No abstract available.
Narcolepsy*

BACKGROUND: Hyperkalemia is a common and potentially life-threatening metabolic disorder. The electrocardiogram(ECG) is known to be a relatively sensitive diagnostic tool hyperkalemia. However many exceptions, in which patients showed normal ECG findings even though hyperkalemic, have been reported. The purpose of this study was to determine the extent of correlation between the ECG findings and hyperkalemia and to determine when the ECG has value for diagnosing hyperkalemia. METHODS: Patients who had been diagnosed as having hyperkalemia at two university hospitals during three years were enrolled in this study. We reviewed the medical records of the patients and evaluated the following 6 ECG abnormalities: tall T waves, narrow T waves, QRS widening, atrioventricular block, loss of P waves, and sine waves. We defined tall T waves and narrow T waves as 20 percentiles of heights and widths of the T waves from the 100 patients with normokalemia. RESULTS: During the study period, there were 100 hyperkalemic patients, and we analyzed 69 available electrocardiograms. Abnormal ECG findings were revealed in 67% of 69 patients. The higher the serum potassium level, the more abnormal ECG findings. The common ECG abnormalities were tall T waves and loss of P waves. The patients with normal ECGs even though hyperkalemic had relatively low potassium levels. And whether chronic renal disease was not correlated to the ECG abnormality. CONCLUSION: The electrocardiogram is a good diagnostic tool for hyperkalemia if it is used with accurate diagnostic criteria. Thus, hyperkalemia should be considered when the ECG shows tall T waves or loss of P waves.
Atrioventricular Block ; Electrocardiography* ; Hospitals, University ; Humans ; Hyperkalemia* ; Medical Records ; Potassium ; Renal Insufficiency, Chronic

Malakoplakia of the bladder is an extremely rare condition in which there are multiple round or oval, plaque like or occasionally polypoid projections of the mucosa and submucosa which may be mistaken for cancer. It is believed to be infectious in origin, secondary to a deficiency of intracellular lysosomal digestion. There is often a clinical history of urinary tract infection, and the condition is considered to be an atypical form of granulomatous response to Gram negative coliform infection. We report a case of malakoplakia of the bladder clinically simulating malignant tumor, which was treated successfully with transurethral resection and antibiotics.
Anti-Bacterial Agents ; Digestion ; Malacoplakia* ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

Papillary eccrine adenoma is a rare sweat gland tumor with a characteristic histopathological appearance and has a benign clinical course. Five cases were reported in Korea since a report by Song et al. in 1988. We report a case of papillary eccrine adenoma in a 38-year-old male who had a firm, dark brown nodule on the medial surface of the left thigh. Microscopically, the tumor was composed of multiple dilated ducts lined by two or more layers of epithelial cells and the luminal cells showed papillary projections into the lumen in some tubules. Immunoperoxidase staining was positive for CEA, S-100, and EMA. We excised the lesion completely and no evidence of recurrence was observed for 6 months.
Adenoma* ; Adult ; Epithelial Cells ; Humans ; Korea ; Male ; Music ; Phenobarbital ; Recurrence ; Sweat Glands ; Thigh

BACKGROUND: Hypothermia is a condition that can lead to serious complications and even to death in newborn. Although the temperature control is essential in neonatal care, it is often neglected during urgent transfer from local private hospitals. The purpose of this study is to evaluate the incidence and clinical outcomes of transfer induced neonatal hypothermia. SUBJECTS AND METHOD: In this retrospective study, subject is limited to transferred outborn babies with age less than 24 hours from June 1996 to May 1999. A total of 3,086 patients were admitted in NICU during the study period and inborn and outborn babies were 1,743(56%) and 1,343(44%) respectively. Among the 1,343 outborn babies, 212 babies were transferred from the private hospital within 24 hours of birth and were eligible for the study. Rectal temperature on arrival, transfer time, birth weight, gestational age, initial arterial gas study, and clinical outcome were compared. Statistical analysis has been done with chi-sqaure test and multiple logistic regression analysis. RESULTS: There were 84 cases(39.6%) hypothermia(<36degrees C> among the 212 babies and the rate of hypothermia in transfered babies have not decreased over the study period. There were significantly more hypothermia in lower gestational age (less than 28 weeks) and lower birth weight (less than 2,000gm) caused hypothermia significantly more than normal gestational age or normal range of birth weight. And time interval (less than 12 hour) from birth to arrival at emergency department was also significant factor in hypothermia. The mortality rate was three fold higher in hypothermia than normothermic or hyperthermic babies. CONCLUSION: This study shows that hypothermia during neonate transportation is a major cause of neonatal mortality and morbidity in prehopital care. Body temperature control during transport of neonates under 24 hours of age should be emphasized for the better outcome of treatment.
Birth Weight ; Body Temperature ; Emergency Service, Hospital ; Gestational Age ; Hospitals, Private ; Humans ; Hypothermia* ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn* ; Logistic Models ; Mortality ; Parturition ; Reference Values ; Retrospective Studies ; Transportation*

