Two cases of malignant histiocytosis, in which skin involvement was a prominent finding at initial clinical presentation, are reported. 1nteresting histopathologic findings, including Langerhans granule in one case and numerous eosinophils in another, were observed. In one case remission was achieved with BACOP chemotherapy (Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, and Prednisone). In the other case, the patient died nine months after the onset of the disease without any treatment.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Eosinophils ; Histiocytic Sarcoma* ; Humans ; Skin ; Vincristine

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

No abstract available.
Cleft Lip*

The effects of sodium hypochlorite for the destruction of P. aeruginosa, E. coli, K. pneumonias and S. anreas and for the prevention of contamination of irrigation fluid, which is either exposed to ICU environment or used for cleansing oral or trachea catheter tips, were tested and the following results were obtained. 1) The sodium hypochlorite solution 1: 800 destroyed P. aeraginosa, E. coli, K. pneomoniue and S. aweas in 5 minutes. This bactericidal effect was observed to be retained after the solution had stood 24 hours. 2) Viable P. aeraginosa was not detected immediately, 5 minutes and 10 minutes after exposure to 1: 500, 1: 800 and 1: 1000 sodium hypochloride solutions respectively. 3) The sodium hypochlorite solution 1: 800 prevented contamination of the irrigation fluids during a 24 hour exposure to the ICU environment. 4) P. aeraginosa and other gram-negative bacilli were frequently isolated from the plain fluid used for irrigating and holding the suction tips which had been used for patients. However, no organisms were isolated from fluid containing sodium hypochlorite 1: 800 even after 24 hour usage. It is concluded that the use of fluid containing sodium hypochlorite for the irrigation of catheter tips can reduce development of infections in the ICU patients.
Catheters ; Humans ; Infection Control* ; Pneumonia ; Sodium Hypochlorite* ; Sodium* ; Suction ; Trachea

No abstract available.
Brain* ; Epilepsy, Frontal Lobe* ; Frontal Lobe*

PURPOSE: As mesial temporal lobe epilepsy (TLE) shows hypometabolism of medial and lateral tempora lobe, we investigated whether symmetric uptake of F-18-FDG in medial temporal lobes can differentiat mesial from lateral TLE. MATERIALS AND METHODS: In 113 patients (83 mesial TLE, 30 lateral TLE) wh underwent anterior temporal lobectomy and/or corticectomy with good surgical outcome, we performe F-18-FDG PET and compared F-18-FDG uptake of medial and lateral temporal lobes. All the patients wi mesial TLE had hippocampal sclerosis except one congenital abnormal hippocampus. Patients with latera TLE revealed cerebromalacia, microdysgenesis, arteriovenous malformation, old contusion, and cortical dys plasia. RESULTS: Sensitivity of F-18-FDG PET and MR for mesial TLE was 84% (70/83) and 73% (61/83 respectively. Sensitivity of F-18-FDG PET and MR for lateral TLE was 90% (27/30) and 66% (20/30 respectively. Twelve patients were normal on F-18-FDG PET. 101 patients had hypometabolism of latera temporal lobe. Among 88 patients who showed hypometabolism of medial temporal lobe as well as later temporal lobe, 70 were mesial TLE patients and 18 were lateral TLE on pathologic examination. Positive predictive value of medial temporal hypometabolism for mesial TLE was 80%. Among 13 patients wh showed hypometabolism of only lateral temporal lobe, 4 were mesial TLE and 9 were lateral TLE. Positive predictive value of hypometabolism of lateral temporal lobe for the diagnosis of lateral TLE was 69% ( 13). Normal MR findings stood against medial TLE, whose negative predictive value was 66%. Conclusion Lateral temporal lobe epilepsy should be suspected when there is decreased F-18-FDG uptake in latera temporal lobe with normal uptake in medial temporal lobe.
Anterior Temporal Lobectomy ; Arteriovenous Malformations ; Contusions ; Diagnosis ; Electrons* ; Encephalomalacia ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Positron-Emission Tomography* ; Sclerosis ; Temporal Lobe*

