Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
Edema ; Hydrazines ; Necrosis ; Paraffin ; Physical Examination ; Shadowing (Histology) ; Skin ; Thyroid Gland ; Thyroid Neoplasms ; Ulcer

No abstract available.
Estradiol* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Progesterone*

Protein C exerts anticoagulant effects by inactivating factor Va and VIIIa and stimulating fibrinolysis. The homozygous protein C deficiency is extremely rare and often results in life threatening thrombosis and purpura fulminans with necrotic cutaneous lesions. A child with homozygous protein C deficiency was treated at 6 months by a living-related liver transplantaion. After induction of anesthesia, we started an FFP infusion for protein C replacement and a low molecular weight heparin continuous infusion to prevent thrombosis. A complete reconstitution of protein C activity and resolution of the thrombotic condition occured postoperatively. So we report this case with a brief review of the literature.
Anesthesia* ; Child ; Factor Va ; Fibrinolysis ; Heparin, Low-Molecular-Weight ; Humans ; Liver Transplantation* ; Liver* ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans ; Thrombosis

BACKGROUND: Epidemiological studies have shown correlation between low incidence of coronary heart disease and high consumption of fish products. It has been suggested that this may be due to the high content of polyunsaturated fatty acids of the n-3 fatty acid group in fish oil. In animal studies eicosapentaenoic acid (EPA) inhibited attachment of monocytes to the arterial endothelium. METHOD: Adhesion assay was performed on the endothelial cells of the human umbilical vein with 25, 50, 100, 200 micrometer EPA-treated U937 cells. The endothelial cells were activated with lipopoysaccharide (LPS). The adhesion assay was repeated with oxidized EPA. EPA was oxidized with CuSO4 and ascorbic acid. RESULT:Viability of U937 cells were not affected by concentrations up to 200 micrometer of EPA and oxidized EPA. LPS treatment of endothelium notably increased the number of U937 cells attached to endothelial cells on the adhesion assay. However, treatment of EPA, native or oxidized, to U937 cells did not affect the number of U937 cells attached to LPS activated endothelial cells. CONCLUSION: EPA treatment, native or oxidized, of U937 cells did not affect U937 cell-endothelial cell adhesion. This suggests that inhibition of monocyte-endothelial cells attachment by EPA is not due to the effects of EPA on monocytes.
Animals ; Ascorbic Acid ; Cell Adhesion* ; Coronary Disease ; Eicosapentaenoic Acid* ; Endothelial Cells ; Endothelium ; Fatty Acids, Unsaturated ; Fish Products ; Humans ; Incidence ; Monocytes ; U937 Cells ; Umbilical Veins

OBJECTIVE: The cytogenetic analysis for earlier detection of fetal chromosome aneuploidies is performed from chorionic villus using either long-term culture or direct chromosome preparation. To analyze the cause of pregnancy loss, we also attempt the cytogenetic study in product of conception(POC) using chorionic villi or fetal tissue. But the failure of analysis often occurs in direct preparation of villus cells and product of conception(POC). We studied to evaluate the clinical usefulness of FISH in uncultured chorionic villus cells of culture-failed cases. METHODS: According to the patient's indication, we performed FISH for chromosome 18, 21, X and Y in chorionic villi as well as POC and compared FISH results with their chromosomal studies. RESULTS: We found one trisomy 18 and one trisomy 21 in Chorionic Villus Sampling and one trisomy 18 and one monosomy X(45, X) in POC. The averages for accuracy of FISH were 83-91% and all cases are represented consistent results with their chromosomal studies. Among them, we could analyze using FISH only in 5 cases of culture failure including one case of monosomy X in POC. CONCLUSION: We could detect aneuploidy with uncultured chorionic villus cells in case of culture failure, using FISH, it may be the potential method to assist the cytogenetic study.
Aneuploidy ; Chorion* ; Chorionic Villi Sampling ; Chorionic Villi* ; Chromosomes, Human, Pair 18 ; Cytogenetic Analysis ; Cytogenetics ; Down Syndrome ; Female ; Fetus ; Monosomy ; Pregnancy ; Trisomy ; Turner Syndrome

