BACKGROUNDS: Headache is one of the common symptoms complained by patients at the emergency department. Postural headache is the characteristic symptom that is aggravated at upright position and relieved at recumbent position. This postural headache is associated with low cerebrospinal fluid (CSF) pressure. Spontaneous intracranial hypotension(SIH) is an unusual syndrome of postural headache and low CSF pressure without a precipitating event. The diagnosis of SIH is confirmed by 60mmH2O or less CSF opening pressure on lumbar puncture. However, the cases of SIH with normal CSF opening pressure have been reported. so it is needed to complement the diagnostic criteria of SIH. METHODS: A retrospective descriptive study with reviewing medical records of 10 patients who had been admitted at Asan Medical Center from Apr. 1995 to Jul. 1999 was done. Analyses were done on 22 variables of age, sex, clinical symptoms, spinal analysis findings, radiologic findings and therapeutic modality. Fisher's exact test and Mann-Whitney test were applied for statistical analysis (p-value < 0.05). RESULTS: 1. The male to female ratio was 3 : 7, and the mean age was 37.30+/-5.96 years. 2. Postural headache was characteristic symptom & complained by all patients. 3. The mean CSF pressure was 22.8+/-30.8 mmH2O. 4. Brain MRI demonstrated the pachymeningeal enhancement in all patients. 5. Radioisotope cisternography demonstrated slow ascent of tracer to the cerebral convexity in 88.9% patients, early soft tissue uptake suggestive of CSF leakage & rapid urinary accumulation of tracer in 66.7% patients, respectively. 6. 90.0% of all patients were recovered with autologous epidural blood patches, and 10.0% were recovered with conservative management. CONCLUSION: The SIH is an unusual syndrome. but we can diagnose the SIH in the patient, complains of a postural headache, if any following two or more criteria are present. 1. 60mmH2O or less CSF opening pressure on lumbar puncture. 2. Brain MRI finding : the pachymeningeal enhancement. 3. Cisternography findings : slow ascent of tracer to the cerebral convexity, early soft tissue uptake suggestive of CSF leakage & rapid urinary accumulation of tracer.
Blood Patch, Epidural ; Brain ; Cerebrospinal Fluid ; Chungcheongnam-do ; Complement System Proteins ; Diagnosis ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Retrospective Studies ; Spinal Puncture

No abstract available.
Hysterectomy*

Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.
Angiography ; Artifacts ; Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diagnosis ; Diagnostic Imaging ; Image Processing, Computer-Assisted ; Prospective Studies ; Retrospective Studies ; Saphenous Vein ; Sensitivity and Specificity ; Surgical Instruments ; Tomography, X-Ray Computed* ; Transplants ; Vascular Diseases

A case of chronic granulomatous infection of Fsarium solani had decreased response to recalled antigens and lacked of dinitrochlorobenzene(DNCB) sensitization in vivo. He has had frequent attacks of common cold-like symptoms and same attacks were very suggestive of pneumonia but he relatively healthy until he developed cutaneous Fusarium infection. Recently he also developed herpes zoster.
Fusariosis ; Fusarium* ; Herpes Zoster ; Pneumonia

PURPOSE: To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. MATERIALS AND METHODS: Sixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended field. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. RESULTS: Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. CONCLUSION: Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.
Disease-Free Survival ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Menopause ; Multivariate Analysis ; Neoplasm Metastasis ; Pelvis ; Postoperative Care ; Prognosis ; Radiotherapy, Adjuvant ; Treatment Failure

We evaluated CT findings of bronchial carcinoid and accuracy of preoperative pathological diagnosis according to two subtypes. The subjects were 10 cases (typical;5, atypical;5), confirmed by surgery and tissue pathology. Sputum cytology (n=10), percutaneous aspiration (n=1) and bronchoscopic biopsy (n=8) were performed, preoperatively. The CT findings were analysed according to two subtypes. Typical carcinoid shows central location in all, and bronchial lumens just proximal to tumor were widened in two, whereas atypical carcinoid presented as peripheral leison in two. Among central atypical carcinoid, two cases showed flat meniscus appearance of lumen. Remaining one showed diffuse wall thickening. Intratumoral low density by necrosis was noted in one. Both subtypes show contrast enhancement. For preoperative diagnosis, sputum cytology & percutaneous aspiration were not conclusive at all. As for bronchoscopic biopsy, only 3 cases were accurately diagnosed as typical carcinoid. Typical carcinoid presented as endobronchial mass in all, whereas atypical carcinoid presented in various appearance. In all atypical & some typical carcinoid were misdiagnosed as primary lung cancer, preoperatively. However, in typical carcinoid, conservative surgery was possible. In conclusion, if there is discrepancy between CT findings & preoperative pathological diagnosis, full understanding of CT findings of bronchial carcinoid is imperative to choose appropriate surgical modality.
Biopsy ; Carcinoid Tumor* ; Diagnosis* ; Lung Neoplasms ; Necrosis ; Pathology ; Sputum

No abstract available.
Danazol* ; Panniculitis*

No abstract available.
Granuloma Annulare ; Rheumatoid Nodule

No abstract available.
Granuloma Annulare ; Rheumatoid Nodule

In this study the authors examined the protein components at various stages of Clonorchis sinensis, and those of tegument and metabolite of adult Clonorchis by using SDS-polyacrylamide gel electrophoresis and immunodiffusion. The following results were obtained: The protein components of C. sinensis were gradually changed during its development. A considerable change occurred during the initial 7 days after the metacercarial infection. Two bands of protein of about 97,000 molecular weight (MW) and 178,000 MW were unique to excysted metacercaria of C. sinensis. Other 2 bands of protein of 23,000 and 25,000 MW which were absent in metacercariae, might be associated with the development of sex organs in adult. In the metabolite, some components of tegumental proteins were detected. And this tegumental protein components in metabolite seems to be the major antigenic components reacting with infected rabbit antiserum by immunodiffusion. Twenty bands of protein were detected in the isolated adult tegument. Among them 6 bands were in 97,000-65,000 MW, 3 bands in 56,000-53,000 MW and 5 bands in 37,000-30,000 MW. On the other hand, in metabolic products of adult C. sinensis, 17 bands were detected.
parasitology-helminth-trematoda ; Clonorchis sinensis ; biochemistry ; protein