Acute renal failure and delayed neuropathy due to anti-freeze ingestion / 대한내과학회지

Antifreeze contains ethylene glycol up to ninty five percent. Ethylene glycol is colorless, odorless, sweet-tasting and water-soluble compound and has been widely used as a chemical solvent. Ethylene glycol has been reported as a common cause of incidental poisoning all over the world because of its easy access. However, in Korea, it is not easy to find statistical references on incidences of ethylene glycol intoxication, except two reported cases. Ethylene glycol itself is not toxic substance. But, many other daughter metabolites are very toxic and lethal. Acid metabolites among them can cause metabolic acidosis. Oxalate, end-product of ethylene glycol, is quickly transformed to calcium oxalate crystals, which precipitate in body tissues such as brain, kidney, heart, liver, and pancreas. We report a case of acute renal failure and neuropathy due to ethylene glycol intoxication along with a review of toxic effects of ethylene glycol.

Comparison of 67Ga planar imaging and SPECT for the evaluation of activity in undetermined minimal pulmonary tuberculosis / 결핵

BACKGROUND: We have studied the 67Ga SPECT to determine the activity of pulmonary tuberculosis, especially in patients with minimal extent of the disease on chest radiographs. Because active minimal pulmonary tuberculosis is sometimes difficult to diagnose by means of initial chest X-ray, sputum examination and 67Ga planar imaging, we compared 67Ga planar imaging with SPECT to evaluate minimal pulmonary tuberculosis activity. METHODS: 67Ga planar imagings and SPECTs of 69 patients suspected of minimal pulmonary tuberculosis by the initial chest X-ray were performed and compared to each other. Active pulmonary tuberculosis was defined by a positive AFB smear and/or culture in the sputum and changes shown on the serial chest X-ray findings. RESULTS: 1)67Ga planar imaging imagings showed positive uptakes in 24 patients and no uptakes in 13 patients, which confirms active pulmonary tuberculosis. But SPECT imagings showed positive uptakes in 25 patients and no uptakes in 12 patients. 2) Patients confirmed with inactive pulmonary tuberculosis showed no up-take on 67Ga planar imaging. Only one of the 32 patients confirmed as having inactive pulmonary tuberculosis showed positive uptake on 67Ga SPECT imaging. CONCLUSIONS: According to the results of our study, 67Ga planar imaging and SPECT are both sensitive in detecting the activity of minimal pulmonary tuberculosis. The difference between the two methods is not statistically significant, and the negative predictive value of the 67Ga SPECT is not higher than that of 67Ga planar imaging.