Intestinal capillariasis is caused by a small trichurid nematode, Capillaria philippinensis, which infects freshwater fish as intermediate hosts and subsequently fish eating birds as definitive hosts. It has occurred in areas such as the Philippines and Thailand where people eat raw fish. We report an imported case of intestinal capillariasis in a 31-year-old Korean man who lived in Saipan for ten years. He suffered from diarrhea with weight loss, abdominal distension, and pitting edema in the lower extremities for two years. He ate raw freshwater fish in the Saipan 2 years ago. The diagnosis was confirmed by jejunal biopsy. Flat mucosal surface without villi contained sections of numerous round worms with stichosome, larvae, and eggs which were identified as Capillaria philippinensis. The patient was successfully treated with albendazole.
Adult ; Albendazole ; Biopsy ; Birds ; Capillaria ; Diagnosis ; Diarrhea ; Eating ; Edema ; Eggs ; Fresh Water ; Humans ; Larva ; Lower Extremity ; Ovum ; Philippines ; Protein-Losing Enteropathies* ; Thailand ; Weight Loss

The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

No abstract available.
Antibodies* ; Blood Donors* ; Chemistry* ; Chlamydia* ; Chlamydophila pneumoniae* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Prevalence*

No abstract available.
Animals ; Female ; Hysterectomy* ; Ovariectomy* ; Rats* ; Spine* ; Tibia*

Cystic nephroma (CN) is a benign cystic neoplasm composed of mixed epithelial and stromal elements. Less than 200 cases have been reported. We had a patient, a 41-year-old woman, who had a huge typical CN. The patient was admitted for a right renal mass that was found incidentally. On laparaoscopic right nephrectomy, there was an encapsulated 7 cm multilocular cystic mass at the upper pole. Microscopically, the cystic wall was lined by a single layer of low cuboidal or hobnail epithelium without a solid area. The thin septa were composed of bland, ovarian type spindle cells. The main differential diagnoses were mixed epithelial and stromal tumor (MEST), low grade multilocular renal cell carcinoma, and tubulocystic carcinoma. The results of immunohistochemical staining were cytokeratin 7/19(+/+) and CD10(-) in lining epithelium, estrogen receptor/progesterone receptor(+/+) in stromal cells. After surgery, she was free of recurrence for 10 months. We report this rare case and compare it with other cystic renal tumors, especially MEST.
Adult ; Carcinoma, Renal Cell ; Diagnosis, Differential ; Epithelium ; Estrogens ; Female ; Humans ; Keratins ; Kidney ; Nephrectomy ; Receptors, Estrogen ; Recurrence ; Stromal Cells

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

We present a very rare case of a 29-month-old boy with acute onset right abducens nerve palsy complicated by inferior petrosal sinus septic thrombosis due to mastoiditis without petrous apicitis. Four months after mastoidectomy, the patient fully recovered from an esotropia of 30 prism diopters and an abduction limitation (-4) in his right eye.
Abducens Nerve Diseases/diagnosis/*etiology ; Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Mastoiditis/*complications/diagnosis/surgery ; Otitis Media/*complications/diagnosis ; Sinus Thrombosis, Intracranial/*complications/diagnosis

Perioperative management of patients with pheochromocytoma is challenging. Accordingly, proper preoperative preparation is important. Prazosin, a selective alpha I blocker, may offer a potential advantage. This 54-year-old woman was treated with prazosin 2 mg, b.i.d. for 15 days and also with propranolol 20 mg, b.i.d. for a few days intermittently before the proposed surgery. Both symptoms and blood pressure were well controlled effectively. Induction of anesthesia was accomplished with nitrolingual spray, fentanyl 100 ug, 1% idocaine 50 mg, 2.5% thiopental sodium 200 mg, vecuronium 6 mg and 100% O2-enflurane. During the surgical and anesthetic procedure, the patient showed a reduced incidence of excessive blood-pressure variations and no arrhythmia was present except for supraventricular ectopic beats. Conclusively, we believe that careful preoperative preparation is recommended to minimize intraoperative hemodynamic dieturbances and their sequelae.
Anesthesia ; Arrhythmias, Cardiac ; Blood Pressure ; Female ; Fentanyl ; Hemodynamics ; Humans ; Incidence ; Middle Aged ; Pheochromocytoma* ; Prazosin* ; Propranolol ; Thiopental ; Vecuronium Bromide