Fracture of the occipital condyle is rare. We report the case of a patient with this fracture who presented with negative plain films and delayed hypoglossal nerve palsy. Diagnosis was estabilished with high resolution computed tomography. In a trauma patient with neck or occipital pain, with or without cranial nerve palsy, this fracture should be considered, even if a plain radiograph is negative.
Cranial Nerve Diseases ; Diagnosis ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Neck

We present a case of Brown-Sequard syndrome due to a massive cervical disc herniation at C5/6 level, presenting sings of sudden and severe spinal cord compression. The lesion was diagnosed by MRI and herniated cervical disc was removed under the surgical microscope via anterior route. The result of operation was good. A brief review of the literature is given.
Brown-Sequard Syndrome* ; Magnetic Resonance Imaging ; Spinal Cord Compression

Simultaneous perioperative measurements of cradiac output were obtained in 16 patients for coronary artery bypass graft with transthoracic impedance and pulmonary artery thermodilution techniques to evaluate the utility of the noninvasive methods. Correlation coefficient of average pairs of the two methods was 0.81 (heart rate<60) 1.00 (60< or =heart rate<70) 0.82 (70< or =heart rate<80) 0.52 (80< or =heart rate<90) 0.65 (heart rate> or =90). Correlation coefficient of individual pairs of the two methods was 0.73 (heart rate<60) 0.99 (60< or =heart rate<70) 0.72 (70< or =heart rate<80) 0.60 (80< or =heart rate<90) 0.57 (heart rate> or =90). Each value has a significance with 95% confidence except average pairs below 60 of heart rate. In a scattergram with +/-20% confidence bands, 100% of data points fall inside this confidence bands when the heart rate is below 70. Each value has a significance with 95% confidence except average pairs below 60 of heart rate. In a scattergram with +/-20% confidence bands, 100% of data points fall inside this confidence bands when the heart rate is below 70, Two methods are in good agreement when the heart rate is below 70. It is concluded that transthoracic impedance can replace thermodilution method for coronary artery bypass graft, at least, in operating room and intensive care unit because heart rate should be managed at relatively low range.
Cardiac Output* ; Cardiography, Impedance ; Coronary Artery Bypass* ; Coronary Vessels* ; Electric Impedance* ; Heart Rate ; Humans ; Intensive Care Units ; Operating Rooms ; Pulmonary Artery ; Thermodilution* ; Transplants

Ischial bursitis is a relatively common cystic lesion that is palpable as a mass in the buttocks. On the other hand, hemorrhagic ischial bursitis accompanied by vascular injury is uncommon, and it can be challenging to diagnose clinically or radiologically. This paper reports a 74-year-old male patient with a cystic lesion in the right ischial tuberosity that occurred after a fall from a ladder 2 months earlier. The initial diagnosis of ischial bursitis was suggested, but conservative treatment did not lead to improvement. Subsequent follow-up showed that the condition was a hemorrhagic ischial bursitis with vascular damage involving a branch of the internal pudendal artery. The patient experienced improvement after undergoing percutaneous embolization.

Semicircular lipoatrophy is a rare entity characterized by atrophic cutaneous indentation, typically involving the anterolateral thigh of young women. Although many previous reports have failed to reveal underlying trauma histories, repeated external microtraumas seem to be the most plausible causal factor at present. We report a case of semicircular lipoatrophy which occurred on both thighs of a 23-year-old woman after she started a new job as a waitress in fast-food restaurant.
Female ; Humans ; Restaurants ; Thigh ; Young Adult

The authors experienced a case of bilateral superior ophthalmic vein thrombosis diagnosed by transfemoral carotid angiography. Thrombolysis was performed by injecting urokinase directly to the obstruction site during angiography. The patient`s visual acuity recovered from light perception to 0.8 in the right eye, and 0.9 in the left eye.
Angiography ; Thrombosis* ; Urokinase-Type Plasminogen Activator* ; Veins* ; Visual Acuity

