No abstract available.

Neovesical-urethral anastomotic stricture is a complication of orthotopic neobladder, with a reported incidence of 2.7% to 8.8%. Strictures of the neovesico-urethral anastomotic site can be treated with regular self-dilation, but high-grade strictures require a surgical procedure involving incision by electrocautery or cold knife. Here we describe a grade III neovesical-urethral anastomotic stricture after an orthotopic bladder substitution that was successfully treated by use of a ureteral dilation balloon catheter.
Catheters ; Cold Temperature ; Constriction, Pathologic ; Electrocoagulation ; Incidence ; Ureter ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder Neoplasms ; Urinary Diversion

PURPOSE: We assessed the usefulness of resistive index(RI) on spectral analysis of Doppler sonography for differential diagnosis of benign and malignant breast lesions. MATERIALS AND METHODS: We retrospectively reviewed 29 benign and 22 malignant lesions of breast, which were examined preoperatively with color and duplex Doppler andwere confirmed by histopathologically after operation. We analyzed the average and distribution of RI in benignand malignant lesions. RESULTS: Although, there was no difference in the average values of RI in benign and malignant breast lesions, the distribution of RI was below 0.7 in eighteen cases (62%) of benign lesions, and above 0.7 in eighteen cases (82%) of malignant lesions. Thus, RI is valuable for differentiation between benignand malignant lesions of breast. CONCLUSIONS: Measurement of RI in breast disease using color and duplex Dopplerstudy is useful modality adjunct to the conventional ultrasonographic differentiation of benign and malignantlesions.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies

The intestinal lesions were studied in dog metagonimiasis by reinfection. The metacercariae of M. yokogawai were collected from naturally infected sweetfish. A total of twenty dogs were divided into three groups; control, primary infection and reinfection groups. The 18 dogs were infected with 10,000 metacercariae; the 5 dogs in primary infection group were killed at the 5 days in 1 week, 4 weeks, 6 weeks after the infection. The remaining 13 dogs were kept for nine weeks, and challenged again with 5,000 metacercaricae. The reinfected dogs were killed at the 1 day, 3 days, 5 days and 1 week, 2 weeks, 4 weeks, 6 weeks, 8 weeks respectively. The chronologic changes of the intestinal lesions in both groups, the worm recovery rate, and distribution patten were examined by gross observation, light and scanning electron microscopies. From the results, it was inferred that the so-called spontaneous and/or self cure phenomena were of negligible importance in metagonimiasis in dogs. In the chronologic observations of pathologic process in intestine, it was also suggested that the host immunity tend to recover the intestinal integrity. And early invasion of young worm to the Lieberkuhn's crypt was considered as the primary cause of lesions of vill(Abstract is summarized again.)
parasitology-helminth-trematoda ; Metagonimus yokogawai ; metagonimiasis ; dog ; histology ; pathology ; electron microscopy ; intestine

Acute calcific tendinitis (ACT) is a benign painful inflammatory disorder characterized by resorptive process of calcific deposits following the formation of calcium hydroxyapatite crystals in the tendons. It can occur at various sites, especially in the shoulder or hip joint. ACT involving the lateral epicondyle of the humerus and the cervical spine is very rare. Few reports have demonstrated successive ACT at different sites. We report three cases of successive ACT in women, occurring at the subscapularis followed by the lateral epicondyle, flexor carpi ulnaris followed by the supraspinatus, and longus colli followed by the iliopsoas, respectively.
Durapatite ; Female ; Hip Joint ; Humans ; Humerus ; Shoulder ; Spine ; Tendinopathy ; Tendons

It is difficult to distinguish Hirayama disease (HD) from other mimicking disorders in adolescent patients with distal upper limb weakness. The prevailing theory of HD postulates that the lower cervical cord is susceptible to compression during neck flexion because of insufficient growth of the dura relative to the spinal column. Confirmation of a dynamic change in the dorsal epidural space on magnetic resonance imaging (MRI) during neck flexion is essential for diagnosing HD. However, neck flexion MRI has not been routinely performed in juvenile patients with distal upper limb weakness in the absence of suspected HD. We report two cases of HD that were initially confused with other diseases because of insufficient or absent cervical flexion during MRI. Full-flexion MRI showed typical findings of HD in both cases. Our cases suggest that dynamic cervical MRI in the fully flexed position is necessary for evaluating suspected HD.
Adolescent ; Cervical Cord ; Diagnosis ; Epidural Space ; Humans ; Magnetic Resonance Imaging ; Neck ; Spinal Cord Diseases ; Spine ; Upper Extremity

Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract. Treatment options include dissolution with enzymes, endoscopic removal or aspiration, and surgery. The outcome differs according to the treatment method. A 57-year-old man was admitted with a 1-month history of epigastric pain. On gastrofiberscopy, an approximately 2-cm deep ulcer was seen on the lesser curvature of the antrum and three huge bezoars were found. In order to remove the first one, we injected Coca-Cola into it directly. It took 20 minutes to cut up and 1 hour to remove completely. To decrease the procedure time, we changed the injection fluid to urokinase for the remaining two bezoars. It took 9 and 10 minutes to cut up the second and third bezoars, respectively, and 1 hour to remove them completely. We report a case of phytobezoars treated successfully by endoscopic injections of Coca-Cola and urokinase.
Bezoars ; Gastrointestinal Tract ; Humans ; Middle Aged ; Ulcer ; Urokinase-Type Plasminogen Activator

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed

OBJECTIVE: To investigate patterns of serial serum interleukin-6(IL-6) concentrations after initial successful cardiopulmonary resuscitation, and to access differences in serum IL16 concentrations in patients with Cerebral Performance Category(CPC, 1-2) and CPC(3-5) at the 5th day after cardiacpulmonary resuscitation(CPR). METHODS: We studied prospectively 12 patients with spontaneous circulation after cardiopulmonary resuscitation. Venous blood samples were taken 2,4,12,24,48 and 72 hours after restoration of spontaneous circulation to measure serum IL-6 levels by the enzyme-linked immunosorbent assay. RESULTS: Serum IL-6 concentrations in the severe neurologically disabled group(CPC, 3-5) were significantly increased at 2, 24 and 48 hours after restoration of spontaneous circulation compared with the less neurolgically disabled group. Also, serum IL-6 concentrations in the severe neurologic disabled group showed dual peak at 4 and 24 hours. CONCLUSION: Our study demonstrates significant incense of seam IL-6 in patients with CPC(3-5) after successful cardiopulmonary resuscitation and the significant correlation between early increase of serum IL-6 and poor neurologic outcome. It suggests that early increase of serum IL-6 can be used as a prognostic marker after successful cardiopulmonary resuscitation.
Cardiopulmonary Resuscitation* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-16 ; Interleukin-6* ; Prospective Studies

Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this is syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blind in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II), clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization, significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she bad the improvement of symptoms arid iron deficiency anemia.
Adult ; Anemia, Iron-Deficiency ; Angiodysplasia ; Arteriovenous Fistula* ; Brain Abscess ; Capillaries ; Cyanosis ; Dyspnea ; Embolization, Therapeutic* ; Female ; Fingers ; Fistula ; Follow-Up Studies ; Gastric Mucosa ; Hemorrhage ; Hepatic Artery ; Humans ; Iron ; Mucous Membrane ; Multiple Pulmonary Nodules ; Oxygen ; Polycythemia ; Pulmonary Artery ; Pulmonary Veins ; Rupture ; Skin ; Steel ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Thorax