Herein, a new left renal vein stenting procedure (expandable metallic stent placement), which provided relief for an 18-year-old man incapacitated by an intermittent gross hematuria, is reported. The placement of an expandable metallic stent is a minimally invasive therapy, and a simpler and more physiological therapy than previous approaches to Nutcracker syndrome.
Adolescent ; Hematuria ; Humans ; Renal Veins ; Stents*

PURPOSE: Prenatal diagnosis of congenital heart disease has been made by fetal echocardiography and its clinical impact on the outcome of complete atrioventricular septal defect(AVSD) cases has been analysed. METHODS: A retrospective study was performed for the fetal cases for complete AVSD diagnosed, confirmed postnatally or at second study and/or at autopsy and/or follow up at CHA hospital between January 1993 and December 2001. The outcome of complete AVSD has been analysed, and the associated anomalies & chromosomal defects has been described. RESULTS: There were 450 cases of significant CHD that had been diagnosed prenatally during the study period. Of whom 35 cases had complete AVSD, and 32 cases had complete AVSD associated with visceral heterotaxy. In the cases with complete AVSD who with chromosomal study, 53.8% had Down syndrome and an additional 7.7% had other chromosomal anomaly. Associated cardiac malformation was 34.2%. Extracardiac anomaly without chromosomal defect was founded in 5 cases(14%) included polydactyly, hydrocephalus, duodenal atresia, omphalocele, cleft lip and single umbilical artery. Among 35 fetal complete AVSD cases, 29 cases of complete AVSD has been terminated, 1 case died in utero, 1 case died at neonatal period and 4 cases were referred to cardiac center for planned delivery. The most common factors of termination were extracardiac and chromosomal anomaly. CONCLUSION: Among the significant CHD, incidence rate of complete AVSD was 7.8%. And the most of the complete AVSD has been terminated. 4 cases(11.4%) were referred to the cardiac center for planned delivery. The rate of termination was 82.9%. Fetal diagnosis of complete AVSD greatly increased the rate of termination.
Autopsy ; Cleft Lip ; Diagnosis ; Down Syndrome ; Echocardiography ; Follow-Up Studies ; Heart Defects, Congenital ; Hernia, Umbilical ; Heterotaxy Syndrome ; Hydrocephalus ; Incidence ; Polydactyly ; Prenatal Diagnosis* ; Retrospective Studies ; Single Umbilical Artery

PURPOSE: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. METHODS: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor(R)) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. RESULTS: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. CONCLUSIONS: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.
Prosthesis-Related Infections/diagnosis/*etiology/surgery ; Porosity ; Orbital Implants/*adverse effects ; Orbital Diseases/diagnosis/*etiology/surgery ; Magnetic Resonance Imaging ; Humans ; Follow-Up Studies ; Female ; Eye Enucleation ; Device Removal ; Aged ; Abscess/diagnosis/*etiology/surgery

Cartilage ; Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Eye ; Humans ; Lip ; Orientation ; Rhinoplasty ; Succinates

Hepatic portal venous gas (HPVG) is a rare disease presenting as acute abdomen. There were first described in children with necrotizing enterocolitis in 1955. HPVG is caused by mesenteric ischemia but may have various etiologies. Predisposing factors that develop mesenteric ischemia include gastric ulcer disease, bowel obstruction, diverticulitis and sepsis. The presence of the air in the portal and mesenteric vein on radiographics has been associated with a mortality rate of more than 75% in earlier studies. Abdominal computed tomography has proven useful for detecting portomesenteric venous gas and pneumatosis intestinalis. We report a case of the patient with hepatic portal venous gas with pneumatosis intestinalis, which showed rapid progress of the disease and eventually died within 24 hours of admission.
Abdomen, Acute ; Child ; Diverticulitis ; Enterocolitis, Necrotizing ; Humans ; Ischemia ; Mesenteric Veins ; Portal Vein ; Rare Diseases ; Sepsis ; Stomach Ulcer

