Embolization of a carotid cavernous fistula(CCF) by means of a detachable balloon is a well-established method for treating CCFs while preserving a patent parent internal carotid artery(ICA). However, failure to embolize the CCF may occur on a few occasions. Herein we describe a stent-assisted Guglielmi detachable coil embolization that completely occludes the fistulous opening rather than fills the cavernous sinus. By applying this technique, we successfully treated a CCF, without compromise of the parent ICA in patients who has failed with balloon technique previously.
Cavernous Sinus ; Embolization, Therapeutic ; Fistula* ; Humans ; Parents ; Stents*

No abstract available.
Immunologic Tests* ; Tuberculosis, Meningeal*

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Pseudomyxoma Peritonei*

No abstract available.
Immunotherapy* ; Sepsis*

Takotsubo syndrome, also known as stress-induced cardiomyopathy, is a transient cardiac syndrome that mimics acute coronary syndrome. This condition should be suspected if the patient presents with chest pain after intense emotional stress, accompanied by an abnormal electrocardiogram, elevated levels of myocardial enzymes, and left ventricular apical akinesia on echocardiography. Coronary angiography should be performed for prompt differentiation from ischemic heart disease. A 77-year-old female presented with traumatic multiple fractures of the left sixth and seventh ribs resulting from a violent strike. Clinical findings of physical examination, laboratory tests, electrocardiogram, and coronary angiography provided the diagnosis of Takotsubo syndrome. We performed conservative management including pain control, and the patient was uneventfully discharged seven days after admission.
Acute Coronary Syndrome ; Aged ; Cardiomyopathies ; Chest Pain ; Coronary Angiography ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Fractures, Multiple ; Humans ; Myocardial Ischemia ; Physical Examination ; Rib Fractures* ; Ribs* ; Stress, Psychological ; Strikes, Employee ; Takotsubo Cardiomyopathy*

We evalusted the magnetic resonance imaging (MRI) findings of the femoral heads in 20 normal and 45 abnormal patients. The bone marrow in the healthy adults consisted of a combination of hematopoietic and fatty marrow, which showed age-related dirtribation, that is the component of fatty marrow was increased and the marrow vascularity was dereased with age. Avascular necrosis (AVN) showed a decreased bone marrow signal within an normal appearing femoral head on T1 and T2-weighted images. In addition, we could see inhomogenous low signal intensity (31 cases), a ring of low intensity with central normal signal intensity (25cases), focal low signal intensity (12 cases), or a band of low signal intensity (4 cases). MRI findings were abnormal in 10 cases with normal radiographic findings as well as in all the cases with abnormal ones. In conclusion, MRI should be the choice of the imaging modality for the evaluation of early bone marrow chages of AVN.
Adult ; Bone Marrow ; Head* ; Humans ; Magnetic Resonance Imaging* ; Necrosis*

No abstract available.
Hiccup*

PURPOSE: Multiple myeloma is characterized by the neoplastic proliferation of a single clone of plasma cells. Multiple myeloma rarely involves the eyeball or the orbital tissues. We report a case of multiple myeloma that presented with corneal crystalline depositions in a patient complaining of decreased vision and irritation of both eyes without any systemic symptoms. CASE SUMMARY: A 63-year-old woman complained of decreased vision and irritation of both eyes that had started suddenly 20 days before. Uncorrected visual acuity was 0.2 in the right eye and 0.3 in the left eye. Best-corrected visual acuity (BCVA) was 0.9 in the right eye and 1.0 in the left eye. Slit lamp examination showed gray-white crystalline depositions on the epithelium, stroma and Descemet membrane of the cornea extensively, except for the limbus. There were no specific findings on intraocular pressure measurement and fundus examination. The patient did not complain of any systemic symptoms. Multiple myeloma was diagnosed by blood examination and bone marrow biopsy. Two months later, the BCVA decreased to 0.3 in both eyes and artificial tears were prescribed to relieve irritation. CONCLUSIONS: When irritation and decreased vision occur abruptly even without systemic symptoms, there is a possibility of multiple myeloma. Systemic evaluations are needed in these cases.
Biopsy ; Bone Marrow ; Clone Cells ; Cornea ; Crystallins ; Descemet Membrane ; Epithelium ; Eye ; Female ; Humans ; Intraocular Pressure ; Middle Aged ; Multiple Myeloma ; Ophthalmic Solutions ; Orbit ; Plasma Cells ; Vision, Ocular ; Visual Acuity