BACKGROUND: Do-Not-Resuscitate(DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. METHODS: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups : DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. RESULTS: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. CONCLUSION: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.
Cardiopulmonary Resuscitation ; Chronic Disease ; Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Medical Records ; Retrospective Studies* ; Shock ; Unconsciousness

Since Brown first described the eosinophilic cystitis in 1959, 42 cases has been reported in the literature. In Korea, only 1 case was reported from the National Medical Center a couple of years ago. Eosinophilic cystitis is characterized histologically by infiltration of eosinophils into the mucosa, submucosa and muscularis of the bladder and cystoscopically by elevated erythematous mucosal lesions. These lesions have been mistakenly diagnosed as bladder tumors prior to biopsy. Clinically, it presents with dramatic and recurrent episodes of dysuria and hematuria. It can occur in two different clinical setups. The first is seen in women and children and is often associated with allergic disorders and eosinophilia. The second presents in older man and is usually associated with bladder injury related to other conditions of bladder and prostate. We herein add two cases of eosinophilic cystitis, review etiologic theories and outline management.
Biopsy ; Child ; Cystitis* ; Dysuria ; Eosinophilia ; Eosinophils* ; Female ; Hematuria ; Humans ; Korea ; Mucous Membrane ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms

Duplication of the renal pelvis and ureter is the most common congenital anomaly of the upper urinary tract. The three most important abnormalities associated with duplicated kidney are vesicoureteral reflux, ectopic ureter and ureterocele. Herein we present three cases of unilateral, complete duplicated ureter in children associated with ectopic ureteral orifice, vesicoureteral reflux and ectopic ureterocele, respectively, with review of related literatures. They have suffered from urinary incontinence with normal voiding since birth, recurrent urinary tract infection and protruding mass from the urethral meatus on straining respectively. Two cases of them were treated with partial nephrectomy and ureterectomy, the third was performed partial nephrectomy, ureterectomy and ureterocelectomy.
Child* ; Humans ; Kidney ; Kidney Pelvis ; Nephrectomy ; Parturition ; Ureter* ; Ureterocele ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

Lichen aureus is regarded as an uncommon variant of the pigmented purpuric dermatosis and resistant to treatment. Recently several authors reported the PUVA therapy to be effective in the pigmented purpuric dermatosis, but there was no report that the PUVA therapy was tried to the lichen aureus. We tried topical PUVA therapy on a 54-year-old male with bilateral lichen aureus. After 23 times of topical PUVA therapy, the lesion improved markedly. This report may provide a new method of treatment for lichen aureus.
Humans ; Lichens* ; Male ; Middle Aged ; PUVA Therapy* ; Skin Diseases

Dual left anterior interventricular coronary artery (also called left anterior descending artery, hereafter referred as LAD) is a rare congenital coronary artery anomaly. Notably, type IV dual LAD has never been reported in Koreans. During a routine dissection, a new variant of type IV dual LAD was found in a 57-year-old Korean male cadaver, whose cause of death was unknown. One LAD originated from the right coronary artery, coursed through the anterior interventricular sulcus, but did not reach the apex cordis. The other LAD arose from the left coronary artery, never entered the anterior interventricular sulcus through its course, but reached the apex cordis, where it met the posterior interventricular branch of the right coronary artery. This is the first report on a new variant of type IV dual LAD in Koreans, which is of clinical importance during procedures containing the coronary artery.
Arteries ; Cadaver ; Cause of Death ; Coronary Vessel Anomalies ; Coronary Vessels* ; Humans ; Korea ; Male ; Middle Aged