No abstract available.
Nocardia Infections*

No abstract available.

A 69-year-old male patient presented with a 2 week history of left leg swelling. The past medical history was unremarkable. On physical examination, his left leg was swollen up to the thigh and Homan's sign was positive. Duplex ultrasound revealed a solid and cystic lesion localized only at the iliac vein. Surgical exploration was performed under the suspicion of adventitial cystic disease (ACD). The final pathologic diagnosis was ACD. Although ACD has usually been reported in arterial segments, venous involvement has been reported. In the majority of these reported patients, the common femoral vein is associated with venous ACD. According to a Medline search, there have been nine reports related with venous ACD. Only two cases of external iliac vein (EIV) involvement of ACD have been previously reported, including one Korean report. We report here on a case of recently experienced EIV ACD.
Aged ; Edema ; Femoral Vein ; Humans ; Iliac Vein ; Leg ; Male ; Physical Examination ; Thigh

Purpose: To investigate the association of the preoperative fat-to-orbit ratio on the outcome of endoscopic orbital decompression in patients with thyroid-associated orbitopathy (TAO). Methods: Between January 2021 and December 2022, 36 patients with TAO, 72 eyes in total, underwent endoscopic orbital decompression at our hospital’s ophthalmology department. We calculated fat-to-orbit ratios using two-dimensional facial computed tomography scans, and conducted both preoperative and postoperative measurements of proptosis and the prism cover test. We used binominal logistic regression analysis to examine the correlation between the ratios and postoperative complications (diplopia, strabismus, lid retraction) following the surgery. Furthermore, simple linear regression analysis was used to assess the relationship between the ratios and change in exophthalmos. Results: The regression indicated significant associations between the ratio and the onset of postoperative complications such as new-onset postoperative diplopia (NOPD) (β = -0.098, p = 0.029), postoperative strabismus (β = -0.123, p = 0.009), and eyelid retraction (β = -0.188, p = 0.002), particularly in cases requiring subsequent strabismus or eyelid retraction surgery after the initial procedure. Conclusions The preoperative fat-to-orbit ratio is a significant predictor of postoperative complications such as NOPD, strabismus surgery and eyelid retraction surgery in patients undergoing endoscopic orbital decompression for thyroid eye disease. Therefore, it should be considered a valuable indicator of surgical outcomes and complications in such patients.

No abstract available.
Intussusception*

A 62-year-old male with a smoking history of 30 pack-years presented with a 1-year history of a periumbilical pulsating mass. He had been treated for hypertension for 2 years. Physical examination revealed a huge pulsating mass in the periumbilical abdomen. Femoral and popliteal arterial pulses were palpable. Computed tomography showed arterial dissection in the proximal segment of the superior mesenteric artery, a huge aneurysm (52×50 mm) with mural thrombus and two smaller aneurysms (20×20 mm) in the right ileocolic and ileal branches, along with atherosclerotic changes. Interposition using the great saphenous vein was performed after aneurysmal isolation and ligation of jejunal branches in the sac. Distal flow was reestablished by end-to-end and end-to-side anastomoses of the right ileocolic and ileal branches, respectively. No complications were observed at 1-year follow-up.
Abdomen ; Aneurysm* ; Aortic Aneurysm, Abdominal* ; Follow-Up Studies ; Humans ; Hypertension ; Ligation ; Male ; Mesenteric Artery, Superior* ; Middle Aged ; Physical Examination ; Saphenous Vein ; Smoke ; Smoking ; Thrombosis

Purpose: To report a case of retrobulbar optic neuritis after COVID-19 infection.Case summary: A 20-year-old Korean man, without any previous relevant medical history, presented with sudden blurred vision in the left eye that began 6 days after a COVID-19 infection. At his initial visit, the best-corrected visual acuity in the left eye was counting fingers at 30 cm. The pupil showed a grade 2 relative afferent pupillary defect. The fundus exam was normal in both eyes. In the visual evoked potential (VEP) exam, the P100 amplitude of the left eye was decreased and delayed. Orbit magnetic resonance imaging showed asymmetric enlargement and mild enhancement in the left optic nerve. No other lesions were observed around the optic nerve. Steroid pulse therapy was started after a diagnosis of retrobulbar optic neuritis. After 1 month, the patient’s visual acuity had improved to 1.0 in the left eye. The relative afferent pupillary defect and visual field defect disappeared. On VEP, the P100 amplitude recovered, and the delay disappeared. Conclusions Retrobulbar optic neuritis is a possible neuro-ophthalmological complication of COVID-19 infection. In such cases, high-dose steroid pulse therapy may be helpful, as in the treatment of other forms of optic neuritis.

