Therapeutic irradiation can induce angiosarcoma. Radiation-induced angiosarcoma constitutes 20% of all angiosarcomas. Although its common site of origin is the skin and subcutaneous tissue, it rarely arises in small or large bowels with a presentation as multifocal abdominal angiosarcomatosis. We report a case of intra-abdominal angiosarcomatosis involving the jejunum, ileum, transverse colon, mesentery and right ovary in a 63-year-old female. It developed 10 years after therapeutic irradiation for squamous cell carcinoma of uterine cervix. She developed panperitonitis due to intestinal perforation. She died from sepsis 3 days after segmental resection of the small bowel and right oophorectomy. We reviewed the previously reported cases and describe the clinicopathologic features of this tumor.
Carcinoma, Squamous Cell ; Cervix Uteri ; Colon, Transverse ; Female ; Hemangiosarcoma ; Humans ; Ileum ; Intestinal Perforation ; Jejunum ; Mesentery ; Middle Aged ; Ovariectomy ; Ovary ; Sepsis ; Skin ; Subcutaneous Tissue

No abstract available.
Estrogens* ; Fibrosis*

BACKGROUND: Spontaneous bacterial peritonitis(SBP) is an infection of ascitic fluid without any apparent intra-abdominal foci of sepsis. Although the definitive diagnosis of SBP requires a positive ascitic fluid culture, causative organisms are not isolated in up to 65% of patients with well defined SBP probably due to inadequate culture techniques. We compared two culture methods for ascites : conventional and blood culture method. METHODS: From June 1989 until December 1994, the blood culture method of ascitic fluid culture was performed(Group A). Ascitic fluid was inoculated at the bedside directly into one aerobic and one anaerobic BACTEC blood culture bottles. During the period from January to December 1995, ascitic fluid was processed by the conventional culture method of inoculating a sample of ascitic fluid on sheep blood agar, MacConKey agar, brucella agar and into thioglycolate broth(Group B). RESULTS: Ascites cultures were positive more frequently with the blood culture method(25 of 56, 44.6%) than with the conventional method(113 of 370; 30.5%) (P<0.05). Sixteen of the 56 patients in Group A had SBP and 29 had culture negative neutrocytic ascites(CNNA) while 66 of the 370 patients in Group B had SBP and 229 had CNNA The conventional method recovered more contaminating microorganisms than the blood culture method(17.7% vs 6.9%). CONCLUSIONS: The inoculation of ascitic fluid into the BACTEC blood culture bottles at the bedside is more sensitive than the conventional method of inoculation on solid media at the laboratory bench in the recovery of pathogens in SBP and should be used routinely for the optimum diagnosis of SBP.
Agar ; Ascites ; Ascitic Fluid* ; Brucella ; Culture Techniques ; Diagnosis ; Humans ; Peritonitis* ; Sepsis ; Sheep

No abstract available.

Papillary and solid epithelial neoplasm is a rare pancreatic tumor of low-grade malignancy. We report a case of a 23 year old female having solid and papillary neoplasm of the pancreatic tail with mutiple omental and peritoneal metastases. Microscopically, the main tumor showed typical histologic findings including solid and papillary areas with cystic change. But the metastasizing nodules were largely solid and the tumor cells demonstrated increased nuclear pleomorphism, hyperchromasia and an increased mitotic rate. The tumor cells contained considerable amount of intracellular and extracellular eosinophilic inclusions which were ultrastructually zymogen-like granules. These inclusions were more frequently found in the metastatic nodules. By flow cytometric study, the tumor was hyperdiploid. The DNA index was not significant.
Female ; Humans ; Neoplasm Metastasis

