Eosinophilic colitis is a chronic inflammatory bowel condition of unknown etiology and a rare subtype of eosinophilic gastrointestinal diseases. It is characterized by gastrointestinal symptoms and increased eosinophil numbers in the intestinal mucosa and absence of other potential causes of gastrointestinal eosinophilia. The clinical presentation is varied and depends on the involved layer of the large intestine. There are no confirmatory laboratory tests, and the morphologic evaluation of biopsies or surgical specimens is required to confirm the diagnosis. A 65-year-old man presented with an 8 day duration of bloody diarrhea and lower abdominal pain. The patient was diagnosed with eosinophilic colitis by histopathological evaluation of biopsies and was further categorized as a nonatopic variant associated with non-IgE-mediated reaction. The patient was successfully treated with systemic corticosteroid for 2 weeks. On follow-up after 9 months, the patient remained well without relapse or new lesions.
Abdominal Pain ; Aged ; Biopsy ; Colitis ; Diarrhea ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Gastrointestinal Diseases ; Humans ; Intestinal Mucosa ; Intestine, Large ; Recurrence

OBJECTIVE: To evaluate the influences of age and height on pulmonary function in cervical spinal cord injury patients and to suggest the reference value of Pulmonary Function Test (PFT) with respect to each level of injury. METHOD: One hundred eighteen subjects with complete cervical spinal cord injury underwent PFT. Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) were measured and percentages of normal predictive values were also calculated. RESULTS: Age, height and injury level were determinants of FVC and FEV1. But only injury level affected the percen-tages of FVC and FEV1 predictive values. The mean FVC of C4, C5, C6, C7, C8 tetraplegic subjects were 1.78 L, 2.00 L, 2.20 L, 2.74 L, 2.94 L respectively. The mean FEV1 of C4, C5, C6, C7, C8 tetraplegic subjects were 1.64 L, 1.83 L, 2.08 L, 2.59 L, 2.74 L respectively. CONCLUSION: Age and height should be considered when interpreting PFT of tetraplegic patients. The reference values suggested would help to evaluate the severity of pulmonary function loss in complete cervical spinal cord injury patients.
Forced Expiratory Volume ; Humans ; Male ; Quadriplegia ; Reference Values ; Respiratory Function Tests ; Spinal Cord Injuries ; Spinal Cord* ; Vital Capacity

Targetoid hemosiderotic nevus (THN) is a rare variant of melanocytic nevus, characterized by a sudden development of a targetoid ecchymotic halo around a pre-existing nevus. THN clinically raises concern for malignant transformation due to its abrupt change in color and size. THN should be distinguished from other diseases showing a peripheral halo, including targetoid hemosiderotic hemangioma, halo nevus, and Meyerson nevus. Dermoscopy can help clinicians to differentiate THN from these diseases. The typical dermoscopic features of THN are known to be divided into two distinctive areas: the central melanocytic area and the peripheral ecchymotic area. In our case, dermoscopy revealed a novel bull’s eye pattern composed of a central area with characteristic features of benign melanocytic nevus, an intermediated white circular ring, and a peripheral milky red area. When a sudden change occurs in a pre-existing nodule showing targetoid features, dermoscopy should be considered before conducting a biopsy or surgical intervention.

The cardiovascular manifestations of hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, atrioventricular block, bundle branch block, angina pectoris, heart failure, and cardiomyopathy. Though complete atrioventricular block is rare, it is important to recognize it in clinical practice because of the possibility of cardiac arrest. We experienced a 47-year-old female patient who had hyperthyroidism with complete atrioventricular block and developed cardiac arrest despite the initiation of an antithyroid drug. We could resuscitate successfully and inserted a temporary pacemaker, but eventually a permanent pacemaker was needed to prevent the recurrence of cardiac arrest. We report a rare case of complete atrioventricular block and cardiac arrest associated with hyperthyroidism with the review of references.
Angina Pectoris ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block* ; Bundle-Branch Block ; Cardiomyopathies ; Female ; Heart Arrest* ; Heart Failure ; Humans ; Hyperthyroidism* ; Middle Aged ; Recurrence ; Tachycardia, Sinus ; Tachycardia, Supraventricular

