We report an autopsy case of secondary hemochromatosis associated with multiple frequent blood transfusion for the treatment of aplastic anemia. A 23-year-old man had been diagnosed as having aplastic anemia at the age of 13. He received a whole blood transfusion, about 1280 ml, every month during the past 10 years. Recently he developed diabetes mellitus and a congestive heart failure. The autopsy revealed that multiple organs were affected by secondary hemochromatosis, including the liver, heart, pancreas, spleen, bone marrow, stomach, thyroid gland, adrenal glands, and testes. The lungs and liver showed gross and microscopic findings consistent with a congestive heart failure in addition to hemochromatosis. The details are presented. This is a case of rare secondary hemochromatosis occurring in a young man and presenting the classic histopathologic changes indistinguishable from those of primary hemochromatosis.
Adrenal Glands ; Anemia ; Anemia, Aplastic* ; Autopsy* ; Blood Transfusion ; Bone Marrow ; Diabetes Mellitus ; Heart ; Heart Failure ; Hemochromatosis* ; Humans ; Liver ; Lung ; Pancreas ; Spleen ; Stomach ; Testis ; Thyroid Gland ; Young Adult

The incidence of intracranial complications of otitis media, including lateral sinus thrombophlebitis, has been significantly reduced since the advent of antibiotics. This entity is rarely encountered in clinical practice, and delay in its diagnosis and institution of appropriate therapy may lead to serious, or even fatal, consequences. The signs and clinical course of lateral sinus thrombophlebitis are non-specific and the final diagnosis rests upon radiological investigations including CT-scans and MRI. We have experienced a case of middle fossa and posterior fossa epidural abscess formation, lateral sinus thrombophlebitis that has developed secondary chronic otitis media with cholesteatoma in a 47 year-old female patient. We report this case which was successfully treated by middle fossa dura and posterior fossa dura drainage, lateral sinus thrombectomy with open mastoidectomy.
Anti-Bacterial Agents ; Cholesteatoma* ; Diagnosis ; Drainage ; Epidural Abscess* ; Female ; Humans ; Incidence ; Lateral Sinus Thrombosis* ; Magnetic Resonance Imaging ; Middle Aged ; Otitis Media* ; Otitis* ; Thrombectomy ; Transverse Sinuses*

No abstract available.
Anti-Bacterial Agents* ; Phagocytosis*

Glassy cell carcinoma is a histologic subtype of cervical cancer with distinct pathologic features and it has an aggressive biologic course. It was first described by Glucksmann and Cherry in 1956 as a poorly differentiated adenoquamous carcinoma and commented on its poor prognosis, unresponsiveness to traditional modes of therapy, and often associated with pregnancy. The characteristic histologic features are defined as follows: 1) cells with a moderate amount of cytoplasm resembling ground glass, 2) a fairly distinct cell membrane that stains with eosin or PAS, 3) large nuclei with prominent nucleoli. We present two cases of glassy cell carcinoma of the cervix successfullyl treated by neoadjuvant chemotherapy and radical hyterectorny, with a brief review of literatures.
Cell Membrane ; Cervix Uteri* ; Coloring Agents ; Cytoplasm ; Drug Therapy* ; Eosine Yellowish-(YS) ; Female ; Glass ; Hysterectomy* ; Pregnancy ; Prognosis ; Prunus ; Uterine Cervical Neoplasms

