BACKGROUND: Intermediate myasthenia syndrome(IMS) is thought to have clinical importance because it may cause sudden respiratory failure during the recovery phase of a cholinergic crisis of organophosphate poisoning. We designed this study to identify the prevalence, the inducing agent, clinical predictor, and the proposed treatment of IMS. METHODS: Patients who had admitted with the diagnosis of acute organophosphate poisoning from 1992 to 1998 at two teaching hospitals were enrolled in this study. We selected the cases of IMS based on a review of medical records using modified He's criteria. RESULTS: Twelve(12) out of 110 patients with acute organophosphate poisoning were diagnosed for a prevalence at 10.9%. The drug inducing IMS were identified as dichlorvos, fenthion, EPN, methidathion, and phosphamidon. The occurrence of IMS was not related to either the initial treatment with atropine and pralidoxime, or the level of serum cholinesterase. Complications were pneumonia, sepsis, pancreatitis, and pseudomembranous colitis, etc. Eleven(11) patients were discharged without sequelae, and one patient was discharged as a hopeless care. CONCLUSION: This study suggests that IMS is not rare, so close observation is required to detect IMS in organophosphate-poisoning patients. Also, more studies are required to find predictors and treatments.
Atropine ; Cholinesterases ; Diagnosis ; Dichlorvos ; Enterocolitis, Pseudomembranous ; Fenthion ; Hospitals, Teaching ; Humans ; Medical Records ; Organophosphate Poisoning ; Pancreatitis ; Phosphamidon ; Pneumonia ; Prevalence ; Respiratory Insufficiency ; Sepsis

We report herein a case of subcutaneous granuloma pyogenicum developed on the fourth interdigital space of right foot of 36-year-old housewife. Histopathological findings showed characteristic lobular capillary hemangioma. The subcutaneous nodule had a thick fibrous capsule and were composed of multiple, confluent cellular, angiomatous lobules separated by loose fibrous tissue. Most lobules contained round, oval or angular capillaries, lined by proliferated prominant endothelial cells projecting into the lumina of the vessels. Clinically, the lesion was a tender subcutaneous nodule with macerated surface aind soft corn or traumatic epidermal cyst were considered in the differential diagnoses.
Adult ; Capillaries ; Diagnosis, Differential ; Endothelial Cells ; Epidermal Cyst ; Foot ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Zea mays

No abstract available.
Carcinoma, Squamous Cell* ; Maxillary Sinus* ; Nose* ; Papilloma, Inverted*

PURPOSE: Surface alterations of titanium discs following instrumentation with either a nylon brush or a metal brush were evaluated. METHODS: A total of 27 titanium discs with 3 surface types (9 discs for each type), including machined (M) surfaces, sandblasted and acid-etched (SA) surfaces, and surfaces treated by resorbable blast media (RBM), were used. Three discs were instrumented with a nylon brush, another 3 discs were instrumented with a metal brush, and the remaining 3 discs were used as controls for each surface type. Surface properties including the arithmetic mean value of a linear profile (Ra), maximum height of a linear profile (Rz), skewness of the assessed linear profile (Rsk), arithmetic mean height of a surface (Sa), maximum height of a surface (Sz), developed interfacial area ratio (Sdr), skewness of a surface profile (Ssk), and kurtosis of a surface profile (Sku) were measured using confocal microscopy. RESULTS: Instrumentation with the nylon brush increased the Ra, Sa, and Sdr of the M surfaces. On the SA surfaces, Ra, Sa and Sdr decreased after nylon brush use. Meanwhile, the roughness of the RBM surface was not affected by the nylon brush. The use of the metal brush also increased the Ra, Sa, and Sdr of the M surface; however, the increase in Sdr was not statistically significant (P=0.119). The decreases in the Rz, Sz, Ra, Sa, and Sdr of the SA surfaces were remarkable. On the RBM surfaces, the use of the metal brush did not cause changes in Ra and Sa, whereas Rz, Sz, and Sdr were reduced. CONCLUSIONS: Titanium surfaces were altered when instrumented either with a nylon brush or a metal brush. Hence, it is recommended that nylon or metal brushes be used with caution in order to avoid damaging the implant fixture/abutment surface.
Dental Implants ; Microscopy, Confocal ; Nylons ; Peri-Implantitis ; Surface Properties ; Titanium

Chronic progressive radiation myelopathy(CPRM) is a rare but serious complication of radiation therapy. It's exact cause is unknown and the diagnosis is usually made based on the exclusion of other causes of myelopathy. Magnetic resonance imaging(MRI) with gadolinium- diethylenetriamine pentaacetic acid(DTPA) enhancement seems to be useful for the diagnosis of CPRM. There is no known effective treatment and the complication is irreversible. We report a case of CPRM after radiation therapy for subglottic cancer which was not respond to high-dose steroid therapy with review of literature.
Diagnosis ; Spinal Cord Diseases*

