Multiple endocrine neoplasi~a type 3 is a rare, heritable or sporadic, multiple neoplastic disorder that is charracterized by thyroid medullary careinoma, pheochromocytoma, multiple mucosal neuroma, and marfanoid habitus. The most important disorder of the syndrome is mucosal neuroma that is an early diagnostic sign of multiple endocrine neoplasia type 3. Early diagnosis of MEN type 3 determines prognosis of the disease. We present a case of multiple endocrine neoplasia type 3 of the sporadic pattern in a 27-year-old man who had typical medullary thyroid carcinoma, mucosal neuroma, marfanoid habitus, and megacolon.
Adult ; Early Diagnosis ; Humans ; Male ; Megacolon ; Multiple Endocrine Neoplasia* ; Neuroma* ; Pheochromocytoma ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

We report a case of a 6-month-old female who had had verrucous hemangioma since birth. The lesions were dark red, verrucous surfaced, hyperkeratotic papules on the right sole. A histopathological examination showed hyperkeratosis, papillomatosis, irregular acanthosis, lobular proliferation and dilatation of blood vessels in the deep dermis with a gap devoid of vessel proliferation in the mid dermis.
Blood Vessels ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Infant ; Papilloma ; Parturition

No abstract available.
Animals ; Jaundice, Obstructive* ; Liver Regeneration* ; Liver* ; Rats*

Feasibility and neurologic complications accompanying spinal anesthesia with variable specific gravities were examined in 56 lumbar disc operation from March 1977 to October 1978. Patients' age ranged from 21 to 36 years with 54 cases of males and 2 females. On myelography, lateral and partial blocks were observed in 50 cases and total blocks in 6 cases. These cases were classified depending on the specific gravity and local anesthetics as follows: .Isobaric group: a) 1% tetracain solution, ampule, mixed with C.S.F., 20 cases. b) tetracaine powder with C.S.F., 11 cases. c) 10% procaine solution with C.S.F., 9 cases. .Hyperbaric group: 1% tetracaine solution with 10% dextrose in water, 10 cases. . Hypobaric group: tetracaine powder with water, 6 cases. Under isobaric, hyperbaric and hypobaric spinal anesthesia, good to excellent results were obtained in 90, 90 and 16.6% respectively. More than 10% of systolic blood pressure fall after block was seen in 15, 90 and 16.6% respectively. No neurologic sequalae were observed. Isobaric spinal anesthesia with tetracaine solution is indicated as safer for recently herniated lumbar disc operations.
Anesthesia, Spinal* ; Anesthetics, Local ; Blood Pressure ; Female ; Glucose ; Humans ; Male ; Myelography ; Procaine ; Specific Gravity ; Tetracaine ; Water

Descending necrotizing mediastinitis (DNM) is one of the most lethal form of mediastinitis originating from an oropharyngeal infection. It requires an early and aggressive sugical treatment, but the operative approach and optimal form of mediastinal drainage remains controversial. We report a case of DNM in a 45-year-old male who underwent right cervicomediastinotomy to drain the deep neck space, upper mediastinum and anterior mediastinal drainage was accomplished through a subxiphoid approach. After this procedure, he steadily improved and was dischrged on hospital day 36. We report this case with a brief review of the literature.
Drainage ; Humans ; Male ; Mediastinitis* ; Mediastinum ; Middle Aged ; Neck

No abstract available.
Fractures, Open*

BACKGROUND: Vascular lesions can be diagnosed by biopsy, simple x-ray, ultrasound, CT, MRI, venography and MR angiography. These diagnostic tools can identify the detailed structure and abnormalities in the peri-lesional area of vascular lesions. Color Doppler ultrasound (CDU) can demonstrate the hemodynamic features, distribution of veins and arteries, shunts and structures of vascular lesions. Authors have tried to categorize vascular lesions with CDU and also applied this to the selection of treatment methods. MATERIALS AND METHODS: Forty-seven vascular lesions were evaluated by means of CDU. All patients underwent a complete clinical evaluation as well as peak systolic velocity (PSV), peak diastolic velocity (PDV), resistive index (RI) of feeding arteries. In particular, we evaluated the hemodynamic features and structures of vascular lesions. We categorized the vascular lesions and then treated them with systemic steroid, compression, SPTL1 Dye laser, steroid intralesional injection and sclerotherapy. We evaluated the clinical improvement and objective effects of treatments by CDU. RESULTS: There were 37 hemangiomas and 10 vascular malformations. Vascular lesions were classified by the hemodynamic features and structures: category Ia (infantile hemangioma, regressed infantile hemangioma), Ib (RICH), Ic (deep hemangioma, mixed hemangioma), II (arteriovenous malformation), III (venous malformation, verrucous hemangioma). The clinical improvement after treatment was associated with the decrease of PSV and RI values. The clinical improvement above 50% resolution of the lesion showed 70.9% in category Ia, 50% in Ib, 66.6% in Ic, 83.3% in II and 50% in III. CONCLUSIONS: The analysis of hemodynamic feature and structures by CDU can be helpful in the study of vascular lesions. These processes suggest CDU be a useful modality in differential diagnosis of vascular lesions and a more advantageous tool in the decision of treatment policy than the conventional modalities. And it is also useful for the evaluation of treatment effects.
Angiography ; Arteries ; Biopsy ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Injections, Intralesional ; Lasers, Dye ; Magnetic Resonance Imaging ; Phlebography ; Sclerotherapy ; Ultrasonography* ; Vascular Malformations ; Veins

