We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 minutes, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography. Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Anaphylaxis ; Anti-Bacterial Agents ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Intensive Care Units ; Middle Aged ; Operating Rooms ; Renal Artery ; Ribs ; Stomach Neoplasms ; Survivors* ; Thorax ; Tomography, Spiral Computed

Epithelioid sarcoma is malignant tumor described by Enzinger, that is likely to be confused with a varety of benign and malignant conditions, especially a granulomatous process, a synovial sarcoma Or an ulerating squamous cell carcinoma. The tumor occurs chiefly in young adult and most commonly affects the soft tissue of the hand, the forearm and the pretibial region. The tumor is characteristically a slowly growing lesion but frequent recurrence is common and metastasis were most frequent in the lung. In this paper, we reported one case which is believed to be epithelioid sarcoma in the forearm.
Carcinoma, Squamous Cell ; Forearm ; Hand ; Humans ; Lung ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Sarcoma, Synovial ; Young Adult

PURPOSE: This study was done to identify the effectiveness of the 'intervention - mother's recorded song' on low-birth weight infants in an neonatal intensive care unit (NICU). METHODS: This study was conducted with a nonequivalent control group pre-posttest quasi-experimental design and the participant group was low-birth weight infants who were admitted to the NICU. Forty-eight infants, 24 in each from two groups, the experimental and control group, participated in the study. RESULTS: For physical response according to vital signs, there were no significant statistical differences in heart rate, respiration rate and pulse oximetry saturation between the experimental group and the control group. For behavioral state, there was a significant statistical difference between the experimental and control group. CONCLUSION: The study results indicate that the intervention using mother's song had some significance as a nursing intervention with positive impacts. Such an intervention can help pediatric nurses improve infants' stabilization of their vital signs and behavioral states. By showing the effectiveness of such an intervention, the results of this study provide further evidence-based information in developing the practice of pediatric nursing.
Heart Rate ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Clinical Trial ; Mothers ; Oximetry ; Pediatric Nursing ; Respiratory Rate ; Singing ; Vital Signs

No abstract available.
Blood Pressure* ; Body Mass Index*

Little objective information is avilable on the influence of occlusive dressings on the healing of cutaneous partial skin defect wounds. Our purpose was to examine the effects of occlusive dressing by using the synthetic dressing mateial, PolyMem in the management of 2nd degree burn wounds and donor sites of split thicknes skin graft and partial-thickness wounds in rabbits. New Zealand white rabbits, 12 to 14 weeks of age, were divided into 2 groups. Two partial thickness skin wounds measuring approximately 40x30 mm were induced using a scalpel on the back of each anesthetized animal. They were designated as group I (dressing with conventional method, n=15), group II (dressing with PolyMen, n=15). Each treated wound was individually covered with the assigned dressing immediately after wounding. Wound were examined and measured at 10 days to determine the extent of healing. By day 10, the PolyMem dressed wounds were approximately 67% healed, while all vaseline gauze dressed wounds were about 50% healed. Standardized 20 mm full-thickness biopsy wounds were treated for 10 days. Section of PolyMem group at POD 10 days showed complete epidermal regeneration above fibrotic dermis (H&E, x40). Section of conventional group at POD 10 days showed marginal epidermal regeneration (H&E, x40). 72 patients (44 patients with 2nd degree burn and 28 patients with skin graft donor sites) were divided into four groups. They were designated as group I (Burn patients with PolyMem, n=24), group II (Burn patients with conventional methods, n=24), group III (S.T.S.G. patients with PolyMem, n=14), group IV (S.T.S.G. patients with conventional methods, n=14). We investigated wound site pain, healing time, comfort and numbers of dressing change. As compared with the control group, the PolyMem dressed group had less pain, more rapid healing time, more comfort, less frequent dressing changes. From these results, we concluded that the occlusive dressing with PolyMem was an effective alternative to the conventional gauze dressig on the wound healing. Our results suggest tat PolyMem is one of the ideal dressing materials.
Animals ; Bandages ; Biopsy ; Burns ; Dermis ; Humans ; Occlusive Dressings ; Petrolatum ; Pheniramine ; Rabbits ; Regeneration ; Skin ; Tissue Donors ; Transplants ; Wound Healing* ; Wounds and Injuries*

Ovarian mature cystic teratoma containing benign prostatic tissue is rare and only 11 cases have been reported in the literature to date. We report a case of mature cystic teratoma of the ovary containing prostatic tissue. A 23-year-old female patient came to our hospital complaining of irregular menstruation for 3 months. Her menarche had occurred when she was 13 years old. The patient showed no evidence of virilization nor of endocrinopathy. A goose-egg-sized mass was palpable in the left lower abdomen on physical examination. Ultrasonography revealed a cystic ovarian mass with internal echogenecity. Microscopic finding was consistent with that of usual mature cystic teratoma except for a 1.5 cm focus of prostatic and bladder tissues. Prostatic tissue demonstrated strong immunoreactivity for prostatic specific antigen (PSA), prostatic alkaline phosphatase (PAP) and cytokeratin 7. Basal cells of the prostate glands were positive for high molecular weight cytokeratin (34betaE12). Although ovarian mature cystic teratoma containing prostatic tissue has been reported as a rare occurrence, a careful examination with immunohistochemical staining may increase the detection of prostatic tissue in mature cystic teratoma of the ovary.
Abdomen ; Adolescent ; Alkaline Phosphatase ; Female ; Humans ; Keratin-7 ; Keratins ; Menarche ; Menstruation ; Molecular Weight ; Ovary ; Physical Examination ; Prostate ; Teratoma* ; Ultrasonography ; Urinary Bladder ; Virilism ; Young Adult

No abstract available.

