No abstract available.
Tuberculosis, Pulmonary*

Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache, and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.
Aged ; Critical Illness* ; Delayed Diagnosis ; Headache ; Humans ; Intensive Care Units ; Male ; Neurologic Manifestations ; Posterior Leukoencephalopathy Syndrome* ; Postoperative Period ; Seizures

Abdominal pregnancy that is a life threatening variant of ectopic pregnancy, has been a rare event with high maternal mortality. It is very difficult to diagnose a abdominal pregnancy clinically. We have experienced a case of early abdominal pregnancy diagnosed at emergency laparotomy and this case was presented with a brief review of the literatures.
Emergencies ; Female ; Laparotomy ; Maternal Mortality ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic

No abstract available.
Glomerulonephritis, Membranous* ; Guillain-Barre Syndrome* ; Uveitis*

BACKGROUND: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et at retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. METHOD: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. RESULTS: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in nineteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), Poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to Inoculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(P<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. CONCLUSION: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement arid serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Chemistry ; Chest Tubes ; Diagnosis ; Drainage ; Empyema* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Lung ; Pleural Effusion ; Retrospective Studies ; Staphylococcus aureus ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed* ; Ultrasonography

To characterize the clinical manifestations, and histologic features of CNS lymphoma in immunocompetent patients, we collected 15 cases of biopsy proven primary CNS lymphoma. Evidences of systemic lymphoma, HIV infection, and immune-compromising diseases were absent at the diagnosis. Brain MRI had been taken before radiation or chemotherapy, and pathologic specimens were classified according to working formulation and some cases underwent immunological marker studies. Mean duration of illness was 1. 8 months, mild CSF protein elevation(mean=58mg%) was observed in 5 of 6 patients, CSF cytology was positive in 2 of 7, and the recurrence rate was 69%. In MR imaging, tumor size was variable, and 5 patients had multiple lesions at diagnosis. All patients showed homogeneous(87%) or heterogeneous(13%) gadolinium enhancement, and secondary tumor change was shown in I case. The tumor had high tendency in abutting on CSF space(60%), and there was no relationship between histologic types and MR imaging I s. Classified by working formulation, the intermediate grade lymphomas(diffuse large cell and small cell cleaved types) were 14 out of 15(93%) and I showed low grade(small lymphocytic). B-cell lymphoma was 8 out of 9, and T-cell was only 1. As compared with the previous reported pathologic data of AIDS-related CNS lymphoma, the histology of lymphoma in immunocompetent patients were less malignant than those related to AIDS and immune-compromised patients.
Biopsy ; Brain ; Diagnosis ; Drug Therapy ; Gadolinium ; HIV Infections ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Magnetic Resonance Imaging ; Recurrence ; T-Lymphocytes

Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scarf, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy ai a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.
Abdomen ; Barium ; Biopsy ; Breast ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Signet Ring Cell* ; Cisplatin ; Colon ; Diagnosis ; Drug Therapy, Combination ; Enema ; Etoposide ; Gallbladder ; Humans ; Lung Neoplasms ; Lung* ; Pancreas ; Prostate ; Radiotherapy ; Rectum ; Stomach ; Ureter ; Urinary Bladder

