Aplastic anemia is a disease characterized by general lack of bone marrow activity; it may affect not only the red blood cells but also the white blood cells and platelets, resulting in pancytopenia. Spontaneous gingival hemorrhage is present in some cases and it is related to the blood platelet deficiency. This case report presents the periodontal treatment of a patient with aplastic anemia. A 43-year-old female was referred for continuous gingival bleeding after periodontal treatment. Periodontal findings revealed generalized gingival imflammation, oozing of blood from gingival crevice, and it was diagnosed as adult periodontitis. Root planing and extraction of the upper left third molar with poor prognosis were put into operation after elevation of the platelet count with platelet transfusion. The extraction socket was sutured with 3-0 silk. Bleeding continued even after digital compression at the upper right second premolar, second molar, and left canine areas, which presented severe inflammation. Although platelets were transfused repeatedly, platelet count did not stay elevated since survival rate of the transfused platelets were low due to alloimmunization. Thrombin gauze packing was not effective. Bleeding ceased 3 days after treatment with transfusion of donor platelets. 20 days after the treatment, the gingiva was generally healthy except upper right second premolar and lateral incisor areas. The result of periodontal treatment was good, but bleeding control after treatment was troublesome. In the periodontal treatment of patient with aplastic anemia, elevation of the platelet count with platelet transfusion seems to be the best method for hemorrhage control.
Adult ; Anemia, Aplastic* ; Bicuspid ; Blood Platelets ; Bone Marrow ; Chronic Periodontitis ; Erythrocytes ; Female ; Gingiva ; Gingival Hemorrhage ; Hemorrhage ; Humans ; Incisor ; Inflammation ; Leukocytes ; Molar ; Molar, Third ; Pancytopenia ; Platelet Count ; Platelet Transfusion ; Prognosis ; Root Planing ; Silk ; Survival Rate ; Thrombin ; Tissue Donors

No abstract available.
Busulfan* ; Lung*

Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.
Aorta ; Cerebral Infarction ; Chest Pain ; Constriction, Pathologic ; Dizziness ; Dyspnea ; Hypertension ; Hyperthyroidism* ; Pulmonary Artery ; Pulmonary Embolism* ; Takayasu Arteritis*

Bronchial mucoepidermoid carcinoma is uncommon, representing 0.2% of all lung tumors. The disease usually presents with symptoms of airway obstruction and recurrent pneumonia. It is commonly classified into two grades in Korea, low and high. We report a case of a bronchial mucoepidermoid carcinoma in a 40-year-old woman who complained of symptoms of an upper respiratory infection. The histological grade after a bronchoscopic biopsy was intermediate. A left upper lobectomy was performed as treatment. The TNM stage of this case was IA (T1N0M0). In addition, 25 cases of bronchial mucoepidermoid carcinoma from 1984 in Korea are also reviewed from the viewpoint of the relationship between the histological grade, TNM stage and clinical course of the tumor.
Adult ; Airway Obstruction ; Biopsy ; Carcinoma, Mucoepidermoid ; Female ; Humans ; Korea ; Lung ; Pneumonia

A paragonimiasis infestation is caused by the paragonimus species. It is commonly found in the lung but has also been found to exist extrapulmonary infestations including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, and gynecologic infestation. On the other hand, a cutaneous infestation is extremely rare. Human infestation is caused by ingesting raw or undercooked intermediate hosts. Because paragonimus westermani larva mature to an adult worm in the lung, the possibility of identifying the adult worm of paragonimus westermani at extrapulmonary region is very rare. CASE: After ingesting a fresh-water crab 1 month prior to the hospital visit, a 45-year old female patient was suffering from right pleuritic chest pain during that 1 month. The patient also complained of a palpable mass that was movable and migrating, and it was localized at the right upper quadrant of the abdomen. The eosinophil fraction of the white blood cell of peripheral blood and pleural fluid was elevated to 55.1% and 90%, respectively. Parasite eggs were not found in her sputum and stool examination. By using the enzyme-linked immunosorbent assay (ELISA), the paragonimus-specific IgG antibody titer was elevated to 0.28. During incisional biopsy, we were able to find the young adult worm of paragonimus westermani. We experienced the rare case of ectopic paragonimiasis with pleural effusion that was confirmed by identifying the adult worm of paragonimus westermani within the abdominal subcutaneous tissue. We report a case with brief literature reviews.
Abdomen ; Adult ; Biopsy ; Chest Pain ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Female ; Hand ; Humans ; Immunoglobulin G ; Larva ; Leukocytes ; Lung ; Middle Aged ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasites ; Pleural Effusion* ; Sputum ; Subcutaneous Tissue* ; Young Adult

Background/Aims: Multi-drug resistant pathogens are increasing among healthcare-associated infections. It is well known that copper and copper alloys have antimicrobial activity. We evaluated the activity of copper against bacteria in a hospital setting in Korea. Methods: This study was conducted in a laboratory and medical intensive care unit (ICU). Methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococcus faecium (VRE) were inoculated onto copper, copper alloy and stainless steel plates. After 24 hours of incubation, colony-forming units (CFU) were counted in the laboratory. Two similar rooms were chosen in the ICU; one room had copper-containing surface, and the other room contained items with a stainless steel surfaces. Items were sampled weekly for 8 weeks when the rooms were not crowded and when the rooms were busier with healthcare workers or visitors. Results: In vitro time-kill curves showed copper or, a copper alloy yielded a significant reduction in MRSA and VRE CFUs over 15 minutes. Upon exposure to stainless steel plates, CFUs were slowly reduced for 24 hours. In vivo, MRSA CFUs were lower in rooms with copper-containing surfaces compared with controls, both after cleaning and after patients had received visitors (p < 0.05). Analysis of VRE revealed similar results, but VRE CFUs from copper-containing surfaces of drug carts in the ICU did not decrease significantly. Conclusions Copper has antimicrobial activity and appears to reduce the number of multi-drug resistant microorganisms in a hospital environment. This finding suggests the potential of the use of copper fittings, instruments and surfaces in hospital.

Background/Aims: Multi-drug resistant pathogens are increasing among healthcare-associated infections. It is well known that copper and copper alloys have antimicrobial activity. We evaluated the activity of copper against bacteria in a hospital setting in Korea. Methods: This study was conducted in a laboratory and medical intensive care unit (ICU). Methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococcus faecium (VRE) were inoculated onto copper, copper alloy and stainless steel plates. After 24 hours of incubation, colony-forming units (CFU) were counted in the laboratory. Two similar rooms were chosen in the ICU; one room had copper-containing surface, and the other room contained items with a stainless steel surfaces. Items were sampled weekly for 8 weeks when the rooms were not crowded and when the rooms were busier with healthcare workers or visitors. Results: In vitro time-kill curves showed copper or, a copper alloy yielded a significant reduction in MRSA and VRE CFUs over 15 minutes. Upon exposure to stainless steel plates, CFUs were slowly reduced for 24 hours. In vivo, MRSA CFUs were lower in rooms with copper-containing surfaces compared with controls, both after cleaning and after patients had received visitors (p < 0.05). Analysis of VRE revealed similar results, but VRE CFUs from copper-containing surfaces of drug carts in the ICU did not decrease significantly. Conclusions Copper has antimicrobial activity and appears to reduce the number of multi-drug resistant microorganisms in a hospital environment. This finding suggests the potential of the use of copper fittings, instruments and surfaces in hospital.

OBJECTIVE: To identify risk factors for maternal morbidity in eclamptic woman. METHODS: A retrospective analysis was performed on the record of eclamptic woman during from August 1989 to February 2002. Univariate analysis was used to determine which of the independent variables were significantly different between two groups (antepartum vs postpartum). RESULTS: The incidence of eclampsia was 1 in 1,795 deliveries and the maternal mortality rate was 4.3%. Maternal complications associated with eclampsia were abruptio placentae (13.0%), pulmonary edema (26.1%), acute renal failure (39.1%), HELLP syndrome (30.4%), disseminated intravascular coagulopathy (8.7%), neurologic sequelae (8.7%), maternal death (4.3%). One patient died from disseminated intra- vascular coagulopathy, sepsis, and multiorgan failure after postpartum eclampsia. Women with antepartum eclampsia had higher incidence of acute renal failure (44.4% vs 20%) and HELLP syndrome (33.3% vs 20%) than did in women with postpartum eclampsia. Conversely, women with postpartum eclampsia had higher incidence of disseminated intravascular coagulopathy (6.7% vs 20%) and neurologic sequelae (6.7% vs 20%). CONCLUSION: Early detection and management of preeclampsia can prevent the eclampsia and maternal mortality and morbidity.
Abruptio Placentae ; Acute Kidney Injury ; Eclampsia ; Female ; HELLP Syndrome ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Postpartum Period ; Pre-Eclampsia ; Pregnancy ; Pulmonary Edema ; Retrospective Studies ; Risk Factors* ; Sepsis

Benign Tracheobroncheal tumor is a rare disease such as 1.9% of all tumor of pulmonary origin. Because clinical manifestation of benign tracheal tumor resembles that of broncheal asthma, these patients are usually treated in a way that used in broncheal asthma. Therefore, the diagnosis is delayed. We experienced a case of tracheal neurilemmoma that awed by bronchoscopic laser therapy. A 23-year-old woman visited ow hospital be cause of progressing dyspnea especially during inspiration. She was treated with aminophylline and 2 agonist under the impression of bronchial asthma at a local clinic. But because the symptoms were not relieved and pulmonary function test revealed variable extrathoracic lesion, we conducted bronclxaopy and biopsy. There were 1.5 x 2cm sized movable mass with stalk attached right anterior wall of bronchus. The biopsy result was neurilemmoma. Therefore we conducted bronchoscopic Laser therapy four times and the lesion disappeared in bronchosccpy and chest CT.
Aminophylline ; Asthma ; Biopsy ; Bronchi ; Diagnosis ; Dyspnea ; Female ; Humans ; Laser Therapy* ; Neurilemmoma* ; Rare Diseases ; Respiratory Function Tests ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: The cardiovascular dysfunction frequently accompanies sleep apnea syndrome, but the exact pathophysiology of cardiovascular dysfunction still remains uncertain. Moreover, most studies are concerned with obstructive sleep apnea syndrome and the studies of central sleep apnea syndrome are rare. METHODS: We studied with sixteen dogs which were anesthetized with intravenous pancuronium bromide. We created nonobstructive breath hold (apnea) in anesthetized dogs by means of alternating fixed duration (30s) of apnea and mechanical ventilation (breathing). After five or seven repetitions of this apnea-breathing cycle, we measured arterial oxygen pressure, arterial carbon dioxide pressure, heart rate, cardiac output, mean femoral artery pressure and mean pulmonary artery pressure separately before apnea (baseline), 25s after apnea (apneic period), 10s (early phase of postapneic period) and 25s (late phase of postapneic period) after resumption of breathing. We analysed the impact of oxygen trial on the hemodynamic changes by comparing measures of the eight 30% oxygen breathing dogs with the other eight room air breathing dogs. RESULTS: Heart rate decreased significantly at apneic period compared to baseline (p<0.05), and increased significantly at early and late phase of postapneic period compared to apneic period (p<0.05). After oxygen trial, this change of heart rate showed significant difference (p<0.05). Cardiac output only tended to decrease during late phase of postapneic period by comparison with baseline and apneic period. Mean femoral artery pressure of apneic period increased more than that of baseline (p<0.05), and persisted until late phase of postapneic period (p<0.05). When oxygen was supplied, this change of increase disappeared, but did not show statistical significance. Mean pulmonary artery pressure did not change according to apnea-breathing cycle and oxygen trial. CONCLUSION: In anesthetized dogs with periodic nonobstructive apnea, the changes of heart rate, cardiac output, mean femoral artery pressure were noted and the change of heart rate was closely related with hypoxia. Through this study, indirectly, we were able to understand partially the changes of cardiovascular function in patients with central sleep apnea syndrome.
Animals ; Anoxia ; Apnea* ; Arterial Pressure ; Carbon Dioxide ; Cardiac Output ; Dogs* ; Femoral Artery ; Heart Rate ; Hemodynamics* ; Humans ; Oxygen ; Pancuronium ; Pulmonary Artery ; Respiration ; Respiration, Artificial ; Sleep Apnea Syndromes ; Sleep Apnea, Central ; Sleep Apnea, Obstructive