PURPOSE: Periocular tuberculosis is common in the form of conjunctival tuberculosis or uveitis; however, orbital tuberculosis is very rare. We report a case of tuberculosis diagnosed based on bilateral orbital masses. CASE SUMMARY: A 64-year-old male with a history of diabetes, hypertension, and chronic obstructive pulmonary disease presented with diplopia. His best-corrected visual acuity was 1.0, and intraocular pressure was 16 mmHg in both eyes. Bilateral proptosis was noted, and inferior orbital masses were palpated in both eyes. On orbital computed tomography, irregular masses were surrounding both globes in the extraconal space. Incisional biopsy of the bilateral orbital masses was performed under local anesthesia. Pathologic examination revealed chronic granulomatous inflammation accompanied by caseous necrosis. The patient was diagnosed with bilateral orbital tuberculosis and underwent triple therapy with isoniazid, rifampin, and ethambutol for 12 months. The orbital masses completely resolved, and there was no recurrence or complication through 12 months after treatment. CONCLUSIONS: To our knowledge, bilateral orbital tuberculosis has not been reported yet. Herein, we report a case of orbital tuberculosis presenting as bilateral orbital masses.
Anesthesia, Local ; Biopsy ; Diplopia ; Ethambutol ; Exophthalmos ; Humans ; Hypertension ; Inflammation ; Intraocular Pressure ; Isoniazid ; Male ; Middle Aged ; Necrosis ; Orbit* ; Pulmonary Disease, Chronic Obstructive ; Recurrence ; Rifampin ; Tuberculosis* ; Uveitis ; Visual Acuity

PURPOSE: To report a case of primary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), of the eyelid. METHODS: A 48-year-old healthy male patient presented with a mass on the upper lid of 2 months in duration. The lesion was reddish, well-demarcated, oval shaped, and measured approximately 8 x 4 mm. The mass did not respond to incisional drainage and intra-lesional triamcinolone. An excisional biopsy for diagnosis was performed. RESULTS: On microscopic examination, a localized dense lymphocytic infiltration was observed in the subepithelial area, and cytologic atypia was observed under high power. On immunohistochemical examination, tumor cells were positive for CD3 but negative for CD20, CD30, CD56, k-light chain immunoglobulin, lambda-light chain immunoglobulin, and increased Ki-67 activity was noted. A histopathological diagnosis of PTCL-NOS was made. CONCLUSIONS: PTCL-NOS, which rarely occurs on the eyelids, commonly accompanies generalized lymphadenopathy and "B symptoms" such as fever and weight loss. Herein, the authors report a case of PTCL-NOS of the eyelid presenting as a rapidly growing solid mass in an otherwise healthy patient.
Biopsy ; Drainage ; Eyelids ; Fever ; Humans ; Immunoglobulins ; Lymphatic Diseases ; Lymphoma, T-Cell, Peripheral ; Male ; Middle Aged ; Triamcinolone ; Weight Loss

The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary, accounting for less than 0.5% of all primary ovarian neoplasm. This tumor is the most common type of all virilizing ovarian tumors. However, only one-third of patients develop virilization. Recently, we experienced a case of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.
Amenorrhea ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Sertoli-Leydig Cell Tumor* ; Sex Cord-Gonadal Stromal Tumors ; Virilism

AA amyloidosis is one of the most significant complications of rheumatoid arthritis characterized by the deposition of amyloid A (AA) in multiple organs and tissues in the body. This disorder displays variable clinical symptoms depending upon the involved organ and a diagnosis is rendered through a biopsy of the affected organ, followed by staining using Congo-red which reveals an apple-green birefringence. Fundamental disease control is critical in the treatment of AA amyloidosis. Anti-tumor necrosis factor alpha (anti TNF-alpha) agents are promising in inducing clinical remission by suppressing systemic inflammation in AA amyloidosis. We report a case of AA amyloidosis in a 71 year old woman with rheumatoid arthritis that responded well to infliximab therapy.
Amyloid ; Amyloidosis ; Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Biopsy ; Birefringence ; Female ; Humans ; Inflammation ; Necrosis ; Infliximab

A distant metastasis from a renal cell carcinoma is quite common after a radical nephrectomy. For this reason, a5 year scheduled follow up is recommended. However, a distant metastasis 5 years after the resection is quite rare. We encountered an endobronchial metastasis from a renal cell carcinoma that was discovered 7 years after the radical nephrectomy, and did not present during the 5 year scheduled follow up regimen. We report this case with a review of the literatures.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Neoplasm Metastasis* ; Nephrectomy*

