Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

OBJECTIVE: The purpose of this study was to evaluate the suicide ideation considering sociodemographic factor and degree of symptoms, subjective emotional state of the social phobia patients. METHODS: Study subjects consisted of 34 social phobia patients diagnosed with the criteria of DSM-IV. The authors evaluated the degree of symptomes, depression, hopelessness, disability. For the evaluation of suicide ideation, Beck Suicide Ideation Scale (SIS) was applied to the patients. Sociodemographic data and Clinical characterictics was analyzed by t test or Oneway ANOVA. We employed the correlation test for the evaluation of relationship between suicide ideation and self reported scale score. RESULTS: 1) Suicide ideation was higher in the young aged, unmarried patients, and past suicide attemptors. 2) In the correlation test, Suicide ideation was highly correlated with depression and hopelessness. 3) There were no significant correlations between suicide ideation and degree of symptomes. CONCLUSION: In this study. We concluded that the most powerful predictor of suicide ideation in social phobia is not the degree of symptomes itself but the depression and hopelessness.
Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Phobic Disorders* ; Self Report ; Single Person ; Suicide*

Rahnella aquatilis, an infrequently isolated gram-negative rod, is the only species of the genus Rahnella within the Enterobacteriaceae family. The organism's natural habitat is water, from which most isolates have been recoverd. Infecions in humans have only occasionally been reported, especially in immunocompromised patients. We reort a case of bacteremia caused by this organism in a hemodialysis patient.
Bacteremia* ; Ecosystem ; Enterobacteriaceae ; Humans ; Immunocompromised Host ; Rahnella* ; Renal Dialysis*

Although involvement of the testis by generalized lymphoma is usual, especially in the terminal stage or the disease. testicular involvement as a initial manifestation of malignant lymphoma is uncommon. approximately 5% of testicular tumor. We report a case of malignant lymphoma with first manifestation in the testis, clinical stage II b, which was treated with radical orchiectomy, systemic chemotherapy and radiation therapy. This case was followed up by C-T.
Drug Therapy ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Orchiectomy ; Testis*

BACKGROUND AND PURPOSE: Catecholamines have an effect on sexual drive. When the sympathetic nervous system is excited, norepinephrine is released from nerve terminals, epinephrine from the adrenal glands, and dopamine in the central nervous system. Serotonin has a central inhibitory effect on sexual drive. Major adrenergic and serotoninergic innervation is found in the hippocampus. This study was performed to investigate the differences in serotonin release from rat hippocampal slices in the central nervous system in response to various catecholamines. MATERIALS AND METHODS: The hippocampus from the rat brain was sliced. After 30 minutes' incubation in normal buffer, the slices were incubated for 20 minutes in a buffer containing 0.1 micro M [3H]5-HT and then washed. After administration of norepinephrine (10-5M), dopamine (10-5M), or epinephrine (10-5M), the release of [3H]5-HT into the buffer was measured. The radioactivity in each buffer and tissue was counted, and the results were expressed as a percentage of the total activity. The value of released [3H]5-HT was expressed as percent of the value at 50 minutes when a steady state of [3H]5-HT release had been obtained. RESULTS: After administration of norepinephrine, dopamine, and epinephrine, the values (mean +/- SE, %) were 115.7 +/- 2.3, 136.8 +/- 10.5, 107.4 +/- 7.7 at 60 minutes and 105.8 +/- 5.5, 140.7 +/- 7.7, 94.2 +/- 6.2 at 70 minutes vs. 96.6 +/- 1.9 at 60 minutes and 89.2 +/- 2.3 at 70 minutes for the control group. The release thus was increased significantly after administration of norepinephrine and dopamine, and the effect of dopamine was more significant than that of epinephrine. CONCLUSIONS: Release of serotonin is increased by norepinephrine and dopamine. The effect of dopamine was more significant than that of epinephrine. Reciprocal increase in serotonin release after administration of catecholamines may be involved in their effect on sexual function.
Adrenal Glands ; Animals ; Brain ; Catecholamines* ; Central Nervous System ; Dopamine ; Epinephrine ; Hippocampus ; Norepinephrine ; Radioactivity ; Rats* ; Serotonin* ; Sympathetic Nervous System

5-hydroxytryptamine (5-HT) containing pathways exert a inhibitory or facilitate effect on copulation. The administration of gamma aminobutyric acid (GABA) receptor agonists to the central nervous system in rats inhibits male copulatory behavior, whereas the administration of antagonists facilitates corpulatory behavior. GABA may influence the erection through dopaminergic pathway. But few about the effect of GABA on serotoninergic neuron are known. Raphe nuclei give rise to the major serotonergic innervation to the hippocampal formation and the GABAergic interneurons are located at the hippocampal formation also. This study was performed to investigate the influence of GABA, inhibitory interneuron, on the 5-HT release from rat hippocampal slices to understand the connection of the serotonergic neurons to GABAergic interneurons. The hippocampus was obtained from the male rat brain and sliced to a 400 Im thickness. After 30 minutes preincubation in the normal buffer, the slices were incubated for 20 minutes in a buffer containing 0.1 microM [3H]5-HT for uptake, and washed. After administration of GABA, the release of [3H] 5-HT into the buffer was measured and the radioactivities in each buffer and the tissue were counted using liquid scintillation counter and the results were expressed as a percentage of the total activity. Spontaneous release of [3H] 5-HT from the rat hippocampal slices decreased rapidly during the first 40 minutes of incubation. Through the rapid release of [3H] 5-HT, a steady state of [3H] 5-HT release was obtained from the 50 minutes of incubation. The value of released [3H] 5-HT after 50 minutes was expressed as percent of the value at 50 minutes. After administration of GABA (10(-4)M), the values (mean +/- SE) of released (3H)5-HT were 97.3 +/- 3.8% at 60 minutes and 91.2 +/- 3.4% at 70 minutes. The values of control group were 96.6 +/- 1.9% at 60 minutes and 89.6 +/- 2.3% at 70 minutes. There were no changes in the release of (3H)5-HT after administration of GABA. These results suggest that there are few connections between GABA and serotoninergic neurons and GABA does not influence the release of 5-HT in rat hippocampus.
Animals ; Brain ; Central Nervous System ; Copulation ; gamma-Aminobutyric Acid* ; Hippocampus ; Humans ; Interneurons ; Male ; Radioactivity ; Raphe Nuclei ; Rats ; Scintillation Counting ; Serotonergic Neurons ; Serotonin*

