POEMS syndrome is a rare disease caused by monoclonal plasma cell proliferative disorder.The typical signs include peripheral neuropathy,organ enlargement,endocrine disease,M proteinemia,and skin changes.In clinical practice,the atypical,complex,and changeable clinical manifestations of this syndrome can easily lead to misdiagnosis and missed diagnosis.A case of POEMS syndrome with peripheral edema and ascites as the main manifestations is reported in this paper.
Humans ; Ascites/etiology* ; POEMS Syndrome/diagnosis* ; Edema/diagnosis* ; Skin

Aged ; Amyloidosis ; complications ; diagnosis ; Diagnostic Errors ; Dyspnea ; etiology ; Edema ; etiology ; Female ; Humans ; Immunoglobulin Light-chain Amyloidosis

Carotid Body Tumor ; complications ; diagnosis ; Diagnosis, Differential ; Edema ; etiology ; Female ; Humans ; Neck ; Young Adult

ObjectiveTo investigate the diagnosis and management of penile fracture.

METHODSFrom June 1993 to May 2017, 46 cases of penile fracture were treated in our hospital, averaging 33.5 (25－42) years of age and 3.45 (1－10) hours in duration, of which 41 occurred during sexual intercourse, 4 during masturbation and 1 during prone sleeping, 4 with hematuria, but none with dysuria or urethral bleeding. Hematoma was confined to the penis. Emergency surgical repair was performed for all the patients, 45 under spinal anesthesia and 1 under local anesthesia, 16 by coronal proximal circular incision and the other 30 by local longitudinal incision according to the rupture location on ultrasonogram. The tunica albuginea ruptures averaged 1.31 (0.5－2.5) cm in length, which were sutured in the "8" pattern for 6 cases and with the 3－0 absorbable thread for 18 cases. The skin graft or negative pressure drainage tube was routinely placed, catheters indwelt, and gauze used for early pressure dressing. In the recent few years, elastic bandages were employed for 3－5 days of pressure dressing and antibiotics administered to prevent infection. The stitches and catheter were removed at 7 days after surgery.

RESULTSShort-term postoperative foreskin edema occurred in 14 of the 16 cases of circular degloving incision, but no postoperative complications were observed in any of the cases of local incision. Twenty-eight of the patients completed a long-term follow-up of 49.4 (10－125) months, which revealed good erectile function, painless erection, and satisfactory sexual intercourse.

CONCLUSIONSFor most penile fractures, local longitudinal incision is sufficient for successful repair of the tunica albuginea, with mild injury, no influence on the blood supply or lymph reflux, and a low rate complications. It therefore is obviously advantageous over circular degloving incision except when the cavernous body of urethra is to be explored, which necessitates circular degloving incision below the coronal groove.

Adult ; Coitus ; Edema ; etiology ; Hematoma ; diagnosis ; etiology ; Humans ; Male ; Masturbation ; complications ; Penile Erection ; Penis ; injuries ; Postoperative Complications ; etiology ; Rupture ; diagnosis ; etiology ; surgery ; Surgical Wound ; Ultrasonography ; Urethra ; surgery

The author reports a case of orbital Sarcoidosis in a 70-year-old female that initially presented as diffuse swelling of the lower eyelid. The patient complained of painless swelling of the left lower lid without palpable mass, and a computerized tomography (CT) scan of the orbit was unremarkable. A serum angiotensin converting enzyme level was elevated, and hilar lymphadenopathy was noted on the chest CT. The patient underwent surgical debulking for histologic confirmation, which led to a final diagnosis of sarcoidosis involving the orbital fat. Unexplained chronic eyelid swelling without a mass should be considered a possible ophthalmic manifestation of orbital sarcoidosis.
Aged ; Biopsy ; Diagnosis, Differential ; Edema/diagnosis/*etiology ; Eyelid Diseases/diagnosis/*etiology ; Eyelids/*pathology ; Female ; Humans ; Orbital Diseases/*complications/diagnosis ; Sarcoidosis/*complications/diagnosis ; Tomography, X-Ray Computed

Brain Infarction ; diagnosis ; etiology ; therapy ; Cerebral Angiography ; Child ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Neoplasms ; complications ; diagnosis ; surgery ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male ; Myxoma ; complications ; diagnosis ; surgery ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Thrombosis ; diagnosis ; etiology ; therapy

