No abstract available.
Abdominal Pain* ; Vomiting*

Urticaria pigmentosa is a form of urticaria characterized by abnormality of cutaneous mast cells. No prediction for either gender has been reported but it usually occurs in children. When it develops in an adult cutaneous manifestations often follows recalcitrant and persistent course. Though tendency of genetic inheritance with an autosomal dominant pattern has been suggested most of patients have no family history of mastocytosis. We report a case of adult-onset urticaria pigmentosa with references.
Adult ; Child ; Humans ; Mast Cells ; Mastocytosis ; Urticaria Pigmentosa* ; Urticaria* ; Wills

OBJECTIVE: The purpose of this article is to assist in early diagnosis and treatment of ectopic pregnancy. METHODS: We analyzed clinical statistics of 401 patients, who visited Masan Samsung Hospital from January 1, 1998 to December 31, 2002, received treatment under diagnosis of ectopic pregnancy, and were comfirmed by histopathologic examination. RESULTS: During the index period, the occurrence rate of ectopic pregnancy was 1:16.5, with peak age of occurrence between 30 to 34 year-old (34.4%). Previous history of artificial abortion was noted in 76.1%, previous cesarean delivery in 17%, previous pelvic inflammatory disease in 15.7% and history of previous ectopic pregancy in 9.5%. Concerned to clinical manifestations, lower abdominal pain was reported in 93.3%, amenorrhea in 86.5%, and vaginal bleeding in 69.3%. Onset of clinical manifestation was 6-8 weeks from the last menstrual period in 39.7%, being the most common. As the implantation site, fallopian tube was affected in 95.3%, ovary in 3%, and cervix of the uterus in 1%. Total amount of intraperitoneal hemorrhage was less then 500 mL in 45.6%. As an operative treatment, salpingectomy of the affected side was conducted in 76.8%. Average lengths of hospital stay for laparoscopy versus laparotomy were 3.4 and 5.2 days, respectively. CONCLUSION: Ectopic pregnancy, as a common emergent disorders, requires continuous attention for women in reproductive age. With the aid of various diagnostic modalities, early diagnosis and treatment can reduce mortality and morbidity rates, and enhance future fetility.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Mortality ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Salpingectomy ; Uterine Hemorrhage ; Uterus

Physostigmine has been used to counteract somnolence or coma induced by different types of pharmacological agent, such as anticholinergics, opioids, ketamine, tricyclic antidepressants and inhalational anesthetics. In this study, we have assessed the effect of physostigmine on arousal and respiration after 50% N2O-50% O2-enflurane general anesthesia under controlled condition such as no premedication, no neuromuscular blockade, same operative procedure and duration. Fifty healthy gynecologic patients scheduled for dilatation & curettage and cervical cone biopsy were divided randomly into two groups such as control group and physostigmine group. In physostigmine group, 0.02 mg/kg of physostigmine was administered intravenously at the end of operation. We evaluated the recovery time of pain response, eye opening on verbal command and orientation after the end of operation. We also checked the end-tidal enflurane concentration with SARACAP spectrometry. Blood pressure, pulse rate, respiration rate and tidal volume were checked at the end of operation and at the time of each recovery parameters returned. The results were as follows; first, pain response time was 5.1+/-2.4 min in control group compared with 3.5+/-2.1 min in physostigmine group. Second, on simple order to patients, eye opening time was 8.5+/-2.3 min in control group compared with 6.5+/-2.1 min in physostigmine group. Third, recovery of orientation to time, place and person was 9.7+/-2.8 min in control group compared with 7.5+/-2.1 min in physostigmine group. Fourth, there was no significant difference in respiratory parameters between the two groups. But there was no significant difference in end-tidal enflurane concentration between the two groups inspite of rapid recovery time in physostigmine group. In conclusion, 0.02mg/kg of physostigmine has the effect of early arousal after enflurane anesthesia without specific problems.
Analgesics, Opioid ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Antidepressive Agents, Tricyclic ; Arousal* ; Biopsy ; Blood Pressure ; Cholinergic Antagonists ; Coma ; Dilatation and Curettage ; Enflurane* ; Female ; Heart Rate ; Humans ; Ketamine ; Neuromuscular Blockade ; Physostigmine* ; Premedication ; Reaction Time ; Respiration* ; Respiratory Rate ; Spectrum Analysis ; Surgical Procedures, Operative ; Tidal Volume

No abstract available.

Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Leukoplakia ; Mouth ; Neoplasm Recurrence, Local ; Neoplasms, Second Primary ; Prognosis ; Recurrence ; Tongue Neoplasms ; Tongue

OBJECTIVE: The frequency of CYP2C8 gene polymorphisms in Korean patients with epithelial ovarian cancer was identified and their association with toxicity and effect of the anticancer drug according to haplotypes was analyzed. METHODS: DNA was extracted from 57 epithelial ovarian cancer patients between January 2004 and March 2005. Genetic variations that are three common SNPs (CYP2C8*1D; -411T>C, CYP2C8*1C; -370T>G and CYP2C8*1B; -271C>A) by direct sequence analysis from 57 Korean women with epithelial ovarian cancer were observed. 33 patients who received debulking surgery, were diagnosed over FIGO state III, serous ovarian cancer were enrolled and received paclitaxel based chemotherapy. Among 33 patients 21 chemo-sensitive patients and 12 resistant patients were analyzed. Using these SNPs, We constructed haplotypes and haplotype pairs. CYP2C8 genotypes according to the clinical characteristics were analyzed and evaluated. RESULTS: Genetic analysis revealed the common SNPs' allele frequencies of -411T>C, -370T>G, and -271C>A were 0.3, 0.44, and 0.1. Two common SNPs allele frequency was similar to the data in Korean population substantially, but CYP2C8*1C frequency was more frequent in epithelial ovarian cancer patients and especially in FIGO stage III. Disease free interval in CYP2C8*1C homologous group was longer than others. CONCLUSION: CYP2C8*1C SNPs were detected more frequently in epithelial ovarian cancer patients and especially in FIGO stage III patients. CYP2C8*1C homologous patients had more longer disease free interval than others.
Cytochrome P-450 Enzyme System ; DNA ; Drug Therapy ; Female ; Gene Frequency ; Genetic Variation ; Genotype ; Haplotypes ; Humans ; Ovarian Neoplasms* ; Paclitaxel ; Polymorphism, Single Nucleotide ; Sequence Analysis

Avulsion fracture of the calcaneal tuberosity is an uncommon injury. Usually it occurs from indirect trauma, and can be seen in old patients with osteoporosis or in patients with diabetic neuropathy. Follow-up studies showed fracture healing in most cases, but skeletal deformity may develop in some cases. Therefore we should do plain X-ray evaluations in diabetic patients with foot and ankle pain, even though there have been no definite trauma history. Four cases of calcaneus avulsion fracture were treated operatively in diabetic patients, and reported.
Ankle ; Calcaneus* ; Congenital Abnormalities ; Diabetic Neuropathies ; Follow-Up Studies ; Foot ; Fracture Healing ; Humans ; Osteoporosis

Gastric neuroendocrine carcinoma is a rare cause of gastric malignant tumors and has a poor prognosis. The carcinoma has histologic features characterized by irregular shape, thick cords and trabeculae of tumor cells. Immunohistochemical staining of tumor cells shows synaptophysin as positive. We report a case of neuroendocrine carcinoma of the stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 70-year-old man visited our emergency room because of abdominal pain. A preoperative abdominal CT showed a pneumoperitoneum in the upper abdomen suggesting ulcer perforation of the stomach. An emergent laparotomy with primary repair of the perforation was performed. After general conditions of the patient improved, endoscopic biopsy was performed. Pathologic examination revealed that the tumor was a gastric neuroendocrine carcinoma. Radical subtotal gastrectomy was additionaly performed.
Abdomen ; Abdominal Pain ; Biopsy ; Carcinoma, Neuroendocrine ; Emergencies ; Gastrectomy ; Humans ; Laparotomy ; Pneumoperitoneum ; Prognosis ; Stomach ; Synaptophysin ; Ulcer

Gastric neuroendocrine carcinoma is a rare cause of gastric malignant tumors and has a poor prognosis. The carcinoma has histologic features characterized by irregular shape, thick cords and trabeculae of tumor cells. Immunohistochemical staining of tumor cells shows synaptophysin as positive. We report a case of neuroendocrine carcinoma of the stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 70-year-old man visited our emergency room because of abdominal pain. A preoperative abdominal CT showed a pneumoperitoneum in the upper abdomen suggesting ulcer perforation of the stomach. An emergent laparotomy with primary repair of the perforation was performed. After general conditions of the patient improved, endoscopic biopsy was performed. Pathologic examination revealed that the tumor was a gastric neuroendocrine carcinoma. Radical subtotal gastrectomy was additionaly performed.
Abdomen ; Abdominal Pain ; Biopsy ; Carcinoma, Neuroendocrine ; Emergencies ; Gastrectomy ; Humans ; Laparotomy ; Pneumoperitoneum ; Prognosis ; Stomach ; Synaptophysin ; Ulcer