No abstract available.
Female ; Metrorrhagia*

Almost all cases of acute methanol intoxication result from ingestion. Absorption of methanol following oral administration is rapid and peak concentration occurs within 30-60 min. Foromic acid converted metabolites of methanol are responsible for its toxic effect. Methanol poisoning typically induces nausea, vomiting, abdominal pain, and mild central nervous system depression. Then there is a latent period lasting, followed by an uncompensated metabolic acidosis and visual dysfunction, depending on the dose of methanol ingested. Here we report on three patients who were victims of methanol intoxication due to ingestion of windshield washer fluid, which was misidentified as an alcoholic beverage. One patient had a mild form, which included abdominal discomfort, another patient had a moderate case, which included nausea, vomiting, and acidosis, and the other patient had severe acidosis and altered mentality and visual dysfunction. Except one case of visual dysfunction, all three patients recovered successfully following medical treatment and hemodialysis.
Abdominal Pain ; Absorption ; Acidosis ; Administration, Oral ; Alcoholic Beverages ; Alcoholics ; Central Nervous System ; Depression ; Eating ; Humans ; Methanol ; Nausea ; Renal Dialysis ; Vomiting

PURPOSE: To compare the neutral, internal, and external rotation positions of the glenohumeral joint during magnetic resonance (MR) arthrography performed to assess changes in the shape of the labroligamentous complex (LLC) and in the labral tear. MATERIALS AND METHODS: MR arthrography of the shoulder was retrospectively evaluated in 36 patients aged 14-66 (mean, 40) years. Fourteen cases were confirmed by arthroscopic surgery (7 SLAP lesions, 2 Bankart lesions, 1 both SLAP and Bankart lesions). Axial fat-suppressed T1-weighted spin-echo images were acquired with each shoulder in the neutral position, and with internal and external rotations. In each position, we measured the angle of rotation between the perpendicular line on the glenoid fossa and the long axis of the humeral head, analyzing the relationship between the rotational angle and changes in the shape of the LLC at each internal and external rotation, relative to the neutral position. In addition, labral tears in 14 arthroscopically confirmed joints were evaluated in each position. RESULTS: Mean angles of rotation relative to the neutral position were 44.1 and 45.3 degrees in internal and external rotation, respectively. Changes in the anterior LLC occurred in 25 and 24 cases of internal and external rotation, respectively. There was a significantly meaningful relationship between rotational angle and change in the shape of the anterior LLC during external rotation, and when this change was noticed, the rotational angle was wider (p<0.05). The posterior LLC changed in shape in 13 and 16 cases of internal and external rotation, respectively, but changes according to the angle of rotation were not statistically significant. In arthroscopically confirmed joints, diagnosis of the eight SLAP lesions at external rotation tended to become more accurate, but no statistically significant differences were noted (p=0.07). Two Bankart lesions were interpreted as a tear in all three positions, and one other such lesion was interpreted as a tear in the neutral position and at external rotation, and a possible tear at internal rotation. CONCLUSION: In shoulder MR arthrography, changes in the shape of the anterior LLC were statistically prominent according to the angle of external rotation, and accuracy of diagnosis in SLAP lesions tended to be significantly higher at external rotation. If a SLAP lesion causes clinical concern, additional axial MR arthrography with the shoulder externally rotated is suggested.
Arthrography* ; Arthroscopy ; Axis, Cervical Vertebra ; Diagnosis* ; Humans ; Humeral Head ; Joints ; Retrospective Studies ; Shoulder Joint ; Shoulder*

The histology of herpes virus infection of the skin is characterized as an intraepidermal vesicle formed as the result of acantholysis and ballooning degeneration of kerationocytes. Dermal changes is limited to polymorphous inflammatory cells infiltrate, leukocytoclastic vasculitis, and herpetic folliculitis. Involvement of eccrine epithelium is very rare finding. We report two cases of herpes zoster with prominent viral infection of the eccrine sweat glands.
Acantholysis ; Eccrine Glands ; Epithelium ; Folliculitis ; Herpes Zoster ; Skin ; Sweat Glands ; Vasculitis

Lightning injury is uncommon, as evidenced by the fact that most physicians never see or treat such a victim. To our knowledge, there were no reports of lightning burn with flame burn. We report a case of lightning burn with flame burn. On a rainy day, a 64-year-old woman with an umbrella in her left hand was walking along a road. When lightning struck the tip of her umbrella, her clothes were flamed. She threw herself into the water in a nearby field. The fire was extinguished. Then she lost consciousness, but she regained consciousness immediately. She was transported to our hospital. On arrival at our emergency center, her physical examination was remarkable. The patient had an entrance wound of the left palm and an exit wound of the left foot as well as 25 % total body surface burns, which were present in the flexor surface of the left hand, left arm, left leg and left flank. Histopathology showed epidermal and dermal necrosis. Three months later the burns were healed spontaneously, with some remaining scars.
Arm ; Burns* ; Cicatrix ; Consciousness ; Emergencies ; Female ; Fires ; Foot ; Hand ; Humans ; Leg ; Lightning Injuries ; Lightning* ; Middle Aged ; Necrosis ; Physical Examination ; Walking ; Water ; Wounds and Injuries

Quadricuspid aortic valve is a rare congenital malformation of the aortic valve. A case is reported of a 51 year old woman with quadricuspid aortic valve associated with regurgitation. In the past, quadricuspid aortic valve was recognised at surgery or necropsy, but now transthoracic and transesophageal echocardiography play a pivotal role in diagnosing this rare valve malformation. On occasion the transthoracic echocardiogram cannot show the quadricuspid nature of the aortic valve, and transesophageal echocardiography must be performed.
Aortic Valve* ; Echocardiography, Transesophageal ; Female ; Humans ; Middle Aged*

