Peutz-Jeghers syndrome (PJS) is a rare hereditary disease where the clinical manifestations are multiple harmatomatous gastrointestinal polyps and pigmentations of the skin. A harmatomatous polyp can develop at any part of the gastrointestinal tract, and the proximal small bowel is frequently involved. Intestinal obstruction, bleeding and intussusception, caused by GI polyps have been reported, which often require repeated surgery. A female patient presented with suffering of abdominal pain for two days duration. The patient was diagnosed with intussusception, and a resection and anastomosis of the small bowel was performed. The patient was treated for 15 days, and was discharged from the hospital without any particular complications. We report this case with a review of the literature.
Abdominal Pain ; Female ; Gastrointestinal Tract ; Genetic Diseases, Inborn ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Skin ; Stress, Psychological

No abstract available.
Dermatitis, Allergic Contact

BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.
Anesthesia, General ; Cardiac Output, Low ; Cause of Death ; Heart Failure ; Humans ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Shock

This study was conducted by analyzing all 33 articles based on the LISREL, published from January 1991 to March 1999 in Korea. The analyses consisted of the publication date of articles, principal dependent variables, subjects of the research, adequacy of sampling, adequacy of research purposes and results, accordance between theoretical model and hypothetical model, fit measures, theoretical base of model modification, and adequacy of conclusion. The results were as follows : The thesis of 33 articles in total were outnumbered as 25 (75.8%) to 8 (24.2%) research articles. As for a sex classification of the subjects, 45.5% of the research were conducted around a female group of subjects, while 54.5% were done for both sex, The range of the sample size was 105 to 803, and the average was 259 subjects. A single theoretical variable was measured for each measurement variable, any difference between variables was hardly found in 8 articles (24.2%), and 19 articles (57.6%) did not consider any measurement error. To analyze if the representative has been considered while collecting the data, most data were collected by a convenient sampling. Seven articles (21.2%) were seen with a sign of a representative. Questionnaires were used in a majority (31 articles) of the data collecting process. Only 2 articles (6.1%) were measured with a physiologic index simultaneously. 14 articles (42.2%) were centered on theory development, 10 articles on theory synthesis, and 9 articles on theory test. The research purposes and results were consistent in 25 articles (75.5%) and 8 articles (24.2%) were inconsistent. The quality of life and health promotion behavior were the concepts most frequently studied as a dependent variable, and 7 articles centered on them. In applied theories a health promotion model was used on 4 articles (12.1%), while role theory and stress-coping models were in 3 articles respectively. The articles were analyzed to see if the hypothetical model was elaborated and tested by the theoretical model. Twenty-five articles proved to be rationale for the inconsistencies. Also, 56.5% proposed hypotheses were supported among the subject articles, and 30 articles (90.0%) suggested a revised model. Path coefficient (17 articles) and theoretical adequacy (17 articles) were the standards mostly used. In conclusion, the principal factors were obtained from the research are to be considered as the principes of LISREL application. First, a model has to be established on a theoretical base rather than empirical results dependent on the data. The results are also required to be globally interpreted. Secondly, at least 200 samples are necessary to satisfy the need. Third, more than 3 measurement variables are to be adjusted to a single theoretical variable; the measurement errors must be suggested as well. Finally, normal distribution characteristics of the data and the estimation method need to be reported. Based on the research result, the follows are suggested; Systematic criteria on the LISREL application and procedure need to be developed Agreement form is required to report the results of research using the LISREL
Classification ; Female ; Health Promotion ; Humans ; Korea ; Models, Theoretical ; Nursing Research* ; Nursing* ; Publications ; Quality of Life ; Surveys and Questionnaires ; Sample Size

No abstract available.
Syphilis, Cutaneous

To study why the palmar capsular connections between radius and lunate remain intact in perilunate ligamentous injury of the wrist joint, and to compare the material properties of the short radiolunate, long radiolunate, and radioscaphoid region of the radioscaphocapitate ligaments (as the extrinsic ligaments) with those of the intrinsic ligaments of the previous papers, the anatomical and mechanical characteristics of those three palmar radiocarpal ligaments of twenty cadavers were measured and tested by a servo-hydraulic test machine. In spite of its small cross-sectional area (24% of short radiolunate ligament), the radioscaphoid ligament demonstrates a failure load of 58% and a stress of 260% of the short radiolunate ligament, and toughness similar to both the short and long radiolunate ligaments. This suggests that the radioscaphocapitate ligament may contribute as an initial constraint to perilunate injury. The failure load of the scapholunate ligament might be smaller than previously reported due to testing strain rate, which coupled with its short initial length may make it more vulnerable to injury at lower applied loads. The short radiolunate ligament, in spite of the largest width and cross-sectional area, has a failure load and toughness similar to the long radiolunate ligament. The material properties of short and long radiolunate ligaments may explain why the rest of the carpals persistently dislocate or fracture about lunate.
Cadaver ; Ligaments* ; Radius ; Wrist Joint ; Wrist*

