A case of Toxic epidermal necrolysis in 19 th years old man is presented. This patient has been suffering from erythematous patches and bullae over entire body including vesicles, erosions, and fissures on both lips since 2 days ago after taking some drugs (analgetics, aspirin, chloramphenicol, sulfisoxazole, erythromycine.) for treatment of tonsillitis. Furthermore, it is very difficult for us to say why the disease has occured. Toxic Epidermal Necrolysis (TEN) by talking drugs or Staphylococcal Scalded Skin Syndrpme (4S) by staphylococcus aurues because staphylococcus aureus was found on bacteriai culture from his throat swab. He was treated with corticosteroid, antibiotics and fluids for 20 days with good result. Literature was briefly reviewed.
Anti-Bacterial Agents ; Aspirin ; Chloramphenicol ; Humans ; Lip ; Palatine Tonsil ; Pharynx ; Skin ; Staphylococcus ; Staphylococcus aureus ; Stevens-Johnson Syndrome* ; Sulfisoxazole ; Tonsillitis

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.
Anesthesia ; Anesthesia, General* ; Anesthesiology ; Cerebrovascular Circulation ; Hydrogen-Ion Concentration ; Pulmonary Gas Exchange ; Ventilation* ; Ventilators, Mechanical

BACKGROUND: It is a routine practice that High Frequency Jet Ventilation (HFJV) is applied through a 14~16 gauge (about 12 French (Fr.)) angiocath. The 14 Fr. suction catheter which is similar to angiocath in its internal diameter is commonly available in the operating room. We evaluated the suction catheter as a carrier of HFJV in point of ventilation, oxygenation and operating field during HFJV at microlaryngeal endoscopic surgery (MES). METHODS: Fifteen adult patients undergoing HFJV via 14 Fr. suction catheter during MES were studied. Time-based arterial blood gas analyses were done before and after HFJV. The movement of operating field was examined using laryngoscopic examination by surgeon and anesthesiologist. We also evaluated complications such as abdominal distension, barotrauma and so on. RESULTS: The mean arterial oxygen tension was maintained above 250 mmHg all the time during HFJV. The mean carbon dioxide tension was less than 51 mmHg. There were no remarkable catheter movement and complications. CONCLUSION: The 14 Fr. suction catheter is a good replacement of angiocath. It provided good operating field, ventilation and oxygenation without complications.
Adult ; Barotrauma ; Blood Gas Analysis ; Carbon Dioxide ; Catheters* ; High-Frequency Jet Ventilation* ; Humans ; Operating Rooms ; Oxygen ; Suction* ; Ventilation

Two cases of vitiligo-type hypomelanosis followed by the local application of Benoquin ointment for the treatment for the treatment of melasma are reported. These two cases of hypomelanosis are unwanted and unintended side effects probably caused by the application of monobenzyl ethers of hydrcquinone (monobenzone). Monobenzone blocks the enzyme tyrosinase and thereby prevents the conversion of tyrosine to dihydroxyphenylanine, a precursor of melanin, and since this does not destroy melanocyte or facilitate the loss of melanin. The skin contact with the material will not occur, repigmentation will slow but eventuaIly complete.
Ether ; Ethers ; Hypopigmentation* ; Melanins ; Melanocytes ; Melanosis ; Monophenol Monooxygenase ; Skin ; Tyrosine ; Vitiligo*

Dupuytren's contracture is a idiopathic hypertrophy of palmar aponeurosis and consequent flexion deformity of distal palms and fingers. This patient is a 58-year-old man who has been suffering from diabetes mllitus since last 20 years. Skin lesion developed from one year ago. Skin lesion is a well defined, yellowish brown, nontender, firm, pea-sized nodule at distal palmar crease proximal to ring finger on both hands. On physical examination, he is within normal limit except skin lesion and flexion deformity on both hands. Skin biopsy on nodule revealed non-specific fibrosis. Literature was briefly reviewed.
Biopsy ; Congenital Abnormalities ; Dupuytren Contracture* ; Fibrosis ; Fingers ; Hand ; Humans ; Hypertrophy ; Middle Aged ; Physical Examination ; Skin

No abstract available.
Adult* ; Humans

No abstract available.
Adult* ; Humans

PURPOSE: DNA mismatch repair gene is responsible for hereditary nonpolyposis colorectal cancer. But it is not well known its role in sporadic colorectal cancer patients. We analysed normal hMSH2, hMLH1 protein expression in colorectal adenocarcinoma tissues and corresponding normal tissues to find out the role of mismatch repair gene in sporadic colorectal cancer by Western blotting. METHODS: Normal hMSH2 and hMLH1 protein expression was studied on 25 colorectal cancer and corresponding normal tissue by Western blot with hMSH2 and hMLH1 monoclonal antibody. Normal protein band was expressed on 100 kD in hMSH2 and 87 kD in hMLH1. SW480 and LoVo cell line was used as positive and negative control for hMSH2 and LoVo and SW480 as positive and negative for hMLH1. And we analysed the relation between the hMSH2, hMLH1 protein expression and clinicopathological parameters. RESULTS: It was 2 cases (8%) that both hMSH2 and hMLH1 protein expression was not observed. Three cases (12%) were negative for hMSH2 and 2 cases (8%) for hMLH1. One or both hMSH2, hMLH1 protein expression was not observed in 7 cases (28%) in total. There was no correlation for proximal occurrence (25% vs 35%), young age (37.5% vs 23.5%) and lymph node metastasis (50% vs 47%). But poorly and mucinous differentiation was regarded as having relation with negative expression of hMSH2 and hMLH1 (50% vs 17.6%) but not significant statistically. CONCLUSION: Sporadic colorectal cancer with negative expression of normal hMSH2 and hMLH1 protein showed no relation to younger age, proximal site preference and lymph node metastasis. But it was suggested that mismatch repair gene protein was involved in cancer cell differentiation in sporadic colorectal cancer.
Adenocarcinoma ; Blotting, Western ; Cell Differentiation ; Cell Line ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Humans ; Lymph Nodes ; Mucins ; Neoplasm Metastasis

No abstract available.
Head* ; Orthognathic Surgery* ; Posture* ; Prognathism*