Malignant acanthosis nigricans is very rare disease. The disease is related with internal malignancy, especially gastrointestinal tract malignancy. Reported occurrence rate of malignant acanthosis nigricans associated internal malignancies are 64% of stomach adenocarcinoma, 27% of other organs of abdomen (liver, gall bladder, small intestine, rectum, uterus, ovary), 9% of non-abdominal organs(breast, lung). We report a case of malignant acanthosis nigricans associated with stomach adenocarcinoma from 20-year-old female and discuss review of literature on a acanthosis nigricans briefly.
Female ; Humans ; Adenocarcinoma

Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins

No abstract available.

BACKGROUND: An epidemiologic study was performed after the outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit (MICU) from December 2006 to May 2007. METHODS: A retrospective case-control study was performed using the medical records of the patients. The case and control patients were compared for age, gender, total length of stay in MICU, prior carbapenem use, Acute Physiology and Chronic Health Evaluation II (APACH II) score, presence of central line, effect of mechanical ventilation, and sputum suction. Environmental and hand-washing studies were performed during the outbreak. RESULTS: Ten CRAB-affected patients and 29 controls were enrolled in this study. Univariate analysis showed that the age, total length of stay in MICU, presence of central line, and prior carbapenem use were associated with the CRAB outbreak. However, multivariate analysis showed that only prior carbapenem use was associated with the CRAB outbreak (odd ratio: 8.67, P=0.01). The outbreak disappeared after implementing a combined infection control strategy, including the sequential disinfection of MICU and strict compliance with cross-transmission prevention protocols. CONCLUSION: The use of carbapenem was associated with an increased risk of CRAB infection. This study suggests that the MICU contamination and infection transmission by health-care workers played a major role in the CRAB outbreak. Novel strategies such as restricted use of broad-spectrum antibiotics, strict hand hygiene, strict isolation of the patients, and MICU disinfection may be required to prevent the CRAB outbreak.
Acinetobacter ; Acinetobacter baumannii ; Anti-Bacterial Agents ; APACHE ; Case-Control Studies ; Compliance ; Disease Transmission, Infectious ; Disinfection ; Epidemiologic Studies ; Hand Hygiene ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Length of Stay ; Medical Records ; Multivariate Analysis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sputum ; Suction

The aim of this study was to evaluate the risk factors of recurrences after their first febrile convulsions in infants and young children. Dlinical studies were made on 187 cases of febrile convulsions who were admitted to the Department of pediatrics of wallace Memorial Baptist Hospital from March, 1990 to December, 1992. 1) 63 cases of 187 cases had recurrences after their febrile convulsions. Thus, the recurrence rate was 33.7%. 2) The male to female ratio was 2.1:1. And there were no significant differences in recurrence rates between sexes. 3) The recurrence rate was significantly higher in those whose initial febrile convulsions were developed before first 18 months of life than those whose initial convulsions were after 18 months of age (49.5% vs. 12.5%). 4) The time interval from initial attack to recurrence was within 12 months in 80% of cases. 5) Our study revealed that the seizure characteristics of the initial febrile convulsion are not important as predictive factors about the probability of recurrences. 6) Among the total 187 cases, family history were present in 52 cases (27.8%). And there were significantly higher recurrence rates if their families show the same history of febrile convulsion (63.5% vs. 22.2%). 7) The risk of recurrence was much higher in patients whose first febrile history of febrile convulsion at the same time.
Child ; Female ; Humans ; Infant ; Male ; Pediatrics ; Protestantism ; Recurrence ; Risk Factors ; Seizures ; Seizures, Febrile*

No abstract available.
Electrodes* ; Humans ; Infant, Newborn*

No abstract available.
Albuterol* ; Humans ; Infant* ; Ultrasonics*

No abstract available.
Larva ; Tick Bites*

Splenic abscess is uncommon, but often fatal entity characterized by high mortality rate which ranges from 60 to 100%, due to nonspecific clinical presentation and failure to preoperative definitive diagnosis. Clinical symptom or simple X-ray was not helpful in diagnosing splenic abscess. Perhaps the most useful information was obtained from the scanning and computerized tomography. Emphasis is placed on the necessity for prompt diagnosis and surgical intervention when splenic abscess was suspected. We have experienced three cases of splenic abscess. Case 1 was a 59 year-old male patient; the cause was possibly direct spreading from pancreatitis; The culture demonstrated klebsiella oxytoca. Case 2 was a 42 year-old female patient; the abscess was produced by preceding infarct. Case 3 was a 64 year-old female; metastatic adenocarcinoma was identified in the soft tissue around spleen, that suggest causative factor. All three cases showed multiple abscesses.
Female ; Male ; Humans ; Mortality ; Adenocarcinoma ; Neoplasm Metastasis

Splenic abscess is uncommon, but often fatal entity characterized by high mortality rate which ranges from 60 to 100%, due to nonspecific clinical presentation and failure to preoperative definitive diagnosis. Clinical symptom or simple X-ray was not helpful in diagnosing splenic abscess. Perhaps the most useful information was obtained from the scanning and computerized tomography. Emphasis is placed on the necessity for prompt diagnosis and surgical intervention when splenic abscess was suspected. We have experienced three cases of splenic abscess. Case 1 was a 59 year-old male patient; the cause was possibly direct spreading from pancreatitis; The culture demonstrated klebsiella oxytoca. Case 2 was a 42 year-old female patient; the abscess was produced by preceding infarct. Case 3 was a 64 year-old female; metastatic adenocarcinoma was identified in the soft tissue around spleen, that suggest causative factor. All three cases showed multiple abscesses.
Female ; Male ; Humans ; Mortality ; Adenocarcinoma ; Neoplasm Metastasis