The etiology of pulmonary edema are myriad. Pulmonary edema is a complication of acute upper airway obstruction secondary to laryngospasm. When pulmonay edema occurs, it usually follows relief of the obstruction. Acute pulmonary edema must be treated promptly among the patients who recover from acute upper airway obstruction. The treatments are fluid restriction, diuretics, steroids, ventilatory assistance to maintain oxygenation. Ventilatory assistance is important and has various methods, but we chosed intrapulmonary percussive ventilation (IPV). It is of benefit to adequate oxygenation without ventilatory induced lung linjury (VILI), easy removal of secretion, intratracheal nebulization with bronchodilator, and patient's comfortness. We present a case of noncardiogenic pulmonary edema that occured in an adult patient following extubation of the trachea caused by a laryngospasm.
Adult ; Airway Obstruction* ; Diuretics ; Edema ; Humans ; Laryngismus ; Lung ; Oxygen ; Pulmonary Edema* ; Steroids ; Trachea ; Ventilation*

It has been known that dilated cardiomyopathy(DCM) is characterized by systolic dysfunction of left ventricle(LV), but there were few studies about correlation between LV systolic function, diameter and diastolic function measured by echocardiography and radionuclide ventriculography(RVG) The purpose of this study is to evaluate LV systolic and diastolic function as well as RV function using regional ejection fraction and functional images by RVG in 17 patients with DCM and to compare these variables with echocardiographic data. The results are as follows : 1) DCM showed diffuse systolic and diastolic dysfunction of LV. The systolic impairment is accounted for the diastolic impairment in DCM. 2) The increased standard deviation of phase angle of left ventricle(LVSDph) revealed LV asynchronous contraction in DCM. 3) LVSDph showed significant correlations with other RVG parameters such as LV ejection fraction, and peak ejection rate, peak filling rate and also with LV systolic and diastolic diameter measured by echocardiography. It is concluded that LVSDph may be useful in evaluation of LV systolic and diastolic function in patients with DCM as well as LV asynchronous contraction.
Cardiomyopathy, Dilated* ; Echocardiography* ; Humans ; Radionuclide Ventriculography* ; Ventricular Function, Right*

The reVersible posterior leukoencephalopathy syndrome (RPLS) describes a syndrome of headaches, confusion, seizures, and visual disturbances associated with transient, predominantly posterior cerebral lesions revealed by neuroimaging. RPLS has been associated clinically with hypertension, immunosuppression, and known triggers include acute renal failure, eclampsia, cyclosporine, and lupus. We report a 45-year-old male with chronic renal failure showed RPLS following hemodialysis and review literatures.
Acute Kidney Injury ; Cyclosporine ; Eclampsia ; Female ; Headache ; Humans ; Hypertension ; Immunosuppression ; Kidney Failure, Chronic* ; Male ; Middle Aged ; Neuroimaging ; Posterior Leukoencephalopathy Syndrome* ; Pregnancy ; Renal Dialysis ; Seizures

Numerous studies have investigated quantifying dietary intake according to the weight status of children and adolescents. However, studies on differences in quality among diets remain scarce. This study compared diet quality by weight status and examined correlations between quality of diet and obesity in children and adolescents. Two hundred fourteen children and adolescents aged between 9 and 18 years participated in this study (Normal weight n=104, Obesity n=110). The data related to food intake were investigated by dietary records, Diet Quality Index-International (DQI-I), and Nutrition Quotient (NQ) and then compared with Dietary Reference Intakes for Korean (KDRIs). In DQI-I, moderation factor (control of unhealthy foods) score was 21.7 in the normal weight group and 19.5 in the obesity group. The normal weight group showed a higher score for moderation factor than the obesity group (P<0.001). Compared with KDRIs, vitamin B6, folate, vitamin C, vitamin E, calcium, potassium, and zinc intakes were insufficient in both groups. Multiple logistic regression analysis revealed that DQI-I moderation was negatively associated with obesity (OR=0.77, 95% CI 0.69-0.87) after adjustment for age, gender, income, and total energy intake. Our results suggest that children and adolescents require nutritional education to understand the importance of vitamin and mineral consumption. Especially, education for children and adolescents with obesity needs to emphasize moderation of nutrient intake that can cause diseases with hyper-ingestion such as sodium and high calorie-low nutrition foods.
Adolescent* ; Ascorbic Acid ; Calcium ; Child* ; Diet Records ; Diet* ; Eating ; Education ; Energy Intake ; Folic Acid ; Humans ; Logistic Models ; Miners ; Obesity* ; Potassium ; Recommended Dietary Allowances ; Sodium ; Vitamin B 6 ; Vitamin E ; Vitamins ; Zinc

BACKGROUND: Radiofrequency catheter ablation (RFCA) becomes an useful treatment for idiopathic ventricular tachycardia, especially right ventricular outflow tract ventricular tachycardia (RVOT VT) typically originates from "superior septal" aspect of right ventricular outflow tract. However, some of the right ventricular outflow tachycardias remain resistant despite repeated attempts of RFCA. This study was focused to search the electrocardiographic characteristics suggesting procedural success of radiofrequency ablation in RVOT VT and ventricular tachycardia that can not be ablated by conventional approach confined to right ventricular outflow tract even though to show similar electrocardiographic morphology. METHODS: The study subjects were 25 patients who underwent RFCA with the diagnosis of RVOT VT. We classified the study subjects into 2 groups and in group 1 (N=17, Age 47.5 +/- 16.8) in those successful RFCA was possible in RVOT. In group 2 (N=8, Age 54.8 +/- 8.0), the removal of VT was not possible with the RFCA confined in RVOT. We analyzed the morphologic characteristics of QRS complex of VT or ventricular premature beats in right precordial leads; V(1-3). The QRS and R wave duration, height of R wave, depth of S wave, R/S ratio and R wave duration index were measured. RESULTS: There was no difference of age and sex between group 1 and 2 (Group 1: N=17, Male 29.4%, Age 49.5 +/- 16.8 vs Group 2: N=8, Age 54.8 +/- 8.0, Male 37.5%). The maximal QRS duration in V(1-3) was 144.2 +/- 23.6 ms in group 1 and 136.3 +/- 25.1 ms in group 2. The R wave duration and R wave duration index were not different either between group 1 and 2. However, the R wave duration of lead V 3 in group 2 was 97.0 +/- 34.4 ms and significantly longer than 65.0 +/- 26.0 msec in Group 1 (p=0.04). R wave duration index also showed significant difference between two groups: 72.0 +/- 23.5% of group 2 vs 45.4 +/- 17.8% of group 1. In comparison of R wave height and depth of S wave in V(1-3) between two groups, the R/S ratio of lead V3 in group 2 showed the ratio of 343.4 +/- 227.7% which was significantly larger than 97.4 +/- 92.2% in group 1. CONCLUSION: For the practice of RFCA for RVOT VT, morphologic characterstics of VT or VPC showing wide R wave and high R/S wave ratio in precordial leads, especially in V3 could be an useful electrocardiographic indicator to suspect the unusual focus of idiopathic VT showing inferior axis and LBBB pattern.
Axis, Cervical Vertebra* ; Bundle-Branch Block* ; Cardiac Complexes, Premature ; Catheter Ablation* ; Diagnosis ; Electrocardiography ; Humans ; Male ; Tachycardia ; Tachycardia, Ventricular*