No abstract available.
Esophagus* ; Melanoma*

A 69-year-old man was admitted to the hospital because of flu-like symptoms and fatigue for 2 weeks. Computed tomography revealed ground glass opacity and consolidation in both the lungs as well as pleural effusion. The patient was diagnosed with pneumonia and was hospitalized. At the time of hospitalization, he complained of shortness of breath and coughed-up blood-tinged sputum. Two days after admission, he died suddenly. An autopsy was performed; cardiomegaly was noted, and further examination revealed that the aortic valve had been destroyed by multiple, irregular vegetations. Herein, we report an autopsy case of infective endocarditis with a review of the relevant literatures.
Aged ; Aortic Valve ; Autopsy* ; Cardiomegaly ; Dyspnea ; Endocarditis* ; Fatigue ; Glass ; Hospitalization ; Humans ; Lung ; Pleural Effusion ; Pneumonia ; Sputum

We reviewed 42 cases (mean age 48.3+/-7.6 years, range 30 to 63 years) who underwent the modified Gittes bladder neck suspension for female stress urinary incontinence between January 1990 and May 1995 to evaluate the efficacy of two different suspension suture materials and new suspension suture carrier. At first we used the No. 1-0 Prolene as suspension suture in 24 cases (group I) and secondly No. 1-0 Ethibond in 18 cases (group II) with Ostycut bone biopsy needle (Angiomed) as suture carrier Following results were obtained. 1. The patient's ages ranged from 30 to 63 years (mean age 48.3+/-7.6 years), and most patients were multiparous with an average of 3.3+/-1.2 deliveries and we classified the patients according to Blaivas classification and there was statistically no difference of variables in both groups except the parity. 2. The mean values of operative time, postoperative days on catheter, and postoperative hospitalization were 65.5+/-11.4 minutes, 6.9+/-1.6 days, 7.3+/-1.4 days respectively. 3. The postoperative complications were transient urinary retention 8 cases (21.1%), vaginitis or cystitis 5 cases (11.9%), wound bleeding 1 case (2.4%) and deviation of urinary steam 1 case (2.4%). 4. The success rate was 83.3% in the group I, 94.4% in group II with minimum followup of 12 months (mean 24.6+/-5.0 months) but the latter wasn't significantly higher than the former statistically. The overall success rate was 88.1%. 5. The Ostycut bone biopsy needle as suspension suture carrier was simple and safe in the bladder neck suspension treatment. With above results, we recommend the No. 1-0 Ethibond as suspension suture material rather than the Prolene in bladder neck suspension and Ostycut bone biopsy needle as suspension suture carrier.
Biopsy ; Catheters ; Classification ; Cystitis ; Female ; Follow-Up Studies ; Hemorrhage ; Hospitalization ; Humans ; Neck* ; Needles ; Operative Time ; Parity ; Polypropylenes ; Postoperative Complications ; Steam ; Sutures* ; Urinary Bladder* ; Urinary Incontinence ; Urinary Retention ; Vaginitis ; Wounds and Injuries

BACKGROUND: An aggressive skin cancer on the nose, tends to have poorly defined clinical margins, and has a higher recurrence rate. A small tumor on the nose is usually easily treated by any of the standard methods. However, removal and reconstruction with preserved cosmesis is more laborous in a basal cell carcinoma larger than 10 mm in diameter. This is because the nose has complex contoures, unique skin color and texture, and the limited availability of mobile adjacent skin. When available Mohs micrographic surgery is the preferred treatment for these large tumors. OBJECTIVE: Our purpose was to investigate the preferred reconstruction method(especially, local flap reconstruction) by the cosmetic unit of the nose after Mohs micrographic surgery. METHODS: From March 1991 to February 1997, twenty-one patients were diagnosed with basal cell carcinoma on the nose at our department. All the tumors were removed with Mohs micrographic surgery, and then the defects were reconstructed with a primary closure, skin graft, and local flap.
Carcinoma, Basal Cell* ; Humans ; Mohs Surgery* ; Nose* ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

