BACKGROUND: Pulmonary arterial hypertension (PAH) in systemic lupus erythematosus (SLE) has very poor prognosis and the prevalence of the disease is also not well delineated. This study was designed to assess the prevalence of PAH in asymptomatic SLE patients and to analyze the potential association between the presence of PAH and SLE including disease activity, organ involvement, and serology. METHODS: Asymptomatic 50 SLE patients and 50 healthy controls of a similar age and sex were assessed by an echocardiographic and clinical study. The diagnosis of PAH was made when the right ventricular systolic pressure (RVSP), measured by 2-dimensional echocardiography, was > or =40 mmHg. RESULTS: Compared to control subjects, lupus patients had significantly increased RVSP (mean+/-SD, 34.9+/-8.9 vs 31.2+/-3.6 mmHg, p=0.008). Patients with SLE were divided into three groups: RVSP> or =40 mmHg, RVSP=30~39 mmHg, RVSP<30 mmHg. Seven patients (14%) had RVSP> or =40 mmHg, 36 patients (72%) had RVSP=30~39 mmHg and 7 patients (14%) had RVSP<30 mmHg. In the healthy controls, none of them had RVSP> or =40 mm Hg. Of the controls, 43 (86%) had RVSP=30~39 mmHg and 7 (14%) had RVSP<30 mmHg. There was no statistical difference in organ involvement, Raynaud's phenomenon, vasculitis, anti-RNP and anti-cardiolipin Ab among the three SLE groups. However, lupus disease activity (checked by SLEDAI-2K) was associated with PAH (p=0.014). CONCLUSIONS: The prevalence of PAH as seen on echocardiograms in SLE patients was 14%. Organ involvement, Raynaud's phenomenon, vasculitis, antiphopholipid antibodies and anti-RNP except SLEDAI-2K were not associated with pulmonary arterial pressure.
Antibodies ; Arterial Pressure ; Blood Pressure ; Diagnosis ; Echocardiography ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Prevalence ; Prognosis ; Vasculitis

Malignancy may cause variable musculoskeletal symptoms which resemble connective tissue disorder. This symptoms as a fine sign of hidden neoplasm can precede the diagnosis of underlying malignancy. But only one case of stomach cancer associated with cancer arthritis was reported in the world. This fact is very interesting in Asia which has high prevalence of stomach cancer. We experienced one case of gastric adenocarcinoma with oligoarthritis involving both knee and right elbow. A 48-year-old man was diagnosed stomach cancer by gastric endoscope and biopsy. After then, he complained pain, tenderness, heating sensation, swelling of both knee and right elbow with high fever. Both knee MRI showed abundant synovial effusion and soft tissue edema. Full dose of nonsteroidal anti-inflammatory drug was not effective to control fever and arthritis. But fever and arthritis were gone after resection of tumor.
Adenocarcinoma* ; Arthritis ; Asia ; Biopsy ; Connective Tissue ; Diagnosis ; Edema ; Elbow ; Endoscopes ; Fever ; Heating ; Hot Temperature ; Humans ; Knee ; Magnetic Resonance Imaging ; Middle Aged ; Prevalence ; Sensation ; Stomach Neoplasms

No abstract available.
Nephrotic Syndrome*

In systemic lupus erythematosus (SLE), besides immunosuppressive therapy, the immunological abnormalities such as impaired phagocytosis and deficiency of cell-mediated immunity contribute to the increased risk of infection. Most of all, the incidence of tuberculous infection is higher and the pattern tends to be more extensive and extrapulmonary than in general population. Therefore the contributory role of tuberculous infection in mortality of SLE should be emphasized, especially in areas endemic for Mycobacterium tuberculosis like Korea. When tuberculous infection involves central nervous system, it can mimic lupus myelitis, showing the clinical manifestations like paraplegia, sensory impairment and bladder dysfunction. Tuberculous myelitis should be differentiated with lupus myelitis as early as possible for proper treatment and better prognosis. We report a 52 year-old woman with SLE presented with paraplegia and urinary incontinence, who were initially suspected as lupus myelitis. But the AFB smear and culture of cerebrospinal fluid were compatible with tuberculosis myelitis.
Central Nervous System ; Cerebrospinal Fluid ; Female ; Humans ; Immunity, Cellular ; Incidence ; Korea ; Lupus Erythematosus, Systemic ; Middle Aged ; Mortality ; Mycobacterium tuberculosis ; Myelitis* ; Paraplegia ; Phagocytosis ; Prognosis ; Tuberculosis ; Urinary Bladder ; Urinary Incontinence

