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*

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

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

In 38 of 70 patients who underwent lumbar spinal surgery, we performed a randomized, prospective double-blind study of the effect of caudal block with morphine sulfate on postoperative pain levels. Age, sex, clinical features, postoperative analgesic consumption, pain score, adverse effects and patient satisfaction on discharge were recorded. The consumption of parenteral analgesics on the 1st, 2nd and 3rd days was significantly lower in the morphine sulfate group(p<0.05), than in the control group. Caudal block with morphine sulfate also led to marked reductions in pain levels and thus increases patients satisfaction during the postoperative period(p<0.05). Transient respiratory depression occurred in three of 38 patients(7.9%), but further treatment was not needed. Seventeen patients(44.7%) developed urinary retention, but this recovered spontaneously. The present study demonstrates that caudal block with morphine sulfate leads to a highly significant reduction in pain during postoperative periods and a corresponding reduction in the need for additional postoperative analgesics, in addition, patients are more satisfied.
Analgesics ; Double-Blind Method ; Humans ; Morphine* ; Pain, Postoperative* ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Respiratory Insufficiency ; Urinary Retention

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

BACKGROUND/AIMS: According to the recent research, mutations in the HBV pre-S region may have an impact on the progression of hepatitis B virus(HBV)-related liver disease. The aim of this study was to clarify the frequency and location of naturally occurring mutations in the pre-S region of HBV, and their possible effects on the clinical course of HBV-associated chronic liver diseases. METHODS: HBV DNA was extracted from the sera of 15 patients (8 with liver cirrhosis and 7 with hepatocellular carcinoma). The pre-S sequence was amplified via polymerase chain reaction, subcloning and sequenced. RESULTS: All patients had point mutations in the pre-S region. Nine of 10 mutation sites (90%) in the pre-S1 region, and 4 of 5 mutation sites (80%) in the pre-S2 region were identical in both liver cirrhosis and hepatocellular carcinoma. Deletions were detected in seven patients (4 with liver cirrhosis and 3 with hepatocellular carcinoma). Among the 4 patients with liver cirrhosis, three had deletion in 5'-end of the pre-S2 region and one spanning the 3'-end of the pre-S1 to 5'-end of the pre-S2 region. All 3 patients with hepatocellular carcinoma had deletions in 5'-end of the pre-S1 region, and two patients had simultaneous deletion spanning the 3'-end of the pre-S1 to the 5'-end of the pre-S2. CONCLUSION: The pre-S mutants were frequently detected in HBV-associated liver cirrhosis or hepatocellular carcinoma and the point mutations or deletions in the pre-S gene were clustered in specific regions.
Carcinoma, Hepatocellular* ; DNA ; Hepatitis B ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Point Mutation ; Polymerase Chain Reaction