Chronic fatigue of the respiratory muscles has contributed to the decreased ventilatory capacity and reduced excercise tolerance of individuals with COPD, especially in kyphoscoliosis. Nasal mask BiPAP has been shown to be useful for the patient with nocturnal muscle fatigue and COPD. A 35-year-old man with severe kyphoscoliosis was admitted to ICU due to acute respiratory failure. He had been diagnosed of COPD and had been intubated with mechanical ventilatory support for 7 times. This time he was intubated with ventilatory support, too, in ICU and readmitted to the ICU for severe hypoxemia and hypercarbia from general ward. Thereafter he refused the intubation. Nasal mask BiPAP ventilatory support system was applied and IPAP, EPAP level being adjusted to the 12, 4 cmH2O under monitoring vital signs and arterial blood gas analysis. His condition was improved and discharged home with support of nasal mask BiPAP system after 33 day-stay in the ICU.
Adult ; Anoxia ; Blood Gas Analysis ; Fatigue ; Humans ; Intubation ; Masks* ; Muscle Fatigue ; Patients' Rooms ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Insufficiency ; Respiratory Muscles ; Vital Signs

Penile augmentation by the injection of mineral oil provokes many serious, undesirable effects. Although there are reports of complications such as deformity, ulceration, necrosis, and erectile dysfunction, Fournier's gangrene resulting from the injection of petroleum jelly into the penis has not been reported. Here, we present a 42-year-old man with penile vaselinoma causing Fournier's gangrene which was treated successfully with aggressive surgical debridement, followed by penoscrotal reconstruction using groin and bilateral superomedial thigh flaps.
Adult ; Fournier Gangrene/chemically induced/pathology/*surgery ; Humans ; Injections, Subcutaneous ; Male ; Penile Diseases/pathology/*surgery ; Petrolatum/administration & dosage/*adverse effects ; Reconstructive Surgical Procedures ; *Surgical Flaps ; Thigh/surgery

Penile augmentation by the injection of mineral oil provokes many serious, undesirable effects. Although there are reports of complications such as deformity, ulceration, necrosis, and erectile dysfunction, Fournier's gangrene resulting from the injection of petroleum jelly into the penis has not been reported. Here, we present a 42-year-old man with penile vaselinoma causing Fournier's gangrene which was treated successfully with aggressive surgical debridement, followed by penoscrotal reconstruction using groin and bilateral superomedial thigh flaps.
Adult ; Fournier Gangrene/chemically induced/pathology/*surgery ; Humans ; Injections, Subcutaneous ; Male ; Penile Diseases/pathology/*surgery ; Petrolatum/administration & dosage/*adverse effects ; Reconstructive Surgical Procedures ; *Surgical Flaps ; Thigh/surgery

No abstract available.
Biopsy* ; Hematuria*

To determine the neuromuscular effect of mivacurium and its reversals in combination with gentamicin or magnesium, pharmacodynamic studies were done using a common peroneal nerve-anterior tibialis muscle preparation in 18, either sex, adult cats(weight, 2.5-4 kg). The ED50 or ED95 of mivacurium obtained by the cumulative dose-response study was 28.2+/-8.5 or 44.7+/-7.3 ug/kg, respectively. The onset of mivacurium under the pretreatment of magnesium (2.8+/-0.4 min.) was slower than that under the pretreatment of gentamicin (1.8+/-0.5 min.). The duration of mivacurium was prolonged. significantly with either gentamicin or magnesium compared to mivacurium alone. However, neostigmine facilitated the recovery of the neuromuscular block induced by mivacurium, even if gentamicin or magnesium was previously treated, and the antagonism effects of neostigmine and spontaneous recovery were always 100%. These results suggest that the neuromuscular blocking actions of mivacurium were potentiated by the pretreatment of gentamicin or magnesium, and mivacurium-induced neuromuscular block with gentamicin or magnesium was reversed completely.
Adult ; Animals ; Cats* ; Gentamicins* ; Humans ; Magnesium* ; Neostigmine ; Neuromuscular Agents ; Neuromuscular Blockade*

