No abstract available.
Ehlers-Danlos Syndrome*

It is well established that the CT is an essential part not only in screening primary brain tumors, but alsoin staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarciomawith brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, thedegree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode ofstroke syndrome and survival duration after neurologic symptoms attacks. The results were as follows; 1. Ten ofthese cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodensedensity and the others were hemorrhagic increased denstiy by CT. 3. All of these showed mass effect to thesurrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion werelocated at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area of bothof them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showedring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed alsoring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrom. One of them was perforemdemergency craniotomy. The remainging 3 cases noted progressive neurologic symptoms. 7. Two cases were noted onlybrain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepaticmetastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brainirradiation (3000 rads/2 weeks). Another one case revealed marked regression of not only metastatic brain lesionbut the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.
Brain Edema ; Brain Neoplasms ; Brain ; Choriocarcinoma ; Craniotomy ; Female ; Mass Screening ; Neoplasm Metastasis ; Neurologic Manifestations ; Occipital Lobe ; Pregnancy ; Rabeprazole ; Stroke

With the development of devices and techniques, including complex shape coils, balloons, multiple catheter techniques, and intracranial stents, endosaccular treatment of ruptured or unruptured wide-necked cerebral aneurysms has advanced rapidly with respect to indications and outcomes. In contrast to other options, stent-assisted aneurysm embolization has a distinct feature in which the stent is permanently implanted in the cerebral vessels. Therefore, we must consider the short-term effect of stent-assisted aneurysm embolization in the prevention of coil migration and adverse thrombogenicity, but also the permanent mechanical, hemodynamic, and biological influence on the parent vessels and the aneurysm. We have reviewed the current experimental and clinical data on stent-assisted coil embolization of cerebral aneurysms.
Aneurysm ; Catheters ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Parents ; Stents

Sporotrichosis is a chronic infection that follows accidental implantation of the fungus Sporothrix schenckii into the skin. The infection begins with skin trauma under conditions when conidia may be present. A 48-year-old woman presented with a 5-year history of an 8X 12 cm sized, centrally depressed, erythematous plaque on the left wrist. She had been treated with antifungal agents at an other hospital for about 6 months but there was no improvement. The histopathological findings showed an infiltration of mononuclear cells and tuberculoid structures on the whole dermis and subcutis. According to the histopathological findings and clinical manifestations, she was diagnosed as having lupus vulgaris. There was much improvement of the lesion after antituberculous therapy. However, 2 months later she developed asymptomatic multiple erythematous papules around the lesion of lupus vulgaris and along the lymphatic drainage of the left arm. The histopathological findings of the newly developed lesion showed a granulomatous reaction and an infiltrate of acute and chronic inflammatory cells. Moist and creamy colonies were changed into brown-to-black ones with a leathery appearance with age. This appearance and clinical manifestations confirmed the diagnosis of lymphocutaneous sporotrichosis. This clinical appearance reflects that the sporotrichosis developed on the ulcerative lesion or biopsy site of lupus vulgaris.
Antifungal Agents ; Arm ; Biopsy ; Dermis ; Diagnosis ; Drainage ; Female ; Fungi ; Humans ; Lupus Vulgaris* ; Middle Aged ; Skin ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Wrist

PURPOSE: To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) after scleral buckling (SB) based on optical coherence tomography (OCT) findings. METHODS: The medical records and spectral domain OCT images of patients in whom MH developed after RRD repair were evaluated retrospectively. RESULTS: A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preserved photoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outer retinal tissues disappeared, resulting in the full-thickness MH. CONCLUSIONS: Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thickness MHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial cone in the fovea.
Aged ; Humans ; Male ; Middle Aged ; *Postoperative Complications ; Retinal Detachment/*surgery ; Retinal Perforations/diagnosis/*etiology ; Retrospective Studies ; *Scleral Buckling ; Tomography, Optical Coherence

Fournier's gangrene is a form of necrotizing fasciitis of the perineal, genital or perianal region due to perianal infection, urinary tract infection or local trauma. Even though many patients may present with minor skin lesions in the early stages of the disease, the natural course of this necrotizing disease is rapid progression of gangrene, eventually resulting in sepsis and death. Therefore, rapid and accurate diagnosis is the most important factor for a successful outcome. We report two cases of Fournier's gangrene in a 21-year-old and 24-year-old male, both of whom commonly presented with painful swelling and tenderness of the scrotum. Although one man showed a rapidly-spreading erythema and induration to the flank and lateral chest, they were both successfully treated with early antibiotic therapy and surgical drainage.
Diagnosis ; Drainage ; Erythema ; Fasciitis, Necrotizing ; Fournier Gangrene* ; Gangrene ; Humans ; Male ; Scrotum ; Sepsis ; Skin ; Thorax ; Urinary Tract Infections ; Young Adult

Actinomycosis is a chronic infection, which mainly affects of the cervicofacial area, thorax or abdomen, and is caused by anaerobic Actinomyces. The predilection site of abdominal involvement is the appendix and cecum. Although perianal actinomycosis as a secondary site of abdominal actinomycotic disease is a well known presentation, primary perianal actinomycosis without involvement of the internal organs is rare. We report a case of primary perianal actinomycosis. A 65-year-old male presented with a recurrent perianal abscess. Histopathologic findings showed acute and chronic inflammation with characteristic sulfur granules, composed of many basophilic, rod-like, Gram-positive bacilli, indicative of actinomycosis.
Abdomen ; Abscess ; Actinomyces ; Actinomycosis* ; Aged ; Appendix ; Basophils ; Cecum ; Humans ; Inflammation ; Male ; Sulfur ; Thorax

