We have recently encountered a case of Kasabach-Merritt syndrome which was characterized by hemangioma, thrombocytopenia, and Disseminated Intravascular Coagulation. The baby was delivered at 35 weeks gestation. A large hemangioma covered right forearm. He received interferon alfa-2a for 120 days after 20 day steroid treatment failure. Blood platelet count increased to acceptable range (>20,000/mm3) after 8weeks of interferon alfa-2alpha treatment and the size of hemangioma decreased.
Disseminated Intravascular Coagulation ; Forearm ; Hemangioma ; Interferons* ; Kasabach-Merritt Syndrome* ; Platelet Count ; Pregnancy ; Thrombocytopenia ; Treatment Failure

Onycholysis is defined as a distal or distal lateral separation of the nail plate from the underlying or lateral supporting structures including nail bed, hyponychium, and lateral nail fold. Trauma, infection, psoriasis, thyrotoxicosis, and numerous drugs are common causes of onycholysis. However, there are few specific data on nail findings in Behcet's disease (BD). In this paper, we report on a 60-year-old man with BD, with no past history except BD, who developed recurrent onycholysis. The symptoms of onycholysis are considered to be recurrent depending on the activity of BD. The nail lesion showed improvement after classic treatment of BD and topical steroid ointment.
Humans ; Middle Aged ; Onycholysis* ; Psoriasis ; Thyrotoxicosis

Here, we report a case of newly diagnosed diabetes, with concurrent pancreatic cancer manifested as hyperglycemic crisis, and aggravated by urinary tract infection. We summarize the initial clinical manifestations and pertinent laboratory, radiologic, and clinical findings in an elderly patient with hyperglycemic emergency. A review of the documents involving pancreatic tumors and hyperglycemic hyperosmolar state, which is an acute complication of diabetes mellitus, is presented. In the absence of other identifiable conditions, it is reasonable to speculate that some factor (or factors) produced by the tumor had a role in the metabolic decompensation. In addition, this discussion should be more carefully considered in the aged people group.
Aged ; Diabetes Mellitus ; Emergencies ; Humans ; Pancreatic Neoplasms ; Urinary Tract Infections

PURPOSE: The aim of this study was to examine the sensitivity and specificity of the influenza rapid antigen test, in comparison with reverse transcription polymerase chain reaction (RT-PCR), according to the time of the test from symptom onset and the clinical manifestations in the patients tested for suspected infection of the influenza A (H1N1) at a second hospital. METHODS: A total of 529 pediatric patients, aged between 6 and 12 years old, who visited the emergency department from October 1, 2009 to December 31, 2009, received the influenza rapid antigen test and RT-PCR. We examined the sensitivity and specificity of the influenza rapid antigen test in comparison with RT-PCR according to the time of the test from symptom onset (<24 hours, 24 to 48 hours, 48 to 72 hours, >72 hours) and clinical manifestations (fever, cough, rhinorrhea.nasal obstruction, sore throat, gastrointestinal symptoms, and general symptoms) in a retrospective study based on hospital charts. RESULTS: The sensitivity of the influenza rapid antigen test at elapsed times of less than 24 hours, 24 to 48 hours, and 48 to 72 hours after the onset of the symptoms was 53.9%, 61.4%, and 62.1% respectively. When the elapse time was greater than 72 hours, the sensitivity was 31.6%; thus, the sensitivity of the influenza rapid antigen test tended to decrease with elapsed time. The sensitivity of the test was 79% in patients presenting with gastrointestinal symptoms, which was the highest, but there was no statistical difference according to the clinical manifestations of the patients. CONCLUSION: Our study suggests that more accurate results might be gained when the influenza rapid antigen test is performed within 72 hours after symptom onset.
Aged ; Child ; Cough ; Emergencies ; Humans ; Influenza, Human ; Pharyngitis ; Polymerase Chain Reaction ; Retrospective Studies ; Reverse Transcription ; Sensitivity and Specificity

We present a series of 97 patients with spinal cord injury. Those patients were treated at Soonchunhyan University Chonan Hospital during six-year-period(January 1986-December 1992), and followed up for at least 3 months. They were divide into four groups ; complete-surgical, complete-conservative, partial-surgical, and partial-conservative. Male to female ratio was 3.6:1, and the peak age was the fifth decade. Passenger's traffic accident(46%) was the most common cause of injury and fall/slip(39%) followed next. Level of spinal injury was cervical in 51%, thoracic in 29%, lumbar in 13%, and others in 7%. Type of injury was fracture-dislocation in 31%, dislocation in 19%, compression fracture in 19%, burst fracture in 18%, cord injury without bony lesion in 7%, and others in 7%. Cord injury was complete in 36 patients(37%) and partial in 61 patients(63%). Surgery was performed in 20 patients with complete cord injury and 34 patients with partial injury. Majority of operations were performed for spinal stability, and posterior instrumentation was the most commonly used operative method. The mean neurotrauma motor index on admission was 44.1 in the complete-surgical group, 39.5 in complete-conservative group, 70.1 in partial-surgical group, and 63.2 in partial-conservative group. It improved to 52.5, 50.3, 90.4, 80.3 at 3 months, and 53.4, 51.7, 91.8, 82.0 at final examination(mean follow-up period was 182.2 days), respectively. The mean values of the final index were higher in the surgically treated groups than the conservatively treated groups, but these differences were not statistically significant(student t-test p>0.1) The mean recovery rate was 14.2% in the complete-surgical group, 17.7% in complete-conservative group, 66.1% in partial-surgical group, and 46.1% in partial-conservative group at 3 months. It improved to 16.6%, 19.3%, 70.0%, and 48.7% at final examination, respectively. The mean recovery rates were higher in the partially injured groups than the completely injured groups(student t-test, p<0.01), regardless the methods of treatment. The final neurotrauma motor index was significantly(regression analysis, p<0.01) related to the initial index except the partial-surgical group. Neurotrauma motor index was a useful method for assessing the injury severity, comparing the recovery rate and predicting prognosis.
Chungcheongnam-do ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Prognosis* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

