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Acute Dystonia by Droperidol during Intravenous Patient-Controlled Analgesia in Young Patients.

Chang Kil PARK ; Hwan Yeong CHOI ; In Young OH ; Myung Suk KIM

Journal of Korean Medical Science.2002;17(5):715-717. doi:10.3346/jkms.2002.17.5.715

Patient-controlled analgesia (PCA) is an important means for postoperative analgesia with parenteral opioid. However, postoperative nausea and vomiting (PONV) remains a major problem with a PCA system. Droperidol is used in PCA to prevent PONV. Extrapyramidal reactions by droperidol are, however, occasionally induced. We describe two cases of severe extrapyramidal hypertonic syndrome with an intravenous administration of droperidol in PCA in young patients, following orthopedic surgery.
Acute Disease ; Adolescent ; Analgesia, Patient-Controlled/*adverse effects ; Analgesics/administration & dosage/*adverse effects ; Droperidol/administration & dosage/*adverse effects ; Dystonia/*chemically induced ; Humans ; Infusions, Intravenous ; Male

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Asynchronous Bilateral Torsion of the Spermatic Cord in the Newborn: A Case Report.

Sang Don LEE ; Chang Sek CHA

Journal of Korean Medical Science.2002;17(5):712-714. doi:10.3346/jkms.2002.17.5.712

Asynchronous bilateral torsion of the spermatic cord in the newborn is extremely rare. We report such a case in a 4-day-old boy with subsequent operative discovery of prior in utero torsion of the contralateral spermatic cord. The diagnosis was made by physical examination, transillumination test, color Doppler ultrasound, and confirmed by emergent surgical exploration. To our knowledge, the present case is the 6th case of asynchronous bilateral torsion of the spermatic cord in the English literature, and the first case in Korea.
Humans ; Infant, Newborn ; Male ; Spermatic Cord Torsion/*diagnosis/pathology/surgery ; Testis/pathology

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Autoimmune Hemolytic Anemia Predominantly Associated with IgA Anti-E and Anti-c.

Young Ae LIM ; Moon Kyu KIM ; Bong Hak HYUN

Journal of Korean Medical Science.2002;17(5):708-711. doi:10.3346/jkms.2002.17.5.708

A patient with warm autoimmune hemolytic anemia (AIHA) due to predominance of immunoglobulin A (IgA) with an Rh specificity, considered to be the first case in Korea, is described. A 13-yr-old male patient with severe hemolytic anemia showed a weak reactivity (1+) in the direct antiglobulin test (DAT) by using anti-IgG antiglobulin reagent. This finding, however, could not fully explain the patient's severe AIHA. When anti-IgA reagent was used for the DAT, strong reactivity (4+) was observed and free anti-E and anti-c autoantibodies were also detected by anti-IgA and anti-IgG reagents. The patient's hemoglobin began to rise with the administration of steroids. Because RBCs coated with multiple types of immunoglobulins are associated with more severe hemolysis than those only with IgG, the DATs using anti-IgA and other reagents are needed for the correct diagnosis when the result of DAT is not compatible with patient's clinical manifestations.
Adolescent ; Anemia, Hemolytic, Autoimmune/diagnosis/*immunology ; Antibody Specificity ; Autoantibodies/*blood ; Coombs' Test ; Humans ; Immunoglobulin A/*blood ; Korea ; Male ; Rh-Hr Blood-Group System/immunology

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Plasma Cell Granuloma in Cyclosporine-Induced Gingival Overgrowth: A Report of Two Cases with Immunohistochemical Positivity of Interleukin-6 and Phospholipase C-gamma1.

Sung Sook KIM ; Dae Woon EOM ; Joo Ryung HUH ; Iel Yong SUNG ; In Pyo CHOI ; Sung Ho RYU ; Pann Ghill SUH ; Sung Min CHUNG

Journal of Korean Medical Science.2002;17(5):704-707. doi:10.3346/jkms.2002.17.5.704

We report two cases of gingival plasma cell granuloma in a 34-yr-old and 40-yr-old two male renal transplant recipients with cyclosporine A (CsA)-induced gingival overgrowth (GO). Histologically, these lesions were composed of mature plasma cells, showing polyclonality for both lambda and kappa light chains and fibrovascular connective tissue stroma. In addition to the fact that CsA-induced plasma cell granuloma is rare, the salient features of our cases were the secretion of interleukin-6 and overexpression of phospholipase C-gamma1 of the tumor cells, which may explain the mechanisms of CsA- induced GO.
Cyclosporine/adverse effects ; Female ; Gingival Diseases/*chemically induced/enzymology/immunology/pathology ; Granuloma, Plasma Cell/*chemically induced/enzymology/immunology/pathology ; Humans ; Immunohistochemistry ; Immunosuppressive Agents/adverse effects ; Interleukin-6/metabolism ; Kidney Transplantation ; Male ; Middle Aged ; Phospholipase C gamma ; Type C Phospholipases/metabolism

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Fever of Unknown Origin as a Presentation of Gastric Inflammatory Myofibroblastic Tumor in a Two-Year-Old Boy.

