Two Cases of Apathetic Hyperthyroidism associated with Peripheral Eosinophilia / 대한내분비학회지

Peripheral eosinophilia is perpetually associated with many disease conditions like asthma, parasitic disease, IL-2 therapy, hypereosinophilic syndrome and eosinophilia/myalgia syndrome. Furthermore, peripheral eosinophilia may also be linked with Graves' disease, which is induced by thyroid-stimulating anti-TSH receptor antibodies and is related to type 2 helper T cell(Th2) predominant condition that is dependent on humoral immunity. In some of the cases of Graves' disease, thyrotoxicosis may induce peripheral eosinophilia associated with relative cortisol deficiency. In our present study, we present a case of two patients who were suffering from Graves' disease without any thyrotoxic symptoms and exhibited increased levels of peripheral eosinophil count. But, the count was observed to decreas in euthyroid state.

The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients / 결핵및호흡기질환

BACKGROUND: Measurement of the FEV1 and PEFR in COPD patients is a significant indicator of the disease severity , the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and FEV1 in COPD patients is not well known. METHODS: From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The FEV1 and PEFR of each patient were measured and all the data was analyzed using SPSS. RESULTS: The average predicted FEV1 % and PEFR % was 56.98 +/- 18.21% and 70 +/- 27.60%, respectively. There was linear correlation between the predicted FEV1 % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. CONCLUSION: In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the FEV1. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the FEV1.

Agranulocytosis Induced by Vancomycin in an ESRD Patient on CAPD

Agranulocytosis is a rare adverse effect associated with prolonged vancomycin therapy, and is potentially serious, especially in end stage renal disease (ESRD) patients. We describe a continuous ambulatory peritoneal dialysis (CAPD) patient that developed vancomycin-induced agranulocytosis during treatment for methicillin-resistant Staphylococcus aureus (MRSA) -associated external cuff infection and pneumonia. The agranulocytosis was rapidly resolved by granulocyte colony-stimulating factor (G-CSF) therapy and by the discontinuation of vancomycin.