OBJECTIVE: To investigate the the effects of interleukin-17 (IL-17)on the production of vascular endothelial growth factor (VEGF)from cultured rheumatoid arthritis synoviocytes. METHODS: Fibroblast-like synovial cells(FLS)were prepared from the synovial tissues of rheumatoid arthritis patients and cultured in the presence of IL-17, IL-17 with or without transforming growth factor-beta(TGF-beta),tumor necrosis factor-alpha(TNF-alpha)and interleukin-1 beta(IL-1 beta).VEGF levels were determined in the culture supernatants by sandwitch ELISA. RESULTS: Stimulation of FLS by serial concentration of IL-17,TGF-beta,TNF-alpha,IL-1 beta increased the production of VEGF by 2.1-2.7,2.2-3.0,2.0-2.9,2.3-3.1 fold over the constitutive levels of unstimulated FLS.Stimulation of FLS by IL- 17 with TGF-beta or TNF-alpha or IL-1 beta also increased the production of VEGF accord-ing to culture periods by 1.6-1.8,1.1-1.9,1.5-1.7 fold over the levels stimulated with TGF-beta or TNF-alpha or IL-1 beta,respectively.This results indicated that IL-17 increased the effect of TGF-beta,TNF-alpha,IL-1 beta on FLS,leading synergistic enhancement of VEGF production. CONCLUSION: IL-17 may be involved in the neovascularization in rheumatoid synovitis by enhancing the production of VEGF.
Arthritis, Rheumatoid* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1 ; Interleukin-17* ; Interleukin-1beta ; Necrosis ; Synovitis ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A*

Calciphylaxis is a rare, but fatal, condition that is characterized by a rapidly progressive ischemic necrosis of the skin, underlying tissue and other organs, as well as rapid vascular calcification. It results in death due to sepsis, heart or respiratory failure. A 67-year old female was admitted to hospital with the chief complaint of constant pain to both lower legs of 1 week duration. She was treated with calcitonin-salmon due to a prior unexplained hypercalcemia of 2 weeks. On the third day post admission. pain and weakness in the lower legs were aggravated, became painful, with violaceous skin lesions developing on the thigh with findings similar to those of rhabdomyolysis. Because she was suspected of having dermatomyositis, she was treated with methylpredrisolone. However, the skin lesions and symptoms were aggravated, and she died of sepsis due to a skin infection. About 160 cases of calciphylaxis have been reported, with most of these cases being associated with secondary hyperparathyroidism due to end-stage renal disease, but cases of calciphylaxis without renal failure are very rare. We now report a case of calciphylaxis without renal failure, mimicking dermatomyositis, and present a brief review of the pathophysiology and treatments of calciphylaxis inform the relevant literature.
Aged ; Calciphylaxis* ; Dermatomyositis* ; Female ; Heart ; Humans ; Hypercalcemia ; Hyperparathyroidism, Secondary ; Kidney Failure, Chronic ; Leg ; Necrosis ; Renal Insufficiency ; Respiratory Insufficiency ; Rhabdomyolysis ; Sepsis ; Skin ; Thigh ; Vascular Calcification

PURPOSE: The aim of our study was to evaluate the usefulness of high-resolution CT scans in addition tohelical CT for characterizing a solitary pulmonary nodule. MATERIALS AND METHODS: Our study included 49 patientswith a solitary pulmonary nodule ; in each patient this was evaluated by both additional high-resolution CT andhelical scanning. Images were evaluated by three independent observers, each of whom read them twice : initiallywith helical CT images only and then with helical images plus high-resolution CT images. After analysis, theobservers recorded the following : histologic diagnosis, benignancy or malignancy of a nodule, and confidence intheir diagnosis (three scales). RESULTS: In differentiating benign and malignant nodules, the accuracy of helicalscans only was 75% (110/147 readings) whereas that of helical plus high-resolution CT scans was 82% (121/147readings) (p=0.001). Correct histologic diagnosis was made in 47% of cases (69/147 readings) when helical scansonly had been evaluated and in 48% of cases (71/147 readings) for which both helical and high-resolotion CT scanswere available (p=0.815). Diagnosis was more often highly confident on the basis of additional high-resolution CTscans (25%) than helical scans only (5%) (p=0.001) . CONCLUSION: By enhancing differential diagnosticaccuracy between benign and malignant nodules and by increasing confidence in the histologic diagnosis of apulmonary nodule, additional high-resolution CT scans are valuable for the evaluation of a solitary pulmonarynodule.
Diagnosis ; Humans ; Solitary Pulmonary Nodule* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

Although cholelithiasis is an uncommon condition in infants, a recent study documented the increasing detection of this disorder. This increase may be explained by the wide use and improvement in abdominal ultrasound. Choledocholithiasis with cholestatic jaundice in infants usually requires therapeutic intervention, even though the incidence of spontaneous resolution has been reported to be higher in infants than adults. Choledocholithiasis in children has traditionally been managed surgically with open common duct exploration. Recently, endoscopic stone removal was accepted as a standard therapy in pediatric choledocholithiasis. We report a case of the successful removal of common bile duct stone using endoscopic papillary balloon dilation (EPBD), in a 28-month-old infant with Down's syndrome.
Infant ; Child ; Adult ; Male ; Female ; Humans ; Incidence