We have experienced acute hepatitis after general anesthesia. We guess that acute hepatitis is caused by enflurane anesthesia. We will report this case with references. A 34 year old pregnant woman suffered from preeclamsia. She admitted for emergence repeat cesarean-section due to labor pain. In this operation general anesthesia was performanced with enflurane. The preoperative liver enzyme were normal and other tests were within normal range. She developed high fever, marked elevation of serum glutamic oxaloacetic transaminase(SGOT)/serum glutamic pyrubic transaminase(SGPT)/ alkaline phosphatase(ALP)/total bilirunbin(T-B) on the 2nd postoperative day. She recovered gradually and discharged after 13 day's hospitalization. A possible cause of the acute hepatitis in this case were considered to be the enflurane.
Adult ; Anesthesia ; Anesthesia, General* ; Enflurane* ; Female ; Fever ; Hepatitis* ; Hospitalization ; Humans ; Labor Pain ; Liver ; Pregnancy ; Pregnant Women ; Reference Values

No abstract available.
Child* ; Humans ; Nevus, Spindle Cell*

PURPOSE: The germ cell proliferation and apoptosis were investigated in testis and its effect to the spermatogenesis. MATERIALS AND METHODS: The biopsy specimens of testis were obtained from 58 infertile males with nonobstructive azoospermia due to primary testicular failure and from 13 prostate cancer cases with normal spermatogenesis. The infertility specimens were divided into 4 groups according to histopathologic findings- Sertoli cell only syndrome(A), maturation arrest(B), hypospermatogenesis(C) and disorganization with sloughing(D) and quantitatively evaluated with Johnsen score system. Germ cell proliferation and apoptosis were determined using immunohistochemical study with MIB-1, bcl-2 monclonal antibodies and TUNEL method, and evaluated the relationship between their results and histopathologic findings. RESULTS: MIB-1 expression was negative in all infertility group A. MIB-1 positivity was revealed no statistical significance among infertility groups B, C, D and control group(p>0.05 in each). Bcl-2 and apoptosis were not expressed in all infertilty group A and control group. Bcl-2 and apoptosis positivity were revealed no significant difference among group B, C and D (p>0.05). MIB-1 expression was shown no relationship with the apoptosis (p>0.05), and a high prevalence in bcl-2 positive group, but there was no significant correlation (p>0.05). In infertility group, the MIB-1 index and bcl-2 positivity were decreased according to high Johnsen score but no statistical difference (p>0.05), and apoptosis was shown no relationship with Johnsen score (p>0.05). CONCLUSIONS: MIB-1 expression did not represent the degree of spermatogenic failure in infertile patients. The apoptosis was detected in all infertility groups except Sertoli cell only syndrome. Apoptosis was suggested to be related somewhat with spermatogeneis.
Antibodies ; Apoptosis* ; Azoospermia ; Biopsy ; Cell Proliferation ; Germ Cells* ; Humans ; In Situ Nick-End Labeling ; Infertility ; Male ; Prevalence ; Prostatic Neoplasms ; Sertoli Cell-Only Syndrome ; Spermatogenesis* ; Testis*

Coronary arteriovenous fistulas (CAVF) are rare malformations of the coronary circulation. They are seen in approximately 0.1% to 0.2% of all patients undergoing selective coronary angiography. We experienced a 58-years old male patient with bilateral coronary AV fistulas whoes diagnosis was confirmed by selective coronary angiography.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Circulation ; Diagnosis ; Fistula ; Humans ; Male ; Middle Aged

Angiosarcoma is a rare, aggressive vascular neoplasm of the endothelial cell origin. It is usually seen in male, elderly patients and generally has a poor prognosis due to its high potential for metastasis. They arise at various sites such as skin, soft tissue, heart and great vessels. However, the tumors have a predilection for skin and superficial soft tissue. Most angiosarcomas of the skin arise in the three clinical variant; primary angiosarcoma of the face and scalp in the elderly patients; following lymphedema, and post radiation or trauma. Although, this tumor tend to recur locally and metastasize to the viscera, especially in the lung, but cutaneous metastasis of angiosarcomas from the internal organ are uncommon. Herein, we report a patient with cutaneous metastasis from primary cardiac angiosarcoma in the right atrium.
Aged ; Endothelial Cells ; Heart ; Heart Atria ; Hemangiosarcoma ; Humans ; Lung ; Lymphedema ; Male ; Neoplasm Metastasis ; Prognosis ; Scalp ; Skin ; Vascular Neoplasms ; Viscera

Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Brachiocephalic Trunk ; Carotid Arteries ; Chimera ; Humans ; Stents ; Transplants

