Tuberculosis of the vagina is very rare disease reported to be involved in less than 1% of female genital tuberculosis. A 53-year-old woman presented with abnormal cervicographic finding at the private clinic. On vaginal physical examination, there were multiple elevated nodular lesion in the vagina and ectocervical area. There was no abnormal vessels or acetowhite epithelium on colposcopic examination. Direct biopsy for histologic examination revealed granulomatous lesion. We performed PCR of mycobacterial DNA and Ziehl-Neelsen staining for acid-fast bacilli (AFB). The Ziehl-Neelsen staining for AFB was negative, but mycobacterial DNA fragments were detected using the PCR method. Diagnosis was confirmed by the detection of acid-fast bacilli in histologic preparations. Anti-tuberculosis medication was effective for this patient.
Biopsy ; Diagnosis ; DNA ; Epithelium ; Female ; Humans ; Middle Aged ; Physical Examination ; Polymerase Chain Reaction ; Rare Diseases ; Tuberculosis* ; Tuberculosis, Female Genital ; Vagina*

Paraovarian cysts arise in the mesosalpinx, between the ovarian hilum and the fallopian tube. Clinical significance of paraovarian tumors is considerably less frequent than ovarian tumors, and malignant paraovarian lesions are exceedingly rare. Paraovarian carcinomas or borderline malignancy mostly occur in young women. Abdominal enlargement and pelvic pain are the usual complaints. Usually they have a capsule, are unilateral and are connected to the broad ligament. Little is known about the biological behavior of the paraovarian borderline malignancies, since these lesions are so rare. The appropriate therapy for this unusual lesion have not been fully defined. We had experienced a case of papillary serous adenocarcinoma of borderline malignancy and report this case with a brief review of literature.
Adenocarcinoma ; Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Pelvic Pain

Multiple system atrophy (MSA) is an idiopathic neurodegenerative disorder involving many neuronal structures. It is a heterogeneous system disorder affecting extrapyramidal, cerebellar and autonomic nervous system. Only a minority of MSA patients are diagnosed before reaching the full blown stage. Its autonomic features like orthostatic hypotension, vocal cord paralysis are directly related to mortality. Up to now, rehabilitation of MSA patients had been rarely reported. Early, proper diagnosis and comprehensive rehabilitation for their heterogeneous clinical features are important. We experienced 54 year old hemiplegic paient who overlaps MSA. He showed some improvement in ADL and cerebellar symptoms after comprehensive rehabilitation programs.
Activities of Daily Living ; Autonomic Nervous System ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Middle Aged ; Mortality ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Neurons ; Rehabilitation ; Stroke* ; Vocal Cord Paralysis

PURPOSE: To report 2 young female patients with bilateral posterior scleritis and serous retinal detachment. CASE SUMMARY: An 11-year-old girl (Case 1) and a 16-year-old girl (Case 2) visited our clinic with bilateral ocular pain, redness, and blurred vision. Slit lamp examinations revealed severe bilateral scleral injection and mild anterior chamber reactions. Fundus examinations showed bilateral serous retinal detachments in the macular area. In both patients, diffuse multifocal leaking and pooling were found at the macula in the early and late phase fluorescein angiography, respectively. On the B-mode ultrasounds and orbital images (MRI or CT), scleral thickening with retention of subtenons fluid were found. There were no systemic diseases associated with the conditions. We diagnosed the patients with bilateral posterior scleritis and administered systemic steroids. After systemic steroid treatment, all of the symptoms were alleviated. Three months after the regression, bilateral posterior scleritis recurred in patient 2. Oral cyclosporine 100 mg was additionally prescribed in addition to the previous medications that she had taken during her first treatment. CONCLUSIONS: Two young patients diagnosed with posterior scleritis and serous retinal detachment was treated with systemic steroids. With proper examination and treatment, posterior scleritis can be treated with no complications.
Adolescent ; Anterior Chamber ; Child ; Cyclosporine ; Female ; Fluorescein Angiography ; Humans ; Orbit ; Retention (Psychology) ; Retinal Detachment ; Retinaldehyde ; Scleritis ; Steroids ; Vision, Ocular

Aneurysmal ruptures associated with middle cerebral artery(MCA) anomalies, such as a duplicated MCA and an accessory MCA, are quite rare. The authors reviewed the clinical relevance and possible etiology of these anomalies.
Aneurysm ; Aneurysm, Ruptured ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Rupture*

No abstract available.

