PURPOSE: To compare the clinical characteristics and laboratory finding between adenoviral and group A streptococcal (GAS) pharyngitis. METHODS: A retrospective review of medical records was performed in the patients with adenovirus infection among those who were admitted for febrile respiratory disease from January 2011 to July 2013 and GAS pharyngitis among those who visited for symptoms of scarlet fever from August 2006 to July 2013. RESULTS: 179 patients (AV1 group) were diagnosed with adenoviral pharyngitis and 37 (AV2 group) of these patients had adenovirus single infection. 26 patients (GAS group) were diagnosed with scarlet fever. Adenoviral infection (AV2 group) developed in younger patients compared to GAS group (2.8+/-2.1 years vs. 5.4+/-1.8 years, P=0.000). Total durations of fever and admission were longer in AV2 (6.3+/-2.6 days vs. 3.3+/-1.9 days, P=0.000; 4.1+/-1.2 days vs. 1.9+/-1.8 days, P=0.000, respectively). WBC counts were higher in AV2 (11,449+/-5,680 cells/mm2 vs. 6,722+/-6,941 cells/mm2, P=0.000). CRP was not significantly different between AV2 and GAS group (3.8+/-3.2 mg/dL vs. 5.2+/-5.1 mg/dL, P=0.368). No difference was found between two groups in the percentage of antibiotics use (91.9% vs. 100%, P=0.261). CONCLUSION: Clinical characteristics and measures of inflammation in the laboratory findings were similar between adenoviral and GAS pharyngitis group. It is necessary to conduct the test for respiratory virus and bacteria in early stage to differentiate in the pharyngitis patients with leukocytosis and elevation of CRP level.
Adenoviridae ; Adenoviridae Infections ; Anti-Bacterial Agents ; Bacteria ; Child* ; Fever ; Humans ; Inflammation ; Leukocytosis ; Medical Records ; Pharyngitis* ; Retrospective Studies ; Scarlet Fever

Solitary fibrous tumors (SFTs) are rare mesenchymal tumors mainly originating in the pleura. Since complete resection is the most important prognostic factor, typical surgical approach has been open laparotomy. In this report, we present a unusual case of large retropancreatic SFT that was successfully treated via laparoscopic resection. A 22-year-old female was diagnosed with a 8×7 cm-sized well-demarcated mass with multiple loculating and enhancing solid portions on the left adrenal fossa. The mass showed no definite invasion of adjacent organs and laparoscopic resection was planned. Using blunt dissection and individual vessel ligation, the operation was successful. The operative time was 220 minutes, and the amount of intraoperative blood loss was estimated to be within 100 ml. The patient recovered without complications. Laparoscopic excision of large retroperitoneal SFTs can be safe and feasible if there is no evidence of local invasion or malignancy on preoperative radiologic images.
Female ; Humans ; Laparotomy ; Ligation ; Minimally Invasive Surgical Procedures ; Operative Time ; Pleura ; Retroperitoneal Neoplasms ; Solitary Fibrous Tumors* ; Young Adult

The need for a short-acting non-depolarizing neuromuscular blocking agent to replace succinylcholine chloride(succinylcholine) is recognized widely and attempts to find such a drug have been numerous. Atracurium besylate(atracurium) is one of the new series of neuromuscular blocking agents with little cardiovascular effect and is not dependent on hepatic and renal function for terminating its action because of its self-destroying mechanism. Because succinylchline may occasionally be contraindieated for intubation in parturients we studied the use of atracurium in 23 patients having cesarean section. All patients received 0. 5 mg/kg atracurium for intubation and neuromuscular relaxation. Hemodynamic changes, the time from the injection of atracurium to maximal twitch suppression, the time between atracurium administration and the return to 10% of control twitch height were recorded and observed the degree of vocal cord relaxation and conditions of intubation and evaluated the Apgar scores. 1) Mean arterial pressure and heart rate increased significantly after intubation compared with that of control and just before intubation but there were no significant changes in 5 minutes after intubation. 2) The 90% twitch suppression following atracurium administration was 75.6+/-20.9 seconds. 3) The return of 10% of control twitch height was 2449.3+/-1114.0 seconds. 4) Intubation conditions were excellent for 19 patients. 5) The Apgar scores of 20 neonates were high. These data suggest that the use of atracurium may be a useful alternative for induction for Cesarean section when succinylcholine is contraindicated.
Arterial Pressure ; Atracurium* ; Cesarean Section* ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pregnancy ; Relaxation ; Succinylcholine ; Vocal Cords

BACKGROUND: Although exact mechanism of adult respiratory distress syndorme (ARDS) is not known, many evidences suggest that inflammatory mediators such as protease and oxygen radicals may be the final common pathway to the endothelial injury. It is gradually accepted that activated neutrophils play a major role in the process. Pentoxifylline is a methylated xanthine with a wide range of actions that make it theoretically useful in the treatment of ARDS. Studies show that it decreases neutrophil phagocytosis and superoxied production. The aim of this experiment is to determine whether pentoxifylline has a preventive effect on oleic acid-induced lung injury. METHODS: Oleic acid (0.08 ml/kg) was infused in 10 mongrel dogs in order to induce acute lung injury. Pentoxifylline (20 mg/kg) was administered 40 mins before oleic acid injection. The author made a comparative studies on the effects of pentoxifylline on hemodynamics and gas exchange before oleic acid injection and at 15, 30, 45, 60, 90 mins after oleic acid injection. RESULTS: There were not significant changes in mean arterial pressure, cardiac output, systemic vascular resistence, pulmonary wedge pressure intrapulmonary shunt in both groups. There were statistical significance in arterial oxygen tension, pulmonary artery pressure, pulmonary vascular resistance between both groups (p<0.05). CONCLUSIONS: Pentoxifylline is a noteworthy drug that could be a candidate as a therapy to help prevent effect in lung injuries that share a common mechanism with oleic acid-induced lung injury.
Acute Lung Injury ; Adult ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs ; Hemodynamics ; Humans ; Lung Injury* ; Lung* ; Neutrophils ; Oleic Acid ; Oxygen ; Pentoxifylline* ; Phagocytosis ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reactive Oxygen Species ; Vascular Resistance ; Xanthine

No abstract available.
Neck*

Schwannomas are neurogenic tumors that arise from Schwann cells of the neural sheath. They are most often benign and solitary. Ancient schwannoma is a rare variant of schwannoma with a typical characteristics of a slow growing benign tumor. A case of ancient schwannoma which originated from the lingual nerve has not been reported in the literature yet. The clinical and histological aspects of this tumor are discussed and the literature regarding this rare entity is reviewed.
Lingual Nerve* ; Neurilemmoma* ; Schwann Cells

Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbock disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbock disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbock disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbock's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.
Arteries ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Osteonecrosis ; Range of Motion, Articular ; Transplants ; Wrist

PURPOSE: To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy. CASE SUMMARY: Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized. CONCLUSIONS: In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.
Anterior Chamber ; Aqueous Humor ; Blister ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Iridectomy ; Prolapse ; Trabeculectomy ; Vitrectomy

PURPOSE: To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy. CASE SUMMARY: Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized. CONCLUSIONS: In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.
Anterior Chamber ; Aqueous Humor ; Blister ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Iridectomy ; Prolapse ; Trabeculectomy ; Vitrectomy

Phendimetrazine is a medication currently being used to help patients with weight loss. It shares a chemical structure with amphetamines. As such, it shares some of the same toxicities, which can include psychosis. Two cases present good examples of phendimetrazine-induced psychotic disorder. A 30-year old female was admitted to emergency room with visual hallucination, auditory hallucination and aberrant behavior. Another 38-year old housewife was accompanied by her family to evaluate mood swing, auditory hallucination and behavioral change to psychiatric clinic. After evaluation in psychiatric ward, they were confirmed to have causal relation with prescription diet pills. These case reports demonstrate the potential dangers of amphetamine based diet pills. There have been several cases of cardiomyopathies and pulmonary hypertension related to phendimetrazine, but psychosis is something that is rarely recognized in an outpatient setting. Two cases showed the importance of obtaining a careful medication history in all patients and specially recognizing diet pills with an amphetamine base causing psychosis.
Amphetamine ; Amphetamines ; Cardiomyopathies ; Diet ; Emergencies ; Female ; Hallucinations ; Humans ; Hypertension, Pulmonary ; Morpholines ; Outpatients ; Prescriptions ; Psychotic Disorders ; Weight Loss