Infectious diseases, particularly pneumonia, remain a major cause of morbidity and mortality in patients with systemic lupus erythematous (SLE), accounting for 30~50% of all death. Because infection appears in various forms in lupus patients, early detection and appropriate treatment is very important. In the case of diffuse infiltration in the whole lung field, we should make a differential diagnosis with drug-induced pneumonitis, interstitial lung disease and pneumonia caused by atypical microorganism infection. In particular, in case of atypical microorganism pneumonia, we usually suspect cytomegalovirus, pneumocystis jiroveci and ebstein-barr virus, but influenza pneumonia is relatively neglected. Here, we report on the case of a 26-year-old female patient with lupus nephritis who presented with dyspnea and diffuse pulmonary infiltration immediately after intravenous cyclophosphamide. She was diagnosed with primary influenza B pneumonia and successfully treated with oseltamivir.
Accounting ; Adult ; Communicable Diseases ; Cyclophosphamide ; Cytomegalovirus ; Diagnosis, Differential ; Dyspnea ; Female ; Humans ; Influenza, Human ; Lung ; Lung Diseases ; Lung Diseases, Interstitial ; Lupus Nephritis ; Oseltamivir ; Pneumocystis jirovecii ; Pneumonia ; Viruses

BACKGROUND: Kawasaki disease (KD) is an acute inflammation of middle-sized arteries such as the coronary artery. KD is an important disease due to its high mortality rate, which approaches 1-2% without appropriate treatment. Since the various mucocutaneous lesions of KD are related to the dermatologic field, dermatologists should take an interest in this disorder and understand the lesions. OBJECTIVE: To evaluate the characteristics of cutaneous lesions in Korean patients with KD. METHODS: A total of 919 patients with KD were assessed at the department of pediatric cardiology and dermatology, Myongji hospital between January 2006 and December 2010. RESULTS: Of the 919 patients, 566 (61.6%) were diagnosed with typical KD and 353 (38.4%) with atypical KD. KD was most frequent in the 4 year-old group (22.7%), and the ratio of male to female was 1.5:1. Among the mucocutaneous manifestations, erythema of the oropharyngeal mucosa (75.7%) occurred most frequently, followed by polymorphous trunk rash (41.7%), and changes of palms and soles (25.6%). A total of 606 patients (65.9%) with KD had associated diseases as follows: pneumonia (211 patients; 34.8%), pharyngotonsilitis (168 patients; 27.7%), gastroenteritis (132 patients; 21.8%), asthma (15 patients, 2.5%), atopic dermatitis (11 patients, 1.8%). CONCLUSION: Our study shows that change in the lips or oral cavity is the most common mucocutaneous manifestation in both classic and atypical KD. Also, morbiliform rash is the most common pattern of polymorphous rashes. Interestingly, erythema multiforme-like lesions occupied accounted for a considerable portion of KD cases compared to previous studies.
Arteries ; Asthma ; Cardiology ; Coronary Vessels ; Dermatitis, Atopic ; Dermatology ; Erythema ; Exanthema ; Female ; Gastroenteritis ; Humans ; Inflammation ; Lip ; Male ; Mouth ; Mucocutaneous Lymph Node Syndrome ; Mucous Membrane ; Pneumonia

Giant congenital melanocytic nevi (GCMN) are defined as melanocytic nevi that are greater than 20 cm in largest dimension at birth. GCMN is a relatively rare condition, affecting approximately 1 in 20,000 newborns. Patients with GCMN on the posterior axis and in the presence of many satellite nevi are associated with neurocutaneous melanosis. A 37-year-old female with mental retardation had dark brown nevi with hair on her back (paraspinal) and on her lower extremities. In addition, she has multiple satellite lesions distributed over her trunk and extremities. Herein, we present a case that demonstrates a relationship between CNS abnormality and multiple satellite nevus in GCMN patients with a review of the relevant literature.
Axis, Cervical Vertebra ; Extremities ; Female ; Hair ; Humans ; Infant, Newborn ; Intellectual Disability ; Lower Extremity ; Melanosis ; Neurocutaneous Syndromes ; Nevus ; Nevus, Pigmented ; Parturition

Methoxy polyethylene glycol-epoetin beta (Mircera(R), Roche), a third-generation erythropoiesis-stimulating agent (ESA) is known as a continuous erythropoietin receptor activator (CERA). In patients with anemia associated with chronic kidney disease (CKD), it is administered intravenously or subcutaneously. Treatment-related adverse events induced by methoxy polyethylene glycol-epoetin beta occurred in 6%. Hypertension, diarrhea and nasopharyngitis were the most commonly reported adverse events. Cutaneous adverse reactions are rarely experienced with methoxy polyethylene glycol-epoetin beta including maculopapular eruption, facial erythema, and tinea pedis. To the best of our knowledge, no cases of leukocytoclastic vasculitis associated with methoxy polyethylene glycol-epoetin beta have ever been published in medical literature. Herein, we report on a case of leukocytoclastic vasulitis induced by methoxy polyethylene glycol-epoetin beta in a patient with anemia associated with chronic kidney disease.
Anemia ; Diarrhea ; Erythema ; Erythropoietin ; Humans ; Hypertension ; Nasopharyngitis ; Polyethylene ; Polyethylene Glycols ; Receptors, Erythropoietin ; Renal Insufficiency, Chronic ; Tinea Pedis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous