In suicidal hanging, a death often occurs within minutes. f rescued, most victims later succumb to the respiratory failure secondary to pulmonary edema, bronchopneumonia, delayed airway obstruction, and acute respiratory distress syndrome(ARDS). Out of these, non-cardiogenic pulmonary edema is likely due to neurogenic factors or negative intrathoracic pressure. A 36-year-old female was brought to the Department of Emergency Medicine after the suicidal hanging attempt. She was unconscious but responsive to painful stimuli. A laryngeal stridor was present. The lung sound of the patient's was dear. Fourteen hours after admission, a chest X-ray showed bilateral diffuse interstitial infiltrates in both lung fields, which was compatible with ARDS. The patient was intubated and placed on a volume respirator with PEEP. She improved over the next 48 hours and a repeat chest X-ray aim showed marked clearing of the infiltrates. We report on the pathophysiologic results of this pulmonary complication and the implication of this finding, regarding the treatment of the patient.
Adult ; Airway Obstruction ; Bronchopneumonia ; Emergency Medicine ; Female ; Humans ; Lung ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Respiratory Sounds ; Thorax ; Ventilators, Mechanical

An aberrant right subclavian artery, the most common congenital anomaly of the aortc arch, is rarely symptomatic during the infancy, if an anomalous origin of a right common carotid artery is also associateda varient of innomiate artery compression syndrome. We experienced a case of an aberrent right subclavian artery associated with an anomalous origin of the right common carotid artery in a female newborn, who showed severe respiratory distress soon after birth. The diagnosis was confirmed by aortogram and operative findings. the ligature and section of the aberrent right subclavian artery resulted in improvement of respiratory distress. A brief review of the related literature is also presented.
Arteries ; Brachiocephalic Trunk* ; Carotid Artery, Common ; Diagnosis ; Female ; Humans ; Infant, Newborn ; Ligation ; Parturition ; Subclavian Artery*

PURPOSE: The purpose of this study was to investigate the knowledge and practice level of infection managements in child guardians with respiratory infections after H1N1 diffusion of 2009. METHODS: The data were collected during February and March 2010 using a self-report questionnaire. The participants were 228 child guardians. Data were analyzed using frequency, percentage, means, SD, t-test, F-test, Pearson correlation coefficients, and Cronbach's alpha with the SPSS 17.0 program. RESULTS: Mean age of the guardians and children were 37.8 years, 4.1 years respectively. For knowledge level of respiratory infections, hand washing method had the highest score and snuffles prevention method, the lowest. For practice level for respiratory infections, environmental hygiene management had the highest score and symptom management, the lowest. Infection management knowledge and practice level had a positively significant correlation in every area. CONCLUSION: The results indicate the necessity of continual education on infection management, and that the most efficient timing for the education appears be for participants during their first pregnancy or after the woman has delivered her child.
Child ; Compliance ; Diffusion ; Female ; Hand Disinfection ; Humans ; Hygiene ; Legal Guardians ; Pregnancy ; Respiratory Tract Infections ; Child Health ; Surveys and Questionnaires

Computed body tomography has become useful in the diagnosis of pancreatic disease. It was found to be are liable, often specific, and noninvasive method for detecting pancreatitis and extra-pancreatic extension of the pathology. Of eight hundred and seventy-two cases studied for abdominal pathology with EMI-CT 5005 whole body scanner form Oct. 1977 to August 1980, 21 cases were confirmed to be pancreatitis clinically or operatively. The authors reviewed the CT findings of the above cases and the results were as follows; 1. Among twenty-one cases, the acute pancreatitis was 12 cases and the chronic pancreatitis was 9 cases. The sex ratio as 17 males to females. 2. In acute pancreatitis, diffuse enlargement of pancreas (11/12), focal enlargement (1/12), loss of peripancreatic fat plane (9/12), thickening of anterior of pararenal fascia (6/12), and smooth margin ofpancreas (5/12) were observed. 3. In chronic pancreatitis, parenchymal atrophy (7/9), normal size (2/9), loss of peripancreatic fat plane (3/9), thickening of anterior pararenal fascia (1/9), calcification (1/9), smooth margin (2/9), and serrated margin (6/9) were observed. 4. The complications were associated with 7 cases of acute pancreatitis and 1 case of chronic pancreatitis; pseudocyst (6), abscess (2), and fat necrosis (3), The sites of the pseudocyst were lesser sac (2), anterior pararenal space (2), posterior pararenal space (1), subhepatic region (1), greater omentum (1), and intrapancreatic region (2). All of them were associated with acute pancreatitis except one in chronic pancreatitis.
Abscess ; Atrophy ; Diagnosis ; Fascia ; Fat Necrosis ; Female ; Humans ; Male ; Methods ; Omentum ; Pancreas ; Pancreatic Diseases ; Pancreatitis ; Pancreatitis, Chronic ; Pathology ; Peritoneal Cavity ; Sex Ratio

