No abstract available.
Adie Syndrome ; Paroxysmal Hemicrania

Although spinal arachnoid cysts are relatively common findings observed incidentally in adults, they are much rarely reported in children. They are usually asymptomatic and are mainly located in the middle and lower thoracic regions. However, in rare circumstances, these cysts can cause mass effects that lead to neurologic symptoms. We report the rare case of a spinal extradural arachnoid cyst in a 12-year-old boy who showed signs and symptoms of cauda equina syndrome. Magnetic resonance imaging of the lumbar spine revealed a huge extradural arachnoid cyst extending from L2 to L5. Emergent laminectomy and repair of dural defect was performed after total resection of the extradural arachnoid cyst. There were no postoperative complications. Total recovery was achieved 6 months after surgery. Here, we report this rare case with a review of the literature.

Lung cancer metastatic to the small intestine is uncommon. Despite the widespread nature of metastases that characterize this carcinoma, symptomatic intestinal metastases are extremely rare, but have been reported as a cause of intestinal obstruction, hemorrhage, malabsorption, and perforation. We have recently encountered two cases with squamous cell lung cancer who underwent endoscopic retrograde cholangiopancreatography for obstructive jaundice. Biopsies obtained from concentric ulcerative mass in the duodenum showed metastatic squamous cell carcinoma in the lymphatics. Histologically, the pulmonary and duodenal lesions were identical and this suggests a lymphatic route of dissemination. This is the report of two cases with obstructive jaundice secondary to duodenal metastasis from primary lung cancer. Metastatic squamous cell carcinoma of the lung to the duodenum should be considered in the differential diagnosis of patients harboring such a malignancy who have obstructive jaundice.
Biopsy ; Carcinoma, Squamous Cell ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Duodenum ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intestine, Small ; Jaundice ; Jaundice, Obstructive* ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Ulcer

Peripheral neuroepithelioma (PNE) of soft tissue is a malignant neuroectodermal tumor arising from peripheral (nonautonomic) nerve. It may occur in both children and adults, and are highly aggressive neoplasms that rapidly give rise to metastatic disease and death. We exprienced a case of peripheral neuroepithelioma of soft tissue in the upper arm in a 18-year-old female. Cytologic features revealed small round cells with scanty cytoplasm occurring both singly and in clusters. The clusters frequently tended to form Homer-Wright rosettes. The cells had a round to oval nucleus with fine chromatin and in- conspicuous nucleoli in a hemorrhagic background.
Adolescent ; Adult ; Arm ; Carcinoma, Transitional Cell ; Child* ; Chromatin ; Cytoplasm ; Female ; Humans ; Neuroectodermal Tumors ; Neuroectodermal Tumors, Primitive, Peripheral ; Urinary Bladder

BACKGROUND AND OBJECTIVES: Human rhinovirus (HRV) infection is the primary cause of the common cold. It was often reported that the frequency of viral rhinitis is higher among patients with chronic rhinosinusitis with nasal polyposis (CRS/ NP) than normal subjects. And, patients with nasal polyps often complain that they suffer from a relatively severe degree of URI. The purpose of this article was to evaluate whether the HRV infection rate and virus-induced cytokine secretion is different between the organ culture model of the nasal polyp mucosae and the sinus mcuosae. MATERIALS AND METHODS: Organ cultures of nasal polyps from sixteen CRS/NP patients and normal sphenoid sinus mucosae from nineteen patients who underwent the trans-sphenoidal pituitary surgery were tested. The successful viral infection by HRV-16 was determined by seminested reverse transcription-PCR. Immunoreactive IL-6 and IL-8 were quantitated using the ELISA. RESULTS: A PCR product indicating the successful RV infection was detected in nine of sixteen (56.3%) polyp samples and eleven of nineteen (57.9%) normal sphenoid sinus samples were tested positive for HRV-16. Rhinovirus infection increased the IL-6 and IL-8 secretion to 236% and 173% in polyp samples and to 231% and 145% in sphenoid mucosa samples respectively. However, there was no significant difference in rhinovirus infection rate and in the rhinovirus-induced IL-6 and IL-8 secretion between the groups. CONCLUSION: The results of this study may suggest that the nasal polyp mucosae, when compared with normal sinus mucosae, did not show more vulnerability to HRV infection nor more intense cytokine response by HRV infection.
Common Cold ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6 ; Interleukin-8 ; Mucous Membrane* ; Nasal Polyps* ; Organ Culture Techniques* ; Polymerase Chain Reaction ; Polyps ; Rhinitis ; Rhinovirus* ; Sphenoid Sinus*

