Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic* ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing* ; Toes

The risk of metachronous advanced neoplasia is linked to the presence of polyps on initial colonoscopy. Consequently, it is crucial to establish an appropriate colonoscopy surveillance period post-polypectomy.Current Concepts: The US Multi-Society Task Force, the European Society of Gastrointestinal Endoscopy, and the British Society of Gastroenterology revised their respective foreign guidelines in the 2020s. In Korea, a revised edition of post-polypectomy colonoscopic surveillance was announced in 2022, with the following risk factors: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesions containing any grade of dysplasia; (7) serrated polyps of at least 10 mm in size; and (8) 3 to 5 (or more) sessile serrated lesions. In these guidelines, suitable surveillance periods are suggested for each risk factor.Discussion and Conclusion: The evidence supporting the best practices for post-polypectomy colonoscopy surveillance has strengthened, helping to support both close follow-up for some populations and less intense follow-up for others.

BACKGROUND: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. METHODS: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. RESULTS: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17.2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr<75ml/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). CONCLUSION: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-predication factors in febrile neutropenia at the time of visiting the emergency department.
Comorbidity ; Emergency Service, Hospital ; Febrile Neutropenia ; Fever ; Humans ; Incidence ; Medical Records ; Mortality ; Neutropenia ; Retrospective Studies ; Seoul ; Shock, Septic ; Thorax ; Vital Signs

OBJECTIVES: The trial was performed to obtain an unbiased comparison of the relative merits of endocervical and vaginal prostaglandin E2(PGE2) in the case of parous and nulliparous woman with favorable and unfavorable cervical features. This study was performed to determine the clinical usefullness of endocervical PGE2 comparing with the vaginal PGE2 in cervical ripening and induction of labor. METHOD: The randomized trial with 65 Participants was performed with sealed envelopes for parity and Bishop score (from March to september, 1998). PGE2 tablet(3mg Dinoprostone) was administrated intravaginally to the 32 pregnant women and endocervically to the 33 pregnant women every eight hours with maximum three times until the regular labor develped. RESULT: Outcomes of labor and delivery were clearly related to cervical score at trial entry. endocerval PGE2 had a more marked effect on cervical ripeness than did vaginal PGE2. There were no significant differences on age distribution, gestatioanal period, primiparity, cervical status, initial B-score in each group. There were no significant differences in cesarian section rate, fetal distress, uterine hyperstimulation, side effect and poor infant outcome between the groups The mean induction time was statistically shorter in cervical group with multiparous women than other group(p=0.0195). In the induction-active labor time, cervical with primi group was statistically shorter than other group(p=0.0245). Statistically significant differences were noted between the nulliparous woman and multiparous women in mean induction time, induction-active labor time, time to B-score 8. In the factor that effects induction-active labor, route was significantly better than other factor.(p=0.0001) CONCLUSION: edocervical PGE2 is more effctive than vaginal PGE2 in cervical ripening and induction of active labor. the endocervical PGE2 resulted in a significantly shorter induction to active labor time compared with vaginal PGE2 and has almost no side effect. Because differences in effectiveness between endocervical and vaginal PGE2 are marginal, preference of woman and clinicians can the choice between them.
Age Distribution ; Cervical Ripening ; Dinoprostone ; Female ; Fetal Distress ; Humans ; Infant ; Parity ; Pregnancy ; Pregnant Women

Primary peritoneal leiomyoma is histologically benign and rare non-neoplastic proliferation of smooth muscle that occurs in the peritoneal wall during the reprodutive years of women. A 51-year old patient had a solid tumor of 18cm diameter in the peritoneal wall, which was pathologically confirmed as a benign leiomyoma primarily originated from the retroperitoneal wall. Laparotomy revealed a solid tumor in the peritoneal wall, about 18cm, and histologically diagnosed as a leiomyoma. We report a case of primary peritoneal leiomyoma with a brief review of literatures.
Female ; Humans ; Laparotomy ; Leiomyoma* ; Middle Aged ; Muscle, Smooth

