We experienced four cases of sporotrichosis including three lymphocutaneous type and one fixed cutaueous type. Case 1 was a 6-year old child, affected over the right chin. Case 2 was a 31-year old housewife, affected over the right forearm, Case 3 was a 53-year old housewife, affected over the right forearm and dorsum of right hand. Case 4 was a 19-year old student, affected over the left forearm. Histopathologically, chronic granulomatous inflammation with the neutrophilic ivfiltration and/or central suppuration were observed. Mycologically, typical colonies with moist, wrinkled and rnembraneous surface were cultured except in case 3. All patients were completly cured by oral administration of low dosage of potassium iodide(63. R-lllg) in a short period (50~86 days).
Administration, Oral ; Adult ; Child ; Chin ; Forearm ; Hand ; Humans ; Inflammation ; Middle Aged ; Neutrophils ; Potassium Iodide* ; Potassium* ; Sporotrichosis* ; Suppuration ; Young Adult

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

Septic embolism and stroke are serious complications in patients with sepsis and often necessitate urgent surgical intervention to control the source of infection. A 69-year-old man presented with severe pain in his back and left thigh. MRI revealed extensive posterior epidural or subdural abscesses extending from the cervical to the lumbar level, as well as an abscess in the iliopsoas muscle. The patient underwent urgent drainage of the abscesses and decompression of the lumbar spine.Postoperatively, he developed sudden-onset atrial fibrillation and altered mental status. Brain CT showed multiple embolic infarctions. His condition deteriorated due to persistent infection, leading to disseminated intravascular coagulation, acute kidney injury, and septic shock. This case highlights the risk of cerebral embolism and hemorrhagic complications in patients with sepsis who undergo surgery.Early recognition of individuals at high risk and comprehensive perioperative management are critical to reducing the likelihood of such complications.

A 35-year-old woman suffered from elementary visual symptom that was confirmed as nonconvulsive simple partial status epilepticus arising from the right occipital lobe. 99mTc-ECD SPECT and 18F-FDG PET were done during the ictal and interictal phase, respectively, which were documented by EEG. Subtraction images of SPECT and PET were overlayed on the MRI by SISCOM to compare the area of metabolic change with that of perfusion change. There was no definite mismatch between the hypermetabolic area and the hyperperfusion area during nonconvulsive status epilepticus.
Adult ; Electroencephalography ; Female ; Fluorodeoxyglucose F18* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe* ; Perfusion ; Status Epilepticus* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The 2005 guidelines for cardiopulmonary resuscitation (CPR) caution that effective compression is essential (Class I) and chest compression (CC) by rescuers should be switched every 2 minutes to avoid rescuer's fatigue. It is controversial how long effective CC by a single individual can be provided. There are few reports about CPR quality, especially when rescuers perform CC for more than 10 minutes. The mean CPR period was about 30 minutes in Korea. We investigated the quality of CC and rescuer's fatigue after about 30 minutes. METHODS: From April 2009 to July 2009, health care providers (HCPs) were recruited into this study. The study simulated 2 person, in-hospital CPR. On the test day, which had been randomly assigned, each participant performed 7 CCs for about 30 minutes. The period of each CC was 2 minutes, and the period of each circulation check was 5 seconds. Participants' heart rates (HR) and visual analogue scale (VAS) scores for fatigue were obtained before and after each CC. Data for each 2 minutes CC was obtained with the use of Resusci Anne(R) with the Laerdal(R) PC skill reporting system. We used one-way repeated measures ANOVA for comparison of quality and fatigue of each CC and multiple linear regression for finding the predictors for correct CC. SPSS 17.0 was used for analysis. RESULTS: Among a total of 30 HCPs, data from 27 were analyzed. All participants were certified as a BLS provider and some were certified as BLS instructors. The rate of effective compression was 83.8+/-24.3%. Despite 2 min CC tasks were repeated alternatively for about 30 minutes, there were no differences in the number of correct CCs, depth and velocity of compression, and the number of incorrect CCs. CONCLUSION: During in-hospital CPR, HCPs may provide effective chest compressions on shifts with minimal effect of fatigue, even if they provide CC for 30 minutes.
Cardiopulmonary Resuscitation ; Fatigue ; Health Personnel ; Heart Rate ; Humans ; Korea ; Linear Models ; Manikins ; Thorax