Urokinase use after stereotaxic evacuation of hematoma became a popular method in treatment of hypertensive intracerebral hematoma. We obtained excellent result in evacuaIon of the hematoma which was remained after stereotaxic evacuation or direct approach for 24 raumatic intracerebral hematoma cases. And we found several advantages in this method compared with standard treatment modalities. We think that this is a new, effective treatment method for traumatic intracerebral hematoma.
Hematoma* ; Urokinase-Type Plasminogen Activator*

OBJECTIVES: The purpose of this study was to examine the effect of the vocational rehabilitation program on the quality of life of the chronic schizophrenics, and to evaluate how chronic schizophrenics felt about their lives. METHOD: The subjects were 39 chronic schizophrenics who had participated in the vocational rehabilitation program(participant group) and now lived in the community. The control group were 43 chronic schizophrenics who were outpatients without vocational rehabilitation(non-participant group). The scale for quality of life was divided into two subscales, i.e., the objective and the subjective areas. The subscales are composed of living situation, family situations, interpersonal relations, work, health, finances, leisure activities, autonomy, and self-esteem. RESULTS: 1) In the demographic characteristics such as age, sex, duration of illness, and duration of education, two groups were not different significantly. However, dosage of antipsychotics were lower in participant group than non-participant group. 2) In the objective quality of life subscale, the scores of living situation, interpersonal relations, work, health, economic state, and leisures were higher in participant group than non-participant group. But, family relations score were lower in participant group than in non-participant group. autonomy were not different between two groups. 3) In the subjective quality of life subscale, the score of living situation, family relations, interpersonal relations, work, health, economic states, leisure activities, and autonomy were all higher in participant group than in non-partcipant group. 4)Self-esteem was significantly higher in participant group than in non-participant group. CONCLUSION: The results from this study suggest that the objective and subjective quality of life of participant group in the vocational rehabilitation program were higher than those of non-participant group. The vocational rehabilitation program of Yong-In Mental Hospital seems to have been effective for the chronic schizophrenics. And the psychosocial rehabilitation program, vocational rehabilitation program, and family education program should be developed more and implemented in the community.
Antipsychotic Agents ; Education ; Family Relations ; Gyeonggi-do ; Hospitals, Psychiatric ; Humans ; Interpersonal Relations ; Leisure Activities ; Outpatients ; Quality of Life* ; Rehabilitation ; Rehabilitation, Vocational*

Bone and joint involement develops in approximately 10 percent of patients with tuberculosis and half of these affected patients have tuterculosis of the spine. The goals of management are to eradicate the infection and to prevent or treat neurologic deficits and spinal deformity. An operation may be performed to drain abscess, to debride sequestered bone and disc, to decompress the spinal cord, or to stabilize the spine for the prevention of correction of deformity. But there are difficulties in approaching the upper thoracic spine(T1-T3). These vertebral bodies can be visualize through a standard thoracotomy. Access is greatly restricted, however, by the scapula and the remaining rabs, making a vertebrectomy and spinal cord decompression very difficult. Reconstruction of the vertebral defect and instrumentation to give spinal stability are equally difficult. We describe a surgical approach to the upper thoracic spine which allow an adequate exposure of the vertebral bodies from T1 to T3. The posterolateral thoracotomy approach seems to be a safe and useful method for the upper thoracic lesion, allows adequate exposure exposure and easy reconstruction.
Abscess ; Congenital Abnormalities ; Decompression ; Humans ; Joints ; Neurologic Manifestations ; Scapula ; Spinal Cord ; Spine ; Spondylitis* ; Thoracic Vertebrae* ; Thoracotomy* ; Tuberculosis

No abstract available.
Blood Transfusion, Autologous*

No abstract available.
Blood Transfusion, Autologous*

The spontaneous spinal epidural hematoma has a rare occurrence. Recently the authors have experienced a case of chronic spontaneous thoracic epidural hematoma in a 26 year old woman. She presented with Lt. scapular and upper thoracic pain, paraparesis and acute voiding difficulty during pregnancy and postpartum period. The thoracic myelography with niopam was performed by lumbar tap and C1-2 tap. Resoluted spinal epidural hematoma was removed with nearly complete recovery after 5 weeks. There was no trauma history but Lt. scapular and upper thoracic pain had been developed during previous pregnancy about 3 years ago. We present that this case may be related with pregnancy and delivery.
Adult ; Female ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Iopamidol ; Myelography ; Paraparesis ; Postpartum Period ; Pregnancy