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

Kasabach-Merritt syndrome presents various problems for anesthetic management, which include thrombocytopenia, bleeding tendency, and problems arising from the hemangioma mass itself. A 1-month-old male was given sclerotherapies, platelet transfusions, steroid, interferon alpha, vincristine because of the bleeding from the right lower leg hemangioma, but platelet numbers were decreased and seizures occurred due to frontal lobe focal hemorrhage. After all, he was scheduled for his right lower leg amputation when he was 7 months old. Anesthesia was carefully induced with thiopental, rocuronium, fentanyl, and flexible bronchoscope. It was maintained with sevoflurane and air/oxygen with fentanyl injection. Although excessive bleeding was expected during anesthesia and surgery, the operation was performed without correction of platelet number. Two days later, postoperative course was improved almost normal.
Amputation ; Androstanols ; Anesthesia ; Bronchoscopes ; Fentanyl ; Frontal Lobe ; Hemangioma ; Hemorrhage ; Humans ; Infant, Newborn ; Interferon-alpha ; Kasabach-Merritt Syndrome ; Leg ; Male ; Methyl Ethers ; Platelet Count ; Platelet Transfusion ; Sclerotherapy ; Seizures ; Thiopental ; Thrombocytopenia ; Vincristine

Dental erosion is defined as tooth structure loss by acidic chemical substance. It is caused by extrinsic factors such as acidic foods, drugs, and working environments, and also intrinsic factors such as gastric acid regurgitation in gastro-esophageal disorder or intensive vomiting in bulimia nervosa. These lesions can be treated with direct resin filling, laminate or full contour crown depending on the intensity of clinical problem. This is a case report about treatment of rare clinical case: labial erosion of anterior tooth caused by frequent intake of acidic fruit and palatal erosion of anterior tooth caused by intensive vomiting in bulimia nervosa.
Bulimia Nervosa ; Crowns ; Fruit ; Gastric Acid ; Intrinsic Factor ; Tooth ; Vomiting

PURPOSE: Finasteride, a 5-alpha reductase inhibitor, has recently been used as a treatment for men with benign prostate hyperplasia(BPH). This study was undertaken to determine whether free-to-total(f/t) PSA ratio changed during the finasteride therapy in patient with BPH and whether it is possible to use this new discriminant ratio after prolonged treatment with finasteride. MATERIALS AND METHODS: The study comprised 31 men (mean age 66 years) with finasteride therapy for BPH. Blood samples were taken before and after 3-13months of therapy with finasteride and f/t PSA ratio is determined using radioimmunometric assay. RESULTS: Although the mean t-PSA, f-PSA are significantly decreased after the treatment with finasteride, f/t PSA ratio remained unchanged. The duration of treatment and the level of initial t-PSA did not affect the f/t PSA ratio. CONCLUSIONS: The f/t PSA ratio is unchanged among the patients with finasteride therapy for BPH.
Finasteride* ; Humans ; Hyperplasia* ; Male ; Oxidoreductases ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms

Acute cerebellitis is a clinically isolated condition showing cerebellar signs such as ataxia, dizziness and dysarthria. Most of them are associated with viral infection, which generally occur in childhood and show benign course without sequelae. Tuberculous cerebellitis is very rare and its outcome is not well described. The aim of this study is to describe the clinical features and course in a patient with tuberculous cerebellits. We will also discuss the possible prognostic factors in acute cerebellitis.
Adult ; Ataxia ; Cerebellum ; Dizziness ; Dysarthria ; Encephalitis ; Humans ; Tuberculosis

BACKGROUND: Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. METHODS: This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015. RESULTS: A total of 12 of the 23 cases were partially ruled in favor of the plaintiff. The average amount (KRW) claimed was 470,638,385 ± 860,634,092 (21,000,000 to 4,020,000,000), and that awarded was 72,906,843 ± 53,389,367 (15,000,000 to 181,080,803). Sixteen of the 23 cases had CRPS type I. In 11 of 23 cases, the site of the pain was located in the lower limb and in 14 cases there was no presence of trauma or event prior to medical treatment. CONCLUSION: Nerve injury was the most frequent reason for taking responsibility in compensating damage in malpractice cases involving CRPS. Physicians should consider various possibilities of such complications in medical practices. It is important to identify and improve areas which need to be improved for patient safety through analyzing the lawsuit judgment cases.
Awards and Prizes ; Complex Regional Pain Syndromes ; Judgment ; Jurisprudence ; Lower Extremity ; Malpractice ; Patient Safety