Purpose: To report a case of both ocular perforation due to periocular acupuncture therapy with vitrectomy in the right eye andbarrier laser photocoagulation without vitrectomy in the left eye.Case summary: A 58-year-old female presented with ocular pain and decreased visual acuity in both eye. She had received periocularacupuncture therapy 4 days earlier. Dilated fundoscopy revealed vitreous hemorrhage. B-scan ultrasonography revealedvitreous opacity. Thus, at the request of the patient, vitrectomy was performed in only the right eye, and did not performed in theleft eye. Intraoperatively, we identified retinal laceration in the temporal and inferior retina. In the left eye, the sites of retinal hemorrhagewere observed in the temporal and inferior retina in the fundus examination, and a barrier laser photocoagulation wasperformed around the lesion. At the three-month postoperative follow-up, the patient’s visual acuity was 0.5 in the right eye withoutmacular edema. In the left eye, visual acuity was 0.01 with macular edema observed on optical coherence tomography. Conclusions Authors present a case of a patient with vitreous hemorrhage and ocular perforations caused by periocular acupuncturetherapy in both eye, able to compare the results of eyes that performed vitrectomy and that did not performed vitrectomyin a same patient. The recovery of visual acuity in eye that performed vitrectomy was better than eye that did not performedvitrectomy. Therefore, we consider performing vitrectomy in patients with eye perforation.

Polyarteritis nodosa is systemic necrotizing vasculitis of medium and small-sized arteries and results in variable manifestations due to ischemia of the involving organs. Diagnosis can either be made pathologically by demonstrating necrotizing vasculitis of arteries or angiographycally by demonstrating small arterial aneurysm. We experienced a case of PAN with dilated cardiomyopathy, confirmed by clinical feature, renal biopsy, angiography and echocardiography.
Aneurysm ; Angiography ; Arteries ; Biopsy ; Cardiomyopathy, Dilated* ; Diagnosis ; Echocardiography ; Ischemia ; Polyarteritis Nodosa* ; Vasculitis

No abstract available.
Pneumonia*

Recently it is known that Turner's syndrome is frequently associated with hypothyroidism. We report a case of Turner's syndrome associated with subclinical hypothyroidism. A 23-year-old female was admitted to the hospital with complaints of amenorrhea and short stature. She had a mosaicism of 45, X0/46, Xi(X_q) in the cell, cultured from the peripheral blood. The plasma thyroxine and triiodothyronine were normal and there was no clinical symptom of hypothyroidism. But the thyroid-stimulating hormone(TSH) concentration was unusually higher(184 uU/L). She has been treated with the cyclic therapy of conjugated estrogen and medroxyprogesterone, in addition to the thyroxine replacement therapy. After 2 months, the menstruation was restored and TSH was normalized.
Amenorrhea ; Cells, Cultured ; Estrogens ; Female ; Humans ; Hypothyroidism ; Medroxyprogesterone ; Menstruation ; Mosaicism ; Plasma ; Thyroxine ; Triiodothyronine ; Turner Syndrome ; Young Adult

PURPOSE: The aim of this study was to evaluate the effectiveness and indication of radiofrequency ablation(RFA) using renal VX2 tumors by implantation of VX2 tumor cells under the renal capsule in rabbits. MATERIALS AND METHODS: Ten rabbits were injected with 30-40microliter VX2 tumor cells(1.2x10(7) viable cells/ml) under the renal capsule of the right kidney by right subcostal incision. On the 14th day after the tumor cells were implanted, we checked for the development of renal tumors, and the sizes and shapes(exophytic or central) of the tumors by the use of computed tomography. We performed RFA in the renal VX2 tumors with a 17G StarBurst electrode through kidney exposure. After the first and third day following RFA, renal function was checked. On the third day, we performed CT and harvested the kidneys for gross and microscopic evaluation. RESULTS: We confirmed the development of renal VX2 tumors in nine cases. Tumor shapes were exophytic in seven cases and central in two cases; the mean size of the tumors was 2.1 cm(range, 1.1-3.8cm). In all tumors, RFA was performed. From the use of enhanced CT after RFA on the third day, all of the lesions treated with RFA showed no enhancement. From the pathological findings, coagulative necroses were seen on all of the lesions treated with RFA. The necrotized tumor size after RFA was not different statistically as measured by CT and a pathological examination (p=0.833) CONCLUSIONS:: In centrally located renal tumors, we experienced thermal injury in pelvocalyceal systems. RFA is an effective method for nephron sparing surgery as the tumor cells completely disappear and there is preserved renal function and the procedure is easy to apply. We suggest that the RFA method for exophytic renal tumors is more effective than other procedures.
Rabbits ; Animals

