Heat stroke, a medical emergency, occurs when the body's thermal regulation is upset and unable to dissipate adequate amounts of heat with a rise in body temperature. It is characterized by hyperyrexia, with a core temperature of 40degrees C or more, hot dry skin, and central nervous system disturbance and usually results in rhabdomyolysis and multiorgan failure. Our case, a 43-year-old healthy male, was caused by a marathon, half course, on a sunny day in late summer. He suddenly fell down on the road and was delivered to a nearby hospital, where a seizure developed. He was transfered to our hospital and then displayed Central Nervous System disturbance, hot dry skin, acute liver failure, rhabdomyolysis, anuric acute renal failure, and disseminated intravasculular coagulopathy. He was treated with general supportive care and hemofiltration. Despite the aggressive management, he died of shock on the fifth day after admission.
Acute Kidney Injury ; Adult ; Body Temperature ; Central Nervous System ; Emergencies ; Heat Stroke* ; Hemofiltration ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Rhabdomyolysis ; Seizures ; Shock ; Skin

No abstract available.
Methotrexate* ; Skin*

Medical records of 570 patients underwent transurethral prostatectomy from 1985 to 1991 were reviewed to analyze the factors affected morbidity after transurethral prostatectomy retrospectively. Transurethral prostatectomy constituted 16.9% of the urologic operation during above periods and there were benign disease in 513 patients(90%), and carcinoma in 57 patients(10%). Age of the patients ranged from 48 to 93 years old with a mean age of 68.3. Of the patients, 298 patients (52.3%) had significant pre-existing medical problems. The resected net tissue weight ranged from 3 to 73 grams, with a mean of 11.8 grams. The mean operation time was 53 minutes with a range from 25 minutes to 126 minutes. The mortality was 0.36% and the operative morbidity was 20.3%. Increased morbidity was found in patients with a resection time of more than 90 minutes, used glycine of more than 20,000ml and resected weight of more than 31 grams (P<0.05) But age greater than 80 years, azotemia, urinary tract infection, serum Na+ change and pre-existing disease did not increased the operative morbidity. Voiding symptom was improved in 551 patients(96.7%) but in 19 patients(3.3%). persistent voiding difficulty was found. postoperatively at three months The causes of voiding difficulty were as follows ; 10 incontinence patients, 8 detrusor areflexia patients and 1 urethral stricture patient. In conclusion, transurethral prostatectomy is one of the most common operations today with a very low mortality and the overall postoperative results are excellent. Further studies, such as a randomized trial, will be necessary to evaluate the long-term outcome of transurethral prostatectomy further.
Azotemia ; Glycine ; Humans ; Medical Records ; Mortality ; Preexisting Condition Coverage ; Prostatic Hyperplasia* ; Retrospective Studies ; Transurethral Resection of Prostate* ; Urethral Stricture ; Urinary Tract Infections

Flow cytometric nuclear deoxyribonucleic acid (DNA) ploidy analysis was done successfully on 35 specimens of stage T1 bladder carcinoma treated with Bacillus Calmette-Guerin(BCG) between June 1986 and June 1993. The histologic tumor grading was done by the same pathologist. Of the specimens 16(46%) were DNA diploidy, 14(40%) were aneuploidy and 5(14%) were tetraploidy. In the relationship between tumor grade and ploidy, diploidy was seen in all (100%) of 5 patients with grade 1, in 13(48%) of 27 patients with grade 2. On the other hand, non-diploidy in 14(52%) of 27 patients with grade 2, and in all(100%) of 5 patients with grade 3. Mean followup period was 29 months(12-97 months). None of the patients died of tumor during the followup period. None(0%) of 16 patients with diploidy had tumor recurrence, in contrast 8(42%) of 19 patients with non-diploidy tumors recurred(p<0.05). None of the 16 patients with diploidy had progression. but 5(36%) in 14 patients with aneuploidy (5 patients(26%) in 19 patients with non-diploidy) progressed to an advanced stage(p<0.05). The DNA ploidy analysis appears to significantly contribute in the elucidation of possible future recurrence and progression in patients with stage T1 bladder carcinoma.
Aneuploidy ; Bacillus ; Diploidy ; DNA* ; Flow Cytometry ; Follow-Up Studies ; Hand ; Humans ; Neoplasm Grading ; Ploidies ; Recurrence ; Tetraploidy ; Urinary Bladder*

No abstract available.

