No abstract available.
Anemia, Hemolytic, Autoimmune* ; Child* ; Hepatitis, Chronic* ; Humans

No abstract available.
Child* ; Humans ; Immunoglobulin G* ; Measles*

BACKGROUND: The selection of anesthetic agents is important in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome patient because serious and unexpected complications can occur after anesthetic exposure.CASE: A 30-year-old man with MELAS syndrome and sepsis underwent colectomy. Propofol was administered by step-wise until target effect-site concentration (Ce) 1.0 µg/ml and stopped for the loss of consciousness and to avoid hemodynamic instability. After the loss of consciousness, total intravenous anesthesia (TIVA) using dexmedetomidine (1.0 µg/ml/h) and remifentanil (1–4 ng/ml of Ce) was performed for the maintenance of anesthesia to avoid malignant hyperthermia and mitochondrial dysfunction. During the surgery, the bispectral index score stayed between 26 and 44, and increased to 97 after the end of anesthesia.CONCLUSIONS: TIVA with dexmedetomidine and remifentanil as non-triggering anesthetic agents in patients with MELAS syndrome and systemic sepsis may have advantages to decrease damages associated with mitochondrial stress and metabolic burden.
Adult ; Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Colectomy ; Dexmedetomidine ; Hemodynamics ; Humans ; Malignant Hyperthermia ; MELAS Syndrome ; Propofol ; Sepsis ; Unconsciousness

BACKGROUND AND OBJECTIVE: Mitral annulus velocity measured by doppler tissue imaging (DTI) has been used as a method of evaluation of the left ventricular diastolic function. This study was aimed to evaluate the left ventricular diastolic function using the mitral annulus velocity measured by DTI in the patients with hypertension. METHODS AND SUBJECTS: One hundered twenty nine patients with blood pressure above 140/90mmHg and age sex matched 123 normotensive subjects were studied. For measuring the mitral annulus velocities by DTI, we used the 2.5 MHz probe (Sequoia, Accuson) in apical four chamber view with the sample volume at the septal portion of the mitral annulus. RESULTS: Mitral annular velocities were easily obtained from all subjects. In the hypertension group, mitral annulus E'velocity was significantly lower than normotensive controls (5.4 1.3 cm/sec vs 6.5 1.8 cm/sec, p<0.001) and mitral annulus A' velocity was significantly higher than normotensive controls (8.6 1.4 cm/sec vs 7.9 1.1 cm/sec, p<0.001). In comparison with patients with normal LVML(IV mass index in hypertension group and subjects with normal LVMI in normotensive controls, mitral annulus E'velocity was reduced in patients with normal LVMI in hypertension group compared with subjects with normal LVMI in normotensive controls (5.6 1.4 cm/sec vs 6.7 1.8 cm/sec, p<0.001). CONCLUSION: Mitral annulus velocity measured by DTI could be used as one of the parameters in evaluating the early changes of left ventricular diastolic function in the patient with hypertension.
Blood Pressure ; Humans ; Hypertension*

To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation(KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: 16.76~17.92) per 100,000 and the cumulative rates for the ages 0~64 and 0~74 were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in 1983~1987. The truncated rate for ages 35~64 was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged 55~59 years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.
Asian Continental Ancestry Group ; Cervix Uteri* ; China ; Diagnosis ; Epidemiology ; Female ; Gynecology ; Humans ; Incidence* ; Insurance ; International Classification of Diseases ; Japan ; Korea ; Medical Records ; Specialization

Bronchial foreign body aspirations are uncommon in adults and usually have various underlying conditions, otherwise accidentally occurred in dental procedure, medical, surgical procedure. The most commonly aspirated objects were food materials, with peanuts leading the list. When bronchial foreign body was aspirated, no definite respiratory symptoms or foreign body is may not seen, then diagnosis is delayed. Therefore late complications was developed. The tendency to use fiberoptic bronchoscope for removal of foreign bodies in adults is increased. We report a rare case of bronchial pneumonia due to occult aspiration of a twig before 1 year with a review of the literatures.
Adult ; Arachis ; Aspirations (Psychology) ; Bronchopneumonia ; Bronchoscopes ; Diagnosis ; Foreign Bodies ; Humans ; Pneumonia*

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.
Adult ; Breast ; Epididymis ; Humans ; Male ; Myoepithelioma ; S100 Proteins ; Salivary Glands ; Skin ; Testis

No abstract available.

OBJECTIVE: To investigate the clinical characteristics and associated risk factors for emergency peripartum hysterectomy classified by the amounts of blood loss. MATERIAL AND METHODS: We reviewed the medical records of 159 cases of peripartum hysterectomy among 46,666 deliveries, from Jan. 1995 to Dec. 2005 at the Dept. of Ob. & Gy. of Graduate School of Medicine, Gachon University of Medicine and Science. We divided the 159 cases into three groups based on the amounts of blood loss, which were group A as less than 2,000 mL of blood loss, group B as 2,000 to 4,000 mL of blood loss, and group C as more than 4,000 mL. The incidence, the type of delivery, the amounts of transfusion, the operative indication and the complications of peripartum hysterectomy were evaluated. RESULTS: The incidence of peripartum hysterectomy was 0.34% (159/46,666) and 0.47% in cases of cesarean section and 0.19% in vaginal delivery, respectively. There was no meaningful correlation between maternal age, parity, gestational age, hospital stay and amount of blood loss. The increments of blood loss correlated to the frequency of peripartum hysterectomy after cesarean section (p<0.05). The most common operative indication in group A was uterine atony (47.19%), and those in group B and C were adherent placentation (48.08%, 50.00%). Intraoperative and postoperative complications according to excessive bleeding were increased, and DIC, pulmonary infection, urethral and bladder injury were observed more frequently in group C than in group A. CONCLUSION: The emergency peripartum hysterectomy was related to adherent placentation and was accompanied with increased blood loss.
Cesarean Section ; Dacarbazine ; Emergencies ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Length of Stay ; Maternal Age ; Medical Records ; Parity ; Peripartum Period ; Placentation ; Postoperative Complications ; Pregnancy ; Risk Factors ; Urinary Bladder ; Uterine Inertia

Milwaukee shoulder syndrome is a rare clinical entity that is a rapid destructive shoulder arthropathy associated with deposition of calcium hydroxyapatite crystals. It mainly affects elderly women. It is characterized by the presence of large amount of noninflammatory synovial fluid containing calcium hydroxyapatite crystals, a complete tear of the rotator cuff and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. We present a case of a 65-year-old woman suffered by Milwaukee shoulder syndrome with literature view.
Aged ; Durapatite ; Female* ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder* ; Synovial Fluid