Pellegrini-Stieda's disease is a post-traumatic disorder of the knee. It is characterized by a crescentric-like bony formation in the region of the medial condyle of the femur, which usually makes its appearance upon roentgenographic examination three or more weeks after injury to the knee. During the three and a half years from January 1979 to July 1982, eleven patients were treated by conservative method and only one patient was treated by operation. The results were as follows; l. All give a history of trauma. 2. The major findings in this disease were pain in motion, local tenderness, and limitation of motion. 3. In roentgenographic findings of these cases, we noted the followings: 1) The most common site of the calcification was the proximal area of the tibial collateral ligament. 2) In seven cases (58%), the evidence of calcification was noted in 4 weeks to 12 weeks following original trauma. 3) Eight cases (67%) showed a radiolucent area from 0.5 to 3mm in thickness between the bony shadow and the femur. 4) Eight cases (67%) showed a crescentric shape of calcified area. 5) In seven cases (58%), the size of calcified mass was 1.5 to 3.5cm in length and 1 to 3mm in width. The mean size of calcified mass about 3cm in length and about 2.5mm in width. 4. Eleven cases were treated conservatively and one case was treated operatively. The results were satisfactory, and all patients were able to return to their works.
Clinical Study ; Femur ; Humans ; Knee ; Medial Collateral Ligament, Knee ; Methods

No abstract available.
Duodenal Ulcer* ; Pepsinogen A*

Objectives: . Otitis media is a common infection worldwide. Owing to the limited number of ear specialists and rapid development of telemedicine, several trials have been conducted to develop novel diagnostic strategies to improve the diagnostic accuracy and screening of patients with otologic diseases based on abnormal otoscopic findings. Although these strategies have demonstrated high diagnostic accuracy for the tympanic membrane (TM), the insufficient explainability of these techniques limits their deployment in clinical practice. Methods: . We used a deep convolutional neural network (CNN) model based on the segmentation of a normal TM into five substructures (malleus, umbo, cone of light, pars flaccida, and annulus) to identify abnormalities in otoscopic ear images. The mask R-CNN algorithm learned the labeled images. Subsequently, we evaluated the diagnostic performance of combinations of the five substructures using a three-layer fully connected neural network to determine whether ear disease was present. Results: . We obtained the receiver operating characteristic (ROC) curve of the optimal conditions for the presence or absence of eardrum diseases according to each substructure separately or combinations of substructures. The highest area under the curve (0.911) was found for a combination of the malleus, cone of light, and umbo, compared with the corresponding areas under the curve of 0.737–0.873 for each substructure. Thus, an algorithm using these five important normal anatomical structures could prove to be explainable and effective in screening abnormal TMs. Conclusion . This automated algorithm can improve diagnostic accuracy by discriminating between normal and abnormal TMs and can facilitate appropriate and timely referral consultations to improve patients’ quality of life in the context of primary care.

Protothecosis is a rare cutaneous soft tissue infection caused by the genus prototheca, most commonly Prototheca wickerhatmii. An 80-year-old woman has had a painful or tender, non-healing, eczematous plaque on the extensor surface of the left forearm for 4 years. A biopsy specimen revealed the characteristic thick-walled morulalike sporangia in the dermis. P. wickerha mili was isolated in the culture and the biochemical studies. Electron microscopic examination showed the thick-walled spores containing dark dense bodies and amyloplasts. Oral itraconazole therapy for 4 weeks resulted-in a marked improvement of the skin lesion.
Aged, 80 and over ; Biopsy ; Dermis ; Female ; Forearm ; Humans ; Itraconazole ; Plastids ; Prototheca ; Skin ; Soft Tissue Infections ; Sporangia ; Spores

Primary small cell carcinomas of the prostate are rare, and their histogenesis and clinical behavior remain poorly defined. The origin of small cell carcinoma remains uncertain, but several hypothesis has been put forward, one of this is that the tumor is derived from the argentaffin or argyrophil cells normally present in the prostate, and the other is that arises from the totipotential basal or reserve cells of the prostatic acini. Primary small cell carcinoma of the prostate is a highly aggressive tumor. causing widespread metastasis and early death. The mean survival is 5 to7 months after diagnosis of the small cell carcinoma regardless of the proportion of small cell component or cell size. We report one case of primary small cell carcinoma of the prostate with brief review of literatures.
Carcinoma, Small Cell* ; Cell Size ; Cellular Structures ; Diagnosis ; Neoplasm Metastasis ; Prostate*

Spine diseases are common and exhibit several causes, including degeneration, trauma, congenital issues, and other specific factors. Most people experience a variety of symptoms of spine diseases during their lifetime that are occasionally managed with conservative or surgical treatments. Accurate diagnosis of the spine pathology is essential for the appropriate management of spine disease, and various imaging modalities can be used for the diagnosis, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), and other studies such as EOS, bone scan, single photon emission CT/CT, and electrophysiologic test. Patient (or case)-specific selection of the diagnostic modality is crucial; thus, we should be aware of basic information and approaches of the diagnostic modalities. In this review, we discuss in detail, about diagnostic modalities (radiography, CT, MRI, electrophysiologic study, and others) that are widely used for spine disease.

A 73-year-old woman who presented with chest discomfort visited the emergency room. The 12-lead electrocardiography showed ST-segment elevation in II, III, and lead augmented vector foot. Emergent coronary angiography revealed a thrombus in the distal right coronary artery. Percutaneous coronary angioplasty with a stent was performed. After the procedure, persistent dyspnea occurred. Her chest computed tomography (CT) showed occlusion of the bilateral pulmonary artery. We could not find a source for the embolization or a hypercoagulable state. We started a course of dual antiplatelets with oral anticoagulants. Pulmonary embolism was resolved at follow-up chest CT scan. Aspirin, clopidogrel and warfarin were given for 6 months. The patient is doing well now 1 year after the episode.
Aged* ; Angioplasty ; Anticoagulants ; Aspirin ; Coronary Angiography ; Coronary Vessels ; Dyspnea ; Electrocardiography ; Emergency Service, Hospital ; Female ; Fibrinolytic Agents ; Follow-Up Studies ; Foot ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Pulmonary Artery ; Pulmonary Embolism* ; Stents ; Thorax ; Thrombosis ; Tomography, X-Ray Computed ; Warfarin

Gastric lymphoma occupies about 1-7% of gastric cancer and is the most common type of extranodal lymphoma. To evaluate the endoscopic morphologic characteristics of gastric lymphoma, we analysed the endoscopic findings in 45 patients with pathologically-proven gastric lymphoma. (continue...)
Gastroscopy ; Humans ; Lymphoma* ; Stomach Neoplasms

Here, we report a case of newly diagnosed diabetes, with concurrent pancreatic cancer manifested as hyperglycemic crisis, and aggravated by urinary tract infection. We summarize the initial clinical manifestations and pertinent laboratory, radiologic, and clinical findings in an elderly patient with hyperglycemic emergency. A review of the documents involving pancreatic tumors and hyperglycemic hyperosmolar state, which is an acute complication of diabetes mellitus, is presented. In the absence of other identifiable conditions, it is reasonable to speculate that some factor (or factors) produced by the tumor had a role in the metabolic decompensation. In addition, this discussion should be more carefully considered in the aged people group.
Aged ; Diabetes Mellitus ; Emergencies ; Humans ; Pancreatic Neoplasms ; Urinary Tract Infections

BACKGROUND: Much time and cost have been consumed for just a treatment of a simple disease and inappropriate management has taken place because of misjudgement by laymen. To establish a desirable health care system, need for the usual-medical-provider system (U.MP. system) has been suggested. This study was performed to find some data that would be helpful to establish the U.MP. system by surveying some factors influencing on choosing care providers of children. METHODS: 440 questionnaires were gathered from surveys administered to the parents of the students in a primary school. The period for study was 1 week of September in 1999 and the response rate was 88.0%. The questionnaire was composed of sociodemographic variables, a question for having U.MP. and some factors related with choosing U.MP. RESULTS: The fourth and fifth decade of age showed higher proportion for having U.MP. than sixth decade. The proportion of having U.MP. was also higher in respondents with higher educational attainment and higher income. The proportion of visiting local clinics or hospitals was about 65.7% in groups having U.MP., whereas the proportion was about 41.5% in group not having U.MP., The frequency of visiting local clinics or hospitals for a year was higher for groups having U.MP., compared with groups not having U.MP.. The factors related with choosing U.MP. were `doctors who explain the disease in detail and easily', `doctors who provide care meticulously', and `effective treatment'. CONCLUSION: To establish the U.MP. system, a kinder attitude and care would be necessary for doctors who will provide care to the patients and their family.
Child ; Surveys and Questionnaires ; Delivery of Health Care ; Humans ; Parents