PURPOSE: The author used optical coherence tomography (OCT) in the identification and classification of choroidal neovascularization to evaluate the potential of this imaging technique for better defining choroidal neovascularization. METHODS: Optical coherence tomography was performed on 20 eyes of 20 patients with the clinical diagnosis of choroidal neovascularization. Its result was compared with fluorescein angiography and indocyanine green angiography RESULTS: Of the 20 eyes, 6 eyes (30%) were identified as classic choroidal neovascularization on fluorescein angiography. Of the 6 eyes, 5 cases were identified as well-demarcated choroidal neovascularization on indocyanine green angiography and optical coherence tomography. One case was identified as fibrovascular pigment epithelial detachment on optical coherence tomograpphy. Of the 13 eyes identified as occult choroidal neovascularization on fluorescein angiography, 6 eyes were identified as well-demarcated choroidal neovascularization on indocyanine green angiography and 7 eyes were identified as well-demarcated choroidal neovascularization on optical coherence tomography. Of the 20 eyes identified as choroidal neovascularization on fluorescein angiography, 3 eyes were missed as choroidal neovascularization on optical coherence tomography. Optical coherence tomography was useful to identify the position and the size of choroidal neovascularization. CONCLUSIONS: OCT was able to distinguish the cross-sectional morphology of various lesions accompanying choroidal neovascularization. This study suggests that OCT may have potential in diagnosing and managing choroidal neovascularization.
Angiography ; Choroid* ; Choroidal Neovascularization* ; Classification* ; Diagnosis* ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Tomography, Optical Coherence*

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell ; Child ; Diagnosis ; Drug Therapy ; Ectoderm ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Prognosis ; Survival Rate ; Biomarkers, Tumor

As a result of comparing the phenolic components of cinnamon medicines, the total phenolic component content of Cinnamomi Cortex in China was about 2.65 times higher than that of Cinnamomi Cortex in Vietnam. In addition, the total phenolic component content of Vietnamese Cinnamomi Cortex Spissus was about 1.80 times higher than that of Chinese Cinnamomi Cortex Spissus. Meanwhile, Vietnamese Cinnamomi Ramulus showed a content about 3.29 times higher than that of Chinese Cinnamomi Ramulus. Cinnamaldehyde, the main component of cinnamon medicines, showed the same tendency as the total phenolic component content. In terms of the average content of the total phenolic components, Cinnamomi Cortex showed the highest content at 23964 μg/g, followed by Cinnamomi Cortex Spissus at 17489 μg/g and Cinnamomi Ramulus at 5435.8 μg/g. These results showed that Cinnamomi Cortex and Cinnamomi Cortex Spissus with stem bark as usage sites had about 3.22 to 4.41 times higher content of phenolic components than Cinnamomi Ramulus with young branches as usage sites.

The relation of atopic dermatitis to various manifestations of ocular disease has been documented in the dermatologic literature. Several lines of evidence suggest that patients with atopic dermatitis have defective ceil-mediated immunity and decreased cellular hypersensitivity. In this paper, we presented two cases of atopic dermatitis developing ocular complication and abnormal immune response in vivo and in vitro during the course of atopic dermatitis.
Dermatitis, Atopic* ; Humans ; Hypersensitivity

BACKGROUND: Abdominal pain is one of the most common complaints in the emergency department and the evaluation presents an extraordinary challenge to the emergency physician's skill. C-reactive protein, an acute phase protein which is increased in the presence of inflammation in various clinical conditions, has been proven useful in assessing disease severity, in monitoring the development of complications, and in evaluating the response to specific treatments. So we tried to determine whether CRP offers an advantage over other clinical or laboratory variables for decision-making in the management of acute abdominal pain in the emergency department. METHOD: Patients who came to a University Hospital ED with acute abdominal pain, between september 1, 1998 and November 30, 1998, were included in this study, Data collection included age, sex, duration of symptom, location of pain, and laboratory dta(white blood cell count, portion of neutrophils, ESR, CRP, amylase). RESULT: This study included 85 patients, 34 of whom were men. The mean age was 36.9+/-19.1 years. CRP might be useful to detect the serious condition, sensitivity 81%, but more useful to differentiate normal condition from serious condition in acute abdominal pain patients, specificity 83%. CONCLUSION: CRP is an useful indicator of decision-making to abdominal patients in the emergency department. Hospitalization or operation is very unlikely when CRP value is normal.
Abdominal Pain* ; Acute-Phase Proteins ; Blood Cell Count ; C-Reactive Protein* ; Data Collection ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Hospitals ; Humans ; Inflammation ; Male ; Neutrophils ; Sensitivity and Specificity