Hypereosinophilic syndrome (HES) is characterized by a persistent eosinophilia of l,500/mm3 lasting for at least 6 months associated with multi-system involvement and no other identifiable cause. A 45-year-old man had hypereosinophilia, cardiopathy, and acute paraplegia. Following corticosteriod with antipletelet agent therapy, paraplegia was improved rapidly and circulating eosinophils were normalized. We postulated that embolic phenomenon was due to hypercoagulable state by eosinophil-derived proteins and/or to direct infiltration by eosinophils.
Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome* ; Middle Aged ; Paraplegia*

Postictal sequential serum prolactin concentrations were observed in 28 patients with various type of seizures who were hospitalized at Keimyung University Hospital. Of 28 epileptic patients, 18 male and 10 female, age ranged from 18 years to 79 years (mean 42 years), 15 with generalized seizures, 13 with focal seizures (5 with simple partial seizures and 8 with partial seizures with generalization). Symptomatic epilepsy and epileptic patients with factors which may affect serum prolactin concentrations were excluded in this study. Serum prolactin concentrations were measure at 15, 30 and 60 minutes after convulsion and 24 hours after convulsion for the base line serum prolactin level. Patients with generalized seizsures and significant elevation of serum prolactin concentrations at 15, 30 and 60 minutes after ictus (Table 1). Same results were obtained in patients with simple partial seizures at 30 minutes and 60 minutes after ictus, and 15 minutes and 30 minutes after ictus in patients with partial seizures with secondary generalization (Table 2 and 3). Level of serum prolactin concentrations were higher in patients with generalized seizure than the other type of seizures. Therefore, measuring serum prolactin level could help differentiate postictal state and other causes of mental change, and also differentiative various type of seizures.
Epilepsies, Partial ; Epilepsy ; Female ; Generalization (Psychology) ; Humans ; Male ; Prolactin* ; Seizures*

No Abstract Available.
Astrocytes* ; Humans*

This study was retrospectively undertaken to evaluate clinical manifestations, electroencephalographic findings, response to antiepileptic drugs and prognosis of 80 benign childhood epilepsy with centrotemporal spikes (BCECT) patients seen between 1967 and 1993 and followed up for more than 2 years. The age of onset ranges from 3 to 15 years. In 93 percent of patients, seizures appeared between 4 to 12 year-old, with peak of 5 year-old. The main manifestations of partial seizure were hemifacial spasm (53%) and oropharygeal signs (52%) with hypersalivation, abnormal sensation of mouth, gutteral sounds, swallowing difficulty and feeling of suffocation. The types of seizure consist of partial seizure(66%) and partial seizure with secondary generalization (34%). Distributions of seizure attack were nocturnal sleep (83%), diurnal sleep state(4%) and waking state (13%). The typical EEG findings were slow diaphasic high voltage centrotemporal spikes with unilateral (94%) and bilateral foci(6%) with normal background. In addition to typical EEG findings, there were associated with multifocal independent sharp-waves (8.9%) and generalized sharp-wave discharges (7.8%). BCECT patients were well controlled by antiepileptic drugs and had good prognosis. During the follow-up period (2-17years), we observed that all patient were well adapted to school and society. Seizures did not occur after adolescent period.
Adolescent ; Age of Onset ; Anticonvulsants ; Asphyxia ; Child ; Child, Preschool ; Deglutition ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Follow-Up Studies ; Generalization (Psychology) ; Hemifacial Spasm ; Humans ; Mouth ; Prognosis ; Retrospective Studies ; Seizures ; Sensation ; Sialorrhea

BACKGROUND: It is well known that when macrophages are stimulated with endotoxin, they produce a wide variety of cytokine mediators, including TNF-α and IL-1β. However, there is an alterationnin the macrophages responsiveness when they are challenged with repeated bouts of endotoxin, termed 'endotoxin tolerance' which is regarded as a self-protective phenomenon from continuous stimulation. In this study, endotoxin tolerance in the peripheral blood monocytes of sepsis patients was evaluated. METHODS: Fourteen patients with organism-documented sepsis were included. The severity of illness was evaluated by APACHE IIscore. Peripheral blood monocytes were isolated from the patients and diluted to 1×105/well. After stimulation with endotoxin(LPS of E. coli O114:B4, 100 ng/ml), they were incubated at 37℃ in 5% CO2 incubator for 24 hours. Supernatant was collected for the measurement of TNF-αand IL-1β with ELISA method. Peripheral blood monocytes of seven healthy volunteers were used as control. RESULTS: The APACHE IIscore(mean±SD) of the patients at the time of blood sampling was 12.2±5.7. The primary infection foci were urinary tract infection, pneumonia, subacute bacterial endocarditis, and catheter related infection, etc. The causative organisms were gram negative rods(10 cases), gram positive cocci(6 cases) with two cases of mixed infection. Serum TNF-α could be measured in 4 cases with 29.9±27.7 pg/ml. Serum IL-1β was measureable in only one patient. The TNF-α level of supernatant of cultured peripheral blood monocytes was 2,703±2,066 pg/ml in patients and 2,102±1,914 pg/ml in controls. The IL-1β level of supernatant was 884±1,050 pg/ml in patients and 575±558 pg/ml in controls. There was no difference of TNF-α and IL-1β level between patients and controls. CONCLUSION: We cannot prove the phenomenon of endotoxin tolerance in this study. Future study needs to be focused on the more severe sepsis patients who were taken for sampling earlier. Addition of serum to the culture medium could be an another valuable option for the success of this study.
APACHE ; Catheters ; Coinfection ; Endocarditis, Subacute Bacterial ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Humans ; Incubators ; Macrophages ; Monocytes ; Pneumonia ; Sepsis* ; Tumor Necrosis Factor-alpha* ; Urinary Tract Infections

