Membranous lipodystrophy is a peculiar type of fat necrosis, present in patients with various types of skin diseases. It is charaeterized by the presence of microcysts and macrocysts lined by amorphous eosinophilic material with a crenelated arabesque appearance and microgranules in the subcutis with massive fat necrosis. The eosinophilic lining and microgranules stain positively with periodic acid-Schiff, are resistant to diastase, and also stain with Sudan black B. We report three cases of subcutanous membranous lipodystrophy in patients with erythema induratum, posttraumatic panniculitis and morphea with typical clinical and histopathologic findings.
Amylases ; Eosinophils ; Erythema Induratum ; Fat Necrosis ; Humans ; Lipodystrophy* ; Panniculitis ; Scleroderma, Localized ; Skin Diseases ; Sudan

Eosinophilic panniculitis is characterized by a prominent infiltration of numerous eosinophils in subcutaneous fat, and has been identified in patients with a variety of associated clinical conditions. A case of eosinophilic panniculitis in a 20-year-old woman with a history of atopic dermatitis is reported. She later developed superior sagittal sinus thrombosis, and we stress the importance of systemic evaluations in patients with eosinophilic panniculitis.
Dermatitis, Atopic ; Eosinophils* ; Female ; Humans ; Panniculitis* ; Subcutaneous Fat ; Superior Sagittal Sinus* ; Thrombosis* ; Young Adult

clinical and radiologic findings that mainly involve the white/gray matter of the parieto-occipital lobes. The purpose of this study was to determine its clinical and radiological characteristics. METHODS: A total of 15 pateints were involved in the study. Their medical records and radiological features of brain MRI were retrospectively reviewed and analyzed. RESULTS: Fifteen pateints were involved. (9 males and 5 females). The patients' ages ranged from 2-20 years (mean age:10 years). The brain MRI revealed fairly symmetric areas of increased T2 signal involving both white and gray matter of parieto-occipital regions. The condition seemed to be associated with cyclosporin A and steroid therapy or a variety of other conditions in which blood pressure rises acutely. CONCLUSION: Reversible posterior leukoencephalopathy syndrome is a complicated neurological condition, but a better understanding of this complex syndrome may obviate unnecessary investigations and lead to prompt and appropriate management of the associated problems.
Blood Pressure ; Brain ; Child* ; Cyclosporine ; Humans ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Male ; Medical Records ; Posterior Leukoencephalopathy Syndrome* ; Retrospective Studies ; Seizures

No abstract available.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Porokeratosis*

No abstract available.
Actinomycosis* ; Hemoptysis*

BACKGROUND/AIMS: Ecabet sodium is used for treating gastric ulcers and gastritis. It exhibits a bactericidal effect against Helicobacter pylori by inhibiting bacterial urease activity. Thus, ecabet sodium has been suggested to improve the efficacy of the H. pylori eradication in patients with peptic ulcers. The aim of this study was to compare the H. pylori eradication rate of lansoprazole-based triple therapy versus lansoprazole-based triple therapy plus ecabet sodium. METHODS: The subjects consisted of 363 H. pylori-positive patients who had undergone eradication therapy from February 2007 to February 2010. In total, 363 patients with H. pylori-positive peptic ulcer disease or symptomatic erosive gastritis received LAC (lansprazole 30 mg b.i.d., amoxicillin 1.0 g b.i.d., clarithromycin 500 mg b.i.d.) or LACE (lansoprazole 30 mg b.i.d., amoxicillin 1.0 g b.i.d., clarithromycin 500 mg b.i.d., ecabet sodium 1 g b.i.d.) for 1 week. Successful eradication was defined as a negative 13Curea breath test 4-5 weeks after treatment completion. RESULTS: H. pylori eradication rates were 81.4% (166/204) in the LAC group and 86.2% (137/159) in the LACE group (p = 0.159). No significant difference in eradication was observed. No significant difference was observed in the side effects experienced by the patients in the two treatment groups. CONCLUSIONS: Our results suggest that adding ecabet sodium did not improve the H. pylori eradication rate significantly in standard lansoprazole-based triple therapy for H. pylori.
Amoxicillin ; Breath Tests ; Clarithromycin ; Diterpenes, Abietane ; Gastritis ; Helicobacter ; Helicobacter pylori ; Humans ; Peptic Ulcer ; Prospective Studies ; Sodium ; Stomach Ulcer ; Urease

