Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.
Acute Kidney Injury ; Antipsychotic Agents ; Clozapine* ; Female ; Humans ; Middle Aged ; Neuroleptic Malignant Syndrome* ; Pulmonary Edema ; Renal Dialysis ; Respiration, Artificial ; Rhabdomyolysis

We have encountered many patients with dermatologic problems caused by animals, but there are not so many systematized literature about them in Korea. Since these causative animals are different from foreign animals in their distribution and habitat, there have been much difficulties in making diagnosis and in studying them based on foreign literature. We have undertaken this study to get the basic material for the possible causative animals in Korea by comparing with foreign literature, searching out the books of zoological claasification, and through personal contacts. One hundred and five species are found to be identical with the species reported in foreign literature, but 324 species are not, although they could be placed in the same genus.
Animals* ; Diagnosis ; Ecosystem ; Epidemiologic Studies* ; Humans ; Korea* ; Skin Diseases* ; Skin*

No abstract available.
Anesthesiology* ; Education* ; Publications*

This paper describes a case of intrapericardial teratoma in a 20-day-old female meonate, who suffered from cyanosis and respiratory difficulty. She was evaluated by echocardiography, chest CT and MRI, the suspected cyanosis and respiratory difficulty. She was evaluated by echocardiography, chest CT and MRI, the suspected intrapericardial mass was identified and surgically removed. The postopervative diagnosis was intrapericardial teratoma, grade II. This case is reported with brief review of some related literature.
Cyanosis ; Diagnosis ; Echocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Teratoma* ; Tomography, X-Ray Computed

PURPOSE: Extrapleural fat hypertrophy is thought to be associated with findings of chronic pleural or pulmonary parenchymal diseases, and more favours clinical course of benign disease rather than malignant disease which is rapidly progressive. Recently, however, we observed frequent extrapleural fat hypertrophy in CT scens of lung cencer patients, especially those with complicated ones. We studied the frequency of extrapleural fat hypertrophy and the relationship between the extrapleural fat hypertrophy and the complications of lung cancer. MATERIALS AND METHODS: We retrospectively analized the CT findings in 95 patients with primary lung cancer. 85 patients were confirmed pathologically and 10 patients were confirmed by clinical and radiological follow-up studies. RESULTS: Among the 95 patients, 79 patients were associated with more than one complications(Lung collapse, pneumonia, pulmonary tuberculosis., pleural reaction, pleural metastasis, empyema, chest wall invasion). Extrapleural fat hypertrophy was observed in 43(54%) patients with complication, and 2(13% ) patients without complication. The frequency of the extrapleural fat hypertrophy was 40%(14/35) in patients with only parenchymal complicated patients, 33%(2/6) in patients with only pleural complication, and 71%(27/38) in patients with both parenchymal and pleural complications. CONCLUSION: Extrapleural fat hypertrophy was more frequently observed in complicated lung cancer patients rather than non-complicated, and higher frequency of the extrapleural fat hypertrophy was noted in those with more than two complications. It was concluded that extrapleural fat hypertrophy in lung cancer patients was non-specific finding caused by associated complication. Its mechanism is thought to be chronic pleural irritation and negative thoracic pressure.
Empyema ; Follow-Up Studies ; Humans ; Hypertrophy* ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Pneumonia ; Retrospective Studies ; Thoracic Wall ; Tuberculosis, Pulmonary

The tests for sputum acid fast bacilli and sputum cytology for malignancy were negative. The PC20 of bronchial methacholine challenge test was 20.2 mg/ml. Transbronchial lung biopsy showed bronchial inflammatory change with infiltration of eosinophils and the existence of fungal hypae. Antibody index for serum IgE-Af and IgG-Af was 10.2 and 2.1 respectively, comparing with Af-sensitive asthma patients. Recently we experienced an allergic bron-chopulmonary aspergillosis with atypical respiratory symptoms. Forty-seven years old female was admitted to our hospital because of cough, sputum, right pleuritic pain for 2 weeks. She had experienced pneumonia several times, but had been not confirmed any causative organism. On physical examination, breathing sound was decreased over right upper lung, but wheezing and crackle were not heard over both lungs. The chest X-ray showed segmental consolidation in right upper lobe, and HRCT showed tubular bronchiectasis and obstruction of right upper lobal bronchus due to mucoid impaction. Allergic skin prick test against Aspergillus fumigatus(Af) and serum preeipitin were negative, but intrader mal skin test was positive for Af. Specific IgE for Af was positive with class I. Total eosinophil count was 650/mm3, total IgE level was more than 3000 IU/ml, ESR was 62mm/hr, and eosinophils in induced sputum was 35%. The test for sputum acid fast bacilli and spu-Tum cytology for malignancy were negative. The PC20 of bronchial methacholine challenge-Test was 20.2 mg/ml. Transbronchial lung bi-Opsy showed bronchial inflammatory change With infiltration of eosinophils and the exis-Serum lgE-Af and lgG-Af was 10.2 and 2.1 Respectively, comparing with Af-sensitive Asthma patients.
Aspergillosis ; Aspergillus ; Asthma* ; Biopsy ; Bronchi ; Bronchiectasis ; Cough ; Eosinophils ; Female ; Humans ; Immunoglobulin E ; Lung ; Methacholine Chloride ; Physical Examination ; Pneumonia ; Respiratory Sounds ; Skin ; Skin Tests ; Sputum ; Thorax

