No abstract available.
Orbit* ; Orbital Cellulitis*

Invasive aspergillosis (IA) is frequent in patients with acute leukemia and results in significant morbidity and mortality among neutropenic patients. Although the lung is a common site of this disease, pneumothorax and pneumomediastinum is rare as initial manifestations of IA. A 22-year-old male was admitted to the hospital due to aggrevated dyspnea, productive cough, fever and nasal bleeding. Acute myelogenous leukemia (AML, M2) was diagnosed. His clinical course was aggrevated despite patient was treated with empirical antibiotics. Chest X-ray and high-resolution computed tomography showed pneumothorax and pneumomediastinum on the left thorax. The clinical course was improved after closed thoracostomy and empirical amphotericin B therapy for the fungal infections was started. IA was pathologically diagnosed by his sputum contained a mucus plug. His symptoms and radiological lesions were completely resolved after amphotericin B therapy alone with a total doses of 2.58g. We report a case of IA complicated by pneumothorax and pneumomediastinum in acute myelogenous leukemia with the review of literatures.
Amphotericin B ; Anti-Bacterial Agents ; Aspergillosis* ; Cough ; Dyspnea ; Epistaxis ; Fever ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Male ; Mediastinal Emphysema* ; Mortality ; Mucus ; Pneumothorax* ; Sputum ; Thoracostomy ; Thorax ; Young Adult

BACKGROUND: Cisplatin (CP), an antitumor agent widely used in the treatment of cancers, has nephrotoxicity. This side effect is closely related to oxidative stress. In the present study, we attempted to reduce CP-induced nephrotoxicity in rats by administering melatonin, an antioxidant. METHODS: Male Sprague-Dawley rats were divided into different groups and were treated as follows: (1) saline control; (2) CP (16 mg/kg, i.p.); (3) CP plus melatonin (10 mg/kg, i.p.). The rats were sacrificed at the 6th day after CP treatment. To evaluate renal damage, BUN, serum creatinine, creatinine clearance and microscopic examination were done. Hydrogen peroxide which is one of the oxygen free radicals, and malondialdehyde which is known as a marker of the oxygen free radical mediated injury, and the activities of the antioxidant enzymes such as superoxied dismutase, catalase, and glutathione peroxidase were also measured. RESULTS: CP-treated rats showed the increase of BUN, serum creatinine, malondialdehyde, hydrogen peroxide and superoxide dismutase (SOD) in kidney. And CP-treated rats also showed the decrease of creatinine clearance and catalase levels. CP-treated rats showed severe tubular necrosis in proximal convoluted tubules under the light microscopic examination. The light microscopic finding and all of the parameters except SOD were restored in the rats injected with CP plus melatonin than those with CP alone. SOD level was higher in the rats injected with CP plus melatonin than that with CP alone. CONCIUSION: These results suggest that melatonin suppresses CP-induced nephrotoxicity by suppressing the production of reactive oxygen species via the activation of SOD and catalase.
Animals ; Catalase ; Cisplatin* ; Creatinine ; Free Radicals ; Glutathione Peroxidase ; Humans ; Hydrogen Peroxide ; Kidney ; Male ; Malondialdehyde ; Melatonin* ; Necrosis ; Oxidative Stress ; Oxygen ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Superoxide Dismutase

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

OBJECTIVE: To assess causative factors that may induce the leakage of the PMMA after the vertebroplasty performed on osteoporotic compression fracture patients. METHODS: Percutaneous vertebroplasty was done on 80 vertebral compression fractures in 54 patients from June.2001 to Nov.2002. Leakage of PMMA was divided into paravertebral, venous, epidural, and intradiscal leakage. The relationship between leakage of PMMA and various factors were analyzed such as clinical features, bone mineral density, existence of bone sclerosis, interval from injury to operation, amount of PMMA, tip location, operation method, compression pattern, compression ratio etc. RESULTS: Leakage was found in 39 vertebral bodies out of a total of 80 operated vertebral bodies. A large amount of PMMA, which was injected into compressed vertebra, induced a high incidence of leakage(P=0.042). Preoperative high bone mineral density in Compressed Vertebra induced a high incidence of leakage(P=0.014). The existence of sclerosis caused a high incidence of leakage.(P=0.014). Other factors, which were examined, did not induce the leakage of PMMA. CONCLUSION: Percutaneous vertebroplasty must be done carefully after a detailed examination of factors that might cause leakage of PMMA.
Bone Density ; Fractures, Compression* ; Humans ; Incidence ; Polymethyl Methacrylate* ; Sclerosis ; Spine ; Vertebroplasty*

Hypercalcemia is a rare complication of chronic myelogenous leukemia, especially in the blastic phase. The incidence is below 5%. PTH-rP (parathyroid hormone- related protein) plays various roles in human physiology by binding PTH receptors. The patient was 32-year-old male, admitted with blatic crisis of chronic myelogenous leukemia associated with hypercalcemia, elevated PTH-rP, depressed PTH level. Chemotherapy was instituted with hydroxyurea and two courses of idarubicin and Ara-C. After chemotherapy serum calcium and PTH-rP level, number of blast were depressed to near normal and PTH was elevated to normal range. But when the patient was re-admitted with recurrence of blastic crisis and hypercalcemia, PTH-rP level was elevated and PTH level was depressed below normal range. There was no other evidence of hypercalcemia as like hyperthyroidism or hyperparathyroidism, bone destruction. These suggest that the hypercalcemic event in this patient was induced by PTH-rP produced by blast cells.
Adult ; Calcium ; Cytarabine ; Drug Therapy ; Humans ; Hydroxyurea ; Hypercalcemia* ; Hyperparathyroidism ; Hyperthyroidism ; Idarubicin ; Incidence ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Male ; Physiology ; Recurrence ; Reference Values

