Plummer-Vinson syndrome / 대한내과학회지

No abstract available.

Comparative Analysis of the Usefulness of Magnetic Resonance Imaging according to the Classification of Pediatric Seizure / 대한소아신경학회지

PURPOSE: The correct classification of seizure is necessary for appropriate evaluation and treatment. Recent development in Magnetic Resonance Imaging(MRI) can provide critical data for classifying epilepsy. But there is limited information about its diagnostic efficacy and current use in the initial evaluation of pediatric epilepsy. So we studied the diagnostic efficacy of MRI in pediatric seizure and analyzed whether MRI could be an appropriate screening procedure. METHODS: EEG and MRI of 236 children with seizure admitted at Keimyung University Hospital from January 1997 to June 2002 were reviewed retrospectively. Patients were classified by clinical information:neonatal, generalized and partial seizure groups. We comparatively analyzed EEG findings and MRI findings in each group. RESULTS: According to the MRI findings, the rate of abnormalities of the neonatal seizure group was 50%, 31% in the generalized seizure group and 41% in the partial seizure group. Correlation between the abnormalities of EEG and MRI findings was identified in partial the seizure group(P<0.05). CONCLUSION: We concluded that MRI is an essential diagnostic tool when a neonatal or partial seizure is investigated. And it will be also useful for some patients with generalized seizure who are suspected of partial seizure.

The frequency of thiamine deficiency in chronic alcoholics and in patients at a long-term care facility / 대한내과학회지

BACKGROUND: As socioeconomic status has improved, malnutrition has become rare in Korea and generally it is no longer considered as a serious problem in medical practice. However, contrary to the above general belief we managed four patients with beriberi in 1999 and it became apparent that malnutrition might remain a problem in certain groups of patients. In this study, we assessed the nutritional state, especially with respect to thiamine deficiency, in chronic alcoholics and in patients residing at a long-term care facility (LTCF). METHODS: Fourteen chronic alcoholic patients and twenty patients being hospitalized in a long-term care facility were assigned as the study groups. The subjects' mean ages and standard deviations were 48.9+/-10.2 and 50.6+/-6.7, respectively. Medical records were reviewed to determine other aspects of their nutritional status and their dietary patterns. Ten peoples who visited the health promotion center at Inha University Hospital, for routine check-ups were allocated to the control group. Blood total thiamine levels were measured by high-performance liquid chromatography. RESULTS: Body mass indices were significantly lower in chronic alcoholics and in patients at the LTCF than in the control group (p=0.0065). Serum albumin levels were within the reference range in all three groups, but were significantly lower in patients at the LTCF than in the control group (p=0.0013). Moreover, no difference was detected between the alcoholic group and the control group in terms of thiamine levels. However, the mean thiamine level in patients at the LTCF was statistically lower than that of the control group and four (20%) patients in the LTCF group showed subnormal blood thiamine levels. The thiamine level tended to decrease with age in both alcoholics and patients at the LTCF. No correlation was found between thiamine level and the other variables examined, namely, hospital stay, body mass index, and serum albumin level. CONCLUSION: A considerable portion of patients in a long term care facility showed thiamine deficiency, however, no evidence of thiamine deficiency was found among alcoholics. This result suggests that thiamine deficiency in patients at long-term care facility may be more prevalent and that thiamine supplementation may be warranted, especially for those with other thiamine deficiency risk factors.

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma of Colon as Multiple Large Polypoid Lesions / 대한소화기내시경학회지

Mucosa-associated lymphoid tissue (MALT) lymphoma of colon usually presents with a solitary lesion of polypoid appearance but may rarely present with multiple polypoid lesions. MALT lymphoma of colon presented as multiple polypoid lesions are not easy to differentiate from multiple lymphomatous polyposis. We experienced a case of MALT lymphoma of colon with a large mass in proximal ascending colon involving ileocecal valve and multiple polypoid lesions in entire colon.

Effect of Initiaion of Hemodialysis and Continuous Ambulatory Peritoneal Dialysis on Blood Pressure Control in Patients with End-Stag Renal Disease / 대한신장학회잡지

Studies describing the effects on blood pressure control by hemodialysis(HD) or continuous amulatory peritoneal dialysis(CAPD) have yielded conflicting results with respect to 24 hour blood pressure control, diurnal variation and blood pressure loads. The aim of the study was to investigate the effect of beginning with HD or CAPD on blood pressure control, diurnal variation and blood pressure loads using ambulatory blood pressure monitoring(ABPM). Twen-ty-seven end-stage renal disease(ESRD) patients(12 on HD and 15 on CAPD) were enrolled into the study. Patients with cardiovascular diseases, erythro-poietin therapy, or severe edema were excluded. ABPM were performed two times before and after the initiation of dialysis. Mean duration of interval between pre- and post-dialysis ABPM were 17+/-4 days on HD and 13+/-3 days on CAPD. Daytime and nighttime were defined as the time from 6:00 AM to 10:00 PM and from 10:00 PM to 6:00 AM of the next day. Systolic and diastolic loads were defined as the percentage of the incidence of systolic and diastolic blood pressure over l% and 90mmHg. Dipper meaning the presence of normal diurnal difference were defined as the differences of daytime- nighttime mean arterial pressure more than 5mmHg. In HD patients, mean systolic and diastolic blood pressure and mean arterial pressure were significantly decreased after dialysis during 24 hour, day- time and nighttime. In CAPD patients, those were also significantly decreased after dialysis during 24 hour, daytime and nighttime(p<0.05). Diurnal differences were increased after CAPD(3.3+/-9.4 vs 5.4+/-6.8mmHg) but decreased after HD(4.3+/-6.2 vs 2.4+/-10.8mmHg) and the differences of diurnal difference between two groups were significantly different(+2.1+/-9.0 vs 1.9+/-8.4mmHg, p<0.05). Proportions of dipper among patients were increased from 16.7 to 66.7% in HD and from 33.3% to 60% in CAPD without statistical significance between two groups. Systolic and diastolic loads were significantly decreased after HD(from 75.0+/-38.0 to 37.5+/-43.8%, from 45.2+/-29.7 to 12.5+/-12.8%, respectively, p<0.05) and after CAPD(from 63.1+/-30,1 to 32.3+/-27.1%, from 43.4+/-36.2% to 12.2+/-16.9%, respectively, p<0.05). Systolic and diastolic loads of daytime and nighttime were significantly decreased after each dialysis modality except nighttime diastolic pressure load in HD. In conclusions, both HD and CAPD improve BP control in ESRD patients. CAPD has more benefit to control of diurnal variations in ESRD patients.