No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

No abstract available.

We experienced three young patients with diffuse lymphoid hyperplasia of the gastric antrum. The peculiar nodularity of the stomach in tliese patients is another cause of etat mammelanne in addition to hypertrophic gastritis and prominence of the areae gastricae. The etiology of the diffuse lymphoid hyperplasia of the gastric antrum is not known. The symptqm is not specific and not related to hitologic and gastroscopic finding but rather to psychological disturbance. We propose longstanding observation for the change of the nodularity.
Gastritis, Hypertrophic ; Humans ; Hyperplasia ; Pyloric Antrum* ; Stomach

To elucidate iron utilization patterns of Staphylococcus aureus according to the growth, we checked the residual iron concentration and the production of siderophores at the indicated times while culturing S. aureus ATCC 6538 and 25923 strains in brain heart infusion broth. By using streptonigrin susceptibility test and investigating growth curves in three culture media of which iron concentration is 0.2, 20, 45 uM, respectively, we found out that iron metabolism of 6538 strain was more active than that of 25923 strain. In point of tendency of iron consumption, 6538 strain steeply consumed iron just before the onset of stationary phase, but 25923 strain did gradually iron throughout the growth phase. Nevertheless, total amount of iron consumed by each strain during the growth was almost no difference between the strains. CAS diffusion assay in detecting siderophores showed that siderophore production followed iron consumption. These results suggest that the siderophores play significant role in iron utilization in vitro.
Brain ; Culture Media ; Diffusion ; Heart ; Iron* ; Metabolism ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare, life-threatening mucocutaneous diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.
Adrenal Cortex Hormones ; Antipsychotic Agents ; Child ; Depression ; Dexamethasone ; Epidermal Necrolysis, Toxic ; Headache ; Humans ; Immunoglobulins ; Mood Disorders ; Nephrotic Syndrome ; Psychotic Disorders ; Sleep Initiation and Maintenance Disorders ; Steroids ; Stevens-Johnson Syndrome

Gastric outlet obstruction (GOO) is a disease that causes pyloric canal or duodenal atresia by various etiologies. It is mainly caused by malignancy or peptic ulcer and rarely caused by corrosive injury, gastric polyp, pyloric stenosis, bezoar, or biliary stone. We report a rare case of GOO due to unreported etiology. A 74-year-old male patient with medical history of hypertension, diabetes mellitus, and stroke came to the emergency medical center with a chief complaint of acute stomachache. On abdominal computed tomography, it was diagnosed as GOO due to gall bladder distension from acute cholecystitis. During conservative treatment and antibiotics administration, gastrofibroscopy and magnetic resonance cholangiopancreatography was performed to determine other etiologies; however, the final diagnosis was made as acute cholecystitis. After laparoscopic cholecystectomy, he was discharged without specific complications. On a pathology examination postoperation, there was no specific diagnosis, except for acute cholecystitis. Gastric outlet obstruction is caused by various etiologies, with the course of treatment being dependent on the specific etiology. We report a rare case of GOO caused by gall bladder distension due to acute cholecystitis. Various etiologies should be considered carefully to include even the rare etiologies for choosing the correct treatment.
Abdominal Pain ; Aged ; Anti-Bacterial Agents ; Bezoars ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute* ; Diabetes Mellitus ; Diagnosis ; Emergencies ; Gastric Outlet Obstruction* ; Humans ; Hypertension ; Male ; Pathology ; Peptic Ulcer ; Polyps ; Pyloric Stenosis ; Stroke ; Urinary Bladder*

BACKGROUND: Vitamin D is thought to play an important role in adipogenesis and in preventing a variety of diseases. There are few studies that analyze the relationship between vitamin D and the distribution of fat in Korean population. This study analyzed the vitamin D status in adults and evaluated its relationship with obesity also with cardiovascular risk factors in a Korean community. METHODS: Subjects involved patients who visited a health promotion center. Anthropometric measurements as in subcutaneous adipose tissue, visceral adipose tissue, body mass index, waist circumference, and blood pressure were assessed. Blood tests including glucose, hemoglobin A1c, lipid profiles, 25(OH)D were evaluated. We analyzed the correlation between 25(OH)D concentrations with obesity factors and with cardiovascular risk factors. RESULTS: Among the studied patients, 25(OH)D status was sufficient for 2.7%, insufficient for 27.2%, and deficient for 70.1%. 25(OH)D was negatively correlated with visceral adipose tissue, but no association was found between subcutaneous fat, waist circumference and body mass index. Among cardiovascular risk factors, glucose, hemoglobin A1c, total cholesterol, triglyceride, low density lipoprotein-cholesterol were negatively correlated with vitamin D. CONCLUSION: Vitamin D deficiency was found in 70.1% in this community. Vitamin D level showed significant correlation with visceral adipose tissue among abdominal fat tissue, but less significant correlation with cardiovascular risk factor.
Abdominal Fat ; Adipogenesis ; Adiposity ; Adult ; Blood Pressure ; Body Mass Index ; Cholesterol ; Glucose ; Health Promotion ; Hematologic Tests ; Humans ; Intra-Abdominal Fat ; Obesity ; Risk Factors ; Subcutaneous Fat ; Triglycerides ; Vitamin D Deficiency ; Vitamin D ; Waist Circumference