BACKGROUND: Considering that both humoral and cell mediated immunities play an important role for human tuberculosis infection, enzyme-linked immunosorbent assay(ELISA) measurement of immunoglobulin G (IgG) antibody to mycobacterial antigens can be used for the serologic diagnosis of tuberculous pleural effusion. METHOD: We measured absorbance values of IgG antibodies to purified-protein-derivative (PPD) and lipoarabinomannan-B (LAM-B) in the pleural fluid (PF) and the serum in 40 tuberculous (TPE) and 19 nontuberculous pleural effusions (NTPE). RESULTS: 1) The IgG antibodies to PPD and LAM-B were significantly (P<0.0005) higher in the PF and the serum of TPE compared to NTPE. 2) The IgG antibodies to PPD and LAM-B in the serum were higher than that in PF. 3) Significant correlations were found between pleural and serum IgG antibodies to PPD and LAM-B. 4) With a cutoff value for IgG antibody to PPD in the PF of 0.091, sensitivity was 55.0% and specificity 94.7% in the diagnosis of TPE. 5) With a cutoff value for IgG antibody to LAM-B in the PF of 0.337, sensitivity was 50.0% and specificity 94.7% in the diagnosis of TPE. 6) The seropositive rates in TPE were not related to PPD skin test status, the amount of PF and coexisting active pulmonary tuberculosis. CONCLUSION: The assay of IgG antibodies to PPD and LAM-B might be useful for the diagnosis of TPE. Our study suggests the mechanism of passive transfer of IgG antibodies to PPD and LAM-B from the serum to the PF through pleural tissue.
Antibodies* ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Immunoglobulin G ; Pleural Effusion* ; Sensitivity and Specificity ; Skin Tests ; Tuberculosis ; Tuberculosis, Pulmonary

*Carcinoma, Renal Cell/pathology/surgery ; *Carcinoma, Transitional Cell/pathology/surgery ; Case Report ; Human ; Hypercalcemia/etiology ; Kidney Calculi/complications/surgery ; *Kidney Neoplasms/pathology/surgery ; Kidney Pelvis ; Male ; Middle Age ; *Neoplasms, Multiple Primary/pathology/surgery ; Nephrectomy

Anisakiasis is a parasitic disease caused by an infection of Anisakinae larvae. It occurs when the live larvae are introduced to the human gastrointestinal tract by eating infected raw fish. The endoscopic features of the gastric mucosa adjacent to the worms include redness, edematous, which are sometimes hemorrhagic and erosive. Gastric anisakiasis forming submucosal tumor, due to unobserved endoscopy, larva is very rare. 2 cases of submucosal tumors caused by gastric anisakiasis were found by endoscopic examination. The well demarcated mass lesion was seen in the submucosal layer of the stomach using endoscopic ultrasonography, and confirmed by laparoscopic wedge resection.
Anisakiasis* ; Eating ; Endoscopy ; Endosonography ; Gastric Mucosa ; Gastrointestinal Tract ; Humans ; Larva ; Parasitic Diseases ; Stomach

PURPOSE: Total hydroperoxide (TH), free radical-mediated oxidation product can be used as a measure of free radical injury. The aim of the present study was to see if preterm newborns are at increased risk for oxidative stress compared with term newborns, and to determine whether oxidative stress during postnatal first 1 week is associated with clinical outcomes in preterm infants. METHODS: Serum TH levels of preterm infants (n=39) were compared with those of term infants (n=24) on the postnatal day 1. Among the preterm infants, serum TH levels of uncomplicated group (n=23) were also compared with those of complicated group (n=16) who developed oxygen radical related diseases on the postnatal day 1 and 7. Retrospective analysis was performed to find out risk factors for oxygen radical injuries based on birth history, laboratory data, neuroimaging findings and clinical progress in two preterm groups. RESULTS: Serum TH levels on postnatal day 1 were higher in the preterm infant group than the term infant group. Serum TH levels on postnatal day 1 in the complicated preterm infant group were significantly higher compared with uncomplicated group, but there was no significant difference in serum TH levels on postnatal day 7. Also, there was no significant difference in serum TH levels between uncomplicated preterm infants and term infants. Serum TH level on postnatal day 1 was independently associated with higher morbidity after adjusting for gestational age, Apgar score (5 min), arterial blood gas analysis. CONCLUSION: Complicated preterm newborns are at increased risk for oxidative stress compared with uncomplicated newborns and term newborns. Oxidative injury during the prenatal or postnatal day 1 is associated with adverse outcomes in preterm infants. Elevated TH levels on postnatal day 1 may have a value to predict clinical outcomes in preterm infants.
Apgar Score ; Blood Gas Analysis ; Gestational Age ; Humans ; Hydrogen Peroxide* ; Infant ; Infant, Newborn ; Infant, Premature ; Neuroimaging ; Oxidative Stress ; Oxygen ; Reproductive History ; Retrospective Studies ; Risk Factors