PURPOSE: To describe a case of exercise-induced anaphylaxis presenting with lower lid angioedema. CASE SUMMARY: A 35-year-old female patient for the past 3 years experienced lower lid edema in her left eye after exercising. In the treadmill exercise test, sneezing, coughing, and lower lid edema in her left eye appeared 13 minutes after initiating exercise. Additionally, contrast-enhanced computed tomography scan revealed minimal soft tissue thickening of the left inferior periorbital subcutaneous area with subtle enhancement after exercise. The serum immunoglobulin E (IgE) test showed elevated total IgE levels. The patient was diagnosed with exercise-induced anaphylaxis based on the above results. We informed the patient on her trigger factors and possible symptoms and prescribed an oral antihistamine and steroid. CONCLUSIONS: In patients presenting with facial edema or eyelid edema after exercise, the possibility of exercise-induced anaphylaxis should be considered. In addition, we have to aware of possibility of complication such as airway obstruction or a life-threatening condition, and it is needed to prevent a recurrence of anaphylaxis by cooperating with other department.
Adult ; Airway Obstruction ; Anaphylaxis* ; Angioedema* ; Cough ; Edema ; Exercise Test ; Eyelids ; Female ; Humans ; Immunoglobulin E ; Immunoglobulins ; Recurrence ; Sneezing

Dr. Youn-Sic Chun and coworkers invented the new machine for getting information about the relative effectiveness of the orthodontic appliances and we named it Calorific machine. The author and colleagues used this machine to compare with tooth moving mechanism by 3 types of the insertion method of precision-TPA for derotating the posterior teeth. We measured the distance of tooth movement and found out the rotational center on the occlusal X-ray film and the tooth movement on the occlusogram and then processed paired t-test by SAS program. The results were as follow : 1. In the intermolar width, the mesial insertion method showed the loss of distance, and the other methods(-distal insertion method, mesial expansion method-) showed the increase of distance. 2. In the arch length, the distal insertion method was exhibited as most recommandable way for increasing the arch length. 3. The rotation center of the mesial insertion method for derotating the molar, was located between mesial pit and central pit of the lower 2nd molar. and, in the distal insertion method, it was located between distal pit and distolingual cusp, and in the mesial expansion method was located at distal pit.
Molar ; Orthodontic Appliances ; Tooth Movement ; Tooth* ; X-Ray Film

PURPOSE: The aim of this study was to evaluate the operative feasibility and safety of endoscopic thyroidectomy via bilateral axillo breast approach (BABA) compared to conventional thyroidectomy in papillary thyroid carcinoma (PTC) patients. METHODS: From July 2009 to November 2010, patients underwent BABA endoscopic thyroidectomy (ET group; n=41) or conventional open thyroidectomy (OT group; n=61) for PTC. Clinical and pathologic characteristics of patients, operation time, post-operative complications, cosmetic satisfaction and thyroglobulin (TG) level were analyzed retrospectively. RESULTS: The mean age of the patients was 40.05±9.58 years (range 25~61 years) and 46.21±13.68 years (range 19~79 years) for the ET and OT group, respectively. The operative extent in the ET group did not include advanced thyroid cancer or lateral neck dissection. The size of the tumor was 0.78±0.59 cm (range 0.1~3.00 cm) and 1.54±1.05 cm (range 0.3~6.00 cm) for the ET and OT group, respectively. Extrathyroidal extension and number of retrieved lymph nodes were significantly higher in the OT group. Postoperative radioactive iodine ablation was performed on 25 patients (72.43%) in the ET group and 48 patients (78.69%) in the OT group. There was no abnormal uptake on radioactive iodine scans in the iodine-treated patients and no significant differences in postoperative off-T4 TG levels between the two groups. There were no significant differences in operative time, amount of drainage, postoperative hospitalization period, hypocalcemia, and vocal cord palsy between the two groups. Cosmetic results of ET group were rated as excellent in a 3-month postoperative questionnaire by 25 (72.43%) of 35 patients. CONCLUSION: Endoscopic thyroidectomy via the bilateral axillo breast approach can be a feasible and effective option for PTC in selected cases.
Breast* ; Drainage ; Hospitalization ; Humans ; Hypocalcemia ; Iodine ; Lymph Nodes ; Neck Dissection ; Operative Time ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy* ; Vocal Cord Paralysis

