Polyethylene glycol (PEG)-3350 is the most frequently used lavage solution for bowel cleansing prior to colonoscopy or elective surgery because its large molecular weight means that it is poorly absorbed. However, if it leaks into the peritoneal cavity, complications may arise. Few published studies have assessed the absorption, distribution, metabolism and excretion of PEG. Moreover, no published clinical data regarding complications due to the intra-peritoneal leakage of PEG-3350 could be found. We report on an elderly patient who developed the poisoning caused by leaking of PEG-3350 during bowel preparation. It resulted in severe metabolic acidosis, hypernatremia, hyperosmolality and a high anion gap, but it was effectively treated with early continuous renal replacement therapy after surgery.
Absorption ; Acid-Base Equilibrium ; Acidosis ; Aged* ; Colonoscopy ; Humans ; Hypernatremia ; Metabolism ; Molecular Weight ; Peritoneal Cavity ; Poisoning* ; Polyethylene Glycols* ; Renal Replacement Therapy ; Therapeutic Irrigation

No abstract available.
Orbit*

No abstract available.
Pregnancy*

OBJECTIVE: Placental oxidative stress is known to be a factor that contributes to pregnancy failure. The aim of this study was to determine whether selenium could induce antioxidant gene expression and regulate invasive activity and mitochondrial activity in trophoblasts, which are a major cell type of the placenta. METHODS: To understand the effects of selenium on trophoblast cells exposed to hypoxia, the viability and invasive activity of trophoblasts were analyzed. The expression of antioxidant enzymes was assessed by reverse-transcription polymerase chain reaction. In addition, the effects of selenium treatment on mitochondrial activity were evaluated in terms of adenosine triphosphate production, mitochondrial membrane potential, and reactive oxygen species levels. RESULTS: Selenium showed positive effects on the viability and migration activity of trophoblast cells when exposed to hypoxia. Interestingly, the increased heme oxygenase 1 expression under hypoxic conditions was decreased by selenium treatment, whereas superoxide dismutase expression was increased in trophoblast cells by selenium treatment for 72 hours, regardless of hypoxia. Selenium-treated trophoblast cells showed increased mitochondrial membrane potential and decreased reactive oxygen species levels under hypoxic conditions for 72 hours. CONCLUSION: These results will be used as basic data for understanding the mechanism of how trophoblast cells respond to oxidative stress and how selenium promotes the upregulation of related genes and improves the survival rate and invasive ability of trophoblasts through regulating mitochondrial activity. These results suggest that selenium may be used in reproductive medicine for purposes including infertility treatment.
Adenosine Triphosphate ; Anoxia ; Antioxidants ; Gene Expression ; Heme Oxygenase-1 ; Infertility ; Membrane Potential, Mitochondrial ; Mitochondria ; Oxidative Stress ; Placenta ; Polymerase Chain Reaction ; Pregnancy ; Reactive Oxygen Species ; Reproductive Medicine ; Selenium* ; Superoxide Dismutase ; Survival Rate ; Trophoblasts* ; Up-Regulation

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

PURPOSE: Authors reviewed CT and MR findings of patients with parapharyngeal masses, and their incidence and characteristic findings were studied. MATERIALS AND METHODS: We reviewed 27 CT and 9 MR of pathologically proven 29 patients with primary parapharyngeal mass Neurogenic tumor (17 cases) and other rare masses (3 carotid body tumors, 2 pleomorphic adenomas, 2 cavernous hemangiomas, 1 cavernous lymphangioma, 2 carotid artery pseudoaneurysms, 1 non-Hodgkin's lymphoma, 1 idiopathic cervical fibrosis) were included and the characteristic CT and MR findings were studied. RESULTS: Neurilemmoma was seen as a well-demarcated, solid mass of heterogeneous attenuation or intensity, so that pleomorphic adenoma of minor salivary gland origin could not be differentiated by demarcation, attenuation, or signal intensity of the tumor itself. The direction of carotid artery displacement was not constant in cases of neurilemmomas while the styloid process was constantly displaced laterally in all cases. Characteristic CT and MR findings of other rare tumors were described. CONCLUSION: Neurogenic tumor is the most common parapharyngeal space mass and the direction of displacement of styloid process might be helpful in differential diagnosis from pleomorphic adenoma. Other rare tumors showed very characteristic CT and MR finidings and could be differentiated easily.
Adenoma, Pleomorphic ; Aneurysm, False ; Carotid Arteries ; Carotid Body Tumor ; Diagnosis, Differential ; Hemangioma, Cavernous ; Humans ; Incidence ; Lymphangioma ; Lymphoma, Non-Hodgkin ; Neurilemmoma ; Salivary Glands, Minor

PURPOSE: To describe the MR features of intraspinal cysticercosis. MATERIALS AND METHODS: Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. RESULTS: There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1 -C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2 weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single I cm cystic lesion at C2 level, which showed hypointense signal on T1 weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. CONCLUSION: lntraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis.
Arachnoid ; Arachnoiditis ; Cysticercosis* ; Edema ; Ischemia ; Magnetic Resonance Imaging* ; Medical Records ; Retrospective Studies ; Spinal Cord ; Subarachnoid Space

The Dandy-Walker syndrome is a developmental disorders of the brain characterized by cystic deformity of the 4th ventricle and agensis of the cerebellar vermis. Other systemic anomalies and chromosomal abnormalities are associated with this syndrome. We are experienced a case in a 9 months old male infant who presented initially with frequent vomiting, low birth weight, On the physical examination, a prominent occiput, palpable mass below the right upper quadrant, pulmonary valve stenosis, congenital dislocation of the hips, ventral flexion of fingers, clubfoots and the rocker-bottom deformities of feet were present. On the chromosomal study, there were chromosomal polymorphisms in a thickened C-band of chromosome No. 1 by C-banding method. The brain CT revealed a large, thin-walled, low density mass of CSF without enhancement in the posterior fossa, showing upward displacement of cerebellar hemisphere with absent inferior vermis(or associated with dysplastic cerebellar hemisphere). A brief review of the related literatures were included in this report.
Brain ; Chromosome Aberrations* ; Clubfoot ; Congenital Abnormalities ; Dandy-Walker Syndrome* ; Dislocations ; Fingers ; Foot ; Hip ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Physical Examination ; Pulmonary Valve Stenosis ; Vomiting

No abstract available.
Cholesterol* ; Granuloma*

PURPOSE: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. METHODS: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. RESULTS: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echocardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patientswere discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were 2.53+/-2.29 and 2.19+/-2.12, respectively (p=0.860). CONCLUSION: Cardiovascular manifestations occurafter acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant initself in the clinical course, and the short-term prognosis of cardiac toxicityis unlikely to be unfavorable in acute CO poisoning.
Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Echocardiography ; Electrocardiography ; Emergencies ; Humans ; Hypokinesia ; Hypotension ; Prognosis ; Retrospective Studies