We present a patient with meralgia paresthetica by a distended iliopsoas bursa and associated with concurrent osteonecrosis of the femoral head. This manifestation is unusual and extremely rare because classically LFCN dose not pass near the iliopsoas bursa. We presume a mechanism of nerve injury by variation of the course of lateral femoral cutaneous nerve.
Head* ; Humans ; Osteonecrosis*

The primary T-cell lymphoma of the stomach is a extremely rare disease, only about 33 cases were described in the literature since 1986. Recent studies have proved a strong relation between Helicobacter pylori infection and several gastric diseases such as peptic ulcer, chronic gastritis, gastric cancer, and lymphoma. We report a case of primary gastric T-cell lymphoma with H. pylori infection in a 63-year-old male who had a history of epigastric fullness for 2 years. Gastroscopy showed a round ulcer of 1cm in size on anterior side of gastric angle. The gastroscopic biopsy revealed diffuse large cell malignant non-Hodgkin' s lymphoma on light microscopic examination, and T-cell immunophenotype with immunohistochemical study. The result of CLOtest was positive. No lymphadeno-pathy was found with chest roentgenogram and computed omography of abdomen and pelvis. Bone marrow examination showed normal finding.
Abdomen ; Biopsy ; Bone Marrow Examination ; Gastritis ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Male ; Middle Aged ; Pelvis ; Peptic Ulcer ; Rare Diseases ; Stomach ; Stomach Diseases ; Stomach Neoplasms ; T-Lymphocytes* ; Thorax ; Ulcer

BACKGROUND: The cerebral vascular response to CO2 has been reported to be preserved during isoflurane and propofol anesthesia. This study compared the cerebral oxygen extraction ratio during normoventilation versus hyperventilation in propofol anesthesia and isoflurane anesthesia. METHODS: 28 patients undergoing cerebral aneurysmal surgery were studied following informed consent. In the isoflurane group (n = 14), anesthesia was induced with thiopental 5 mg/kg, and maintained with isoflurane and nitrous oxide (N2O) in oxygen (FiO2 0.33). In the propofol group (n = 14), anesthesia was induced with propofol 2 mg/kg, and maintained by infusion of propofol and N2O-O2 (FiO2 0.33). Monitoring included measurement of mean arterial blood pressure, heart rate, body temperature, end-tidal CO2 (PetCO2), jugular bulb O2 saturation (SjO2) and arterial O2 saturation (SaO2). Mechanical ventilation was adjusted to achieve PetCO2 levels of 40 and 25 mmHg. Ten minutes of equilibration were allowed at each PetCO2 level. Blood was sampled from the jugular bulb and radial artery at each PetCO2 level (40 and 25 mmHg). The cerebral oxygen extraction ratio was calculated as (CaO2 CjO2) / CaO2 (CaO2; arterial oxygen content, CjO2; jugular bulb oxygen content). RESULTS: The cerebral oxygen extraction ratio was higher in hyperventilation (PetCO2 25 mmHg) compared to normoventilation (PetCO2 40 mmHg) in each group (P < 0.05) and higher in the propofol group compared to the isoflurane group (P < 0.05). CONCLUSIONS: The increased cerebral oxygen extraction ratio in hyperventilation during both isoflurane and propofol anesthesia showed that cerebral vascular CO2 reactivity was maintained during both isoflurane anesthesia and propofol anesthesia. The cerebral oxygen extraction ratio was higher during propofol anesthesia compared to isoflurane anesthesia in both normoventilation and hyperventilation, therefore this data showed that cerebral blood flow was lower during propofol anesthesia compared to isoflurane anesthesia.
Anesthesia* ; Arterial Pressure ; Body Temperature ; Heart Rate ; Humans ; Hyperventilation ; Informed Consent ; Intracranial Aneurysm ; Isoflurane* ; Nitrous Oxide ; Oxygen* ; Propofol* ; Radial Artery ; Respiration, Artificial ; Thiopental