BACKGROUND AND OBJECTIVES: Continuous Positive Airway Pressure (CPAP) is generally effective in correcting sleep-related respiratory disturbance in Obstructive Sleep Apnea Syndrome (OSAS). But the failure to comply with this treatment poses a serious limitation to its use. The aim of this study is to investigate the state of compliance and the cause of noncompliance of auto-adjusting positive airway pressure (autoPAP) treatment in Korean OSAS patients. MATERIALS AND METHODS: This study performed a survey of 45 patients who had selected the autoPAP treatment between August 2000 and May 2003. RESULTS: Twelve of the 45 patients (26.7%) refused the autoPAP treatment immediately after the first trial due to claustrophobia. Also, twenty patients (44.4%) stopped using it within 1 month. Only 13 patients (28.9%) continued to use it for more than 1 month. Twenty seven of the 33 patients (81.8%) who had used the autoPAP complained of claustrophobia after the first trial. The major factors of low compliance were claustrophobia, restricted body position while asleep, nasal symptoms, high cost, and inadequate education of patients. CONCLUSION: This study shows that claustrophobia is a major cause for the noncompliance of autoPAP. It also shows that the patients are encouraged by the effectiveness of the autoPAP to use it for a longer period. Therefore, we should focus on explaining the effects and drawbacks of autoPAP, desensitization and behavioral modification.
Compliance* ; Continuous Positive Airway Pressure ; Humans ; Patient Education as Topic ; Phobic Disorders ; Sleep Apnea, Obstructive*

Peutz-Jeghers syndrome is a familial syndrome consisting of mucocutaneous pigmentation and gastrointestinal polyposis and appears to be inherited as a single pleiotropic autosomal dominant gene with variable and incomplete penetrance. Cases of hamartomatous polyps of the Peutz-Jeghers type without Peutz-Jeghers syndrome have only rarely been reported. Moreover, only one case of a Peutz-Jeghers polyp at the appendix has been reported; it was resected by appendectomy. We report here on a case of a 45 year old man who had a hamartomatous polyp of the Peutz-Jeghers type arising from the appendix. The polyp was successfully removed by endoscopic polypectomy. To our knowledge, this is the first case of a hamartomatous polyp of the Peutz-Jeghers type that originated from the appendix and that was resected endoscopically.
Appendectomy ; Appendix ; Genes, Dominant ; Penetrance ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps

No abstract available.
Cardiomyopathies* ; Peripartum Period*

Autoimmune hemolytic anemia (AIHA) is characterized by the production of Coombs' antibodies, which are responsible for the destruction of RBCs. The antibody specificity of warm AIHA (WAIHA) is very complex while all cells tested are usually reactive in routine test. Although some autoantibodies have broad specificity to the Rh system, apparent specificity for simple Rh antigen (D, C, E, c, e) is rare. A 63 year-old farmer was admitted at Inha University Hospital for evaluation of anemia. He had no history of blood transfusion. He presented overt anemia with decreased Hb (6.6g/dL) and increased reticulocyte count (18.5%, corrected reticulocyte count 8.4%). The direct antiglobulin test (DAT) was strongly positive for IgG and negative for C3d while indirect antiglobulin test (IAT) was weakly positive. Both two different antibody identification test kits identified this antibody as anti-e. His Rh phenotype was CDe. Although the eluted antibody from his own RBCs failed to show specificity against e but agglutinated all the reagent RBCs, we diagnosed this case as WAIHA induced by IgG anti-Rh(e) because his serum agglutinated all e-positive RBCs while it was non-reactive with e-negative RBC in the cross-matching test. Drugs (loxoprofen, cimetidine) couldn't be ruled out as causative agent.
Anemia ; Anemia, Hemolytic, Autoimmune* ; Antibodies ; Antibody Specificity ; Autoantibodies ; Blood Transfusion ; Coombs Test ; Humans ; Immunoglobulin G ; Middle Aged ; Phenotype ; Reticulocyte Count ; Sensitivity and Specificity

Autoimmune hemolytic anemia(AIHA) is characterized by the production of Coombs antibodies, which are responsible for the destruction of RBCs. The antibody specificity of warm A1HA(WAIHA) is very complex while all cells tested are usually reactive in routine test. Although some autoantibodies have broad specificity to the Rh system, apparent specificity for simple Rh antigen(D, C, E, c, e) is rare. A 63 year-old farmer was admitted at Inha University Hospital for evaluation of anemia. He had no history of blood transfusion. He presented overt anemia with decreased Hb (6.6g/dL) and increased reticulocyte count(18.5%, corrected reticulocyte count 8.4%). The direct antiglobulin test(DAT) was strongly positive for IgG and negative for C3d while indirect antiglobulin test(IAT) was weakly positive. Both two different antibody identification test kits identified this antibody as anti-e. His Rh phenotype was CDe. Although the eluted antibody from his own RBCs failed to show specificity against e but agglutinated all the reagent RBCs, we diagnosed this case as WAIHA induced by IgG anti-Rh(e) because his serum agglutinated all e-positive RBCs while it was non-reactive with e-negative RBC in the cross- matching test. Drugs(loxoprofen, cimetidine) couldn' t be ruled out as causative agent. (Korean J Blood Transfusion 10(1): 61-67, 1999)
Anemia ; Anemia, Hemolytic, Autoimmune* ; Antibodies ; Antibody Specificity ; Autoantibodies ; Blood Transfusion ; Humans ; Immunoglobulin G ; Middle Aged ; Phenotype ; Reticulocyte Count ; Reticulocytes ; Sensitivity and Specificity