No abstract available.
Spinal Cord Diseases* ; Spinal Cord*

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

No abstract available.
Esophageal Neoplasms*

OBJECTIVE: The purposes of this article are to present 5 cases of intracranial meningioma with leptomeningeal dissemination (LD) and investigate the characteristics of this disease. METHODS: We present a retrospective case series of 5 females at our institutions (age ranged 21-72 years, mean 54.6 years) diagnosed with LD of an intracranial meningioma after surgery between 1998 and 2013. A database search revealed 45 cases with LD of meningioma in the English literature. Characteristic features were analyzed and compared. RESULTS: The incidence rate at our institutions of LD of meningioma was 0.9% (5/534). World Health Organization (WHO) grade was distributed as follows: I : 2, II : 2, and III : 1. Time to LD ranged from 2.5 months to 6.9 years; the patient with WHO grade III had the shortest interval to LD. The patient with an intraventricular meningioma (WHO grade II) had the second shortest interval to LD (1.7 years), and simultaneously revealed both LD and extraneuronal metastases. Four of 5 patients showed a disease progression, with the survival ranging from 1 month to 3.8 years after LD. Based on the literature, the initial tumor was an intraventricular meningioma in 9 patients, and their time to LD was shorter on average (mean 1.9 years). Histologically, 26 of 45 (58%) were initially diagnosed with a WHO grade II or III meningioma, and 6 of 19 patients (32%) with WHO grade I revealed malignant transformation. CONCLUSION: This study shows that intraventricular location and histologically aggressive features seem to increase the chance of LD of meningioma.
Disease Progression ; Female ; Humans ; Incidence ; Meningeal Carcinomatosis ; Meningioma* ; Neoplasm Metastasis ; Retrospective Studies* ; World Health Organization

There have been some reports about formation of free radical species in aqueous humor after excimer laser photorefractive keratectomy(PRK). We investigated whether there exists an increase of nitric oxied(NO) level in aqueous humor after excimer laser treatment. Of the 41 albino rabbits(81 eyes) used for this study, 25 eyes served as controls. The remaining 56 eyes were divided into three groups, i.e., a group with its epithelium removed mechanically(3 eyes), -6.0D PRK group(24 eyes) and -12.0D PRK group(29 eyes). After varing time intervals following excimer laser treatment, aqueous NO concentration was determined with ELISA method using Griess reagent. The mean aqueous NO concertration was 101.83ng/ml in normal control group and showed no difference(107.00ng/ml) from that of mechanically abladed group, Aqueous NO was increased 30 min after PRK in both groups compared to normal(-6.0D : 218.67ng/ml, -12.0D : 198.68ng/ml) and maintained at one hour postoperatively. Eyes with -12.0D ablation still while eyes with -6.0D ablation showed no difference from normal. Six hours after PRK, aqueous NO was returned to the normal level in both groups of PRK. The results of this study showed that excimer laser PRK induced NO production in aqueous humor, and the more extensive amount of excimer laser applied, the longer time would be taken to restore the normal NO level. It seems that such an elevation of NO level could be one of the factors that cause temporary corneal stromal edema or anterior chamber reaction after excimer laser PRK.
Anterior Chamber ; Aqueous Humor ; Edema ; Enzyme-Linked Immunosorbent Assay ; Epithelium ; Lasers, Excimer* ; Nitric Oxide*

A case of arterial priapism was treated by superselective transcatheteric autologous clot embolization of cavernosal artery 25 days after blunt periheal trauma. No immediate improvement was noted but the priapism subsided on 48th day after the procedure. Normal physiclogic erectlie function was achieved on 53rd day after the procedure, and the period of postprocedure impotence was shortened, as compared with previously reported cases. Autologous blood clot embolization may be an effective treatment method even in delayed priapism, and superselective technique is thought to be more effective to shorten the postprocedure erectlie dysfunction
Arteries ; Erectile Dysfunction ; Male ; Priapism*

45 eyes of 37 adult patients with nasolacrimal duct[NLD]obstruction were treated with silicone tube intubation. Silicone tube was removed between 1 and 12 months[mean 3.96 months]after surgery. After variable follow-up periods of 3 to 23 months[mean 6.82 months], 57.8%showed no epiphora, 28.9% showed intermittent epiphora and 13.3%showed ersistent epiphora. Complications were minimal and did not affect the outcome. We recommend that silicone intubation can be an alternative to dacryocystorhinostomy in selected adult patients. It is safe and less traumatic procedure with relatively high success rate in partial NLD obstruction and total obstruction with recent onset.
Adult ; Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Silicones*

No abstract available.
Humans ; Male*