No abstract available.
Thorax*

Occupational asthma induced by the inhalation of the spore of Ganoderma lucidum was demonstrated in a 43-year-old woman who had cultivated it indoors for 6 years. She had suffered from paroxysmal cough and rarely wheezing dyspnea for two years. Recently she also had chest tightness and paroxysmal and repeated cough immediately after the exposure to Ganoderma lucidum spores. Her pulmonary function was normal. But, her PC20 was 6.4mg/ml in MBPT (methacholine bronchial provocation test). She showed not only positive reaction to skin prick test but also dual asthmatic reaction to the bronchial challenge test with antigenic extract of Ganoderma lucidum spores.
Adult ; Asthma, Occupational* ; Bronchial Provocation Tests ; Cough ; Dyspnea ; Female ; Ganoderma* ; Humans ; Inhalation ; Reishi ; Respiratory Sounds ; Skin ; Spores* ; Thorax

Anomalous orignin of the left Coronary artery from the pulmonary artery is very rare, and being alleviatedsurgically, recognition of the lesion and associated hemodynamics is important. Authors had experenced a case ofthe anomalous orgin of left coronary artery from the pulmonary artery.
Coronary Vessels ; Hemodynamics ; Pulmonary Artery

Acute cerebellitis is a rare inflammatory syndrome and is one of the important causes of acute cerebellar dysfunction in children. The cerebrospinal fluid (CSF) IgG index is most often tested clinically in the diagnosis of multiple sclerosis. However, it is not specific to multiple sclerosis, and can be elevated in a variety of neurologic diseases. A 7-year-old boy with acute cerebellitis presenting with sudden onset headache and subtle cerebellar dysfunction demonstrated an elevated CSF IgG index (1.1) and an absence of oligoclonal bands. On the seventeenth day, the follow-up CSF IgG index was 0.71. Two-month and one-year follow-up magnetic resonance imaging revealed cerebellar atrophy, although the patient showed no neurologic deficit. To the best of our knowledge, this case report is the first to describe acute cerebellitis accompanied by an elevated CSF IgG index and an absence of CSF oligoclonal IgG bands. These findings suggest that a breach in the blood-brain-barrier might occur in acute cerebellitis.

No abstract available.
Peer Review*

The status of left ventricular (LV) intrinsic contractile function in pure rheumatic mitral stenosis is an unsettled issue. Although the overall LV ejection performance is reduced in a number of patients with MS, it is the product of the interaction of four variables; intrinsic myocardial contractile state, end-diastolic myocardial length(preload), afterload and LV myocardial mass. Although LV intrinsic contractility in MS has been found to be normal in previous studies, we found it to be decreased on the basis of newer techniques for assessing cardiac mechanics. Reliable load-independent indexes of intrinsic contractility using M-mode echocardiography are end-systolic pressure or end-systolic meridian wall stress to end-systolic volume or dimension ratio and fractional fiber shortening to end-systolic stress relations. We assessed LV intrinsic myocardial contractile state as measured by the aforementioned methods in patients with pure rheumatic MS. The results were as follows; 1) The clinical characteristics are no statistical significance of differences between the 2 groups. 2) Preload (LV end-diastolic volume index) was increased in patients with MS(77+/-23 VS 67+/-21 ml/m2, p<0.05). Fractional fiber shortening and LV ejection fraction were significantly lower in patients with MS(31+/-7 VS 40+/-7%, 66+/-9 VS 77+/-8%, p<0.001). 3) End-systolic stress was significantly elevated in the patient population compared with the control subjects (70.1+/-18 VS 50.5+/-10 dynes-cm2x103, p<0.001) The increased in end-systolic stress in the presence of reduced systolic blood pressure(106+/-8 VS 116+/-7mmHg, p<0.001) was due to a higher end-systolic volume index(26+/-12 VS 15+/-6ml/m2 p<0.005) and reduced systolic wall thickening (1.13+/-0.2 VS 1.54+/-0.2cm, p<0.001). 4) The end-systolic stress to volume index ratio and systolic pressure to end-systoli volume ratio were significantly lower in patients with MS(p<0.001). Relation between LV end-systolic wall stress and fractional shortening in patients with MS superimposed on 95% confidence limits of values in 105 normal control subjects derived from a previous study(r=-0.58, p<0.005). Thirty-six(75%) patients were below the 95% confidence limits of normal values.
Blood Pressure ; Echocardiography ; Humans ; Mechanics ; Mitral Valve Stenosis* ; Reference Values

No abstract available.

