Calciphylaxis has been described as a rare condition in patients with end-stage renal disease and secondary hyperparathyroidism. Selye et al. first coined the term calciphylaxis to describe soft-tissue calcification and cutaneous necrosis. The common manifestation include painful digital necrosis and medial calcification of small and medium sized vessels. Calciphylaxis is a clinical diagnosis and is characterized by painful, violaceous, mottled skin lesions. Radiographic studies reveal calcification of median and small vessels under the knee but vascular calcification is not specific for calciphylaxis. Histolopathologic findings show a markedly reduced lumen, secondary to the fibrin deposition and inflammation in and around the outer media with an outer ring of calcification which leads to progressive ischemic tissue necrosis. Kidney transplantation and parathyroidectomy is recommened but it is controversial. We present the case of a 64-years-old man with chronic renal failure as well as painful ischemic necrosis on the lower extremity. The pertinets literature is reviewed.
Calciphylaxis ; Diagnosis ; Fibrin ; Humans ; Hyperparathyroidism, Secondary ; Inflammation ; Kidney Failure, Chronic* ; Kidney Transplantation ; Knee ; Lower Extremity ; Necrosis ; Numismatics ; Parathyroidectomy ; Skin ; Vascular Calcification

Congenital pneumonia is defined as pneumonia acquired transplacentally or perinatally. It is frequently associated with prolonged rupture of the membranes, chorioamnionitis, prolonged labor, premature labor, fetal distress, prematurity and meconium staining. It is one of the important causes of neonatal death. We report a case of congenital pneumonia of a full-term, female neonate who was born by cesarian section and died at 10th hours of her life. There were no maternal signs and symptoms of infection and amniotic fluid was not stained with meconium at birth. We insist that full physical examination and routine laboratory examinations including simple chest X ray are required even in grossly normal neonate without specific risk factors and that possibility of neonatal pneumonia should always be considered when the cause of death cannot be explained immediately by gross autopsy findings.
Amniotic Fluid ; Autopsy ; Cause of Death ; Chorioamnionitis ; Death, Sudden* ; Female ; Fetal Distress ; Humans ; Infant, Newborn ; Meconium ; Membranes ; Obstetric Labor, Premature ; Parturition* ; Physical Examination ; Pneumonia* ; Pregnancy ; Risk Factors ; Rupture ; Sudden Infant Death ; Thorax

Autoerotic death is an accident occurring during individual, usually solitary sexual activity in which a device or apparatus used to enhance the sexual stimulation. Although it is a well-known phenomenon described in many forensic medicine reports, cases are rare in Korea because of conservative tradition of the society and embarrassment of the victim 's family members. It may be far more common than realized. We present a case of the autoerotic accident involving a plastic bag asphyxia in a 67-year-old man. The death scene investigation and findings at autopsy will provide police officers and physicians with adequate knowledge about this phenomenon to make an accurate diagnosis.
Aged ; Asphyxia ; Autopsy ; Diagnosis ; Forensic Medicine ; Humans ; Korea ; Plastics ; Police ; Sexual Behavior

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

Fibroadenoma is a rare lesion of the vulva. It has been proposed that the origin of the tissue is either ectopic breast tissue or vulvar mammary-like glands (MLG). We report a case of vulvar fibroadenoma in a 33-year-old woman with a right vulvar mass presenting clinically as vulvar cyst. The cut surface of the tumor showed a white and homogenous appearance that was 2.5 cm in maximum dimension. Microscopically, the lesion was well-circumscribed but non-encapsulated. It revealed nodular, glandular and stromal proliferation, consistent with fibroadenoma of breast. Immunohistochemical staining for the estrogen receptor and progesteron receptor revealed nuclear positivity in the epithelium. Smooth muscle actin confirmed the presence of a myoepithelial cell layer. Staining for pancytokeratin showed epithelial cytoplasmic positivity.
Actins ; Adult ; Breast ; Cytoplasm ; Epithelium ; Estrogens ; Female ; Fibroadenoma* ; Humans ; Muscle, Smooth ; Vulva*

Emphysematous pyelonephritis is a rare complication of acute pyelonephritis that occurs in diabetics or urinary obstruction and spontaneous gas formation around renal parenchyme. Diagnosis. in appropriate clinical setting. is confirmed radiographically. Plain film demonstrates a surprising pneumonephrogram, mottled gas shadow in the renal parenchyme as well as perirenal gas. Surgical intervention after unsuccessful antibiotics and conventional medical measurement is necessary. We experienced 3 cases of emphysematous pyelonephritis which occurred in diabetic women with brief review of the literature.
Anti-Bacterial Agents ; Diabetes Mellitus ; Diagnosis ; Female ; Humans ; Pyelonephritis*

The halogenated anesthetics, halothane, enflurane and isoflurane undergo biotransformation in man. They produce inorganic fluoride ion as a metabolite, which is well known as the cause of methoxyflurane induced nephrotoxicity. This study was done to investigate the rapidity and extent of biotransformation of volatile anesthetics for 2 hours of operation. Thirty patients were randomly divided into halothane, enflurane and isoflurane group according to anesthetics. Blood and urine sampling was done before operation, post-induction 10 min, 20 min, 30 min, 1 hour, 1 hour 30 min and 2 hours for the measurement of inorganic fluoride ion. Aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine levels were measured before and 24 hours after operation. The results were as follows ; 1) The values of blood fluoride ion in halothane and isoflurane group were decreased with time during operation and there was no change in enflurane group. 2) The values of urine fluoride ion in three groups were increased with time during operation. The rate of increase was the greatest in enflurane group. 3) There were no changes in the value of AST, ALT, BUN and creatinine. The above results suggest that the biotransformation of volatile anesthetics to inorganic fluoride ion was the greatest in enflurane, but the level was insufficent to cause renal dysfunction during 3.18 hour operation.
Alanine Transaminase ; Anesthetics* ; Aspartate Aminotransferases ; Biotransformation* ; Blood Urea Nitrogen ; Creatinine ; Enflurane ; Fluorides ; Halothane ; Humans ; Isoflurane ; Metabolism ; Methoxyflurane

Meconium peritonitis is a non-bacterial foreign body and chemical peritonitis caused by meconium contamination resulting from bowel perforation during late intrauterine or early neonatal periods. Prenatal ultrasonographic diagnosis of the meconium peritonitis provides the preparation for proper management and decreasing motality and morbidity of the neonate. We have experienced a case of meconium peritonitis diagnosed by ultrasonography at 34+4 gestational weeks and presented this case with a brief review of the literatures.
Diagnosis ; Foreign Bodies ; Humans ; Infant, Newborn ; Meconium* ; Peritonitis* ; Ultrasonography ; Ultrasonography, Prenatal*

Duodenal diverticulitis is a rare complication of the duodenal diverticulum. Its rarity is due to the relatively large diameter of the duodenum, which makes the intraluminal flow of sterile liquid duodenal contents fluent. Additionally, nonspecific signs and symptoms of duodenal diverticulitis make it very difficult to diagnose properly. We describe a patient presenting with abdominal pain, nausea, and leukocytosis, with diverticulitis of the third portion of the duodenum caused by the impaction of a foreign body, who was diagnosed and treated with enteroscopy.
Abdominal Pain ; Diverticulitis ; Diverticulum ; Double-Balloon Enteroscopy ; Duodenum ; Foreign Bodies ; Humans ; Leukocytosis ; Nausea