Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient’s platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up.
Aorta ; Aorta, Abdominal* ; Blood Platelets ; Embolism ; Extremities ; Follow-Up Studies ; Humans ; Hydroxyurea ; Ischemia ; Myeloproliferative Disorders ; Platelet Count ; Recurrence ; Thrombocythemia, Essential ; Thrombocytosis ; Thromboembolism* ; Thrombosis

Forty eight cases of spontaneous thalamic hemorrhage diagnosed by brain CT scan, were analyzed clinically. The age incidence was highest in the 6th decade. We have classified the thalamic hemorrhage by location of hematoma and arterial blood supply. The anteromedial types were 12 cases(25%) and the posterolateral types were 14 cases(29%), the superomedial types were 10cases(21%), the posteromedial types were 5cases(10%), the globe types were 7cases(15%). The sites of hemorrhage were highest in the thalamogeniculate artery territories. In the aspect of clinical symptoms, ocular signs were more common in the posteromedial and the globe type. Motor weakness and sensory symptoms were developed in the all types, almostly. Speech involvements were developed in 14% of Lt.side thalamic hemorrhages. Mental symptoms(confusion, disorientation) appeared in the large amount of hemorrhage exclusively. The mortality rate was 10.4%. Prognosis was correlated with the extent of involvement and the amount of hematoma, not the location.
Arteries ; Brain ; Hematoma ; Hemorrhage* ; Incidence ; Mortality ; Prognosis ; Thalamus ; Tomography, X-Ray Computed

Thoracoabdominal aortic aneurysm accompanied by Leriche syndrome is an extremely rare combination of aortic diseases, the surgical management of which has not been described to date. We report the successful treatment of one such case through open surgical repair of the thoracoabdominal aorta.
Aorta ; Aortic Aneurysm, Thoracic* ; Aortic Diseases ; Arterial Occlusive Diseases ; Blood Coagulation Disorders ; Leriche Syndrome* ; Thrombosis

The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.
Aorta ; Cardiopulmonary Bypass ; Debridement ; Esophageal Diseases ; Follow-Up Studies ; Humans ; Mediastinitis* ; Mediastinum ; Pancreatitis* ; Pancreatitis, Acute Necrotizing ; Thrombosis

In this study, We evaluated the safety and efficacy of mycophenolate mofetil (MMF) for the prevention of acute rejection episodes when given in combination with cyclosporine and corticosteroids during the postoperative period in living donor kidney transplantation. 212 patients were enrolled; 106 patients received triple therapy with azathioprine (control group) and another 106 patients received triple regimen with MMF 2 g/day (study group). There was two subgroup in the study group. Of the study group, one subgroup was 90 patients treated MMF after acute rejection episode or an increase in serum creatinine level above 2.0 mg/dl (MMF conversion) and another group was 16 patients with primary MMF therapy. We made no demographic difference between study and control groups with patient selection for reducing bias. There was no statistical differences in serum creatinine level between two groups at 2 years after transplantation. There were 12 (13.3%), 3 (18.8%) acute rejection episodes in the MMF conversion and primary MMF therapy groups and 36 (33.7%) in the control group with statistic difference (p=0.01). 5 patients (5.6%) in the MMF-treated group lost their graft versus 16 patiens (15%) in the AZA-treated group. The 2-year graft survival rate was 97.4% in the study group and 83.9% in the control group. There was signficant difference in 2-year graft survival (p=0.003). The adverse effects of MMF were opportunistic infection, leukopenia, abdominal pain and diarrhea. MMF in combination with cyclosporine and prednisone was superior to a standard immunosuppressive regimen including azathioprine. Taken together, the data indicated that MMF will be a valuable addition to the list of immunosuppressants available for the prevention and treatment of acute renal rejection after renal transplantation. Its final place in clinical transplantation will be determined by further analysis of future, randomized-prospective studies, and by broadening experience with this important addition to the immunosuppressive regimen.
Abdominal Pain ; Adrenal Cortex Hormones ; Azathioprine ; Bias (Epidemiology) ; Creatinine ; Cyclosporine ; Diarrhea ; Graft Survival ; Humans ; Immunosuppressive Agents ; Kidney Transplantation* ; Leukopenia ; Living Donors ; Opportunistic Infections ; Patient Selection ; Postoperative Period ; Prednisone ; Transplants*

Two strains of non-O group 1 Vibrio cholerae (non-0:1V. cholerae) were isolated from blood of a woman who had undergone a gastrectomy and from peritoneal fluid of a man with an impaired liver function. Microbiology laboratories in countries where raw fish and shellfish are frequently consumed should consider the possibility of non-0:1 V. cholerae when they identify vibrios from extraintestinal sources.
Adult ; Cholera/complications* ; Female ; Human ; Male ; Middle Age ; Peritonitis/etiology* ; Septicemia/etiology* ; Vibrio cholerae/isolation & purification

Combined double chambered right ventricle(DCRV) and discrete subaortic stenosis(DSAS) is a rare entity on which only 12 cases have been reported in the literature. We presented a case of combined DCRV and DSAS in an 18 year old girl. She had type II(thin membranous type) DSAS and the peak systolic prssure gradient between aorta and left ventricle was 38 mmHg. Aberrant muscle bundle was found on the right ventriculography and the pressure gradient in the right ventricle was 35 mmHg. She also had aortic regurgitation, persistent left sided superior vena cava and extracardiac malformations such as kyphoscoliosis and congenital cloacal anomaly.
Adolescent ; Aorta ; Aortic Valve Insufficiency ; Discrete Subaortic Stenosis* ; Female ; Heart Ventricles* ; Humans ; Vena Cava, Superior

OBJECTIVE: To investigate the correlation between the concentrations of insulin-like growth factor-II (IGF-II), insulin-like growth factor binding protein-1, 3 (IGFBP-1, 3) in the follicular fluid and the cumulative embryo score (CES) in the patient who underwent in vitro fertilization and embryo transfer (IVF-ET). MATERIALS AND METHODS: A total of 21 cycles of 18 patients which underwent IVF-ET cycle after controlled ovarian hyperstimulation (COH) were included in this study. Using immunoradiometric assay (IRMA), we measured the concentrations of IGF-II, IGFBP-1, 3 in the follicular fluid. The patients were grouped into the pregnant and non-pregnant group. The concentrations of IGF-II, IGFBP-1, 3 in the follicular fluid were compared between the two groups and the correlations of the follicular concentrations of IGF-II, IGFBP-1, 3 and cumulative embryo score were evaluated. Results were analyzed with Mann-Whitney U test and Spearman's rank correlation coefficient and statistical significance was defined as p<0.05. RESULTS: There were no statistical significance in the follicular concentrations of IGF-II, IGFBP-1, 3 between the pregnant group and non-pregnant group. There were signifiant correlation between the follicular concentration of IGF-II and cumulative embryo score (p=0.001). There might be correlations between the follicular concentration of IGFBP-3, and free IGF-II and cumulative embryo score (p=0.053, p=0.056, respectively). CONCLUSION: The follicular IGF-II and free IGF-II might have an influence to development of good- quality embryos in patients undergoing IVF-ET.
Embryo Transfer ; Embryonic Structures* ; Female ; Fertilization in Vitro ; Follicular Fluid ; Humans ; Immunoradiometric Assay ; Insulin-Like Growth Factor Binding Protein 1* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor II*

Incontinentia pigmenti (IP) is an uncommon genodermatosis that usually occurs in female infants. It is characterized by ectodermal, mesodermal, neurological, ocular, and dental manifestations. The aim of this study was to clarify clinical symptoms, accompanying diseases, and complications of IP. Forty cases of IP have been reviewed by their medical records, laboratory data, clinical photographs, and telephone survey. Male-to-female ratio was 1 to 19 and their onsets were mostly in utero. They were usually diagnosed during the neonatal period owing to their early expression of skin manifestation. Central nervous system anomalies were found in 46.7%. Ocular disorders and dental defects were detected in 66.7% and 72.7% respectively. The most commonly diagnosed anomalies were hypodontia, retinopathy, and seizure. For better understanding of IP, long term and close cooperation between dermatologists, pediatricians, neuroscientists, genentic counselors, and even dentists is crucial.
Stomatognathic Diseases/complications ; Skin Diseases/complications ; Male ; Magnetic Resonance Imaging/methods ; Korea ; Infant, Newborn ; Infant ; Incontinentia Pigmenti/*diagnosis/pathology ; Humans ; Female ; Eye Diseases/complications ; Eosinophilia/complications ; Child, Preschool ; Child ; Central Nervous System Diseases/complications

We report a rare case of primary tracheal malignent melanoma documented by careful clinical examination. Differentiation between primary and metastatic malignant melanoma is very difficult. We conclude that this tracheal tumor is a primary malignant melanoma based on characteristic pathologic features and the exclusion of the possibility of spontaneous regression of the primary site by patient's history and physical examination.
Melanoma* ; Physical Examination ; Trachea