Sepsis refers to the systemic response to serious infection. Patients with sepsis usually manifest fever, tachycardia, tachypnea, leukocytosis, and a localized site of infection. Methicillin-resistant Staphylococcus aureus(MRSA) is a gram-positive, nonmotile, aerobic, catalase- positive coccus, which is resistant to all the B -lactam antibiotics. Cutaneous manifestations in sepsis are maculopapules, nodules, petechiae, ecchymoses, purpurae, pustules, vesiculobullae, hemorrhagic bullae and ulcers. When MRSA is identified in blood cultures and skin tissue cultures, the skin lesions can be considered as cutaneous manifestations in sepsis caused by MRSA. We report two cases with erythematous pustules, petechiae, hemorrhagic bullae and maculopapules caused by MRSA sepsis. MRSA grew in blood cultures and skin tissue cultures.
Anti-Bacterial Agents ; Ecchymosis ; Fever ; Humans ; Leukocytosis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Purpura ; Sepsis* ; Skin ; Staphylococcus ; Tachycardia ; Tachypnea ; Ulcer

A 38-year-old male patient visited our clinic complaining of three skin lesions on the scalp. There were yellowish to brownish, waxy, non-tender, walnut-sized nodules. Hematoxylin and eosin staining revealed amorphous pinkish material deposits in the dermis. The Congo red stain and Dylon stain under polarizing microscopy showed yellow-green birefringence and the immunoglobulin-lambda light chain stain showed a positive reaction. An electron microscopic examination revealed filaments with uniform diameter(6 to 10nm) that were straight and neither branched nor anastomosed. Based on the clinical, histopathological, immunohistochemical and electron microscopical findings, the skin lesions were diagnosed as nodular amyloidosis.
Adult ; Amyloidosis* ; Birefringence ; Congo Red ; Dermis ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Male ; Microscopy ; Scalp ; Skin

Cartilage ; Cleft Lip ; Congenital Abnormalities ; Ear ; Humans ; Palate ; Rhinoplasty ; Transplants ; Young Adult

The authors dissected and examined a horseshoe kidney from the cadaver of a 54-year-old Korean female. The results were as follows. Other congenital anomalies or complications were not found, and no renal stones showed on plain radiography of the horseshoe kidney. The horseshoe kidney was located in the area between the 12 th thoracic vertebra and the 4th lumbar vertebra, with the superior extremity of the left kidney 10mm more inferior than that of the right. The isthmus connecting the bilateral kidneys was located at the level of the 3rd lumbar vertebra. The size of the kidney was 102mm × 52mm × 44mm (right) and 108mm × 62mm × 34mm (left), and the superoinferior and anteroposterior lengths of isthmus were 22mm and 10mm, respectively. The abdominal aorta and inferior vena cava passed posteriorly to the isthmus, with the inferior mesenteric artery and lumbar splanchnic nerve passing anteriorly. Some grooves were found on the anterior surface of the bilateral kidney. The hilum of the right kidney faced the anteromedial direction and that of the left kidney faced the anterolateral direction. At the hilar plane, the right renal arteries and veins passed anteriorly and posteriorly to the renal pelvis ; the left renal arteries passed posteriorly to the renal pelvis, with the left renal veins passing anteriorly and posteriorly. Three branches of the right renal arteries passed renal hilum, while two branches did not, and two branches of the left renal arteries passed renal hilum, while six branches did not. The two arteries arising from the aortic bifurcation were distributed to the isthmus. The number of renal veins passing the renal hilum were three in the right, and two in the left. The right and left ovarian veins drained to the renal veins. There were 12 minor calyces distributed normally in the right kidney, 13 minor calyces distributed radially in the left kidney, and 3 minor calyces in the isthmus, composed of parenchyme. The left portion of the horseshoe kidney was concluded to have developed poorly, on the basis of incomplete ascension and abnormal rotation during development, the imperfect configuration of the renal shape, and the abnormal distribution of the renal vessels and renal calyces.
Aorta, Abdominal ; Arteries ; Cadaver ; Extremities ; Female ; Fused Kidney* ; Humans ; Kidney ; Kidney Pelvis ; Mesenteric Artery, Inferior ; Middle Aged ; Radiography ; Renal Artery ; Renal Veins ; Spine ; Splanchnic Nerves ; Veins ; Vena Cava, Inferior

No abstract available.
Arteriovenous Fistula* ; Biopsy*

No abstract available.
Lymphoma, Large-Cell, Anaplastic*

The prognostic factors for extrahepatic biliary atresia (EHBA) after Kasai portoenterostomy include the patient's age at portoenterostomy (age), size of bile duct in theporta hepatis (size), clearance of jaundice after operation (clearance) and the surgeon's experience. The aim of this study is to examine the most significant prognostic factor of EHBA after Kasai portoenterostomy. This retrospective study was done in 51 cases of EHBA that received Kasai portoenterostomy by one pediatric surgeon. For the statistical analysis, Kaplan-Meier method, Logrank test and Cox regression test were used. A p value of less than 0.05 was considered to be significant. Fifteen patients were regarded as dead in this study, including nine cases of liver transplantation. There was no significant difference of survival to age. The age is also not a significant risk factor for survival in this study (Cox Regression test; p = 0.63). There was no significant difference in survival in relation to the size of bile duct. However, bile duct size was a significant risk factor for survival (Cox Regression test; p = 0.002). There was a significant difference in relation to survival and clearance (Kaplan-Meier method; p = 0.02). The clearing was also a significant risk factor for survival (Cox Regression test; p = 0.001). The clearance of jaundice is the most significant prognostic factor of EHBA after Kasai portoenterostomy.
Bile Ducts ; Biliary Atresia* ; Humans ; Jaundice ; Kaplan-Meier Estimate ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Risk Factors

Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.
Calcaneus ; Follow-Up Studies ; Tendinopathy

No abstract available.
Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells*