No abstract available.
Prostate* ; Testis*

Livedo vasculitis is thought to be a thrombogenic disorder that is related to the autoimmune disease. It clinically shows purplish mottling and recurrent painful ulcers in the lower extremities, leaving atrophie blanche after healing of the ulcers. Histopathologic finding are thrombotic occlusion in the mid-dermal vessels without necrotizing vasculitis. The therapeutic approach has largely been made by the use of drugs that stimulate endogenous fibrinolytic activitiy, that inhibit thrombus formation, or that cause vasodilation, but surgical intervention by excision and skin graftion has rarely been reported as a primary treatment.In our experience, two patients with livedo vasculitis, who had been unresponsive to various medications, were treated with wide excision and several times of skin grafting. And they experienced complete healing without recurrence.
Autoimmune Diseases ; Humans ; Lower Extremity ; Recurrence ; Skin ; Skin Transplantation ; Thrombosis ; Ulcer ; Vasculitis* ; Vasodilation

Background: Esmolol as a drug for induced hypotension can, not only avoid many drawbacks of nitroprusside, but reduce the amount of intraoperative bleeding and make better operative field. This study was performed to evalute cardiovascular changes during esmolol-induced controlled hypotension. Methods: Induced hypotension using esmolol was applied to 18 adult patients receiving spinal surgery under the diagnosis of spinal stenosis or scoliosis. After prehydraion of 2,000 ml of crystalloid solution, 0.5 mg/kg esmolol was used as loading dose once, twice or three times until mean blood pressure (MBP) fell below 70 mmHg, followed by continuous infusion (50~300 microg/kg/min) of esmolol. MBP and heart rate (HR) were measured before, 5, 10, 15, 30, 60 and 90 min after esmolol administration, and 5, 10 and 15 minutes after discontinuation of esmolol. In 8 patients, cardiac output (CO) and mixed venous oxygen tension and saturation were measured before, during and after esmolol use. Results: MBP was decreased from 91+/-12 mmHg to 67+/-7 mmHg after 15 min (P<0.05). HR(BPM) was decreased from 76+/-17 to about 60 after 15 min (P<0.05). CO was decreased about 30% during induced hypotension but recoverd to initial level 15 min after esmolol discontinuation. While oxygen transport was reduced significantly during induced hypotension (P<0.05), oxygen consumption was maintained all the time. Conclusion: With the use of esmolol, stable hypotension could be achieved. Although oxygen transport decreased possibly due to reduction of CO, but oxygen consumption was maintained.
Adult ; Blood Pressure ; Cardiac Output ; Diagnosis ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Hypotension, Controlled ; Nitroprusside ; Oxygen ; Oxygen Consumption ; Scoliosis ; Spinal Stenosis

BACKGROUND: The purpose of this study was to measure and compare the optimum depth of the internal jugular venous catheterization between the right and left side. METHODS: Forty-four patients were enrolled for this study and divided into two groups (22 patients each). The optimum depth of the catheterization was calculated using the sum of two component (A and B); the advanced length of the catheter from the level of the cricoid cartilage (A) and the distance from the catheter tip to the junction of the superier vena cava and right atrium (B). RESULT: The optimum depths of the internal jugular venous catheterization were 16.0 1.0 cm (right) and 18.4 1.5 cm (left) respectively. Left side was significantly longer than right side (p<0.05). In this study, we experienced some complications; arterial punctures (5 cases) and migration of the catheter to the opposite subclavian vein (1 case). Five complications were associated with left internal jugular venous cannulation and one was associated with the right side cannulation. CONCLUSION: We concluded that the optimum depth of the internal jugular venous catheterization was longer in the left side than in the right side.
Catheterization* ; Catheters* ; Cricoid Cartilage ; Heart Atria ; Humans ; Punctures ; Subclavian Vein

Gangiogliomas are rare tumors, primarily seen in patients under the age of 30 years. They occure least commonly in the spinal cord. We present a 17-year-old girl who harbored an intramedullary conus ganglioglioma.
Adolescent ; Conus Snail* ; Female ; Ganglioglioma* ; Humans ; Spinal Cord

No abstract available.
Typhlitis*

Mesoblastic nephroma is an uncommon congenital tumor of infancy that rarely occurs in adults. We report an adult case of mesoblastic nephroma. A 38- year-old man was incidentally found to have a right renal mass by abdominal ultrasonography. Computerized tomography revealed a relatively homogeneous tumor with hypervascularity. Radical nephrectomy was performed. The tumor was an encapsulated whitish- yellow and myxoid solid mass. Microscopically, the tumor was composed of spindle cell proliferation. Atypia and mitosis were not identified. Among the tumor cells, there were tubular arranged epithelial components. Mesoblatic nephroma is benign, so that survival following nephrectomy alone is excellent but local recurrence and metastases have been reported. Regular postoperative follow-up is mandatory.
Adult ; Cell Proliferation ; Follow-Up Studies ; Humans ; Mitosis ; Neoplasm Metastasis ; Nephrectomy ; Nephroma, Mesoblastic* ; Recurrence ; Ultrasonography