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

Spontaneous spinal epidural hemorrhage(SSEH) represent 0.3%~0.9% of spinal epidural-space-occupying lesions. The therapeutic outcome seems to be determined by the accuracy of the diagnosis and by the time interval between the onset of symptom and surgical decompression. Thus, SSEH is a rare spinal emergency and a diagnostic challenge. We experienced two such cases. In one case, the symptoms were confused with those for a ureter stone, aortic aneurysm, spinal cord infarction. That patient completely recovered spontaneously within 2 hours. In the other case, which was initially diagnosed incorrectly as a cerebral infarction, surgical decompression was performed. That patient recovered completely within 1 month.
Aortic Aneurysm ; Cerebral Infarction ; Decompression, Surgical ; Diagnosis ; Emergencies ; Hematoma, Epidural, Spinal* ; Humans ; Infarction ; Spinal Cord ; Ureter

Persistent cloaca is a very rare congenital malformation with the incidence of 1/50,000-250,000 births. This malformations have a single common perineal opening for the genital, urinary and gastrointestinal tracts. Because of wide spectrum of abnormal anatomy involving upper urinary tract, gastrointestinal systems, cardiovascular system, central nervous system, and respiratory system, prenatal diagnosis is difficult through ultrasound during pregnancy. It has been reported that if the anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with meconium peritonitis and hydrometrocolpos confirmed by neonatal surgery after emergency cesarean section.
Cardiovascular System ; Central Nervous System ; Cesarean Section ; Cloaca* ; Emergencies ; Female ; Gastrointestinal Tract ; Incidence ; Meconium* ; Parturition ; Peritonitis* ; Pregnancy ; Prenatal Diagnosis ; Respiratory System ; Ultrasonography ; Urinary Tract

PURPOSE: The purpose of this study is to evaluate clinical characteristics and surgical outcomes of rhegmatogenous retinal detachment in children. METHODS: The medical records of 29 children (30 eyes, younger than 15 years of age) who underwent the surgery for retinal detachment at our hospital were reviewed retrospectively. RESULTS: Twenty-six (90%) of the 29 patients were male, and three (10%) were female. Their average age was 11 years old (range 4years~15years). Retinal detachment was caused by, in order of frequency, trauma, high myopia, Morning glory disc anomaly, previous intraocular surgery and had an unknown cause in 6 eyes. Proliferative vitreoretinopathy (PVR) was involved in eleven (37%) of the 30 eyes at presentation. The overall reattachment rate was 73% after the first operation and 93% after the second operation. CONCLUSIONS: Retinal detachments in children have poor surgical outcomes than that in adults due to delayed diagnosis, frequent macular involvement and presence of PVR. For the children with certain diseases, we should exam carefully and regularly for the subtle changes even in the absence of specific complaints.
Adult ; Child* ; Delayed Diagnosis ; Female ; Humans ; Male ; Medical Records ; Myopia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Vitreoretinopathy, Proliferative

BACKGROUND: This prospective, double-blind randomized study was performed to compare the characteristics of recovery after general anesthesia induced by target-controlled propofol and sevoflurane. METHODS: Sixty, ASA class 1 or 2 female patients scheduled for an elective total abdominal hysterectomy were randomly allocated to two groups of 30; i.e. Propofol or Sevoflurane groups. General anesthesia was induced using propofol plus a fentanyl bolus (1 microgram/kg), and maintained with 66% nitrous oxide and either propofol infusion or sevoflurane inhalation. Anesthetic depth was controlled under bispectral index (BIS) monitoring: propofol and sevoflurane concentrations were adjusted to achieve target BIS values, and were between 40-60 during surgery and 60-70 during the final 15-20 minutes. The two anesthetic agents were discontinued following subcutaneous layer closure. After skin closure, the patients were ventilated manually with 100% oxygen until extubation. Patients were evaluated in terms of level of consciousness and side effects at the end of anesthesia and at 5, 15, 30 and 120 min after anesthesia. RESULTS: There were no significant differences in recovery times. The incidences of side effects were similar in the two groups, though the incidence of postoperative nausea was higher in the sevoflurane group. CONCLUSIONS: These results suggest that sevoflurane inhalation anesthesia has an emergence similar to that of propofol, except for a higher incidence of postoperative nausea.
Anesthesia* ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthetics ; Consciousness ; Female ; Fentanyl ; Humans ; Hysterectomy ; Incidence ; Inhalation ; Nitrous Oxide ; Oxygen ; Postoperative Nausea and Vomiting ; Propofol* ; Prospective Studies ; Skin