The vagina is an infrequent site of primary sarcomas, which are less than 2% of all malignant vaginal neoplasm. The most common malignant mesenchymal tumor of the vagina is rhabdomyosarcoma, but leiomyosarcoma is rare type tumor of the vagina. Microscopically, spinle cells with pleomorphic nuclei and mitotic figures were frequently noted, but cross-striations were not found in the tissue. Alpha-smooth muscle actin and desmin were positive, but sarcomeric actin was negative in the tumor cells. The authors report a case of primary leiomyosarcoma of the vagina with brief literature review.
Actins ; Desmin ; Leiomyosarcoma* ; Rhabdomyosarcoma ; Sarcoma ; Vagina* ; Vaginal Neoplasms

No abstract available.

We report here two cases of foreign body granulomas that arose from the pelvic wall and liver, respectively, and simulated recurrent colorectal carcinomas in patients with a history of surgery. On contrast-enhanced CT and MR images, a pelvic wall mass appeared as a well-enhancing mass that had invaded the distal ureter, resulting in the development of hydronephrosis. In addition, a liver mass had a hypointense rim that corresponded to the fibrous wall on a T2-weighted MR image, and showed persistent peripheral enhancement that corresponded to the granulation tissues and fibrous wall on dynamic MR images. These lesions also displayed very intense homogeneous FDG uptake on PET/CT.
Adult ; Aged ; Colorectal Neoplasms/pathology/*surgery ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Fluorodeoxyglucose F18/diagnostic use ; Granuloma, Foreign-Body/complications/*diagnosis ; Humans ; Hydronephrosis/etiology ; Image Enhancement/methods ; Liver/pathology/radionuclide imaging ; Liver Neoplasms/*diagnosis/secondary ; Magnetic Resonance Imaging ; Male ; Pelvic Neoplasms/*diagnosis/secondary ; Pelvis/pathology/radiography ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed

Anthracosis is a very common disease of the bronchus, while anthracosis of the gastrointestinal tract is extremely rare. Only a few cases of anthracosis of the esophagus have been reported and no cases of anthracosis of the terminal ileum are known, except one patient in Korea who was described as having melanosis ilei. A black pigmented lesion was detected in the terminal ileum on colonoscopic examination of a 51-year-old woman. Histological examination revealed a pigmented lesion beneath the mucosal epithelial layer and lymphoid follicular hyperplasia. The lesion consisted of an aggregation of histiocytes containing abundant tiny black pigments. She has taken oral charcoal for 7 years. We diagnosed anthracosis of the terminal ileum caused by oral charcoal and report a case of charcoal-induced anthracosis of the terminal ileum.
Anthracosis ; Bronchi ; Charcoal ; Esophagus ; Female ; Gastrointestinal Tract ; Histiocytes ; Humans ; Hyperplasia ; Ileum ; Korea ; Melanosis ; Middle Aged

Candesartan and olmesartan are angiotensin II receptor blockers (ARBs) used for the treatment of hypertension and heart failure. Quantitation methods for candesartan and olmesartan were developed using ultra-high performance liquid chromatography-tandem mass spectrometry following protein precipitation. Candesartan was separated using 5 mM ammonium formate (A) and 100% acetonitrile (B) and olmesartan was separated using 2 mM ammonium formate with 0.1% formic acid (A) and 100% acetonitrile (B). Separation was performed using an isocratic method with a Thermo hypersil GOLD C18 column. Electrospray ionization was used for analyte ionization and detection of candesartan, olmesartan, and the internal standards by multiple reaction monitoring. Developed method showed excellent linearity (r > 0.99) in the concentration range of 2–500 ng/mL for candesartan and 5–2,500 ng/mL for olmesartan. were 86.70–108.8% for candesartan and 87.87–112.6% for olmesartan. These methods were able to successfully measure plasma candesartan or olmesartan concentrations in hypertensive patients. This study can be used for pharmacokinetic studies of candesartan or olmesartan in humans.

