 segmental distributions were benign (p = 0.090). Thirty (73.2%) of the 41 nonpalpable lesions and 19 (61.3%) of the 31 palpable lesions were benign (p = 0.609). CONCLUSIONS: A non-mass image-forming low echoic area seen on breast US was malignant at a higher rate when it was found in conjunction with suspicious mammographic finding. There was no significant correlation between the distribution of the non-mass image-forming low echoic areas on US or their palpability and the pathologic results.
Biopsy ; Breast ; Humans ; Mammography ; Ultrasonography, Mammary