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*

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.

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

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

There is an urgent need for accurate and rapid diagnostic assays capable of identifying carbapenemase-producing Enterobacteriaceae (CPE). We assessed the performance of the RESIST-4 O.K.N.V. (OKNV) assay (Coris BioConcept, Gembloux, Belgium) for the identification of oxacillinase (OXA)-48-like-, Klebsiella pneumoniae carbapenemase (KPC)-, New Delhi metallo-β-lactamase (NDM)-, and Verona integron-encoded metallo-β-lactamase (VIM)-producing Enterobacteriaceae grown on sheep blood agar (SBA) and the CHROMagar KPC medium. Sixty-five carbapenem-resistant Enterobacteriaceae (CRE) isolates with characterized carbapenemase content were used to evaluate the OKNV assay. The assay correctly identified all 30 isolates that produced one of the four targeted carbapenemase families. Additionally, it correctly identified 15 isolates that co-produced KPC and NDM, VIM and NDM or OXA-48-like and NDM, but failed to identify an NDM-1 and OXA-232 co-producing Klebsiella pneumoniae isolate. All 16 non-carbapenemase-producing CRE and four CPE isolates exhibited negative results, and no cross-reaction was observed. Overall, the sensitivity and specificity of the assay were 97.8% and 100%, respectively. The OKNV assay is an accurate and rapid assay for identifying OXA-48-like, KPC, NDM, and VIM carbapenemases produced by Enterobacteriaceae isolates cultured on both SBA and the CHROMagar KPC media in the clinical microbiology laboratory.

A silicone-covered modified Gianturco stent in patients with malignant esophageal stricture is an easy, safe, and effective palliative procedure, but reports of complications arising from stent placement in patients with this condition are numerous. There have been no reports of fracture of the modified Gianturco esophageal stent. We report a case of stent fracture in association with gastric migration of modified Gianturco esophageal stent in a patient with malignant esophageal stricture. It appears that the fracture was probably due to oxidation of the stent by gastric juice.
Esophageal Stenosis* ; Gastric Juice ; Humans ; Stents*