BACKGROUND: To determine the needs of medical service system for mass-gathering event. We analyzed the process of delivered medical care system and types of medical problems of 1999 Winter Asian Games thus we are able to provide the basic data for planning future events. METHODS: We surveyed the organizing system of 1999 Winter Asian Game such as the operating system, medical goods, equipments, and overall patient status created at the medical room by retrospective chart review form 31st January to 6th February. RESULTS: The medical room were operated at two athletic villages and six game grounds. The medical rooms of athletic villages were operated by doctors, nurses, pharmacists, and EMTs and the rooms at the game grounds were operated by a doctor and a nurse. the medical goods and equipments for minor patients were satisfied, but those for critical patients were not satisfied. Most of the patient visited the medical rooms, had minor symptoms or musculoskeletal injuries. The symptom complex of the upper respiratory infection was the most commonly complained symptom(250 patients), followed by the gastrointestinal symptoms(200 patients) and musculoskeletal injuries(168 patients). However there was also a patient with acute myocardial infarction who required medically critical management including oxygen supplement, EKG monitoring, and transfer to a specialized medical center. The oral medications(581 patients), bandages and dressings(35 patients), physical therapies(25 patients), eyedrops(23 patients), and injections(21 patients) were supplied to the patients. CONCLUSION: The organized medical care was mainly prepared by the administration. The management for minor patients was satisfied, but of the critical patients was not satisfied.
Asian Continental Ancestry Group* ; Bandages ; Electrocardiography ; Humans ; Myocardial Infarction ; Oxygen ; Pharmacists ; Retrospective Studies ; Sports

BACKGROUND: It is important for the medical providers who work in the emergency department to ave the adequate knowledge about the nature and the ways to deal with the patients who suffer from domestic violence because in our country the management of them is primarily performed at the emergency centers. The purpose of this study is to provide basic data about the domestic violence and to help in developing the education and management model for the medical providers. METHODS: The authors retrospectively reviewed the medical records of 198 patients who visited the emergency center of Chunchon Sacred Heart Hospital from July 1997 to August 1998. RESULTS: The violence against the spouses was highest(108 cases:54.5%) and most of the victims were female(92%) in those cases. The violence against children younger than age 3 was 30%. The majority of the victims were arrived around noon(54.5%) and among them, the aged and children were more concentrated. The degree of injury was severer than that of the victims of general violence. CONCLUSION: In this study the violence against the spouses was the highest in incidence and against the aged was the lowest. The violence rate against children younger than age 3 was lower than that of other comparable studies. The incidence of sexual violence was significantly lower than that of other countries. The degree of injury was generally severer than that of general violence patients. But these result should be carefully criticized and accepted because up to now the system for the detection and management for them is not well established.
Child ; Domestic Violence* ; Education ; Emergencies* ; Emergency Service, Hospital* ; Gangwon-do ; Heart ; Humans ; Incidence ; Medical Records ; Retrospective Studies ; Sex Offenses ; Spouses ; Violence

BACKGROUND: To develop the guidelines and the education models for primary agents caring for victims of child abuse, and investigate victims of child abuse visited the department of emergency medicine, College of Medicine, Hallym University, Choon-chun Sacred Heart Hospital. METHODS: Survey assessed the age, sex, visiting time, offender tools of maltreatment, types of maltreatment, and types of injury of 47 victims under 18 years old visited the emergency center, between the Jul. 1996 and the Aug. 1998. The injury severiy of victims of child abuse was compared with control group of 197 general violence victims visited the same emergency center at the same duration. RESULTS: The age distribution was 12.8%(n=6) of the 0-1 year old, 17%(n=8) of the 1-3 years old, 8.5%(n=4) of the 4-6 years old, 12.8%(n=6) of the 7-12 years old, and 48.9%(n=23) of over the 13 years old. The sex distribution was 49%(n=23) of male and 51%(n=24) of female. The most common visiting time was 59.6%(n=28) of the 22-02 o'clock. The types of abuse were 46.6%(n=22) of the physical abuse, 27.7%(n=13) of the neglect, 17%(n=8) of the psychic abuse, and 8.5%(n=4) of the sexual abuse. The offender was 38%(n=18) of the parents, 26%(n=12) of the relatives, 4.3%(n=3) of the grandmothers, and 6.4%(n=3) of the nurses. The severity of injury was applied to the ISS(injury severity score). The severity of injury according to ISS was mean ISS=3.82+/- 2.2 in the case of child abuse and mean ISS=1.86+/-1.6 in the case of general violence(P=0.000). CONCLUSION: Most victims of child abuse still never come to the overt attention of physicians, social workers, or other professionals. Therefore the establishment of CAN(Child abuse and neglect) protocol and the organization of CAN team in the hospital consisted by department of emergency medicine, pediatrics, and psychiatrics is essential. Furthermore, the co-operation system with child welfare facilities and polices in community is needed.
Adolescent ; Age Distribution ; Child ; Child Abuse* ; Child Welfare ; Child* ; Criminals ; Education ; Emergencies ; Emergency Medicine ; Female ; Heart ; Humans ; Male ; Parents ; Pediatrics ; Sex Distribution ; Sex Offenses ; Social Workers ; Violence

