The causes of hypocalcemia in patients suffering from severe infection including sepsis are largely uncertain. So we measured serum albumin, total protein, cholesterol, PTH, and calcitonin of the infection-associated hypocalcemic children and compared with those of normocalcemic children suffering from tsutsugamushi disease. All had normal renal functions and had been admitted to the department of pediatrics of Gyeongsang National University Hospital. Hypocalcemic patients were hypoalbuminemic. Serum total calcium was inappropriately more decreased compared to the decreased amount of serum albumin in the hypocalcemic group. We also observed more frequent incidence of hypocholesterolemia (<100mg/dL) in this group. And serum PTH was appropriately elevated in the hypocalcemic patients. Serum calcitonin was elevated in both groups, but 6 times higher in the hypocalcemic group than in the normocalcemic one. Serum total calcium was positively correlated with serum albumin and negatively correlated with serum PTH and calcitonin.
Calcitonin ; Calcium ; Child ; Cholesterol ; Humans ; Hypoalbuminemia ; Hypocalcemia* ; Incidence ; Pediatrics ; Scrub Typhus ; Sepsis ; Serum Albumin

This report describes a very rare case of primary undifferentiated carcinoma of the endometrium with small cell and trophoblastic differentiation. The patient was 54-year-old woman with complaints of vaginal bleeding and palpable lower abdominal mass. The light microscopic findings revealed predominantly small cells with round nuclei, spindle cells, and large cells with hyperchromatic bizarre nuclei. Foci of syncytiotrophoblastic giant cells are scattered, especially in the hemorrhagic areas. Immunohistochemical stainging for neuron specific enolase and beta-hCG showed positive reactions to small cells and syncytiotrophoblastic giant cells, respectively. Argentaffin and argyrophil stains, however, showed negative reactions to small cells. The histogenesis of small cell undifferentiated carcinoma of the endometrium remains unclear; however, it may arise from epithelial precursors instead of neuroendocrine cells, and syncytiotrophoblastic cells may be differentiated or dedifferentiated from the undifferentiated carcinoma cells.
Female ; Humans

Syringomyelia was described by Etienne et al in 1954 and was named by Ollivier in 1827 by reason of the pathologic cavitation of cord. Also it is considered a very chronic and irregulary progressive disease of the spinal cord of unknown cause which has predilection for the cervical and lumbar enlargements. The patient of 19 years old male had been suffered from the painless, severe swelling and instability of right elbow after trauma on right elbow, aud had complained of the sensory and temperature dissociation, muscle weakness with clawing hand in right upper extremity and scoliosis of mild degree. These symptoms and findings were same as those of the classic syringomyelia. Therefore the syningomyelia which is relatively rare in incidence will be reviewed by this report with the references.
Animals ; Elbow ; Hand ; Hoof and Claw ; Humans ; Incidence ; Male ; Muscle Weakness ; Scoliosis ; Spinal Cord ; Syringomyelia ; Upper Extremity

Neurilemmomas are benign tumors of the nerve sheaths. They are usually painless and are most common in the upper extremities. Pathologically, neurilemmoma is encapsulated and made up of organized element: the Antoni A cells, the Antoni B cells and the Verocay bodies. According to Stout, neurilemmomas never become malignant. Two cases of neurilemmoma of tibial nerve and One case of neurilemmoma of lateral antebrachial cutaneous nerve are presented with a review of the literature. Tumors were enucleated and confirmed by pathological examination.
B-Lymphocytes ; Nerve Sheath Neoplasms ; Neurilemmoma ; Tibial Nerve ; Upper Extremity