Dieulafoy's lesion is a rare distinetive arterial malformation that can cause massive gastrointestinal henorrhage. Although in most cases the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction, similar lesions have been described in the antrum, duodenum, jejunum, colon, and rectum. We report 3 unusually located Dieulafoy-like lesion, two gastric antrum and one jejunum in patient who had gastrojejunostomy for pancreatic caneer. After a year follow up there was no bleeding episode in patient after endoscopic treatment.
Colon ; Duodenum ; Esophagogastric Junction ; Follow-Up Studies ; Gastric Bypass ; Hemorrhage ; Humans ; Jejunum* ; Pyloric Antrum* ; Rectum ; Stomach

The direct antiglobulin test (DAT) is used in investigating autoimmune hemolytic anemia, drug-induced antibodies, hemolytic diseases of newborn and alloimmune reactions to recently transfused red cells. We performed 3,033 DATs in our blood bank from 1985 to 1992. When using a polyspecific antihuman globulin reagent, the DAT was positive in 7.2% of all cases tested. In further studies using monospecific anti-IgG and anti-C3d reagents, three patterns of reactivity were founded: in 37% of cases, red cells are coated with IgG alone; in 18% of cases, the red cells are coated with both IgG and complement; and in 45% of cases only with complement. We evaluated clinical significance of DAT positive results with the 227 patients' medical records which can be available for reviewing among the positive DAT patients. The male to female ratio of DAT positive patient was 1:2 and 41% of cases were belong to the 20-30 years old age group. The most common underlying disorders were systemic lupus erythematosus (29.5%), idiopathic (10.1%), hematologic malignancy (8.8%), and liver disease (6.2%). Patients with warm reactive autoantibodies account for 60.4% of all DAT positive cases. Cold reactive autoantibodies were demonstrated in 11%, and the mixed-types were 2.6%. Drug-induced DAT positive findings were observed in 15.4% and the DAT positve caused with transfusion associated alloantibodies were 7.5%. IgG warm-reactive autoagglutinins were more commonly detected in patients with autoimmune hemolytic anemia and drug induced hemolysis. Definite hemolysis was present in 37% of all DAT positive patients and especially in all patients with mixed type autoagglutinin. Drugs caused a positive DAT were cephalosporin, penicillin, isoniazid, and rifampicin.
Anemia, Hemolytic, Autoimmune ; Antibodies ; Autoantibodies ; Blood Banks ; Complement System Proteins ; Coombs Test* ; Female ; Hematologic Neoplasms ; Hemolysis ; Humans ; Immunoglobulin G ; Indicators and Reagents ; Infant, Newborn ; Isoantibodies ; Isoniazid ; Liver Diseases ; Lupus Erythematosus, Systemic ; Male ; Medical Records ; Penicillins ; Rifampin

A retrospective analysis of 122 consecutive of rhegmatogenous retinal detatchment cases which obtained successful surgical results was performed. All the cases were followed for longer than 1 year postoperatively. 15 eyes (12.3%) developed macular pucker. There was no significant difference in sex distribution and mean age was 43.7 years. The mean lapse time between surgery and the development of macular pucker was 7.2 months. Significant factors for developing macular pucker were multiple operation, preoperative macular detachment, and duration of retinal detachment (longer than 1 month). Other factors such as subretirial fluid drainage and myopia were not significant. 9 of 15 eyes with macular pucker were treated with vitrectomy and visual acuity improved in 66.7% of surgically treated eyes. These results suggest that success with single surgical procedure, operation before macular detachment, and early treatment of retinal detachment are important for preventing postsurgical macular pucker.
Drainage ; Myopia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Sex Distribution ; Visual Acuity ; Vitrectomy