Uterine perforation is a serious complication in users of intrauterine devices for contraception. Authors encountered one case of displacement of Copper-T IVD into urinary blpossibly due to uterine perforation on insertion of the Copper-T IUD in a 28 year old 1-multipara, who experienced normal intrauterine pregnancy in the circumstances. This patient was in silent, asymptomatic condition and underwent cesarean section. And Copper-T IUD was removed under the cystotomy. So we report one case with brief review of literatures
Adult ; Asymptomatic Diseases ; Cesarean Section ; Contraception ; Copper* ; Cystotomy ; Female ; Humans ; Intrauterine Devices ; Pregnancy ; Urinary Bladder* ; Uterine Perforation

Guillain-Barre syndrome (GBS) is an autoimmune polyneuropathy that presents with acute onset and rapid progression of ascending quadriparesis and hyporeflexia, which can be triggered by various conditions. However, GBS following cerebral infarction is very rare. We describe herein a patient with facial diplegia, ophthalmoplegia, and areflexia that occurred during acute cerebral infarction. The symptoms were improved after intravenous immunoglobulin treatment. The details of this case suggest that GBS is triggered by immune dysregulation after acute cerebral infarction.
Cerebral Infarction* ; Guillain-Barre Syndrome* ; Humans ; Immunoglobulins ; Ophthalmoplegia ; Polyneuropathies ; Quadriplegia ; Reflex, Abnormal

BACKGROUND AND OBJECTIVES: Although disequilibrium is common type of dizziness in older people, it is sometimes difficult to identify a specific cause for this problem. The diffuse brain pathology including subcortical ischemia and atrophy can be a cause for patients with disequilibrium of unknown cause. Aim of this study is to identify the eye movements and neuroimaging features in patients with disequilibrium. MATERIALS AND METHODS: We performed a prospective investigation in patients with disequilibrium of unknown cause. We collected information on demographic characteristics and clinical features of disequilibrium. The impact of dizziness on everyday life was assessed by 25-item dizziness handicap inventory (DHI). Vestibular function test (VFT) includes smooth pursuit, saccade, optokinetic nystagmus, and rotatory chair test. Subcortical white matter lesions and brain atrophy were graded from brain magnetic resonance image (MRI). RESULTS: This study included 14 patients (12 female and 2 male), aged between 64 and 84 years, mean age 74.01+/-6.02 years. The score of DHI was 39.4+/-11.8 (20-58). Eye movements were abnormal in 13 patients and normal in only one patient. The degree of subcortical ischemia was mild in 7, moderate in 4, and severe in 3 patients. Ventricular brain ratio was 0.23+/-0.03. However, there was no significant relationship between MRI findings and the degree of oculomotor alterations (result of VFT). CONCLUSION: Patients with disequilibrium of unknown cause are usually elderly women. Alterations in oculomotor movements and diffuse brain pathology including white matter lesions and atrophy were observed in patients with disequilibrium of unknown cause.
Aged ; Atrophy ; Brain ; Brain Diseases ; Brain Ischemia ; Dizziness ; Eye Movements ; Female ; Humans ; Ischemia ; Magnetic Resonance Imaging ; Neuroimaging ; Nystagmus, Optokinetic ; Prospective Studies ; Pursuit, Smooth ; Saccades ; Vestibular Function Tests

A 38-year-old nulliparous woman was referred to our clinic because of cervical incompetence at 19 weeks of gestation. Trans-abdominal cervicoisthmic cerclage was performed after failure of modified Shirodkar cerclage operation in the patient at 21 weeks of gestation via a laparotomic approach. Another 38-year-old patient, who underwent loop electrosurgical excision procedure conization for treatment of cervical dysplasia 4 years ago, presented for cervical incompetence. At 18 weeks of gestation, we performed trans-abdominal laparotomic cervicoisthmic cerclage without any post-operative complications. During antenatal follow-up, there were no obstetrical co-morbidities and finally she gave birth to a healthy infant at full term by cesarean section. We report two cases of women who underwent trans-abdominal cervicoisthmic cerclage surgery because of cervical incompetence as they were not suitable for transvaginal cervical cerclage. Both patients successfully maintained their pregnancy until full term after undergoing transabdominal cervicoisthmic cerclage at more than 18 weeks of gestation.
Adult ; Cerclage, Cervical ; Cesarean Section ; Conization ; Female ; Follow-Up Studies ; Humans ; Infant ; Parturition ; Pregnancy* ; Uterine Cervical Incompetence