The Holt-Oram syndrome or cardiomelic syndrome is characterized by the association of upper limb and heart malformations. Most frequently, abnormalities of the thumb and secundum atrial septal defects are associated with the disease. The mode of inheritance is autosomal dominant. The etiology of this disease is unknown but is most likely of multifactorial origin. Here we report a case Holt-Oram syndrome with affected mother which was diagnosed at 18th gestational weeks by prenatal ultrasonograpy. Fetal ultrasonography revealed abnormalities of upper limbs, and heart. The upper limbs were shorter than normal, syndactyly of both hands were seen and both wrists were markedly angulated. Ventricular septal defect was suspicious. After genetic counselling her pregnancy was terminated at 22nd gestational week.
Hand ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Mothers* ; Pregnancy ; Syndactyly ; Thumb ; Ultrasonography* ; Ultrasonography, Prenatal ; Upper Extremity ; Wills ; Wrist

We report two cases of cutaneous Mycobacterium(M.) marinum infections in a 43-year-old man and a 31-year-old woman who had multiple subcutaneous nodules on the left upper extremity and an erythematous ulcer on the right elbow, respectively. Skin biopsy specimens revealed chronic granulamatous inflammation and AFB positive bacilli in the dermis. The culture from tissue specimens on Lowenstein-Jensen media at 30'C for 10 days, yielded cream-colored colonies, which became yellow when exposed to light. The organism was identified as M. marinum by selected biochemical reactions. The patients were treated with surgical excision followed by administration of minocycline and administration of minocycline, respectively.
Adult ; Biopsy ; Dermis ; Elbow ; Female ; Humans ; Inflammation ; Minocycline ; Mycobacterium marinum* ; Mycobacterium* ; Skin ; Ulcer ; Upper Extremity

A clinical observation was made on 116 patients of cryptorchidism who had been admitted to the Department of Urology, Gil Genersl Hospital during 34 months from March, 1992 to January l995. The results were as follows: 1. The age distribution varies from to 1 to 33 years and the most frequent group was l to5 years old(62%). 2. Bilateral cryptorchidism was found in 22 cases(19%), and in the case of unilatera1, right in 52 cases(44.8%) and left in 42 cases(36.2%). 3. Of the 138 testes, most frequent location was in the inguinal canal in 123 testes(89.1%). 4. Orchiopexy was perrormed on 130 testes(94.2%) by subdartos pouch technique and 7 testes were performed the orchiectomy 5. Among the associated anomalies, the most common anomaly was inguinal hemia in 131 cases and others were contralateral hydrocele, hypospadias, congenital heart disese and syndactyly.
Age Distribution ; Cryptorchidism* ; Female ; Heart ; Humans ; Hypospadias ; Inguinal Canal ; Male ; Orchiectomy ; Orchiopexy ; Syndactyly ; Testis ; Urology

The non-ELR-containing CXC chemokines Mig and IP-10 have been shown to function as chemotactic cytokines for activated T lymphocytes. In this study, we examined the potential involvement of Mig and IP-10 in antimycobacterial response of mice immunized or infected with M. bovis BCG. The accumulation of Mig and IP-10 mRNA in resident peritoneal monocytes (RPMPHI) was slightly reduced by stimulation with vBCG, and the degree was greater for 24 hr culture even though IFN-gamma was added. Expression of Mig, IP-10, and IFN-gamma in 24 hr delayed-type hypersensitivity (DTH) response was stronger in vBCG-immune mice than in the non-immune. The increase of DTH measured by foot-pad thickness appears to be clearly related to the levels of chemokines Mig and IP10 messages and those of IFN-gamma and IL-12. Stimulation with vBCG for 2 days decreased or completely dropped the levels of Mig message in non-immune or immune splenocytes, respectively, whereas IP-10 message was slightly decreased in 2 days culture. Moreover, messages for IL-12 (p40) showed similar kinetics for Mig. The levels of Mig and IP-10 mRNA during the course of infection with BCG were not readily changed in lungs, livers, and spleens from BCG-infected mice. Although there was no obvious changes of Mig and IP-10 messages in the target organs during infection process, we found that the infection progressed over the first 3 wk before being contained by the emerging immune response suggested from detectable amount of IFN-gamma mRNA around this time. In view of selectivity of chemokines Mig and IP-10 for activated T cells, these data suggest that chemokine Mig and IP-10, especially in collaboration with IL-12 and IFN-gamma, may play a role as T cell recruiters in immune response against mycobacterial infection.
Animals ; Chemokines ; Chemokines, CXC* ; Cooperative Behavior ; Hypersensitivity ; Interleukin-12 ; Kinetics ; Liver ; Lung ; Mice* ; Monocytes ; Mycobacterium bovis* ; RNA, Messenger ; Spleen ; T-Lymphocytes

OBJECTIVE: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. METHODS: Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using κ statistics. RESULTS: The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows: Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (κ=0.511) and good for asymptomatic neuroforamens (κ=0.696). Intraobserver agreement by reader 1 for operated neuroforamens was good (κ=0.776) and that for asymptomatic neuroforamens was very good (κ=0.831). In terms of lumbar level, interobserver agreement for L5–S1 (κ=0.313, fair) was relatively lower than the other level (κ=0.804, very good). CONCLUSION: MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5–S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.
Constriction, Pathologic* ; Female ; Foraminotomy ; Humans ; Lumbar Vertebrae ; Magnetic Resonance Imaging* ; Spinal Stenosis ; Spine