Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology. We report a case of KD with acute respiratory distress syndrome (ARDS) after intravenous immunoglobulin (IVIG) infusion. Lung manifestations associated with KD have previously been reported in the literature. Although IVIG infusion is an effective therapy for acute KD, there are some reported complications related to IVIG infusion: hypotension, aseptic meningitis, acute renal failure, hemolytic anemia, etc. The case of KD reported here was treated with IVIG and aspirin. A few days after recovery from KD, the patient developed fever and maculopapular rash. A diagnosis of relapse KD was made and retreated with IVIG infusion. However, the patient developed ARDS four days after the second IVIG infusion. The patient recovered from ARDS after nine days of ICU care, which included high frequency oscillation ventilation with inhaled nitric oxide, steroid treatment and other supportive care.
Acute Kidney Injury ; Anemia, Hemolytic ; Aspirin ; Diagnosis ; Exanthema ; Fever ; High-Frequency Ventilation ; Humans ; Hypotension ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Lung ; Meningitis, Aseptic ; Mucocutaneous Lymph Node Syndrome* ; Nitric Oxide ; Recurrence ; Respiratory Distress Syndrome, Adult* ; Systemic Vasculitis

PURPOSE: To evaluate tlne significance of vaginal air seen on CT scan in preoperative staging of uterine cervical carcinoma. METHODS AND MATERIALS: A comparison was made between CT findings of vaginal air and true vaginal involvement status in 85 patients with uterine cervical carcinoma. CT findings were analyzed in terms of the presence or absence of vaginal air, number of CT slices in which vaginal air was seen, shape of vaginal air, and relation of vaginal airto cervical mass. RESULTS: Vaginal air was present in 35 patients and was absent in 50. Although the mere presence of vaginal air or multiplicity of CT slices showing vaginal air did not signify the presence of vaginal involvement, vaginal air with irregular margin or vaginal air adjacent to uterine cervical mass was suggestive of vaginal involvement. CONCELUSION: These observation of vaginal air in interpreting CT may be helpful in the preoperative staging of uterine cervical carcinoma.
Humans ; Tomography, X-Ray Computed ; Vagina*

No abstract available.
Hemorrhoidectomy*

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*

No abstract available.
Deglutition Disorders ; Facial Nerve ; Glossopharyngeal Nerve ; Herpes Zoster ; Herpes Zoster Oticus ; Paralysis

No abstract available.
Chancre* ; Eczema* ; Nipples*

BACKGROUND AND OBJECTIVES: Supraglottic laryngectomy is a well established technique for the treatment of appropriate carcinoma of supraglottic larynx. The purpose of this study was to determine factors that may contribute to postoperative aspiration related to deglutition problem following supraglottic laryngectomy. MATERIALS AND METHOD: A retrospective analysis of medical records of 19 patients who consecutively underwent supraglottic laryngectomy was undertaken. Contribution of the following factors was investigated: age, T stage, pack-years of smoking, and parameters of pulmonary function test. The authors used a computerized acoustic analysis program (CSL-MDVP) to measure fundamental frequency, jitter, shimmer, and noise to harmonics ratio. RESULTS: Eleven patients had no problem, 5 patients had clinically insignificant problem, and 3 patients had moderate problem in postoperative 6 months. A greater number of pack-years of smoking and decreasing FEV1/FVC were significantly correlated with poor outcome with regards to postoperative aspiration and deglutition problem. No statistically significant difference was seen between patients with supraglottic laryngectomy and the control group. CONCLUSION: This study showed that less than 60% FEV1/FVC signifies a greater risk for postoperative aspiration.
Acoustics ; Deglutition ; Forced Expiratory Volume ; Humans ; Laryngectomy* ; Larynx ; Medical Records ; Noise ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking ; Vital Capacity ; Voice

BACKGROUND AND OBJECTIVES: The incidence of deep neck infection has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. The purposes of this study are to find out common organisms, rates of antimicrobial resistance in the deep neck infection. SUBJECTS AND METHOD: We have conducted a retrospective study of 76 patients with the diagnosis of deep neck infection that had been seen between January 1998 and December 2003. RESULTS: The most common pathogens found were Streptococcus viridans (34%), followed by Klebsiella pneumoniae (19.4%), Streptococcus Group F (11.9%), beta-hemolytic streptococci (11.9%) and Peptostreptococcus (7.5%). Staphylococcus species was not found. Of the aerobes found, 74.1% were sensitive to all antibiotics. All Streptococci, with one exception, were not resistant to any antibiotics. All Klebsiella pneumoniae were resistant to ampicillin. Klebsiella pneumoniae were cultured in 50% of DM patients. CONCLUSION: The most common pathogens were Streptococcus viridans (34%). Of these aerobes, 74.1% were sensitive to all antibiotics. All isolated microorganisms were sensitive to ampicillin/sulbactam (Unasyn(R)) used before the results of bacterial cultures.
Abscess ; Ampicillin ; Anti-Bacterial Agents ; Bacteria ; Diagnosis ; Drug Resistance, Microbial ; Humans ; Incidence ; Klebsiella pneumoniae ; Neck* ; Oral Hygiene ; Peptostreptococcus ; Retrospective Studies* ; Staphylococcus ; Streptococcus ; Viridans Streptococci

No abstract available.
Child* ; Heart Neoplasms* ; Humans

No abstract available.
Cervix Uteri* ; Female