No abstract available.
Hand*

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*

The squamous cell carcinoma of ovary is very rare in the ovarian malignancy. The majority of squamous cell carcinomas of ovary are considered to be associated with mature cystic teratoma, Brenner tumor and malignant degenerated endometriosis. Therefore, pure ovarian squamous cell carcinoma is extremely rare. The pathogenesis, prognosis and proper treatment guideline of this malignancy are still unknown, because of it's rarity. Recently we experienced a case of primary squamous cell carcinoma without previously commented disease condition. After nearby cytoreductive surgery, postoperative chemotherapy with radiotherapy has been undergoing. We report this malignancy with a brief review of literature.
Brenner Tumor ; Carcinoma, Squamous Cell* ; Drug Therapy ; Endometriosis ; Female ; Ovary* ; Prognosis ; Radiotherapy ; Teratoma

The involvement of subaortic structures in the aortic valve endocarditis appears more common than previously recognized. The most common location of the subaortic complications is mitral-aortic intervalvular fibrosa(MAIVF) and the complications may be presented as abscess or pseudoaneurysm. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa mimicking abscess. In our case, complete AV block was revealed on ECG after aortic valve replacement (AVR). Several days after the first operation, re-do AVR and reconstruction of the MAIVF was performed because of complete AV block and dual fistula complicated by pseudoaneurysm in MAIVF.
Abscess ; Aneurysm, False* ; Aortic Valve* ; Atrioventricular Block* ; Echocardiography ; Electrocardiography ; Endocarditis* ; Fistula* ; Humans

Vascular catheters are associated with complications such as infection, thrombosis and stenosis. The embolization of a venous catheter fragment is a rare complication. A 39-year-old woman underwent placement of a totally implantable venous access device for chemotherapy to treat a recurrent liposarcoma of the left thigh. The "pinch-off sign" was noted on a routine chest X-ray but that was ignored. Three-months after implantation of the intravenous access device, the indwelling central catheter was fractured and embolized to the pulmonary trunk. The catheter in the pulmonary trunk was successfully removed through a percutaneous femoral vein approach using a pigtail catheter and goose neck snare.
Thigh/pathology ; Pulmonary Artery/*injuries/surgery ; Liposarcoma/drug therapy ; Humans ; Foreign-Body Migration/*complications/surgery ; Female ; *Equipment Failure ; Embolism/*etiology/surgery ; Catheters, Indwelling/*adverse effects ; Catheterization, Central Venous/*adverse effects/instrumentation ; Adult

Acinetobacter baumannii infections have become significant pathogen in hospitalized patients, especially in the intensive care unit setting. Community-acquired Acinetobacter meningitis in adults is a very rare infection of the central nervous system. Most community-acquired Acinetobacter infections have been reported from countries with a tropical or subtropical climate. Acinetobacter infections mainly affect patients with some form of comorbidity and are also associated with heavy smoking and excess alcohol consumption. In our case, a 62-year-old male patient with DM, hypertension, and excess alcohol consumption developed meningitis. Bulging membrane and inflammation were observed in the right ear. A. baumannii meningitis was confirmed by blood, CSF, and ear discharge culture. The patient was treated effectively with meropenem for 21 days. After antibiotic treatment, follow-up cultures of CSF, blood, and ear discharge showed a negative result, and the CSF cell profile was normalized. However, the patient died of recurrent pneumonia on hospital day 45. We report on a case of community-acquired Acinetobacter meningitis in an adult in Korea.
Acinetobacter ; Acinetobacter baumannii ; Acinetobacter Infections ; Adult ; Alcohol Drinking ; Central Nervous System ; Climate ; Comorbidity ; Ear ; Follow-Up Studies ; Humans ; Hypertension ; Inflammation ; Intensive Care Units ; Korea ; Male ; Membranes ; Meningitis ; Pneumonia ; Smoke ; Smoking ; Thienamycins