Unilateral keratosis fotlicularis has the same histological features of classic Darier's diseases and is considered to be a localized variant of Darier's disease. Unlike classic Darier's disease, it is not related to family history but with a later age of onset, unilateral and linear lesions. Lack of solar aggravation and increased irritation from sweating also characterize this disease. A 45-year-old female presented with scaly follicular papules in a linear distribution limited to one side of her lower extremity. There was no family history or other signs of Darier's disease elsewhere in the body. Histopathological features were typical of acantholytic dyskeratosis. The condition was aggravated during the summer and regressed with residual pigmentation after topical application of corticosteroid and tretinoin.
Age of Onset ; Darier Disease* ; Female ; Humans ; Keratosis* ; Lower Extremity ; Middle Aged ; Pigmentation ; Sweat ; Sweating ; Tretinoin

BACKGROUND:Epidural anesthesia has been shown to have a direct sedative effect, and to markedly reduce the hypnotic requirement of intravenous anesthetics. The purpose of this study was to investigate whether the level of sensory block by epidural anesthesia is related with the degree of sedation, and to the hypnotic requirement of propofol. In addition, we tested whether bispectral index (BIS) monitoring can quantify the sedative effects of epidural anesthesia. METHODS: Thirty two patients scheduled for elective upper abdominal or lower extremity surgery were allocated into two groups. 2% lidocaine 15 ml was administered through an epidural catheter at the T9 T10 level (group T, n = 16) or at the L3-L4 level (group L, n = 16). Observer's assessment of alertness/sedation (OAA/S) and BIS were evaluated 20 min after the epidural injection. Hypnotic doses of propofol were then determined by evaluating the loss of open eyes in response to a verbal command as an end point while propofol was administered by target controlled infusion (target effect concentration 5microgram/ml, induction time 3 min). At the time of induction of hypnosis, the target effect concentration and BIS were recorded. RESULTS: The average level of sensory block was up to T3 in group T, and up to T11 in group L. Compared with the group L, more decreases were noticed in group T in terms of the hypnotic dose of propofol (1.13+/-0.31 mg/kg vs. 1.67+/-0.36 mg/kg; P = 0.03). A decrease in the OAA/S scale from 5 to 4 was more frequently noticed in group T than in group L (93.7% vs. 12.5%, P < 0.05). BIS recorded at the time of induction of hypnosis was higher in group T than in group L (94.8+/-2.8 vs. 82.6+/-2.2; P < 0.001). CONCLUSIONS: A higher sensory block observed in group T than in group L induced a more profound sedative effect and hypnotic induction with a lesser dose of propofol. These results support the condition that the level of sensory block by epidural anesthesia affects the degree of sedation. Moreover, BIS monitoring could not quantify the sedative effect induced by epidural anesthesia.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics, Intravenous ; Catheters ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Injections, Epidural ; Lidocaine ; Lower Extremity ; Propofol

Myofascial pain syndrome is defined as the sensory, motor and autonomic symptoms caused by the myofascial trigger points. The sternocleidomastoid muscle is a complex muscle that frequently contains multiple trigger points. These trigger points cause symptoms that are easily misdiagnosed as other conditions. Earache of unexplained origin is likely to be caused by trigger points in the clavicular division of the sternocleidomastiod muscle. The authors report a case of earache caused by a trigger point in the sternocleidomastoid muscle. A 34 year-old woman had earache without any history of trauma or infection. The patient did not have any abnormal finding by otolaryngologic testing, except for an earache, which had not subsided. On physical examination, trigger points in the clavicular division of the sternocleidomastiod muscle were found, and the earache was successfully treated by trigger point injections.
Adult ; Earache* ; Facial Neuralgia ; Female ; Humans ; Myofascial Pain Syndromes ; Pain, Referred ; Physical Examination ; Trigger Points*

Carcinoid tumors are low-grade malignant tumors arising from neuroendocrine cells. Primary renal carcinoid tumors are extremely rare, and only 56 cases have been reported in the literature. Because of the rarity of the lesion, its histogenesis and prognosis are unclear. Here we report a case of a primary renal carcinoid tumor in a 51-year-old man that was found incidentally in a medical examination and was treated by transperitoneal radical nephrectomy.
Carcinoid Tumor ; Humans ; Kidney ; Middle Aged ; Nephrectomy ; Neuroendocrine Cells ; Prognosis