BACKGROUND: Shivering, which occurs in the postanesthetic period, annoys many patients, so we examined the correlation of postanesthetic shivering (PAS) and warming intravenous fluids, the level of sensory blockade, and skin temperature during spinal anesthesia. METHODS: 65 patients undergoing an operation on a lower extremity were randomly allocated to 2 groups. The patients in group 1 and 2 received 500 ml of the unwarmed (ambient temperature) and warmed fluids prior to spinal anesthesia, respectively. All patients were anesthetized with 0.5% bupivacaine in 8% glucose. We measured the decrements of mean blood pressure (MBP) and heart rate, the highest sensory block level, and the increment of skin temperature 30 min after anesthesia, and the operating room temperature. After the operation we also evaluated the PAS by using the 10-mm visual anlalogue scale. RESULTS: The decrement of MBP was higher in group 2 than in group 1 (13 mmHg vs 5 mmHg, P<0.05). The highest sensory block level was higher in group 2 than in group 1 (T6.4 vs T7.6, P<0.05). However, there was no significant difference in heart rate decrement, skin temperature increment, ambient temperature, and PAS between groups. The more the MBP decrement, the less the PAS in all patients (r = 0.326, P = 0.008) and in group 1 (r = 0.480, P = 0.005), but there was no correlation between PAS and MBP decrement in group 2. The more the ambient temperature, the less the PAS in all patients (r = 0.334, P = 0.007), in group 1 (r = 0.386, P = 0.027), and in group 2 (r = 0.394, P = 0.026). The heart rate decrement, skin temperature increment, and sensory blockade level did not correlate with PAS. CONCLUSIONS: PAS lowers as MBP decreases and operating room temperature increases during spinal anesthesia, but warming intravenous fluids, sensory block level, and skin temperature change doesn't affect PAS.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine ; Glucose ; Heart Rate ; Humans ; Lower Extremity ; Operating Rooms ; Shivering* ; Skin Temperature* ; Skin*

Spontaneous intracranial hemorrhage (ICH) occurs rarely during general anesthesia. We report a case of metastatic brain tumor producing an ICH during general anesthesia. A 47-year-old man was scheduled for the wedge resection of left lower lobe of lung under general anesthesia. He did not show any abnormal neurological sign and coagulation abnormality on arrival in the operating room. But he had a history of right hemiplegia 9 months ago which resolved completely. He was anesthetized for about 2 hours. Until 1 hour after the end of anesthesia and operation he did not regain his consciousness, but responded well to external stimuli. He was expected to be better, but his mentality became worse. Immediate computerized tomogram of brain revealed a left ICH. An emergency craniectomy was performed to remove the hematoma. Pathological investigations demonstrated a metastatic brain tumor from liver cell carcinoma. We presume that this intratumoral bleeding was produced by high intracranial blood pressure relating to general anesthesia or obstruction of jugular venous drainage by abnormal positioning of head.
Anesthesia ; Anesthesia, General* ; Blood Pressure ; Brain Neoplasms* ; Brain* ; Carcinoma, Hepatocellular ; Consciousness ; Drainage ; Emergencies ; Head ; Hematoma ; Hemiplegia ; Hemorrhage ; Humans ; Intracranial Hemorrhages* ; Lung ; Middle Aged ; Operating Rooms

No abstract available.
Gemfibrozil* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory*

Dislocation of the hemate bone is very rare. There is no reported case in Korea. The mechanism of injury may be attributed to direct trauma. We have experiened a case of dislocation of the hamate bone, treated it by open reduction and internal fixation using two Kirschner wires. The result was satisfactory. A case of dislocation of the hamte bone is reported with brief review of literature.
Bone Wires ; Dislocations ; Hamate Bone ; Korea

No abstract available.
Idiopathic Pulmonary Fibrosis*

PURPOSE: To assess the characteristic features of MR imaging in the diagnosis of spinal tuberculosis. MATERIALS AND METHODS: We retrospectively reviewed MR imaging of 27 cases with pathologically-proven spinal tuberculosis and analyzed the MR findings including the extent of the lesions on non-contrast T1, proton density, and T2*VI, and the specific contrast enhancement patterns of the lesion on Gd-DTPA enhnced TIWI. RESULTS: The inflammatory lesions showed low signal intensity on T1WI in 25 patients(93%) and high signal intensity on T2*gradient echo image in 25 patients(93%). Bone destruction was noted in 15 patients(55%), disc-space narrowing in 21 patients(77%), paravertebral abscess in 16 patients(59%), subligamentous extension in 23 patients(85%), kyphosis in 8 patients(29%), and spinal canal narrowing in 19 patients(70%). After Gd-DTPA was administrated, rim-enhancement was noted in all patients(100%). CONCLUSION: We conclude that MR imaging is an excellent imaging modality for establishing the diagnosis of spinal tuberculosis as well as delineating the extent of soft tissue involvement. Characteristic peripheral rim enhancement after injection of Gd-DTPA may provide rather specific diagnosis in spinal tuberculosis.
Abscess ; Diagnosis ; Gadolinium DTPA ; Kyphosis ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies ; Spinal Canal ; Tuberculosis, Spinal*