PURPOSE: Lymphoma is considered when multiple, nonnecrotic lymph nodes are present in the superficial and deep lymphatic chains, especially if they are large and bilateral, on CT scan. It is reported that combined nodal and extranodal presentation of HD is uncommon. However, we found central low density in involved lymph node of NHL, and combined nodal and extranodal disease in HD, not infrequently. The purpose of this study is to ascertain whether our findings may be characteristics of NHL and HD. MATERIALS AND METHODS: CT findings with contrast enhancement were reviewed in 23 patients with untreated neck lymphoma:18 NHL and 5 HD. The followings were analyzed in each case: nodal or extranodal involvement; unilateral or bilateral involvement; presence or absence of central low density with peripheral enhancement in nodal lesion ;infiltration into adjacent structures. Nodal and extranodal lesions were confirmed by pathologic studies. RESULTS: Of 18 patients with NHL, nine cases had nodal disease and the rest had combined nodal and extranodal disease. Lymphadenopathy was bilateral in ten cases and unilateral in eight. Five cases with HD were composed of three combined nodal and extranodal diseases and two nodal diseases. Central low density of involved lymph node was shown in eight cases of 18 NHL and in one case of five HD. CONCLUSION: Central low density with peripheral enhancement was not uncommon in NHL, in contrast to HD. Hence, it is suggested that in case of nodal necrosis, NHL be also considered, besides tuberculous lymphadenitis and metastatic lymphadenopathy. It is not considered that nodal or extranodal disease, and unilateral or bilateral involvement are of high significance in differentiation of NHL from HD.
Hodgkin Disease* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Neck* ; Necrosis ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

No abstract available.
Pregnancy* ; Pyelonephritis*

Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.
Arteries ; Constriction, Pathologic ; Humans ; Hypertension ; Hypertension, Renovascular ; Intermittent Claudication ; Intracranial Aneurysm ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Rhabdomyolysis* ; Sturge-Weber Syndrome* ; Vascular Diseases

OBJECTIVES: The prevalence of smoking in schizophrenic patients (74-92%) is higher than that of all psychiatric patients (34-54%) or general population (30-35%). This higher smoking Prevalence is demonstrated even after controlling for known confounders, such as marital status, alcohol use, and socioeconomic status. This study was conducted to determine whether there would be any difference in nicotine intake and metabolism between schizophrenics and normal controls. METHODS: Sixteen schizophrenic patients and sixteen normal controls were collected. All subjects were supplied with a pack of cigarette a day. Urinary cotinine excretion was measured by using gas chromatographic mass spectrometric method. RESULTS: Cotinine excretion was significantly increased in schizophrenic patients compared to normal controls (p<0.05). None of variables such as age at initial smoking, the average number of cigarettes at initial smoking, pack year (packs daily smoked x smoking year), abstinence history were found to influence cotinine levels when examined via the ANOVA, even when the interaction with diagnosis was considered. CONCLUSION: This result suggests that nicotine intake and consumption are increased in schizophrenic patients compared to normal controls, which can be an attempt to improve sensory inhibition and counteract neuronal effect of antipsychotic medications.
Cotinine* ; Diagnosis ; Humans ; Marital Status ; Metabolism ; Neurons ; Nicotine ; Prevalence ; Schizophrenia ; Smoke ; Smoking ; Social Class ; Tobacco Products

