Streptococcus anginosus is a member of Streptococcus milleri group, and is found in the oral mucosa, respiratory tract, and gastrointestinal tract as normal flora. It can develop into a disease in patients with deteriorating clinical condition or with clinical risk factors. A previously healthy 15-year-old boy was admitted due to fever, abdominal discomfort and vomiting which lasted for 7 days. He had a history of dental procedure 1 day before the development of fever. He was diagnosed with acute acalculous cholecystitis based on the clinical, laboratory, and imaging finding, and S. anginosus was isolated from the blood culture. The patient was successfully treated with antibiotic therapy.
Acalculous Cholecystitis ; Adolescent ; Bacteremia ; Cholecystitis ; Fever ; Gastrointestinal Tract ; Humans ; Mouth Mucosa ; Respiratory System ; Risk Factors ; Streptococcus ; Streptococcus anginosus ; Streptococcus milleri Group ; Vomiting

No abstract available.
Priapism*

No abstract available.
Priapism*

Ameloblastic fibrosarcoma is an extremely rare variety of odontogenic tumor. It has not previously been reported in Korea. The tumor is composed of benign odontogenic epithelium with a mesenchymal part which exhibits the histologic features of fibrosarcoma. We have reported a case of amloblastic fibrosarcoma of the mandible in a 26-year-old man with swelling of right mandible for 2 weeks. The tumor showed yellowish ill-demarcated ulcerating mass involving right premolar and molar area. Light microscopy revealed irregularly arranged strands and islands of odontogenic epithelium surrounded by abundant mesenchymal tissue with the feature of fibrosarcoma. The fibrosarcoma cells were strong positive on immunostain for vimentin and ameloblastic cells were weakly positive for cytokeratin. S-100 and CEA were negative in both epithelial and sarcoma cells. The sarcoma cells were corresponding to fibroblasts on the electron microscopy with abundancy of RER and mitochondria and covering of basal lamina. Two types of virus like particles were distributed in the cytoplasm and nuclei of sarcoma cells. We treated the patient with surgery and chemotherapy. The recovery was uneventful and the prognosis is under observation.
Male ; Humans

This study was performed to investigate the effect of endotoxin to the CCl4-induced liver injury. Twelve Sprague-Dawley rats were intraperitoneally injected 1.6 g/kg CCl4 as control group. Another 24 rats were orally administrated 300 mg/kg of neomycin at 16 and 3 hours prior to CCl4 injection as experimental group. Twelve among them were intraperitoneally infected 1.0 mg/kg of endotoxin(E-Coli, 0111:B4, No L-2630, lipopolysaccharide, Sigma, USA) and CCl4 simultaneously for offsetting neomycin effect. The rats were sacrificed at 1, 4, 10, and 24 hours after CCl4 injection. The liver tissues from all experimental groups were observed by light and electron microscopy. The results obtained were summarized as follows: In the CCl4 only group, the hepatocytes revealed sweling of ER and mitochondria with many lipid droplet in the cytoplasm. Focal cellular necrosis was seen at the later phase. The Kupffer cells were activated and showed many cytoplasmic processes, secondary lysosomes, and vaculoles. The endothelial cells were edematous. Several neutrophils, platelets, and microthrombi were scattered in the sinusoid. In the neomycin-CCl4-endotoxin administrated group, both hepatocytic destruction and intrasinusoidal microthrombi formation were more pronounced. In the neomycin pretreated group, the hepatocytes revealed mild cellular destruction without necrosis. There is no intrasinusoidal microthrombi. According to these results, it would be concluded that the small dosage of gastrointestinal tract-derived endotoxin affects to the liver injury caused by CCl4. The synergistic effects of CCl4 and gastrointestinal tract-derived endotoxin which can not be detoxified by damaged Kupffer cells, may be more important in the pathogenesis of CCl4-induced liver injury.
Rats ; Animals

