Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder and is essentially a disorder of capillary, venous, and lymphatic malformations. Hematochezia is the most common symptom associated with intestinal hemangiomatosis and remains one of the life-threatening emergencies in KTS. We reported one patient of KTS presented with rectal bleeding and severe anemia who was successfully managed by sphincter-saving operation.
Anemia ; Capillaries ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Emergencies ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Klippel-Trenaunay-Weber Syndrome

Emergency physicians often have to treat patients suffering from testicular pain. Testicular torsion is a critical disease which can, in the worst situation, require orchiectomy. Testicular torsion is more common among neonates and adolescents than adults, and there are very few adults reported to have testicular torsion. There are several cases of testicular torsion among adults aged 20 to 40. However, there have been almost no reports of patients with testicular torsion over the age of 50. Patients over the age of 50 have a greater possibility of a delayed diagnosis. Therefore, they also have a greater possibility of requiring an orchiectomy. In our case, 57-year-old male patient complained of testicular pain that developed during his sleep after golf practice. After exploratory surgery, he was diagnosed as having testicular torsion. In conclusion, emergency physicians should consider the possibility of testicular torsion when older adults complain of testicular pain. Also, patients who suffer from intermittent testicular pain show higher rates of developing testicular torsion.
Adolescent ; Adult ; Aged ; Delayed Diagnosis ; Emergencies ; Golf ; Humans ; Infant, Newborn ; Male ; Middle Aged ; Orchiectomy ; Scrotum ; Spermatic Cord Torsion ; Stress, Psychological

BACKGROUND:The present study aimed to determine whether there is a regulatory mechanism exerted by endogenous nitric oxide (NO) in the regulation of aquaporin (AQP) water channels in the kidney. METHODS:Male Sprague-Dawley rats were used. They were divided into 4 groups: 1) L-NAME group was treated with N(G)-nitro-L-arginine methyl ester (L-NAME, 100 mg/L drinking water) for 1 week, 2) indomethacin group was treated with indomethacin (5 mg/kg, twice a day, i.p.) for 2 days, 3) L-NAME/ indomethacin group was treated with L-NAME for 1 week in which indomethacin was cotreated for the last two days, and 4) control group was kept untreated. The abundance of AQP2 and AQP3 proteins was determined in the inner medulla of the kidney. RESULTS:The expression of AQP2 and AQP3 proteins was significantly decreased by indomethacin. L-NAME abolished the indomethacin-induced decreases of AQP channels, although it did not significantly affect the expression of AQP channels by itself. CONCLUSION:These results suggest that endogenous NO system, when stimulated, may downregulate the expression of AQP2 and AQP3 channels in the kidney.
Animals ; Aquaporin 3 ; Aquaporins* ; Down-Regulation* ; Drinking ; Indomethacin ; Kidney ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley

Glechoma longituba is a common medicinal plant that is common in wet and sunny land. This plant is used to treat various illnesses including jaundice and edema. But, ingestion of the plant can cause severe pain and swelling on lip and mouth. We experienced three cases that had oral pain and sensory change after ingestion of G. longituba, which we report with a literature review.
Eating ; Edema ; Jaundice ; Lamiaceae ; Lip ; Mouth ; Paresthesia ; Plants ; Plants, Medicinal

It is very difficult to discern edible mushrooms such as Naematololma sublateritium from toxic mushrooms such as Naematololma. fasciculare in the natural environment. We experienced a case of a patient who accidentally ingested Naematololma. fasciculare. The patient was admitted to the emergency department with nonspecific abdominal symptoms such as nausea, vomiting, abdominal pain and diarrhea. Treatment involved supportive care instead of gastric lavage and charcoal, since their effectiveness is unproven for relief of mushroom intoxication.
Abdominal Pain ; Agaricales ; Charcoal ; Diarrhea ; Emergencies ; Gastric Lavage ; Humans ; Nausea ; Vomiting

Fluconazole is a fungistatic agent that is used for treating systemic and superficial fungal infections like onychomycosis and tinea pedis. Various adverse effects of fluconazole have been reported regardless of the total dosage and the duration of treatment. We consider the number of patients who visit the emergency room with nonspecific symptoms that are related to antifungal agents are not inconsiderable. In this case, 44-year-old male patient experienced mental change during taking fluconazole to treat tinea pedis. The understanding of the side effects and the drug interactions with antifungal agents like fluconazole can help to treat patients with nonspecific symptoms that are related to antifungal agents.
Adult ; Antifungal Agents ; Consciousness ; Drug Interactions ; Emergencies ; Fluconazole ; Humans ; Hyperammonemia ; Male ; Onychomycosis ; Tinea ; Tinea Pedis