BACKGROUND: Current non-invasive methods for evaluating the mediastinum by computed tomographic(CT) scan have limited sensitivity and specificity. The recently introduced PET was reported to be a more sensitive and specific method for the mediastinal staging of NSCLC(sensitivity:76-100%, specificity:81-100%) than CT or MRI. We assessed the usefulness of PET in the mediastinal staging of NSCLC. METHODS: We reviewed the medical records of NSCLC patients that had undertaken staging work-up by both CT and PET before thoracotomy between January 1997 and December 1998. A total of 23 patients were enrolled in the study(14 males and 7 females) with a mean age of 61±9 years. By comparing the clinical(CT and PET) and pathologic stagings, we evaluated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET in thoracic nodal staging. RESULTS: Sensitivity, specificity, positive predicted value and negative predicted value were 38%, 40%, 25% and 50% respectively for computed tomography, and 50%, 60%, 30% and 69% for PET. The accuracy of FDG-PET in our study was lower than that reported by previous other studies. CONCLUSION: Tne addition of FDG-PET to CT scanning has limited benefit for the thoracic nodal staging of NSCLC, but its value in our study was lower than that observed by others.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Magnetic Resonance Imaging ; Male ; Mediastinum ; Medical Records ; Sensitivity and Specificity ; Thoracotomy ; Tomography, X-Ray Computed

Clinical studies were made on 37 cases with thalamic hemorrhage diagnosed by computed tomographic scan and only localized on the thalamic area, were admitted to the Keimyung University Dongsan hospital from January 1981, to December 1985. The age and sex distribution, symptoms and neurologic signs on admission, relationship between the hospital course and many factors affecting the prognosis such as age, side of lesion, level of consciousness, volume of the hematoma, degree of hydrocephalus and ventricular hemorrhage were analysed. The results were summarized as follows; 1. The most prevalent age group was above 51 years of age with 41-50 years, 21-30 years and 31-40 years of age in the order of frequency. Male to female ratio was 15:22. 2. The clinical symptoms on admission in the order of frequency were the impairment of consciousness, headache, nausea and vomiting, speech disturbance and hemiparesis, dizziness and voiding difficulties. The neurologic signs on admission showed hemiparesis, hyperreflexia, and positive Babinski sign, impaired consciousness, hemisensory deficit, central facial nerve palsies, dysarthria, sluggish and unreactive light reflex, small pupil and absent gag reflex, impaired vertical gaze, papilledema, aphasia and abducens nerve palsies in that order. 3. The hospital course had no significant relationship with the age of the patients and the side of hematoma but there was a significant relationship between the alert-drowsy group and the stuporcoma group (P<0.01). 4. The hospital course had no significant relationship with the degree of volume of hematoma and hydrocephalus. The hospital course had a significant relationship with ventricular hemorrhage (P<0.05) but the hospital course of the improved group had no significant tendency to the rate of improvement.
Abducens Nerve Diseases ; Aphasia ; Consciousness ; Dizziness ; Dysarthria ; Facial Nerve ; Female ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Male ; Miosis ; Nausea ; Neurologic Manifestations ; Papilledema ; Paralysis ; Paresis ; Prognosis* ; Reflex ; Reflex, Abnormal ; Reflex, Babinski ; Sex Distribution ; Vomiting

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

BACKGROUND: It is well known that the prevalence of lung cancer is higher in idiopathic pulmonary fibrosis(IPF) patients than in the general population. This high prevalence is explained by the concept of 'scar carcinoma'. There have been several reports on the prevalence of histologic type of lung cancer in IPF with conflicting results. Despite of the high smoker rate in almost all previous reports, none considered the smoking history of patients. Therefore we performed a separate studies on fibrosis associated lung cancer and smoking associated lung cancer. The purpose of this study is to investigate the proportion of lung cancer in IPF that is fibrosis assiciated and to determine the most common histologic type in fibrosis associated lung cancer in IPF. METHODS: A retrospective review of medical records and radilolgic studies was performed for cases of lung cancer with IPF. We investigated smoking history, sequence of diagnosis of lung cancer and IPF, histologic type of lung cancer and the cancer location, especially whether the location is associated with fibrosis. To evaluate the proportion of fibrous associated lung cancer, the lung cancer in IPF were categorized according to the presence of fibrosis at cancer location. RESULTS: Fifty seven patients were subjects for this analysis. Six(11%) cases were diagnosed as lung cancer during follow-up for IPF, and both diseases were diagnosed simultaneously in the others. Ninety four percent of patients were smokers and the average smoking amount was 47.1±21.9 pack-year. Among the patients with IPF and lung cancer, 42(80.8%) cases were considered as 'fibrosis associated'. The remainder was 'not fibrosis associated' and probably was due to smoking etc. Although the most frequent histologic type was squamous cell carcinoma as a whole, adenocarcinoma was the prominent histologic type in 'fibrosis associated lung cancer.' CONCLUSION: Considering the proportion of 'fibrosis not associated lung cancer' in the patients with IPF and lung cancer, significant proportion of lung cancer in IPF may not be fibrosis induced. This may influence the distribution of histologic type of lung cancer in IPF.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Diagnosis ; Fibrosis* ; Follow-Up Studies ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung Neoplasms* ; Lung* ; Medical Records ; Prevalence ; Retrospective Studies ; Smoke ; Smoking