Hansen's disease(HD) is a chronic infectious disorder acquired by inoculation of Mycobacterium leprae. With the establishment of complex multidrug therapy, the incidence rate of leprosy patients has continually shown to decline by 90% compared to the incidence rate in the 1990s. However, the prevalence of the disease still remains high in southeast asian countries. Due to the rarity and diverse nature of cutaneous presentation, HD is often misdiagnosed with other dermatoses or infectious conditions. Especially, when a patient presents with unusual presentation with leprosy reaction with no classical feature such as sensory disorders and skin lesion, the diagnosis is further delayed with misguided treatments. Herein we present a 27-year-old Indonesian immigrant who displayed clinical features mimicking that of orbital cellulitis who was later diagnosed with borderline lepromatous leprosy through histologic and PCR confirmation, in light of alerting the probability of leprosy in immigrants with intractable skin presentations.
Adult ; Asian Continental Ancestry Group ; Diagnosis ; Emigrants and Immigrants ; Humans ; Incidence ; Leprosy ; Leprosy, Borderline ; Leprosy, Multibacillary ; Mycobacterium leprae ; Orbit ; Orbital Cellulitis ; Polymerase Chain Reaction ; Prevalence ; Sensation Disorders ; Skin ; Skin Diseases

Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristic of a malignant nature. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 23-year-old woman which had invaded the cervical spine. The patient presented with severe both shoulder pain, left upper extremity weakness(Grade IV) and paresthesia at admission. Radiologic studies of the cervial spine showed an aggressive osteolysis of C4 vertebral body, pedicle and lamina with compression of the spinal cord posteriorly on C3, C4, C5 levels. The tumor was totally removed by a combined anterior and posterior approach. The removed vertebral body was replaced with autogenous bone and stabilized by Codman locking plate symtem. The pathological examination showed characteristic of mesenchymal chondrosarcoma.previous symptoms well improved postoperatively. The authors present a case of mesenchymal chondrosarcoma with review of literature.
Chondrosarcoma, Mesenchymal* ; Female ; Humans ; Osteolysis ; Paresthesia ; Shoulder Pain ; Spinal Cord ; Spine* ; Upper Extremity ; Young Adult

The persistent primitive trigeminal artery is the most common of the carotid-basilovertebral anastomoses and is located in the most cephalic portion of them. Embryologically arising from the internal carotid artery in the 4mm embryo, it supplies the longitudinal neural artery. Failure of regression of the trigeminal artery in the 14mm embryo results in the persistent primitive trigeminal artery. It is associated with a vascular anomaly in 25% of the cases, such as aneurysm, arteriovenous malformation, agenesis or hypoplasia of the internal carotid artery, and moyamoya disease. The authors present a case of persistent primitive trigeminal artery aneurysm presenting with the abducens nerve palsy. The clinical features of the persistent primitive trigeminal artery aneurysm are discussed, with the review of literature.
Abducens Nerve Diseases ; Aneurysm* ; Arteries* ; Arteriovenous Fistula ; Carotid Artery, Internal ; Embryonic Structures ; Equipment and Supplies ; Moyamoya Disease

Cystic mesothelioma of the peritoneum is a very rare tumor which has a clinically and histologically benign nature. It occurs predominantly in young to middle-ged women and tends to recur locally. It affects chiefly the pelvic peritoneum-articularly the cul-e-ac, uterus, and rectum. We report a case of cystic mesothelioma of the visceral peritoneum which was located anterior to the ascending colon. A 54-ear-ld female patient visited our hospital with a palpable tender mass in the right flank. A computed tomographic scan of the abdomen showed a multicystic mass with an enhancing wall and septum in front of the ascending colon. The patient underwent a right hemicolectomy, and the mass was completely removed. Grossly, the tumor consisted of a multilocular cyst containing clear, serous, or gelatinous fluid and partially solid areas. Microscopically, the solid areas were composed of fibrous tissue, and the lining cells varied from flattened to cuboidal cells with a strong positive reactivity for cytokeratin and mild positive reactivity for epithelial membrane antigen on immunohistochemical staining. These findings suggest that the tumor was mesothelial in origin.
Abdomen ; Colon* ; Colon, Ascending ; Female ; Gelatin ; Humans ; Keratins ; Mesothelioma, Cystic* ; Mucin-1 ; Peritoneal Neoplasms ; Peritoneum ; Rectum ; Uterus

We herein describe a 70-year-old woman who presented with respiratory failure due to extensive lung adenocarcinoma. Despite advanced disease, care in the intensive care unit with ventilator support was performed because she was a newly diagnosed patient and was considered to have the potential to recover after cancer treatment. Because prompt control of the cancer was needed to treat the respiratory failure, empirical treatment with an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was initiated before confirmation of EGFR-mutant adenocarcinoma, and the patient was successfully treated. Later, EGFR-mutant adenocarcinoma was confirmed.
Adenocarcinoma* ; Aged ; Female ; Humans ; Intensive Care Units ; Lung* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilators, Mechanical ; Erlotinib Hydrochloride