We report a rare case of lung disease caused by Mycobacterium terrae in a previously healthy woman. A 45-year-old woman was referred to our hospital due to a chronic cough with sputum. A computed tomography scan of the chest revealed bronchiolitis in conjuction with bronchiectasis in both lungs. Nontuberculous mycobacteria were identified and isolated from the bronchoalveolar lavage fluid collected from each lung. All isolates were identified as M. terrae by various molecular methods that characterized the rpoB and hsp65 gene sequences. Antibiotic therapy using clarithromycin, rifampin, and ethambutol improved the patient's condition and successfully resulted in sputum conversion.
Bronchiectasis ; Bronchiolitis ; Bronchoalveolar Lavage Fluid ; Clarithromycin ; Cough ; Ethambutol ; Female ; Humans ; Lung ; Lung Diseases ; Middle Aged ; Mycobacterium ; Mycobacterium Infections, Nontuberculous ; Nontuberculous Mycobacteria ; Rifampin ; Sputum ; Thorax

Churg-Strauss syndrome (CSS) is a systemic necrotizing vasculitis of the small and medium vessels, associated with extravascular eosinophilic granulomas, peripheral eosinophilia, and asthma. The exact etiology of CSS is unknown. This syndrome commonly affects the lungs, peripheral nerves, skin, heart, and gastrointestinal tract, but rarely the central nervous system. Subarachnoid and intracerebral hemorrhage in CSS patients is extremely rare; however, clinicians should consider that CSS may be a cause of intracranial hemorrhage and its high rate of mortality and morbidity. The authors report on two cases of subarachnoid and intracerebral hemorrhage with CSS and discuss a brief review of CSS.
Asthma ; Central Nervous System ; Cerebral Hemorrhage ; Churg-Strauss Syndrome ; Eosinophilia ; Eosinophilic Granuloma ; Gastrointestinal Tract ; Heart ; Humans ; Intracranial Hemorrhages ; Lung ; Peripheral Nerves ; Skin ; Subarachnoid Hemorrhage ; Vasculitis

Lesch-Nyhan disease (LND) is a rare X-linked recessive inherited purine metabolic disorder that accompanies neurodevelopmental problems. Neurofibromatosis type 1 (NF1) is a relatively common autosomal dominant inherited genetic disorder characterized by tumors in various systems. Some children with NF1 also accompanies neurodevelopmental problems.Here, we describe a 5-year-old boy with a maternally inherited pathogenic variant in NF-1 and hypoxanthine-guanine phosphoribosyltransferase (HPRT ). He was referred for severe neurodevelopmental impairment and hyperuricemia. His mother was diagnosed with NF1 and the patient was also suspected of having NF1 because of cafe au lait macules. He had dystonia, rigidity, cognitive deficit, and speech/language impairment. Serum and urine uric acid concentrations were elevated. He had more severe neurodevelopmental delay than patients with only NF1, so his clinical symptoms could not be fully understood by the disease alone. To find the cause of his neurologic symptoms and hyperuricemia, the patient and his mother underwent a whole-exome sequencing test. As a result, the pathogenic variant c.151C>T (p.Arg51Ter) in HPRT1 was identified as hemizygote in the patient and heterozygote in his mother. The pathogenic variant c.7682C>G (p.Ser2561Ter) in NF-1 was identified as heterozygotes in both of them. Although the clinical symptoms of both diseases were overlapping and complicated, genetic testing was helpful for accurate diagnosis and treatment. Therefore, we suggest to consider preemptive genetic evaluation if there are symptoms not sufficiently explained by known existing diseases. And it is considered valuable to review this rare case to understand the clinical course and possible synergic effects of these diseases.