A phytobezoar is the most common type of bezoar, which is a gastrointestinal mass composed of vegetable. A persimmon is a common cause of a phytobezoar. The majority of bezoars are found in the stomach, with the small intestine being the next most commonly involved site. The colon is a rare site for a bezoar. Recently, we experienced a colonic bezoar that caused colonic obstruction in a 66-year-old female patient who took persimmons regularly. The patient came to the hospital because of abdominal pain and distension. To differentiate a tumor or other problems that can cause intestinal obstruction, we performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal descending colon. A large impacted bezoar was seen in the sigmoid colon, which was completely obstructed, and it was successfully removed by using colonoscopy.
Abdominal Pain ; Aged ; Bezoars ; Colon ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Diospyros ; Female ; Humans ; Intestinal Obstruction ; Intestine, Small ; Porphyrins ; Stomach ; Vegetables

The percutaneous endoscopic gastrostomy is used for nutritional support in patients requiring prolonged tubal feeding. Unfortunately, numerous complications, such as infection, stomal leak, fever, local pain, ileus and tube occlusion, have been reported since its introduction. The buried bumper syndrome is a rare but well-recognized long-term complication. The tight anchorage between the internal and external bumpers leads to gastric mucosal erosion and embedding of the internal bumper into the gastric wall, obstructing feeding. Our case involves an elderly patient with a buried bumper syndrome complicated by an abdominal wall abscess. A similar case has not been reported in Korea before. This article reports our findings and management with a review of the literature.
Abdominal Wall ; Abscess ; Aged ; Fever ; Gastrostomy ; Humans ; Ileus ; Korea ; Nutritional Support

To investigate the properties of ryanodine binding sites of the bird skeletal SR vesicles, SDS PAGE, purification of RyR, and (3H)ryanodine binding study were carried out in the SR vesicles prepared from the chicken pectoral muscle. The chicken SR vesicles have two high molecular weight (HMW) protein bands as in eel SR vesicles on SDS PAGE. The HMW bands on SDS PAGE were found in the (3H) ryanodine peak fraction (Fr3-5) obtained from the purification step of the ryanodine receptor protein. Bmax and KD of the chicken (3H)ryanodine binding sites were 12.52 pmol/mg protein and 14.53 nM, respectively. Specific (3H)ryanodine binding was almost maximal at 50~100 micrometer Ca2+, but was not increased by 5 mM AMP and not inhibited by high Ca2+. Binding was significantly inhibited by 20~100 micrometer ruthenium red and 1 mM tetracaine, but slightly inhibited by Mg2+. From the above results, it is suggested that chicken SR vesicles have the ryanodine binding sites to which the binding of ryanodine is almost maximal at 50~10 micrometer Ca2+, is significantly inhibited by ruthenium red and tetracaine, slightly inhibited by Mg2+, but not affected by AMP and not inhibited by high Ca2+.
Binding Sites* ; Birds ; Chickens* ; Eels ; Electrophoresis, Polyacrylamide Gel ; Molecular Weight ; Ruthenium Red ; Ryanodine ; Ryanodine Receptor Calcium Release Channel ; Sarcoplasmic Reticulum ; Tetracaine

BACKGROUND AND OBJECTIVES: The idiopathic sudden sensorineural hearing loss (ISSHL) is a disease occurring instantly or developing over several days. An etiological role for virus families is assumed. Corticosteroids improve the prognosis for hearing recovery in ISSHL, but the effects of acyclovir are still uncertain. The purpose of this study is to evaluate the therapeutic efficacy of antiviral drug acyclovir (Zoylex) in ISSHL. MATERIALS AND METHODS: One hundred thirty four ears were divided into a study (41 ears, using acyclovir and steroid) and a control (93 ears, using steroid only) groups. Prognostic factors such as initial hearing loss, pattern of initial audiogram, coexistence of dizziness or tinnitus were used for parameters of comparison between two groups. RESULTS: The overall recovery rate of the study group (53.7%) was better than that of the control group (46.2%), but it was not statistically significant (p>0.05). The recovery rate of the study group was better than that of the control group on some prognostic factors, especially the period between the symptom attack and the beginning of treatment: however, there were no statistically significant differences either (p>0.05). CONCLUSION: Therefore, no beneficial effects from combining acyclovir with prednisolone could be established in ISSHL.
Acyclovir ; Adrenal Cortex Hormones ; Deafness ; Dizziness ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Prednisolone ; Prognosis ; Tinnitus

A 59-year-old man treated with pneumococcal meningitis 4 months ago was hospitalized for acute heart failure and performed aortic valve replacement by rupture of aortic valve. The frequent association of pneumococcal meningitis and endocarditis is known as Austrian syndrome. Though Austrian syndrome is a clinically rare disease, the evolution of pneumococcal endocarditis is very aggressive and associated with high mortality, and early recognition for evidence of endocardial lesion in patients with pneumococcal meningitis is important to reduce the complications and mortality rate.
Aortic Valve ; Endocarditis ; Heart ; Heart Failure ; Humans ; Meningitis ; Meningitis, Pneumococcal ; Middle Aged ; Rare Diseases ; Rupture ; Streptococcus pneumoniae