No abstract available.
Child* ; Humans ; Melanoma*

BACKGROUND: Systemic inflammatory reaction syndrome (SIRS) describes the systemic inflammatory process and can be seen following a wide variety of insults. This is the leading cause of morbidity and mortality for patients admitted to the ICU. The arterial keton body ratio (AKBR), serum lactate level and the thyroid hormones, thyroid stimulation hormone (TSH), thyroxine (T4), free thyroxine (FT4) and triiodothyronine (T3) deteriorate in critically ill patients with a poor prognosis. The APACHE (Acute Physiology, and Chronic Health Evaluation) III and multiple organ failure (MOF) score have been known as good prognostic predictors in the ICU. The object of this study was to compare the AKBR, lactate and thyroid hormone levels, and the APACHE III and MOF score between the survivors (SV) and nonsurvivors (NSV) and the correlation among the above predictors. METHODS: 35 patients with no known thyroid or liver disease who were admitted to the SICU with the criteria of SIRS were selected. Arterial blood was drawn for the AKBR, and the lactate and thyroid hormones studies. The APACHE III and MOF scorings were done in the first 24 hours of SICU admission. RESULTS: There were no significant difference between SV and NSV except APACHE III (SV: 68.7 24.6, NSV; 92.9 27.6). There were significant correlations between the APACHE III and MOF score (R = 0.688, P<0.01), APACHE III and lactate (R = 0.575, P<0.01), and MOF score and lactate (R =0.483, P<0.01). Thyroid hormones had positive correlations among themselves only. CONCLUSIONS: We conclude that APACHE III is the only good predictor of mortality. The APACHE III, MOF score, and lactate level show good correlations indicating the severity in condition of the ICU patients.
APACHE ; Critical Illness ; Humans ; Lactic Acid ; Liver Diseases ; Metabolism* ; Mortality ; Multiple Organ Failure ; Physiology ; Prognosis ; Survivors ; Thyroid Gland* ; Thyroid Hormones* ; Thyroxine ; Triiodothyronine

Heterotopic pregnancy is the coexistence of intrauterine and extrauterine pregnancy. It is a rare obstetrical phenomenon with an incidence rate about 0.003%. The risk factors of heterotopic pregnancy are IUD, PID, endometriosis, tubal surgery, etc resulting in functional and anatomical injury to tubes. Recently, the wide use of ovulation induction and in vitro fertilization has increased the incidence rate. The clinical manifestation are low abdominal pain, adnexal mass, peritoneal irritation signs, vaginal bleeding, etc. Early detecion of heterotopic pregnancy is very difficult. However, recently, due to development of pelviscopy, ultrasonogram and other diagnostic procedures, the diagnostic rate has increased.Because of the high maternal morbidity and mortality resulted from intraabdominal bleeding after rupture of ectopic pregnacy, immediate termination of ectopic pregnancy is required usually by operative methods. We experienced a case of heterotopic pregnancy after tubal reanastomosis and report this case with a brief review of literatures.
Abdominal Pain ; Endometriosis ; Female ; Fertilization in Vitro ; Hemorrhage ; Incidence ; Mortality ; Ovulation Induction ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Risk Factors ; Rupture ; Sterilization Reversal* ; Ultrasonography ; Uterine Hemorrhage

Traditionally, total parenteral nutrition(TPN) has been used when patients with hypaemesis gravidarum failed to respond to conservative management, but now many physicians attempt to enteral feeding via nasogastric tube because TPN is expensive and has many complications. Recently, we experienced 2 cases of hyperemesis gravidarum successfully managed by enteral feeding via nasogastric tube, therefore we think that this method may be carefully considered to the patients with hyperemesis gravidarum failed to respond to conservative management. So we report them with brief review of the literatures.
Enteral Nutrition* ; Female ; Humans ; Hyperemesis Gravidarum* ; Pregnancy

Despite the rarity of 48, XXYY, having an incidence rate of 1 in 50,000 persons, 1 in 300 persons are reported to have a mental disorder of criminal behavior. The clinical characterics of 48, XXYY are similar to Klinefelter's syndrome such as small testis, tall stature, gynecomastia and can show mental retardation and skeletal anomaly. When the cause of elevated maternal serum AFP is not explained by USG or measurement of amniotic fluid AFP, during the second trimester of pregnancy, it is defined as unexplained elevation of maternal serum AFP. We report a case of 48, XXYY with unexplained elevation of maternal serum AFP which has been experienced in our hospital with brief review of literature.
Amniotic Fluid ; Criminals ; Female ; Gynecomastia ; Humans ; Incidence ; Intellectual Disability ; Klinefelter Syndrome ; Male ; Mental Disorders ; Pregnancy ; Pregnancy Trimester, Second ; Testis

