Giant condyloma and carcinoma-like condyloma is relatively rare. Although it has histological similarities to condyloma acuminata, it is believed by most authorities to be a clearly defined variant of epidermoid carcinoma. Clinically it is easily mistaken for the more aggressive metastasing epidermoid carcinoma. The legion was first described by Buschke in the German literature in 1896. as a varient of condyloma acuminata. A case of malignancy of the penis which have apparently been transformed from giant condyloma acuminata of the penis are herein presented with review of literature.
Carcinoma, Squamous Cell ; Male ; Penis

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Angiography ; Anoxia ; Causality ; Echocardiography ; Emergency Service, Hospital ; Female ; Humans ; Infarction* ; Intensive Care Units ; Middle Aged ; Protein C Deficiency ; Pulmonary Embolism ; Risk Factors ; Splenic Infarction ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

BACKGROUND: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. MATERIAL AND METHOD: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. RESULT: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. CONCLUSION: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischemic heart disease should undergo a preoperative coronary angiography to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.
Angiography ; Arteries ; Arteriosclerosis ; Atherosclerosis ; Cause of Death ; Coronary Angiography* ; Coronary Artery Bypass ; Diabetes Mellitus ; Extremities ; Heart ; Heart Diseases ; Hospitalization ; Humans ; Hypercholesterolemia ; Hypertension ; Lower Extremity* ; Mortality ; Myocardial Ischemia ; Peripheral Arterial Disease ; Peripheral Vascular Diseases ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. MATERIAL AND METHOD: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. RESULT: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. CONCLUSION: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischemic heart disease should undergo a preoperative coronary angiography to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.
Angiography ; Arteries ; Arteriosclerosis ; Atherosclerosis ; Cause of Death ; Coronary Angiography* ; Coronary Artery Bypass ; Diabetes Mellitus ; Extremities ; Heart ; Heart Diseases ; Hospitalization ; Humans ; Hypercholesterolemia ; Hypertension ; Lower Extremity* ; Mortality ; Myocardial Ischemia ; Peripheral Arterial Disease ; Peripheral Vascular Diseases ; Risk Factors ; Smoke ; Smoking

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Angiography ; Anoxia ; Causality ; Echocardiography ; Emergency Service, Hospital ; Female ; Humans ; Infarction ; Intensive Care Units ; Middle Aged ; Protein C Deficiency ; Pulmonary Embolism ; Risk Factors ; Splenic Infarction ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Objective: Urgent upper endoscopy is performed to achieve acute hemostasis in patients with high-risk bleeding sources. Emergency physicians must identify patients who require urgent endoscopic treatments. This study assessed the performance of blood urea nitrogen (BUN) for predicting severe bleeding that necessitates urgent endoscopic hemostasis compared to the risk assessment scores in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB). Methods: The presumed ANVUGIB patients were classified into endoscopic and non-endoscopic hemostasis groups. Data including historical features, symptoms, signs, and routine laboratory tests were collected and compared. Results: Three hundred and ninety-one patients were analyzed, including 116 patients in the endoscopic hemostasis and 275 patients in the non-endoscopic hemostasis group. In the area under curve (AUC) of the receiver operator characteristic curve, BUN (AUC 0.733; 95% confidence interval [CI], 0.681-0.785) and BUN/creatinine (AUC, 0.727; 95% CI, 0.672-0.783) were superior to total protein, Glasgow-Blatchford score (GBS), modified GBS (AUC, 0.649, 0.623 and 0.646, respectively) for predicting endoscopic hemostasis. Pre-endoscopy Rockall score and AIMS65 were statistically insignificant. The same results were obtained when the patients with liver and chronic kidney diseases were excluded. Conclusion The current results suggest that BUN was an independent predictor of endoscopic hemostasis in patients with ANVUGIB. Further studies will be needed to determine if BUN can be used in clinical practice.