Résumé
Acute aortic syndrome including intramural hematoma is a life-threatening disease encountered in the emergency department with high in-hospital mortality even when a timely diagnosis is made. Therefore, accurate differential diagnosis of acute aortic syndrome and its mimics is important to determine the patient's treatment plan. Until now, a few pathologic diseases mimicking aortic intramural hematoma such as periaortic lymphoma and immunoglobulin G4-elated periaoritis have been reported. Here, we report a rare case of granulomatosis with polyangiitis-related periaortitis misdiagnosed as aortic intramural hematoma presenting to the emergency department with chest pain and similar radiologic findings.
Résumé
High intensity focused ultrasound (HIFU) is a non-surgical and non-invasive treatment option in patients with uterine myoma and adenomyosis. As the use of HIFU increases in the clinical practice, it is important to be aware of imaging findings related to ultrasound (US)-guided HIFU ablation and its potential complications. However, there are few reports on the imaging findings regarding complications of US-guided HIFU ablation. Here, we report a case of acute complication after US-guided HIFU ablation, surgically confirmed as thermal injury with necrosis of skin, subcutaneous tissue, anterior abdominal wall muscles, peritoneum and uterus.
Résumé
Nesidioblastosis is a term that describes the prolonged differentiation of islets of Langerhan's cells from the epithelium of the pancreatic duct. Nesidioblastosis is a primarily childhood disease, which is often associated with hyperinsulinemic hypoglycemia, but rarely found in adults. A 62-year-old man with hyperinsulinemic hypoglycemia complained of general weakness and mental change while fasting. Abdominopelvic CT, celiac angiography, intra-arterial calcium stimulation test and endoscopic ultrasonography did not reveal any tumor in the pancreas. A subtotal pancreatectomy (nearly 80% of pancreas was removed) was then carried out. He was diagnosed with nesidioblastosis inform the pathology after the operation. Herein, our experience of a 62-year-old Nesidioblastosis patient is reported.
Sujets)
Adulte , Humains , Adulte d'âge moyen , Angiographie , Calcium , Endosonographie , Épithélium , Jeûne , Hypoglycémie , Nésidioblastose , Pancréas , Pancréatectomie , Conduits pancréatiques , AnatomopathologieRésumé
OBJECTIVE: In this study, We investigated the circulating level of leptin in the maternal and cord serum to estimate the effect of leptin on the fetal growth. METHODS: In full-term pregnancy, right after delivery, we calculated the concentration of leptin in the maternal and cord serum by using an immunoassay. we studied the relation between these value, the maternal BMI at the time of delivery, the neonatal body weight. RESULTS: At the time of delivery, mean concentration of maternal leptin and cord leptin showed 335.7 pg/ml and 118.3 pg/ml and there was no statistical significance between them. Mean concentration of matenal leptin has positive relation with maternal body weight. but not to neonatal weight. Mean concentration of cord serum leptin has a positive relation with neonatal weight. There was a correlation between the maternal BMI and the neonatal weight at the time of delivery. We evaluated the mean leptin level of neonates of two different sexes, that difference did not show a statistically significant level. CONCLUSION: In this study, no correlation was found between concentration of maternal leptin and cord leptin. These data suggested that the cord serum leptin has a positive relation with fetal growth independantly, regardless of maternal leptin and maternal BMI.
Sujets)
Humains , Nouveau-né , Grossesse , Poids , Sang foetal , Développement foetal , Dosage immunologique , LeptineRésumé
Premature rupture of membrane generally leads to a poor perinatal outcome. For better perinatal survival, transabdominal prophylatic amnioinfusion and active expectant management was performed. We experienced a case of fetal right arm multiple skin bullae and stomach perforation after amnioinfusion. Underskin bullae was to disappear within a few days and stomach perforation site was treated by primary closure.