PURPOSE: The purpose of this study was to compare the efficacy of curative emergency surgery for complicated colon cancer in terms of tumor recurrence and survival compared with that of elective surgery. METHODS: A total of 238 primary surgeries for colon cancer were performed. All patients were deemed to have undergone a curative resection. Patients were classified into an emergency surgery group for complicated colon cancers (n=40) and an elective surgery group for uncomplicated colon cancers (n=198). RESULTS: Emergency colonic cancers present at a more advanced stage (P=0.002). The postoperative mortality rate in the emergency group was significantly higher than it was in the elective group (15.0% vs. 2.5%, P= 0.004). There were differences between the two groups in tumor recurrence (32.5% vs. 13.1%, P=0.003), overall survival (52.5% vs. 71.7%, P=0.017), and disease-free survival (50.0% vs. 69.7%, P=0.016). However, after the patients were stratified according to tumor stage, no statistical differences were observed. CONCLUSIONS: When compared with uncomplicated colon cancers, complicated colon cancers present at a more advanced stage with a higher postoperative mortality and an overall worse prognosis. However, the difference decreases when patients are stratified according to the tumor stage. The negative prognostic efficacy of emergency surgery for complicated colon cancers appears to be confined to the perioperative period. Despite the more advanced stage of tumors in patients undergoing emergency surgery, the aim of the surgeon should be to offer a curative resection for better survival, if possible.
Colon* ; Colonic Neoplasms* ; Disease-Free Survival ; Emergencies* ; Humans ; Mortality ; Perioperative Period ; Prognosis ; Recurrence

Background: Corrective osteotomy is an effective surgery for correcting posture in patients with ankylosing spondylitis (AS). Despite satisfactory correction, some patients experience re-stooping during follow-up. However, there have been no studies on restooping in AS. We aimed to analyze the factors that affect re-stooping. Methods: Fifty patients (50 cases) who underwent thoracolumbar corrective osteotomy for AS from March 2006 to April 2018 were analyzed. We defined re-stooping as global kyphosis that recurs after corrective osteotomy. The patients were divided into two groups based on the ratio of correction loss: non-re-stooping group (N group) and re-stooping group (R group). We analyzed the demographic data and radiological parameters, such as modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), sagittal vertical axis, and various angles. We also investigated the factors affecting re-stooping by analyzing the correlation between the ratio of correction loss and various factors. Results: A significant difference was seen in the change in the mSASSS from before surgery to the last follow-up between the N group (2.87 ± 3.08) and the R group (9.20 ± 5.44). In multivariate analysis, only the change in the mSASSS from before surgery to the last follow-up was significantly correlated with the ratio of correction loss. Conclusions Thoracolumbar corrective osteotomy seems to provide high satisfaction among patients with AS but can lead to re-stooping during follow-up. The change in mSASSS was related with re-stooping in the current study. We recommend active rehabilitative exercises and appropriate medication depending on the patient’s condition, which may help delay the postoperative progression of AS.

OBJECTIVE: This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). METHODS: CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. RESULTS: Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was 56.7 +/- 19.3 mmHg (Mean +/- SD) and 7.4 +/- 3.3 mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. CONCLUSION: CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.
Carpal Tunnel Syndrome ; Catheters ; Cytidine Triphosphate ; Electrodiagnosis ; Humans ; Wrist

Carpal tunnel syndrome(CTS), the most common compressive neuropathy, is usually diagnosed by clinical features and nerve conduction test(NCS). However, NCS might show no abnormal finding. Ultrasonography(USG), known as helpful adjunctive in diagnosis of CTS, also might show false negative finding. A 33-year-old woman presented with complaints of pain and numbness in median nerve area on her right hand for 4 years. Despite typical clinical features of CTS, neither NCS nor USG showed abnormal finding. Because of persistent symptom, without significant improvement on conservative management, endoscopic carpal tunnel release(ECTR) was performed with carpal tunnel pressure(CTP) measurement. The measured CTP was 27.9mmHg before ECRT, which was reduced to 5.9mmHg after operation. The pain and numbness subsided after operation. Our case showed the usefulness of CTP measurement in diagnosis of CTS. The measurement of CTP might be an important diagnosis modality for some patients having CTS, especially in cases without definitive findings in NCS and USG.
Adult ; Carpal Tunnel Syndrome ; Cytidine Triphosphate ; Electromyography ; Female ; Hand ; Humans ; Hypesthesia ; Median Nerve ; Neural Conduction