Campylobacter jejuni isolates from diarrhea patients and chickens in 2008 in Iksan, Korea were tested for biochemical characteristics, and for possession of genes hipO, mutated gyrA, and cdtB. Among the chickens tested 52% carried C. jejuni. All 28 patient isolates and 48 chickens isolates had typical biochemical characteristics, except for nalidixic acid resistance. All isolates from patients and chickens were resistant to ciprofloxacin, and had mutated gyrA gene indicating good correlation of the two tests. Analysis of pulsed-field gel electrophoresis (PFGE) pattern of SmaI-restricted DNA of 53 isolates showed 14 clusters. Twenty-eight patient isolates and two chicken isolates (57%) showed an identical pattern (cluster 9). Chicken isolates C37 and C48 (cluster 2), C31 and C33 (cluster 3), C29, C34, C35, and C36 (cluster 4), and C43, C44 (cluster 6) had identical patterns. All patient isolates, compared to 87% and 80% of chicken isolates, were susceptible to amikacin and chloramphenicol, respectively. Antibiotics with the lowest MIC90 were imipenem, gentamicin, and erythromycin, whereas, those with the highest were ampicillin and tetracycline. In conclusion, C. jejuni carriage rate of chickens in Iksan, Korea, was high, all 28 isolates from patients and two from chickens were an identical clone, whereas isolates from patients and remaining chickens were different clones with only 62% similarity, all isolates had hipO and cdtB genes, and all isolates were resistant to ciprofloxacin.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Bacterial Toxins ; Campylobacter ; Campylobacter jejuni ; Chickens ; Chloramphenicol ; Ciprofloxacin ; Clone Cells ; Diarrhea ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Erythromycin ; Genotype ; Gentamicins ; Humans ; Imipenem ; Korea ; Nalidixic Acid ; Tetracycline

A 65 year-old female was suddenly expired soon after arriving in emergency room. Before arriving, she complained chest discomfort. Her neck mass was diagnosed as thyroid tumor about 11 years ago. She was recommended operation, but not taken due to arrhythmia. The neck mass was originally diagnosed as thyroid mass(goiter) by radiologic studies. The mass (10.5 x 9.5 x 7.0 cm, 319 gm) is mainly located in the lower neck and partly in the anterior superior mediastinum. The trachea is compressed by the mass and its tubal structure is flattened. The cause of death is mechanical asphyxia by thymoma(type B1 according to the WHO classification of thymoma, and stage I according to Masaoka's classification). On review of her past history, paraneoplastic syndrome including myasthenia gravis is not present. Generally, the patient with large thymic mass shows symptoms including chest pain, respiratory difficulty, hemoptysis, cough, superior vena cava syndrome. Although the symptoms related with its mass effect are common, but the death from mechanical asphyxia by thymoma is very rare in recent days.
Aged ; Arrhythmias, Cardiac ; Asphyxia* ; Cause of Death ; Chest Pain ; Classification ; Cough ; Emergency Service, Hospital ; Female ; Hemoptysis ; Humans ; Mediastinum ; Myasthenia Gravis ; Neck ; Paraneoplastic Syndromes ; Superior Vena Cava Syndrome ; Thorax ; Thymoma* ; Thyroid Gland ; Trachea