Eosinophilic fasciitis (EF) is scleroderma-like disease without Raynaud's phenomenon or visceral involvement. It is characterized by painful swelling of the extremities, accompanied by rapid weight gain, fever and myalgia. The acute state of disease is associated with significant peripheral blood eosinophilia, an elevated erythrocyte sedimentation rate and hypergammaglobulinemia. EF is also frequently associated with hematological abnormalities, including malignant lymphoproliferative diseases, but rarely associated with autoimmune thyroiditis. In the present study we report a case of eosinophilic fasciitis associated with autoimmune thyroiditis.
Biopsy ; Diagnosis, Differential ; Eosinophilia/diagnosis/*etiology ; Fasciitis/diagnosis/*etiology ; Female ; Forearm ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Muscle, Skeletal/pathology ; Thyroiditis, Autoimmune/*complications/diagnosis

No abstract available.
Fingers*

Strongyloides stercoralis, which has two different generations: the free living and parasitic generation, is primarily adapted to warm climates, but strongyloidiasis has been reported sporadically in temperate and cold regions. Strongyloidiasis may be asymptomatic in almost 50 percent of the cases, rarely, infestation presents with severe clinical pictures. The reason for this exacerbation of illness is probably a rapid increase in the number of infecting larvas through the development or acceleration of a cycle of autoinfection. A breakdown of the host-parasite equilibrium due to decreased host resistance may occur in malnutrition, debilitating diseases or therapy with immunosuppressive drugs. Corticosteroid treatment may have an important role in the sudden occurrence of severe stongyloidiasis. We experienced a case of strongyloidiasis with severe malnutrition, accompanied with bronchial asthma and diabetes mellitus. This patient has been treated with corticosteroid for several years. So, we report this rare case with the literature review.
Acceleration ; Asthma ; Climate ; Diabetes Mellitus ; Family Characteristics ; Humans ; Larva ; Malnutrition* ; Strongyloides stercoralis ; Strongyloidiasis*

Evaluation of the mechanism of anemia in cancer patients might help to select patients for the more efficient use of erythropoietin (EPO, a growth factor for erythroid precursor cells). For this, we investigated whether the production of EPO responds to anemia and the bone marrow responds to EPO appropriately, and whether chronic inflammation is inhibitory to erythropoiesis in anemic cancer children. Serum levels of EPO, soluble transferrin receptor (sTfR), tumor necrosis factor (TNF)-alpha, and erythrocyte sedimentation rate (ESR) in anemic cancer children were measured by enzyme-linked immunosorbent assay and then the correlation coefficients between those parameters and hemoglobin (Hb) were determined. Both in leukemia and in solid tumor patients, there were significant inverse correlations between Hb and EPO (leukemia: tau=-0.547, p<0.0001; solid tumor: tau=-0.591, p<0.0001), and between sTfR and EPO (leukemia: tau=-0.223, p<0.05; solid tumor: tau=-0.401, p<0.05). In contrast, sTfR showed a correlation with Hb in leukemia (tau=0.216, p<0.05) but not in solid tumor patients. sTfR was suppressed in 53% of anemic episodes of leukemia and 78% of those of solid tumor patients. Our results suggest that in cancer children, the EPO production is not defective and chronic inflammation is not inhibitory to erythropoiesis. Rather, the defective erythropoiesis itself is thought to be responsible for the anemia.
Anemia/etiology/*physiopathology ; Blood Sedimentation ; Bone Marrow/physiology ; Child ; Erythropoiesis/*physiology ; Erythropoietin/blood ; Female ; Humans ; Male ; Neoplasms/complications/*physiopathology ; Receptors, Transferrin/blood ; Solubility ; Tumor Necrosis Factor-alpha/metabolism

Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.
Aged ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Diaphragm ; Fistula ; Hernia, Diaphragmatic* ; Humans ; Male ; Postoperative Complications ; Stomach ; Surgical Flaps ; Sutures ; Thoracic Surgery

A case of endobronchial tuberculosis with left main bronchial stenosis and atelectasis of left lower lobe in a 26-year-old female is reported. She had taken antituberculous agents for 9 months, but she complained of chest pain and coughing. Bronchoscopy revealed patency of left upper bronchus and bronchiectasis of left lower lobe. She underwent left lower lobectomy with bronchoplasty. After the operation she had significant improvement of pulmonary function. Although surgical treatment of endobronchial tuberculosis is controversial, bronchoplastic surgery can be an effective treatment of tuberculous bronchial stenosis because it relieves patients from symptoms by preserving lung functions.
Adult ; Bronchi ; Bronchiectasis ; Bronchoscopy ; Chest Pain ; Constriction, Pathologic* ; Cough ; Female ; Humans ; Lung ; Pulmonary Atelectasis ; Tuberculosis

Pulmonary sequestration is an abnormal lung tissue that does not communicate with tracheobronchial tree, and that receives blood supply from anomalous arteries. Pulmonary sequestration is divided into two anatomical forms, intralobar and extralobar. Extralobar pulmonary sequestration is usually located between the diaphragm and the lower lobe and has systemic arterial supply and venous drainage, and most patients are diagnosed in their infancy. We report an extralobar pulmonary sequestration located between the right upper lobe and the lower lobe in a 48-year-old female adult, which has anomalous blood supply from the right pulmonary artery and venous drainage directly into the left atrium.
Adult ; Arteries ; Bronchopulmonary Sequestration* ; Diaphragm ; Drainage ; Female ; Heart Atria ; Humans ; Lung ; Middle Aged ; Pulmonary Artery

BACKGROUND: Because the development of medicine, the survival of ESRD(end stage renal disease) patients were improved and the chance of secondary arteriovenous fistula formation was increased. The purpose of this study is to evaluate the patency rate of one of the secondary arteriovenous fistula formation. MATERIAL AND METHOD: From January 1995 to September 1998, arteriovenous fistulae were made in 365 patients with ESRD. Among them, 62 patients underwent revisional arteriovenous fistula. RESULT: The patency rate for revisional arteriovenous fistula was 78.8% at 6 months, 72% at 12 months, 63% at 24 months, 56.9% at 36 months. CONCLUSION: Revision is a reliable procedure for salvaging a failed and inadequate fistula, which yields an acceptable patency rate.
Arteriovenous Fistula* ; Fistula ; Forearm* ; Humans ; Kidney Failure, Chronic

Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.
Aneurysm, False ; Aneurysm, Infected* ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic* ; Aortic Aneurysm ; Emergency Service, Hospital ; Esophageal Fistula ; Fistula* ; Hematemesis ; Humans ; Laparotomy ; Melena ; Operating Rooms ; Polyethylene Terephthalates ; Sternotomy ; Sutures ; Thoracotomy ; Transplants

Endoscopic symphathicotomy is an effective treatment for hyperhidrosis. Chylothorax is a rare but life-threatening complication. We recently encountered a case of chylothorax after endoscopic symphathicotomy at T2-T4 symphathetic nerve. We successfully treated chylothorax by electric cauterization with thoracic endoscopy.
Cautery ; Chylothorax* ; Endoscopy ; Hyperhidrosis