, Jeong Yoon Yim, Sung Kee Ryu, Hong Keun Cho, Si-Hoon Park, Gil Ja Shin The pacemaker syndrome is a complex of clinical signs and symptoms related to the adverse hemodynamic and electrophysiologic consequence of ventricular pacing in the absence of other cause.
The following illustrates a case of pacemaker syndrome proven by cardiac catheterization. A 64-year-old female patient who had been previously managed with single chamber pacemaker(VVI mode) due to sick sinus syndrome, suffered from chest discomfort, headache, dizziness, lightheadedness.
We thought that she suffered from pacemaker syndrome and changed single chamber pacing to dual chamber pacing. At that time we performed cardiac catheterization perioperatively.
Pulmonary capillary wedge pressure, amin pulmonary arterial pressure, right atrial pressure and right ventricular pressure were normalized after the change and she didn't feel any symptoms.
, Seon Hee Cheon, Ki Sook Hong Rifampin-induced thrombocytopenia has been recognized as an immunological reaction associated with intermittent high dose therapy, or after administration of rifampin fo11owing aninterruption of therapy, and rarely seen with daily low dose therapy.
The patient was a 64 year-old male who was given rifampin 600mg daily for treatment of recurrent pulmonary tuberculosis. He had been received antituberculous treatment includingriftmpin 4 years ago. Spontaneous gum bleeding, petechiae on whole body, hemoptysis wasnoted two weeks after initiating the treatment. His platelet count was 5000/mm^3. Antituberculous medication was discontinued, but the platelet count was not recovered. He diedof severe hypoxemia due to pulmonary hemorrhage.
With the essential use of rifampin for the treatment of tuberculosis infections, clinicianshould recognize the possible complication of this drug causing such serious immunologic reactions as thrombocytopenia, hemolytic anemia, and acute renal failure with daily or intermittenttheupy.
, Hye Young Son, Hye Kyoung Jung, Sun Young Yi The aims of this study were to assess the clinical observation of outpatient who showed hematochezia, and to determine whether specific clinical symptoms associated with hematochezia were predictive of important gastrointestinal pathology.
Prospective study was carried out from July 1998 to July 1999 with sixty-five outpatients(35 males and 30 females with mean age, 43±11 years) who had no evidence of recent bleeding. Patients were interviewed by questionnaires about the amount and frequency of bleeding, change in bowel habits, weight loss, usage of aspirin/NSAIDs, and family history, prior gastrointestinal pathologic illness before colonoscopy. Based on this information, endoscopist were asked to predict whether the bleeding was from a benign perianal or other lesion. Important gastrointestinal pathology was defined as carcinoma, adenomas more than 1cm, active ulcerative colitis, and active tuberculosis by colonoscopy.
Colonoscopic findings were as follows : 27 cases of benign anorectal lesion ; 16 cases of polyps, 10 cases of normal ; 8 cases of acute colitis and nonspecific colitis ; 7 cases of coloerctal cancer, 7 cases of ulcerative colitis and intestinal tuberculosis ; and other cases. Important gastrointestinal pathology was 17 cases. Variables including duration, type and frequency of bleeding, weight loss and change in bowel habit did not predict the colonoscopic diagnosis. Of the 35 patients diagnosed clinically by endoscopist to begin anorectal lesion alone, 18 patients were found to have benign anorectal lesion, 2 patients had cancer, 2 patient had polyp(bigger than 1cm), and 1 patient had ulcerative colitis.
In outpatients with hematochezia, the incidence of colon cancer was 10.8%. Clinicians were unable to distinguish significant colonic lesions by history. Therefore accurate diagnostic workup is needed for this group of patients.
, Hye Young Son, Hye Kyoung Jung, Sun Young Yi Twenty six out of 35 subjects completed the study. Patient's sex, age, smoking status, alcohol consumption, or history of ulcer had no significant effect on eradication of
Ranitidine bismuth citrate in combination with clarithromycin and amoxicillin in a one week b.i.d dosing regimen is well tolerated and effective in eradicating
, Hye Young Son, Young Sun Kim, Sun Young Yi In prospective, controlled study of patients with reflux esophagitis without other gastrointestinal disease, the prevalence of
The prevalence of
The prevalence of
, Min Gyeu Hwang, Hye Young Son, Sun Young Yi The apparent acute hepatitis A was occuring among adolescene and young adults during last several years. So here we present the clinical manifestations and laboratory finding and risk factors of 72 patients with acute hepatitis A who were referred to our community hospital.
Seventy-two Patients, 6 to 40 years of age(mean ; 22±8 years) with hepatitis A identified by testing their sera for IgM anti-HAV antibody. Medical records for patients with HAV infection were retrospectively reviewed for symptoms, signs, and laboratory values.
The prevalence of hepatitis A have been increased recently, especially during last 2 years. The probable exposures to HAV included food- or waterborne source, household, foreign travel, day care centers. The clinical symptoms are not distinguishable from hepatitis due to other agents. The mean laboratory tests included total bilirubin 6.0mg/dl, AST/ALT 1064.0±1123.4mIU/mL, 1561.7±1203.0mIU/ml, respectively. All 72 patients experienced complete clinical and biochemical recovery within 6 months after onset of illness.
Abrupt increase of hepatitis A was occuring among the adolescents and young adults recently. Improved sanitation has brought our countries shifting a nearly universal asymptomatic infection in children to a less common but more significant disease expression in adults.
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