BACKGROUND: This study was performed to determine the effect of a endotracheal intubation & induction of anesthesia using propofol 2.0 mg/kg or 2.5 mg/kg and fentanyl 2 g/kg without succinylcholine chloride. Also we have compared this method with technique using succinylcholine 1.5 mg/kg and thiopental sodium 5 mg/kg. METHODS: They were divided into 3 groups as follows: group 1, succinylcholine 1~1.5 mg/kg and thiopental sodium 5 mg/kg; group 2, propofol 2 mg/kg and fentanyl 2 microgram/kg; group 3, propofol 2.5 mg/kg and fentanyl 2 microgram/kg. Systolic arterial pressure (SAP) and diastolic arterial pressure (DAP), and heart rate (HR) were measured before induction, after induction, after tracheal intubation immediately, at 1, 2, 3, and 5min. after tracheal intubation in all patients. The incidence of adverse effects and the quality of condition for intubation were measured in all patients. RESULTS: There were significant increases in SAP, DAP, HR after intubation in group 1 but significant decreases in SAP, DAP after induction and at 5min. after intubation in group 2 and group 3. The incidence of adverse effects, and the quality of condition for intubation were no significant difference between group 1 and group 3. CONCLUSIONS: From the above result, use of propofol 2.5 mg/kg and fentanyl 2microgram/kg provided a satisfactory alternative to succinylcholine and thiopental sodium for rapid sequence induction of anesthesia.
Anesthesia ; Arterial Pressure ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Propofol ; Sodium* ; Succinylcholine ; Thiopental

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

BACKGROUND: Meningococcal diseases occur worldwide and there are several case reports and reports on carriage rates in Korean military personnel. However, there are only few data on meningococcal diseases in the civilian. This study was performed to determine the incidence, clinical features of meningococcal disease, and a pharyngeal carriage rate of meningococcus in nonmilitary persons in metropolitan Incheon, Korea. MATERIALS AND METHODS: Patients with meningococcal diseases were searched by the following methods: discharge diagnosis of 'meningococcal infection' or 'meningococcal meningitis' or 'meningococcal sepsis'; positive cases in bacterial culture of blood or cerebrospinal fluid (CSF); positive meningococcal antigen in CSF. Two university hospitals in Incheon were participated and medical records of the meningococcal infection were reviewed. A survey of pharyngeal carriage of N. meningitidis was done at a high school by throat culture. RESULTS: A total of 15 cases of meningococcal diseases were identified. Ten cases were from Inha University hospital from January 1997 to May 2004, and five cases were from Gacheon Medical School Gil hospital from January 2002 to May 2004. Neisseria meningitidis was isolated in 11 cases and the remaining 4 cases were diagnosed by detecting of meningococcal antigen. The minimal annual incidence rates of meningococcal infection in metropolitan Incheon city ranged from 0.077/ 100,000 to 0.192/100,000. Majority of the patients were under 15 years old and occurred between October to May. The diagnosis was meningitis in 14 patients and sepsis in one patient. Patient with sepsis died but all the other patients recovered.Two among five strains produced beta-lactamase. Throat cultures from 78 high school students showed Neiserria meningitidis in 6 (7.7%) students. CONCLUSION: Epidemiologic data and clinical features were similar to other reports from developed countries. However antimicrobial resistance rate may be higher. Further studies on meningococcal serogroup or sequence type, antimicrobial resistance, and prevalence of antibody against meningococcus are needed.
Adolescent ; beta-Lactamases ; Cerebrospinal Fluid ; Developed Countries ; Diagnosis ; Hospitals, University ; Humans ; Incheon* ; Incidence ; Korea* ; Medical Records ; Meningitis ; Meningococcal Infections* ; Military Personnel ; Neisseria meningitidis ; Pharynx ; Prevalence ; Schools, Medical ; Sepsis

BACKGROUND: Meningococcal diseases occur worldwide and there are several case reports and reports on carriage rates in Korean military personnel. However, there are only few data on meningococcal diseases in the civilian. This study was performed to determine the incidence, clinical features of meningococcal disease, and a pharyngeal carriage rate of meningococcus in nonmilitary persons in metropolitan Incheon, Korea. MATERIALS AND METHODS: Patients with meningococcal diseases were searched by the following methods: discharge diagnosis of 'meningococcal infection' or 'meningococcal meningitis' or 'meningococcal sepsis'; positive cases in bacterial culture of blood or cerebrospinal fluid (CSF); positive meningococcal antigen in CSF. Two university hospitals in Incheon were participated and medical records of the meningococcal infection were reviewed. A survey of pharyngeal carriage of N. meningitidis was done at a high school by throat culture. RESULTS: A total of 15 cases of meningococcal diseases were identified. Ten cases were from Inha University hospital from January 1997 to May 2004, and five cases were from Gacheon Medical School Gil hospital from January 2002 to May 2004. Neisseria meningitidis was isolated in 11 cases and the remaining 4 cases were diagnosed by detecting of meningococcal antigen. The minimal annual incidence rates of meningococcal infection in metropolitan Incheon city ranged from 0.077/ 100,000 to 0.192/100,000. Majority of the patients were under 15 years old and occurred between October to May. The diagnosis was meningitis in 14 patients and sepsis in one patient. Patient with sepsis died but all the other patients recovered.Two among five strains produced beta-lactamase. Throat cultures from 78 high school students showed Neiserria meningitidis in 6 (7.7%) students. CONCLUSION: Epidemiologic data and clinical features were similar to other reports from developed countries. However antimicrobial resistance rate may be higher. Further studies on meningococcal serogroup or sequence type, antimicrobial resistance, and prevalence of antibody against meningococcus are needed.
Adolescent ; beta-Lactamases ; Cerebrospinal Fluid ; Developed Countries ; Diagnosis ; Hospitals, University ; Humans ; Incheon* ; Incidence ; Korea* ; Medical Records ; Meningitis ; Meningococcal Infections* ; Military Personnel ; Neisseria meningitidis ; Pharynx ; Prevalence ; Schools, Medical ; Sepsis

