Two Cases of Unilateral developmental deficiency of lung found in Identical Twin / 대한내과학회지

Unilateral developmental deficiency of lung is rare. As the most of those, unilateral agenesis or Scimitar syndrome(hypogenetic lung syndrome) had been reported. We experienced that two cases of unilateral developmental deficiency of lung, which is different form each other, are found in identical twin. To our knowledge, this condition has not been reported before. We evaluated lung parenchyma and bronchus(; simple chest PA, chest CT(HRCT, 3DCT)), vasculatures(; pulmonary angiography and cardiac catheterization) and combined anomalies (;abdominal ultrasound, echocardiography, routine blood chemistry, and chromosomal study). This 31 yrs old twin female patient was confirmed as an unilateral agenesis of left upper lobe and hypoplasia of left lower lobe without combined anomalies. She's twin younger sister was confirmed as unilateral agenesis of right lung with atrial septal defect(ASD).

A Case of Digoxin-like Immunoreactive Substance(DLIS) Poisoning After Ingestion of Fried Water Toad (Bufo Stejnegeri Schmidt) / 대한내과학회지

Everybody knows that toads are not eatable because of their toxins. But water toads are very similar to frogs morphologically, so fried water toads are eaten by some people on occasion. It has been studied that the granular glands of the toads secrete toxins known as digoxin-like immunoreactive substances (DLIS) such as bufogenins and bufotoxins. DLIS have cross-reactivity with micro particle enzyme immunoassay for the quantitative mea surement of digoxin. We report a case of DLIS poisoning in 56-year-old male patient who showed vomiting, syn cope, and marked bradyarrhythmia with block (heart rate down to 29 beats per minute) after ingestion of the fried water toads (Bufo stejnegeri Schmidt).

A Case of Left Ventricular Pseudoaneurysm Detected by Transesophageal Echocardiography

Left ventricular pseudoaneurysm, in which a ventricular free wall rupture is locally contained by adherent pericardium, is a rare complication of myocardial infarction. Compared w'th a true left ventricular aneunsm, a pseudoaneurysm has a greater propensity to sudden rupture, with catastrophic sequelae. Pseudoaneurysm may be surgically curable, a prompt and accurate diagnosis is thus essential. Transthoracic echocardiography has been the procedure of choice in the diagnosis of pseu- doaneurysm. Transesophageal echocardiography can provide more accurate information than transthoracic echocardiography for the evaluation of ventricular pseudoaneurysm located in posterior and inferior wall. We experienced a case of pseudoaneurysm of left ventricle in a 75-year-old female who presented with dyspnea. A large pseudoaneurysm of left ventricle vith narrow neck was de- tected by transesophageal echocardiography.

A Study of the Diurnal Variation of the Power Spectral Density After 24 hour Holter Monitoring in the Assessment of the Diabetic Autonomic Neuropathy / 대한내과학회지

Objective: We studied the efficacy of the power spectral and nonspectral analysis and its diurnal variations for the early detection of the diabetic autonomic neuropathy. METHOD: The spectral and nonspectral analysis of 24hour-Holter monitoring were done for both diabetic neuropathy patients and controls. We also made a comparative analysis of the diurnal variations between the patient and control groups by means of hourly power spectral analysis. RESULT: 1) The power spectral density of the diabetic neuropathy patients was below than that of the normal controls (P<0.05) (Table 2, Fig. 1). 2) The nonspectral analysis of the diabetic neuropathy patients was below than that of the normal controls except for the mean RR intervals (P<0.05) (Table 3). 3) Every hour-power spectral analysis showed a diurnal variation of day time (06:00 to 16:00) decrease in high frequency area of the normal controls. On the contrary, there was a disappearance of the diurnal variation in patient group. CONCLUSION: The power spectral and nonspectral analyses after 24hour-Holter monitoring and its diurnal variation in the diabetic patients are considered as good means of the early detection of autonomic neuropathy, but further study of its diagnostic value will be needed.