We analysed 58 patients who were admitted to the Department of Pediatrics, Yonsei University College of Medicine due to infectious mononucleosis from January 1986 to August 1992. Of 58 patients who had responses to IgM to EBV viral capsid antigen and/or heterophil antibody, 35 patients had hapatitis. Of 35 hepatitis patients, group I consisted of 22 patients who had only EBV infection and group II consisted of 13 patients who had hepatitis B markers or cytomegaloviral markers. The results were as follows: 1) Sex distribution revealed males to females to be 1.1:1. In the age distribution, the proportion of patients with 1 to 3 years of age occupied 40.9% for group I and 30.8% for group II. In non-hepatitis group, 73.9% of patients were in 2 months to 3 years of age. 2) The common presenting symptoms and signs of hepatitis group included hepatomegaly in 24 cases (68.6%), fever in 19 (54.3%), anorexia in 17 (48.6%), throat injection in 16 (45.7%), splenomegaly in 5 (42.9%), and cervical lymphadenopathy in 10 cases (28.6%) etc. 3) In group I, complications or combined diseases included pneumonia in 4 case, disseminated intravascular coagulation in 2 and 1 case in acute pancreatitis. Group II included 1 case of iron deficiency anemia, acute renal failure, peritonitis and pulmonary hemorrhage respectively. 4) Anemia (Hb: <10g/dl) was found in 3 cases (13.6%) for group I, and in 2 cases (15.4%) for group II. Leukocytosis above 10,000/mm3 was demonstrated in 15 cases (68.2%)for group I and in 3 cases (23.1%)for group II. The higher percentage (>15%)of atypical lymphocytes were found in 3 cases (13.6%)for group I and in 1 case(7.7%) for group II. Thrombocytopenia (platelet: <100,000/mm3) was detected in 1 case (4.5%) for group I and in 3 cases (23.1%)for group II. Total bilirubin above 1.0mg/dl was found in 6 cases (27.3%)for group I and in 5 cases(58.1%)for group II. 5) AST level of 100~500IU/L was found in 10 cases(45.4%)for group I, and in 5 cases (38.5%) for group II. AST level above 500IU/L was demonstrated in 1 case (4.5%) and in 3 cases (23.1%) respectively. The mean values of AST level were 253.4 455.3IU/L and 316.7 102.4 IU/L, respectively. 6) Elevated ALT level of 100~500 IU/L was found in 9 cases (40.9%)for group I and in 9 cases(69.2%)for group II. ALT level above 500IU/L was detected in 5 cases (22.7%)for group I and in 3 cases (15.4%)for group II. The mean values of ALT level were 356.9 561.2IU/L and 308.3 259.1IU/L, respectively. 7) Elevated ALT levels returned to normal values within 3 weeks in 14 cases (82.4%) for group I and in 6 cases (66.7%)for group II. The mean duration of normalization of ALT level were 17.3 14.1 days for group I and 19.9 14.8 days for group II. Our results suggest that it AST/ALT levels are elevated and hepatitis A, B, C markers are negative, or if sudden elevated AST/ALT levels are noted in hepatitis B carriers or a patient with cytomegaloviral hepatitis, Epstein-Barr virus infection should be suspected.
Acute Kidney Injury ; Age Distribution ; Anemia ; Anemia, Iron-Deficiency ; Anorexia ; Bilirubin ; Capsid ; Disseminated Intravascular Coagulation ; Epstein-Barr Virus Infections ; Female ; Fever ; Hemorrhage ; Hepatitis A ; Hepatitis B ; Hepatitis* ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Infectious Mononucleosis ; Leukocytosis ; Lymphatic Diseases ; Lymphocytes ; Male ; Pancreatitis ; Pediatrics ; Peritonitis ; Pharynx ; Pneumonia ; Reference Values ; Sex Distribution ; Splenomegaly ; Thrombocytopenia

BACKGROUND: Plasmapheresis or plasma exchange is the procedure to remove various pathogenic materials from the circulation of patients and retransfuse the formed elements into the doners with type specific fresh frozen plasma or albumin for the replacement of the withdrawn plasma. METHODS: In order to evaluate clinical experience of plasma exchange, we examined a total of 133 plasma exchange procedure on 25 patients of January 1993 - May 1994 in Kyungpook national university hospital. RESULTS: The results are as follows: 1. There were 8 kinds of diseases and the most frequent diseases was Guillian-Barre syndrome(l 2 cases) and the decreasing order was CIDP(6 cases), multiple myeloma(2 cases), acute fulminant hepatitis(1 case), mushroom poisoning(1 case), lupus nephritis(l case), TTP(I case) and myasthenia gravis(l case). 2. The patient's age ranged from 13 to 65 years. 3. There were 14 males and 11 females and the sex ratio was 1.3:1. 4. We had got clinical improvement in 16 of 25 cases, especially most dramatic effect in Guillian-Barre syndrome. CONCLUSION: To achieve more successful outcome of plasma exchange, we should select patients with restrict application, prevent rebound phenomenon with intense practice, choose what kind of replacement fluid to consider patient's clinical condition and check serological parameter with clinical evaluation to monitor effectiveness of treatment.
Agaricales ; Female ; Gyeongsangbuk-do ; Humans ; Male ; Plasma Exchange* ; Plasma* ; Plasmapheresis ; Sex Ratio

No abstract available.