BACKGROUND: Recently, there has been an increase in acute poisonings in the elderly, which may be associated with attempts at suicide. The purpose of this study was to compare and analyze the clinical aspects and outcomes of acute poisonings in aged individuals with those of younger individuals. METHODS: We performed a retrospective analysis of 207 patients seen in the emergency department (ED) with acute poisoning from January 2009 to December 2010. Two groups were created, >65 years and <65 years. The following were carefully compared-annual frequency, gender distribution, cause of poisoning, poisoning substance, motive for suicide, past psychiatric history, psychiatric interview, psychiatric diagnosis, disposition after ED visit, disposition after admission, poisoning severity score (PSS), duration of hospitalization, intensive care unit (ICU) admission rate, and mortality. RESULTS: The annual frequency was 0.1% in the >65 group and 0.3% in the <65 group, 0.4% in total. The cause of poisoning was accidental more often in those >65 years than in those <65 years. As motive for suicide, health problem was cited more often in the older group (p=0.000). The older group had fewer interviews with psychiatrists and were more often diagnosed with depressive disorder (p=0.010, p=0.041, respectively). PSS and mortality were higher in the older group (p=0.002, p=0.010, respectively). CONCLUSION: A better understanding for the cause of poisonings and the poisonous substance used in the aged population is needed. And because of the more serious effects of acute poisonings to the elderly patient, they should readily receive regular comprehensive care including psychiatric care.
Aged ; Depressive Disorder ; Emergencies ; Hospitalization ; Humans ; Intensive Care Units ; Mental Disorders ; Psychiatry ; Retrospective Studies ; Suicide

Kasabach-Merritt syndrome (KMS) consists of thrombocytopenia, microangiopathic hemolytic anemia, and localized consumption coagulopathy that develops within vascular hemangioma. This syndrome may also be associated with occult hemangiomas located at various sites. Tc-99m RBC scintigraphy and SPECT have proven to be reliable for confirming or excluding hemangioma. Total body blood pool imaging study during the scintigraphy also provides a means of screening for occult lesions. The authors report the case of a 29-year-old man who presented with a giant hepatic hemangioma complicated by KMS, and underwent Tc-99m RBC scintigraphy and SPECT including a total body blood pool imaging study.
Adult ; Anemia, Hemolytic ; Disseminated Intravascular Coagulation ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome ; Mass Screening ; Thrombocytopenia ; Tomography, Emission-Computed, Single-Photon

A 68-year-old man with small cell carcinoma of the lung and adenocarcinoma of the prostate underwent Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bilateral symmetrical photon defects in both parietal bones of the skull were observed. The radiographs of the skull demonstrates biparietal thinning in the same area of the abnormality identified on bone scintigraphy. Although these findings in cancer patients can be mistaken for skeletal metastases, the symmetry and location of the photon defects are generally indicative of biparietal thinning.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell ; Humans ; Lung ; Neoplasm Metastasis ; Parietal Bone ; Prostate ; Radionuclide Imaging* ; Skull ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed, Single-Photon*

A 59-year-old man with thymic carcinoma underwent Tc-99m MIBI myocardial SPECT, and Tc-99m MIBI uptake in the mass was unexpectedly found in a planar image. SPECT images of the thorax showed an increased uptake area with central photon deficiency (a ring-like appearance), which reflected central tumor irreversible ischemia or progressing necrosis with peripheral viable tumor tissue.
Humans ; Ischemia ; Middle Aged ; Necrosis ; Thorax ; Thymoma* ; Tomography, Emission-Computed, Single-Photon

A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.
Breast ; Carcinoma, Ductal ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Radionuclide Imaging* ; Skull* ; Technetium Tc 99m Medronate

A 61-year-old man had a F-18 FDG PET/CT scan for evaluation of a common bile duct cancer identified on CT. The PET/CT image showed a hypermetabolic mass in the common bile duct, and a focal area of increased F-18 FDG uptake in segment IV of the liver, which corresponded to a hypoattenuated lesion on non-enhanced CT, and was consistent with hepatic metastasis. The patient underwent choledochojejunostomy with hepatic resection, and pathologic findings were compatible with an eosinophilic abscess in the liver. This case demonstrates that F-18 FDG uptake by an eosinophilic abscess can mimic hepatic metastasis in a patient with a malignancy.
Abscess ; Choledochostomy ; Common Bile Duct ; Eosinophils ; Humans ; Hydrazines ; Liver ; Liver Abscess ; Middle Aged ; Neoplasm Metastasis