Cervical pregnancy is a rare form of ectopic gestation and it can cause serious bleeding, shock and death. Although hysterectomies are still performed due to massive hemorrhages, there are some conservative approaches to cervical pregnancies to conserve fertility. Methotrexate is a very useful agent in the management of trophoblastic disease, and has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of viable cervical pregnancy treated successfully with intraamniotic injection of methotrexate guided by transabdominal ultrasonography.
Fertility ; Hemorrhage ; Hysterectomy ; Methotrexate* ; Pregnancy* ; Shock ; Trophoblasts ; Ultrasonography*

Pregnancy-associated aplastic anemia is an uncommon problem and conditions in which an acellular or markedly hypocellular bone marrow results in pancytopenia(anemia, neutropenia, and thrombocytopenia). In most cases, aplastic anemia and pregnancy appear to have been a chance association. We experienced one case of pregnacy-associated aplastic anemia and so we present it with brief review of literature.
Anemia, Aplastic* ; Bone Marrow ; Neutropenia ; Pancytopenia ; Pregnancy

BACKGROUND: HIV serologic testing is essential for blood donor screening, and the test results should be accurate. It is important that clinical laboratories perform quality control, quality management and standardization for obtaining accurate laboratory results. The Korean National Institute of Health, the Division of AIDS and the Center for Immunology and Pathology have all performed annual external quality surveillance assessment (EQS, EQA) with using a 5 sera panel for all the Korean HIV testing laboratories that have collaborated with the Quality Assurance Committee of the Korean Society of Laboratory Medicine since 2005. The results of HIV testing in the clinical laboratories during the year 2007 were analyzed. METHODS: The results for the clinical laboratories that participated in the HIV EQAS during 2007 were collected and analyzed. The HIV test results and questionnaire data were sent to the web site "http://hivqa.nih.go.kr". Three hundred thirty two results from 303 institutions in 2007 were analyzed. RESULTS: The most widely used HIV testing method was an automated chemiluminescent immunoassay, such as the Abbott AxSym and the Architect system or the Roche Elecsys. About 5% of erroneous results were reported among 332 results. The causes of error were mostly clerical errors and specimen errors. CONCLUSION: The current status for HIV testing in Korean clinical laboratories was that fully automated immunoassay analyzers were used along with manual POCT tests.
Blood Donors ; HIV ; Humans ; Immunoassay ; Mass Screening ; Quality Control ; Serologic Tests ; Surveys and Questionnaires

Jejunal infarction as a complication of acute pancreatitis is not common and can not be well recognized. This jejunal infarction usually arises from the venous thrombosis rather than arterial thrombosis. Jejunal infarction results in bowel perforation or stenosis according to its extension of injury and progression rate. Pathologic findings of the involved jejunum show a segmental transmural infarction and mesenteric venous thrombotic occlusions. Early diagnosis should be made for better prognosis. We report a patient with jejunal infarction resulting perforation due to acute pancreatitis, in which the initial presenting symptoms were hematemesis and abdominal distention.
Acute Disease ; Adult ; English Abstract ; Humans ; Infarction/diagnosis/*etiology ; Intestinal Perforation/diagnosis/*etiology ; Jejunal Diseases/diagnosis/*etiology ; Jejunum/*blood supply ; Male ; Pancreatitis/*complications ; Rupture, Spontaneous

Streptococcal Toxic Shock Syndrome (STSS) is one of reemerging infectious diseases, most common sources of which are skin and throat. In this report, we present a case of decompensated STSS originated from unusual clinical situation. A 31-year-old previously healthy nongravid woman presented with acute onset, diffuse abdominal pain:she was diagnosed with acute panperitonitis and acute salpingitis. Culture from the peritoneal cavity was positive for Streptococcus pyogenes. Clinical and laboratory finding not the criteria of STSS:hepatic injury, acute renal failure, acute respiratory distress syndrome, disseminated intravascular coagulopathy, desquamative rash with bullae, and soft tissue necrosis. Hemodynamic shock was managed with fluid and inotropics. Initial broad-spectrum antibiotics were changed to combination therapy of intravenous penicillin G and clindamycin after diagnosing of STSS. Gamma globulin was administered intravenously. Acute hypoxemic respiratory failure was managed with mechanical ventilation. The patient died of multi-organ dysfunction syndrome ten days after the disease onset. Because STSS may be one of the reemerging infectious diseases with grave illness and have different clinical course in contrast to septic shock, earlier confirmative diagnosis and constitution of proper antibiotic therapy are mandatory for better outcome.
Acute Kidney Injury ; Adult ; Anti-Bacterial Agents ; Clindamycin ; Communicable Diseases, Emerging ; Constitution and Bylaws ; Diagnosis ; Exanthema ; Female ; gamma-Globulins ; Hemodynamics ; Humans ; Necrosis ; Penicillin G ; Peritoneal Cavity ; Pharynx ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Salpingitis* ; Shock ; Shock, Septic* ; Skin ; Streptococcus pyogenes