Min Young CHO ; Youn Ki MIN ; Nam Ryeol KIM ; Seong Jin CHO ; Han Kyeom KIM ; Kwang Chul LEE ; Sung Ock SUH ; Cheung Wung WHANG

Journal of Korean Medical Science.2002;17(5):699-703. doi:10.3346/jkms.2002.17.5.699

Gastric inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion with mimicking malignant features and accompanied with various clinical manifestations. Here we present a 2-yr-old boy who had a gastric IMT with a huge extragastric mass, which closely resembled a neuroblastoma on imaging studies. He experienced intermittent fever and poor appetite for 6 weeks. Fever remained up to 38degrees C even on the operation day. He underwent partial gastrectomy and distal pancreatectomy with splenectomy including the tumor. The preoperative fever disappeared and did not recur in the postoperative course.
Child, Preschool ; Fever of Unknown Origin/*etiology ; Granuloma, Plasma Cell/*complications/*diagnosis/surgery ; Humans ; Male ; Stomach Diseases/*complications/*diagnosis/surgery

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Takayasu's Arteritis Presented with Subarachnoid Hemorrhage: Report of Two Cases.

Dal Soo KIM ; Jae Keon KIM ; Do Sung YOO ; Phil Woo HUH ; Kyuong Suck CHO ; Joon Ki KANG

Journal of Korean Medical Science.2002;17(5):695-698. doi:10.3346/jkms.2002.17.5.695

Takayasu's arteritis is a chronic inflammatory disease that produces a narrowing of the aorta and its major branches. Fibrosis and thickening of the arterial wall often occur in later stages, resulting in a cerebrovascular accident. The authors report two young women patients who presented with subarachnoid hemorrhage (SAH) and occlusive cerebrovasular disease associated with Takayasu's arteritis. Both patients had sudden headache and hemiparesis. Physical examination showed weak radial pulse, carotid bruit, and asymmetrical blood pressure. Erythrocyte sedimentation rate (ESR) was elevated in both patients. SAH was confirmed by brain computerized tomography (CT) or lumbar puncture. Occlusive cerebrovascular disease was diagnosed by brain magnetic resonance imaging (MRI), brain magnetic resonance angiography (MRA), and cerebral angiography. The findings of aortography and cerebral angiography were compatible with Takayasu's arteritis, but intracranial aneurysm was not found in either patient.
Adult ; Cerebral Angiography ; Cerebrovascular Disorders/complications/diagnosis ; Female ; Humans ; Subarachnoid Hemorrhage/*complications/diagnosis ; Takayasu Arteritis/*complications/diagnosis ; Tomography, X-Ray Computed

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Aspergillus Infection in a Large Thrombus of a Permanent Ventricular Pacing Lead.

Hee Yeol KIM ; Chong Jin KIM ; Tai Ho RHO ; Ho Joong YOUN ; Eun Ju CHO ; Seung Won JIN ; Hui Kyung JEON ; Jang Seong CHAE ; Jae Hyung KIM ; Soon Jo HONG ; Kyu Bo CHOI

Journal of Korean Medical Science.2002;17(5):691-694. doi:10.3346/jkms.2002.17.5.691

Pacemaker lead infection is a rare but a dangerous complication. Diagnosis can usually be established by the clinical picture and blood cultures. Transesophageal two dimensional echocardiography might be crucial in the diagnosis by visualizing pacing lead vegetations. Medical treatment alone is rarely successful, and several studies have suggested the infected pacemaker systems should be removed quickly for optimal management. We describe a case of Aspergillus infection in a permanent ventricular pacing lead, which appears to be the first reported case in Korea. A 30-yr-old man was evaluated for the symptoms and signs of congestive heart failure 3 yr after DDD pacemaker implantation. The transthoracic and transesophageal echocardiogram showed a large movable round shaggy mass attached to a ventricular lead in the right atrium. The atrial and ventricular leads were removed during cardiopulmonary bypass, and a new epicardial pacing system was implanted. The functional ventricular pacemaker lead was encased in a large organized thrombus. Histological findings were consistent with Aspergillus infection in a large thrombus attached to a pacemaker lead.
Adult ; Aspergillosis/diagnosis/*etiology/microbiology ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria/microbiology ; Humans ; Male ; Pacemaker, Artificial/*adverse effects/microbiology ; Thrombosis/diagnosis/*etiology/microbiology

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The First Human Case of Hepatic Dirofilariasis.

