We experienced a case of postoperative mental change with seizure after propofol-N2O anesthesia for thoracoscopic sympathectomy. A 23-year-old male patient was anesthetized with N2O-O2-propofol, and postoperative pain control was achieved with intravenous morphine. Bilateral electrocauterization of the upper dorsal sympathetic chain at the T2 and T3 level was performed with thoracoscopy. Thoracoscopy was done with carbon dioxide insufflation. In the postoperative recovery room, the patient experienced seizure, fever and a mental change. He was transferred to the intensive care unit and treated with acyclovir, mannitol, diphenylhydantoin and dexamethasone. Fourteen days after the operation, the patient was discharged with a clear mentality.
Acyclovir ; Anesthesia* ; Carbon Dioxide ; Dexamethasone ; Fever ; Humans ; Insufflation ; Intensive Care Units ; Male ; Mannitol ; Morphine ; Pain, Postoperative ; Phenytoin ; Propofol ; Recovery Room ; Seizures* ; Seizures, Febrile ; Sympathectomy* ; Thoracoscopy ; Young Adult

Lichen nitidus is an uncommon chronic inflammatory disease characterized by multiple minute discrete flesh-colored dome shaped papules. Its distribution is frequently localized on trunk, arm or penis. There are a few cases reported to occur on palm and sole. We report a case of lichen nitidus which presents erythematous or brownish colored hyperkeratotic plaques, composed of 1-2 mm sized small papules on the right palm. Its hitopathologic findings were consistent with a diagnosis of lichen nitidus.
Arm ; Diagnosis ; Lichen Nitidus* ; Lichens* ; Male ; Penis

Purpose: This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR). Methods: A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test. Results: The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, p = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, p = .028 and t = 3.91, p < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem. Conclusion The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.

No abstract available.
Doxorubicin* ; Etoposide* ; Stomach Neoplasms*

Basal cell carcinoma(BCC)s are most frequently found on the sun-exposed skin of the head and neck regions. Rarely, BCCs occur in odd sites such as the scrotum, vulva, perineum, nipple, and axilla without any apparent carcinogenic factor such as arsenic, radiation, chronic ulceration or scars. Genital BCC accounts for fewer than 1% of all BCCs and vulvar BCCs represent fewer than 5% of all vulvar neoplasms. We report a case of BCC arising on the mons pubis clinically mimicking malignant melanoma, which presents with 2cm sized, deep purple colored protruding mass.
Arsenic ; Axilla ; Carcinoma, Basal Cell* ; Cicatrix ; Female* ; Genitalia* ; Head ; Humans ; Melanoma ; Neck ; Nipples ; Perineum ; Scrotum ; Skin ; Ulcer ; Vulva ; Vulvar Neoplasms

Seborrheic keratoses are benign skin tumors and exceedingly common. The etiology of seborrheic keratoses is unknown. Several possible causes such as genetic propensity, sun exposure, human papillomavirus and epidermal growth factors are suggested. Among these findings, their familial occurrences have been rarely reported in the literature. We report a case of early-onset, multiple, familial seborrheic keratoses in a 36-year-old man.
Adult ; Epidermal Growth Factor ; Humans ; Keratosis, Seborrheic* ; Skin ; Solar System

BACKGROUND/OBJECTIVES: Excessive intake of simple sugars induces obesity and increases the risk of inflammation. Thus, interest in alternative sweeteners as a sugar substitute is increasing. The purpose of this study was to determine the effect of saccharin on inflammation in 3T3-L1 adipocytes.MATERIALS/METHODS: 3T3-L1 preadipocytes were differentiated into adipocytes. The adipocytes were treated with saccharin (0, 50, 100, and 200 µg/mL) for 24 h. Inflammation was induced by exposure of treated adipocytes to lipopolysaccharide (LPS) for 18 h and cell proliferation was measured. The concentration of nitric oxide (NO) was measured by using Griess reagent. Protein expressions of nuclear factor kappa B (NF-κB) and inhibitor κB (IκB) were determined by western blot analysis. The mRNA expressions of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), interleukin 1β (IL-1β), interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-α (TNF-α) were determined by real-time PCR.RESULTS: Compared with the control group, the amount of NO and the mRNA expression of iNOS in the LPS-treated group were increased by about 17.6% and 46.9%, respectively, (P < 0.05), and those parameter levels were significantly decreased by saccharin treatment (P < 0.05). Protein expression of NF-κB was decreased and that of IκB was increased by saccharin treatment (P < 0.05). Saccharin decreased the mRNA expression of COX-2 and the inflammation cytokines (IL-1β, IL-6, MCP-1, and TNF-α) (P < 0.05).CONCLUSIONS: The results of this study suggest that saccharin can inhibit LPS-induced inflammatory responses in 3T3-L1 adipocytes via the NF-κB pathway.

BACKGROUND: We assessed the early and mid-term results of the modified Norwood procedure for first-stage palliation of hypoplastic left heart syndrome (HLHS) and its variants to identify the risk factors for hospital mortality. MATERIAL AND METHOD: Between March, 2003, and December, 2009, 23 patients (18 males and 5 females) with HLHS or variants underwent the modified Norwood procedure. The age at operation ranged from 3 to 60 days (mean, 11.7+/-13.2 days) and weight at operation ranged from 2.2 to 4.8 kg (mean, 3.17+/-0.52 kg). We used a modified technique that spared the anterior wall of the main pulmonary artery in 20 patients. The sources of pulmonary blood flow were RV-PA conduit in 15 patients (group I) and RMBTS in 8 (group II). Follow-up was completed in 19 patients (19/20, 95%) in our hospital (mean 26.0+/-22.8 months). RESULT: Early death occurred in 3 patients (3/23, 13%), of whom 2 had TAPVC. Fourteen patients underwent subsequent bidirectional cavopulmonary connection (BCPC, stage 2) and seven underwent the Fontan operation (stage 3). Three patients died between stages, 2 before stage 2 and one before stage 3. The estimated 1-year and 5-year survival rates were 78% and 69%, respectively. On multivariate regression analysis, aberrant right subclavian artery (RSCA) and associated total anomalous pulmonary venous connection (TAPVC) were risk factors for hospital mortality after stage 1 Norwood procedure. CONCLUSION: HLHS and its variants can be palliated by the modified Norwood procedure with low operative mortality. Total anomalous pulmonary venous connection adversely affects the survival after a stage 1 Norwood procedure, and interstage mortality rates need to be improved.
Aneurysm ; Cardiovascular Abnormalities ; Deglutition Disorders ; Follow-Up Studies ; Fontan Procedure ; Hospital Mortality ; Humans ; Hypoplastic Left Heart Syndrome ; Male ; Norwood Procedures ; Pulmonary Artery ; Risk Factors ; Subclavian Artery ; Survival Rate

The paper was printed with an error of omitting research funding source and author's affilication.