Secondary cutaneous cryptococcosis may occur earlier than other manifestations of disseminated cryptococcosis. A 68-year-old woman presented with multiple ulcerative lesions on the right calf of 2 weeks duration. She had been treated with antibiotics, but the lesions spread rapidly. The initial clinical impression was necrotizing fasciitis, but routine KOH mounting from the ulcerative lesions showed numerous budding yeast cells with peripheral clear zones and further investigations including a skin biopsy, tissue cultures and India ink preparations allowed a rapid and definitive diagnosis of cutaneous cryptococcosis. Studies for other evidence of infection elsewhere revealed an asymptomatic pulmonary lesion. We report a case of secondary cutaneous cryptococcosis clinically mimicking necrotizing fasciitis that occured before other manifestations of disseminated cryptococcosis.
Aged ; Anti-Bacterial Agents ; Biopsy ; Cryptococcosis* ; Diagnosis ; Fasciitis, Necrotizing* ; Female ; Humans ; India ; Ink ; Saccharomycetales ; Skin ; Ulcer

OBJECTIVE: The goal of this study was to determine the efficacy of prolotherapy in relieving the pain of patients with tendon or ligament laxity. METHOD: The subjects were 67 patients (40 male, 27 female) who were suffering from chronic musculoskeletal pain, excluding those with metabolic diseases that could influence the nature of the pain. The effect of the treatment was evaluated by checking the VAS score after a monthly injection of 15% dextrose solution injected around the patient's ligaments and teno-osseous junction that were suspicious of laxity. This same procedure was followed after a second injection. To make an accurate evaluation before and after the treatment, the use of NSAID, physical therapy or exercise therapy was prohibited. RESULTS: The mean pain duration of the subjects was 5.48+/-7.04 years, and the mean age of the subjects was 49.58+/-16.52 years. The result from VAS showed a statistically remarkable reduction after the injection (p<0.01). The VAS decreased from 7.00+/-0.17 to 4.31+/-0.21 after the first injection and this score further decreased to 2.55+/-0.19 after the second injection. There was no statistically significant relationship between the duration of pain and the effect of the treatment (p>0.05). CONCLUSION: This research demonstrated that prolotherapy is an effective method in treating patients with chronic musculoskeletal pain caused by tendon or ligament relaxation.
Chronic Pain* ; Exercise Therapy ; Glucose ; Humans ; Ligaments ; Male ; Metabolic Diseases ; Musculoskeletal Pain ; Musculoskeletal System* ; Relaxation ; Tendons

No abstract available.
Lymphocyte Subsets* ; Lymphocytes*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

No abstract available.
Cisplatin* ; Humans ; Nausea* ; Ondansetron* ; Vomiting*

No abstract available.
Aneurysm* ; Humans ; Hydrocephalus*

No abstract available.

No abstract available.
Lung Neoplasms* ; Lung*

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

PURPOSE: Takotsubo cardiomyopathy is a relatively uncommon type of stress-induced cardiomyopathy characterized by transient left ventricular regional wall motion abnormalities. Emotional and physical stresses play a key role in this type of cardiomyopathy in postmenopausal women. The current hypothesis is that the syndrome represents a form of catecholamine surge due to stress or epinephrine-mediated acute myocardial stunning. METHODS: A 44-year-old woman had suffered premature ventricular contraction following a cardiogenic shock during a breast augmentation surgery under enflurane anesthesia and tumescent solution infiltration. She was treated with cardiopulmonary resuscitation at a local clinic. Then she was brought to the Emergency Department of the authors' hospital. RESULTS: The woman's echocardiogram showed an ejection fraction of 20~25% with associated basal hyperkinesis and left ventricular apical ballooning. The patient was admitted to the ICU and required inotropic support for two weeks. The patient's condition dramatically improved, and her ejection fraction returned to 70%. CONCLUSION: It is believed that there were multiple triggering factors of the onset of Takotsubo cardiomyopathy in the woman's social and family history, including infiltration of a large volume of the tumescent solution and VPCs induced by enflurane anesthesia without premedication. The importance of careful history-taking, careful pre-operative consultation on psychological suffering especially for breast surgery, premedication before surgery, patient reassurance, and post-operative psychosocial and emotional assistance was again seen in this case.
Adult ; Anesthesia ; Breast ; Cardiomyopathies ; Cardiopulmonary Resuscitation ; Emergencies ; Enflurane ; Female ; Humans ; Hyperkinesis ; Premedication ; Shock, Cardiogenic ; Stress, Psychological ; Takotsubo Cardiomyopathy ; Ventricular Premature Complexes