The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.
Age Distribution ; Chest Pain ; Cough ; Dyspnea ; Female ; Hemoptysis ; Humans ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule* ; Strikes, Employee ; Tuberculoma

BACKGROUND/AIMS: This study evaluated the efficacy of endoscopic treatment in a bile leak that occurred through various causes. METHODS: The medical records of 35 patients (mean age 55.4 years; male/female 25/10), who were diagnosed with a bile leak by endoscopic retrograde cholangiopancreatography in Yeungnam University Hospital from January 1998 to January 2006, were reviewed. RESULTS: The most common cause of the bile leak was an open cholecystectomy (n=13, 37.1%) followed by a laparoscopic cholecystectomy (n=10, 28.6%), trauma (n=2, 5.7%), transarterial chemoembolization (n=3, 8.6%), spontaneous (n=3, 8.6%), and a hepatic resection (n=4, 11.4%). Thirty-four patients were treated endoscopically by the insertion of a plastic stent with/without a sphincterotomy (70.6%, 24/34), a nasobiliary drainage (11.8%, 4/34), or a sphincterotomy alone (17.6%, 6/34). Of these 34 patients, 30 were cured by the endoscopic treatment, 2 patients died from liver failure despite the use of nasobiliary drainage and 2 patients did not improve after endoscopic treatment. One patient underwent surgery without endoscopic treatment because of a transsection of the common bile duct. With the exception of the two who died from liver failure, the overall cure rate of endoscopic treatment was 90.9% (30/33). There were no complications associated with the endoscopic treatment. CONCLUSIONS: Endoscopic treatment for a bile leak is safe and effective regardless of the cause.
Bile* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Common Bile Duct ; Drainage ; Humans ; Liver Failure ; Medical Records ; Plastics ; Stents

BACKGROUND AND OBJECTIVES: Renin-angiotensin system (RAS) inhibitors are likely to reduce the development of atrial fibrillation (AF) by preventing atrial fibrosis. We attempted to assess the relevance of strain echocardiography for quantitative assessment of the left atrial (LA) status in AF, its modification by RAS inhibitors and changes of biochemical markers during cardiac remodeling in AF. SUBJECTS AND METHODS: Strain echocardiography is performed 2 times (baseline and 12 month) in 60 patients with AF (RAS inhibitors-used group: 30, non-used group: 30). In an apical 4-chamber view, the regional analysis consisted of placing the region of interest cursor at the basal segments of the septal and lateral wall of LA. Mean peak systolic and early diastolic strain/rate are measured with LA end-systolic antero-posterior, longitudinal and transverse dimensions. RESULTS: Six patients of RAS inhibitors-used group (group A, 20%) and three patients of non-used group (group B, 10%) were converted to normal sinus rhythm during the study. LA size, E wave velocity, E/E', strain parameters showed no significant differences between groups at the baseline. There were no significant differences in LA size and E wave velocity between groups at the 12 months, however, peak systolic strain/rate were significantly higher in group A (36.71+/-13.63% and 2.98+/-0.59s(-1), p<0.05, respectively) than group B (27.21+/-10.49% and 2.21+/-0.47s(-1)). In addition, peak early diastolic strain/rate were significantly higher in group A (-1.89+/-3.30% and -2.32 +/-0.77s-1 p<0.05, respectively) than group B (-0.83+/-2.79% and -1.77+/-0.25s(-1)). There were no significant differences in C-reactive protein (CRP) and B-type natriuretic peptide (BNP) at the baseline, but BNP were significantly reduced in group A (822.9+/-798.3 pg/mL, p<0.05) than group B (1481.9+/-209.97 pg/mL) at the 12-month follow-up. CONCLUSION: The increased values of atrial peak systolic and diastolic strain/rate after treatment with RAS inhibitors revealed that passive stretching and shortening of LA wall might improve in some patients with AF even before LA size change possibly because of reduced atrial fibrosis and increased compliance. Our results indicated that strain echocardiography provides clinically useful information of LA function and remodeling and treatment with RAS inhibitors appears to preserve LA reservoir function in AF patients without visible LA structural change.
Atrial Fibrillation ; Atrial Function, Left ; Biomarkers ; C-Reactive Protein ; Compliance ; Echocardiography ; Fibrosis ; Humans ; Muscle Stretching Exercises ; Natriuretic Peptide, Brain ; Prospective Studies ; Renin-Angiotensin System ; Sprains and Strains

Neurilemmoma, also refired to as Schwannoma, neurinoma and perineural fibroblastoma, is well capsulated solitary tumor of Schwann cell origin. The most common sites for benign solitary neurilemmoma are the extremities or the head and neck region. In the retroperitoneum, they are commonly seen in the presacral region. It is incidentally detected and confirmed by pathologic findings. We report a case of retroperitoneal neurilemmoma arising from adjacent to kidney, in 49 years old man.
Extremities ; Head ; Humans ; Kidney* ; Middle Aged ; Neck ; Neurilemmoma*

Daylight Saving Time (DST) is used worldwide and affects millions of people annually. In the most countries, DST begins turning clocks forward by an hour in the spring and backward by an hour in the fall. transition out of DST in the fall increases the available daylight in the morning by one hour. Springtime transition into DST leads to an increase of the available daylight in the evening. During World War I, in an effort to reduce fuel consumption, Germany and England began to practice DST in 1916. Currently, 77 countries and most of OECD adopted DST except Korea, Japan, Iceland. The rationale for Daylight Saving Time (DST) is bolstered by the fact that it increases daylight hours within which the activity a population reaches its peak. Therefore, the effects of transitions into DST to the public health should be further explored, as DST affects millions of people annually and its impacts are still largely unknown. A general perception is that Turning clock forwards (on spring) or backwards (on fall) by one hour would affect our health. In This study, the association between Daylight Saving Time (DST) and health in population was investigated through theoretical and systemic review studies. Since the study was conducted solely on theoretical grounds, further research is needed to assess additional health-related impacts of Daylight Saving Time (DST) and to carry out more specific analysis on population health in Korea. In conclusion, population health is more strongly affected during spring transition into DST than during fall transition out of DST.
England ; Germany ; Iceland ; Japan ; Korea ; Public Health ; World War I

This study was carried out to observe and evaluate the middle ear pressure(MEP) change by nitrous oxide(N2O) and end tidal PCO2 during general anesthesia with halothane or enflurane. MEP was measured during general anesthesia by impedance audiometer(GSI 28 Auto tymp model) in 50 patients who were relatively healthy without upper respiratory tract infection and otologic problems from August 1987 at Chonbuk National University Hospital. The results were as follows: 1) During general anesthesia with 100% O2 and halothane or enflurane, MEP was decreased progressively under the preinduction level with time. 2) The decrease in MEP during general anesthesia with 100% O2 and halothane or enflurane was reversed by relative hypoventilation, but MEP showed negative values in all patients. 3) End tidal PCO2 was increased progressively by relative hypoventilation and returned gradually to pre-hypoventilation level by normoventilation. 4) MEP was increased during general anesthesia using N2O, which is propotional to the concentration of N2O by 20 minutes. Thereafter, MEP remained increased until termination of N2O administration. From the above results, it is concluded that MEP is increased during anesthesia using N2O. MEP can also be affected by end tidal PCO2 even though physiologic range. Therefore, it is prudent to avoid N2O especially when hyperventilation is not adequately permitted during general anesthesia for middle ear surgery and patient with middle ear disease.
Anesthesia ; Anesthesia, General* ; Ear, Middle* ; Electric Impedance ; Enflurane ; Halothane ; Humans ; Hyperventilation ; Hypoventilation ; Jeollabuk-do ; Nitrous Oxide ; Respiratory Tract Infections