Min Kyung KIM ; Chul Hwan KIM ; Beom Woo YEOM ; Seong Hwan PARK ; Sang Yong CHOI ; Jong Sang CHOI

Journal of Korean Medical Science.2002;17(5):686-690. doi:10.3346/jkms.2002.17.5.686

Most of human dirofilariasis are pulmonary or subcutaneous infections, but there have been a few reports of human dirofilariasis in unusual sites, such as large vessels, mesentery, peritoneal cavity, and spermatic cord. We present the first case of human hepatic dirofilariasis, which was surgically diagnosed. A 39-yr-old man without any evidence of systemic symptom was found incidentally to have a hepatic nodule during routine physical check-up. The histologic findings of the resected lesion showed a granulomatous lesion with central necrosis containing up to 35 transverse sections of a nematode, ranging 30-80 micrometer in diameter. Thin (1.5-5 micrometer) cuticle with transverse striations surrounded polymyarian and muscle bundles occupied a sixth of both sides of outer body cavity. Central portion of the body cavity was occupied with an intestine-like tubular structure and a larger reproductive tube. These microscopic findings were consistent with degenerated Dirofilaria immitis. Antibody test by enzyme-linked immunosorbent assay for patient serum reacted positively against adult D. immitis antigen.
Adult ; Animals ; Dirofilaria immitis/anatomy & histology/isolation & purification ; Dirofilariasis/*diagnosis/parasitology ; Humans ; Liver Diseases, Parasitic/*diagnosis/parasitology ; Male

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Comparison of Psychopathology in the Mothers of Autistic and Mentally Retarded Children.

Sunay FIRAT ; Rasim Somer DILER ; Ayse AVCI ; Gulsah GULSAH

Journal of Korean Medical Science.2002;17(5):679-685. doi:10.3346/jkms.2002.17.5.679

The aim of this study was to evaluate anxiety, depression, alexithymia, and general psychological symptoms in the mothers of autistic children in comparison with those in the mothers of mentally retarded children. Forty mothers of autistic children and 38 mothers of mentally retarded children were included in the study. After a clinical interview, psychometric tests were performed for depression, anxiety, alexithymia, and Symptom Distress Check List (SCL-90) for general psychological symptoms. Non-depression rates was 27.5% in the mothers of autistic children whereas the rate was 55.3% in the mothers of mentally retarded children. There was no difference regarding anxiety and alexithymia between the two groups. The psychopathology in the mothers of autistic children was more frequent than in those of mentally retarded children in all sub-scales of SCL-90 (somatization obsessive-compulsive, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid thought, psychotism, and extra scale). The mothers of autistic children experienced more psychological distress than those of mentally retarded children. Our findings indicates that the assessment of autistic and mentally retarded children should include psychological assessment of their mothers.
Adult ; Affective Symptoms/etiology ; Anxiety/etiology ; Autistic Disorder/*psychology ; Child ; Child, Preschool ; Cross-Sectional Studies ; Depression/etiology ; Female ; Humans ; Male ; Mental Retardation/*psychology ; *Mother-Child Relations ; Psychopathology ; Turkey

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Caffeine Induces Apoptosis in Human Neuroblastoma Cell Line SK-N-MC.

Mi Hyeon JANG ; Min Chul SHIN ; In Sug KANG ; Hyung Hwan BAIK ; Yong Ho CHO ; Jong Phill CHU ; Ee Hwa KIM ; Chang Ju KIM

Journal of Korean Medical Science.2002;17(5):674-678. doi:10.3346/jkms.2002.17.5.674

Caffeine is one of the most widely consumed neuroactive drugs, coming mostly from everyday beverages such as coffee and tea. To investigate whether caffeine induces apoptosis in the central nervous system, 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) assay, 4,6-diamidino-2-phenylindole (DAPI) staining, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay, flow cytometric analysis, DNA fragmentation assay, and caspase-3 enzyme assay were performed on SK-N-MC human neuroblastoma cells. Cells treated with caffeine at concentrations as high as 10 mM exhibited several characteristics of apoptosis. In addition, caffeine was shown to increase the caspase-3 activity. These results suggest that high-dose of caffeine induces apoptosis in human neuroblastoma cells, probably by increasing the caspase-3 enzyme activity.
Apoptosis/*drug effects ; Caffeine/*toxicity ; Caspase 3 ; Caspases/metabolism ; Cell Cycle/drug effects ; Cell Survival/drug effects ; Central Nervous System/cytology/*drug effects ; DNA Fragmentation ; Humans ; Neuroblastoma/enzymology/pathology ; Tumor Cells, Cultured

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