BACKGROUND: The aim of this study was to analyze the gender factors associated with good or bad prognosis after return of spontaneous circulation after out-of hospital cardiac arrest. METHODS: The patients admitted to the intensive care unit after successful resuscitation after out-of hospital cardiac arrest were retrospectively identified and evaluated. Thirty days mortality after admission, and neurologic outcome at 6 months after hospital discharge (cerebral performance category [CPC]) were evaluated. RESULTS: One hundred forty-two patients were evaluated in this study; there were 101 males (71.1%). The median age was 52 years old (43-63). Thirty days after admission, 85 patients (59.9%) survived, 40 patients had a good neurologic outcome (CPC 1-2). The factors associated 30 days mortality were cause of arrest (non-cardiac, p = 0.03), lactate in emergency department (p = 0.05) and the factors associated with good neurologic outcome were males (p = 0.007), young age (p = 0.01), body weight and height (p = 0.001), cause of death (cardiac, p = 0.000). Alcohols and smoking were not associated with mortality and neurologic outcome. In multiple logistic regression analysis, men had a 8-fold increased good neurologic outcome (CPC 1-2) (odds ratio [OR] 8.038, 95% Confidence Interval [CI] 1.079-59.903). Other factors associated with good neurologic outcome were cardiac cause of death (OR 5.523, 95% CI 1.562-19.533) and young age (OR 1.055, 95% CI 1.009-1.103). CONCLUSIONS: Men had a good neurologic outcome after return of spontaneous circulation after out-of hospital cardiac arrest in one emergency center. Other additional factors including gonadal hormones should be evaluated.
Alcohols ; Body Weight ; Cause of Death ; Emergencies ; Gonadal Hormones ; Heart Arrest ; Humans ; Intensive Care Units ; Lactic Acid ; Logistic Models ; Male ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Resuscitation ; Retrospective Studies ; Smoke ; Smoking

BACKGROUND: Recently, there have been reports of infections with multidrug-resistant Pseudomonas aeruginosa. To determine the mechanism of the resistance, we investigated the prevalence of Ambler class A and D beta-lactamases, their extended-spectrum derivatives, and class B and D carbapenemase in multidrug-resistant P. aeruginosa isolates. METHODS: During the period of March 2006 to May 2007, clinical isolates of multidrug-resistant P. aeruginosa were collected from patients in Chungnam National University Hospital, Daejeon, Korea. Inhibitor-potentiated disk diffusion tests were used for the screening of metallo-beta-lactamase (MBL) production. PCR and DNA sequencing were conducted for the detection of beta-lactamase genes. We also employed the enterobacterial repetitive intergenic consensus (ERIC)- PCR method for an epidemiologic study. RESULTS: A total of 37 consecutive, non-duplicate, multidrug-resistant P. aeruginosa were isolated. Twenty- nine of 37 isolates harbored blaOXA-10 (56.8%), blaOXA-2 (18.9%), and blaOXA-1 (5.4%). Only one isolate produced IMP-1, and it also harbored blaOXA-1. None harbored Ambler class A beta-lactamase or class D carbapenemase. The strains producing OXA type beta-lactamases showed a significantly higher resistance to aminoglycoside compared to non-producers. The ERIC-PCR pattern of the 19 OXA-10 producing strains indicated that the isolates were closely related in terms of clonality. CONCLUSION: OXA type beta-lactamases are the most prevalent among the acquired beta-lactamases produced by multidrug-resistant P. aeruginosa isolated at a university hospital in Chungcheong Province. Besides beta-lactam antibiotics, the strains harboring OXA type beta-lactamase showed a significantly higher resistance to aminoglycoside and qunolone.
Anti-Bacterial Agents ; Bacterial Proteins ; beta-Lactamases ; Consensus ; Diffusion ; Drug Resistance, Multiple ; Epidemiologic Studies ; Humans ; Korea ; Mass Screening ; Oxytocin ; Polymerase Chain Reaction ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Sequence Analysis, DNA