Solar urticaria is a fairly uncommon but Well recognized clinical entity characterized by erythema and wheal with itching immediately following exposure to sunlight or artifical radiation. A 33-year-old female had a six-year duration of urticaria, tightness of chest and dizziness that appeared within 15 minutes of exposure to sunlight. The action spectrum of this patient was between 320 and 400nm and the passive and reverse passive transfer test were negative. Solar urticaria of our patient appeared to belong to type g in the classification of Harber et al(1963). The patient was treated with antihistamines and repeated exposure to sunlight for inducing tolerance. After 3 months of the treatment, the symptoms did not appear even after 3 hours of exposure to sunlight.
Adult ; Classification ; Dizziness ; Erythema ; Female ; Histamine Antagonists ; Humans ; Intradermal Tests ; Pruritus ; Sunlight ; Thorax ; Urticaria*

A case of scabies combined with superficial dermatophytosis which was aggravated by application of topical fluorinated steroid for 6 months is presented. One year ago a 60-year-old male began to have pruritic erythematous papules on the lower abdomen which spread slowly to the inguinal and buttock area. He had had onychomycosis for six years and for the last 6 months he had applied a. fluorinated steroid. preparation. After application of steroid, the aggravated skin lesions spread rapidly over the whole body. A KOH mount showed sarcoptes scabiei and fungus. A count of itch mites from scales brushed off and collected from. the overall surface of the patients body showed 263 adults, 169 Iarvae and 534 eggs. T. rubrum from a culture of scales from the trunk and nails was confirmed. On admission FBS and oral GTT test revealed diabetic curve, however it could not be determined whether the diabetes mellitus was primary or secondary to the use of topical steroid application. The patient has been treated with crotamiton cream and antifungal agent with remarkably effective results.
Abdomen ; Adult ; Buttocks ; Diabetes Mellitus ; Eggs ; Fungi ; Humans ; Male ; Middle Aged ; Mites ; Onychomycosis ; Ovum ; Sarcoptes scabiei ; Scabies* ; Skin ; Tinea* ; Weights and Measures

The importance of the ticks in medical field has been emphasized because of their association with and transmission of various diseases. We report herein a case of tick bite in a 55-year-old male farmer, who visited our hospital on July 2, 1981 with a parasite attached on right lower flank and rice to small pea sized, pruritic erythematous papular skin eruptions on chest and right lower flank. The skin lesions disappeared completely with.in five days after removal of the parasite, which was identified with an adult female tick which belongs to Genus Ixodes.
Adult ; Female ; Humans ; Ixodes* ; Male ; Middle Aged ; Parasites ; Peas ; Skin ; Thorax ; Tick Bites* ; Ticks*

Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.
Bronchogenic Cyst ; Humans ; Mediastinal Diseases ; Mediastinoscopy ; Mediastinum

A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior en bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.
Giant Cell Tumors ; Orthopedics ; Spine* ; Thoracoscopy ; Thoracotomy

The authors report the surgical results of thalamotomy and pallidotomy, performed at our hospital between 1983 and 1993 for the treatment of Parkinson's disease. The series included a retrospective analysis of 156 patients with this condition by stereotactic ventrolateral(VL) thalamotomy(126 patients, 138 thalamotomies) and posterolateral pallidotomy(30 patients, 30 pallidotomies). Each patient was followed up postoperatively, for one year. Among those who underwent the stereotactic VL thalamotomy, 136/138 procedures(99%) led to improvement of tremor, and 83/138(60%) resulted in reduced rigidity. Stereotactic posterolateral pallidotomy, led to improvement of bradykinesia after 27/30 procedures(90%), of rigidity after 22/30(73%) and of tremor after 13/30(43%). Drug-induced dyskinesia showed a 42% improvement in the thalamotomy series and a 93% improvement in the pallidotomy series; the difference between the two series was significant(p<0.001). The patients themselves and their relatives used the Hoehn & Yahr staging scale to assess postoperative improvement in disability, and according to the results, 91/126 patients(72%) in the thalamotomy series and 26/30(87%) in the pallidotomy series showed improvement. In the thalamotomy series, there was a significantly higher improvement in disability for preoperative groups I and II(Hoehn & Yahr staging scale) than for groups III and IV(p<0.029), while in the pallidotomy series, there was no statistically significant difference in postoperative improvement between these same groups(p>0.557). In addition, for groups with greater preoperative disability(Hoehn & Yahr staging, groups III and IV), improvement was more likely after pallidotomy than after thalamotomy. In the pallidotomy series, dysphasia was the only serious complication and this was seen after 20% of procedures. In the thalamotomy series, however, complications included hypotonia(24%), transient confusion(19%), transient dysphasia(11%), permanent dysarthria(7%), subjective numbness(4%) and epileptic seizure(3%). The authors believe that posterolateral pallidotomy is much more effective than VL thalamotomy for the control of Parkinsonian bradykinesia and rigidity, but that thalamotomy is still a useful surgical option for the control of Parkinsonian tremor.
Aphasia ; Dyskinesia, Drug-Induced ; Humans ; Hypokinesia ; Pallidotomy* ; Parkinson Disease* ; Retrospective Studies ; Tremor

