The antiphospholipid syndrome is characterized by arterial thrombosis, venous thrombosis, pregnancy wastage, and thrombocytopenia associated with a persis tently positive lupus anticoagulant and/or moderate to high positive anticardiolipin antibodies(IgG or IgM). The antiphospholipid antibodies have been detected in many medical conditions, but the antiphospholipid syndrome (APS) has mainly been restricted to the primary antiphospholipid syndrome and APS associated with systemic lupus erythematosus. Rarely, the APS has been reported in other autoimmune disorders in the literature. We describe a woman with a limited form of scleroderma and the APS manifested by complete occlusion of left axillary artery with probable thrombotic occlusive nature, thrombocytope nia, prolonged aPTT, and persistently positive lupus anticoagulant.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Axillary Artery ; Female ; Humans ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Pregnancy ; Scleroderma, Limited* ; Thrombocytopenia ; Thrombosis ; Venous Thrombosis

No abstract available.
Diagnosis*

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

Selective internal pudendal pharmaco-arteriographies were performed in 38 posttraumatic arteriogenic impotent patients who were supposed to undergo vascular reconstructive surgeries. The arteriographic findings in accordance with trauma character were analyzed and compared with penile brachial index (PBI), duplex sonogram of cavernosal artery and cavernosal artery occulusive pressure (CAOP). The results were obtained as follows : l. The arterial stenoses were found on both sides in 12 (63.1%) out of l9 patients of pelvic bone fracture with urethral rupture, and found on either one (3) or both sides (4) in 7 patients of pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. The arteriograms were norma1 on both sides in 2 out of 7 patients of vertebral fractures and in one patient of electric burn on glans. 2. The stenotic lesions were most commonly Found in common penile artery (63.5%) followed by proximal cavernosal artery with or without dorsal artery (34.6%) and only one case of distal pudendal artery. Complete obstruction (66.7%) was most common in the common penile artery, whereas partial obstruction (77.8%) was most common in the proximal cavernosal artery. 3. Concerning site of the obstruction in accordance with the trauma character the stenosis occurred more frequently in the common penile artery after pelvic bone fracture with urethra` rupture and in the proximal cavernosal artery after penile injury, and occurred with similar frequency either in the common penile artery or in the proximal cavernosal artery after pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. 4. Out of fourteen cases of complete or partial obstruction on the arteriograms, 9 (64.3%) have abnormal findings on the duplex sonograms. Among l2 cases of obstruction on the arteriogram, only 4 (33.3%) were less than O.7 of PBI. Four cases of normal arteriogram shower abnormal duplex sonogram but normal PBI in all. 5. CAOP was 20 mmHg or more lower than brachial systolic pressure in 6 (66.7%) out of 9 cases or obstruction on the arteriogram. In conclusion, selective internal pudendal pharmaco-arteriography seems to be a valuable diagnostic method to investigate enile arterial traumatic obstruction. However, it is thought that the arteriography should be done complementarily with another methods because it still has limits of specificity and sensitivity.
Angiography ; Arteries ; Blood Pressure ; Burns, Electric ; Constriction, Pathologic ; Erectile Dysfunction* ; Humans ; Male ; Pelvic Bones ; Rupture ; Sensitivity and Specificity

Selective internal pudendal pharmaco-arteriographies were performed in 38 posttraumatic arteriogenic impotent patients who were supposed to undergo vascular reconstructive surgeries. The arteriographic findings in accordance with trauma character were analyzed and compared with penile brachial index (PBI), duplex sonogram of cavernosal artery and cavernosal artery occulusive pressure (CAOP). The results were obtained as follows : l. The arterial stenoses were found on both sides in 12 (63.1%) out of l9 patients of pelvic bone fracture with urethral rupture, and found on either one (3) or both sides (4) in 7 patients of pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. The arteriograms were norma1 on both sides in 2 out of 7 patients of vertebral fractures and in one patient of electric burn on glans. 2. The stenotic lesions were most commonly Found in common penile artery (63.5%) followed by proximal cavernosal artery with or without dorsal artery (34.6%) and only one case of distal pudendal artery. Complete obstruction (66.7%) was most common in the common penile artery, whereas partial obstruction (77.8%) was most common in the proximal cavernosal artery. 3. Concerning site of the obstruction in accordance with the trauma character the stenosis occurred more frequently in the common penile artery after pelvic bone fracture with urethra` rupture and in the proximal cavernosal artery after penile injury, and occurred with similar frequency either in the common penile artery or in the proximal cavernosal artery after pelvic bone fracture without urethral rupture and urethral rupture without pelvic bone fracture. 4. Out of fourteen cases of complete or partial obstruction on the arteriograms, 9 (64.3%) have abnormal findings on the duplex sonograms. Among l2 cases of obstruction on the arteriogram, only 4 (33.3%) were less than O.7 of PBI. Four cases of normal arteriogram shower abnormal duplex sonogram but normal PBI in all. 5. CAOP was 20 mmHg or more lower than brachial systolic pressure in 6 (66.7%) out of 9 cases or obstruction on the arteriogram. In conclusion, selective internal pudendal pharmaco-arteriography seems to be a valuable diagnostic method to investigate enile arterial traumatic obstruction. However, it is thought that the arteriography should be done complementarily with another methods because it still has limits of specificity and sensitivity.
Angiography ; Arteries ; Blood Pressure ; Burns, Electric ; Constriction, Pathologic ; Erectile Dysfunction* ; Humans ; Male ; Pelvic Bones ; Rupture ; Sensitivity and Specificity

