Candidiasis is the most common fungal infection complicating the course of patients with hematologic malignant neoplasms. Although widespread organ involvement is characteristic of disseminated candidiasis, reports of skin are rare. Reports describing typical clinical and histopathological finding of cutaneous lesions are very important since it may enable a diagnosis of disseminated candidiasis to be made and thus antifungal therapy can be initiated earlier. A 50-year-old housewife was admitted with a 5-month history of fatigue and easy bruising. She was diagnosed as ha.ving acute myelocytic leukemia and treatment was begun with daunorubicin and cytosin, arabinoside. Eight days after the start of chemotherapy, she developed a fever and generalized tender well demacated erythematous to purplish papulonodular eruption. A biopsy specimen from the skin lesion showed perivascular mononuclear cell infiltration and spore and pseudohypae v,rere found within the dermis and subcutis in PAS stain. Cultures of one skin biopsy specimen and one of four blood sarnples grew Candida tropicalis. The patient was treated with intravenous amphotericin B for disseminated candidiasis. On the tenth day of antifun gal therapy, she developed cardiopulmonary arrest and died.
Amphotericin B ; Biopsy ; Candida tropicalis ; Candidiasis* ; Daunorubicin ; Dermis ; Diagnosis ; Drug Therapy ; Fatigue ; Fever ; Heart Arrest ; Humans ; Leukemia, Myeloid, Acute ; Middle Aged ; Skin Manifestations* ; Skin* ; Spores

No abstract available.
Carcinoma, Renal Cell* ; Colon* ; Colonic Neoplasms*

A 63-year-old man had a huge verrucous protruding mass over the suprasternal area. The lesion enlarged rapidly over 3 mooths, and measured about 10×8 cm. The histologic finding of the biopsy specimen showed nests of squamous epithelium with central keratinization, infiltrating the dermis. The neoplasm was treated successfully with surgical excision.
Biopsy ; Dermis ; Epithelium ; Humans ; Keratoacanthoma* ; Middle Aged

BACKGROUND: Decreased heart rate variability(HRV) has been shown to be an independent predictor of poor outcome after acute myocardial infarction, Spectral analysis of HRV has recently been shown to be a reliable noninvasive test for quantiative assessment of cardiovascular autonomic regulatory response. We estimated the reproducibility and circadian rhythm of HRV parameters in patients with acute myocardial infarction. METHODS: Three consecutive 24-hour ambulatory electrocardiographic recordings were made in 24 patients with acute myocardial infarction, with 10~14 days after the acute attack, and analyzed for HRV parameters of both frequency and time domains. Parameters of frequency domain include low frequency(LF) and high frequency(HF) components. Parameters of time domain include sdRR, SDANN, SD, pNN50, rMSSD, HRV index. RESULTS: Mean total, low frequency and high frequency amplitude spectral densities were 33msec, 19msec and 11msec, respectively. Mean values of sdRR, SDANN, SD, rMSSD, pNN50 and HRV index were 103msec, 90msec, 47msec, 28msec, 7% and 32, respectively. Coefficients of variation(CV) of total amplitude spectral density, and low and high frequency components were 7%, 9% and 12%, respectively. CV of most HRV parameters of time domain were also around 10% except rMSSD and pNN50. Heart rate increased in the morning to be sustained during the day time and decreased in the night. Heart rate variability of high frequency component decreased in the early morning to be sustained during day time with increase in the night. CONCLUSIONS: We conclude that in the predischarge period of acute myocardial infarction, HRV parameters of frequency and time domains are reproducible and there are some morning fall of cardiac vagal activity.
Circadian Rhythm ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Myocardial Infarction*

No abstract available.
Tuberculosis, Miliary*

A nosocomial outbreak of severe acute respiratory syndrome-coronavirus-2 occurred in two general wards. One outbreak had pre-symptomatic transmission and was linked epidemiologically with an index case. The other outbreak was associated with early detection failure in a crowded room. Notably, adherence to appropriate mask wearing was not confirmed in the hospital outbreak. Confirmed cases were moved into isolation rooms, and contacts were quarantined. Quarantined cases were tested regularly and facilitated early termination of the hospital outbreak.

A nosocomial outbreak of severe acute respiratory syndrome-coronavirus-2 occurred in two general wards. One outbreak had pre-symptomatic transmission and was linked epidemiologically with an index case. The other outbreak was associated with early detection failure in a crowded room. Notably, adherence to appropriate mask wearing was not confirmed in the hospital outbreak. Confirmed cases were moved into isolation rooms, and contacts were quarantined. Quarantined cases were tested regularly and facilitated early termination of the hospital outbreak.

OBJECTIVES: People at ultra-high risk for psychosis have heterogenous character and different long-term outcomes. We divided ultra-high risk subjects into two subgroups by presence of familial history and tried to find different pattern of functional connectivity of the default mode network (DMN) between the two groups in order to examine the effects familial loading. METHODS: Eleven subjects at clinical-high risk (CHR) group with familial history of psychiatric illness and nineteen subjects of CHR group without familial history were recruited. All the subjects were scanned using resting-state functional magnetic resonance imaging. A posterior cingulate cortex was the seed region of the analysis, and the DMN of the both high risk group were analyzed with voxel-wise two sample T test. RESULTS: The CHR group with familial history showed greater functional connectivity in the precuneus area in contrast with the other high risk subjects (peak-level t=5.49, p<0.001). There were no significant differences in total score on the Positive and Negative Syndrome Scale and Scales of Psychosis-risk Syndrome between the two groups. CONCLUSION: The study suggests that the abnormalities of functional connectivity between precuneus and posterior cingulate area may be associated with the genetic vulnerability of high risk trait.
Gyrus Cinguli ; Magnetic Resonance Imaging ; Pilot Projects ; Psychotic Disorders ; Seeds ; Weights and Measures

PURPOSE: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. RESULTS: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 6.8%. CONCLUSION: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.
Abdominal Abscess ; Gastrectomy* ; Hemorrhage ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Pancreas ; Pancreatic Fistula ; Retrospective Studies ; Spleen ; Stomach Neoplasms* ; Survival Rate

No abstract available.
Humans* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium*