A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte ; Pneumonia ; Pneumonia, Aspiration ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Ear Cartilage ; Ectropion ; Eyelids ; Transplants

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Humans ; Plasma* ; Tranexamic Acid* ; Urticaria*

Ureteroscopic management of ureteral calculi is an established successful technique with low complication. We performed 140 ureteroscopies for stone removal from January 1990 to April 1995. The stone were removed successfully in 131 cases (94%), and complication occurred in 37 cases (27%). In 9 cases, complete removal of stone was failed due to upward migration of stone (3 cases), not mobilization of stone (3 cases), inability to introduce ureteroscope into the intramural ureter (2 cases), inadequate illumination due to bleeding (1 case). Complications of ureteroscopic removal of stone were ureteral perforation (8 cases), tearing of ureteral mucosa (5 cases), gross hematuria (19 cases), infection (3 cases) and fever (2 cases). All complications were treated successfully with conservative treatment. We conclude that ureteroscopic removal of stone is still primary useful treatment of middle and lower ureteral stones and can be done safely if certain guide lines such as proper selection of patient, adequate use of lithotriptor, careful dilatation of ureteral orifice are kept strictly.
Dilatation ; Fever ; Hematuria ; Hemorrhage ; Humans ; Lighting ; Mucous Membrane ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

Granulocytic sarcoma is an uncommon extramedullary localized tumor composed of granulocytic precursor cells. The majority of cases have been reported in association with acute myeloid leukemia(AML) especially in children, but infrequently may occur in patients with myeloproliferative disorders or myelodysplastic syndromes. Most common sites of involvement were bone, soft tissue, lymph nodes and skin, but gastrointestinal tract, testis, central nervous system are also involved rarely. We present an unusual case of granulocytic sarcoma of the intracranium and the retro-orbital soft tissue occurring in a patient with concurrent myelodysplastic syndrome, diagnosed by brain magnetic resonance images and ultrasound guided needle biopsy.
Biopsy, Needle ; Brain ; Central Nervous System ; Child ; Gastrointestinal Tract ; Granulocyte Precursor Cells ; Humans ; Lymph Nodes ; Myelodysplastic Syndromes* ; Myeloproliferative Disorders ; Sarcoma, Myeloid* ; Skin ; Testis ; Ultrasonography

In an open reduction of the mandibular angle fracture, it is crucial to approximate each fracture segment as closer as possible for the reduction of the healing period. In this case report, we proposed a new technique for the mandibular angle fracture. This was designed to minimize the gap between two separated segments using mini-implants and surgical wires. Mini-implants were placed around the fracture line, followed by wire ligation to minimize the fracture gap. And then internal fixation was easily employed with plates and screws. The advantages of this technique were reduced time for operation, the promotion of healing, rapid functional recovery, and few complications.
Ligation

BACKGROUND: Dermal papilla cells, which are mesenchymal components of the hair bulb are considered to play an important role in the regulation of hair growth by production of diffusible factors that stimulate follicular epithelial cells. Degenerative changes in the dermal papilla cells in the involved scalp of alopecia areata cases indicate that these cells are one of the important targets in this disease. OBJECTIVE: We investigated the effects of serum from alopecia areata patients on the proliferation of dermal papilla cells. METHOD: Dermal papilla cells and fibroblasts from normal human scalp were cultured in DMEM media with 10% or 20% of normal and alopecia areata serum for 48hrs and 96hrs. Cell proliferation was measured by cell counts and [3H]-thymidine incorpoartion. RESULTS: Both 10% and 20% alopecia areata serum had no significant effects on the proliferation of dermal papilla cells and fibroblasts after 48hrs and 96hrs. CONCLUSION: These results suggest that there are no serum factors that inhibit the proliferation of dermal papilla cells.
Alopecia Areata* ; Alopecia* ; Cell Count ; Cell Proliferation ; Epithelial Cells ; Fibroblasts ; Hair ; Humans ; Scalp