Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an uncommon disease which can occurs secondary to tuberculous meningitis. A 31-year-old woman was diagnosed as tuberculous meningitis after mental disorientation. Her mentality was recovered after antituberculous therapy. After 7 months of antituberculous therapy, paraplegia has developed. Magnetic resonance imaging (MRI) revealed a mass lesion between the T1 and T12 spinal levels with arachnoid thickening which results in the development of tuberculoma. She received surgical resection of IETSC followed by antituberculous therapy and neurological function has been improved. The two years after surgical treatment, spinal MRI showed syringomyelia between T1 to L1. But, her neurological outcome was not aggravated.
Adult ; Arachnoid ; Female ; Humans ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord* ; Syringomyelia ; Tuberculoma* ; Tuberculosis, Meningeal*

Pseudo-kaposi's sarcoma is a vasoproliferative disorder that may resemble Kaposi's sarcoma, clinically and histologically. In most cases, it has been associated with congenital or iatrogenic arteriovenous fistula and chronic venous insuffiency. We present a 36-year-old male patient with pseudo-Kaposi's sarcoma caused by a deed vein thrombosis in the absence of any detectable underlying etiologic factors.
Adult ; Arteriovenous Fistula ; Humans ; Male ; Sarcoma ; Sarcoma, Kaposi* ; Thrombosis ; Veins ; Venous Thrombosis*

OBJECTIVE: This study was designed to evaluation the diagnostic value of procalcitonin (PCT) in patients with spinal infection, compare to the classical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count. METHODS: All patients who were diagnosed as a spinal infection between January, 2013 and July, 2014 were included in this study. Serum PCT, CRP, ESR, and WBC count were checked at initial hospital visit and once a week serially until they were discharged. Patient's medical history, causes and pathogens of spinal infection were reviewed. RESULTS: Total 34 (16 men, 18 women) patients were included in this study. Mean age of the patients was 65.6 year-old. Causes of spinal infection were pain block procedure (14, 41.2%) and post-operation (5, 14.7%). Out of 25 patients who showed elevated initial serum PCT level, 20 patients (80%) had a combined systemic infection. 14 patients (6.7%) had a sepsis, 3 patients (14.2%) had a urinary tract infection and 2 (9.6%) had a pneumonia. 14 patients (41.2%) showed elevation of serum PCT level during treatment. Among them, 9 patients (64.3%) had a combined infection such as sepsis and urinary tract infection. CONCLUSION: Serum CRP showed more sensitivity compared to serum PCT in patients with spinal infection. Patients with spinal infection who showed elevated serum PCT level should be investigated for combined infection and proper antibiotics should be applied.
Anti-Bacterial Agents ; Biomarkers ; Blood Sedimentation ; C-Reactive Protein ; Discitis ; Humans ; Leukocytes ; Male ; Pneumonia ; Sepsis ; Spondylitis ; Urinary Tract Infections

Rectus sheath hematoma is an uncommon cause of acute abdomen, caused by a tear in deep epigastric vessels or its branches. It occurs spontaneously, after trauma or surgery. Rectus abdominus myonecrosis is a life threatening complication of rectus sheath hematoma. We report a case with fatal rectus sheath hematoma complicated by rectus abdominus myonecrosis caused by ischial fracture in a chronic active rheumatoid arthritis patient.
Abdomen, Acute ; Arthritis, Rheumatoid* ; Hematoma* ; Humans

OBJECTIVE: To compare the efficacy of suprapapillary and transpapillary meth-ods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied. MATERIALS AND METHODS: Stents were placed in 59 patients. Strictures were cat-egorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared. RESULTS: Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapap-illary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p =0.37) or method (p = 0.62). CONCLUSION: For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.
Bile Duct Neoplasms/complications ; Bile Duct Obstruction, Extrahepatic/etiology/*therapy ; Cholangiography ; Comparative Study ; Digestive System Neoplasms/complications ; Female ; Human ; Male ; Middle Age ; Palliative Care/*methods ; *Radiology, Interventional ; Retrospective Studies ; *Stents ; Tomography, X-Ray Computed

OBJECTIVE: To compare the efficacy of suprapapillary and transpapillary meth-ods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied. MATERIALS AND METHODS: Stents were placed in 59 patients. Strictures were cat-egorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared. RESULTS: Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapap-illary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p =0.37) or method (p = 0.62). CONCLUSION: For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.
Bile Duct Neoplasms/complications ; Bile Duct Obstruction, Extrahepatic/etiology/*therapy ; Cholangiography ; Comparative Study ; Digestive System Neoplasms/complications ; Female ; Human ; Male ; Middle Age ; Palliative Care/*methods ; *Radiology, Interventional ; Retrospective Studies ; *Stents ; Tomography, X-Ray Computed

Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia.
Actinomycosis* ; Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Biopsy, Needle ; Cough ; Cryptogenic Organizing Pneumonia ; Exudates and Transudates ; Fever ; Fibrin ; Humans ; Male ; Pneumonia* ; Recurrence ; Sputum ; Sulfur

OBJECTIVE: The purpose of this study was to investigate the effects of haloperidol on [Ca2+]i in hamster insulinoma cells (HIT T-15). METHODS: [Ca2+]i levels were measured by calcium imaging techniques, and membrane potential ionic currents were recorded using conventional patch-clamp methods. RESULTS: Haloperidol induced a transient [Ca2+]i increase, which was abolished by the removal of extracellular Ca2+ or pretreatment with Ca2+ channel blockers (nimodipine and mibefradil). Haloperidol depolarized the membrane potential and inhibited the ATP-sensitive K+ (KATP) channels. Sigma receptor agonists, (+)-SKF10047 and ifenprodil, induced a transient [Ca2+]i increase similar to haloperidol. BD1047, a sigma receptor antagonist, completely blocked the [Ca2+]i increase induced by haloperidol. Haloperidol inhibited the KCl-induced [Ca2+]i increase and voltage-dependent Ca2+ currents. Sigma receptor agonists [(+)-SKF10047, ifenprodil] also inhibited the KCl-induced [Ca2+]i increase. CONCLUSION: Our results suggest that haloperidol induces depolarization, which increases [Ca2+]i by voltage-gated Ca2+ currents via the closing of KATP channels. Haloperidol also inhibits KCl-induced [Ca2+]i increases in the same manner. These effects of haloperidol seemed to be mediated by sigma receptors, which might be linked to the pathogenesis of haloperidol-induced diabetes mellitus.
Animals ; Calcium ; Cricetinae ; Diabetes Mellitus ; Haloperidol* ; Insulinoma* ; KATP Channels ; Membrane Potentials ; Receptors, sigma

No abstract available.
Intestinal Polyposis*

PURPOSE: Individual gastric cancers demonstrate complicated genetic alterations. The PCR-based analysis of polymorphic microsatellite sequences on cancer-related chromosomes has been used to detect chromosomal loss and microsatellite instability. For the purpose of preoperative usage, we analyzed the correspondance rate of the microsatellite genotype between endoscopic biopsy and surgical specimens. MATERIALS AND METHODS: Seventy-three pairs of biopsy and surgical specimens were examined for loss of heterozygosity and microsatellite instability by using 40 microsatellite markers on eight chromosomes. Microsatellite alterations in tumor DNAs were classified into a high-risk group (baseline- level loss of heterozygosity: 1 chromosomal loss in diffuse type and high-level loss of heterozygosity: 4 or more chromosomal losses) and a low-risk group (microsatellite instability and low-level loss of heterozygosity: 2 or 3 chromosomal losses in diffuse type or 1~3 chromosomal losses in intestinal type) based on the extent of chromosomal loss and microsatellite instability. RESULTS: The chromosomal losses of the biopsy and the surgical specimens were found to be different in 21 of the 73 cases, 19 cases of which were categorized into a genotype group of similar extent. In 100 surgical specimens, the high-risk genotype group showed a high incidence of nodal involvement (19 of 23 cases: < or =5 cm; 23 of 24 cases: >5 cm) irrespective of tumor size while the incidence of nodal involvement for the low-risk genotype group depended on tumor size (5 of 26 cases: < or =5 cm; 18 of 27 cases: >5 cm). Extraserosal invasion was more frequent in large-sized tumor in both the high-risk genotype group (< or =5 cm: 12 of 23 cases; >5 cm: 23 of 24 cases) and the low-risk genotype group (< or =5 cm: 7 of 26 cases; >5 cm: 16 of 27 cases). The preoperative prediction of tumor invasion and nodal involvement based on tumor size and genotype corresponded closely to the pathologic tumor stage (ROC area>0.7). CONCLUSION: An endoscopic biopsy specimen of gastric cancer can be used to make a preoperative genetic diagnosis that accurately reflect the genotype of the corresponding surgical specimen.
Biopsy* ; Classification* ; Diagnosis ; DNA ; Genotype ; Incidence ; Loss of Heterozygosity ; Microsatellite Instability ; Microsatellite Repeats* ; Stomach Neoplasms*