No abstract available.
Colon* ; Colonic Neoplasms* ; Humans ; Vaccination*

Purpose: To answer the questions of ambulation dependency for risk of urolithiasis, the urinary lithogenic factors in normal controls were compared with long hospital stay immobilized patients. Materials and Methods: Fifty immobilized patients and twenty normal controls, on usual constant regular diet, were evaluated with 24-hour urine for the excretion rate differences of lithogenic and inhibitory constituents, such as volume, pH, calcium, phosphorus, uric acid, oxalate, citrate, magnesium, sodium, potassium, chloride and creatinine. The incidence of metabolic abnormalities in the immobilized patients was also evaluated. Results: The immobilized patients showed significantly increased excretions of uric acid, oxalate, sodium, potassium, urine volume, but decreased excretions of citrate and magnesium (p<0.05). No differences were found between the two groups with regard to urinary excretions of calcium, phosphate, creatinine and chloride or in the pH of excretions. The frequent metabolic abnormalities in the immobilized patients were hypomagnesuria (92%), hypocitraturia (86%), hyperoxalaturia (82%), hypernatriuria (44%), hyperuricosuria (16%) and hypercalciuria (12%). Conclusions: These results reveal that hypomagnesuria, hypocitraturia and hyperoxalaturia were the most important risk factors for urolithiasis in the immobilized patients. However, a further controlled prospective study will be needed with regard to the influence of ambulation.
Calcium ; Citric Acid ; Creatinine ; Diet ; Humans ; Hydrogen-Ion Concentration ; Hypercalciuria ; Immobilization* ; Incidence ; Length of Stay ; Magnesium ; Oxalic Acid ; Phosphorus ; Potassium ; Risk Factors ; Sodium ; Uric Acid ; Urinary Calculi ; Urolithiasis ; Walking

Portal vein thrombosis (PVT) is an uncommon cause of presinusoidal portal hypertension. Among various hepatoportal disorders, noncirrhotic portal hypertension conditions such as idiopathic portal hypertension (IPH) are considered to have a close relation with PVT. PVT is known to have several predisposing conditions, including infection, malignancies, and coagulation disorders. There is growing interest and recognition that deficiencies in proteins C and S are associated with a hypercoagulable state. These deficiencies are regarded as key factors of systemic hypercoagulability and recurrent venous thromboembolism. We report the case of a 19-year-old male diagnosed as IPH with PVT and combined deficiencies in proteins C and S.
Humans ; Hypertension, Portal/complications/*diagnosis/pathology ; Male ; *Portal Vein ; Protein C Deficiency/*complications ; Protein S Deficiency/*complications ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*diagnosis/pathology ; Young Adult

PURPOSE: Spontaneous bacterial peritonitis (SBP) frequently develops in patients with liver cirrhosis; however, there is little data to suggest whether the acquisition site of infection influences the prognosis. This study compared the bacteriology, clinical characteristics and treatment outcomes of community-acquired SBP (CA-SBP) and nosocomial SBP (N-SBP). MATERIALS AND METHODS: The medical records of 130 patients with hepatitis B virus (HBV)-related liver cirrhosis, who had experienced a first episode of SBP between January 1999 and December 2008, were reviewed. RESULTS: The study population included 111 (85.4%) patients with CA-SBP and 19 (14.6%) patients with N-SBP. Baseline and microbiological characteristics as well as clinical course, including in-hospital mortality, did not differ between patients with CA-SBP and those with N-SBP (all p>0.05). The median survival time was 6.5 months, and 117 (90.0%) patients died during the follow-up period. Patients with CA-SBP and N-SBP survived for median periods of 6.6 and 6.2 months, respectively, without significant difference (p=0.569). Time to recurrence did not differ between patients with CA-SBP and N-SBP (4.7 vs. 3.6 months, p=0.925). CONCLUSION: The acquisition site of infection did not affect clinical outcomes for patients with HBV-related liver cirrhosis who had experienced their first episode of SBP. Third-generation cephalosporins may be effective in empirically treating these patients, regardless of the acquisition site of the infection.
Community-Acquired Infections/etiology/*microbiology/mortality/virology ; Female ; Hepatitis B virus/*pathogenicity ; Humans ; Liver Cirrhosis/complications/mortality/*virology ; Male ; Middle Aged ; Peritonitis/etiology/*microbiology/mortality/*virology ; Retrospective Studies