A 45-year-old woman with recurrent disturbances of consciousness for 4 years with hypoglycemia was hospitalized with the clinical suspicion of an insulinoma. The findings of transabdominal ultrasonography, computed tomography and angiography were negative. Transhepatic venous sampling for pancreatic hormone assay showed sudden step-up of serum level of insulin in the venous blood from the tail of the pancreas. Finally, an endoscopic ultrasonographic examination established with certainty the origin of the tumor from the tail of the pancreas, which was subsequently confirmed at operation. In conclusion, endoscopic ultrasonography is a useful and valuable procedure for the localization of insulinoma especially in patient with insulinoma of the pancreas that cannot be localized by conventional methods.
Angiography ; Consciousness ; Endosonography* ; Female ; Humans ; Hypoglycemia ; Insulin ; Insulinoma* ; Middle Aged ; Pancreas ; Ultrasonography

Bow hunter's stroke is a rare symptomatic vertebrobasilar insufficiency in which vertebral artery (VA) is mechanically occluded during head rotation. Various pathologic conditions have been reported as causes of bow hunter's stroke. However, bow hunter's stroke caused by facet hypertrophy of C1-2 has not been reported. A 71-year-old woman presented with symptoms of vertebrobasilar insufficiency. Spine computed tomography showed massive facet hypertrophy on the left side of C1-2 level. A VA angiogram with her head rotated to the right revealed significant stenosis of left VA. C1-2 posterior fixation and fusion was performed to prevent serious neurologic deficit from vertebrobasilar stroke.
Aged ; Constriction, Pathologic ; Female ; Head ; Humans ; Hypertrophy ; Neurologic Manifestations ; Spine ; Stroke ; Vertebral Artery ; Vertebrobasilar Insufficiency ; Zygapophyseal Joint

We tried to investigate the incidence and the clinical profile of intractable epilepsy with hippocampal atrophy and ictal onset zones located in areas other than the hippocampus (extra-medial-temporal epilepsy; EMTE). We included patients who had hippocampal atrophy confirmed by MRI but with extra-medial-temporal ictal onset zones as verified by invasive intracranial electrodes or video-EEG monitoring. The case histories, interictal EEG, ictal semiology, other MRI findings in addition to hippocampal atrophy, and results of ictal SPECT and PET scans were evaluated. Results were compared with those of surgically proven medial temporal lobe epilepsy with hippocampal atrophy recruited during the same period. 8.5% of the intractable epilepsy patients with hippocampal atrophy had extra-medial temporal epileptogenic zones. A history of encephalitis and hemiconvulsion-hemiparesis were significantly common in the EMTE group. Most of the interictal EEGs of EMTE patients showed extratemporal irritative zones. MRI, ictal SPECT, and FDG-PET seemed to be helpful at localizing the true epileptogenic zones. The predominant EMTE seizure type was focal motor seizure with secondary generalization. Some portion of intractable epilepsy patients with hippocampal atrophy had extra-medial-temporal epileptogenic foci and careful analysis of semiology and neuroimagings could yield clues to correct diagnosis.
Adult ; Atrophy ; Electroencephalography ; Epilepsy/physiopathology ; Epilepsy/epidemiology* ; Epilepsy/diagnosis ; Epilepsy, Temporal Lobe/epidemiology ; Hippocampus/pathology* ; Human ; Incidence ; Magnetic Resonance Imaging ; Retrospective Studies ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon

We have evaluated the outcome of the high myopic patients who had been underwent cataract extraction with 0 diopter posterior chamber intraocular lens (PC IOL)implantation (15 eyes)and without PC IOL implantation (11 eyes), retrospectively.The average axial length was 31.1 mm and the average calculated diopter of PC IOL was +0.48 diopter.The preoperative corrected visual acuity (VA)had no statistically difference between the two groups.But the numbers of eyes that had postoperative corrected VA above 20/40 were 1 of 11 aphakic eyes and 7 of 15 pseudophakic eyes, and had significant difference (p<0.05).The after cataracts were found in 4 eyes of aphakic eyes and 1 eye of 0 diopter pseudophakic eyes.Among of them, 4 eyes of aphakic eyes underwent Nd:YAG laser posterior capsulotomy and not revealed the retinal detachment.So we thought that PC IOL implantation after cataract extraction in high myopic eyes could improve the visualacuity, decrease the incidence of after cataract and retinal detachment.
Aphakia* ; Cataract ; Cataract Extraction ; Humans ; Incidence ; Lenses, Intraocular ; Myopia* ; Posterior Capsulotomy ; Pseudophakia* ; Retinal Detachment ; Retinaldehyde ; Visual Acuity