No abstract available.
Drug Therapy, Combination* ; Necrosis* ; Radiotherapy* ; Small Cell Lung Carcinoma*

No abstract available.
Candida* ; Esophagitis* ; HIV Infections* ; HIV* ; Humans

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.
Abdominal Pain ; Adult ; Female ; Humans ; Incidence ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproduction

Barrett's esophagus is a metaplastic process in which the squamous epithelium of the lowet esophagus is replaced by columnar epithelium. Most cases are believed to be related to prolonged gastroesophageal reflux. Detection of Barretts esophagus is important in that it results in adenocarcinoma in about 10% of patients. We report a case of adenocarcinoma arising from Barrett's esophagus in a 56 year-old man, diagnosed incidentally at a physical check-up. Grossly, the esophagogastric junction was irregular and there were two small ulcers in the lower esophagus. Microscopically, ihe squamous epithelium of the lower hagus was replaced by specialized intesinal mucosa with a small focus of adenocarcinona confined to the submucosa in one area. Many separate dysplastic foci were also present in the nearby esophageal mucosa.
Adenocarcinoma* ; Barrett Esophagus* ; Epithelium ; Esophagogastric Junction ; Esophagus* ; Gastroesophageal Reflux ; Humans ; Intestines* ; Middle Aged ; Mucous Membrane ; Stomach* ; Ulcer

No abstract available.
Thoracic Outlet Syndrome*

We reviewed 26 cases of cardiac rhabdomyoma in children which were diagnosed between 1986 and 1991 in Seoul National University Children's Hospital. Twenty-two cases were associated with tuberous sclerosis. Total tumor count was 58 and mean tumor count per patient was "daehakgyo".23. Their cardiac rhabdomyomas were diagnosed from fetal period through 12 years after birth. Median age was 9."uiwon" months. Fifteen patients were males and rest 11 patients were females. Cardiac symtoms and signs at initial diagnosis were present in 12 cases. They consisted of cardiac murmur in "hakgyo", arrhythmia in 8 and congestive heart failure in "daehakgyo" cases (one with murmur and the other with arrhythmia). Cardiomegaly was seen in 9 cases on chest X-ray and other "byeongwon" case showed abnormal left cardiac border. Electrocardiography and 24 hour Holter monitorings showed arrhythmia in 15 cases. Clinically significant arrhythmias were found in 7 cases on 24 hour Holter monitorings. They consisted of 1with frequent premature ventricular contractions, "daehakgyo uigwadaehak" with frequent premature atrial contractions, "daehakgyo" with atrial tachycardia and "daehakgyo uigwadaehak" with atrio-ventricular block ("daehakgyo" cases of atrio-ventricular block had other arrhythmias also). The locations of tumors were left ventricle in 21, interventricular septum in 21, right ventricle in 13 and atrium in "daehakgyo uigwadaehak" tumors. Mean tumor count per patient in fetal period and infancy was "daehakgyo".86 and it was statistically much more than that after infancy which was "byeongwon".5. Mean tumor area which was calculated on two dimensional echocardiography was larger in fetal period and infancy(128.9 +/- 38.2mm2)than that after infancy(47.8 +/- 11.2mm2). Mean relative tumor area to aortic root dimension was also significantly larger in fetal period and infancy than that after infancy ("daehakgyo".07vs 0.30). In tuberous sclerosis, mean mass area and mean relartive tumor area to aortic root dimension in fetal period and infancy was significantly larger than those in patients after infancy. Of 26 cases, tumorectomy was done in "daehakgyo uigwadaehak" cases due to hemodynamic obstruction and arrhythmia. One case died immediately after operation and the other "daehakgyo" cases are still alive with the follow up period of 30 and 44 months each. Of the 7 patients with significant arrhythmia on 24 hour Holter monitorings, pacemaker insertion was done in "byeongwon" case who received tumorectomy and other 1 case was treated with anti-arrhythmic drugs. All the other patients did not need anti-arrhythmic drugs or other management.
Arrhythmias, Cardiac ; Atrial Premature Complexes ; Cardiomegaly ; Child* ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Failure ; Heart Murmurs ; Heart Ventricles ; Hemodynamics ; Humans ; Male ; Parturition ; Rhabdomyoma* ; Seoul ; Tachycardia ; Thorax ; Tuberous Sclerosis ; Ventricular Premature Complexes

Reentrant tachycardias can often be terminated by discrete pacing stimuli that penetrate the reentrant circuit. Antitachycardia pacemaker PASAR 4172 (Programmable Automatic Scanning Arrhythmia Reversion, Model 4172, Telectronics) is designed to detect tachycardia automatically and subsequently to deliver programmed one or two extrastimuli to revert to sinus rhythm. We experienced two patients, one paroxysmal supraventricular tachycardia and one paroxysmal ventricular tachycardia, who had had frequent and often prolonged episodes of tachycardia that responded poorly to pharmacologic antiarrhythmic therapy. Each patient underwent a detailed preimplantation clinical electrophysiological study in order to determine the number of stimuli required for termination of tachycardia, the most satisfactory site for electrode placement, and the tachycardia termination zone. During the follow-up period of 7 to 11 months after implantation of PASAR 4172, no patient complained of an episode of sustained tachycardia although they experienced symptoms of an impending attack. We conclude that antitachycardia pacemaker PASAR 4172 is a safe, effective, and well tolerated method for the therapy of drug resistant paroxysmal supraventricular tachycardia and paroxysmal ventricular tachycardia.
Arrhythmias, Cardiac ; Electrodes ; Follow-Up Studies ; Humans ; Tachycardia ; Tachycardia, Paroxysmal* ; Tachycardia, Supraventricular ; Tachycardia, Ventricular

