The authors report one-case of hyperthyroidism that occurred in a 56-year-old woman with bipolar disorder after 3 years of chronic lithium treatment. The high level in thyroid fuction test returned to normal after discontinuation of lithium. This case is shows that lithium-induced hyperthyroidism can be reversible.
Bipolar Disorder ; Female ; Humans ; Hyperthyroidism* ; Lithium Carbonate* ; Lithium* ; Middle Aged ; Thyroid Gland

PURPOSE: The treatment was done on benign prostatic hyperplasia (BPH) patients and BPH wth diabetes mellitus patients. Comparisons have been made before and after the treatment international prostatic symptom score (IPSS), quality of life index (QOL index), maximal flow rate (Qmax) and patient's satisfaction to find what kind of treatment results in the most effect and contentment. MATERIALS AND METHODS: 361 cases were chosen as subjects who were able to follow up for more than 3 months following the treatment. This retrospective study comprised of two groups; one is a BPH patients group (A group: n=246) and the other is BPH with DM patients group (B group: n=115). Each group was treated with medical or surgical therapy. The IPSS, QOL index, Qmax and patient's satisfaction were analyzed and compared between the groups. RESULTS: After medical therapy in the A group, the IPSS reduced from 18.8+/-4.3 to 10.8+/-2.8, QOL index from 3.9+/-1.0 to 2.1+/-1.7 and Qmax improved from 9.7+/-1.6ml/sec to 12.8+/-1.9ml/sec. In B group, from 19.4+/-4.7 to 15.2+/-3.6, 4.8+/-1.0 to 3.1+/-0.9 and 8.6+/-0.9ml/sec to 10.9+/-0.5ml/sec respectively (p<0.05). After surgical therapy in the A group, the IPSS reduced from 21.9+/-6.1 to 8.2+/-5.4, QOL index from 4.1+/-1.2 to 1.8+/-0.8 and Qmax improved from 8.6+/-1.7ml/sec to 16.6+/-2.9ml/sec. In B group, from 24.7+/-7.2 to 10.3+/-5.7, 4.3+/-1.5 to 2.2+/-0.7 and 7.7+/-1.8ml/sec to 14.0+/-1.8ml/sec respectively (p<0.05). In B group much more improvement was made than medical therapy group. CONCLUSIONS: In BPH with DM patients, the initial surgical therapy was found to have better effect than through medical therapy in the degree of the patients satisfaction, IPSS, QOL index and Qmax. We suggest that surgical therapy is good therapeutic option even in BPH with DM patients at short term postoperative period.
Diabetes Mellitus* ; Follow-Up Studies ; Humans ; Postoperative Period ; Prostatic Hyperplasia* ; Quality of Life ; Retrospective Studies

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

We report a case of the transradial approach for carotid artery stenting (CAS) as a useful alternative to the traditional transfemoral approach when femoral access is not available. A 50-year-old male visited our emergency room with dysarthria and right-side weakness. Magnetic resonance imaging showed acute cerebral infarction on the left middle cerebral artery territory and carotid stenosis on both sides. CAS for each carotid stenosis was attempted by the usual femoral access, but there was no pulse on either side of the femoral artery, and computed tomography angiogram of the lower extremity revealed Leriche syndrome, which is an aortoiliac occlusive disease. So, we changed the access to the radial artery and was successfully performed.

Developmental venous anomalies (DVAs) are cited as the most common intracranial vascular anomaly. In the majority of cases, it has a benign clinical course, and complications such as intracranial hemorrhage (ICH) are rarely reported. In the rare cases of DVAs presenting ICH, the causes of hemorrhage are usually by a combined vascular anomaly, mostly cavernous malformation (CM) or complicated DVAs, such as thrombosis in the vein of DVAs. We report a rare case of uncomplicated DVA presenting hemorrhage without accompanied vascular anomaly, such as CM. The cause of hemorrhage is suggested to be a specific form of DVA, arterialized DVA. Arterialized DVAs should be noted that they have a greater risk of hemorrhage than classic DVAs.

