We experienced two cases of Gaucher's disease of adult type in brother aged four years and two years. The patients showed hepatosplenomegaly with anemia and thrombocytopenia. Typical Gaucher cells were found in bone marrow and biopsy specimens of liver and spleen through light and electron microscopic examination. Splenectomy was followed by improvement of anemia and thrombocytopenia. A brief review of literature was made.
Adult ; Anemia ; Biopsy ; Bone Marrow ; Gaucher Disease* ; Humans ; Liver ; Siblings* ; Spleen ; Splenectomy ; Thrombocytopenia

A 53-year-old man developed some erythematous follicular macules accompanied with tingling sensation on both shoulders. Histologic finding showed a dense lymphocytic infiltrate around the infundibular portion of the follicle, where separation of the dermoepidermal junction was seen. The insect, obtained from the skin lesion, was identified as a larva of an Ap- hid
Aphids ; Cryptococcosis* ; Humans ; Insect Bites and Stings ; Insects ; Larva ; Middle Aged ; Sensation ; Shoulder ; Skin

Myocardial infarction is almost regularly associated with severe and widespread obstructive coronary artery disease. Recently, there have been some reports of myocardial infarction with normal of near normal coronary arteries on cineangiography. The following report concerns 6 cases (4% of a series of 142 consecutively studied patients with myocardial infarction) of myocardial infarction proved on clinical grounds with normal or near normal coronary arteries at coronary angiography obtained several months later. The clinical data was shown in Table 1 and Table 2. All 6 patients were male. Three were in the fifth, two in the sixth, and one in the seventh decade. Multiple risk factors were present in only one patient. Areas of localized dyskinesia or hypokinesia were demonstrated in five on the left ventricular cineangiography. The left ventricular end-diastolic pressure was greater than 12 mmHg in all 6 patients. One patient had hypertrophic cardiomyopathy and the remaining 5 patients had no underlying heart diseases. One patient had moderate congestive heart tailure. It is possible that prolonged, localized coronary artery spasm or platelet thrombi that subsequently resolved are a part of the pathogenic mechanism.
Blood Platelets ; Cardiomyopathy, Hypertrophic ; Cineangiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dyskinesias ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Humans ; Hypokinesia ; Male ; Myocardial Infarction* ; Risk Factors ; Spasm

Coronary arterivenous fistula(CAVF) is an uncommon congenital coronary anomaly-Bilateral CAVFs that originate from both coronary arteries are very rare. Coronary arteriography performed in recent years has clarified the incidence and various features of this lesion. Baim et al.1) reported that only 5% of the coronary artery fistulas arose from bilateral coronary arteries. In this report, we present a case of bilateral coronary artery pulmonary artery fistulas associated with atypical chest pain.
Angiography ; Arteries* ; Chest Pain ; Coronary Vessels ; Fistula* ; Incidence ; Pulmonary Artery

No abstract available.
Breast Neoplasms* ; Breast* ; Mammography*

The increasing use of intravenous polyethylene catheters has led to a growing incidence of accidental catheter breakage and migration of fragments into the central vascular system usually in the inferior vena cave, the right atrium, of the pulmonary artery. The most common complications were formation of a thrombus in the area of the foreign body, infection with endocarditis, and perforation of the heart. And so obviously the polyethylene catheter must be removed. In 1967, Massumi and Ross et al have been successful in removing a catheter fragment from the right atrum percutaneously with a snare device. With some modification as suggested by Curry, method of retrieving fragments of polyethylene catheters from the heart without chest surgery utilize wire snares or endoscopic forceps. This report describe the technique and its use in successfully managing these complications in four consecutive cases.
Catheters* ; Endocarditis ; Foreign Bodies ; Heart Atria ; Heart* ; Incidence ; Polyethylene ; Pulmonary Artery ; SNARE Proteins ; Surgical Instruments ; Thorax ; Thrombosis

This study was carried out to elucidate the cytokine mRNAs expression and morphological features according to a microglial proliferation and apoptosis in a rat lumbar spinal cord, after a right sciatic nerve transection. The control group was composed of 5 rats (Spraque-Dawley) and the experimental group was composed of 70 rats. On post operation day (pod) 1, 2, 3, 5, and 7 eight rats were sacrificed on those days. On pod 10 five rats were sacrificed as well as five rats sacrificed on post operation weeks 2, 3, 4, 5, and 6. On light microscopy, activated microglia were often found in a perineuronal position around motoneurons in the ventral gray matter and more randomly distributed throughout the neuropil in the dorsal gray matter of lumbar spinal cord. GSA I-B4-positive microglia began to increase from 1 day after transection, and reached peak at 2~3 days and it persisted at 5~7 days and decreased thereafter. TUNEL-positive microglia was not observed in control group and began to increase from 5 days after transection and increased gradually until 3 weeks and decreased thereafter. On in situ RT-PCR, the positive signal for IL-1alpha and IL-6 mRNA was found mainly in the cytoplasm of the activated microglia and astrocytes at 1 day after transection and showed stronger signal at 3 days and decreased gradually until 10 days. TNF-alpha mRNA was detected 1 day after transection and remained for 7 days and localized to activated microglia as well as probably some astrocytes. The signal intensity of IL-1alpha and IL-6 mRNA was generally stronger than TNF-alpha mRNA. On transmission electron microscopy, there were chromatin condensation with margination toward nuclear membrane and condensation of cytoplasm at 3 days after transection. Apoptotic bodies were found after 5 days and increased gradually until 3 weeks. According to the above findings, it is concluded that apoptosis appears to be one mechanism by which activated microglia are gradually eliminated and cytokine expression seems to played an active role in the microglial turnover.
Animals ; Apoptosis* ; Astrocytes ; Chromatin ; Cytokines ; Cytoplasm ; Interleukin-6 ; Microglia ; Microscopy ; Microscopy, Electron, Transmission ; Neuropil ; Nuclear Envelope ; Rats* ; RNA, Messenger ; Sciatic Nerve* ; Spinal Cord* ; Tumor Necrosis Factor-alpha

Acupuncture with gold needle insertion is utilized in Oriental medicine, and the effect of therapy is represented by anti-inflammatory and analgesic function, But sometimes the needle is erroneously inserted into abdominal organs, and then it may cause dangerous complications. We report a case of multiple gold needles in the abdominal organs without having definete clinical symptoms.
Acupuncture* ; Medicine, East Asian Traditional ; Needles* ; Radiography*

No abstract available.
Insulinoma*

BACKGROUND: Total obstruction of the left main coronary artery is a common cause of sudden death but is rarely seen in patients who survive to undergo diagnostic evaluation or treatment. METHODS: During twenty six-year period, we encountered 5 patients with chronic total obstruction of the left main coronary artery out of about 4,000 patients who underwent coronary angiography. RESULTS: All patients have undergone coronary bypass surgery. These patients present with increasingly severe angina. A right dominat coronary anatomy is always found, usually with well-developed right-to-left collaterals. Left ventricular function was severely impaired in two patients out of five patients. CONCLUSIONS: The results of surgical revascularization in our patients and others described in the literature can support the safety and efficacy of this approach.
Coronary Angiography ; Coronary Vessels* ; Death, Sudden ; Humans ; Ventricular Function, Left