PURPOSE: To evaluate the CT and MR findings of bronchial anthracofibrosis. MATERIALS AND METHODS: Forty-one patients with ronchoscopically confirmed bronchial anthracofibrosis were included in this study. Thirty-six were female and five were male, and all were aged between 53 and 89 (mean, 70) years. The CT (n=41) and MR findings (n=5) were retrospectively analysed with regard to bron-chostenosis, atelectasis, air-space consolidation, lymph node enlargement, calcified lymph node, mass and bronchial wall thickening, as seen on CT, and signal intensity of the mass and lymph nodes, as seen on MR. RESULTS: CT scans revealed the presence of bronchostenosis (n=34, 83%), atelectasis (n=24, 59%), pneumonic consolidation (n=26, 63%), enlarged mediastinal lymph node (n=39, 95%), calcified lymph node (n=22, 54%), mass (n=4,10%), and thickening of bronchial wall (n=1, 2.4%). Multifocal involvement of bron-chostenosis, atelectasis, and air-space consolidation occurred in 61%, 50% and 30% of cases, retrospectively. MR imaging showed low signal intensity of mass (n=3) and lymph nodes (n=10) on T1WI and T2WI. but in one case, mass and lymph node showed central high signal intensity on T2WI. CONCLUSION: A multiplicity of bronchostenosis, atelectasis, air-space consolidation and enlarged mediastinal lymph nodes were characteristic CT findings of bronchial anthracofibrosis. Most MR findings included relatively low signal intensity of masses and lymph nodes on T2WI, possibly indicating the benign nature of the diseases
Female ; Humans ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Male ; Pneumoconiosis ; Pulmonary Atelectasis ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: Since the 1960 s rabbit antihuman globulin reagent has been used widely. Recently most conjugate of enzyme immunoassay is produced from goat, and precise purification method is developed. Therefore we evaluated the commercial value of the goat antihuman globulin as a blood bank test reagent. METHODS: The human IgG was purified by protein-A gel, and injected into goat. The goat antihuman globulin was coupled by CNBr activated sepharose 4B-gel and purified by 0.2M glycine elution buffer. For verification of this reagent, commercial reagents(Ortho rabbit reagent & DiaMed Gel test) were used. RESULTS: The minimal concentration for detecting antibody of goat reagent was 9 ng/mL. The results of direct antiglobulin tests, with 400 samples collected from donated blood in CPDA-1, were all negative(false positive rate: 0%). With 613 samples collected from inpatients of Severance Hospital, the results were positive in 35 patients(positive rate:5.7%), and those results were in complete agreement with commercial reagent(concordance rate: Goat vs. Ortho :99.8%, Goat vs. DiaMed :98.4%). And with 30 samples of artificially prepared complement-coated RBC, the results were all negative. Indirect antiglobulin test showed higher agglutination score than commercial reagents. CONCLUSIONS: Goat reagent showed high sensitivity and specificity in comparison with rabbit reagent. Because false positive reaction was not observed in negative control samples, the heterophil agglutinin reaction, which was the major problem when the reagent was initially developed, might be excluded. In conclusion, goat reagent seems to be more economical than rabbit reagent because the former can be obtained in a large quantity and of high potency.
Agglutination ; Blood Banks ; Coombs Test ; False Positive Reactions ; Glycine ; Goats* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Indicators and Reagents ; Inpatients ; Sensitivity and Specificity ; Sepharose

An osteoma is a protruding mass composed of abnormally dense but otherwise normal bone and arises in the periosteum. It is usually found in the skull or facial bone, most often in the frontal or ethmoid sinuses, rarely occurring in the external auditory canal. The mass is usually hard and painless, and is connected to the osseous canal by its stalk or neck. Differential exestotic diagnosis is important. We report a case of osteoma of the external auditory canal.
Diagnosis ; Ear Canal* ; Ethmoid Sinus ; Facial Bones ; Neck ; Osteoma* ; Periosteum ; Skull

Autoimmune hepatitis accompanied by systemic erythematosus lupus is rare. Usually, lupus-related advanced liver involvement is indistinguishable from autoimmune hepatitis accompanied by lupus, as they share common clinical, biochemical, serological, and histological manifestations. However, each disease has its own diagnostic criteria, and they have been defined as two different categories. Therefore, distinguishing between the two diseases is important to determine the correct diagnosis and treatment. A 41-year-old woman was hospitalized with jaundice and a malar rash. The patient met the diagnostic criteria of both systemic erythematosus lupus and autoimmune hepatitis. After corticosteroid treatment, the patient's condition improved. Therefore, we report our experience of a rare case of autoimmune hepatitis accompanied by systemic erythematosus lupus with a review of the literature.
Adult ; Exanthema ; Female ; Hepatitis ; Hepatitis, Autoimmune ; Humans ; Jaundice ; Liver ; Lupus Erythematosus, Systemic