OBJECTIVE: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%-6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. METHODS: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was > or =5.7% or <5.7%. Lipid levels, blood pressure, BMI (kg/m2), total abdominal, and visceral fat levels were measured by computed tomography. RESULTS: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, 6.03+/-0.8% and 5.88+/-0.72%(p<0.05). Only the mean values of age and visceral fat area were different between HbA1c> or =5.7% and <5.7% in both male and female group (p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c > or =5.7% (odds ratio=1.005, 95% CI 1.002~1.008). CONCLUSIONS: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is > or =5.7%. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs.
Adult ; Blood Pressure ; Cardiovascular Diseases ; Diabetes Mellitus ; Female ; Health Education ; Hemoglobins ; Humans ; Intra-Abdominal Fat ; Male ; Prediabetic State ; Risk Factors

Toxic epidermal necrolysis (TEN) is a rare, acute, serious, and potentially fatal skin disease, in which cell death causes the epidermis to separate from the dermis. It is thought to be a hypersensitivity complex that affects the skin and mucous membranes, and is caused by certain medications, infections, genetic factors, underlying immunologic disease, or more rarely, cancers. We report two cases of TEN associated with deflazacort (DFZ), a derivative of prednisolone, used in the first episode of nephrotic syndrome (NS). The skin eruption appeared on the 4(th) and 5(th) weeks after DFZ administration, while NS was in remission. The widespread lesions were managed by intensive supportive treatment, discontinuation of DFZ, and oral administration of cyclosporine. Both patients showed a rapid improvement in symptoms of TEN without any complications or relapse of NS.
Administration, Oral ; Cell Death ; Cyclosporine* ; Dermis ; Epidermis ; Humans ; Hypersensitivity ; Immune System Diseases ; Mucous Membrane ; Nephrotic Syndrome* ; Prednisolone ; Recurrence ; Skin ; Skin Diseases ; Stevens-Johnson Syndrome*

PURPOSE: It is not always easy to determine the existence of tendon injuries when it comes to patients with finger lacerations. Thus, we tried to find the difference in effectiveness and in compliance of patients when we employed two different types of diagnosis, conventional gross confirmation and ultrasonographic confirmation. METHODS: From December 2009 to March 2010, we enrolled 14 patients with finger tendon injury at Soonchunhyang University Cheonan Hospital. The median age of the patients was 35.9+/-14.4, and the ratio of females to males was 1:2.5 We evaluated the compliance of each patient by measuring four different categories (level of cooperativeness in showing their wound and in following the instructions, level of movement of their fingers during the diagnosis and total number of attempts to diagnose) by using a score from 1 to 3 for each category, for a total possible score of 12 for each patient. We also measured the painfulness of each patient by using a score of 1 to 10 and the time required for each diagnosis. RESULTS: The levels of patients' compliance was 8.9+/-2.1 when diagnosed with gross confirmation and 9.8+/-2.1 when diagnosed with ultrasonographic confirmation (p value=0.042). The pain score of the patients was 3.7+/-1.7 with gross confirmation and 2.9+/-1.2 with ultrasonographic confirmation (p value=0.020). The median duration of time in each test was 6.7+/-4.8 minutes with gross confirmation and 10.5+/-4.2 minutes with ultrasonography (p value=0.006). CONCLUSION: Comparing gross confirmation and ultrasonographic confirmation, gross confirmation is a better method than ultrasonography because of time efficiency. However, ultrasonographic confirmation has advantages over gross confirmation in pain scale and better compliance of patients. Emergency physicians generally employ gross confirmation rather than ultrasonography in determining the existence of tendon injury in patients. In patients with finger lacerations without bone injury, ultrasonography can be considered as a secondary diagnostic tool, especially when patients have much pain.
Compliance ; Emergencies ; Female ; Fingers ; Humans ; Lacerations ; Male ; Tendon Injuries ; Tendons