No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

A tuberculous psoas abscess is a frequently described complication of tuberculous spondylitis. Although rare, a tuberculous psoas abscess can develop without any demonstrable spinal involvement. In patients with no evidence of sponylitis, the abscess may result from direct spread from the involved lymph node or via a hematogeous route. The treatment of a psoas abscess is either drug therapy or surgical intervention in conjunction with drug therapy. Image-guided percutaneous drainage in conjunction with drug therapy is also a safe and effective treatment for a tuberculous psoas abscess. We report an unusual case of bilateral tuberculous psoas abscesses without any concomitant spinal involvement. The tuberculous psoas abscess may have formed by fistulization between the necrotic lymph node and psoas sheath. The diagnosis was confirmed by computed tomography and a histology examination of the biopsy sample. The patient improved after administering anti-tuberculous agents for 2 years along with surgical and percutaneous drainage of the abscess.
Abscess ; Biopsy ; Drainage ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Psoas Abscess ; Spondylitis ; Tuberculosis

Epithelioid angiosarcoma has recently been described as a variant of angiosarcoma, based on its pathologic feature which is characterized by epithelioid or histiocytoid morphology of the malignant tumor cells. We report a case of epithelioid angiosarcoma on the lower back of a 65-year-old man. The patient had several, variable-sized, pedunculated, fungating masses. On histopathologic examination, the tumor was chiefly composed of solid sheets of atypical epithelioid cells with prominent eosinophilic cytoplasm, a large vesicular nuclei, and occasional intracytoplasmic vacuoles. Primitive vascular spaces, and a cleft with malignant cells and proliferating vessels were also found in some areas. The reticulum stain and immunohistochemical stain using factor VII-related antigen and CD 31 were focally positive in the tumor. He was treated by wide surgical excision.
Aged ; Cytoplasm ; Eosinophils ; Epithelioid Cells ; Hemangiosarcoma* ; Humans ; Reticulum ; Vacuoles

Toxic epidermal necrolysis (TEN) is a rare, life-threatening, mucocutaneous drug reaction, which causes extensive epidermal detachment and serious complications involving ocular structures and internal organs. Recently, intravenous immunoglobulin (IVIG) was suggested to be effective in treating TEN through the blockage of Fas receptors which initiate keratinocyte apoptosis. Herein, we tried IVIG teratment (0.6 g/kg/day for 4 consecutive days) for a case of TEN. As a result, the progression of epidermal detachment was interrupted within 2 days and epithelialization was completed in 3 weeks without significant side effects.
Antigens, CD95 ; Apoptosis ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Keratinocytes ; Stevens-Johnson Syndrome*

Toxic epidermal necrolysis (TEN) is a rare, life-threatening, mucocutaneous drug reaction, which causes extensive epidermal detachment and serious complications involving ocular structures and internal organs. Recently, intravenous immunoglobulin (IVIG) was suggested to be effective in treating TEN through the blockage of Fas receptors which initiate keratinocyte apoptosis. Herein, we tried IVIG teratment (0.6 g/kg/day for 4 consecutive days) for a case of TEN. As a result, the progression of epidermal detachment was interrupted within 2 days and epithelialization was completed in 3 weeks without significant side effects.
Antigens, CD95 ; Apoptosis ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Keratinocytes ; Stevens-Johnson Syndrome*

PURPOSE: The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. METHODS: In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. RESULTS: The mean ages of the febrile convulsion and control group were 16.3+/-7.4 and 15.8+/-6.1 months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb <10.5 gm/dL) was more frequent in the febrile convulsion group than in the control group, although there was no statistical significance. Unexpectably, the RDW (red blood cell distribution width) was significantly lower and the MCNC (mean corpuscular hemoglobin concentration) was significantly higher among seizure cases than among the controls (P<0.05). There is no statistical difference between simple and complex febrile groups in the clinical and laboratory profiles. On multiple logistic regression analysis, iron deficiency anemia was more frequent, but the RDW was lower, among the cases with febrile convulsion, compared with the controls. Conclusions: Our study suggests that the iron deficiency anemia is associated with febrile convulsion, and screening for iron deficiency anemia should be considered in children with febrile convulsions.
Aged ; Anemia, Iron-Deficiency ; Blood Cells ; Case-Control Studies ; Child ; Hemoglobins ; Humans ; Infant ; Iron ; Logistic Models ; Mass Screening ; Seizures ; Seizures, Febrile

Supernumerary derivative (22) syndrome is a rare genomic syndrome. It is characterized by severe mental retardation, microcephaly, failure to thrive, preauricular tag or sinus, ear abnormalities, cleft and/or high-arched palate, micrognathia, kidney abnormalities, congenital heart defects, and genital abnormalities in males. In 99% of the cases, one of the parents is a balanced carrier of a translocation between chromosome 11 and chromosome 22. To date, there have been about 100 case reports of supernumerary derivative (22) syndrome. In most of the cases, supernumerary derivative (22) syndrome was the result of 3:1 meiotic segregation in the maternal 11;22 translocation carrier. We now report a case of 47,XX, + der(22)t(11;22)(q23;q11.2) resulting from 3:1 meiotic segregation of the paternal translocation carrier.
Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 22 ; Congenital Abnormalities ; Ear ; Failure to Thrive ; Heart ; Humans ; Intellectual Disability ; Kidney ; Male ; Microcephaly ; Palate ; Parents ; Trisomy

Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient. Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters. Results: Modified Cormack and Lehane grade showed a significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001). Conclusions Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient. Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters. Results: Modified Cormack and Lehane grade showed a significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001). Conclusions Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

We report here on a rare case of adrenal paragonimiasis that presented with an adrenal incidentaloma. A 52-year-old male presented with fatigue and weight loss. The laboratory findings revealed eosinophilia (8.5%) and an increased eosinophil count (910/microL). The computed tomography scan showed 6.5 x 5 cm sized multilocular cystic mass in the right adrenal gland, which was non-functioning, and cystic lesions with variable sizes were also noted in the abdominal cavity. On the surgical field, whitish patches were spread out in the peritoneum, the omentum, the dome of the liver and the diaphragm. The right adrenal gland was replaced by a cystic mass filled with mucopurulent creamy materials. The pathologic findings revealed numerous eggs of Paragonimus spp. Also, the ELISA was positive for IgG paragonimus antibody. The adrenal gland can become infected by various microbial pathogens, including parasites, although it is relatively uncommon. However, in the case of a cystic adrenal mass with accompanying eosinophilia in an endemic area, clinicians should consider the possibility of parasitic infection.
Abdominal Cavity ; Adrenal Gland Neoplasms ; Adrenal Glands ; Diaphragm ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Fatigue ; Humans ; Immunoglobulin G ; Liver ; Male ; Middle Aged ; Omentum ; Ovum ; Paragonimiasis ; Paragonimus ; Parasites ; Peritoneum ; Weight Loss