No abstract available.
Carcinoma, Squamous Cell* ; Colon* ; Colonic Polyps* ; Female* ; Humans ; Urethra*

Systemic lupus erythematosus is a connective tissue disease which can affect every organ system. Neurologic abnormalities are common, occuring in approximately half of all patients at some time during the course of their illness. But symptoms of nervous system as the sole presenting symptoms occur in less than 1% of lupus patients. In patients initially presenting with neurologic symptoms and signs, differential diagnosis is difficult and sometimes it may be misdiagnosed. Therefore extensive laboratory investigations should be carried out in all patients with unusual neurological symptoms, since early diagnosis of lupus can help in providing effective treatment. We report a patient with systemic lupus erythematosus who presented with dysarthria and dysphagia resembling multiple sclerosis.
Connective Tissue Diseases ; Deglutition Disorders ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis* ; Nervous System ; Neurologic Manifestations

Arterial cannulation for constant monitoring of arterial pressure and blood gase analyses has become commonplace in the care of the critically ill patients. The radial artery is often regarded as causing a negligible complication risk because of extensive collateral arterial flow in the hand. One of other alternative sites for arterial cannulation is femoral artery. Femoral artery cannulation has a high degree of success in very small, critically ill children. It should be considered an acceptable alternative to small-vessel cannulation when the latter is not technically achievable, or in the unstable patient where rapid establishment of reliable artery access is necessary. Arterial cannulation may cause many complications: arterial catheters can directly injure the vessels, resulting in thrombosis, occlusion, distal embolization or ischemia. Local insertion site complications, such as hematoma, hemorrhage, and infection may occur. Arterial catheter may also be a source of systemic sepsis. We report an unusual case of unintentional release of a catheter fragment into the external iliac artery in a 7-month (7.8 kg) male patient with tetralogy of Fallot, which was inadvertently inserted during right femoral artery cannulation. The catheter fragment was successfully retrieved with the Amplatz Goose Neck microsnare under fluoroscopy without any problems.
Arterial Pressure ; Arteries ; Catheterization* ; Catheters* ; Child ; Critical Illness ; Femoral Artery* ; Fluoroscopy ; Hand ; Hematoma ; Hemorrhage ; Humans ; Iliac Artery* ; Ischemia ; Male ; Neck ; Radial Artery ; Sepsis ; Tetralogy of Fallot ; Thrombosis

No abstract available.
Adult* ; Chronic Periodontitis* ; Doxycycline* ; Humans

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

A 41-year-old man was diagnosed with a huge symptomatic liver mass and was referred to our hospital for liver biopsy and further evaluation. He presented with right upper quadrant tenderness. Enhanced abdominal computed tomography and magnetic resonance imaging revealed a 12.5-cm relatively well-defined heterogeneous enhancing mass in the right inferior liver with a large exophytic component containing a fat component and progressive delayed enhancement. The patient underwent right inferior sectionectomy. The pathological diagnosis was confirmed as angiomyolipoma, 12.3×9.2×5.0 cm in size, with tumor necrosis in 20% of the tissue. Hepatic angiomyolipoma is known as a benign tumor, but in our case, because of the large tumor size and coagulative necrosis, this tumor had malignant potential; surgical resection was deemed to be appropriate, and close follow-up monitoring was essential postoperatively.

A 41-year-old man was diagnosed with a huge symptomatic liver mass and was referred to our hospital for liver biopsy and further evaluation. He presented with right upper quadrant tenderness. Enhanced abdominal computed tomography and magnetic resonance imaging revealed a 12.5-cm relatively well-defined heterogeneous enhancing mass in the right inferior liver with a large exophytic component containing a fat component and progressive delayed enhancement. The patient underwent right inferior sectionectomy. The pathological diagnosis was confirmed as angiomyolipoma, 12.3×9.2×5.0 cm in size, with tumor necrosis in 20% of the tissue. Hepatic angiomyolipoma is known as a benign tumor, but in our case, because of the large tumor size and coagulative necrosis, this tumor had malignant potential; surgical resection was deemed to be appropriate, and close follow-up monitoring was essential postoperatively.

Cartilage is one of the most commonly manipulated tissue in esthetic and reconstructive surgery. Cartilage has an important role in longitudinal bone growth. Anabolic hormones and locally produced peptide growth factors are known to influence this process Matrix composition changes through proliferation, maturation, and differentiation of chondrocytes, and endochondral ossification thereafter. Defined cartilage matrix is synthesized during the maturation of chondrocytes where the major change is the increment of type II collagen. Variable sulfated mucololysaccharides and hyaluronic acid are also synthesized during this maturation. IGF-I(insulin like growth factor-I), so called somatomedin C, is a prominent growth factor in serum. IGF-I is known to be involved in long growth. IGF-I is affected by pituitary growth hormone. There are few studies done on IGF-I effect in cartilage matrix formation and possible changes of collagen subtypes. This experiment was designed to see the IGF-I effect on the colagen synthesis of cultured chondrocytes. Optimal concentration of IGF-I for the experiment was determined using H3-thymidine incorporation into DNA. The IGF-I effect on collagen synthesis was studied using H3-proline. The IGF-I effect on the synthesis of subtypes of collagen was studied using SDS-PAGE and immunocytochemical staining. Chondrocytes were isolated from the ears of New Zealand white rabbit and cultured in 2 X 10(5) cells/300 microgram density. IGF-I increased DNA synthesis, and optimal concentration of IGF-I was determined by dose-relationship curve as 10ng/ml. Collagen synthesis was increased by IGF-I. Type II collagen was increased on SDS-PAGE with IGF-I and this gel electrophoresis showed type X collagen, also. The increase in type II collagen was confirmed with immunocytochemical staining, the reaction becoming stronger with the addition of IGF-I. Type I collagen was not changed with IGF-I on immunocytochemistry. We conclude that IGE-I is an important modulator influencing not only proliferation and maturation but also terminal different-iation of chondrocytes.
Bone Development ; Cartilage ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; Collagen Type X ; Collagen* ; DNA ; Ear ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Growth Hormone ; Hyaluronic Acid ; Immunohistochemistry ; Insulin-Like Growth Factor I* ; Intercellular Signaling Peptides and Proteins ; New Zealand

BACKGROUND: We compared indomethacin therapy with the more aggressive approaches of anti-cancer chemotherapy and surgery in the treatment of isolated Langerhans cell histiocytosis (LCH) of bone in children. METHODS: Comparisons were made with respect to healing of the lesion without recurrence, time to radiological healing of the lesion, time to functional recovery, and complications related to treatment. RESULTS: Complete radiologic healing of the lesion (mean, 15.3 months) and functional recovery (mean, 5.6 months) were observed in all patients treated with either approach. No significant differences were noted in the time to complete radiologic healing or the time to functional recovery between the two groups. There were no recurrences with either approach until the last follow-up (mean, 56 months). Complications were common with anti-cancer chemotherapy, but indomethacin was well-tolerated. CONCLUSIONS: Indomethacin seems to be effective for treating isolated LCH of bone in children. Hence, morbidities associated with aggressive treatment approaches such as anti-cancer chemotherapy or surgery can be avoided.
Adolescent ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Bone Diseases/*drug therapy/radiography/radionuclide imaging ; Child ; Child, Preschool ; Cyclooxygenase Inhibitors/*therapeutic use ; Eosinophilic Granuloma/*drug therapy/radiography/radionuclide imaging ; Female ; Humans ; Indomethacin/*therapeutic use ; Infant ; Male ; Recurrence