PURPOSE: Dynamic changes in the dimensions of the left ventricle (LV) during cardiac arrest might influence the efficacy of CPR. However, the relationship between change in LV dimensions during cardiac arrest and CPR hemodynamics and outcomes have not yet been addressed. In the present study, we investigated changes in left ventricular volume and area during prolonged, untreated ventricular fibrillation (VF); we related those change to coronary perfusion pressure (CPP) during CPR and resuscitation outcomes. METHODS: In 12 domestic male pigs weighing 40+/-3 kg, VF was electrically induced and left untreated for 15 min. CPR was performed for 5 min prior to defibrillation. CPR was continued until the return of spontaneous circulation (ROSC) or for a maximum of 15 minutes. Mean aortic pressure and right atrial pressures were measured and CPP was calculated. LV dimensions were continuously assessed by echocardiographic measurement during the 15 minutes of interval VF. RESULTS: Six animals were successfully resuscitated. During the 15 minute interval of VF, LV area and volume were reduced in all animals. In animals that were not resuscitated, LV dimensions were significantly lower than those in resuscitated animals (p<0.01). These differences were observed after 10 minutes of VF. The animals with greater reduction in LV dimension during VF achieved significantly lower CPP during CPR in contrast to animals with larger LVs during VF. CONCLUSION: Greater decreases in LV volume and area during cardiac arrest are associated with low CPP during CPR and poor resuscitation outcomes. LV dimensions prior to starting CPR might therefore modulate the effectiveness of resuscitation interventions.
Animals ; Arterial Pressure ; Atrial Pressure ; Cardiopulmonary Resuscitation ; Heart Arrest ; Heart Ventricles ; Hemodynamics ; Humans ; Male ; Perfusion ; Piperazines ; Resuscitation ; Swine ; Ventricular Fibrillation

BACKGROUND AND OBJECTIVES: Chronic atrial fibrillation (AF) causes atrial enlargement and impairs cardiac function. It is known that restoration of sinus rhythm reduces left atrial size and improves left ventricular ejection fraction (EF). However, it's unclear whether the restoration of sinus rhythm is more beneficial than controlling the ventricular rate. This study was designed to compare the effects of two treatment strategies on structural and functional changes of the heart in patients with AF. SUBJECTS AND METHODS: Thirty-seven AF patients who initially cardioverted to sinus rhythm were studied. At 6 months after cardioversion, 17 patients (Group I) maintained normal sinus rhythm (NSR) and 20 (Group II) experienced AF recurrence. Initial and follow-up echocardiography were evaluated in each patient and compared between the two groups. RESULTS: Baseline clinical and echocardiographic findings were similar between the two groups except that the left atrial length was longer in Group II than in Group I. Compared to baseline, left atrial dimension (LAD) and left ventricular mass index (LVMI) measured by M-mode were significantly reduced in group I at follow-up (p<0.05); however, these changes were not observed in group II. The reduction of LAD and LVMI was observed only in patients with less than 50% EF and/or dilated left atrium at baseline (p<0.05). CONCLUSION: In patients with AF, maintenance of NSR after cardioversion significantly reduces LAD and LVMI, especially in cases of left ventricular dysfunction or dilated left atrium. Even after adjustment of baseline LAD, LVMI and EF, maintenance of NSR remains the independent factor that reduces LAD at follow-up (p=0.001).
Atrial Fibrillation* ; Echocardiography ; Electric Countershock* ; Follow-Up Studies ; Heart Atria ; Heart* ; Humans ; Recurrence ; Stroke Volume ; Ventricular Dysfunction, Left

Purpose: To derive the optimized intraocular lens (IOL) constants from automated and manifest refraction after cataract surgery in Korean patients, and to evaluate whether there is a difference in optimized IOL constants according to the refraction method. Methods: This retrospective multicenter cohort study enrolled 4,103 eyes of 4,103 patients who underwent phacoemulsification and in-the-bag IOL implantation at 18 institutes. Optimized IOL constants for the SRK/T, Holladay, Hoffer Q, and Haigis formulas were calculated via autorefraction or manifest refraction of samples using the same biometry and IOL. The IOL constants derived from autorefraction and manifest refraction were compared. Results: Of the 4,103 eyes, the majority (62.9%) were measured with an IOLMaster 500 followed by an IOLMaster 700 (15.2%). A total of 33 types of IOLs were used, and the Tecnis ZCB00 was the most frequently used (53.0%). There was no statistically significant difference in IOL constants derived from autorefraction and manifest refraction when IOL constants were optimized with a large number of study subjects. On the other hand, optimized IOL constants derived from autorefraction were significantly smaller than those from manifest refraction when the number of subjects was small. Conclusions It became possible to use the IOL constants optimized from Koreans to calculate the IOL power. However, if the IOL constant is optimized using autorefraction in a small sample group, the IOL constant tends to be small, which may lead to refractive error after surgery.

BACKGROUND: Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. METHODS: In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10–14 days. RESULTS: The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. CONCLUSION: The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD.
Depression ; Humans ; Hypotension, Orthostatic ; Korea ; Movement Disorders ; Parkinson Disease ; Quality of Life ; Reproducibility of Results ; Sleep, REM ; Weights and Measures