OBJECTIVE: Heterotopic ossification (HO) is a well-known complication after total hip replacement. But the occurrence rate by the time-course, clinical effect and risk factors of HO after total cervical disc replacement (TCDR) are not well described. The purpose of this study is to evaluate the occurrence rate by the time-course and risk factors for HO after TCDR with a ProDisc-C. METHODS: Thirty-two patients whom followed up more than one year after the TCDR are enrolled. Radiographic study was done at 12, 24 and 36 months after the TCDR and classified HO with McAfee classification. Segmental range of motion, preoperative existence of spondylosis, type of operation, disc space occupying ratio by artificial disc, surgical level are analyzed to identify the risk factors of HO. The visual analog scale and the neck disability index were evaluated preoperatively and at last follow-up time for clinical parameters. RESULTS: Eighteen patients (56%) showed HO at 12 months, 18 patients (86%) showed HO at 24 months and 6 patients (89%) showed HO at 36 months after the TCDR. Clinical significant HO(Grade 3 and 4) was shown in one patient (3%) at 12 months, 3 patients (14%) at 24 months and 5 patients (56%) at 36 months. Only post-operative follow-up period increases the risk of development clinical significant HO. All patients showed improvement of clinical parameters (p<0.005). CONCLUSION: Incidence of HO is getting higher as time course progress. However, there are no relation between clinical outcome and radiologic change of ROM and the grade of HO.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Humans ; Incidence ; Neck ; Ossification, Heterotopic ; Range of Motion, Articular ; Risk Factors ; Spondylosis ; Total Disc Replacement

Persistent sciatic artery (PSA) is a continuation of the internal iliac artery into the popliteal-tibial vessels and this structure provides the major blood supply to the lower limb bud during early embyrologic development, Its remnants participate in the formation of the inferior gluteal, deep femoral, popliteal, peroneal and pedal vessels. When the femoral artery develops, the PSA then involutes. In rare circumstances it persists and so provides the only major blood supply to the lower limb. The PSA was first reported by Green in 1832 and until now, only about 100 cases have been reported in the world literatures. This rare vascular anomaly is associated with aneurysmal formation in 15% to 46% of cases and it has a bilateral location in 22% of PSA cases. In more than 40% of cases, PSA is asymptomatic. When present, such non-specific symptoms as gluteal pain and painful buttock mass are presented. However, the most frequent clinical finding is lower limb ischemia because in 25% of such cases, the presented symptoms are limb threatening. We describe here the case of a 54 year-old female affected with PSA occlusion, and she was treated with a combination of thrombolysis and thromboembolectomy.
Aneurysm ; Arteries* ; Buttocks ; Extremities ; Female ; Femoral Artery ; Humans ; Iliac Artery ; Ischemia ; Lower Extremity ; Middle Aged

OBJECTIVE: The purpose of this study is to determine the proper hand position during driving by measuring of the wheel rotation strength according to the wheel angle and hand position to the wheel. METHOD: BTE Work Simulator was used to measure the clockwise and counter clockwise static wheel rotation force of twenty healthy men in three different hand position (2~10 spot, 3~9 spot, and 4~8 spot) and two different wheel angle (45 degrees and 60 degrees), average and peak force were measured during maximal isometric contraction. RESULTS: The average and peak force was significantly different by the wheel angle, and hand position (p<0.01), but the direction of rotation didn't an effect on the rotation force. The hand position was the most significant factor, especially wheel rotation force at 2~10 spot hand position was significantly lower than that of 3~9 spot and 4~8 spot (p<0.05). The rotation force by the wheel angle was influenced by hand position, and lower in 60 degrees wheel angle in the 2~10 spot (p<0.05). CONCLUSION: The rotation force of wheel was influenced by the hand position. Therefore proper hand position is recommended during driving to reduce muscle fatigue.
Hand* ; Humans ; Isometric Contraction ; Male ; Muscle Fatigue

Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing ; Toes

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*