BACKGROUND: Despite recent advances in multimodality therapy, the prognosis for invasive esophageal cancer is poor, with five years survival rate generally below 10%. Therefore, immunotherapy is considered as one of the new therapeutic modality in esophageal cancer. However, expression of tumor specific antigen in tumor tissue should be necessary for immunotherapy of tumor. This study is to clarify that mutant p53 protein and MAGE-3 gene product is expressed in esophageal cancer specifically and they can be played a role of prognostic factors in esophageal cancer. MATERIAL AND METHOD: Expression of mutant p53 protein and MAGE-3 gene products in formalin fixed, paraffin embedded samples of 79 patients with primary squamous cell carcinoma of the esophagus, who undewent esophageal resection, were analyzed immunohistochemically with DO-7 monoclonal antibody and anti- MAGE-3 antibody. Twenty cases of esophageal normal mucosa and 20 cases of leiomyoma which is a benign tumor of esophagus, were used as control groups. Immunoreactivities of mutant p53 and MAGE-3 gene product in esophageal cancer tissues were analyzed and the relationships between immunoreactivity of mutant p53 protein, MAGE-3 gene product and AJCC stage of esophageal cancer were determined by the Chi-square test. RESULT: Positive immunoreactivity of mutant p53 and MAGE-3 gene product were each of 41/79(51.9%), 48/79(60.8%) in esophageal cancer tissue, but 0% in normal mucosa and leiomyoma of esophagus(p<0.001). Both immunoreactivity of mutant p53 and MAGE-3 gene products were not related to AJCC stage of esophageal cancer(p=0.193, p=0.452). There was not correlation between expression of mutant p53 protein and MAGE-3 gene product in esophageal cancer(p=0.697). CONCLUSION: Mutant p53 and MAGE-gene product cannot be a prognostic factor in squamous cell carcinoma of esophagus, but mutant p53 and MAGE-3 gene product is expressed in squamous cell carcinoma of the esophagus specifically, so esophageal cancer can be target for cytotoxic T lymphocyte in anticancer immunotherapy.
Carcinoma, Squamous Cell* ; Esophageal Neoplasms ; Esophagus ; Formaldehyde ; Humans ; Immunotherapy ; Leiomyoma ; Lymphocytes ; Mucous Membrane ; Paraffin ; Prognosis ; Survival Rate

BACKGROUND: Intravenous patient-controlled analgesia (IV-PCA) is widely used because it is a simple, safe, and effective method for postoperative pain control. Controversies exist over the use of a continuous basal infusion in IV-PCA regarding its effectiveness. We evaluated the analgesic efficacy and side effects of PCA with basal infusion after gynecologic surgery and compared these results with PCA alone. METHOD: Eighty women undergoing elective gynecologic surgery under general anesthesia were studied. These patients were randomly assigned to receive either PCA alone (group 1) or PCA with basal infusion (group 2). Analgesic consumption, visual analogue scale (VAS) pain score, and side effects were assessed at postoperative 6 hours and 24 hours. RESULTS: In group 1, the amounts of analgesic used during the postoperative 6 hours and 24 hours were 15 +/- 5 and 30 +/- 13 ml, the median VAS pain score at postoperative 6 hours and 24 hours were 50 and 35 respectively. In group 2, the amounts of analgesic used during the postoperative 6 hours and 24 hours were 19 +/- 7 and 43 +/- 1 ml, the median VAS pain score at postoperative 6 hours and 24 hours were 50 and 38 respectively. The analgesic consumption during the postoperative 6 hours and 24 hours was significantly higher in group 2 than in group 1. There was no significant difference in median VAS pain score between the groups. There were no significant differences in incidence of side effects between groups. CONCLUSIONS: The use of a PCA with basal infusion appears to offer no clinical advantage over PCA alone.
Analgesia, Patient-Controlled* ; Anesthesia, General ; Female ; Gynecologic Surgical Procedures* ; Humans ; Incidence ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis*

BACKGROUND: Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia in children. Currently, no study exists regarding the frequency of the mycoplasmal antibody on Jeju Island. The aim of the present study was to investigate the frequency of mycoplasmal antibody among children living on Jeju Island. METHODS: From March 2009 to February 2011, the frequency of mycoplasmal antibody among 1580 pediatric (<10 years old) patients who were tested for the mycoplasmal antibody titer in Cheju Halla Hospital were retrospectively investigated. The authors also analyzed the positive rates according to age, sex, and season. RESULTS: The frequency of mycoplasmal antibody titers were 69.4% for an antibody titer >1:40, 20.8% in an antibody titer >1:320, and 10.7% in an antibody titer >1:640. The positive rates of each antibody titer were lowest in children under the age of 6 months, and the positive rates increased gradually with age until 4 years, where the frequency showed a "plateau." There were minor cyclic increases of positive rate (>1:320, >1:640) every three months from August 2009 to June 2010, and there was a major increase of positive rate (>1:320, >1:640) from July 2010 to January 2011. However, there was no positive rate cyclic pattern of mycoplasmal antibody in the lower titer (>1:40) patients. CONCLUSION: The frequency of mycoplasmal antibody titer is lowest under the age of 6 months. The positive rates rise gradually with age until the age of 4 years. The present study showed minor peaks of mycoplasmal antibody titer every three months and a major peak of mycoplasmal antibody titer. The results can be helpful for the interpretation and diagnosis of MP among pediatric patients on Jeju Island.
Antibodies ; Child ; Humans ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Retrospective Studies