BACKGROUND: Diabetic ketoacidosis(DKA) is serious acute metabolic complication and the most important cause of high morbidity and mortality of diabetes. The object of this study is to examine the clinical characteristics of patients with DKA who had a prior history of diabetes or not. METHOD: Authors reviewed retrospectively the medical records of 49 cases adimitted to Kyungpook National University Hospital from January 1991 to June 1997 with a diagnosis of DKA and classified cases as type I, type II and newly diagnosed diabetics according to prior history of diabetes. RESULTS: 1. Of 49 cases of DKA, 24(49%) were classified as type I, 17(35%) as type II from data available in the medical records, and 8(16%) had DKA as the initial manifestation of the disease. 2. The male to female ratio was 0.5 : 1 in type I, 1.1 : 1 in type II and 1.7 : 1 in newly diagnosed diabetics, and the mean age was 24.4 in type I, 57.9 in type II and 23.9 years old in newly diagnosed diabetics. 3. The mean duration between initial diagnosis of diabetes and the occurrence of DKA was 2.6 in type I and 6.9 years in type II diabetes. The occurrence of DKA within 2 years of initial diagnosis of diabetes was 54% in type I and 18% in type II diabetes, but the occurrence of DKA after 5 years of initial diagnosis of diabetes was 17% in type I and 47% in type II diabetes. 4. The precipitating factors of DKA were identified in 88% in type I, 76% in type II and 38% in newly diagnosed diabetics, and the most common precipitating factor was omission of treatment in both type I and type II(type I: 56%, type II: 35%). 5. The altered mental status was correlated with increased osmolality (p<0.05), but not with other laboratory values such as pH, bicabonate, glucose, anion gap and dehydration status(p>0.05). CONCLUSION: It is necessary to conduct early aggressive evaluation for early diagnosis and proper treatment of DKA, because DKA occurs in patients with prior history of type II diabetes and without prior diabetic history as well as patients with prior history of type I diabetes.
Acid-Base Equilibrium ; Dehydration ; Diagnosis ; Early Diagnosis ; Female ; Glucose ; Gyeongsangbuk-do ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical Records ; Mortality ; Osmolar Concentration ; Precipitating Factors ; Retrospective Studies

Respiratory syncytial virus (RSV) and Influenza virus are the most common pathogen for causing severe upper respiratory infection in all age groups. A multiplex reverse transcription polymerase chain reaction (RT-PCR) has been developed to detect and subtype influenza A (H3N2 and H1N1), B virus and RSV simultaneously in one tube reaction. Amplification with primers derived from conserved sequences within the nucleocapsid for RSV and hemagglutinin subunit for Influenza A (H3N2 and H1N1) and B viruses yielded a 384 bp, a 300 bp, a 236 bp and a 151 bp, respectively. Assay specificity was confirmed by pulse field gel electrophoresis and autosequencing method. Assay sensitivity was 3 PFU/ml of RSV, 22 PFU/ml, 45 PFU/ml of Influenza type A (H3N2 and H1N1) and 6.6 PFU/ml of Influenza B virus by plaque assay. A rapid and sensitive detection method of a one-tube with multiplex RT-PCR capable of identifying more than one viral template as well as synchronizing reverse transcription and PCR had the potential to produce considerable savings of time and cost effectiveness in the diagnostic laboratory.
Conserved Sequence ; Cost-Benefit Analysis ; Electrophoresis ; Hemagglutinins ; Herpesvirus 1, Cercopithecine ; Humans* ; Income ; Influenza B virus ; Influenza, Human* ; Nucleocapsid ; Orthomyxoviridae* ; Polymerase Chain Reaction* ; Respiratory Syncytial Virus, Human* ; Respiratory Syncytial Viruses ; Reverse Transcription* ; Sensitivity and Specificity

It is suggested that evaluation of diet quality may be a great indicator of nutritional assessment. The aim of this study was to evaluate the diet quality of children and adolescents based on nutrient and food group intake and Diet Quality Index-International (DQI-I). This survey was conducted through questionnaires and diet record survey to 477 students (elementary school students; n = 131, middle school students; n = 136, and high school students; n = 210). The results showed that high school students were significantly more often to skip breakfast compared with the other groups. The middle and high school students consumed significantly higher intakes of food and energy compared to the elementary school students. Also the number of nutrients in Index of Nutritional Quality (INQ) < 1.0 of high school students were significantly higher than that of elementary and middle school students. The Korean's dietary diversity score (KDDS) of elementary school, middle school and high school students were 4.1, 4.4 and 4.3 respectively. The average DQI-I of elementary school, middle school and high school students were 66.7, 65.5, and 63.7, respectively and there was significant difference. Also, middle school students showed to have higher score in variety and adequacy category compared with the other groups, and elementary school students appeared to have higher score in moderation category. In conclusion, high school students appeared to have unhealthy dietary habits in terms of high frequency of skipping breakfast and lower INQ and DQI-I score compared to the elementary school and middle school students. Therefore, the proper dietary management should be needed for high school students.
Adolescent ; Breakfast ; Child ; Diet ; Diet Records ; Food Habits ; Humans ; Nutrition Assessment ; Nutritive Value ; Surveys and Questionnaires