The causes of jaundice in patients with hepatocellular carcinoma are usually attributed to the underlying liver diseases or extensive hepatic destruction by tumor. Obstructive jaundice by the intraluminal tumor fragment of intrahepatic and/or extrahepatic bile duct in hepatocellular carcinoma is exceedingly rare and usually diagnosed by operation or autopsy. Recently, we observed a patient in whom the fragment of tumor from the primary hepatocellular carclnoma obstructed the common hepatic duct, which was confirmed by peroral choledochoscopy. Using peroral choledochoscopy. we could see the mass located at the common hepatic duct and diagnose histologically by cytologic examination of aspirated material of common bile duct. We describe here this rare case with review the literature on primary hepatocellular carcinoma with jaundice caused by biliary obstruction.
Autopsy ; Bile Ducts, Extrahepatic ; Carcinoma, Hepatocellular* ; Common Bile Duct ; Hepatic Duct, Common* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Liver Diseases

Malignant melanoma is a neoplasm of the skin and mucous membrane. Extragenital malignant melanoma that metastasizes to the ovary is seen rarely, and in only a few cases has the diagnosis been made before autopsy. The most common histologic feature that should raise the question of metastatic melanoma is the presence of numerous epitheloid cells with abundant eosinophilic cytoplasm. Despite advances in chemotherapy and immunotherapy the efficacy of treatment of advanced melanoma remains limited and the prognosis of metastatic disease remains guarded. We describe a case of malignant melanoma metastatic to the ovary and right axillae occurring one year and four months after diagnosis of cutaneous malignant melanoma on the patient's back.
Autopsy ; Axilla ; Cytoplasm ; Diagnosis ; Drug Therapy ; Eosinophils ; Female ; Immunotherapy ; Melanoma* ; Mucous Membrane ; Ovary* ; Prognosis ; Skin

Authors report a case of cystic tuberculosis of left olecranon in a 44 year-old woman, which mimicked the bone tumor at initial presentation. She complained mild discomfort in the left elbow over a month. On examination there were no local redness, swelling, tenderness and deformity. There was no limitation of left elbow motion. After open curettage of the lesion, bone tuberculosis was confirmed by histological study. Postoperative triple chemotherapy of 12 months (Rifamcpicin, ethambutal, INH) could cure the disease.
Congenital Abnormalities ; Curettage ; Elbow ; Female ; Humans ; Olecranon Process ; Tuberculosis ; Tuberculosis, Osteoarticular

PURPOSE: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. MATERIALS AND METHODS: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. RESULTS: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. CONCLUSION: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.
Ankle ; Follow-Up Studies ; Foot ; Humans ; Metatarsal Bones* ; Methods ; Retrospective Studies

The pregnancy-associated breast cancer is one of the most common malignancy developed during pregnant period and occupies 1-2% of the all breast cancer patients. There is no evidence to implicate pregnancy or lactation in either the etiology and the progression of breast cancer. Careful breast examination early in the pregnancy is very important to find solid masses before breast engorgement hides them. But unfortunately, delay in the diagnosis is common and most of patients with operable primary lesions have positive axillary lymph nodes. The treatment of choice is the modified radical mastectomy and adjuvant chemotherapy. The authors report a patient of breast cancer diagnosed and treated during pregnancy with review of literature.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Humans ; Lactation ; Lymph Nodes ; Mastectomy, Modified Radical ; Pregnancy*

Multiple trichoepithelioma is an autosomal dominant skin disease characterized by the presence of many small papules predominantly on the face. A 12-year-old brother and a 10-year-old sister had small, round, skin-colored papules around the nose for 3~4 years. On history taking, there was no family member with similar skin lesions. Histopathologic study showed typical findings of trichoepithelioma that were basophilic basaloid tumor islands, horn cyst, fibroblastic stroma, and papillary mesenchymal bodies. The lesions were treated with CO2 laser. We experienced and report uncommon and interesting cases of multiple trichoepithelioma in a brother and sister.
Animals ; Basophils ; Child ; Fibroblasts ; Horns ; Humans ; Islands ; Lasers, Gas ; Nose ; Siblings* ; Skin ; Skin Diseases