Recently, interest has been increased on the role of catecholamines in extrarenal potassium homeostasis. This study has undertaken to investigate the effects of epinephrine added to lidocaine for axillary block in HR, MAP, ABG, blood sugar and electrolytes (Na+, K+), and the effects of propranolol, beta-adrenergic blocker, on the data. The patients admitted to our hospital for operation of upper extremities were divided into three groups. Group I was 10 patients blocked with lidocaine 30 ml. Group II was 14 patients blocked with lidocaine 30 ml with epinephrine 0.3 mg(1:100,000). Group III was 10 patients pretreated with propranolol (10u/kg) and blocked with lidocaine 30 ml with epinephrine. After block, the results were as follows. 1) MAP decreased in all group and group III decreased more than group I. 2) HR increased all group and group III decreased more than group I. 3) ABG showed hypoventilatory pattern due to sedative effect by diazepam (0.15mg/kg). 4) Blood sugar value was increased in group I and II, showed increasing tendency in group III, but this tendency was not significant. 5) Blood K+ concentration decreased significantly and the maximal decrease was 0.5 mEq/L in 30 min after block, but there was not significant decrease in group III. This results indicate that clinical dose of epinephrine(1;100,000) decrease blood K+ concentration significantly and propranolol (10u/kg) pretreatment prevent K+ decreasing effect of epinephrine. In clinical practice, it is suggested that much care must be paid to use of local anesthetics with epinephrine to hypokalemic patients.
Anesthetics, Local ; Blood Glucose ; Brachial Plexus* ; Catecholamines ; Diazepam ; Electrolytes ; Epinephrine* ; Homeostasis ; Humans ; Hypnotics and Sedatives ; Lidocaine* ; Potassium ; Propranolol* ; Upper Extremity

Recently, interest has been increased on the role of catecholamines in extrarenal potassium homeostasis. This study has undertaken to investigate the effects of epinephrine added to lidocaine for axillary block in HR, MAP, ABG, blood sugar and electrolytes (Na+, K+), and the effects of propranolol, beta-adrenergic blocker, on the data. The patients admitted to our hospital for operation of upper extremities were divided into three groups. Group I was 10 patients blocked with lidocaine 30 ml. Group II was 14 patients blocked with lidocaine 30 ml with epinephrine 0.3 mg(1:100,000). Group III was 10 patients pretreated with propranolol (10u/kg) and blocked with lidocaine 30 ml with epinephrine. After block, the results were as follows. 1) MAP decreased in all group and group III decreased more than group I. 2) HR increased all group and group III decreased more than group I. 3) ABG showed hypoventilatory pattern due to sedative effect by diazepam (0.15mg/kg). 4) Blood sugar value was increased in group I and II, showed increasing tendency in group III, but this tendency was not significant. 5) Blood K+ concentration decreased significantly and the maximal decrease was 0.5 mEq/L in 30 min after block, but there was not significant decrease in group III. This results indicate that clinical dose of epinephrine(1;100,000) decrease blood K+ concentration significantly and propranolol (10u/kg) pretreatment prevent K+ decreasing effect of epinephrine. In clinical practice, it is suggested that much care must be paid to use of local anesthetics with epinephrine to hypokalemic patients.
Anesthetics, Local ; Blood Glucose ; Brachial Plexus* ; Catecholamines ; Diazepam ; Electrolytes ; Epinephrine* ; Homeostasis ; Humans ; Hypnotics and Sedatives ; Lidocaine* ; Potassium ; Propranolol* ; Upper Extremity