No abstract available.
Sterilization, Tubal*

No abstract available.

We report a case of cardiac lymphoma in a 40-year-old man, who had a mediastinal mass which was diagnosed as sclerosing mediastinitis pathologically. The mediastinal mass caused right pulmonary arterial stenosis. The patient developed myocardial hypertrophy and echocardiography showed restrictive physiology and severely decreased left ventricle ejection fraction, 6 months later. MRI showed global left ventricular myocardial hypertrophy and diffuse late gadolinium hyperenhancement after administration of contrast material. Thus, non-ischemic cardiomyopathy was suspected on MRI. However, pathology confirmed the myocardial abnormality as lymphoma after myocardial biopsy. Because a basal part of the left ventricle and global subendocardial myocardium were not involved on contrast-enhanced delayed MRI, the MRI abnormalities could be differentiated from amyloidosis and other myocardial diseases. The peculiar non-mass forming diffuse hypertrophy pattern of cardiac lymphoma has not been known in the MRI literature.
Adult ; Amyloidosis ; Biopsy ; Cardiomyopathies ; Constriction, Pathologic ; Echocardiography ; Gadolinium ; Heart Ventricles ; Humans ; Hypertrophy ; Lymphoma ; Mediastinitis ; Myocardium ; Sclerosis

To formulate treatment strategies for poor-grade patients after aneurysmal subarachnoid hemorrhage(SAH), medical records were analyzed for 166 patients who were in Hunt and Hess grade IV or V among 588 consecutive aneurysmal SAH patients admitted during the past 5 years. Causes for unfavorable outcome(poor or dead) in these 166 patients were carefully evaluated to improve the management outcome. Overall management results were favorable(good or fair) in 71(42.8%), and unfavorable in 95(78 dead, 17 poor). Direct clipping was performed in 90 patients, and the surgical results were favorable in 69(76.7%) and unfavorable in 21(23.3%). Surgery was not performed in 76 patients because of moribund state on arrival in 41, neurological deterioration due to rebleeding in 15, massive brain swelling in seven, serious medical illness in five, severe delayed ischemic deficit in one, and massive cerebral infarction following angiography in one, and refused surgery in six. Seven patients survived from non-surgery group(2 fair, 5 poor). Direct effects of aneurysm rupture(34.8%) and early rebleeding(34.8%) were the causes of unfavorable outcome in grade IV patients, while it was direct effect of aneurysm rupture(91.8%) in grade V patients. It is suggested that since rebleeding is the only preventable factor of unfavorable outcome, urgent management seems necessary to prevent rebleeding, especially for grade IV patients. Grade IV patients should be treated aggressively with direct clipping for non-complex aneurysms or for patients with hematoma, and with coil embolization for complex aneurysms without hematoma.
Aneurysm ; Angiography ; Brain Edema ; Cerebral Infarction ; Embolization, Therapeutic ; Hematoma ; Humans ; Intracranial Aneurysm* ; Medical Records

No abstract available.
Myelography*

BACKGROUND: As the population of immunocompromised patients continues to grow, the incidence of infections caused by opportunistic filamentous fungi will continue to increase. Inhalation of fungal spores which are found in the environmental air precedes infection with molds. We investigated the relative frequency of various molds recovered from hospital air as compared to isolates from clinical specimens. METHODS: Air samples were taken from 83 sites in Chonnam University Hospital during December 1997. Air sampler (Biotest, Germany) with Rose Bengal agar strip (Biotest, Germany) was calibrated to take 40 liters of air. The strips were incubated at 37degrees C for 2-14 days. The results of air cultures were compared with those from the clinical specimens during a year (1997). RESULTS: Of 83 air samples cultured, 61 (73.5%) were positive for molds: 43 (51.8%) samples with 1-2 CFU, 15 (18.1 %) samples with 3-5 CFU, and 3 (3.6%) samples with > 5 CFU. A total of 184 molds were isolated and the most frequently recovered molds were Cladosporium (26.0%), followed by Penicillium (25.5%), Aspergillus (18.5%) and Alternaria (9.8%). The most frequently isolated molds from clinical specimens were Aspergillus (62.8%) and Fusarium (20.2%). For Aspergillus species, A. flavus (28,8%) and A. fumigates (25.4%) were predominant among the clinical isolates, whereas A sydowii (44.1%) and A. niger (38.2%) were common in the hospital air. CONCLUSION: This result shows that Cladosporium and Penicillium are the predominant molds in the hospital air and the relative frequency of molds recovered from hospital air is quite different from those of clinical isolates.
Agar ; Alternaria ; Aspergillus ; Cladosporium ; Fungi* ; Fusarium ; Immunocompromised Host ; Incidence ; Inhalation ; Jeollanam-do ; Niger ; Penicillium ; Rose Bengal ; Spores, Fungal

