We studied the association of nonspecific bronchial hyperresponsiveness with general characteristics, exposure concentration, respiratory symptoms, chest x-ray findings, past histories and pulmonary function. We determined bronchial hyperresponsiveness by methacholine challenge test. And we conducted a respiratory symptom questionnaire and performed spirometry on 111 workers occupationally exposed to isocyanates in various industries. About 21.6% of subjects had bronchial hyperresponsiveness. No significant differences were observed between the hyperresponsive and non-responsive group with respect to age, sex, employment period, height, and smoking histories cough and breathlessness were significantly associated with the bronchial hyperresponsiveness. The hyperresponsive group had more experience of bronchitis and asthma in the past than the non-responsive group. The lower FEV1 and FEV1 % were closely related with bronchial hyperresponsiveness. Bronchial hyperrespoosiveness seems to be associated with some of respiratory symptoms, past histories and pulmonary function parameters in workers exposed to isocyanates.
Asthma ; Bronchitis ; Cough ; Employment ; Isocyanates* ; Methacholine Chloride ; Occupations ; Surveys and Questionnaires ; Smoke ; Smoking ; Spirometry ; Thorax

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*

BACKGROUND: The diagnosis of chlamydial infection is based on serology. The current gold standard of diagnosis is MIF(microimmunofluorescence), but this modality is subjective and time-consuming. Protein microarray with using a SPR(surface plasmon resonance) sensor has recently been suggested as a method for detecting infection. For developing a protein chip to diagnose chlamydial infection, EBs(elementary bodies) were immobilized on a gold chip and the interaction between an antibody for Chlamydophila pneumoniae and the EBs(elementary bodies) immobilized on the surface of the gold chip was measured by using an SPR sensor. METHODS: For the surface antigen, the EBs of Chlamydophila pneumoniae LKK1 were purified. Charged arrays were prepared by using PDDA(polydiallyldimethylammonium chloride) which has a positive charge. After immobilization of the chlamydial EBs on the PDDA surface, the investigation of the surface was done with using atomic force microscopy. After the antibody for C. pneumoniae was applied on chip, we monitored the SPR wavelength-shift to detect any antigen-antibody interaction with using a self-assembled SPR sensor. RESULTS: The chlamydial EBs on the positively charged PDDA were visible on the surface with using atomic force microscopy. The SPR wavelength increased after interaction of antibody for C. pneumoniae with the EBs immobilized on charged gold surface. The wavelength-shift was correlated with the concentration of antigens. CONCLUSION: The surface immobilization of EBs on the gold surface with the charged arrays was identified and the antigen-antibody interaction on the gold chip was detected via the SPR sensor. Further investigations are needed to apply this technique to the clinical field.
Antigens, Surface ; Chlamydial Pneumonia ; Chlamydophila pneumoniae ; Diagnosis* ; Immobilization ; Microscopy, Atomic Force ; Pneumonia* ; Protein Array Analysis*

We presented a patient with cerebral decompression sickness, who showed predominant vasogenic edema on a 3.0 Tesla (3T) magnetic resonance imaging (MRI) findings, including diffusion-weighted image (DWI) and apparent diffusion coefficient (ADC) mapping. Within minutes of surfacing, he developed paresis of the right lower limb. During transport, he began shivering, followed by severe spasm that eventually progressed to a tonic-clonic seizure. Emergent hyperbaric oxygen therapy (HBOT) was performed with U.S. Navy treatment table 6A after a treatment of seizure activity. Brain MRI was performed after hyperbaric oxygen therapy to detect any cerebral lesions, which showed subcortical hyperintensity signal changes in the left fronto-parietal region on the ADC map. Overlying cortical hyperintensity on DWI sequences and cortical hypointensity on the ADC map were simultaneously observed. Moreover, these findings disappeared in a followup MRI with complete resolution of symptoms. These findings indicate that vasogenic edema can cause cerebral decompression sickness (DCS) and that 3T MRI with DWI and ADC mapping may be useful for diagnosing cerebral DCS. In addition, these findings suggest that DW-MRI may also be useful in predicting the prognosis of cerebral DCS.
Brain ; Brain Edema ; Decompression Sickness* ; Decompression* ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Edema ; Follow-Up Studies ; Humans ; Hyperbaric Oxygenation ; Lower Extremity ; Magnetic Resonance Imaging* ; Paresis ; Prognosis ; Seizures ; Shivering ; Spasm

Kounis syndrome refers to an acute coronary syndrome induced by an allergic reaction. Kounis syndrome is not a rare disease but is considered to be underdiagnosed. This syndrome is a potentially life threatening medical emergency. We described a case of Kounis syndrome caused by injection of intravenous gadolinium-based contrast agent. We also discussed emergency drugs used for treatment of Kounis syndrome.
Acute Coronary Syndrome* ; Anaphylaxis* ; Contrast Media ; Emergencies ; Hypersensitivity ; Rare Diseases

