The clinical and pathological features of a paraganglioma arising in the cauda equina is described and compared with previous reports. The right microscopic fetures were similar to those of paragangliomas from other sites, with a 'Zellballen' pattern of cells containing arzyrophil granules. Immunohistocytochemical stains for neurone specific enolase, S-100 protein, cytokeratin were positive, but stains for glial fibrillary acidic protein were negative. Electron microscopy showed densely staining membrane-bound granules, cilia like structures and fibros bodies in the cytoplasm. The last two features only occur in paragangliomas from this site. The pathological findings suggest that paragangliomas in this site arise from pre-existing paraganglia, possibly of the visceral autonomic group.

Pancreatic encephalopathy is a rare complication of acute pancreatitis. We report a 80-year-old woman who, after an acute episode of pancreatitis, developed a fluctuating confusion and clouded consciousness. She experienced two relapses with alternating encephalopathic features. Serum amylase was highly increased and symptoms were relieved in accord with normalized amylase value. We suggest that this encephalopathic features may be related with pancreatitis.
Aged, 80 and over ; Amylases ; Consciousness ; Female ; Humans ; Pancreatitis* ; Recurrence

Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

Melanosis ilei is a condition that's characterized by gross greyish-black or brownish-black pigmentation of the mucosa of the terminal ileum. There were several substances that produce gastrointestinal tract pigmentation such as lipofuscin, iron sulphide (FeS), Hemosiderin and exogenous material such as silicates and titanium. We report here on a case of a 58-year-old female who ingested charcoal for a long time, and she was diagnosed with melanosis ilei by colonoscopy. Her condition improved after she stopped ingesting the charcoal.
Charcoal ; Colonoscopy ; Female ; Gastrointestinal Tract ; Hemosiderin ; Humans ; Ileum ; Iron ; Lipofuscin ; Melanosis* ; Middle Aged ; Mucous Membrane ; Pigmentation ; Silicates ; Titanium

Most ingested foreign bodies spontaneously pass through the upper and lower intestinal tract. The impaction of an ingested foreign body in the colon is rare. Foreign bodies swallowed inadvertently often cause serious complications, such as perforation, obstruction, abscess formation, enterocolic fistula, or hemorrhage. Physicians should proceed with routine medical care while considering the possibility of the ingestion of a foreign body In cases where abdominal pain of an unknown origin is observed, particularly in elderly patients who wear dentures, alcoholics, mentally disturbed, or rapid eating, and presenting with altered bowel habits. We report a case of a colonoscopically-removed wooden toothpick that impacted the sigmoid colon and was complicated by the formation of a local abscess with a review of the literature.
Abdominal Pain ; Abscess ; Aged ; Alcoholics ; Colon ; Colon, Sigmoid* ; Colonoscopy ; Dentures ; Eating ; Fistula ; Foreign Bodies ; Hemorrhage ; Humans

Hypereosinophilic syndrome, the disease with continuous over production of eosinophil from bone marrow without any identifiable underlying disorder, causes various symptoms or signs by infiltrating organs. As many as 28,780/mm3 eosinophils in peripheral blood, the eosinophilic hyperplasia in bone marrow and features of hepatic involvement -revealed elevated serum AST, ALT and ultrasonogram of abdomen showed the multiple nodules scattered throughout the liver, we have reached to make a diagnosis of the rare hyper eosinophilic syndrome carrying the eosinophil-rich exudate in pleural effusion. The patient showed improvement of clinical symptoms with oral administration of predinisolone, and we report this case with literature consideration.
Abdomen ; Administration, Oral ; Bone Marrow ; Diagnosis ; Eosinophils ; Exudates and Transudates ; Humans ; Hypereosinophilic Syndrome ; Hyperplasia ; Liver ; Pleural Effusion* ; Ultrasonography