No abstract available.
Alloxan* ; Animals ; Rats*

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors

OBJECTIVES: Periodic limb movement disorder (PLMD) has been debated with regard to its clinical significance and diagnostic criteria. The current diagnostic criterion for PLMD in adults has been changed from periodic limb movement index (PLMI) > 5/ hour to PLMI > 15/hour by the International Classification of Sleep Disorders (ICSD). In this study, we aimed to investigate the changes in polysomnographic sleep variables according to PLMI and to determine the relevance of the diagnostic criterion for PLMD. METHODS: Out of 4195 subjects who underwent standard polysomnography, we selected 666 subjects (370 males and 296 females, aged 47.1 ± 14.8) who were older than 17 years and were not diagnosed with primary insomnia, sleep apnea, narcolepsy, or REM sleep behavior disorder. Subjects were divided into three groups according to PLMI severity: group 1 (PLMI ≤ 5), group 2 (5 < PLMI ≤ 15), and group 3 (PLMI > 15). Demographic and polysomnographic sleep variables and Epworth sleepiness scale (ESS) were compared among the three groups. RESULTS: There were significant differences among the three groups in age and gender. Sleep efficiency (SE) and stage 3 sleep percentage in group 1 were significantly higher than those in groups 2 and 3. The wake after sleep onset (WASO) score in group 1 was significantly lower than those in groups 2 and 3. However, there were no significant differences in SE, stage 3 sleep percentage, or WASO between groups 2 and 3. Sleep latency (SL) in group 1 was significantly lower than that in group 3, but there was no difference in SL between group 2 and group 3. ESS score in group 1 was significantly higher than that in group 3, but there was no difference between group 2 and group 3. Partial correlation analysis adjusted by age showed that PLMI was significantly related to SE and WASO. CONCLUSION: This study suggests that PLMI influences polysomnographic sleep variables. In addition, we found the individuals who did not have PLMD but had PLMI > 5 were not different in polysomnographic sleep variables from the individuals who had PLMD according to the current criterion. These results raise questions about the relevance of the current diagnostic criterion of PLMD.
Adult ; Classification ; Extremities* ; Female ; Humans ; Male ; Narcolepsy ; Nocturnal Myoclonus Syndrome ; Polysomnography ; REM Sleep Behavior Disorder ; Sleep Apnea Syndromes ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders

A 73-year-old woman with a history of chronic hypertension and severe chronic obstructive pulmonary disease, presented to a district general hospital with thoracic pain in a profound state of shock. She was diagnosed with cardiac tamponade, severe mitral regurgitation, and Stanford type A (Debakey type I) intramural hematoma. Her ascending aorta was of a significant size and therefore emergent repair was done to replace the ascending aorta and mitral valve. After 6 months, an increased aneurysmal size of 6.0 cm was observed in a follow up contrast-enhanced computed tomography angiography. The patient was successfully treated by a staged hybrid procedure involving initial supra-aortic reconstruction.
Aged ; Aneurysm ; Angiography ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Cardiac Tamponade ; Chimera ; Endovascular Procedures ; Female ; Follow-Up Studies ; Hematoma ; Hospitals, General ; Humans ; Hypertension ; Mitral Valve ; Mitral Valve Insufficiency ; Pulmonary Disease, Chronic Obstructive ; Shock ; Vascular Grafting

BACKGROUND/AIMS: This study evaluated the clinical features of double-chambered right ventricle (DCRV) in adults. Most cases of DCRV are diagnosed and treated during childhood. Consequently, very few reports include cases in which its clinical characteristics are evident in adults. METHODS: We reviewed the clinical data for 10 adult patients (age > or = 18 years) with DCRV. RESULTS: Electrocardiogram showed right ventricular hypertrophy in 3 DCRV patients. All cases were associated with ventricular septal defect (VSD; 7 for perimembranous, 2 for muscular outlet, and 1 for the subarterial type). Surgical correction was done for 7 DCRV patients all of whom survived operations. Their follow-up echocardiogram showed the pressure gradient in their right ventricle was significantly decreased from 69.4 +/- 17.2 mmHg preoperatively to 10.2 +/- 5.0 mmHg postoperatively (p < 0.05). In the short-term follow-up, there was no significant increase in the pressure gradient in the right ventricle. CONCLUSIONS: There are lots of cases of DCRV that are not diagnosed accurately in adults. In our experience, all DCRV cases had VSD and surgical correction of these cases showed excellent results. Therefore, accurate diagnosis of DCRV is necessary so that DCRV is not overlooked and operations are enabled within an appropriate time.
Adolescent ; Adult ; Age Factors ; Echocardiography, Doppler ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Catheterization ; Heart Septal Defects, Ventricular/*diagnosis/*surgery ; Heart Ventricles ; Humans ; Hypertrophy, Right Ventricular/*diagnosis/*surgery ; Male ; Middle Aged ; Ventricular Dysfunction, Right/*diagnosis/*surgery ; Young Adult