PURPOSE: To evaluate CT findings for the differential diagnosis of mechanical bowel obstruction and paralytic ileus. MATERIALS AND METHODS: Without information relating to clinical or operative findings, we retrospectively analyzed the CT scans of 24 patients with mechanical bowel obstruction and 19 patients with paralytic ileus. Final diagnosis was confirmed by operation (n=26), or by clinical symptoms, radiologic findings and follow-up study CT findings were obtained : 1) the diameter of the most dilated part of the small bowel, and the thickness and enhancing pattern of the dilated small bowel wall; 2) the diameter of the most dilated part of the descending colon and the ratio of the diameter of the small bowel to that of the descending colon; 3) the number of transitional zones, length and thickness. and 4) associated ascites and its location. RESULTS: The mean diameters of the most dilated part of the small bowel in mechanical bowel obstruction and paralytic ileus were 3.6cm and 2.9cm, respectively. The diameter of the small bowel in mechanical bowel obstruction was significantly greater than in paralytic ileus(p< .05). The mean thickness of dilated small bowel wall was 4.0mm in mechanical bowel obstruction and 2.4mm in paralytic ielus, and target-like enhancement was prominent in mechanical bowel obstruction (46%) (p< .05). he mean diameter of the most dilated part of the descending colon was not significantly different to that of the most dilated part of the small bowel, but the ratio of the diameter of the small bowel to that of the colon was 2.9 in mechanical bowel obstruction and 1.9 in paralytic ileus, respectively, which was statistically significant (p< .05). A transitional zone was seen in 23 cases (96%) of mechanical bowel obstruction and in nine (47%) of paralytic ileus. In mechanical bowel obstruction, mean transitional zone length was 2cm, shorter than that of paralytic ileus (3.4cm) (p< .05) The thickness of transitional zone and the presence of ascites and its locations were not significantly different between mechanical bowel obstrction and paralytic ileus. CONCLUSION: In the differential diagnosis of mechanical bowel obstruction and paralytic ileus, the following CT findings were considered useful : diameter of the most dilated part of the small bowel ; thickness and target-like enhancing pattern of dilated small bowel wall ; ratio of the diameter of the small bowel to that of the descending colon ; and the number of transitional zones, and their length.
Ascites ; Colon ; Colon, Descending ; Diagnosis ; Diagnosis, Differential* ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction* ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND/AIMS: We examined the ischemia-modified albumin (IMA) level during exercise in patients with coronary artery disease (CAD). METHODS: Forty patients with a history of chest pain underwent both symptom-limited treadmill exercise stress testing and coronary angiography within one week. During the treadmill tests, blood samples were obtained at baseline and 5 min after exercise to measure the serum IMA level. RESULTS: Of the 40 patients, fourteen (35%, CAD group) had significant coronary artery stenosis, while the other 26 (65%, non-CAD group) did not. The baseline and post-exercise IMA levels in the two groups did not differ significantly (105.2+/-7.2 vs. 107.7+/-6.7 U/mL at baseline and 93.1+/-10.1 vs. 94.8+/-5.7 U/mL at post-exercise in the CAD and non-CAD groups, p=0.29 and 0.57, respectively). The changes in IMA after exercise did not differ either (-10.4+/-7.5 vs. -14.0+/-7.6 U/mL in the CAD and non-CAD groups, respectively, p=0.10). Similarly, the change in IMA between the exercise ECG test positive (TMT positive, n=9) and negative (TMT negative, n=20) groups did not differ (-14.63+/-5.19, vs -8.50+/-9.01 U/mL, p=0.15, in the TMT positive and negative groups, respectively). CONCLUSIONS: Our results suggest that IMA has limitation in detecting myocardial ischemia during symptom-limited exercise stress tests.
Aged ; Albumins/*diagnostic use/metabolism ; *Chest Pain ; Electrocardiography ; *Exercise Test/instrumentation ; Female ; Humans ; Lactic Acid/blood ; Male ; Middle Aged ; Myocardial Ischemia/blood/*diagnosis/physiopathology ; Pilot Projects

Background: The On-X valve was recently introduced. It was the aim of this study to assess the safety and feasibility from the data derived from 28 patients who underwent aortic and/or mitral valve replacement with this prosthesis in National Medical Center. Material and Method: From May 1999 and May 2003, a series of 28 consecutive patients who had been implanted with 32 On-X prosthesis were reviewed. The operative procedure comprised of 12 MVR, 10 AVR and 6 DVR. The study followed the guidelines of AATS/STS. Mean follow-up was 27 months (total 64 patient-years). Result: Early ( Bilirubin ; Echocardiography ; Follow-Up Studies ; Freedom ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Hematocrit ; Hemodynamics ; Humans ; Incidence ; Mitral Valve ; Mortality ; Prostheses and Implants ; Reference Values ; Reticulocytes ; Surgical Procedures, Operative

This is to analyze and compare the distribution of the liver function test and its abnormal rates of the preemployment screening for office workers in asymptomatic young age groups between female and male. Liver function test(SGPT and SGOT) of 8,184 young adults(2,633 in female and 5,551 in male) were examined during the period from Jan.1,1994 to Dec. 31, 1994. The results were as follows; 1. Mean level of SGPT was 9.l+/-7.6(IU/L) in female, 21.0+/-27.9(IU/L) in male, and that of SGOT was 15.1+/-6.0(IU/L) in female, 20.5+/-26.5(IU/L) in male. There were significant differences(p<0.01) between female and male in both SPT and SGOT. And also there was significant increasing trend(p<0.05) by age groups in male for SGPT, decreasing trend(p<0.01) in female for SGOT. 2. In the abnormal rates of liver function test by the level of cut-off value, there were significant differences up to twice between the lowest and the highest cut-off value in both female(0.4% vs 0.7%) and male(6.5% vs 12.4%) 3. Abnormal rate of SGPT was 0.4% in female and 6.3% in male, and that of SGOT was 0.2% in female and 1.2% in male with significant differences between female and male in both tests.
Alanine Transaminase ; Aspartate Aminotransferases ; Female ; Humans ; Liver Function Tests* ; Liver* ; Male ; Mass Screening*