The pelvic abscess communicating with the appendix is relatively rare, however, it could be diagnosed preoperatively by various diagnostic modalities such as ultrasonography, computed tomography or laparoscopy. We experienced a case of pelvic abscess presented as a pelvic mass invading vesical wall, and report this unusual presentation with a brief review of literature.
Abscess* ; Appendicitis* ; Appendix ; Laparoscopy ; Ultrasonography

The Say–Barber–Biesecker–Young–Simpson variant of Ohdo syndrome (SBBYSS) (Online Mendelian Inheritance in Man #603736) is a rare autosomal dominant disorder and clinically features blepharophimosis with ptosis, a mask-like facial appearance, cryptorchidism, congenital heart defect, long thumbs/great toes, and thyroid dysfunction. The etiology of SBBYSS has been shown to be due to heterozygous KAT6B gene mutation. Here we report a case of a neonate with SBBYSS identified a novel mutation in KAT6B gene. The patient showed typical dysmorphic facies, cryptorchidism with micropenis, overriding fingers, and long thumbs and toes at birth. He had also hypothyroidism, large atrial septal defect, and sensorineural hearing loss. The next generation sequencing identified a heterozygous novel variant, c.5206C>T (p.Gln1736Ter) in KAT6B gene. At the 9 months of age, he underwent patch closure for atrial septal defect. Until the 12-month follow-up, he was under-developed.

We analyzed the practical problems and factors which affect making the correct differential diagnosis in the interpretation or test results from the nocturnal penile tumescence (NPT) test and erotic stimulation test (EST). This was done to provide better information for higher diagnostic accuracy in the clinical application of these tests. The followings are the results of NPT tests and EST identifying the factors affecting correct differential diagnosis by comparison the other differential diagnostic methods. The overall sensitivity of NPT test (Number: 114 total patients) was 82%. 21 cases (18%) could not be diagnosed correctly due to traction of the sensor (12 cases, 10%) and sleep disturbance (9 cases, 8%). The overall sensitivity of EST (Number: 174 total patients) without considering the degree of patient`s sexual drive to erotic stimulation was 77%. 40 cases (23%) could not be diagnosed correctly due to tolerance to pornographic film (17 cases, 10 %), discomfort by the body attachments (14 cases, 8%) and traction of the sensor (9 cases, 5%). However, higher sensitivity (90%) and lower rate of incorrect diagnosis (10% ) were observed in 119 patients who showed Grade II or III (moderate to good) sexual drive to erotic stimulation. The results suggest that undesirable factors in the primary screening methods, traction of sensor, sleep disturbance in NPT test, and tolerance to pornographic film, discomfort by the body attachments, traction of sensor in EST must be taken into consideration when interpretation of test results is being performed.
Diagnosis ; Diagnosis, Differential ; Diagnostic Tests, Routine* ; Erectile Dysfunction* ; Humans ; Male ; Mass Screening ; Penile Erection ; Traction

Background: F-18 Fluorodeoxyglucose positron emission tomography (F-18 FDG PET), which can cover the body from the skull base to the thigh in one scan, is beneficial for evaluating distant metastasis. F-18 FDG PET has interested policymakers because of its relatively high cost. This study investigated the effect of the F-18 FDG PET reimbursement criteria amendment on healthcare behavior in breast cancer using an interrupted time series (ITS) analysis. Methods: We retrospectively analyzed the inpatient and outpatient data from Korea’s Health Insurance Review and Assessment Service (HIRA) from January 1, 2013 to December 31, 2018. ITS analysis was performed for the number of each medical imaging modality and the total medical imaging cost of the breast cancer patients. Results: The annual number of breast cancer patients has been increasing steadily since 2013. The trend of F-18 FDG PET increased before the reimbursement criteria was amended, but intensely decreased immediately thereafter. The chest and abdomen computed tomography scans showed a statistically significant increase immediately after the amendment and kept steadily increasing. A change in the total medical imaging cost for the breast cancer patient claimed every month showed an increasing trend before the amendment (β = 5,475, standard error [SE] = 1,992, P = 0.008) and rapid change immediately after (β = −103,317, SE = 16,152, P < 0.001). However, there was no significant change in the total medical imaging cost at the long-term follow-up (β = −912, SE = 1,981, P = 0.647). Conclusion Restriction of health insurance coverage for cancer may affect healthcare behaviors. To compensate for it, the policymakers must consider this and anticipate the impact following implementation.