BACKGROUND: As socioeconomic status has improved, malnutrition has become rare in Korea and generally it is no longer considered as a serious problem in medical practice. However, contrary to the above general belief we managed four patients with beriberi in 1999 and it became apparent that malnutrition might remain a problem in certain groups of patients. In this study, we assessed the nutritional state, especially with respect to thiamine deficiency, in chronic alcoholics and in patients residing at a long-term care facility (LTCF). METHODS: Fourteen chronic alcoholic patients and twenty patients being hospitalized in a long-term care facility were assigned as the study groups. The subjects' mean ages and standard deviations were 48.9+/-10.2 and 50.6+/-6.7, respectively. Medical records were reviewed to determine other aspects of their nutritional status and their dietary patterns. Ten peoples who visited the health promotion center at Inha University Hospital, for routine check-ups were allocated to the control group. Blood total thiamine levels were measured by high-performance liquid chromatography. RESULTS: Body mass indices were significantly lower in chronic alcoholics and in patients at the LTCF than in the control group (p=0.0065). Serum albumin levels were within the reference range in all three groups, but were significantly lower in patients at the LTCF than in the control group (p=0.0013). Moreover, no difference was detected between the alcoholic group and the control group in terms of thiamine levels. However, the mean thiamine level in patients at the LTCF was statistically lower than that of the control group and four (20%) patients in the LTCF group showed subnormal blood thiamine levels. The thiamine level tended to decrease with age in both alcoholics and patients at the LTCF. No correlation was found between thiamine level and the other variables examined, namely, hospital stay, body mass index, and serum albumin level. CONCLUSION: A considerable portion of patients in a long term care facility showed thiamine deficiency, however, no evidence of thiamine deficiency was found among alcoholics. This result suggests that thiamine deficiency in patients at long-term care facility may be more prevalent and that thiamine supplementation may be warranted, especially for those with other thiamine deficiency risk factors.
Alcoholics* ; Alcoholism ; Beriberi ; Body Mass Index ; Chromatography, Liquid ; Health Promotion ; Humans ; Korea ; Length of Stay ; Long-Term Care* ; Malnutrition ; Medical Records ; Nutritional Status ; Reference Values ; Risk Factors ; Serum Albumin ; Social Class ; Thiamine Deficiency* ; Thiamine*

Ischemic colitis is the consequence of a sudden reduction in colon blood supply, which in turn results in ischemic injury. The splenic flexure and rectosigmoid junction are the areas most often affected. Ischemic colitis occurs with greater frequency in the elderly and is caused by various medications and procedures. Pseudoephedrine acts as a vasoconstrictor directly affecting adrenal receptors of nasal mucous membrane. Pseudoephedrine occasionally causes vascular insufficiency due to intense vasoconstriction, even at standard doses. Ischemic colitis associated with pseudoephedrine has been reported in other countries,, but it has never been reported in Korea. In this paper, we describe 3 cases of ischemic colitis that occurred after taking pseudoephedrine for nasal congestion.
Aged ; Colitis, Ischemic* ; Colon ; Colon, Transverse ; Estrogens, Conjugated (USP) ; Gastrointestinal Hemorrhage ; Humans ; Korea ; Mucous Membrane ; Pseudoephedrine* ; Vasoconstriction

OBJECTIVES: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics, and to find links for their intervention and prevention. METHODS: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS)have reported six major occupational diseases; occupational musculoskeletal disorders of the upper extremities(MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome(HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. RESULTS: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, respectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With respect to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidences of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. CONCLUSIONS: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.
Asthma, Occupational ; Carpal Tunnel Syndrome ; Dermatitis, Contact ; Dimethylformamide ; Drug-Induced Liver Injury ; Food Services ; Gyeongsangbuk-do* ; Hepatitis ; Incidence ; Korea ; Nickel ; Occupational Diseases ; Occupational Health Services ; Occupations ; Skin Diseases ; Solvents ; Textiles ; Vibration

BACKGROUND: A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. METHODS: Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia (PaO2/FIO2 ratio O(FIO2 1.0) was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. RESULTS: (1) Median age was 56 years(male:female=4:3). (2) The baseline PaO2 was 78+/-16 mmHg, which increased significantly to 269+/-116 mmHg(p=0.018) with CPAP. After the BAL, the PaO2 did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The SpO2 showed a similar trend with the PaO2 and did not decrease to below 90 % during the duration of the study. (3) The PaCO2 increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. CONCLUSION: In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.
Anoxia* ; Bronchoalveolar Lavage* ; Bronchoscopes ; Continuous Positive Airway Pressure* ; Gases ; Humans ; Hydrogen-Ion Concentration ; Intubation ; Masks ; Mouth ; Oxygen ; Respiratory Insufficiency ; Ventilators, Mechanical ; Vital Signs