A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

A case of fibrocalcifying pseudotumor occuring at a very unusual site, the intraosseous region of axis, is presented. Previous reports of similar lesions in skull base, intracranial parenchyme, soft tissue around spine, mediastinum, and pleura have been described under the designation 'fibro-osseouslesions' and 'calcifying pseudoneoplasm' The etiology, pathogenesis and natural course of the lesion are still unknown. Bvt the lesion is probably benign nature and reactive lesion rather than neo-plastic. Authors performed resection of lamina, spinous process, and a portion of pedicles and occipitocervical fusion to prevent spinal cord compression due to cortical expansion or fracture. Microscopically, amorphous, basophilic, hyaline, and chondroid calcifying masses were rimmed by palisading histiocytes and foreign body-type giant cells. No evidence of malignancy was found.
Axis, Cervical Vertebra* ; Basophils ; Giant Cells, Foreign-Body ; Histiocytes ; Hyalin ; Mediastinum ; Pleura ; Skull Base ; Spinal Cord Compression ; Spine

Nine scaphoid non-unions, which were treated by through curettage of the scar tissue on pseudarthrosis, iliac bone grafts between the fragments and Herbert screws fixation, were analysed. The average follow up period from operation was 16.9 months. The interval between the fracture and the time of the operation ranged from 10 months to 48 months(average 21.6 months). Average union time was 14 weeks after operation. The initial radiologic cystic changes disappeared and overall clinical results were improved. Mean postoperative range of motion of the wrist was flexion 55 and extension 45°. Three of them had DISI deformity preoperatively which their scapholunate angles (mean 104°) has been corrected after reduction (mean 75°). In one case among three DISI deformities, partial radial styloidectomy and triscaphe fusion were added (to bone graft and Herbert screw fixation). A case of incorrect positioning of the screw and a case of neuroma were complicated. Treatment of scaphoid nonunion with curettage of the scar tissue and iliac bone graft and Herbert screw fixation seems to be encouraging to regain the normal anatomy of scaphoid and function of the wrist.
Cicatrix ; Congenital Abnormalities ; Curettage ; Follow-Up Studies ; Neuroma ; Pseudarthrosis ; Range of Motion, Articular ; Transplants ; Wrist

No abstract available.
Wounds and Injuries

No abstract available.
Adolescent* ; Humans

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

No abstract available.
Candidiasis* ; Paget Disease, Extramammary* ; Vulva

No abstract available.
Ultrasonography, Doppler, Color*

There are many known methods of dermo-epidermal separation for the investigation of autoimmune blistering diseases. Investigators should select a proper method since many differences exist preservation of antigenicity. In order to determine the stabilization of antigenirity by different separation methods, we have separated dermo-epidermal junction by means of 1M s;ilt, 56C PBS, 20mM EDTA and dispase. Indirect immunofluarescence and immunoblotting were performed on each specimen with sera of patients with pemphigus vulgaris, pemphigus foliaceus, paraneoplastic pemphigus, bullous pemphigoid and epidermolysis bullosa acquisita. The results are as follows : 1. In indirect immunofluorescence study of pemphigus group, best, result were obtained when normal skin without dermo-epidermal separation was used. Dispase well preserved antigenicity of pemphigus after dermo-epidermal separation, but no differences were noted in antigenicity stabilization among separation mehods by immunoblotting. 2. In indirect immunofluorecence study for differentiation of bullous pemphigoid and epidermolysis bullosa acquisita, we recommend EDTA and dispase methods in addition to 1M salt induced skin separation that have been most popularly used. 3. Results of the immunoblotting of bullous pemphigoid showed that 1M salt, EDTA and heat preserved the antigenicity well but the antigenicity was lost by dispase. 4. Results of the immunoblotting of epidermolysis bullosa acquisita she wed that antigen did not exist in epidermal extract. 5. Antigen preservation according to the different methods of demo-epidermal separation was not identical between indirect immunofluorescence and immunoblotting.
Blister* ; Edetic Acid ; Epidermolysis Bullosa Acquisita ; Fluorescent Antibody Technique, Indirect ; Hot Temperature ; Humans ; Immunoblotting ; Pemphigoid, Bullous ; Pemphigus ; Research Personnel ; Skin

PURPOSE: To evaluate tlne significance of vaginal air seen on CT scan in preoperative staging of uterine cervical carcinoma. METHODS AND MATERIALS: A comparison was made between CT findings of vaginal air and true vaginal involvement status in 85 patients with uterine cervical carcinoma. CT findings were analyzed in terms of the presence or absence of vaginal air, number of CT slices in which vaginal air was seen, shape of vaginal air, and relation of vaginal airto cervical mass. RESULTS: Vaginal air was present in 35 patients and was absent in 50. Although the mere presence of vaginal air or multiplicity of CT slices showing vaginal air did not signify the presence of vaginal involvement, vaginal air with irregular margin or vaginal air adjacent to uterine cervical mass was suggestive of vaginal involvement. CONCELUSION: These observation of vaginal air in interpreting CT may be helpful in the preoperative staging of uterine cervical carcinoma.
Humans ; Tomography, X-Ray Computed ; Vagina*