PURPOSE: To determine optimal scan time for the early phase of two-phase spiral CT and to evaluate its usefulness in the detection and assessment of extension of urinary bladder lesions. MATERIALS AND METHODS: In four normal adults, we performed dynamic scanning and obtained time-density curves for internal and external iliac arteries and veins, and the wall of the urinary bladder. Sixty patients with 68 lesions of the urinary bladder or prostate underwent precontrast and two-phase spiral CT scanning. After injection of 100ml of noninonic contrast material, images for the early and delayed phases were obtained at 60 seconds and 5 minutes, respectively. We measured CT H.U. of the wall, the lesion, and lumen of urinary bladder as seen on axial scanning, in each image in which the lesion was best shown. For the detection of bladder lesions and assessment of their extension, precontrast, early-, and delayed phase images were compared. RESULTS: Dynamic study of normal adults showed maximum enhancement of bladder wall between 60 and 100 seconds. The difference of CT H.U. between bladder wall and the lesion was greatest in the early phase. The best detection rate (98.5%) was seen during this phase, and for the detection of bladder lesion, this same phase was superior or equal (66/68,97.1%) to the delayed phase. The precontrast image was also superior or equal (31/68,45.6%) to that of the delayed phase. For the assessment of extension of bladder lesion, the early phase was superior (36/68,52.9%) to the delayed phase, and precontrast image was superior (1/68, 1.5%) to that of the delayed phase. For determining the stage of bladder cancer, the early phase was most accurate if the stages was below B2 or D, while for stage C, the delayed phase was most accurate. CONCLUSION: In two-phase spiral CT scanning, we consider the optimal time for the early phase to be between 60 and 100 seconds after injection of contrast material. For the detection and assessment of extension of urinary bladder lesion, the early phase was superior to the late phase, and for evaluation of the ureter, the delayed phase was useful. The precontrast image was inferior to that of the delayed phase. We suggest that for the detection and assessment of extension of urinary bladder lesion without scanning of the precontrast image, two-phase spiral CT is reliable.
Adult ; Humans ; Iliac Artery ; Prostate ; Tomography, Spiral Computed* ; Ureter ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Veins

Non-Hodgkin's lymphoma presented as a malignancy of the uterine cervix is exceedingly rare disease and accounts for approximately only 0.12-0.6% of extranodal lymphomas. Most reported cases were B-cell lymphomas and there is no consensus on the management and prognosis of the disease because of its extreme rarity. Primary T/natural killer (NK)-cell lymphoma arising from the uterine cervix is scarcely encountered that, in the review of literature, only 1 case has been reported by Mhawech et al. We encountered a woman with T/NK-cell lymphoma involving the uterine cervix that initially presented with severe vaginal bleeding. Therefore, we report the case with a brief review of literature.
Cervix Uteri* ; Consensus ; Female ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Prognosis ; Rare Diseases ; Uterine Hemorrhage

Systemic lupus erythematosus (SLE) is a multisystem inflammatory disorder mediated by autoantibodies and immune complexes that exhibit a range of symptoms. Although thirty-five to forty percent of patients with SLE show signs or symptoms of gastrointestinal involvement, acute pancreatitis is an uncommon complication of SLE, and SLE presenting with acute pancreatitis is extremely rare. We report a case of a 28-year-old female SLE patient who initially presented with acute abdominal pain and elevated pancreatic enzyme levels. The patient was diagnosed clinically with acute pancreatitis and then with SLE after further investigations. Her condition improved after high dose steroid therapy.
Abdominal Pain ; Adult ; Antigen-Antibody Complex ; Autoantibodies ; Female ; Humans ; Lupus Erythematosus, Systemic ; Pancreatitis

PURPOSE: It has been proposed that a decreased nephron number may be associated with the increased risk of glomerulosclerosis. In order to test the hypothesis that a reduced number and an increased volume of glomeruli may contribute to the pathogenesis of focal segmental glomerulosclerosis (FSGS), we compared the number and volume of glomeruli between 9 patients with FSGS and 8 with minimal change nephrotic syndrome (MCNS). METHODS: Mean glomerular volume was measured using the method of Weibel and Gomez. An estimate of glomerular number (index) was obtained by multiplying the cortical volume of a kidney by the fraction of renal cortex made up of glomeruli and dividing this by the mean glomerular volume for that kidney x 10(6). We determined kidney volume from ultrasonographic measurement. RESULTS: Patients with FSGS had significantly greater glomerular volume than patients with MCNS [2.02+/-0.36 (x10(6) micrometer3) vs. 1.57+/-0.27 (x10(6) micrometer3)] (p<0.025). However, there was no significant difference in the index of glomerular number (estimated glomerular number) between FSGS & MCNS patients (2.8+/-1.4 vs. 3.0+/-0.8). CONCLUSION: The glomerular volume was greater in FSGS patients than MCNS patients. But there was no significant difference in the index of glomerular number between patients with FSGS and MCNS.
Glomerulosclerosis, Focal Segmental* ; Humans ; Kidney ; Kidney Glomerulus ; Nephrons* ; Nephrosis, Lipoid* ; Nephrotic Syndrome

PURPOSE: To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. METHODS: Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. RESULTS: Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). CONCLUSION: Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.
Aged ; Friends ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant Nutritional Physiological Phenomena ; Internet ; Korea ; Meat ; Milk ; Mothers ; Organothiophosphorus Compounds ; Surveys and Questionnaires ; Soy Milk ; Weaning