A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Sparganosis*

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

No abstract available.
Pregnancy* ; Purpura*

No abstract available.
Pregnancy*

Background: The relationship between cystitis glandularis (CG) and bladder malignancy remains unclear. Methods: We identified the oncologic significance of CG at the molecular level using liquid chromatography-tandem mass spectrometry-based proteomic analysis of 10 CG, 12 urothelial carcinoma (UC), and nine normal urothelium (NU) specimens. Differentially expressed proteins (DEPs) were identified based on an analysis of variance false discovery rate < 0.05, and their functional enrichment was analyzed using a network model, Gene Set Enrichment Analysis, and Gene Ontology annotation. Results: We identified 9,890 proteins across all samples and 1,139 DEPs among the three entities. A substantial number of DEPs overlapped in CG/NU, distinct from UC. Interestingly, we found that a subset of DEP clusters (n = 53, 5%) was differentially expressed in NU but similarly between CG and UC. This “UC-like signature” was enriched for reactive oxygen species (ROS) and energy metabolism, growth and DNA repair, transport, motility, epithelial-mesenchymal transition, and cell survival. Using the top 10 shortlisted DEPs, including SOD2, PRKCD, CYCS, and HCLS1, we identified functional elements related to ROS metabolism, development, and transport using network analysis. The abundance of these four molecules in UC/CG than in NU was consistent with the oncologic functions in CG. Conclusions Using a proteomic approach, we identified a predominantly non-neoplastic landscape of CG, which was closer to NU than to UC. We also confirmed a small subset of common DEPs in UC and CG, suggesting that altered ROS metabolism might imply potential cancerous risks in CG.

PURPOSE: To report a case treated with therapeutic keratoplasty using a cryo-preserved cornea in a patient with Candida albicans keratitis. CASE SUMMARY: A 77-year-old female visited our clinic because of left ocular pain and visual disturbance for 3 days. Microscopic slit lamp examination revealed a 1.2 mm sized round corneal epithelial defect with deep stromal infiltration, brownish pigmentation and signs of inflammation with cyclitic membranes in the anterior chamber. On suspicion of Candida keratitis, we performed penetrating keratoplasty using a cryo-preserved donor cornea in Optisol-GS® (Bausch & Lomb, Irvine, CA, USA) solution with excision of the infected iris and colony of the anterior chamber. After the procedure, injection of intravitreal or intracameral amphotericin B and voriconazole were administered alternately. At 2 weeks after the second surgery, infection signs disappeared. At the follow-up in the outpatient clinic, signs of infection were not observed. CONCLUSIONS: Therapeutic keratoplasty using a cryo-preserved donor cornea can be an immediate and effective therapeutic strategy for Candida albicans keratitis.
Aged ; Ambulatory Care Facilities ; Amphotericin B ; Anterior Chamber ; Candida albicans* ; Candida* ; Cornea* ; Corneal Transplantation* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Iris ; Keratitis* ; Keratoplasty, Penetrating ; Membranes ; Pigmentation ; Slit Lamp ; Tissue Donors ; Voriconazole

No abstract available.
HLA-DR Antigens* ; Polymerase Chain Reaction*

Hailey-Hailey disease(benign familial chronic pemphigus) is a rare autosomal dominant disorder characterized by blisters at sites of friction such as the neck, axillae and groin which are caused by suprabasal epidermal acantholysis. We report two cases of Hailey-Hailey disease in the one family. One of the two cases has asymptomatic multiple longitudinal white bands in the fingernails associated with typical skin lesions. The nail lesions have not been described until reported by Burge in 1992 and it may be a characteristic finding in Hailey-Hailey disease.
Acantholysis ; Axilla ; Blister ; Friction ; Groin ; Humans ; Nails ; Neck ; Pemphigus, Benign Familial* ; Skin

BACKGROUND AND OBJECTIVES:Traditionally, down beat nystagmus is regarded as a sign of central nervous system dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior semicircular canal BPPV, and to propose the new treatment method. MATERIALS AND METHOD:From November 1999 to March 2004, we sampled the 103 patients with positional or positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous system dysfunction, nonspecific or artifact result, idiopathic origin. RESULTS:All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and reversibility was reported in 1 patient. Average latency was checked less than 2 seconds. CONCLUSION:Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Artifacts ; Central Nervous System ; Diagnosis ; Humans ; Semicircular Canals ; Vertigo*