Infected walled-off pancreatic necrosis (WOPN) is dangerous complication of acute pancreatitis. Open necrosectomy and post-operative irrigation of necrotic cavity have been conventional treatment for infected pancreatic necrosis, however, recently minimally invasive techniques such as endoscopic necrosectomy has been regarded as preferred treatment method for infected WOPN. Endoscopic necrosectomy provides a targeted approach with a reduction in the systemic inflammatory response and avoidance of wound complications. Non alcohol related Wernicke encephalopathy is rare disease caused by thiamine deficiency due to intravenous feeding, and presented an encephalopathy, oculomotor dysfunction, gait ataxia. We report herein a case of Wernicke encephalopathy after successful endoscopic necrosectomy for infected WOPN.
Gait Ataxia ; Necrosis ; Pancreatitis ; Pancreatitis, Acute Necrotizing* ; Parenteral Nutrition ; Rare Diseases ; Thiamine Deficiency ; Wernicke Encephalopathy* ; Wounds and Injuries

No abstract available.
Leukemia, Myeloid, Acute*

No abstract available.
Aged, 80 and over ; DNA, Ribosomal/chemistry ; Diabetes Mellitus, Type 2/*complications/diagnosis ; Fatal Outcome ; Humans ; Male ; Mucormycosis/*complications/diagnosis/*microbiology ; Rhizopus/*isolation & purification ; Sequence Analysis, DNA ; Sequence Homology ; Tomography, X-Ray Computed

No abstract available.
Adult ; Aged ; Aged, 80 and over ; Blood Chemical Analysis/instrumentation ; Blood Platelets/*cytology/physiology ; Female ; Flow Cytometry/*instrumentation/standards ; Humans ; Male ; Middle Aged ; Platelet Count/*instrumentation/standards ; Reference Values ; Republic of Korea ; Young Adult

Cases of pediatric eosinophilic meningitis following duraplasty with a bovine graft have been reported. These patients recovered following the surgical removal of the dural graft or steroid therapy. Decompression for Chiari malformation is a common procedure in both pediatric and adult neurosurgery. We describe the case of a 33-yr-old male patient with eosinophilic meningitis following Chiari decompression via bovine graft duraplasty. Cerebrospinal fluid (CSF) study showed 49 red blood cells/μL and 129 leukocytes/μL with 17% eosinophils. There was no evidence of infectious disease. To our knowledge, this is the first report of adult eosinophilic meningitis after bovine graft duraplasty in Korea.
Adult* ; Arnold-Chiari Malformation* ; Cerebrospinal Fluid ; Communicable Diseases ; Decompression ; Eosinophils* ; Humans ; Korea ; Male ; Meningitis* ; Neurosurgery ; Transplants*

BACKGROUND: Amino-terminal pro-B type natriuretic peptide (NT-proBNP) is a well-established prognostic factor in heart failure (HF). However, numerous causes may lead to elevations in NT-proBNP, and thus, an increased NT-proBNP level alone is not sufficient to predict outcome. The aim of this study was to evaluate the utility of two acute response markers, high sensitivity C-reactive protein (hsCRP) and heart-type fatty acid binding protein (H-FABP), in patients with an increased NT-proBNP level. METHODS: The 278 patients were classified into three groups by etiology: 1) acute coronary syndrome (ACS) (n=62), 2) non-ACS cardiac disease (n=156), and 3) infectious disease (n=60). Survival was determined on day 1, 7, 14, 21, 28, 60, 90, 120, and 150 after enrollment. RESULTS: H-FABP (P<0.001), NT-proBNP (P=0.006), hsCRP (P<0.001) levels, and survival (P<0.001) were significantly different in the three disease groups. Patients were divided into three classes by using receiver operating characteristic curves for NT-proBNP, H-FABP, and hsCRP. Patients with elevated NT-proBNP (≥3,856 pg/mL) and H-FABP (≥8.8 ng/mL) levels were associated with higher hazard ratio for mortality (5.15 in NT-proBNP and 3.25 in H-FABP). Area under the receiver operating characteristic curve analysis showed H-FABP was a better predictor of 60-day mortality than NT-proBNP. CONCLUSIONS: The combined measurement of H-FABP with NT-proBNP provides a highly reliable means of short-term mortality prediction for patients hospitalized for ACS, non-ACS cardiac disease, or infectious disease.
Acute Coronary Syndrome/blood/*diagnosis/mortality ; Aged ; Area Under Curve ; Biomarkers/blood ; C-Reactive Protein/*analysis ; Fatty Acid-Binding Proteins/*blood ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Natriuretic Peptide, Brain/*blood ; Peptide Fragments/*blood ; Prognosis ; Proportional Hazards Models ; ROC Curve