No abstract available.
Granuloma, Plasma Cell*

BACKGROUND: Lung cancer is the most common cause of cancer related death. Alterations in gene sequence, structure, and expression have an important role in the pathogenesis of lung cancer. Fusion genes and alternative splicing of cancer-related genes have the potential to be oncogenic. In the current study, we performed RNA-sequencing (RNA-seq) to investigate potential fusion genes and alternative splicing in non-small cell lung cancer. METHODS: RNA was isolated from lung tissues obtained from 86 subjects with lung cancer. The RNA samples from lung cancer and normal tissues were processed with RNA-seq using the HiSeq 2000 system. Fusion genes were evaluated using Defuse and ChimeraScan. Candidate fusion transcripts were validated by Sanger sequencing. Alternative splicing was analyzed using multivariate analysis of transcript sequencing and validated using quantitative real time polymerase chain reaction. RESULTS: RNA-seq data identified oncogenic fusion genes EML4-ALK and SLC34A2-ROS1 in three of 86 normal-cancer paired samples. Nine distinct fusion transcripts were selected using DeFuse and ChimeraScan; of which, four fusion transcripts were validated by Sanger sequencing. In 33 squamous cell carcinoma, 29 tumor specific skipped exon events and six mutually exclusive exon events were identified. ITGB4 and PYCR1 were top genes that showed significant tumor specific splice variants. CONCLUSION: In conclusion, RNA-seq data identified novel potential fusion transcripts and splice variants. Further evaluation of their functional significance in the pathogenesis of lung cancer is required.
Alternative Splicing* ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Exons ; Gene Fusion ; Lung ; Lung Neoplasms ; Multivariate Analysis ; Real-Time Polymerase Chain Reaction ; RNA* ; Sequence Analysis ; Sequence Analysis, RNA*

As chemicals become common in everyday life, serious burns are increasing due to chemicals. Chemical burns are characterized by continuous tissue destruction until the harmful substances are neutralized. The longer the skin is in contact with the chemical, the deeper the burn can be. In cases of chemical burns caused by glacial acetic acid, the burns were caused by a mixture of a small amount of glacial acetic acid and a large amount of flour. Despite the prolonged contact with the dough, tissue damage was managed through debridement and split thickness skin graft, leading to relatively good results.

Necrotizing fasciitis is a deep soft tissue infection that includes the muscle fascia and subcutaneous fat. It is rare, but it causes necrosis of the muscle, fascia, and subcutaneous tissues. It advances quickly and becomes a life-threatening bacterial infection with high morbidity and mortality. Alcoholics with diabetes are especially vulnerable to necrotizing fasciitis and at high risk of progression to severe sepsis and septic shock. In that sense, early diagnosis and prompt treatment are important in the management of necrotizing fasciitis, especially in diabetic alcoholics. We recently treated necrotizing fasciitis on the left lower leg of a 55-year-old diabetic alcoholic who had not controlled blood sugar for 4 years. In our case, a minor burn wound on the left lower leg caused by the hot ramen soup progressed to necrotizing fasciitis within ten days. The patient who was diagnosed with necrotizing fasciitis of the left lower leg was successfully managed with prompt diagnosis, serial debridement, and a split-thickness skin graft while controlling blood sugar levels.

Epidural analgesia is frequently used for control of labor pain. Seizure of parturient could be misdiagnosed as eclampsia. A parturient presented a generalized tonic clonic seizure during first stage of labor in two and a half hour after dural puncture and epidural blood patch. She had received an emergency cesarean section under general anesthesia and had another seizure during transfer to the intensive care unit. A brain computed tomography showed intracerebral hemorrhage and pneumocephalus. After conservative treatment, she could discharge without any sequelae in 13 days. The anesthesiologists should be aware of the possibility of intracerebral hemorrhage when they confront a seizure of parturient although there is no evidence of relation between dural puncture and intracerebral hemorrhage.
Analgesia, Epidural ; Anesthesia, General ; Blood Patch, Epidural ; Brain ; Cerebral Hemorrhage ; Cesarean Section ; Eclampsia ; Emergencies ; Female ; Intensive Care Units ; Labor Pain ; Pneumocephalus ; Pregnancy ; Punctures ; Seizures