No abstract available.
Antibodies, Monoclonal* ; Brain* ; Epitopes* ; Humans*

A 13-year-old girl was transferred from a private clinic to our emergency department due to lower abdominal pain and acute urinary retention. Radiologic evaluation showed an imperforate hymen with hematocolpometra. In the emergency department, an imperforate hymen is a rare cause of acute urinary retention. Usually, the diagnosis of a congenital inperforate hymen can be made by inspection of the perineum; however, in many cases, an extensive radiologic evaluation must be performed because of misdiagnosis. The emergency physician should consider an imperforate hymen in girls with lower abdominal pain and urinary retention.
Abdominal Pain* ; Adolescent ; Diagnosis ; Diagnostic Errors ; Emergencies ; Emergency Service, Hospital ; Female ; Humans ; Hymen* ; Perineum ; Urinary Retention*

PURPOSE: Fitz-Hugh-Curtis (FHC) syndrome is characterized by right upper quadrant pain due to perihepatitis with pelvic inflammatory disease (PID). It is diagnosed by using its typical symptoms, but final diagnosis is made by confirmation of the presence of laparoscopically visualized perihepatic violin string like adhesions. However, laparoscopy is difficult to perform in the emergency department. Recently, on computerized tomography (CT) a linear enhancement of the liver capsule was detected in a patient with FHC syndrome. We present a review of a series of 11 cases in female of FHC syndrome diagnosed by CT. METHODS: We reviewed the medical records and the CT findings of 11 cases of FHC syndrome diagnosed during 7 months in the emergency department. The clinico radiologic criteria of our hospital is as follows: First, right upper quadrant pain. Second, linear enhancement of the liver capsule in the contrast enhancement phase of CT. Third, no pathologic findings for the liver, the gallbladder and the biliary tract in CT. RESULTS: Eleven patients were diagnosed during 7 months by using criteria. The mean age was 30.2 (range: 16~46) years. Seven patients had a history of PID within 6 months. Seven of the 9 patients who take a pelvic examination were positive in C. trachomatis PCR (polymerase chain reaction), and another patient had a positive N. gonorrhoeae cervix culture. One patient who showed negative in both the C. trachomatis PCR and the N. gonorrhoeae cervix culture had cultured E. coli in urine and blood culture. CONCLUSION: CT makes easy the previously difficult diagnosis of FHC syndrome in female patients capable of pregnancy with right upper quadrant abdominal pain.
Abdominal Pain ; Biliary Tract ; Cervix Uteri ; Chlamydia trachomatis ; Diagnosis ; Emergency Service, Hospital ; Female ; Gallbladder ; Gynecological Examination ; Humans ; Laparoscopy ; Liver ; Medical Records ; Pelvic Inflammatory Disease ; Polymerase Chain Reaction ; Pregnancy ; Tomography, Spiral Computed

Subependymal giant cell astrocytoma is a very rare cerebral glioma and is known to be usually associated with tuberous sclerosis. We experienced a case of this tumor occurred at the wall of both lateral ventricles near the foramen of Monro in a patient of tuberous sclerosis who had symtoms and signs of hydrocephalus and other complex manifestations of facial adenoma sebaceum, huge fibroma on occipital scalp and hamartoma on the right retina. The masses were removed completely through transcallosal approach with microsurgical technique. The literatures are also reviewed.
Astrocytoma* ; Cerebral Ventricles ; Fibroma ; Glioma ; Hamartoma ; Humans ; Hydrocephalus ; Lateral Ventricles ; Retina ; Scalp ; Tuberous Sclerosis

PURPOSE: Recent guidelines for sepsis treatment emphasizes the need for early recognition of disease, leading to the development of the MEDS scoring system. However, there has been no prospective validation or comparison against other scoring systems. Therefore, we prospectively validated the MEDS scoring system and compared it withMultiple Organ Dysfunction Score (MODS) and Sepsisrelated Organ Failure Assessment (SOFA) scoring systems. METHODS: MEDS, MODS, and SOFA scores of 288 patients who were suspected to have systemic infection were calculated at the times of their emergency department visits, and clinical data of the patients were reviewed after six months. Results: MEDS, MODS, and SOFA scoring systems were all valid in the prediction of mortality according to logistic regression analysis. The results of probit analysis revealed significant and direct relationships between the scores and the mortality rate and demonstrated the parallelism of the mortality prediction of the three scoring systems. The cut-off values for the MEDS scoring system successfully divided subjects into five groups according to their risk for death. And the MEDS score well predicted the admission to ward or intensive care unit in survived patients. CONCLUSION: MEDS, MODS, and SOFA scor all were good predictors of outcome for patients with suspected sepsis and showed the same degree of predictive power. The MEDS scoring system, however, featured ease of calculation and definite clinical cut-off values which were useful in guiding decisions about treatment options. It also was well correlated with the prognosis of survived patients. We believe it to be the most useful and appropriate clinical prediction tool in cases of suspected sepsis in the emergency department.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units ; Logistic Models ; Mortality* ; Multiple Organ Failure ; Organ Dysfunction Scores ; Prognosis ; Prospective Studies ; Research Design ; Sepsis*

We present a case of recurrent left atrial myxoma which occurred 7 years and 10 months after initial operation despite resection of originaltumor and adjacent atrial septum. This is the first case report of recurrence in Korea. Among the possible causes of recurrence, regrowth from pretumorous focus seems to be the most suggesting one in this case. Histopathologic findings of recurrent myxoma showed increased cellularity with active proliferation and nuclear hyperchromasia. These findings, together with the rapidity of regrowth, suggest that recurrent myxoma may have 'wilder' behavior. Prolonged postoperative observation is important, even if ample resection was done at the initial operation including atrial septum.
Atrial Septum ; Korea ; Myxoma* ; Recurrence*