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Valproic acid is an effective anticonvulsant used in neurology and psychiatry. Valproic acid-induced hyperammonemic encephalopathy is an unusual complication characterized by a decreasing level of consciousness, the development of progressive confusional states and, sometimes, a coexisting increase in the frequency of seizures after the onset of valproic acid treatment. It can lead to death, but can be reversed if a swift diagnosis is made. We report the case of a 58-year-old woman with an intracerebral hemorrhage and normal liver function who presented with valproic acid-induced hyperammonemic encephalopathy. After valproic acid treatment, she developed encephalopathy and became comatose, with seizures and a markedly elevated serum ammonia level. Her neurologic manifestations and hyperammonemia improved after discontinuing the valproic acid.
Ammonia ; Cerebral Hemorrhage ; Coma ; Consciousness ; Female ; Humans ; Hyperammonemia ; Liver ; Middle Aged ; Neurologic Manifestations ; Neurology ; Seizures ; Valproic Acid

PURPOSE: To investigate postoperative incidence of complications and functional results between two groups, primary bipolar hemiarthroplasty and internal fixation with compression hip screw on unstable intertrochanteric fractures of the femur with severe osteoporosis in elderly patients. MATERIALS AND METHODS: 78 cases treated under unstable intertrochanteric fractures of the femur with severe osteoporotic elderly patients from March 1997 to August 2001 who have been followed up for more than a year were evaluated retrospectively between the group of bipolar hemiarthroplasty, 38 cases out of 60 cases and group of compression hip screw, 40 cases out of 59 cases. The incidence of complications and functional ability according to Merle d'Aubigne scale and the mortality rate were compared using student t-test. RESULTS: The means of Merle d'Aubigne scale for the hemiarthroplasty group and the compression hip screw group were at the last follow up, 15.0 and 13.6 respectively. The differences were statistically significant (p=0.04). Bipolar group revealed significant differences in general (18%) and mechanical complications (5%) between two groups (p<0.05). The mortality rates were 28% and 22% respectively and there were no significant differences statistically (p>0.05). CONCLUSION: We consider that primary bipolar hemiarthroplasty would be better method in the treatment of the unstable femoral intertrochanteric fracture with severe osteoporosis but we need much longer follow up.
Aged* ; Femur* ; Follow-Up Studies ; Hemiarthroplasty* ; Hip Fractures* ; Hip* ; Humans ; Incidence ; Mortality ; Osteoporosis ; Retrospective Studies

PURPOSE: To compare the clinical, radiologic results and complications between the patellar non-resur-faced and resurfaced cases in total knee arthroplasty. MATERIALS AND METHODS: From March 1998 to May 2003, the subjects were 37 patellar non-resurfaced and 45 patellar resurfaced cases followed up more than a year among the patients who had total knee arthroplasty in degenerative arthritis. The results were evaluated by the range of motion, Hospital for Spe-cial Surgery (HSS) knee rating score, and Laurin's and Merchant's congruence angle. Student t-test was used in statistical analysis in comparison of both groups. RESULTS: In non-resurfaced group, the range of motion was incrased from 90.6 degree preoperatively to 108.6 degree postoperatively and HSS score from 62.6 to 84.1 respectively, while in resurfaced group, range of motion was increased from 88.2 degree preoperatively to 110.4 degree postoperatively and HSS score from 59.3 to 85.3. There were no significant differences between two groups (p>0.05). There were some patella-asso-ciated complications in each group, and revision due to patella-associated complications were 1 case (3%) and 2 cases (4%) each. So, patella-associated complications and revision rates revealed no significant dif-ferences (p>0.05). CONCLUSION: There is no difference in the clinical results and complications between patella resurfacing and selective non-resurfacing with relatively good cartilage, More follow up is needed for the necessity of revision due to patella-associated complications.
Arthroplasty* ; Cartilage ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Patella ; Range of Motion, Articular