One step TaqMan real-time reverse transcription polymerase chain reaction (R/T RT-PCR)using a set of primers/probes was developed for the detection of foot-and-mouth disease (FMD)virus. The gene-specific probes labeled fluorogen for the internal ribosomal entry site, Leader sequence and 2B regions were used to detect FMD virus (FMDV). This assay specifically detected FMDV both in cell culture preparations and clinical samples, and was capable of distinguishing FMD from other viral diseases similar to clinical signs (swine vesicular disease, vesicular stomatitis and bovine viral diarrhea). This assay was shown to be 1000-fold more sensitive than the conventional RT-PCR method. The detection limits of this assay was 1 TCID 50 /ml of the FMDV RNA concentration. Quantification was obtained by a standard curves plotting threshold cycle values versus known infectivity titer. The assay was sensitive, specific and rapid enough to detect FMDV RNA genome in probang samples. As such, the described method is reliable and provides faster disease diagnostics than the conventional RT-PCR procedure to detect FMDV.
Animals ; Foot-and-Mouth Disease/*diagnosis/virology ; Foot-and-Mouth Disease Virus/*isolation&purification ; Reverse Transcriptase Polymerase Chain Reaction/*methods ; Sensitivity and Specificity ; Taq Polymerase

PURPOSE: The aim of this study was to analyze anatomical popliteal artery entrapment syndrome (PAES) and to individualize the treatment of this condition according to the anatomical status of the artery and the adjacent structure. METHODS: A total of 35 anatomical PAES legs in 23 consecutive patients treated within the Asan Medical Center, Seoul, Korea between 1995 and 2011 were analyzed retrospectively. Anatomical PAES was diagnosed by MRI and/or CT scans of the knee joint, and CT or conventional transfemoral arteriography of the lower extremities. RESULTS: We noted a type II gastrocnemius medial head (GNM) anomaly, a type III GNM anomaly, or an aberrant plantaris muscle in 51.4%, 20%, and 28.6% of PAES legs, respectively. In assessments of the arterial lesions, popliteal or tibial artery occlusion was noted in 19 of 26 symptomatic PAES legs. For cases without popliteal artery lesions, myotomy of the anatomically deranged muscle was performed in 5 of 7 symptomatic and 4 of 9 asymptomatic PAES legs. For occluded popliteal arteries, we performed ten direct repairs of the pathological popliteal artery and 4 femoro-below the knee popliteal bypass surgeries. As a result of the arterial Surgery, 9 direct procedures with myotomy yielded a patent artery, while 3 graft failures were noted in the bypass group. The median follow-up period was 84 months (range, 12–206 months). CONCLUSION: We recommend that treatment of PAES should be individualized based on pathology, symptoms, and various imaging studies.
Angiography ; Arteries ; Chungcheongnam-do ; Follow-Up Studies ; Head ; Humans ; Knee ; Knee Joint ; Korea ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Pathology ; Popliteal Artery* ; Retrospective Studies ; Seoul ; Tibial Arteries ; Tomography, X-Ray Computed ; Transplants

10% of labeled tumor cells) of TNF receptor 1 (TNFR1), the protein product of TNFRSF1A gene, was correlated with sarcomatoid dedifferentiation and was an independent predictive factor of clinically unfavorable response and shorter survivals in separated TKI-treated ccRCC cohort.CONCLUSION: TNF-α signaling may play a role in TKI resistance, and TNFR1 expression may serve as a predictive biomarker for clinically unfavorable TKI responses in ccRCC.]]>
Biomarkers ; Carcinoma, Renal Cell ; Cohort Studies ; Dataset ; Drug Resistance ; Gene Expression ; Gene Expression Profiling ; Heterografts ; Humans ; Immunohistochemistry ; Protein-Tyrosine Kinases ; Receptors, Tumor Necrosis Factor ; Receptors, Tumor Necrosis Factor, Type I ; Tumor Necrosis Factor-alpha