The pleomorphic adenoma is the most common neoplasm involving both the major and minor salivary glands. It is a benign, slowgrowing tumor, but local recurrences can occur. The pleomorphic adenoma gene 1 (PLAG1), which is a novel zinc finger gene, is frequently activated by reciprocal chromosomal translocations involving 8q12 in a subset of salivary gland pleomorphic adenomas. This experimental study was preformed to observe the translocation patterns between PLAG1 gene and the three translocation partner genes. We also have analyzed the presence of PLAG1 transcripts by RT-PCR. CTNNB1/PLAG1 gene fusion was observed in three of nine pleomorphic adnomas. However, LIFR/PLAG1 and SII/PLAG1 gene fusions were not detectable. All of three gene fusions was not detectable in one Warthin's tumor and three inflammatory salivary gland tissues. PLAG1 transcripts were expressed in all inflammatory salivary gland tissues and tumors except for three pleomorphic adenomas. Of particular one pleomorphic adenoma showing CTNNB1/P AG1 gene fusion did not express PLAG1 transcipt. Our data indicate that gene fusion involving PLAG1 is a frequent event in pleomorphic adenoma, but correlation between gene fusion involving PLAG1 and PLAG1 transcription is not definite.
Adenoma, Pleomorphic* ; Gene Fusion ; Recurrence ; Salivary Glands* ; Salivary Glands, Minor ; Translocation, Genetic ; Zinc Fingers

The pubic louse, Pthirus pubis is a blood-sucking ectoparasite adapted to hold onto pubic, axillary and body hairs. It is usually confined to the pubic and inguinal region. However, it may also rarely involve the scalp and eyelashes. We report two cases of phthiriasis occurring on unusual sites, the first case occurring on the scalp of a 5 month-old male infant, and the second case on the eyelashes of a 49-year-old fe-male.
Eyelashes ; Hair ; Humans ; Infant ; Male ; Middle Aged ; Phthiraptera ; Scalp

Ankylosing spondylitis is a chronic inflammatory disease of unknown etiology that affects spine, sacroiliac joint, and the large joints of the extremities, and lead to fibrous or bony ankylosis and deformity. The rigid ankylosed spine of ankylosing spondylitis is prone to fracture by minimal trauma, and the resulting fractures likely to be unstable and damage to spinal cord or cauda equina. The authors report a case of paraplegia in ankylosing spondylitis after open reduction of the femoral trohanteric fracture.
Ankylosis ; Cauda Equina ; Congenital Abnormalities ; Extremities ; Femur ; Joints ; Paraplegia ; Sacroiliac Joint ; Spinal Cord ; Spine ; Spondylitis, Ankylosing

No abstract available.
Caloric Tests*

Polyarteritis nodosa (PAN) is a necrotizing angitis that predominantly affects small-and medium-sized arteries in which microaneurysm or occlusion of the visceral arteries can be seen by arteriography. Patients with PAN may have non-specific symptoms at the beginning of their illness, but progression can be sudden and result in severe, even life threatening, complications. These include central nervous system hemorrhages, gastrointestinal hemorrhages or perforation, acute appendicitis, liver infarcts, acute renal failure, renal perirenal hematomas, and cardiac failure. A diagnosis of PAN should be considered when multiple small-sized aneurysms are detected by angiography, even if a biopsy is negative. Involvement of gastrointestinal and renal arteries is frequent in polyarteritis nodosa. The most common complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. Another rare but potentially life-threatening complication is perirenal hematoma caused by spontaneous rupture of renal aneurysm. Because of this possibility, rapid evaluation of these patients is necessary to make early diagnosis and treatment possible. We describe an extremely rare case of polyarteritis nodosa with development of spontaneous perirenal hematoma due to rupture of renal aneurysm, which was evaluated with immediate angiography and treated by coil embolization.
Acute Kidney Injury ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Appendicitis ; Arteries ; Biopsy ; Central Nervous System ; Cholecystitis ; Diagnosis ; Early Diagnosis ; Embolization, Therapeutic ; Emergencies* ; Emergency Service, Hospital* ; Gastrointestinal Hemorrhage ; Heart Failure ; Hematoma ; Hemorrhage ; Hepatitis ; Humans ; Infarction ; Liver ; Polyarteritis Nodosa* ; Renal Artery* ; Rupture* ; Rupture, Spontaneous ; Ulcer

Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated as well with the demyelination of extrapontine areas of the central nervous system. Although the etiology and pathogenesis are unclear, CPM is usually associated with states such as too rapid correction of hyponatremia, alcohol intoxication, malnutrition, liver disease, burn, cancer, addison's disease, dehydrated disease, and electrolyte imbalance. Clinical presentations are nonspecific but are typically characterized by confused mentation, bulbar or pseudobulbar palsy (dysarthria, dysphagia, tetraplegia), rock-in syndrome, and common symptoms such as lethargy and dysarthria. Brain magnetic resonance imaging(MRI) in CPM results in diffuse high signal intensity in the pons on T2-weighted images, and shows slightly decreased signal intensity and no enhancement in the central pons on T1-weighted images. We described a case of a 30-year-old woman presenting with continuous nausea and vomiting in the 16th week of pregnancy. In order to achieve early diagnosis of CPM, We recommend that emergency physicians should consider CPM during differential diagnosis. Prompt diagnosis and management of associated complications are essential for favorable clinical outcomes in CPM.
Addison Disease ; Adult ; Brain ; Burns ; Central Nervous System ; Deglutition Disorders ; Demyelinating Diseases ; Diagnosis ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Emergencies ; Female ; Humans ; Hyponatremia ; Lethargy ; Liver Diseases ; Malnutrition ; Myelinolysis, Central Pontine* ; Nausea* ; Pons ; Pregnancy* ; Pseudobulbar Palsy ; Vomiting