Cytokine production was studied in thyroid fine needle aspirates and peripheral blood and the production of interferon-gamma by peripheral blood mononuclear cell(PBMC) culture in response to interleukin-2(IL-2) stimulation was also studied from patients with hyperthyroidism, non toxic goiter, thyroid nodule. The expression of glycer aldehyde 3-phosphate dehydrogenase(GAPDH), interleukin-1beta(IL-1beta), IL-2, interleukin-8(IL-8), platelet- derived growth factor-A(PDGF-A) and interferon-gamma(IFN-gamma) chain was assessed by RT-PCR(reverse transcriptase polymerase chain reaction) in fine needle aspirates of thyroid and peripheral blood mononuclear cell : the samples were obtained from 7 patients with hyperthyroidism, 6 patients with non toxic goiter, 7 patients with thyroid nodule. A dose of IL-2(25 U/ml) was utilized to induce IFN-gamma production by PBMC from all patients.The results were as follows:1) In case of cytokine expression of fine-needle aspirates, GAPDH and IL-1beta, IL-8 were expressed highly but IFN-gamma, IL-2 were not expressed in hyperthyroidism and non-toxic goiter, thyroid nodule. PDGF-A was expressed in hyperthyroidism and thyroid nodule but not in non toxic goiter. 2) In case of cytokine expression of PBMC, GAPDH, IL-1beta were expressed in hyperthyroidism and non toxic goiter, thyroid nodule and highly expressed after IL-2 stimulation than before. But PDGF-A was more expressed in non toxic goiter and thyroid nodule than hyperthyroidism. Also, IFN-gamma was less expressed in thyroid nodule than hyperthyroidism and non toxic goiter. 3) The incremental increase in IFN-gamma value in supernatants of PBMC culture was significantly higher in patients with non toxic goiter than that in PBMC from hyperthyroidism and thyroid nodule(p<0.05).Therefore it seems that the cytokine production was found in hyperthyroidism and non toxic goiter and thyroid nodule. There were variability in their distribution each other, in general, higher expressed in hyperthyroidism than non toxic goiter. And RT-PCR Method that employed should be sufficiently sensitive to permit the analysis of cytokine gene expression in fine needle aspiration biopsies from patients with thyroid disease.
Biopsy ; Biopsy, Fine-Needle ; Cell Culture Techniques ; DNA-Directed RNA Polymerases ; Gene Expression ; Goiter ; Humans ; Hyperthyroidism ; In Vitro Techniques ; Interferon-gamma ; Interferons ; Interleukin-2 ; Interleukin-8 ; Methods ; Needles ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule

OBJECTIVE: The purpose of this study was to establish the effect of oligohydramnios and intrauterine infection on fetal and umbilical blood flows in patients with preterm premature rupture of membranes (PPROM). METHODS: Pulsed-wave Doppler imaging was used to determine the pulsatility index (PI) in the fetal renal, descending aorta, middle cerebral and umbilical arteries in 62 patients with PPROM. Amniocentesis was performed in 38 patients with PPROM. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasma. The patients with PPROM were divided into two groups according to the presence (n=21) or absence (n=41) of oligohydramnios and the presence (n=14) or absence (n=24) of intrauterine infection. Oligohydramnios was defined as the largest single pocket that measured <2 cm in the vertical plane. Data was expressed as multiples of the median (MOM) adjusted for gestational age, and statistical analysis was conducted with nonparametric statistics. RESULTS: 1) Fetuses with the presence of oligohydramnios had significantly lower MOM of PI of the fetal renal artery and higher MOM of PI of the fetal descending aorta than those without this condition (MOM of PI of the fetal renal artery: median [range]; 0.030 [-0.532, 0.404] vs. 0.167 [-0.357, 2.81] p=0.03. MOM of PI of the fetal decending aorta: median [range]; 0.085 [-0.160, 0.470] vs. -0.120 [-0.587, 0.548] p=0.004). 2) There was a significantly negative relationship between the largest single vertical pocket and MOM of PI of the fetal descending aorta (r=-0.283, p=0.03). 3) There were no significant differences in the MOM of PI of the fetal middle cerebral artery and umbilical artery between the two groups of patients. 4) Amniotic fluid culture was positive in 37% (14/38). 5) There were no significant differences in the MOM of PI of the fetal middle cerebral, renal artery, descending aorta and umbilical arteries between patients with and without the intrauterine infection. CONCLUSION: Blood flow of the fetal renal artery and descending aorta, but not the middle cerebral and umbilical arteries, were affected by oligohydramnios in patients with PPROM but intrauterine infection did not affect the blood flow of the fetal and umbilical arteries in fetuses with PPROM.
Amniocentesis ; Amniotic Fluid ; Aorta ; Aorta, Thoracic ; Bacteria, Anaerobic ; Female ; Fetal Blood* ; Fetus ; Gestational Age ; Humans ; Membranes* ; Middle Cerebral Artery ; Mycoplasma ; Oligohydramnios* ; Pregnancy ; Renal Artery ; Rupture* ; Umbilical Arteries*

Vaginal and cervical agenesis is an uncommon Mullerian anomaly. Total hysterectomy and vaginoplasty remains the classical treatment of this malformation. We present a case of reconstruction of utero-neovaginal continuity in the patient with normal functioning uterus and previously constructed neovagina by McIndoe method. She experienced two episodes of withdrawal bleeding during 2 months after surgery and fully satisfied with the results.
Hemorrhage ; Humans ; Hysterectomy ; Uterus