We presented a case of non-occupational scrotal cancer in 66-year-old male. He was a farmer and did not contact with any known carcinogen on past history. He had several erythematous walnut-sized nodules on scrotum and diffuse oozing erythema on penoscrotal and hoth crural areas. And his sclera was icteric and liver was palpable to the 3-flnger-breadth from the costal margin and had hard consistency and nodular surface. Spleen was palpable to the 4-finger-breadth. On laboratorary exarninations marked liver furtction impairment was noted. On histologic examinations of biopsied scrotal skin and ingoiaal lymyhnode undifferentiated squamous cell carcinoma was noted. On the 5th day of admission he became dull and irritable and tbe condition was deteriorated from day to day. At that time blood ammonia level was elevated to 140.63mcg% He was discharged in comatose state without any treatrnent for the scrotal cancer itself and died 4 days later.
Aged ; Ammonia ; Carcinoma, Squamous Cell ; Coma ; Erythema ; Humans ; Liver ; Male ; Sclera ; Scrotum ; Skin ; Spleen

BACKGROUND: Rapid and accurate identification of methicillin-resistant Staphylococcus (MRSA) is very important for patients because they are one of the most common etiologic agents of hospital infection. Conventional identification methods for MRSA are influenced by various factors such as pH, concentration of salt, conditions of media. METHODS: 53 methicillin resistant staphylococcus strains identified by ATB plus system (Biomerieux, France) were preformed the polymerase chain reaction (PCR), Southern blot hybridization fort the detection of mec A gene, and subcultured in Meuller-Hinton media containing 4 microgram/mL oxacillin for the comparison. RESULTS: The correlation of detection rate of mec A gene PCR and ATB plus systems was 81.6%. The correlation of mec A gene PCR and MRSA on Mueller-Hinton media containing 4 microgram/mL oxacillin was 80%. We confirmed by Southern blot hybridization the amplified mer A gene originated from chromosome of MRSA. As the results of oxacillin sensitivity test, minimal inhibitory concentrations of MRSA were distributed between 40 microgram/mL and 320 microgram/mL. When compared with executing time, ATB plus system took 24 hours, but PCR took 5 hours for identification. CONCLUSION: We concluded that mec A gone PCR techniques were simple and rapid for detection of MRSA comparative to conventional methods.
Blotting, Southern ; Cross Infection ; Genes, vif ; Humans ; Hydrogen-Ion Concentration ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Polymerase Chain Reaction* ; Staphylococcus

Erythromelalgia is a rare disease characterized by burning pain of the extremities associated with erythema and increased temperature of the skin. A case of erythromelalgia was reported with review of literatures. It seemed that this is the first reported case in Korean literatures. patient was 12 years old male having erythematous swelling associated with burning pain on his feet and lower legs for five years. Immersion of his feet in warm water quickly, increased the pain but cold water gave prompt relief that he soaked his feet for many hours during the day and night. No specific abnormalities were noticed in Iaboratory studies, Treatment with various topical, systemic medication revealed of unfavorable result.
Burns ; Child ; Erythema ; Erythromelalgia* ; Extremities ; Foot ; Humans ; Immersion ; Leg ; Male ; Rare Diseases ; Skin ; Water

Ultrasonography affords an accurate assessment of the presence, size, location and internal consistency of apelvic mass. We present our experience of 105 cases of pelvic masses in female patients by ultrasonography, andthe results are as described; 1. Ultrasonography is nonspecific, however, the possibility of mucinous cystadenomaof ovary, teratoma(dermoid cyst), uterine leiomyoma and trophoblastic disease can be suggested due to theircharacteristic internal consistency. 2. This smooth internal septation seen within mucinous cystadenoma, eccentricsolidmural component of dermoid cyst, enlarged uterine wall with lobulated outer margin of leiomyoma, andyesicular appearance of trophoblastic disease were the specific sonographic features. 3. Loculated ascites and hydronephrosis were identified with malignant ovarian neoplasm and pelvic metastasis. 4. Accurate ultrasonographicdiagnosis was made in 88 cases (83.7%) and it may be improved with clinical history of the mass in question.
Ascites ; Cystadenoma, Mucinous ; Dermoid Cyst ; Female ; Humans ; Hydronephrosis ; Leiomyoma ; Mucins ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary ; Trophoblasts ; Ultrasonography

No abstract available.
Humans ; Lupus Erythematosus, Systemic* ; Renal Veins* ; Thrombosis*

No abstract available.
Emergencies* ; Emergency Medicine* ; Humans

We report a case of 34-year-old woman who had left main coronary artery disease and treated with medication only. She was presented with severe chest pain. Isolated left main coronary disease was demonstrated on selective left coronary angiography. There was no regional wall motion abnormality on echocardiogram with normal global LV systolic function. We considered the lesion as a varient of Takayasu's arteritis. So with anti-anginal medication, treatment started with steroid therapy. After then there was no chest pain. We performed follow-up coronary angiography after 1 month and 3 month in which revealed improved left main lesion. Since then there was no subjective symptom and Thallium-201 SPECT revealed no significant ischemic finding. We think that this case's underlying disease is may be Takayasu's arteritis which has isolated left main stenosis without systemic involvement and improved with medical treatement only.
Adult ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Female ; Follow-Up Studies ; Humans ; Takayasu Arteritis ; Tomography, Emission-Computed, Single-Photon