OBJECTIVE: To determine the fetal aneuploidy in fetal blood cells from cordocentesis. METHODS: We analyzed their karyotype and performed fluorescence in situ hybridization(FISH) for chromosome 18, 21, X, and Y in 14 cases of fetal blood cells from cordocentesis at Department of Obstetrics & Gynecology, College of Medicine, Seoul National University and Hamchoon Women's Clinic. RESULTS: In all cases we obtained the consistent results in both methods and were able to rapidly detect aneuploidy in uncultured fetal blood cells using FISH before karyotyping with culture for 48 hr. The averages for accuracy of FISH were from 84.6 % to 93.9%. CONCLUSION: In this study we suggest that the rapid detection in uncultured fetal blood using FISH is possible and that this diagnostic method will be clinically useful when rapid result would be demanded.
Aneuploidy* ; Chromosomes, Human, Pair 18 ; Cordocentesis ; Fetal Blood* ; Fluorescence* ; Gynecology ; In Situ Hybridization* ; Karyotype ; Karyotyping ; Obstetrics ; Seoul

BACKGROUND: Disinfectants play an important role in preventing nosocomial infection. But the misuse of disinfectants may lead to waste money and decrease the effectiveness of disinfectants by emergence of resistant-bacteria. We studied to evaluate the in vitro bactericidal activity of various disinfectants used in the hospital against major nosocomial pathogens. METHOD: Disinfectants studied were chlorhexidine (0.05%, 0.1 %, 02%, 0.5%, 1%), hibicol 0.5%, alkyl diaminoethyl glycine (0.01 %. 0.05%, 0.1%. 0.5%, 1%), benzalkonium chloride (0, 1%, 0.3%), hydrogen peroxide (1.5%,3%), isopropyl alcohol 70%, potadine iodine(7.5%, 10%), and gentian violet (0.01 %, 0.1%, 1%). Bactericidal activity of disinfectants was assessed against MRSA (methicillin-resistant S. aureus), P. aeruginosa, VRE (vancomycin-resistant enterococci), K. pneumoniae. CNS (coagulase-negative staphylococci) and C albicens. Those microorganisms were obtained from the patients with hospital-acquired infections, In vitro susceptibility was determined using a macrodilution method with various exposure times to several concentrations of disinfectants of 30sec, 1 min, 2 min, 5 min, 15 min and 30 min. RESULT: Microorganism studied were killed after exposure to hibicol 0,5%, isopropyl alcohol 70%, pcradme iodine (7.5%, 10%) within 30sec. 0.05% chlorhexidine needs exposure time above 5 min for bactericidal action. 0.01% alkyl diaminoethyl glycine needs exposure time above 15 min. 0.1% and 0.3% benzalkonium chloride needs exposure time above 1 min. MRSA and P. aeruginosa were killed within 30sec after exposure to gentian violet (GV), but against CNS, 0.01% GV needs exposure time for 15min and 0.1% and 1% GV needs exposure time for 2 min. C. albicans were killed above 1 min. K. pneumoniae was not killed at all. H202 was ineffective for all tested bacteria. CONCLUSION: The results of this study show most disinfectants used in our hospital demonstrated bactericidal activity against major nosocomial pathogens. In-house diluted, 3% H202 failed to demonstrate killing of any microorganisms tested. The appropriate selection of disinfectants regarding to concentration and exposure time was necessary to inhibit growth of major nosocomial pathogens.
2-Propanol ; Bacteria ; Benzalkonium Compounds ; Chlorhexidine ; Cross Infection ; Disinfectants* ; Gentian Violet ; Glycine ; Homicide ; Humans ; Hydrogen Peroxide ; Iodine ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia

FISH is suggested as a possible method to detect the numerical and structural abnormalities of chromosomes in interphase nucleus. We performed this study to discuss the clinical usefulness of FISH in uncultured amniocytes and to set up the cut-off value for further study. We collected amniotic fluid samples from patients whose chromosome studies were recommended due to screen positive for Down and Edword syndrome in triple marker test using maternal serum. The centromeric probe for chromosome 18 and the locus-specific probe for chromosome 21 were used and the results were compared to their karyotypes. We could find 2 cases of trisony 21 and 2 cases of trisony 18 and the other cases represented normal karyotypes. The accuracies were 91% for disomy 18, 89% for trisomy 18, 92% for disomy 21 and 88% for trisomy 21. Therefore FISH technique is a possible method to detect the chromosomal abnormalities in uncultured amniocytes and the use of locus-specific probe for chromosome 21 would be more useful for detecting the aneuploidy of chromosome 21 than 13/21 centromeric probe.
Amniotic Fluid ; Aneuploidy ; Chromosome Aberrations ; Chromosomes, Human, Pair 18 ; Chromosomes, Human, Pair 21 ; Down Syndrome* ; Female ; Fluorescence* ; Humans ; In Situ Hybridization* ; In Situ Hybridization, Fluorescence ; Interphase ; Karyotype ; Trisomy

The brachial plexus block is a valuable method of providing anesthesia for the surgery of forearm and hand. Common technique for brachial plexus block include axillary, supraclaviculer, and interscalene approaches. The supraclavicular brachial plexus block offers adventages, ie, high success rate, rapid onset of action and relatively complete block over axillary and interscalene approach, but may be associated with pneumothorax. We marked the P point which was placed on the upper margin of clavicle that crossed the first rib on the chest PA film and marked on the skin of the patient and inserted 23G scalp needle at that point to the first rib. We performed this modified technique of supraclavicular brachial plexus block using chest PA film in 20 patients and there was no incidence of pneumothorax after this block but general anesthesia was sdministered in one case because of incomplete block. We recommend that this modified technique guided by chest PA film for supraclavicular block is simple, reliable and may reduce the incidence of pneumothorax and to increase the success rate in difficult case such as patient with extremely obesity.
Anesthesia ; Anesthesia, General ; Brachial Plexus* ; Clavicle ; Forearm ; Hand ; Humans ; Incidence ; Needles ; Obesity ; Pneumothorax ; Ribs ; Scalp ; Skin ; Thorax*

BACKGROUND: Online health information can influence consumers to make informed decisions. There are conflicting messages online about health concerns on the use of e-cigarettes. We aimed to investigate differences in those messages through Naver and Google's English versions, which are the most representative portal sites in Korea and in the world. METHODS: We reviewed the top 100 web pages related to health effects of e-cigarettes on Naver and Google in May 2018. Two medical doctors sorted the web pages into three groups as positive, negative, and mixed messages for e-cigarettes, as well as two groups based on the relative safety of conventional smoking versus e-cigarettes. RESULTS: There were 10 and 27 positive, 65 and 45 negative, and 25 and 28 mixed messages on Naver and Google, respectively. There were 15 messages on Naver and 53 on Google that considered e-cigarettes safer than conventional cigarettes. The most frequent topics were toxicity (71%) and diseases (22%) on Naver. Google provides topics of health concerns for young people, including gateway effect (47%), diseases (35%), and toxicity (25%). Particularly, harm reduction which was not present on Naver, came up on Google as 24%. CONCLUSIONS: We found that Naver provides more negative messages on e-cigarettes than does Google, which means that Koreans are exposed more to negative information on e-cigarettes than are foreign people who use Google. In future, more open discussions about harm reduction should be conducted to resolve the imbalance in information regarding health effects of e-cigarettes in Korea.
Electronic Cigarettes ; Harm Reduction ; Internet ; Korea ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products