Ludwig’s angina is a rapidly progressive and gangrenous cellulitis in the submandibular, sublingual spaces, and neck. It is characterized by an elevated tongue and laryngeal edema, resulting in airway compromise and, rarely, in sudden death. The most common cause is an odontogenic infection of a molar tooth. Infection can spread to the superior mediastinum and buccal area through anatomical structures. Herein, we report the sudden death of a 45-year-old male who was not diagnosed with Ludwig’s angina. He died in the emergency room 20 minutes after loss of consciousness. Intubation was impossible owing to severe laryngeal edema. The C-reactive protein level was 33.81 mg/dL. On autopsy, a diffuse light green abscess of the submandibular space was detected, along with severe edema of the epiglottis, aryepiglottic fold, and vocal cords. Subsequently, we confirmed that the airway obstruction was caused by Ludwig’s angina based on a literature review. In conclusion, this report emphasizes the need to identify the infection source and perform a detailed dissection according to the anatomical structure in the autopsy procedure for Ludwig’s angina.

BACKGROUND: Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC), however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, arid survival of concurrent chemotherapy with etoposide and cisplatin(EP) arid radiation therapy for unresectable stage III NSCLC. METHODS: Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without, malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide arid cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. RESULTS: Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient The median survival was l2.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia(> or = grade 3,46%) Thrombocytopenia over grade 3 was found in 1%. Radiation pneumonitis occurred in 13 patients(46%). CONCLUSION: Concurrent chemotherapy(EP) pins radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Etoposide* ; Humans ; Lung Neoplasms ; Pleural Effusion, Malignant ; Radiation Pneumonitis ; Radiotherapy ; Survival Rate ; Thorax ; Thrombocytopenia

BACKGROUND: Behcet's disease (BD) is a systemic disease of unknown cause, belonging to vasculitis pathologically. There are only few reports describing the frequency and clinical features of cardiovascular involvement in BD, even though the vascular lesions involving artery and large-sized vein has been reported to be important in prognosis. We performed a retrospective study to address the clinical features of Behcet's disease involving cardiovascular system. METHODS: We studied 155 patients with BD who fulfilled the international criteria. The frequency and clinical characteristics of cardiovascular involvement were studied retrospectively. RESULTS: Among 155 patients with BD, 27 patients (17.4%) have cardiovascular involvement. When they were compared with patients without cardiovascular lesions, male proportion was significantly higher (OR 5.541, 95% CI 2.033~15.105, p=0.001) and the age at onset was younger (OR 1.059, 95% CI 1.003~1.118, p=0.037). Nine patients (5.8%) had arterial lesions which included 10 cases of arterial aneurysm and 3 cases of arterial occlusion. Arterial aneurysm occurred at aorta (3 cases) and pulmonary artery (3 cases) most frequently. Arterial occlusion occurred at coronary artery, brachial artery and digital artery. There were 4 patients with cardiac valvular lesions which included aortic regurgitation (3 cases) and tricuspid stenosis (1 case). Nineteen patients (12.3%) had venous lesions. Among them deep vein thrombosis were 25 cases, and transverse sinus thrombosis was one case. When the patients with deep vein thrombosis were divided by the site of the lesion, the cases involving deep femoral and popliteal vein were the most frequent (6 patients respectively), which were followed by iliac vein, superficial femoral vein, and superior vena cava. When the patients were divided into arterial and venous involvement groups, they showed no significant differences in clinical features. CONCLUSION: In BD patients, the frequency of cardiovascular involvement was 17.4% of which that of deep vein thrombosis was the highest. Arterial aneurysm was the most frequent among arterial lesions. The patients with cardiovascular involvement had significantly higher male proportion and younger onset age than the patients without cardiovascular lesions.
Age of Onset ; Aneurysm ; Aorta ; Aortic Valve Insufficiency ; Arteries ; Brachial Artery ; Cardiovascular System ; Constriction, Pathologic ; Coronary Vessels ; Femoral Vein ; Humans ; Iliac Vein ; Lateral Sinus Thrombosis ; Male ; Popliteal Vein ; Prognosis ; Pulmonary Artery ; Retrospective Studies ; Vasculitis ; Veins ; Vena Cava, Superior ; Venous Thrombosis