Piloleiomyoma is a benign neoplasm arising from the erector pili muscle in the skin. It occurs as linear or dermatomal arrangements of firm, red to brown intradermal nodules, which are fixed to the skin but not to the deeper tissues. Although various treatments have been attempted, they have shown limited success and several complications remain. A 21-year-old male presented with 3-year history of multiple, erythematous, firm 4 mm to 3 cm sized nodules on the chest. The histopathological examination was compatible with piloleiomyoma. The lesions were removed using the dermal shaving method with a suction-assisted cartilage shaver. Each lesion were markedly flattened. This treatment was quicker and caused less subjective pain to the patient compared with those of classic surgical excision. No signs of adverse events or recurrence have been observed.
Cartilage ; Humans ; Male ; Muscles ; Recurrence ; Skin ; Thorax ; Young Adult

BACKGROUND: Although there are growing evidences linking Chlamydophila pneumoniae infection to myocardial infarction, it remains controversial. The authors intended to assess whether C. pneumoniae infection is associated with myocardial infarction. METHODS: Sera and peripheral mononuclear cells (PMNCs) were collected from 54 cases of acute myocardial infarction (MI), 33 cases of old MI, and 60 normal controls. Anti-C.pneumoniae IgG and IgM antibodies were measured using a microimmunofluorescence (mIF) method, and C.pneumoniae DNA was detected using polymerase chain reaction (PCR). RESULTS: Seropositivity of anti-C.pneumoniae IgM antibody by mIF was shown 5.0% in control group, 29.6% (OR=8.00) in the acute MI and 6.1% (OR=1.23) in old MI group. Seropositivity of anti C.pneumoniae IgG antibody were 60.0 % in control group, 92.6% (OR=8.33) in the acute MI and 87.9% (OR= 4.83) in old MI group. The antibody titers in the acute MI and old MI group tended to be higher compared to those in control group. No C.pneumoniae DNA was detected in any case by PCR. CONCLUSION: The seropositivity and antibody titers were significantly higher in the acute MI and old MI group than in control group, suggesting that C.pneumoniae infection may be a risk factor for myocardial infarction.
Antibodies ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila* ; DNA ; Immunoglobulin G ; Immunoglobulin M ; Myocardial Infarction* ; Pneumonia ; Polymerase Chain Reaction ; Risk Factors

No abstract available.
Humans ; T-Lymphocytes*

BACKGROUND: Hypoxemia during one lung ventilation (OLV) for thoracotomy in patients in the lateral position remains a clinical problem. And thoracic epidural anesthesia (TEA) during one lung ventilation recently has been combined with general anesthesia in our clinical practice for thoracic surgery. Then the effects of TEA combined with general anesthesia on PaO2 remains controversial. The aim of this study to investigate whether thoracic epidural anesthesia (TEA) affect PaO2 and pulmonary shunt during one lung anesthesia. METHODS: Fifteen patients undergoing lobectomy with one lung ventilation were examined. Each group was injected normal saline (control group, n = 7) or 1% lidocaine (TEA group, n = 8) 8 ml through thoracic epidural catheter after induction. We compared pulmonary shunt fraction (Qs/Qt) after OLV 30, 60 minutes and after two lung ventilation (TLV). RESULTS: We found the significant increases of intrapulmonary shunt fraction (%) in the TEA group compared to control group at each event, OLV30, 60 and TLV. And significant increase of intrapulmonary shunt was found after one lung ventilation in the both groups. CONCLUSIONS: These results suggest that TEA may influence hypoxic pulmonary vasoconstriction (HPV) by blockade of sympathetic activity during OLV.
Anesthesia* ; Anesthesia, Epidural* ; Anesthesia, General ; Anoxia ; Catheters ; Humans ; Lidocaine ; Lung* ; One-Lung Ventilation ; Tea ; Thoracic Surgery ; Thoracotomy ; Vasoconstriction ; Ventilation