A 68 year-old woman visited our hospital because of constipation and hematochezia. Colonoscopy revealed an invasive fungating mass with a narrowing of lumen and severe ulceration at the sigmoid colon. An abdominal/pelvic CT scan showed an irregular wall thickening with a 10cm long narrowing at the sigmoid colon, and a 2 cm long right adrenal mass. We did an anterior resection and adrenalectomy. The histology of the specimens of the resected sigmoid colon and adrenal gland was the same. Finally, we diagnosed this case as being an adrenal metastasis from an advanced sigmoid colon cancer. The patient has been well for a year since the adrenalectomy, and been treated by the oral chemotherapeutic agent: doxifluridine 600 mg, leucovorin 90 mg.
Adrenal Glands ; Adrenalectomy* ; Aged ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms* ; Colonoscopy ; Constipation ; Female ; Gastrointestinal Hemorrhage ; Humans ; Leucovorin ; Neoplasm Metastasis* ; Sigmoid Neoplasms ; Tomography, X-Ray Computed ; Ulcer

No abstract available.
Dermatitis, Seborrheic* ; Lice Infestations*

No abstract available.
Dermatitis, Seborrheic* ; Lice Infestations*

Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

Ancient schwannoma is a variant of schwannoma characterized by slow progression, degenerative changes, and a higher incidence in older adults. There have been two prior reported cases of ancient schwannoma arising from the distal ulnar nerve at the wrist level, but neither were longstanding or very large. Herein, we report an ancient schwannoma found in the ulnar nerve of the distal forearm that was found to be clinically meaningful in size. A 61-year-old man presented with complaints of tingling sensation of the fourth and fifth fingers and bulging of the ulnar side of the wrist. The patient reported that the mass in his wrist had grown very slowly, starting about 10 years ago, and that he had started experiencing a tingling sensation in his fourth and fifth fingers about 3 years prior, which had become worse in the past year. Based on the results of the preoperative examination, a benign nerve sheath tumor was suspected. As it was thought that the possibility of malignancy was not high, we elected to perform a marginal excision. Pathological examination confirmed ancient schwannoma. At his most recent visit, 3 years after surgery, he reported no recurrence and that he felt better than before surgery, but some tingling sensations remained. As with small ancient schwannoma in the distal wrist, most cases of large ancient schwannoma can be treated without special complications based on an accurate preoperative diagnosis.

BACKGROUND: During and immediately after percutaneous transluminal coronary angioplasty(PTCA), reversible ischemic electrocardiographic change and/of left ventricular dysfunction are developed. But it is not investigated whether there are potential myocardial cell damages following PTCA or not, and the clinical Significance of myocardial cell damage following PTCA. Recently cardiac Troponin-T has been developed as a new myocardial specific marker, especially myocardial damage. The object of this study is to investigate whether potential Myocardial damage following PTCA was occurred and the utility of cardiac Tropoin-T for predicting the complications during and immediately after PTCA. METHODS: The study group comprised 12 patients(M/F;8/4mean age;60 +/- 4year,AMI in 6) undergoing PTCA, Samples for Troponin-T were obtained before, directly after, after 2 hours, 6 hours, and after 12 hours and was determined by enzyme immunoassay on an ES 300 analyzer(Boehringer Mannheim). Discrimination limit for myocardial cell damage is 0.1 ng/ml in normal baseline level but if the baseline level is elevated such as acute myocardial infarction or unstable angina, myocardial cell damage is defined with further increase of cardiac Troponin-T(>0.1 ng/ml) compare to baseline level. RESULTS: 1) The mean duration of total balloon inflation is 10.7 +/- 2(3-22) minutes and the mean duration of single maximal inflation is 3.9 +/- 0.6(1-8) minutes. There are no significant change in concentration of Troponin-T by inflation time. None of the patients showed electroca rdiographic evidence for myocardial infarction. 2) Troponin-T were increased in 2 patients with unstable angina(0.01 vs 0.11 ng/ml) which were developed major dissection including acute closure during PTCA, and 2 patients with acute myocardial infarction(2.37 vs 3.73 ng/ml) which didn't developed dcomplication. The increase of cardiac Troponin-T were observed in 2 of 10 patients with uncomplicated PTCA(20%). 3)The subacute complications were not developed. CONCLUSION: The cardiac Troponin-T were increased significantly in two AMI patients with uncomplicated PTCA(2/10,20%). The increase of cardiac Troponin-T following PTCA is associated with periprocedural complications but the prognostic significance to detect postprocedural complication did not define in this study because there were no subacute complications after PTCA and may be limited value due to time course of complication(usaully within 1 hour after PTCA) and relatively long analytic time.
Angina, Unstable ; Discrimination (Psychology) ; Electrocardiography ; Humans ; Immunoenzyme Techniques ; Inflation, Economic ; Myocardial Infarction ; Troponin T* ; Ventricular Dysfunction, Left

Scleroderma renal crisis is defined as the new onset of accelerated arterial hypertension and/or rapidly progressive oliguric renal failure. The pathogenesis is not well understood but there is increasing evidence that renin- angiotensin system is involved. We report an one female patient with diffuse scleroderma and renal crisis. Initial treatment with ACE inhibitor was not effective in controlling blood pressure until the temporal initiation of hemodialysis. Predialysis serum creatinine level was 8.4 mg/dL, but after initiation of hemodialysis, adequate control of blood pressure was achieved with ACE inhibitor alone. This case illustrated many features of the syndrome of scleroderma renal crisis and supported the early use of captopril and emergency hemodialysis if indicated.
Angiotensins ; Blood Pressure ; Captopril ; Cough* ; Creatinine ; Emergencies ; Female ; Humans ; Hypertension ; Renal Dialysis ; Renal Insufficiency ; Scleroderma, Diffuse ; Tic Disorders* ; Tics*

Anti-thrombin III deficiency is known as a disease of autosomal dominant trait and relatively common, but in Korea, exact incidence and mortality is not known, In general, Anti-thrombin III deficiency is expressed to venous thromboembolism like deep vein thrombosis or pulmonary embolism. But, arterial embolism is very rare. We experienced a case of Antithrombin III deficiency expressed as myocardial infarction of inferior wall by huge thrombosis in the mid and distal right coronary artery.
Antithrombin III Deficiency ; Coronary Vessels ; Embolism ; Incidence ; Korea ; Mortality ; Myocardial Infarction* ; Pulmonary Embolism ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis