Cavernous hemangioma is the most common primary orbital tumor in adults. This tumor is usually unilateral and single.The authors experienced a young male patient who complained of postural variations of proptosis and was diagnosed as an orbital cavernous hemangioma associated multiple intracranial lesions. The diagnosis was based on histopathological examination and various radiologic studies including computed tomography (CT), magnetic resonance imaging (MRI), and single photon emission computed tomography (SPECT). So we report a rare case of cavernous hemangioma which occurred multiplly with a brief review of the literature.
Adult ; Diagnosis ; Exophthalmos ; Hemangioma, Cavernous* ; Humans ; Magnetic Resonance Imaging ; Male ; Orbit* ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Angiomyolipoma* ; Tuberous Sclerosis*

OBJECTIVE: To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions. MATERIALS AND METHODS: Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty. RESULTS: In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63 +/- 0.30 to 0.99 +/- 0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8 +/- 8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed. CONCLUSION: The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.
Aged ; *Alloys ; Arterial Occlusive Diseases/*therapy ; Equipment Design ; Female ; Human ; *Iliac Artery ; Male ; *Stents ; Support, Non-U.S. Gov't

Reversible thermal injury to the esophagus as the result of drinking hot liquids has been reported to generate alternating white and red linear mucosal bands, somewhat reminiscent of a candy cane. This phenomenon is associated with chest pain, dysphagia, odynophagia, and epigastric pain. Here, we report a case of thermal injury to the esophageal and oral cavity due to the drinking of hot tea, including odynophagia and dysphagia. A 69-year-old man was referred due to a difficulty in swallowing which had begun a week prior to referral. The patient, at the time of admission, was unable to swallow even liquids. He had recently suffered from hiccups, and had consumed five cups of hot adlay tea one week prior to admission, as a folk remedy for the hiccups. Upon physical examination, the patient's oral cavity evidenced mucosal erosion, hyperemia, and mucosa covered by a whitish pseudomembrane. Nonspecific findings were detected on the laboratory and radiological exams. Upper endoscopy revealed diffuse hyperemia, and erosions with thick and whitish pseudomembraneous mucosa on the entire esophagus. The stomach and duodenum appeared normal. We diagnosed the patient with thermal esophageal injury inflicted by the hot tea. He was treated with pantoprazole, 40 mg/day, for 14 days, and evidenced significant clinical and endoscopic improvement.
Tea/*adverse effects ; Mouth Mucosa/injuries ; Male ; Humans ; Heat/adverse effects ; Esophagus/*injuries ; Deglutition Disorders/*etiology ; Chest Pain ; Burns/drug therapy/*etiology/physiopathology ; Anti-Ulcer Agents/therapeutic use ; Aged ; 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use

Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate(Ca++ : 3.5 mEq/L). Furthermore, the high calcium concentration in standard dialysate may have a suppressive effect on parathyroid hormone(iPTH) level, contributing to the high prevalence of low-urnover bone disease. We studied the effect of low calcium dialysate(Ca++ : 2.5 mEq/L) for those patients with high risk of low- turnover bone disease. Among 386 patients(1996. 1.- 1999. 12.) who had been stable on CAPD for at least 3 months, 46 patients were included in this study. The patients were divided into 3 groups on the basis of the iPTH levels(<150 pg/mL) and/or corrected serum calcium levels(>10 mg/dL) before the conversion to low calcium dialysate. Group 1(n=29), iPTH <150 pg/mL and Ca++>10 mg/dL; Group 2 (n=14), iPTH <150 pg/mL and Ca++<10 mg/dL; Group 3(n=3), iPTH >150 pg/mL and Ca++ >10 mg/ dL. During a 2-month run-in period, those patients were treated with standard dialysate. After that, a 12-month therapy with low calcium dialysate was followed. Biochemical data including calcium, phosphorus, iPTH and alkaline phosphatase were measured regularly and daily phosphate binder and calcitriol intake(pill counting) were assessed during the run-in and therapy period. We obtained the following result: the prevalence of hypercalcemia(Ca++>10.5 mg/dL) was 5.7%(22/ 386 patients). Serum calcium levels decreased during the therapy period(12 months)(10.5+/-1.4 vs 9.4+/-1.3 mg/dL, p<0.05). Serum phosphorus levels remained unchanged. Mean serum alkaline phosphatase level increased(203.0+/-92.9 vs 257.2+/-103.4 U/L, p<0.05). Serum iPTH levels increased (92.7+/-128.8 vs 225.3+/-237.3 pg/mL,p<0.05). The mean intake of oral phosphate binders was not significantly different between run-in period and therapy period. But calcitriol doses increased 0.038+/-0.087 at run-in period to 0.158+/-0.288 tablets/person/day at therapy period(p<0.05). In the six patients, low calcium dialysate was converted to standard dialysate due to high iPTH level (n=3), symptomatic hypo calcemia(n=2), and uncontrolled edema(n=1). In conclusion, in the study of 46 patients over 12 month period, the usage of 2.5 mEq/L calcium dialysate resulted in a significant decrement in calcium levels and increased iPTH levels. Therefore, we propose that dialysis with a low calcium dialysate is an acceptable form of therapy for the patients with high risk of low-turnover bone disease showing hypercalcemia and low iPTH level. However, further study will be needed for evaluating the effect of low calcium dialysate in low-turnover bone disease.
Alkaline Phosphatase ; Bone Diseases* ; Calcitriol ; Calcium* ; Dialysis ; Humans ; Hypercalcemia ; Peritoneal Dialysis, Continuous Ambulatory* ; Phosphorus ; Prevalence

Tsutsugamushi disease is one of the acute febrile diseases caused by Orientia tsutsugamushi that is transmitted to human by the bite of larval-stage trombiculid mite (chigger). The clinical illness is characterized by abrupt onset of fever, headache, rashes, myalgia and eschar. Chest radiologic findings show reticulonodular infiltration, cardiomegaly, lymphadenopathy and in a minority, pleural effusion. About pleural effusion, it is supposed to be caused by tsutsugamushi disease itself in most cases and no case has been reported that the pleural effusion confirmed by pleural biopsy and revealed granulomatous lesions. We experienced a case of tsutsugamushi disease with pleural effusion which was also confirmed to granulomatous lesion by pleural biopsy. So we report this case with a brief review of literatures.
Biopsy ; Cardiomegaly ; Exanthema ; Fever ; Granuloma ; Headache ; Humans ; Lymphatic Diseases ; Myalgia ; Orientia tsutsugamushi ; Pleural Effusion* ; Scrub Typhus* ; Thorax ; Trombiculidae

The use of superselective embolization was assessed as a treatment for bleeding from arteriovenous fistulas and pseudoaneurysm after renal biopsy procedure. But unless it is sufficiently selective, the procedure results in loss of significant amount of renal parenchyme. We experienced one case of renal arterial pseudoaneurysm, which happened at 5days after percutaneous renal biopsy. Diagnosis of pseudoaneurysm was made by ultrasound examination with Doppler flow and was confirmed with arteriography. The rupture of pseudoaneurysm was occluded by transcatheter embolization with placement of a steel coli and polyvinlyl alcohol from the renal arterial approach. This procedure was allowed non surgical closure of the AV fostula and pseudoaneurysm without significant change of renal function.
Aneurysm, False* ; Angiography ; Arteriovenous Fistula ; Biopsy* ; Diagnosis* ; Hemorrhage ; Rupture ; Steel ; Ultrasonography

Acute mercury inhalation poisoning is a rare cause of acute lung injury. It is usually fatal because of progressive pulmonary failure. We experienced a patient with acute respiratory distress syndrome (ARDS) after illicit use of mercury vapor for hemorrhoid treatment; he developed acute chemical pneumonitis following exposure to mercury vapor. Prompt treatment with corticosteroids and penicillamine for acute chemical pneumonitis was instituted; radiologic pulmonary infiltrates disappeared within a week, but late phase neurologic sequelae and pulmonary interstitial fibrosis progressed.
Adrenal Cortex Hormones/administration & dosage ; Aged ; Antidotes/administration & dosage ; Disease-Free Survival ; Human ; Inhalation Exposure/adverse effects* ; Male ; Mercury Poisoning/diagnosis ; Mercury Poisoning/complications* ; Penicillamine/administration & dosage ; Respiratory Distress Syndrome, Adult/drug therapy ; Respiratory Distress Syndrome, Adult/chemically induced* ; Substances:Penicillamine ; Substances: Antidotes ; Substances: Adrenal Cortex Hormones

PURPOSE: To analyze the clinical and radiologic results of treatments in proximal femoral fracture with Proximal Femoral Nail-Antirotation (PFNA). MATERIALS AND METHODS: We retrospectively reviewed the results of 21 cases of proximal femoral fracture treated with PFNA from September 2006 to October 2007 which could be followed up for minimum of more than a year. The mean age was 61.5 (20~88) years old. Male were involved in 12 cases, female in 9 cases. The mean follow up was 14.3 (12~18) months. The Garden alignment index, Cleveland index, tip apex distance were evaluated by post-operative radiologic evaluation and complications of bone union, failure of internal fixation and deformity were evaluated by follow up radiologic findings. Clinical results were assessed by social function score of Jensen and mobility score of Parker and Palmer at last follow up. RESULTS: All fractures were united and the mean time to bone union was 15.7 (13~18) weeks. Garden alignment index showed good results of above 'good' in 15 cases (71.4%), Cleveland index showed 14 cases (66.4%) positioning in zone 5 and tip apex distance showed 17.81 (+/-5.65~27.52) mm in radiologic findings. The mean sliding of blade was 1.32 (0.34~2.94) mm in follow up radiologic findings and fracture of distal locking screw area was found in 1 case as a complication. Among 21 cases, the function before injury was completely recovered in 15 cases (71.4%) which were assessed by social function score of Jensen and 13 cases (61.9%) by mobility score of Parker and Palmer. CONCLUSION: We think that PFNA is effective osteosynthetic device for proximal femur fracture with satisfactory radiologic and clinical outcomes.
Congenital Abnormalities ; Female ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Male ; Nails ; Retrospective Studies

BACKGROUND: ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing. METHODS: In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol. RESULTS: The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods. CONCLUSIONS: ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.
ABO Blood-Group System/*blood ; Automation ; Blood Banks ; Blood Grouping and Crossmatching/instrumentation/*methods ; Humans