Reported cases of gastrosplenic fistulas are extremely rare in the literature. Malignancy is the primary cause in 50% of patients, followed by perforated peptic ulcer (40%). Fistulas can cause spleen rupture and potential bleeding that threaten the life of the patient. Lymphoma is the most common cause of malignancy complicated with gastrosplenic fistula. Most gastrosplenic fistulae caused by lymphoma eventually close following chemotherapy, although splenectomy should be performed to avoid further complications. We experienced a case of non-Hodgkin's lymphoma complicated with gastrosplenic fistula in a 21 year-old man. He was admitted to our hospital because of LUQ mass. On the abdominal CT, a splenic mass with central necrosis and gas was discovered. The biopsy specimen of the stomach and spleen displayed diffuse, large B cell type non-Hodgkin's lymphoma. After one cycle of CHOP chemotherapy, the LUQ mass was markedly regressed although the gastrosplenic fistula was still present on the follow-up CT. The fistula was treated by splenectomy and a partial resection of gastric fundus. Follow-up chemotherapy was continued after surgery.
Biopsy ; Drug Therapy ; Fistula* ; Follow-Up Studies ; Gastric Fundus ; Hemorrhage ; Hodgkin Disease* ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Necrosis ; Peptic Ulcer ; Rupture ; Spleen ; Splenectomy ; Stomach ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: In younger children, early diagnosis of acute appendicitis can be difficult because patients may not be able to provide a good history of their symptoms and the etiologies of the abdominal pain is often unclear. Therefore, the diagnosis is may be delayed and may be made after perforation has occurred. METHODS: The cases of 20 children of 3 years of age or less who underwent appendectomies due to appendicitis from January 1995 to March 2000 were retrospectively reviewed. Data were gathered including seasonal variation, gender, mean age, presenting signs and symptoms, physical signs, diagnostic methods, WBC counts, postoperative complications and length of postoperative hospital stay. RESULTS: The male-to-female ratio was 1.5:1. Fifteen cases were diagnosed after perforation had occurred, and 5 cases were nonperforated. The mean age was 29.6(+/-5.5) months; 60% were males(12/20). The most common presenting symptom was abdominal pain(95%). The most common signs was abdominal tenderness; especially, muscle guarding was more common in the perforated group(100% vs. 0%). The mean duration of symptoms prior to visiting the ED and the average length of hospital stay were 4.4 days and 10.1 days in the perforated group and 2.2 days and 4.2 days in the nonperforated group, retrospectively. CONCLUSION: In children of 3 years of age or less, when abdominal pain is persistent without response to conservative treatment and there is associated abdominal tenderness, appendicitis must be considered. especially, when there are fever, diarrhea and muscle guarding, perforated appendicitis must be considered.
Abdominal Pain ; Appendectomy ; Appendicitis* ; Child* ; Diagnosis ; Diarrhea ; Early Diagnosis ; Fever ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Seasons

PURPOSE: Many methods have been employed for the diagnosis of acute myocardial infarction (AMI) in emergency departments (ED). However, there is still no definite screening marker for the early diagnosis of AMI, We studied arterial lactate as an inexpensive and simple potential screening marker for diagnosis of early onset AMI. METHODS: A retrospective study was performed on 369 patients who visited our ED for chest pain between September 2004 and August 2005. Arterial lactate was sampled and compared against traditional cardiac enzymes such as troponin I and CK-MB. We focused on 171 patients who visited the ED within 4 hours after their symptoms had developed, a time frame in which traditional cardiac enzyme tests usually give normal results. RESULTS: The overall sensitivity of arterial lactate in the detection of AMI was 57.4%, and when tested within 4 hours after the development of symptoms its sensitivity was 63.9%. Sensitivity of testing with troponin I and CK-MB, by contrast, was 42.6%. However, the combined overall sensitivity of detection using lactate, troponin I, and CK-MB for the diagnosis of AMI within 4 hours of first symptoms was 85.2%. CONCLUSION: Arterial lactate alone was not particularly sensitive for the detection of AMI, but combination testing using lactate, troponin I, and CK-MB was highly sensitive for AMI.
Chest Pain ; Diagnosis* ; Early Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Lactic Acid* ; Mass Screening ; Myocardial Infarction* ; Retrospective Studies ; Troponin I

Malignant Sertoli cell tumor was diagnosed in a 5-year-old male Shih Tzu dog. Clinical features of the dog were anorexia, urinary incontinence, constipation, anemia, alopecia, and epistaxis. The dog also had unilateral cryptorchid testis in the abdomen. Several abdominal and thoracic masses were identified on radiography. Grossly, the cryptorchid testicular mass was markedly enlarged to 8 cm in diameter. On cut surface, firm and well demarcated milk-white neoplastic areas were irregularly separated by white fibrous bands. Histologically, the testicular mass was diagnosed as tubular pattern Sertoli cell tumor. In addition, abdominal and mediastinal lymph nodes metastasis were found. Immunohistochemically, the tumor cells were strongly positive for vimentin and neuron specific enolase, but negative for S-100 and cytokeratin.
Abdomen ; Alopecia ; Anemia ; Animals ; Anorexia ; Constipation ; Dogs ; Epistaxis ; European Continental Ancestry Group ; Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Phosphopyruvate Hydratase ; Preschool Child ; Sertoli Cell Tumor ; Testis ; Urinary Incontinence ; Vimentin

INTRODUCTION: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. MATERIALS AND METHODS: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). RESULTS: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. CONCLUSION: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.
Female ; Follow-Up Studies ; Head ; Humans ; Lip ; Male ; Mandible ; Medical Records ; Mouth Floor ; Mouth Mucosa ; Mouth Neoplasms ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Oropharynx ; Palate ; Recurrence ; Salivary Glands