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

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

No abstract available.
Caloric Tests*

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

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: As a sedative hypnotic agent, etomidate has a little side effect like respiratory depression and has an excellent pharmacokinetics and hemodynamics. The objective of this study is comparison of etomidate effect in the two groups, only lidocaine injection group and combinational administration group, during closed thoracostomy in the emergency department. METHODS: The patients with respiratory problems, which needed a closed thoracostomy, from March 1, 2003 to February 29, 2004 were enrolled in this prospective study. Thus, we were enrolled 68 patients. etomidate were used for 34 patients and only lidocaine local injection was used for 34 patients. Patients of combinational administration were randomized to receive intravenous boluses of etomidate (0.2 mg/kg) prior to fentanyl (1.0 ug/kg) during PSA (procedural sedation anesthesia). We recorded pre-administration and interval of 5 minute, 10 minute, 15 minute and transcutaneous oxygen saturation, heart rate, respiratory rate, blood pressure, degree of sedation, satisfaction of sedation, and side effects after administration. RESULTS: Of all combinational administration group, significant hemodynamic, as hypotension or bradycardia etc. and respiratory depression, as apnea or tachypnea etc. were absent. With comparison of two groups, significant clinical problems and statistics were not different and degree of sedation was fast and impaired conscious was effective in the combinational administration group. CONCLUSION: We conclude combinational administration with etomidate and fentanyl during procedural sedation is safty and excellent effectiveness. Therefore we recommened the use of etomidate for emergency procedural sedation in emergency department.
Apnea ; Blood Pressure ; Bradycardia ; Emergencies ; Emergency Service, Hospital ; Etomidate* ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Hypnotics and Sedatives* ; Hypotension ; Lidocaine ; Oxygen ; Pharmacokinetics ; Prospective Studies ; Respiratory Insufficiency ; Respiratory Rate ; Tachypnea ; Thoracostomy*

PURPOSE: The aim of this study was to determine the epidemiology and risk factors associated with patients in a level I trauma center following fall injuries, and to define potential avenues for risk prevention. METHODS: The records of 186 patients admitted to the emergency department of Chosun University Hospital with a history of a fall from January 2004 to August 2006 were examined. Data were collected on each patient's age, sex, date of fall, the causea and height of fall, Galsgow Coma Scale (GCS), Revised Trauma Score (RTS), and previous history. Injuries were reviewed and Injury Severity Score (ISS) were calculated. RESULTS: Falls constituted 0.86% of total trauma patients. Among the 186 patients, 134 (72.0%) were male and 52(28.0%) were female, and the most common ages og fall patients were the thirties and forties, with a mean age of 41.73 years. The mean RTS was 11.15. Most falls were from a height of less than 6meters, with a mean height of 4.77 meters. One hundred sixty-four falls (88.2%) were accidental and 22 falls (11.8%) were from suicide attempts. The peak times for free falls were from 9 a.m. to 12 noon (n=44, 23.7%) and from 3 p.m to 6 p.m.(42, 22.6%). The most common fall injuries were cranial injuries (73, 39.2%), followed by spinal injuries (61, 32.8%)and extremity injuries (28, 15.1%). The median length of hospital stay was 25days (range 1-685days). The mortality rate was 9.14% (17 of 186). The average ISS was 12.06 (range 1-41), with a survivors' mean ISS of 11.37 and non-survivors' mean ISS of 17.92. CONCLUSION: The factors that significantly correlate with the Injury Severity for free fall patients are the height of fall, lower GCS or RTS score, intention of suicide, and hardness of impact surface (p<0.05). Patients most at risk can be more accurately identified in the emergency department through the development and implementation of educational programs.
Coma ; Emergencies* ; Emergency Service, Hospital* ; Epidemiology ; Extremities ; Female ; Hardness ; Humans ; Injury Severity Score ; Intention ; Length of Stay ; Male ; Mortality ; Risk Factors ; Spinal Injuries ; Suicide ; Trauma Centers

Hyponatremia is a condition of body fluid and electrolyte imbalance frequently encountered in clinical practice. However, treatment with small amounts of furosemide has in rare instances been reported to be associated with hyponatremia. We report a case of a 50-years-old woman who developed symptomatic hyponatremia after treatment for anaphylaxis and rhabdomyolysis resulting from snake bite. The woman was presented with hypotension and hypersensitivity induced by administration of antivenom after a snake bite. She was treated by fluid therapy and administration of epinephrine. One day after hospitalization, she complained of abdominal pain, and her myoglobin level and creatine phosphokinase concentration had increased. She was treated with hydration and urine alkalization. Renal failure and compartment syndrome were not complications of the clinical course. However, pleural effusion and ascites developed following fluid therapy. A small amount of furosemide was administered for treatment, and one day after administration, hyponatremia was found to have developed. The possibility of prescribing a small amout furosemide should be considered for patients who are treated with fluid therapy and require administration of antivenom for anaphylaxis and rhabdomyolysis resulting from snake bite.
Abdominal Pain ; Anaphylaxis* ; Ascites ; Body Fluids ; Compartment Syndromes ; Creatine Kinase ; Epinephrine ; Female ; Fluid Therapy ; Furosemide ; Hospitalization ; Humans ; Hypersensitivity ; Hyponatremia* ; Hypotension ; Myoglobin ; Pleural Effusion ; Renal Insufficiency ; Rhabdomyolysis* ; Snake Bites* ; Snakes*