OBJECTIVES: To investigate the role of ATP-sensitive potassium channel (KATP) during sustained ventricular fibrillation (VF), the effects of gliburide, a specific blocker of KATP channel and PCO400, an KATP opener, were studied in isolated and perfused swine right ventricular free walls (n=). METHODS: Recording of single cell transmembrane potentials was performed and constructed action potential duration restitution (APDR) curve by plotting APD 90%(APD90) versus preceding diastolic interval (DI). RESULTS: All isolated tissues fibrillated spontaneously. In this preparation, stable VF could persist over a 4-hour period if it was allowed to continue undisturbed (n=). Gliburide (1-5 uM) increased DI without significant changes in APD90 during VF, resulting in more regularization of VF. Higher concentration (10-20 uM) increased both APD90 and DI, and converted to monomorphic ventricular tachycardia (MVT) through the transitional period characterized by APD alternans. PCO400 (1-2.5 uM) caused a significant shortening of APD during MVT and a period of APD alternans became more evident before conversion from MVT to VF. Gliburide eliminated profibrillatory effect of PCO400. This antifibrillatory action of gliburide was accompanied by gradual decrease in the maximum slope of APDR curve during VF. CONCLUSION: KATP channel blockade causes a transition from VF to MVT via lengthening of DI and APD alternans, concomitantly with a reduction of the slope of APD restitution curve.
Action Potentials ; Membrane Potentials ; Potassium Channels ; Swine ; Tachycardia, Ventricular ; Ventricular Fibrillation*

The corpus callosum consists of white fibers connecting the cerebral hemispheres. Agenesis of the corpus callosum is an uncommon congenital anomaly which is easily diagnosed in the postnatal period by ultrasound and computed tomographic scan or MRI, but its prenatal sonographic diagnosis is difficult because of fetal head positioning and limiting trans-axial scans. We experienced a case of agenesis of the corpus callusum with chromosomal anomaly. The prenatal sonographic findings are ventricular abnormalities that demonstrated dilatation of lateral ventricles and disproportionate enlargement of the occipital horns, which were suggestive findings for the corpus callosal agenesis. We could confim the diagnosis of the corpus callosal agenesis with chromosome anomaly by postnatal MRI and chromosome analysis.
Agenesis of Corpus Callosum* ; Animals ; Cerebrum ; Corpus Callosum ; Diagnosis ; Dilatation ; Head ; Horns ; Lateral Ventricles ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: Return of spontaneous circulation (ROSC) is closely related to a favorable treatment outcome in out-of-hospital cardiac arrest and is also a reliable treatment target in clinical trials. The aim of this study is the identification of major factors affecting field ROSC by analyzing the updated data encompassing the pre-hospital treatment processes. METHODS: This is a retrospective review of cardiopulmonary resuscitation (CPR) cases performed by 119 rescuers before hospital arrival from January 2012 to December 2014 in one province. Cases with traumatic cardiac arrest, unnecessary CPR, arrest occurred during transport, under age 14 years, and incomplete medical records were excluded. RESULTS: Of 1,832 patients enrolled in the study, ROSC was achieved in 99 cases (5.4%). Among them, 50 (50.5%) had ROSC at the event field and others achieved ROSC during the transport process, respectively. Total cases were divided into two groups based on ROSC before arrival at the hospital. Age, underlying cardiovascular illnesses, the event place, presence of a witness, bystander CPR, application of an automated external defibrillator (AED), the initial shockable rhythm, defibrillation, advanced airway, hydration, the arrival time of rescuer CPR, application time of AED, and defibrillation showed significant statistical differences. In multivariate analysis, age, defibrilOf 1,832 patients enrolled in the study, ROSC was achieved in 99 cases (5.4%). Among them, 50 (50.5%) had ROSC at the event field and others achieved ROSC during the transport process, respectively. Total cases were divided into two groups based on ROSC before arrival at the hospital. Age, underlying cardiovascular illnesses, the event place, presence of a witness, bystander CPR, application of an automated external defibrillator (AED), the initial shockable rhythm, defibrillation, advanced airway, hydration, the arrival time of rescuer CPR, application time of AED, and defibrillation showed significant statistical differences. In multivariate analysis, age, defibrillation, hydration, bystander CPR, and the call-to-rescuer CPR interval appeared to be correlated with field ROSC. CONCLUSION: To improve the survival rate through field ROSC, a public campaign to improve bystander CPR, prompt recognition of cardiac arrest, and rapid application of pre-hospital treatment and political support of the public institution are mandatory.
Cardiopulmonary Resuscitation ; Defibrillators ; Emergency Medical Services ; Heart Arrest ; Humans ; Medical Records ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Posterior epidural migration of a sequestrated intervertebral lumbar disc with cauda equina syndrome is quite rare. This paper reports two unusual cases of posterior epidural migration of a sequestrated intervertebral lumbar disc with cauda equina syndrome to emphasize the importance of early diagnosis and complete decompression.
Cauda Equina ; Decompression ; Early Diagnosis ; Polyradiculopathy

Objective: Hyperbaric oxygen therapy (HBOT) is the most crucial treatment for decompression sickness (DCS), which needs to be administered as swiftly as possible. This study evaluates the therapeutic responses of DCS patients and analyzes the major factors for clinical outcomes. Methods: This is a retrospective cohort single-center study on patients who arrived at our hospital’s emergency department for diving-related symptoms and were diagnosed with DCS and administered HBOT. Results: Totally, 337 patients were enrolled from June 2015 to May 2020. The proportion of SCUBA diving, rapid ascent, and inter-facility transport cases was higher in the recreational group, with a longer lag time from symptom onset to HBOT. The professional group had a higher proportion of cases with previous DCS history, total diving time, bottom time, in-water decompression, and repetitive diving. Examination of treatment outcomes revealed more type I cases and a shorter lag time from symptom onset to HBOT in the complete recovery group. Conversely, the incomplete recovery group had a higher proportion of type II cases and aggravation of symptoms before HBOT was administered. Conclusion DCS can occur regardless of professional or recreational divers. Both groups showed a similar level of severity. It is recommended that recreational divers should be cautious of accidents related to safety (such as rapid ascent) and receive swift treatment in case of the onset of symptoms. Occupational divers need more active efforts to get HBOT rather than just performing in-water recompression or home O2 therapy.