Tow surgically treated cases of thoracic tuberculous spondylitis with multievel involvement are presented. Radical debridement produced large deficit in the anterior structures and spinal instability. A reconstruction with mesh cylinder graft and combined anterior instrumentation surgery in one stage operation. Anterior Instrumentation provided immediate stability and protected against development of kyphotic deformity. There was no persistence or recurrence of infection after surgery. The average length of follow up was 24month including 12month, 18month course of chemotherapy.
Congenital Abnormalities ; Debridement ; Drug Therapy ; Follow-Up Studies ; Recurrence ; Spondylitis* ; Transplants

BACKGROUND: Mediastinal neurogenic tumors are generally benign lesions and they are ideal candidates for performing resection via video-assisted thoracoscopic surgery (VATS). However, benign neurogenic tumors at the thoracic apex present technical problems for the surgeon because of the limited exposure of the neurovascular structures, and the optimal way to surgically access these tumors is still a matter of debate. This study aims to clarify the feasibility and safety of the VATS approach for performing surgical resection of benign apical neurogenic tumors (ANT). MATERIAL AND METHOD: From January 1996 to September 2008, 31 patients with benign ANT (15 males/16 females, mean age: 45 years, range: 8~73), were operated on by various surgical methods: 14 VATS, 10 lateral thoracotomies, 6 cervical or cervicothoracic incisions and 1 median sternotomy. 3 patients had associated von Recklinhausen's disease. The perioperative variables and complications were retrospectively reviewed according to the surgical approaches, and the surgical results of VATS were compared with those of the other invasive surgeries. RESULT: In the VATS group, the histologic diagnosis was schwannoma in 9 cases, neurofibroma in 4 cases and ganglioneuroma in 1 case, and the median tumor size was 4.3 cm (range: 1.2~7.0 cm). The operation time, amount of chest tube drainage and the postoperative stay in the VATS group were significantly less than that in the other invasive surgical group (p<0.05). No conversion thoracotomy was required. There were 2 cases of Hornor's syndrome and 2 brachial plexus neuropathies in the VATS group; there was 1 case of Honor's syndrome, 1 brachial plexus neuropathy, 1 vocal cord palsy and 2 non-neurologic complications in the invasive surgical group, and all the complications developed postoperatively. The operative method was an independent predictor for postoperative neuropathies in the VATS group (that is, non-enucleation of the tumor) (p=0.029). CONCLUSION: The VATS approach for treating benign ANT is a less invasive, safe and feasible method. Enucleation of the tumor during the VATS procedure may be an important technique to decrease the postoperative neurological complications.
Ants ; Brachial Plexus Neuropathies ; Chest Tubes ; Drainage ; Female ; Ganglioneuroma ; Humans ; Mediastinum ; Neurilemmoma ; Neurofibroma ; Retrospective Studies ; Sternotomy ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Vocal Cord Paralysis

BACKGROUND: Complicated pleural space occupying lesions (SOL) have been treated by thoracentesis, closed thoracotomy drainage (CTD) or surgical intervention with using a video thoracosocpe or open thoracotomy depending on the extent of the disease. With the development of video assisted thoracoscopic surgery (VATS), VATS pleural adhesiolysis and decortication have revealed good results as compared to those for open thorcotomy. To assess the effectiveness of VATS pleural adhesiolysis and decortication, we retrospectively analyzed the medical record and radiologic findings of the patients with complicated pleural SOL and who were treated by this surgery. MATERIAL AND METHOD: From May 1996 to April 2006, 64 patients (mean age: 41.8 years) with complicated pleural SOL underwent 65 VATS. To analyze the surgical outcome, we classified the postoperative findings on the simple chest X-rays into 4 classes as Class I: no or minimal pleural lesion, Class II: blunting of the cardiophrenic angle and mild pleural thickening, Class III: an elevated diaphgram or persistent lung collapse and Class IV: complicated or recurrent effusion. RESULT: Before VATS, the patients underwent the diagnostic or therapeutic procedures: single or repeat diagnostic tapping for 41, thoracoscotomy drainage for 11, pigtail catheter drainage for 10 and intrapleural fibrinolytics for 10. The mean duration between the onset of symptom and surgery was 18.4 days. There was neither mortality nor severe complications. The surgical outcomes were class 1 for 28, class 2 for 13, class 3 for 19 and class 4 for 5. There were statistically significant differences between the symptom duration and the classes, and between the operation time and the classes. CONCLUSION: VATS pleural adhesiolysis and decortication are effective, safe treatments for managing complicated pleural SOL, and an earlier operation is needed for obtaining a better surgical outcome.
Catheters ; Drainage ; Humans ; Medical Records ; Pleural Effusion ; Polymethyl Methacrylate ; Pulmonary Atelectasis ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thoracotomy ; Thorax

Simultaneous occurrence of remote intracerebral hemorrhage (ICH) and intracranial aneurysmal subarachnoid hemorrhage is very rare. We report on a case of concurrent hypertensive ICH at the left thalamus and rupture of an intracranial aneurysm at the bifurcation of the single A2 segment of the anterior cerebral artery in a 64-year-old woman, which was clipped previously, with review of the literature. To our knowledge, this is the first case report demonstrating bleeding of previously clipped aneurysm with simultaneous hypertensive ICH. Hypertensive crisis following ICH seems to have provoked rupture of the residual aneurysm.
Aneurysm ; Anterior Cerebral Artery ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhage, Hypertensive ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Thalamus