Endoluminal reconstruction of an intracranial aneurysm using flow-diverting devices, such as the pipeline embolization device (PED), is a new treatment modality with good clinical outcomes. The device was originally indicated for challenging cases, such as wide-necked large or giant aneurysms, and is gaining popularity as a reliable treatment for nearly all intracranial aneurysms. The overall complication rate of flow-diverting devices use is 17.0%, including occlusion of side-branching or perforating arteries, rerupture of the aneurysm, in-stent thrombosis, and, rarely, stent migration. We report a rare complication of the PED: delayed migration of the PED after successful stent implantation during treatment of an unruptured vertebral artery dissecting aneurysm, which resulted in rupture of the aneurysm. Further, we discuss technical steps that can be taken to prevent this potential complication.

We report a case of the transradial approach for carotid artery stenting (CAS) as a useful alternative to the traditional transfemoral approach when femoral access is not available. A 50-year-old male visited our emergency room with dysarthria and right-side weakness. Magnetic resonance imaging showed acute cerebral infarction on the left middle cerebral artery territory and carotid stenosis on both sides. CAS for each carotid stenosis was attempted by the usual femoral access, but there was no pulse on either side of the femoral artery, and computed tomography angiogram of the lower extremity revealed Leriche syndrome, which is an aortoiliac occlusive disease. So, we changed the access to the radial artery and was successfully performed.

Developmental venous anomalies (DVAs) are cited as the most common intracranial vascular anomaly. In the majority of cases, it has a benign clinical course, and complications such as intracranial hemorrhage (ICH) are rarely reported. In the rare cases of DVAs presenting ICH, the causes of hemorrhage are usually by a combined vascular anomaly, mostly cavernous malformation (CM) or complicated DVAs, such as thrombosis in the vein of DVAs. We report a rare case of uncomplicated DVA presenting hemorrhage without accompanied vascular anomaly, such as CM. The cause of hemorrhage is suggested to be a specific form of DVA, arterialized DVA. Arterialized DVAs should be noted that they have a greater risk of hemorrhage than classic DVAs.

Thromboembolism is one of the major complications during coil embolization of an aneurysm, which usually causes familiar neurological deficits, such as, weakness, aphasia, etc. We report a rare complication by thromboembolism after coil embolization causing hemiballism. A 69-year-old female presented with unruptured posterior communicating artery aneurysm and was treated by coil embolization. After the procedure, the patient showed global aphasia and right hemiparesis, and there were small multiple, scattered infarctions on the left middle cerebral artery territory. The neurologic deficit subsided after five days, but hemballism occurred thereafter. There was no other medical history to explain the hemiballism. The patient was treated with clonazepam and antiepileptics and the hemiballism subsided at postoperative day 20. We report a case of rare complication, hemiballism, during coil embolization.

Acute eosinophilic pneumonia(AEP) was first described in 1989 and represents a clinical entity distinct from chronic eosinophilic pneumonia. AEP is characterized by acute respiratory insufficiency, hypoxemia, fever, diffuse radiographic infiltrates, and eosinophilia in bronchoalveolar lavage fluid or lung biopsies in the absence of infection, atopy, or asthma. Rapid response to corticosteroids is characteristic. We experienced a 47-year-old metal driller presenting typical clinical and radiological characteristics of AEP. We confirmed eosinophilic pneumonia with brochoalveolar lavage analysis and transbronchial lung biopsy. We report a case of AEP diagnosed by clinical, radiographic, and histologic findings with a brief review of the literature.
Adrenal Cortex Hormones ; Anoxia ; Asthma ; Biopsy ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils* ; Fever ; Humans ; Lung ; Middle Aged ; Pulmonary Eosinophilia* ; Respiratory Insufficiency ; Therapeutic Irrigation