Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

Hydrochlorothiazide is a diuretic drug used in the treatement of edema and hypertension. We report a case of hydrochlorothiazide induced photosensitivity in a 54 year old woman who had taken hydrochlorothiazide for 3 years for hypertension. She complained of itching and burning sensation with erythematous papules and lichenified plaques on light-exposed areas. Fhototest showed marked decrease of the minimal erythema dose(MED) for UVA. The symptoms subsided after the use of topical steroid and the substitution atenolol for hydrochlorothiazide.
Atenolol ; Burns ; Edema ; Erythema ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Middle Aged ; Pruritus ; Sensation

To present a case of unusual dorsal epidural gas (EG) accumulation after a simple lumbar microdiskectomy (MD), treated with computed tomography (CT)-guided needle aspiration.A 78-year-old woman underwent simple lumbar MD at the L3–4 level. One week after the operation, the patient complained of severe back pain radiating to the right thigh. Follow-up magnetic resonance imaging (MRI) and CT revealed huge EG formation at the dorsal L3–4 epidural space. Conservative treatment did not resolve the patient's pain. We performed CT-guided needle aspiration after 1 week of conservative treatment. The patient's pain fully resolved after aspiration, but it recurred 1 week later. Follow-up MRI and CT revealed reaccumulation of the dorsal EG at the L3–4 level. CT-guided needle aspiration was repeated, again leading to full pain resolution. Follow-up CT 6 months after the second aspiration showed no recurrent dorsal EG. The patient has been symptom-free for 1 year since the second aspiration. CT-guided needle aspiration is a safe and effective alternative to reoperation in the context of dorsal EG formation after MD.

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

No abstract available.
Humans ; Renal Insufficiency, Chronic* ; Rhabdomyolysis*

Rudimentary meningoceles represent a developmental anomaly in which meningothelial elements are found in the skin. The majority of rudimentary meningoceles occur on the scalp over the occiput or along cranial suture lines. They are present as a pink papule, nodule or an area of alopecia. Histologically, the lesion consists of scattered foci of meningothelial cells, an anastomosing network of empty spaces with psammoma bodies and collagen bodies, and small vessels, which may be located from the dermis to the subcutis. Immunohistochemically, the meningothelial cells are commonly positive for vimentin and often positive for EMA. We report the cases of two infants who were noted at birth to have scalp hair anomalies. One had a translucent, bald, slightly atrophic patch on the midline of the vertex and the other had a subcutaneous nodule surrounded by long hairs, so called "hair collar sign" on the midline of the occipital area. The latter had an underlying skull defect without a communication with intracranial spaces. Due to the occasional presence of connection to the central nervous system, any midline lesion in an infant, including rudimentary meningocele, deserves careful preoperative evaluation including imaging studies.
Alopecia ; Central Nervous System ; Collagen ; Cranial Sutures ; Dermis ; Hair ; Humans ; Infant ; Meningocele* ; Parturition ; Scalp ; Skin ; Skull ; Vimentin

We report three cases of sarcoidosis with pulmonary involvement. The skin lesions showed three types of cutaneous manifestations which were erythema nodosum, pruritic maculopapular eruptions, and subcutaneous nodules respectively. Erythema nodosum in our cases accompanied by arthralgia and bilateral hilar adenopathy, so we call it Lofgrens syndrome. Histopathologic findings of the case with eythema nodosum revealed septal panniculitis and the others showed characteristic histopathologic findings of sarcoidosis so-called naked tubercle. Regressions of the skin lesions were obtained with systemic and/or topical corticosteroid therapy except for subcutaneous nodules. Subcutaneous nodules initially improved but new lesions have been found.
Arthralgia ; Erythema Nodosum ; Panniculitis ; Sarcoidosis* ; Skin

Heparin is commonly used to prevent and treat of thromboembolic events during the endovascular intervention. Rarely, heparin-induced thrombocytopenia (HIT), which is characterized by moderate thrombocytopenia and paradoxical vascular thromboses, complicates systemic heparinization given during endovacular procedures. We present a case of an endovascular treatement of the anterior communicating artery aneurysm complicated by HIT. This case of HIT manifested thromboembolic event and intracerebral hemorrhage simultaneously.
Aneurysm ; Cerebral Hemorrhage ; Embolization, Therapeutic* ; Heparin ; Intracranial Aneurysm* ; Thrombocytopenia* ; Thrombosis

No abstract available.
Carbon*

PURPOSE: To assess the usefulness of T2-weighted oblique coronal MR imaging (T2OCI) in the differential diagnosis of complete and partial tears of the anterior cruciate ligament (ACL) of the knee. MATERIALS AND METHODS: Thirty-three patients with ACL tear (16 complete and 17 partial tears), comfirmed by arthroscopy, were included in this study. Conventional MR imaging and T2OCI were performed, and the findings were retrospectively reviewed by two radiologists in terms of continuity, shape, axis and internal signal intensity of the ligament. Each finding was tested if there were stastistically significant differences in its prevalence between partial and complete tears. The diagnostic accuracy of T2OCI and conventional MR imaging in the detection of partial and complete tears of the ACL were compared. RESULTS: Conventional MR imaging revealed no statistically significant finding for differential diagnosis of complete and partial ACL tears. The reliable and statistically significant (p<0.001) findings of T2OCI were complete discontinuity of the ligament in cases involving complete ACL tears (14 of 16 complete tears and 2 of 17 partial tears) and the preservation of the band form for partial ACL tears (2 of 16 complete tears and 15 of 17 partial tears). The accuracy of T2OCI and conventional MR imaging was 88% and 70%, respectively. CONCLUSION: When ACL injury is vague on conventional MR images, a modality which is more useful in the differential diagnosis of partial and complete tears of the ACL, and in predicting the site of a tear, is T2-weighted oblique coronal imaging.
Anterior Cruciate Ligament* ; Arthroscopy ; Axis, Cervical Vertebra ; Diagnosis, Differential* ; Humans ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Prevalence ; Retrospective Studies