Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

No abstract available.
Joints*

No abstract available.

Adjunctive use of Mitomycin C (MMC)in trabeculectomy has greatly improved the success rate. Trabeculectomy with MMC, however, has resulted in a cystic and thin-walled filtering bleb, which may be more susceptible to infection. Late onset bleb-related endophthalmitis developed in a glaucoma patient at 40 months after MMC trabeculectomy. Filtering bleb in this patient had been avascular, thin-walled and cystic prior to the occurrence of endophthalmitis. Patient complained of decreased visual acuity with ocular discomfort and conjunctival injection and showed a mucopurulent infiltrate within the bleb, hypopyon and vitritis. Visual acuity was hand motion. An intensive treatment included anterior chamber irrigation, lensectomy,par plana vitrectomy, intravitreal and subconjunctival antibiotics (vancomycin,gentamycin) injection and topical and systemic corticosteroid (dexamethasone) and antibiotics,which led to a resolution.
Anterior Chamber ; Anti-Bacterial Agents ; Blister ; Endophthalmitis* ; Glaucoma ; Hand ; Humans ; Mitomycin* ; Trabeculectomy* ; Visual Acuity ; Vitrectomy

Nuclear DNA content in 31 cases of thyroid neoplasm was determined by flow cytometry with the use of paraffin-embedded archival tissue. DNA aneuploidy was found in 6 cases (19.4%) of the 31 thyroid neoplasms; such as 2 of 8 (DI=1.16, 1.56) follicular adenomas, 1 of 6 (DI=1.10) follicular carcinomas, 1 of 15 (DI=1.18) papillary carcinomas and 2 of 2 (DI=1.76, 2.07) medullary carcinomas. The remaining tumors were diploid. No significant difference between follicular adenomas and carcinomas was detected with respect to the S phase fraction(SPF). In the papillary carcinoma group the SPF was higher than in the follicular neoplasm group, but it was statistically insignificant. Regional lymph node metastasis was present in 8 of 15( 53.3%) papillary carcinomas but absent in all of the 14 follicular neoplasms. In the medullary carcinoma group one case showed regional node metastasis at the time of resection and the other developed metastasis 11 months after surgical removal of the primary lesion. In this study tumors predominantly composed of Hurthle cells were found to have a significantly higher D.I. than those with few or no Hurthle cells. No significant difference was found between tumors with metastasis and those without metastasis.
Adenoma ; Neoplasm Metastasis

We observed the change of intraocular pressure(IOP)and the complications after contact transscleral cyclophotocoagulation with Neodymium:YAG (Nd:YAG)laser for the refractory glaucoma patients. Refractory glaucoma in twenty eyes was treated with contact transscleral continuous-wave Nd:YAG laser cyclophotocoagulation with a sapphire-tipped probe. Using 7W of power for 0.7 seconds with 32 applications and intraocular pressure(IOP) was measured at 1 day, 1 week, 1 month, 2 months, 3 months, 4 months, 5 months and 6 months, postoperatively. The intraocular pressure(IOP)decreasing rate was 62% and the success rate was 60%at 6 months postoperatively. It is suggested that contact transscleral cyclophotocoagulation with Nd:YAG laser is useful in lowering IOP in refractory glaucoma patients.
Glaucoma* ; Humans

Epithelial cadherin (E-cadherin) is a Ca2+ -dependent cell-cell adhesion molecule that connects cells via homotypic interactions. Its function is critical in the induction and maintenance of cell polarity and differentiation, and its loss is associated with an invasive and poorly differentiated phenotype in a wide range of tumors. Formalin-fixed, paraffin-embedded tissue sections from 36 cases of cervical intraepithelial neoplasia (CIN) and 14 cervical squamous cell carcinomas were investigated for the expression of E-cadherin immunohistochemically. While E-cadherin expression was usually restricted on the cell membrane of basal and parabasal cells in normal cervix, the presence of cytoplasmic E-cadherin was found to be associated with its grade in CIN lesions. Also, marked cytoplasmic staining was commonly revealed in poorly differentiated ones than well-differentiated squamous cell carcinomas. More intense reactivity of cytoplasmic E-cadherin was frequently seen in the foci of invasion than adjacent carcinoma in situ, and in its periphery than the center of tumor islands. In addition, DNA ploidy and S-phase fraction of squamous cell carcinomas were analyzed and compared with those of CIN lesion. We found that invasive squamous cell carcinomas more frequently disclosed DNA aneuploidy than CIN lesions, and there was correlation between cytoplasmic E-cadherin expression and DNA aneuploidy. Also, cytoplasmic E-cadherin-reactive cervical neoplasms had a higher rate of cell proliferation than that of membranous E-cadherin-reactive cases. These data suggest that the increased cytoplasmic E-cadherin expression may represent one of the abnormalities underlying the loss of polarity and invasiveness of cancer cells, and the abnormal E-cadherin expression combined with/without DNA ploidy or S-phase fraction may serve as a prognostic indicator.
Aneuploidy ; Cadherins* ; Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cell Membrane ; Cell Polarity ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Cytoplasm ; DNA* ; Female ; Islands ; Phenotype ; Ploidies* ; Uterine Cervical Neoplasms

No abstract available.
Myocarditis* ; Stomach*

Epithelioid smooth muscle tumor is relatively rare and potentially malignant, especially in retroperitoneum. Distinct criteria for malignancy still have not been clarified in this epithelioid variant arising in retroperitoneum. We report a deceptively benign-appearing epithelioid leiomyosarcoma in a 50-year-old female. She was admitted with abdominal discomfort and dysuria. Abdominal CT showed a well-demarcated, 10 10 cm sized, solid mass in retroperitoneum. Concomitant metastatic lesions were noted in right lung field. Surgical excision of retroperitoneal mass and right lung lobectomy were performed. The retroperitoneal mass showed yellowish-tan, well-delineated and lobulated appearance. Histologically, this tumor was composed of predominantly epithelioid, round to oval cells with distinct clear cytoplasm and slightly atypical nuclei. Mitosis was rare (0~1/50 HPF). Lung lesions were morphologically similar to that of retroperitoneum.
Cytoplasm ; Dysuria ; Female ; Humans ; Leiomyosarcoma* ; Lung ; Middle Aged ; Mitosis ; Smooth Muscle Tumor ; Tomography, X-Ray Computed

No abstract available.
Bilirubin* ; Humans ; Infant, Newborn*