Review of the Anesthetic Records of Those Who Received General Anesthesia More Than 50 Times: A report of 2 cases / 대한마취과학회지

General anesthesia is the most common method used for operations and volatile anesthetics are commonly used for general anesthesia. Moreover, it is known that the newly developed volatile anesthetics are safe in liver and kidney. However, inorganic fluoride levels increase with anesthetic time and increase the possibility of renal toxicity and repeat a anesthesia in short term period increase the possibility of hepatic failure. We experienced 2 cases who received general anesthesia with volatile anesthetics more than 50 times without any organ failure. Here, we review the anesthetic records and preoperative laboratory findings of each operation.

Clinical observations of idiopathic hypoparathyroidism / 대한내과학회지

BACKGROUND: Idiopathic hypoparathyroidism is a relatively rare disease characterized by hypocalcemia and hyperphosphatemia due to parathyroid hormone deficiency of unknown cause. It usually develop at young age and various clinical symptoms and signs accompanied with hypocalcemia develop at late period. And rarely associated with polyglandular autoimmune syndrome during follow-up. So we reviewed retrospectively our clinical experiences in diagnosis and management. METHODS: We observed the 6 cases with idiopathic hypoparathyroidism from 1986 to 2002. Four female and two male patients were examined demographic characteristics, clinical manifestations, laboratory findings, radiologic finding, and occurrence of polyglandular autoimmune syndrome. RESULTS: All patients aged from 18 to 51 years and had no familial history. The most frequent two symptoms of idiopathic hypoparathyroidism were paresthesia (67%) and tetany (67%). The incidence of Chvostek's and Trousseau's sign were 83% and 67%, respectively. From the history taking, patient who had psychotic problem was two, ocular lesion was two, and Graves's disease was one before admission. One patient had transient hypogonadism because of acute illness but recovered during follow-up. One patient developed primary adrenal insufficiency after 2 years. Neuroimaging study revealed bilateral calcification and ECG showed Q-T interval prolong. CONCLUSION: Idiopathic hypoparathyroidism may be suspected in patients with various neurologic symptoms and signs associated with hypocalcemia. It was difficult to predict other endocrine dysfunction at diagnosis. Therefore, we need to follow-up laboratory examinations for early detection of accompanied autoimmune disease in idiopathic hypoparathyroidism patient.

A case of eosinophilic gastroenteritis with terminal ileal obstruction / 대한내과학회지

Eosinophilic gastroenteritis is a rare clinicopathologic entity of an unknown etiology with a variety of digestive symptoms. The clinical features depend on the site of eosinophilic infiltration and affected layer of intestinal wall. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence extra-intestinal disease, and exclusion of various disorders that could mimic similar conditions. We experienced a 54-year-old man with 6 months history of severe intermittent abdominal colic associated with malnutrition and weight loss. Abdominal computed tomography showed mass like lesion at terminal ileum, which caused partial small bowel obstruction. So, we carried out laparotomy, and then segmental resection and ileo-ascending colostomy were done because of small bowel obstrucion. We diagnosed the case as transmural type of eosinophilic gastroenteritis. We report this case with a brief review of the literatures.

The diagnostic value of sputum eosinophil counts in patients with chronic cough / 알레르기

We studied sputum eosinophil count of patients with chronic cough. Differential count of sputum cells(simple direct smear with Wright stain) were successfully examined in 44(73%) among 60 patients with chronic cough. The patients were divided according to PC2O value; 20(45%) patients had increased airway hyper responsiveness(AHR) (PC2O 5%) was found in 66% of patients with increased AHR. In patients without increased AHR, increased sputum eosinophil ratio was found in three patients(12%) and increased peripheral blood eosinophil ratio was found in 24%. This discrepancy between two groups was statisticalla significant(p<0.01). In regarding to sputum eosinophilia, increased sputum eosinophil ratio was in 14(32%) of 44 patients with chronic cough. Eleven patients(78%) of them had increased AHR. Only nine(30%) among 30 patients without sputum eosinophilia had increased AHR. These discrepancies between two groups were statistically significant(p<0.01). To predict AHR, sputum eosinophilia has 55% of sensitivity and 88% of specificity. Significant positive correlation between peripheral blood eosinophil ratio and sputum eosinophil ratio was found in patients with cough-variant asthma (r=0.76, p<0.01), We suggest that simple direct smear for sputum eosinophil count could be an useful test to diagnose the patients with chronic cough.