BACKGROUND: Although urticaria is a common disorder that affects as many as 20% of all people at some time during their lifetime, the etiology of urticaria is still unknown in most cases. OBJECTIVE: We attempted to analyze the clinical characteristics of chronic urticaria according to etiological aspects. METHODS: The study was carried out on 230 patients with chronic urticaria, who visited our clinic with urticaria between March 2003 and February 2006. The diagnosis was made by detailed questionnaire and limited laboratory and provocation tests. RESULTS: Of the 230 patients with chronic urticaria, 138 (60.0%) presented with idiopathic urticaria, 53 (23.1%) autoimmune urticaria, 33 (14.4%) physical urticaria and 6 (2.5%) another type. Chronic idiopathic urticaria was combined with physical components in 97 cases (42.2%), and cholinergic component was the most common form. Chronic idiopathic urticaria and autoimmune urticaria showed a higher score than physical urticaria in the severity of disease, but there was no significant difference in the duration of urticaria. CONCLUSION: Our data shows the clinical-etiological aspects and classification of chronic urticaria. Although the symptom severity of chronic idiopathic urticaria and autoimmune urticaria is higher than that of physical urticaria, our data is limited to predict the treatment response rate or the prognostic variables of chronic urticaria owing to the short follow-up period. Further studies will be needed to identify the natural course of chronic urticaria.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Surveys and Questionnaires ; Urticaria*

PURPOSE: Percutaneous fine needle aspiration biopsy is known to be a useful diagnostic method for the diagnosis of various pulmonary diseases. Its diagnostic yield is high, and it is safe, but complications such as pneumothorax can occasionally occur. We reviewed the complications arising after needle aspiration biopsy and analyzed the risk factors of pneumothorax. MATERIALS AND METHODS: The medical records and radiographic studies of 157 patients with various pulmonary diseases who underwent needle aspiration biopsy of the lung between 1990 and 1996 were retrospectively reviewed. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, diameter of needle, number of punctures, and obstructive pulmonary abnormalities were analyzed. RESULTS: Complications occurred in 40 of 157 cases (25.5%), namely pneumothorax in 26 (16.6%), hemoptysis in 11 (7%), hemothorax in two (1.3%), and recurrence of malignancy at the site of aspiration in one (0.6%). When the patients were divided into three groups according to depth of lesion, there were significant difference in the incidence of pneumothorax ; the results were as follows : less than 2cm, 12.9% ; between 2 and 4cm, 24.1% ; and larger than 4cm, 57.1% (p<0.05). In pulmonary function testing, FVC (forced vital capacity) of patients with pneumothorax was less than that of patients without (2.6+/-0.9L vs 3.1+/-0.8L, p<0.05), but FEV1 (forced expiratory volume in 1 second), FEV 1% (percentage of predicted FEV1), FEV1/FVC,and FVC%(percentage of predicted FVC) were not different between the two groups. The incidence of pneumothorax in patients with pleura-attached lesion (9%) was lower than that of those with non-attached lesion (26%, p=0.01). The age of patients, size of lesion, diameter of the needle, guidance methods and number of aspirations showed no significant relationship with pneumothorax. CONCLUSION: In needle aspiration biopsy of the lung, depth of lesion and passage of a needle through aerated lung are significant risk factors of pneumothorax.
Aspirations (Psychology) ; Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Hemoptysis ; Hemothorax ; Humans ; Incidence ; Lung Diseases ; Lung* ; Medical Records ; Needles ; Pneumothorax* ; Punctures ; Recurrence ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors*

BACKGROUND: Interleukin-6 (IL6) is an important regulator of cellular hypertrophy through the gp130/Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway. We tested the hypothesis that IL6 and its downstream gp130/JAK2/STAT3 pathway participated in high glucose (HG)–induced podocyte hypertrophy. METHODS: IL6 levels in the media and lysates of podocytes were measured by enzyme-linked immunosorbent assay. Western blots were performed to determine the protein expression levels of gp130/JAK2/STAT3 among podocytes cultured with normal glucose (NG), NG + mannitol, NG + recombinant IL6, HG, and HG + IL6-neutralizing antibodies (IL6NAb). Immunoprecipitation was examined to determine whether gp130 interacted with JAK2 in response to HG or IL6. Podocyte hypertrophy was verified using protein/cell counts and flow cytometry. RESULTS: IL6 levels were significantly increased in the media and lysates of podocytes cultured in HG compared with the NG groups. The nuclear phospho-STAT3/STAT3 ratio was increased by HG and NG + IL6 and was attenuated in the HG + IL6NAb groups, indicating that nuclear STAT3 was activated following JAK2 and cytosolic STAT3 activation in response to IL6 secreted by HG-stimulated podocytes. Immunoprecipitation showed increased phospho-JAK2 recruitment to gp130 in the HG and NG + IL6 groups, and the addition of IL6NAb in the HG group significantly abrogated these increases. Podocyte hypertrophy was significantly increased in the HG and NG + IL6 compared with the NG condition and was diminished by the addition of IL6NAbs to the HG group. CONCLUSION: IL6 might play a prominent role in the local activation of JAK2/STAT3 in podocyte hypertrophy under HG conditions. In vivo studies examining this pathway are warranted.
Antibodies ; Blotting, Western ; Cytosol ; Diabetic Nephropathies ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Glucose ; Hypertrophy* ; Immunoprecipitation ; Interleukin-6 ; Mannitol ; Phosphotransferases ; Podocytes* ; Transducers