Sujets)
Bras , Membranes , Rupture , Peau , EstomacRésumé
The diagnosis of abruptio placentae is frequently difficult despite advanced diagnostic tool because of symptomatic diversity, so additional diannostic parameter would be useful. Maternal serum CA 125, which is derived from decidua, shows an increase by the tenth weeks and then decreases, remaining low level until delivery.However, within 1 hour after term delivery, CA 125 level shows a second increase, probably because of decidual disruption. Serum CA 125 level was measured in 45 patients between 29 and 41 weeks gestation who were seen with vaginal bleeding and in 30 control patients of same gestational age.Mean(+/-SD) CA levels were higher(p < 0.05) among patients with abruptio placentae(61.2+/-52.9U/ml) than among those with bleeding due to placenta previa(17.4+/-8.5U/ml) or control patients(20.3+/-21.3U/ml).Mean(+/-SD) serum CA 125 level in 17 control patients within 6 hours postpartum(81.7+/-102.6U/ml) were higher than those among patients with palcenta previa or normal pregnancy(p < 0.05).Sensitivity and specificity of maternal serum level of CA 125 for diagnosis of abruptio placentae were 73% and 92% on cut off level of 30U/ml, respectively.
Sujets)
Femelle , Humains , Grossesse , Hématome rétroplacentaire , Caduques , Diagnostic , Hémorragie , Placenta , Sensibilité et spécificité , Hémorragie utérineRésumé
The diagnosis of abruptio placentae is frequently difficult despite advanced diagnostic tool because of symptomatic diversity, so additional diannostic parameter would be useful. Maternal serum CA 125, which is derived from decidua, shows an increase by the tenth weeks and then decreases, remaining low level until delivery.However, within 1 hour after term delivery, CA 125 level shows a second increase, probably because of decidual disruption. Serum CA 125 level was measured in 45 patients between 29 and 41 weeks gestation who were seen with vaginal bleeding and in 30 control patients of same gestational age.Mean(+/-SD) CA levels were higher(p < 0.05) among patients with abruptio placentae(61.2+/-52.9U/ml) than among those with bleeding due to placenta previa(17.4+/-8.5U/ml) or control patients(20.3+/-21.3U/ml).Mean(+/-SD) serum CA 125 level in 17 control patients within 6 hours postpartum(81.7+/-102.6U/ml) were higher than those among patients with palcenta previa or normal pregnancy(p < 0.05).Sensitivity and specificity of maternal serum level of CA 125 for diagnosis of abruptio placentae were 73% and 92% on cut off level of 30U/ml, respectively.
Sujets)
Femelle , Humains , Grossesse , Hématome rétroplacentaire , Caduques , Diagnostic , Hémorragie , Placenta , Sensibilité et spécificité , Hémorragie utérineRésumé
Gastric neurofibroma is rare and its exact incidence is unknown. We experienced a case of solitary gastric neurofibroma. A 49-year-old woman was admitted because of hematemesis and melena. Neither cafe-au-lait spots in skin nor superficial tumor were found. Gastrofibroscopic examination and UGI series showed a 3 * 4 cm sized luminal protruding mass with adjacent bridging mucosal fold and cental ulceration on the anterior wall of lower body. Mass excision was performed. Grossly, the mass was 4.5 * 3.0 * 2.0 cm sized, well circumscribed submucosal tumor with homogenous cut surface, Microscopically, each of the tumor cells had oval shaped nucleus and spindle shaped cytoplasm. Nuclear atypism and frequent mitosis were not observed. We report a rare case of solitary gastric neurofibroma with review of the literatures.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Taches café-au-lait , Cytoplasme , Hématémèse , Incidence , Méléna , Mitose , Neurofibrome , Phénobarbital , Peau , Estomac , UlcèreRésumé
Radiation necrosis is the main obstacle for radiosurgery delivering high dose ionizing radiation inhomogeneously into small field of lesion with spatial accuracy. The complication probability is closely related to dose-volume effect. To reduce the complication rate, the optimum dose should e prescribed for the isodose curve enclosing the target lesion according to the lesion volume and isodose fall-off. However, the shape, volume and isodose fall-off of the lesions are different from each other. To choose the optimum doses for radiosurgery in each case, it is necessary to have a reasonable model for predicting dose-volume effects. Flickinger developed an integrated logistic formula using normalized total dose(NTD) as a reasonable model to predict complications from gamma knife radiosurgery. The authors developed a computer program to calculate the risk probability using that formula. As previously emphasized, the risk probability derived from the formula is useful and indispensable as a guidance to dose prescription in gamma knife surgery.