No abstract available.
Tuberculosis, Laryngeal*

PURPOSE: Acute drug-intoxicated patients visiting the emergency room often develop pneumonia after emergency treatment. The purpose of this article is to investigate the risk factors associated with the development of pneumonia and to aid in the treatment of such patients. METHODS: 108 patients who visited the Chosun University Hospital emergency room from May 2002 through August 2004 for the treatment of acute drug intoxication were investigated retrospectively. RESULTS: In this study, 52(48.1%) of 108 patients developed pneumonia. The development of pneumonia was significantly higher in patients who were intoxicated with insecticide, were not alert, were hypotensive and apneic, vomiting, required artificial ventilation through intubation due to increased secretions patients. CONCLUSION: In acute drug-intoxicated patients, changes in consciousness, the amount of secretion and performed of endotracheal intubation are risk factors associated with an increased possibility of developing pneumonia. Careful inspection and observation are needed for acute drug-intoxicated patients with these risk factors.
Consciousness ; Emergency Service, Hospital ; Emergency Treatment ; Humans ; Intubation ; Intubation, Intratracheal ; Pneumonia* ; Retrospective Studies ; Risk Factors* ; Ventilation ; Vomiting

A patient who was transferred to our Emergency Medical Center from a local clinic with a dermatologic disorder of unknown origin presented to us with TEN with a 40% skin slough. The patient was a 53-year-old women with complaints of erythematous rash and blisters on her trunk and both proximal extremities. She had taken NSAIDS, 1300 mg per oral, every 8 h for 5 days. Five days after administration of NSAIDS began, the doctors at the local clinic noted that a rash with blisters had begun on her back and progressed to her extremities. After 4 days of that progression she came to us. On physical examination, she had asymptomatic multiple clear filled bullae and erosion with brown- to black-colored hyperpigmentation on her trunk and proximal extremities involving 40% of the body surface. She was admitted to a private room to prevent secondary infections, and her management included fluid replacement, third-generation cephalosporin and corticosteroid administration, and intensive wound care. Fifteen days after admission, no further treatment was required, and only a small scar and a mild dispigmentation lesion could be seen. Emergency department physicians should think about TEN if the patient has extensive exfolating skin lesions. Treatment of patients with suspected TEN must be directed at minimizing fluid and electrolyte loss and preventing secondary infection, and an effort should be made to identify the suspicious drug and to educate patient to avoid the drug.
Anti-Inflammatory Agents, Non-Steroidal ; Blister ; Cicatrix ; Coinfection ; Emergencies ; Epidermal Necrolysis, Toxic ; Exanthema ; Extremities ; Female ; Humans ; Hyperpigmentation ; Middle Aged ; Patients' Rooms ; Physical Examination ; Porphyrins ; Skin

PURPOSE: As medicine has progressed, the human average lifetime has increased. Thus the number of geriatric patients has increased and, in particular, the number of older drivers has increased. Mortality rates for older trauma patients are higher than those for any other age group, but little research has been done about the severity of injuries to older patients involved in vehicle accidents. This study evaluated a number of factors and correlations involving old driver trauma patients. METHODS: We prospectively analyzed clinical information on 155 trauma patients over 65 years of age who were involved in vehicle accidents and visited the emergency department of Chosun University Hospital between Jan 2007 and Aug 2008. The following variables were examined for their ability to predict severity of injury: age, gender, vital signs, and mechanism of injury along with the Glasgow Coma Scale (GCS), the Abbreviated Injury Scale (AIS), and the Injury Severity Score(ISS). We divided the ISS scores into three groups: mild (1~8), moderate (9~15), and severe(above 16). RESULTS: Most cases involved men (94.2%), and a majority involved agriculture (65.8%). The most common vehicle was the motorcycle (48.4%), and 51 (32.9%) patients were drunk at the time of the accident. Many had acquired their driver's licenses more than 30 years earlier (40.7%), and almost all of the patients (81.9%) never wore any safety devices. The patients who had multiple underlying diseases, coupled living type, low blood pressure at admittance, and more time since they had acquired their licenses scored higher on mean ISS than the other cases. CONCLUSION: Old trauma patients had more longer admission days, had longer recovery times, and received more expensive treatment. For the same level of trauma, they took longer to heal than younger patients and experienced higher rates of mortality. Therefore, when the old driver trauma patients visit the emergency department, doctors need to perform more careful studies and provide a higher level of critical care. To lessen the number of old driver trauma patients, we should educate older drivers about safe driving methods and about the use of safety device, and we should enforce traffic laws and laws about drinking and driving.
Abbreviated Injury Scale ; Agriculture ; Critical Care ; Drinking ; Emergencies ; Glasgow Coma Scale ; Humans ; Hypotension ; Jurisprudence ; Licensure ; Male ; Motorcycles ; Prospective Studies ; Protective Devices ; Vital Signs