Acrylonitrile is most commonly used aliphatic nitrile compounds characterized by the structural formula R-C=N and used mossy to make acrylic fibers, plastics, synthetic rubber, and wall coverings. In recent, because of its extensive usage and the rapid expansion of the chemical industry, many poisonings have been reported and many studies on its health effects have been performed. Acute toxicity resembles cyanide poisoning and results mainly in effects on the nervous system. High exposure also can cause temporary damage to red blood cells and the liver and can cause lead to death. Because long-term occupational exposure to the acrylonitrile has been with cancer in humans, the U.S EPA classifies acrylonitrile as probable carcinogen. For this reason, The federal government has developed regulations and advisories to protect individuals firm the potential health effects of acylonitrile in the environment, but there are few studies, case reports and regulations of the government in our country. We experienced acute poisoning caused by acrylonitrile inhalation that occurred in an industrial accident. So, we report this case with literature reveiw.
Accidents, Occupational ; Acrylonitrile* ; Chemical Industry ; Elastomers ; Erythrocytes ; Federal Government ; Humans ; Inhalation* ; Liver ; Nervous System ; Occupational Exposure ; Plastics ; Poisoning* ; Social Control, Formal

A clinical observation was made on 19 patients of renal cell carcinoma who were treated by radical nephrectomy with extended retroperitoneal lymphadenectomy in the Department of Urology, Catholic Medical College during the period from May, 1980 to August, l985. Results were as follows; 1. Clinical stages by Robson`s staging system were 7 cases of stage I, 6 cases of stage II, 5 cases of stage III and 1 case of stage IV. Acuracy rate of clinical staging was 68.4%. 2. Pathologic stages were 8 cases of stage I, 5 cases of stage II, 4 cases of stage HI and 2 cases of stage IV. 3. Metastatic sites were perirenal fat(5 cases), regional lymphnode (2 cases), vessel(4 cases) and lung (2 cases). The rate of regional lymphnode involvement was 10.5%. 4. Postoperative complications were colocutaneous fistula (1 case), prolonged ileus (1 case) and pleural effusion (1 case). 5. Out of 19 cases 13 cases were alive without recurrence, 2 cases were alive with metastasis, 3 cases died with recurrence and 1 case died with other cause. 1 year survival rate was 77.8%.
Carcinoma, Renal Cell* ; Fistula ; Humans ; Ileus ; Lung ; Lymph Node Excision* ; Neoplasm Metastasis ; Nephrectomy* ; Pleural Effusion ; Postoperative Complications ; Recurrence ; Survival Rate ; Urology

Partial nephrectomy frequently accompanies serious complications such as secondary bleeding and urinary fistula and these complications result from necrosis of renal cut margin after partial nephrectomy. We have performed experimental partial nephrectomy to compare the extent of necrosis of renal cut margin after the wedge resection(Group l), the transverse polar resection(Group 2) and the chromic ligature resection(Group 3). In order to investigate which type of 3 partial nephrectomies cause less complications, 15 adult mongrel dogs were divided into three groups and partial nephrectomy was performed at the lower one quarter of 10 kidneys of 5 dogs in each group. The gross and microscopic findings of renal cut margin were observed at 1, 2, and 3 weeks after the operation. The results were as follows; 1. Mean depth of necrosis of the renal cortex at cut margin in Groups 1, 2 and 3 were 1.Ocm, O.2 cm and O.3cm, respectively. 2. Mean depth of necrosis of the renal medulla in Groups 1, 2 and 3 were 1.1cm, O.9cm and O.8cm, respectively. 3. On microscopic examination of the renal cortex at the 3rd week after operation, Groups 2 and 3 showed complete healing of necrosis but Group 1 showed delayed healing with remained necrotic tissue. From the present experiment it was found that both the transverse polar and chromic ligature resection cause less complications than the wedge resection.
Adult ; Animals ; Dogs* ; Hemorrhage ; Humans ; Kidney ; Ligation ; Necrosis* ; Nephrectomy* ; Urinary Fistula

We evaluated the antitumor activity and toxicity of recombinant human interferon gamma (LBD -001) as a new modality for advanced renal cell carcinoma from March, 1988 to August, 1989 at the Department of Urology, St. Mary's Hospital, Catholic University Medical College. Eleven patients with advanced renal cell carcinoma were given recombinant gamma interferon at dose of 5.0-7.6 x 106U/day, subcutaneously three days per week. Among eleven patients, only one achieved partial response. Major adverse effects included fever, fatigue, myalgia and leukopenia, but no life threatening side effects were found. Although recombinant human interferon gamma have an antitumor activity against advanced renal cell carcinoma, further study is necessary to define the optimal treatment regimen.
Carcinoma, Renal Cell* ; Fatigue ; Fever ; Humans ; Interferons* ; Leukopenia ; Myalgia ; Urology

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BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume*

Transient global amnesia is characterized by a sudden memory loss of recent and/or remote events and transient inability to acquire new knowledge. Although mostly followed by complete recovery within a day, this rare and unexpected event in recovery phase after general anesthesia should be embarrassing and confusing, so we must proceed with prompt differential diagnosis for other organic intracranial pathology including transient ischemic attack and go on close observation. We describe a case of transient global amnesia of a 66-year-old woman after general anesthesia for excision and biopsy of left neck mass.
Aged ; Amnesia ; Amnesia, Transient Global ; Anesthesia, General ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Ischemic Attack, Transient ; Memory Disorders ; Neck

We report the first case of an angiomyomatous hamartoma (AH) of the popliteal lymph nodes (LNs) occurring in association with diffuse pigmented villonodular synovitis (PVNS) of the knee. AH is a rare benign vascular disease with a predisposition for the LNs of the inguinal region. Twenty-five cases of AH have been reported to date; however, the precise pathogenesis is still undetermined. In the present case, an open synovectomy revealed two of three popliteal LNs in close proximity to the extra-articular component of diffuse PVNS. These LNs demonstrated irregularly distributed thick-walled blood vessels in the hilum. These vessels extended into the medulla and cortex and were associated with haphazardly arranged smooth muscle cells in the sclerotic stroma. These findings are compatible with an AH. Our observations raise the possibility that AH of the popliteal LNs may represent an abnormal proliferative reaction against the inflammatory process caused by PVNS of the knee.
Angiomyoma ; Blood Vessels ; Hamartoma ; Knee ; Lymph Nodes ; Myocytes, Smooth Muscle ; Synovitis, Pigmented Villonodular ; Vascular Diseases

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors

A clinical observation was made with particular attention to radiologic diagnosis, complication and management on 69 patients of renal injury admitted to the Catholic Medical Center during the last 10 years. The results were as follows: 1. Minor renal injury was in 49 cases (71%), major renal injury in 19 cases (27.5%) and pedicle injury in 1 case (1.5%) according to Scott's classification. 2. IVU was performed in 68 cases for initial diagnostic study and 18 cases (31%) needed additional radiologic study for accurate staging. 3. CT was performed in 14 cases and its diagnostic accuracy was 93%. 4. Renal angiography was performed in 6 cases. Angioinfarction was performed in 1 case due to continuous bleeding and the other 5 cases showed localized parenchymal infarction or normal finding. 5. Sonography was performed in 6 cases for initial diagnostic study and in 3 cases for follow up study. 6. In major renal injury patients, the group which decided treatment after CT study revealed 16 7% of complication rate but the group which decided treatment without CT study revealed 38 5% of complication rate. 7. In major renal injury or pedicle injury patients, initial operative treatment group resulted in kidney loss in 70% of cases without complication but initial conservative treatment group resulted in kidney loss in 60% of cases and the delay of operation resulted in 70% of complication rate.From these results, CT is the choice of additional staging technique after initial IVU and initial surgical operation is adequate treatment procedure in major renal injury or pedicle injury patients.
Angiography ; Classification ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Kidney