The infantile polycystic kidney disease is rare fetal urinary tract anomaly. It is inherited with an autosomal recessive pattern and recurrence rate is 25%. The gene locus is on chromosome 6p. The pathogenesis of infantile polycystic kidney is the primary defect of the collecting ducts. The ultrasonographic finding of infantile polycystic kidney is oligohydramnios, bilaterally symmetrical enlarged kidneys with maintenance of their reinform shape. The differential diagnosis with adult polycystic kidney disease is important. The massive enlargement of the kidneys is rarely seen in adult polycystic kidney disease and the examination of the parents and other members of the family is helpful to confirm the adult polycystic kidney disease. If there is severe renal involvements, stillbirth or neonatal death secondary to pulmonary hypoplasia would be developed. If it were diagnosed before viability, termination of pregnancy is recommended. In a fetus at risk, diagnosed after viability, pregnancy termination is also recommended since this condition is uniformly fatal. We present a case of infantile polycystic kidney.
Diagnosis, Differential ; Female ; Fetus ; Humans ; Kidney ; Oligohydramnios ; Parents ; Polycystic Kidney Diseases* ; Polycystic Kidney, Autosomal Dominant ; Pregnancy ; Recurrence ; Stillbirth ; Urinary Tract

Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants

Von Hippel-Lindau disease is an autosomal dominant disorder characterized by the presence of multiple benign and malignant tumors including hemangioblastomas of the retina and central nervous system, pancreatic cysts and tumors, renal cell carcinomas, pheochromocytomas and epididymal cystadenomas. We report the radiologic findings of a case of von Hippel-Lindau disease, describing the family history.
Carcinoma, Renal Cell ; Central Nervous System ; Cystadenoma ; Hemangioblastoma ; Humans ; Pancreatic Cyst ; Pheochromocytoma ; Retina ; von Hippel-Lindau Disease*

No abstract available.
Bowen's Disease*

PURPOSE: Epstein-Barr virus(EBV) exists in the human population in two genetic forms, usually referred to as type 1 and type 2 which have been defined on the basis of sequence divergence in the EBNA-2 and EBNA-3 family genes. In this study, we were intended to investigate whether the subtypes of EBV in malignant lymphoma in Korea were associated with specific disease entities and geographical distribution. MATERIALS AND METHODS: Biopsy samples obtained from 18 Korean patients with malignant lymphoma including Hodgkin's disease(3 cases), B cell lymphoma(1 case), and NK/T cell lymphoma(14 cases) were analyzed to determine the subtype of EBV infected therein. DNA was extracted from formalin-fixed, paraffin-embeded tissues by ordinary method and specific viral sequences were sought using the polymerase chain reaction(PCR) and Southern blot hybridization assay. Oligonucleotide primers used for examination of EBV strain type were derived from the EBNA-3B and EBNA-3C coding regions. As a control, four cases of reactive hyperplasia were analyzed. RESULTS: The two of four reactive hyperplasia cases were associated with type 1 and the rest of two cases with both types. Among the 18 cases with malignant lymphoma, thirteen cases(72%) had type 1, one(6%) had type 2, and four(22%) had dual infections with both types. In case of NK/T cell lymphoma(14 cases) occupying 78% of 18 biopsy samples, 86%(12 cases) were associated with type 1, 7%(1 case) with type 2, and 7%(1 case) with both types. In case of Hodgkin's disease, all of three cases had both types. B cell lymphoma taking only one case of twenty two cases was determined as type 1. CONCLUSION: These observations indicated that type 1 EBV was predominant in Korean patients with malignant lymphoma, especially NK/T cell lymphoma and showed high frequency of dual viral infections(22%) in Hodgkin's disease as well as in reactive hyperplasia.
Biopsy ; Blotting, Southern ; Clinical Coding ; DNA ; DNA Primers ; Genotype ; Herpesvirus 4, Human ; Hodgkin Disease ; Humans ; Hyperplasia ; Korea* ; Lymphoma* ; Lymphoma, B-Cell

CT has an important role in the evaluation of gastric adenocarcinoma. It clearly demonstrates the primary tumor itself and reveals the spread of cancer to adjacent or distant structures. It is therefore useful in the staging of gastric carcinoma, and has proved valuable in the differential diagnosis of this and other gastrictumors. Recent advances in technology such as spiral CT with water ingestion, improve the value of CT. This report describes the characteristic findings of gastric adenocarcinomas by spiral CT, and elucidates its role in the staging of gastric carcinoma.
Adenocarcinoma* ; Diagnosis, Differential ; Eating ; Tomography, Spiral Computed* ; Water