The incidence of ectopic pregnancy is a marked increase in both the absolute number and rate in recent years. But dramatic decrease in death from ectopic pregnancies probably due to improved diagnosis and management. The aim of the study was to investigate the effect of intramuscular Methotrexate(MTX) injection on the treatment of ectopic pregnancy. The method of the study was made by the retrospective clinical observations on the 32 cases of unruptured ectopic pregnancies in Chung Goo Sung Sim hospital, department of Obstetrics & Gynecology. The results were as follows: 1) The most frequent age group was 25-29 year group(37.5%). 2) Nullipara was 31.3% and the case who experienced artificial abortion was 75%. 3) A previous history of abdominal or pelvic surgery was in 40.6% and pelvic inflammatory in 6.3%. 4) The mean ectopic gestational week was 6.4 weeks, 5) On symptomatological analysis, lower abdominal pain was encounted 53.1%, vaginal spotting was 40.6%. 6) The resolution of patients was obtained in 29 cases(90.6%)of 32 unruptured tubal pregnancies with intramuscular methotrexate treatment. 7) The mean resolution duration was 23.8 days. 8) The side effects of methotrexate were observed in 10 cases(31.2%)of 32 unruptured tubal pregnancies, but the severity of symptoms was mild. Consequently, tveatment by intramuscular injection of MTX expects to be one of the therapies alternating to surgery. However success rate remained 90.6% with and toxicity rate 31.2% with MTX injection. Therefore patients selection criteria and MTX dosage adjustment are more stricdy required for rising success rate and avoidance of toxic complication.
Abdominal Pain ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Injections, Intramuscular ; Methotrexate* ; Metrorrhagia ; Obstetrics ; Patient Selection ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies

T cell lymphoblastic lymphoma is characterized by immature lymphoid cells that are indistinguishable from the lymphoblasts and prolymphocytes of acute lymphoblastic leukemia. Several characteristic clinical features of lymphoblastic lymphoma, with include a high male-to-female ratio, a relatively high incidence in older children and young adults, the frequent presence of mediastinal involvement at the time of diagnosis. Also, this disease is rapidly progressive, and early dissemination to the bone marrow, blood, and central nervous system leads to the evolution of a picture resembling a acute lymphoblastic leukemia. We have experienced a rare case of congenital T-cell lymphoblastic lymphoma in which 1/365 year old female newborn had generalized multiple irregular protruding mass on her body. On bone marrow biopsy, CSF analysis, ultrasonogram and whole body MRI studies. We found metastasized tumor mass to, orbit, abdominal cavity, bulva, skin, and lower extremities. Histopathologically, specimen from mass on the right thigh showed diffuse infiltration of poorly differentiated and immature lymphoid cells in the skelectal muscle and subcutaneous soft tissue. By immunophenotyping studies using anti T cell and B cell monoclonal antibody, these cells were reactive with UCHL-1, MB2, but unreactive with MB1, L26. Based on these findings, the lesion was diagnosed as lymphoblastic lymphoma of the T-cell type, which occurred congenitally. Most T cell lymphoblastic lymphoma are noted, but congenital case was not reported. So we report it with a brief review of literature.
Abdominal Cavity ; Biopsy ; Bone Marrow ; Central Nervous System ; Child ; Diagnosis ; Female ; Humans ; Immunophenotyping ; Incidence ; Infant, Newborn ; Lower Extremity ; Lymphocytes ; Magnetic Resonance Imaging ; Orbit ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Skin ; T-Lymphocytes ; Thigh ; Ultrasonography ; Young Adult

Placental site nodules and plaques have been recently described to designated single or multiple, well-circumscribed, rounded lesions at the placental site, composed of viable or degenerating intermediate trophoblastic cells and extensive hyalinization between the cells. We described clinicopathologic findings of 14 cases of placental site nodules and plaques. The age of 14 patients ranged from 25 to 39(average 33) years and all of them had been pregnant in the past. Ten of them presented with vaginal spotting, which was preceded by recent pregnancy in only 3 cases. Three patients presented with secondary infertility and one with secondary infertility and vaginal spotting. Urine pregnancy tests were negative in all 14 cases at the time of presentation. Ultrasonographic examination disclosed abnormalities in only 3 cases and the remaining cases were normal. Hysterosalpingography was performed in 3 patients who presented with 2 degrees infertility and revealed moderate to severe intrauterine adhesions. Microscopically, chronic endometritis of varying degrees evidenced by plasma cells and eosinophiles were present in all cases and these were more prominent in the vicinity of the lesions. It is presumed that the placental site nodules and plaques are not sloughed at the time of menstruation and it may cause chronic endometritis or intrauterine adhesions at any time after previous delivery.
Pregnancy ; Female ; Humans