Recently short term chemotherapy has become popular for the treatment of genitourinary tuberculosis. But it is questionable weather short term chemotherapy can cure all cases of genitourinary tuberculosis regardless of their severity ;and the role of nephrectomy in patients with renal tuberculosis is still controversial. Herein we analyzed 52 patients with confirmed urinary tuberculosis who were treated with triple drugs, including isoniazid, rifampicin and ethambutol, for 6 to 9 months. The patients ranged from 13 to 71 years of age, and the male to female ratio was 2.4: 1. Follow up period ranged from 6 to 65 months with a mean period of 19.7 months. The patients were classified according to the severity of renal tuberculosis on pyelography into Group I ( minimal, 8 patients), II (moderate, 9 patients) and III (severe, 35 patients), and treatment result were analyzed in each group. Of 52 patients, 19 were treated by chemotherapy only and 33 (63.5%) reconstructive surgery. Success rates of short term chemotherapy in terms of cure of tuberculosis and preservation of functional renal tissue were :overall 75%, 100% in Group I , 77% in Group II and 68.6% in Group III. Two of 9 patients in Group II and 10 of 17 in Group III who were treated with chemotherapy only, deteriorated with loss of the kidney. Poor vascular pyonephrotic kidney and progressive ureteral stricture were suggested as the main cause of failure. Ureteroneocystostomy and double J enting were helpful not only in the preservation of the kidney but also in the rapid cure of a renal tuberculosis. 24 patients who were treated with 6 to 9 months chemotherapy after removal of their nonfunctioning kidney were relapse-free on follow up. In conclusion, 6 to 9 months chemotherapy is adequate minimal urinary tuberculosis. For the treatment of moderate to advanced urinary tuberculosis, a longer period of chemotherapy may be adequate, and meticulous follow up with IVP and aggressive management of ureteral stricture is essential. A far advanced, nonfunctioning, unilateral tuberculosis kidney is better to be removed early, followed by 6 to 9 months' chemotherapy.
Constriction, Pathologic ; Drug Therapy* ; Ethambutol ; Female ; Follow-Up Studies ; Humans ; Isoniazid ; Kidney ; Male ; Nephrectomy ; Rifampin ; Tuberculosis* ; Tuberculosis, Renal ; Ureter ; Urography ; Weather

The emergency arteriography have been performed in a total of 13 patiens with extermity trauma, including 9fractures, 3 blunting traumas, and 1 penetrating injury. over 17 months period. The indications were as follows:absent or diminishe pulse, swelling, sensory or motor deficit , and hypotension. Patients with an absent pulse,the most reliable indication of arterial injury, should have immediate arteriography. The superficial femoralartery was commonly injured especially with distal femoral shaft fracture. The most common arteriographic findingswas arterial occlusion.
Angiography ; Emergencies ; Extremities ; Humans ; Hypotension

PURPOSE: The purpose of this study is to describe Magnetic Resonance(MR) findings of two epidural cavernous malformations of the spine. MATERIALS AND METHODS: MR imaging was performed in 2 patients(29-year-old man and 54-year-old woman). Sagittal T1 -, T2-weighted images and Gadolinium (Gd)-enhanced axial and sagittal images were acquired. Two patients had surgery and MR findings were compared with surgical and histopathological findings. RESULTS: MR imaging showed high- and low-signal intensity components of these lesions that were characteristic of an epidural cavernous malformation in one case. The other case showed a high signal intensity on T2- and strong enhancement on Gd-enhanced T1 -weighted images. We think that the former may be due to mixed subacute and chronic hemorrhage and the latter may be due to blood within the endotheliumlined sinusolds without hemorrhage. CONCLUSION: These findings were well correlated with the surgical and histo-pathological findings of cavernous malformation.
Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Spine*

No abstract available.
Nasal Cavity* ; Papilloma, Inverted* ; Paranasal Sinuses*

No abstract available.
Asthma* ; Humans ; Prednisolone* ; Theophylline*