Basic life support training is a part of the curricula of medical school in Anesthesiology practice. Every effort should be made to improve proper mouth-to-mouth breathing and perform correct extemal chest compression. Skillmeter Resusci(TM) Anne (Laerdal(R), Finland) is known to be an extremely valuable aid for accurate and objective training of medical students and for evaluating their performance. Fiftytwo medical students have been trained in basic life support skills and have been evaluated with Skillmeter Resusci Anne. We adopted standards by American Heart Association. As other reports, trainees' outcome was related to psychosomatic skill rather than their knowledge or clinical experience. Repeated training improves the performance capability of artificial ventilation better than external chest compression. At least 6 times of training session seemed required for over ninety percents of the students to reach the desired level of competence in these skills. In summary, a state-of-the-art resuscitaion training manikin displayed an objective individual evaluation and also aroused the interest of the students in CPR basic life support teaching.
American Heart Association ; Anesthesiology ; Cardiopulmonary Resuscitation ; Curriculum ; Humans ; Manikins ; Mental Competency ; Respiration ; Schools, Medical ; Students, Medical* ; Thorax ; Ventilation

A 59-year-old woman was scheduled to undergo a robot-assisted distal gastrectomy under general anesthesia. During the operation, the vital signs were maintained in normal range. After 7 hours of surgery, the pulse oxymeter graph became flat and the end tidal CO2 concentration suddenly decreased. Palpation of the carotid artery revealed no heart beat but the EKG continued to show sinus rhythm. Pulseless electrical activity (PEA) was diagnosed. An advanced cardiopulmonary life support protocol for PEA was immediately initiated, which included chest compressions and doses of IV cardiovascular drugs. However, in spite of continuous CPR, the heart wasn't recovered from the arrest. We experienced cardiac arrest for pulseless electrical activity during robot-assisted distal gastrectomy.
Anesthesia, General ; Cardiopulmonary Resuscitation ; Cardiovascular Agents ; Carotid Arteries ; Electrocardiography ; Female ; Gastrectomy ; Heart ; Heart Arrest ; Humans ; Hypovolemia ; Middle Aged ; Palpation ; Peas ; Reference Values ; Thorax ; Vital Signs

Systemic lupus erythematosus(SLE) is a multiorgan disease which is associated with the occurrence of immune vascular damage. Antiendothelial cell antibodies(aECA) have been demonstrated in patients with SLE, and their presence could be related to vascular injury. Endothelial cell(EC) in vasculitic lesions of patients with SLE show evidence of activation. In vitro treatment of EC with cytokines can produce a pattern of activation such as the increased expression of surface molecules. Activation of EC was shown to influence the interaction between aECA and endothelial surface. The authors, therefore, examined the prevalence of IgG aECA and investigated the association of aECA with clinical findings and anticardiolipin antibodies(aCL). We also investigated the role of cytokine in binding of IgG-aECA to EC in patients with SLE. Sera from 92 patients with SLE and 20 healthy controls were assayed for IgG- aECA by cellular ELISA method using cultured human umbilical vein endothelial cell(HUVEC) and IgG-aCL by ELISA method, and We also examined the binding of IgG-aECA to EC activated with IL-1 or TNF-a< in sera from 60 patients with SLE. IgG-aECA was detected in the serum of 31 out of 92 patients(33.7%). The mean serum titers of IgG-aECA were significantly higher in SLE than in healthy controls(19.38 U/ml vs 8.79 U/ml, P<0.05). There was no correlation between serum titers of IgG-aECA and IgG-aCL(r=-0.0265). The mean serum titers of IgG-aECA in patients with digital vasculitis or Raynaud' s phenomenon were significantly increased in comparison with patients without these manifestations (35. 28 U/ml vs 18. 16 U/ml, P<0.05, 27.18 U/ml vs 15. 24 U/ml, P<0.05 respectively). The mean serum titers of IgG-aECA in 60 patients were significantly increased(P<0.0001) following the stimulation with IL-la as compared with unstimulated EC, but those of IgG-aECA were not increased following the stimulation with TNF-a<. The IgG-aECA binding reactivity to IL-la stimulated EC was significantly higher in patients with digital vasculitis, Raynaud s phenomenon, renal disorder, thrombosis, neuropsychiatric manifestation and avascular necrosis as compared with unstimulated EC. IgG-aECA was detected in 28 of the 60 patients(46. 7%). Its frequency was increased following the stimulation with IL-1<(68. 3%), but there was no significant difference in frequency following the stimulation with TNF-a<(48.3%). These data suggest that presence of IgG-aECA and enhanced binding of IgG- aECA to EC induced by IL-la< can play an important role in the occurrence of clinical manifestations associated with vascular damage in SLE.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin G ; Interleukin-1 ; Lupus Erythematosus, Systemic* ; Necrosis ; Prevalence ; Thrombosis ; Umbilical Veins ; Vascular System Injuries ; Vasculitis