PURPOSE: To report transient corneal edema after phacoemulsification as a predictive factor for the development of pseudophakic cystoid macular edema (PCME). METHODS: A total of 150 eyes from 150 patients (59 men and 91 women; mean age, 68.0 ± 10.15 years) were analyzed using spectral domain optical coherence tomography 1 week and 5 weeks after routine phacoemulsification cataract surgery. Transient corneal edema detected 1 week after surgery was analyzed to reveal any significant relationship with the development of PCME 5 weeks after surgery. RESULTS: Transient corneal edema developed in 17 (11.3%) of 150 eyes 1 week after surgery. A history of diabetes mellitus was significantly associated with development of transient corneal edema (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.41 to 11.54; p = 0.011). Both diabetes mellitus and transient corneal edema were significantly associated with PCME development 5 weeks after surgery (OR, 4.58; 95% CI, 1.56 to 13.43; p = 0.007; and OR, 6.71; CI, 2.05 to 21.95; p = 0.003, respectively). In the 8 eyes with both diabetes mellitus and transient corneal edema, 4 (50%) developed PCME 5 weeks after surgery. CONCLUSIONS: Transient corneal edema detected 1 week after routine cataract surgery is a predictive factor for development of PCME. Close postoperative observation and intervention is recommended in patients with transient corneal edema.
Adult ; Aged ; Aged, 80 and over ; Cornea/*pathology ; Corneal Edema/*diagnosis/etiology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glucosinolates ; Humans ; Macular Edema/diagnosis/*etiology ; Male ; Middle Aged ; *Phacoemulsification ; Pseudophakia/*complications/diagnosis ; Retrospective Studies ; Tomography, Optical Coherence

Cardiogenic unilateral pulmonary edema (UPE) is a rare clinical entity that is often misdiagnosed at first. Most cases of cardiogenic UPE occur in the right upper lobe and are caused by severe mitral regurgitation (MR). We present an unusual case of right-sided UPE in a patient with cardiogenic shock due to acute myocardial infarction (AMI) without severe MR. The patient was successfully treated by percutaneous coronary intervention and medical therapy for heart failure. Follow-up chest Radiography showed complete resolution of the UPE. This case reminds us that AMI can present as UPE even in patients without severe MR or any preexisting pulmonary disease affecting the vasculature or parenchyma of the lung.
Acute Disease ; Aged ; Coronary Angiography ; Diagnosis, Differential ; Heart Atria/ultrasonography ; Heart Failure/diagnosis/etiology ; Humans ; Male ; Mitral Valve Insufficiency/ultrasonography ; Myocardial Infarction/complications/*diagnosis/therapy ; Pulmonary Edema/*diagnosis/etiology/therapy ; Shock, Cardiogenic/*diagnosis/etiology/therapy ; Tomography, X-Ray Computed

We treated a 54-year-old woman who was suffering from membranoproliferative glomerulonephritis associated with a complete type of hydatidiform mole. The renal manifestations were proteinuria and hematuria. A renal biopsy, performed before gynecologic management, disclosed focal and segmental subendothelial deposits with a proliferation of the mesangial cell and showed irregularly thickened capillary loops by light and electronmicroscoy. Genralized edema, proteinuria and hematuria were completely recovered by suction and curettage of the hydatidiform mole with prophylactic chemotherapy. The clinical manifestation of earlier presented 3 cases have been the nephrotic syndrome. The common feature of them was a complete remission of the nephropathy after the removal of the hydatidiform mole. The relationship between the hydatidiform mole and glomerulonephritis remains unresolved at present. But we concluded that the hydatidiform mole might be a cause of glomerulonephritis in this case.
Case Report ; Diagnosis, Differential ; Edema/etiology ; Female ; Glomerulonephritis, Membranoproliferative/pathology ; Glomerulonephritis, Membranoproliferative/etiology* ; Hematuria/etiology ; Human ; Hydatidiform Mole/therapy ; Hydatidiform Mole/diagnosis* ; Hydatidiform Mole/complications* ; Middle Age ; Pregnancy ; Proteinuria/etiology ; Uterine Neoplasms/therapy ; Uterine Neoplasms/diagnosis* ; Uterine Neoplasms/complications*

Neurogenic pulmonary edema (NPE) leading to cardiopulmonary dysfunction is a potentially life-threatening complication in patients with central nervous system lesions. This case report describes a 28-yr woman with life-threatening fulminant NPE, which was refractory to conventional respiratory treatment, following the rupture of an aneurysm. She was treated successfully with extracorporeal membrane oxygenation (ECMO), although ECMO therapy is generally contraindicated in neurological injuries such as brain trauma and diseases that are likely to require surgical intervention. The success of this treatment suggests that ECMO therapy should not be withheld from patients with life-threatening fulminant NPE after subarachnoid hemorrhage.
Adult ; Brain/radiography ; Decompressive Craniectomy ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Intracranial Aneurysm/complications/*diagnosis ; Pulmonary Edema/*diagnosis/etiology/therapy ; Subarachnoid Hemorrhage/etiology ; Tomography, X-Ray Computed