Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

We report a case of bilateral bridges of atlas of a Korean atlas and accompanying variation of the course of the left suboccipital nerve that was observed during the practice of the human anatomy in Seonam university, college of medicine. Bridges of atlas across the groove for the vertebral artery run inferomedially from the posterior margins of the superior articular processes to the posterior margins of the grooves. Widths of the narrowest middle portions of the bridges are 5.05 mm at the left and 0.7 mm at the right. Superior and inferior widths of left bridge are 11.6 mm and 10.9 mm, and of the right are 4.45 mm and 4.65 mm respectively. Cross-sectional areas of the foramina formed by bridges of atlas are 34.7 mm 2 at the left and 29.3 mm 2 at the right. These sizes are much smaller than the sizes of the transverse foramina of the atlas at each side, but diameters of the second and third portions of the left vertebral artery are same as 4.3 mm. At the junction between the left bridge and the posterior arch distinct suture line was observed. Because of the relatively wide bridge, the left suboccipital nerve runs more laterally than the right. It turns to the posterior, pierces the obliquus capitis inferior muscle, and branches out to adjacent suboccipital muscles. Branch to the rectus capitis posterior muscles obliquely cross over the suboccipital triangle to these muscles.
Humans ; Muscles ; Sutures ; Vertebral Artery

No abstract available.
Densitometry*

BACKGROUND: Nowadays, acute drug intoxication is a important section of emergency medicine. The purpose of this study was to determine what is the best-way to manage acutely intoxicated patients with drug in emergency department setting. METHODS: Clinical assessment were made on 135 cases of drug intoxication visited to emergency center of Hospital during one year from June 1997 to May 1998. RESULTS: 1. The total number of cases of acute drug intoxication was 135 which is 0.5% of total patients presented to emergency center. 2. There was no sexual difference in incidence, but the highest incidence of age group was in 3rd decade(23.7%) and the next was 7th decade(20.0%). 3. High frequency of acute intoxication was observed in autumn. October had the largest portion in monthly distribution. The largest portion of presumed time of poisoning was noon - 4 p.m. and of the time on arrival to emergency center was 8 p.m. -midnight. 4. Suicidal attempt was the most common motive of intoxication (72.6%). 5. The most common drug of intoxication was insecticides (35.7%) and the others were centrally active agents, herbicides in orders. 6. Mental change was observed in 20.7% of patients and the abnormal vital signs were hypertension, tachycardia, and hypotension in order on arrival to emergency center. 7. Mean duration of treatment was 36.1 hours. Mortality rate of the cases was 7.4%. CONCLUSION: The mortality rate was high in patients who ingested relatively fatal drugs (i.e. herbicides, antimicrovials, insecticides), showed mental change on arrival or received mechanical ventilatory care(p<0.05).
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Herbicides ; Humans ; Hypertension ; Hypotension ; Incidence ; Insecticides ; Mortality ; Poisoning ; Tachycardia ; Vital Signs

No abstract available.

No abstract available.
Synostosis*

Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by multiple nodules and papules, which are accompanied by intense pruritus. Treatment is challenging and requires a diverse approach. Recently, a few reports have described successful treatment of PN with dupilumab. We report a case of a patient with treatment-resistant PN who was successfully treated with dupilumab. Dupilumab was administered at the standard dose: an initial induction dose of 600 mg, followed by 300 mg every 14 days. Pruritus reduced after 2 weeks and almost completely disappeared after 4 weeks of treatment.

Klippel-Feil syndrome(KFS) consists of short neck, low posterior hairline and restriction of motion of the neck due to fusion of cervical vertebrae. The typical disorder results from a failure of the normal segmentation of mesodermal somites during 3-8 weeks of gestation. In 1912, the first complete clinical description of this syndrome was given by Klippel and Feil. Feil reported additional cases in 1919 and distinguished between three morphologic groups. The incidence of KFS has been estimated to be approximately 1 : 40,000-42,000 births. A slight female predilection has been noted. Although the disorder is sporadic, there are examples of familial occurrence; how ever, no clear mechanism of inheritance has been accepted. Since the disturbance producing a short neck occurs early in embryogenesis, defects in other organ systems may occur at the same time. Common musculoskeletal anomalies that accompany KFS include scoliosis, as well as Sprengel's deformity in as many as one-third of cases. Neurologic, cardiovascular, and urinary tract anomalies are associated with KPS. We report a case of Klippel-Feil syndrome with associates anomalies include Sprengel's deformity.
Cervical Vertebrae ; Congenital Abnormalities ; Embryonic Development ; Female ; Humans ; Incidence ; Klippel-Feil Syndrome* ; Mesoderm ; Neck ; Parturition ; Pregnancy ; Scoliosis ; Somites ; Urinary Tract ; Wills