A 38-year-old woman with twin pregnancy was referred after detection of hydrocephalus in one fetus at 23+1 weeks' gestation. Sonography showed hydrocephalus, a scalloping of the frontal bone giving a lemon-like configuration, and meningocele. The affected twin was terminated by ultrasonographically guided intracardiac injection of 4 ml (8 mEq/L) potassium chloride solution at 24+5 weeks' gestation. Chromosomal analysis of the other fetus showed normal findings (46, XX). Serial ultrasound scans and coagulopathy tests were unremarkable. Preterm premature rupture of the membrane was developed at 33+3 weeks' gestation, and emergency Cesarian section was done. A healthy 1360 g female was born, with Apgar scores of 7 and 8 at one and five minutes, respectively.
Adult ; Arnold-Chiari Malformation* ; Emergencies ; Female ; Fetus ; Frontal Bone ; Humans ; Hydrocephalus ; Membranes ; Meningocele ; Pectinidae ; Potassium Chloride ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Twins, Dizygotic* ; Ultrasonography

Twenty eight patients with negative but technically satisfactory four-vessel angiography-admitted to our department from 1985 to 1995 were followed for long term evaluation. The aim of this retrospective study of patients with SAH of unknown etiology was to evaluate the clinical features, long-term prognosis in mortality rate and risk of rebleeding, and the daily functional capacity. Twenty eight out of 1035(2.7%) spontaneous subarachnoid hemorrhage patients were found to have subarachnoid hemorrhage(SAH) of unknown etiology. Twenty eight patients were confirmed as SAH, by computed tomography or lumbar puncture. CT scan was undertaken in all cases(in 28 cases within 5 days of hemorrhage). SAH of unknown etiology classified as Hunt and Hess grade I was 60.7% of cases, but there were no patients with Grade V. Arterial hypertension was present on admission in 35.7% of cases. We only performed the angiogram once in 16 of 28 patients, but there were no rebleedings caused by aneurysm. The period of follow-up ranged from 2 to 11 years, with the mean of 4.3 years. Only one of 28 patients(3.6%) experienced late rebleeding, and again had normal cerebral panangiography. Two patients(7.1%) showed a moderate disability in activities of daily living, one patient(3.6%) was mild disabled, and two(7.1%) had died of pneumonia. Based on the ADL grade, Grade I was 28.6% at the time of discharge however, during follow-up, increased up to 81.5%.
Activities of Daily Living ; Aneurysm ; Follow-Up Studies* ; Humans ; Hypertension ; Mortality ; Pneumonia ; Prognosis ; Retrospective Studies ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

PURPOSE: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. METHODS: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. RESULTS: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. CONCLUSION: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.
Central Nervous System Diseases ; Child ; Encephalitis ; Fluid Therapy ; Glucose ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Incidence ; Meningitis ; Meningitis, Bacterial ; Meningitis, Viral ; Pediatrics ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Pneumonia, Viral ; Sodium

Since oxidative stresses are involved in gastroenteritis and diarrhea, we investigated antioxidative and antidiarrheal activities of persimmon flesh extract (PFE) and persimmon calyx extract (PCE) in vitro and in vivo, respectively. PCE significantly scavenged 1,1-diphenyl-2-picrylhydrazyl hydrate and 2,2'-azinobis (3-ethylbenzthiazoline-6-sulfonic acid) from 500 microg/mL, although PFE was ineffective. In addition, PFE and PCE exhibited strong nitric oxide-scavenging effects from 1 microg/mL, in which PCE was superior to ascorbic acid (50 microM). Furthermore, PFE and PCE significantly inhibited FeCl3-induced lipid peroxidation as well as Cu2+/H2O2-induced protein oxidation from 10 microg/mL. In vivo charcoal-propulsion assay, in contrast to a negligible effect of PFE, treatment with PCE (160-500 mg/kg) markedly inhibited intestinal motility. The results indicate that extracts of persimmon, especially PCE, possess antioxidative, antiinflammatory and antidiarrheal activities. Therefore, it is suggested that persimmon extracts could be used for the relief of gastroenteritis and diarrhea.
Ascorbic Acid ; Biphenyl Compounds ; Diarrhea ; Diospyros ; Gastroenteritis ; Gastrointestinal Motility ; Lipid Peroxidation ; Oxidative Stress ; Picrates