BACKGROUND: The information on nasal transport and the metabolism of peptides have been obtained from pharmacokinetic investigations in experimental animals. However, there are no transport and metabolic studies of human nasal epithelial cells. In this study, the permeability characteristics and the metabolic properties of in vitro human nasal cell monolayers were investigated. Material and METHODS: Normal human inferior nasal conchal tissue samples were obtained from patients undergoing endoscopic nasal cavitary surgery. The specimens were cultured in a transwell using an air-liquid interface (ALI) culture, and the transepithelial electrical resistance (TEER) value of the blank filter and confluent cell monolayers were measured. To determine the % leakage of mannitol, 4µmol 14C-labelled mannitol was added and the % leakage was measured every 10 minute for 1 hour. RESULT: Human nasal epithelial cells in the primary culture grew to a confluent monolayer within 7 days and expressed microvilli. The tight junction between the cells was confirmed by transmission electron microscopy. The TEER value of the blank filter, fifth day and seventh day reached 108.5 ohm.cm2, 141 ohm.cm2 and 177.5 ohm.cm2, respectively. Transcellular % leakage of the 14C-mannitol at 10, 20, 30, 40, 50 and 60 minutes was 35.67±5.43, 34.42±5.60, 32.75±5.71, 31.76±4.22, 30.96±3.49 and 29.60±3.68 %, respectively. CONCLUSION: The human nasal epithelial monolayer using ALI using techniques is suitable for a transcellular permeability study. The data suggests that human nasal epithelial cells in as ALI culture technique shows some promise for a nasal transport and metabolism study.
Animals ; Culture Techniques* ; Electric Impedance ; Epithelial Cells* ; Humans* ; Mannitol ; Metabolism ; Microscopy, Electron, Transmission ; Microvilli ; Peptides ; Permeability ; Tight Junctions

This study was conducted to establish the feasibility of corneal transplantation using the big-bubble technique (BBT) to perform deep anterior lamellar keratoplasty (DALK) in three dogs. After the cornea was trephined 750 µm, 4 mL of air was injected, and the blanched stroma was removed to expose Descemet's membrane (DM). The donor corneal button, which was gently stripped off the DM, was sutured onto the bare DM of the recipient cornea. The dogs received topical antibiotics every 6 h for 7 days and 2% cyclosporine ointment every 12 h for 1 month. The eyes were examined post-operatively at 7, 14, 21, 28 and 150 days. The central portion of the transplanted cornea stayed transparent while corneal haze developed around the transplanted margin. Menace response was normal even though the transplanted cornea was edematous until 3 weeks after surgery. A marginal haze was rarely observed between the donor and recipient corneas at 150 days after the operation. A spotted haze developed in the central part of the deep stroma near the DM. Upon histopathological examination, the stroma and epithelium of the donor cornea had normal structures. Corneal transplantation using DALK with BBT can be performed in dogs preserving the healthy endothelium.
Animals ; Anti-Bacterial Agents ; Cornea ; Corneal Transplantation* ; Cyclosporine ; Descemet Membrane ; Dogs* ; Endothelium ; Epithelium ; Humans ; Tissue Donors

OBJECTIVE: The development of a dictionary of clinical terminology based on medical concepts is essential for understanding the precise meanings of the clinical terminologies used in EMR systems. For an unambiguous presentation and retrieval of the terminologies in practical data entry, this study propose a clinical terminology dictionary, which integrates and manages the wide range of data in EMR Systems. METHODS: The structure of the system and attributes were defined. The structures should satisfy the following: all terminologies should be consistent with the medical concepts, all concepts have multiple relationships, all concepts have many synonyms, all concepts can be mapped to concepts in an external medical terminology system, and all concepts can be grouped as value sets by setting the "domain". RESULTS: With the derived entity objects and attributes, the physical clinical terminology database was constructed and an editor was developed using MySQL 5.0.45 and JAVA Swing. To verify the structure and contents of the developed clinical terminology dictionary, the terminology experts used the editor to search and register the medical concepts. CONCLUSION: Although the contents refinement and complements are an unsolved problem, it is anticipated that the proposed research will provide unambiguous meanings of the clinical terminology and be applicable to many services in EMR systems.
Complement System Proteins ; Indonesia