Epidural hematoma after epidural catheterization is very rare but one of serious complications. Although true incidence and origin is unknown yet, coagulopathies and anticoagulant therapy are predominant risk factors. Other risk factors are NSAIDs treatment and ankylosing spondylitis. We experienced a case of epidural hematoma without any risk factors after epidural catheterization for postoperative pain control. We performed epidural catheterization before operation and postoperatively the patient received continuous epidural infusion for postoperative pain control. On the first operative day, the patient was noted to have developed complete paraplegia and hypoesthesia below L1 and anesthesia below L2 level. Immediately after noting we performed TL-spine MRI and epidural hematoma at T10 level was diagnosed and treated by decompressive laminectomy. But she has not fully recovered yet.
Anesthesia ; Anti-Inflammatory Agents, Non-Steroidal ; Catheterization* ; Catheters* ; Hematoma* ; Humans ; Hypesthesia ; Incidence ; Laminectomy ; Magnetic Resonance Imaging ; Pain, Postoperative ; Paraplegia ; Risk Factors ; Spondylitis, Ankylosing

Spontaneous intracranial hypotension (SIH) is an uncommon disease which present as a spontaneously occurring postural headache. Diagnosis is supported by a low CSF pressure by lumbar puncture, diffuse dural enhancement on gadolinium-enhanced brain MRI, or by a CSF leakage site on a radioisotope cisternography or by computed tomographic myelography. Usually SIH treatment is conservative but often requires caffeine, steroids, continuous epidural saline infusion and an epidural blood patch. The most important complication of SIH is bilateral subdural hematoma (SDH), because it may require urgent neurosurgical intervention. We experienced two-cases of SIH with SDH treated with an epidural blood patch, but subdural hematoma increased after radioisotope cisternography, so burr hole drainage was performed with another epidural blood patch.
Blood Patch, Epidural ; Brain ; Caffeine ; Diagnosis ; Drainage ; Headache ; Hematoma, Subdural* ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Spinal Puncture ; Steroids

PURPOSE: To evaluate characteristic MR findings of primary cardiac and pericardiac tumors. MATERIALS AND METHODS: There were myxomas (n=7), malignant lymphoma (n=l), lipoma (n=l), and pericardiac mesotheliomas (n=2). We analyzed location, size, shape, signal intensity, contrast enhancement, and associated findings of adjacent structures such as pericardiac and pleural effusion, and mediastinal lymph node enlargement. RESULTS: Locations of the myxomas were left atrium in four cases, left ventricle in one, right atrium in one, and right ventricle in one. Mean diameter was 3.5cm (range, 2-7cm). They were polypoid or Iobulated in shape, and attached to interatrial or interventricular septurn in all cases except in right atrial myxoma which was attached to lateral wall. Their peduncles were demonstrated in three left atrial myxomas. The signal intensities were iso or slightly high on T1-weighted images and high on T2-weighted images. Pleural and pericardial effusions were shown in the three cases. Malignant lymphoma was manifested as large mass in right ventricle infiltrating to right atrium, interventricular septum, right paratracheal and retrocardiac area. It had slightly high intensity in both T1- and T2-weighted images with a strong contrast enhancement and associated with both pericardiac and pleural effusion. Lipoma was polypoid in shape and attached to lateral wall of left ventricle with bright T1 and high T2 signal intensity. Pericardiac mesothelioma was manifested as a pericardiac and atrial mass with diffuse irregular uneven thickening of pericardium which had iso signal on T1- and high T2-weighted images with moderate contrast enhancement. Conculsion: MR imaging is a very useful method in demonstration of the location, extent, tissue characteristics of the mass, and relationship with its adjacent structu res in evaluation of cardiac and pericardiac tumors.
Heart Atria ; Heart Ventricles ; Lipoma ; Lymph Nodes ; Lymphoma ; Magnetic Resonance Imaging* ; Mesothelioma ; Myxoma ; Pericardial Effusion ; Pericardium ; Pleural Effusion

Trichophyton(T.) rubrum is known to be the most common causative agent of tinea cruris, tinea corporis, and tinea pedis, and hygiene, nutritional status, and high temperature/humidity are known to play an important role in pathogenesis. Although there has been a report on a case of co-infection in which tinea pedis subsequently developing tinea cruris with the foot lesion being a reservoir of the later lesion, there is of yet no report which confirmed co-infection of two different lesions through identification of definite causative organisms. This case concerns a 32 year-old patient who presented with erythematous annular scaly patches on the groin and axilla. Although no organism was identified on mycosel culture, DNA base sequence and RFLP analysis of the scales revealed T. rubrum in both of the lesions. Considering that this is a rare case of tinea cruris accompanied by tinea corporis in the axilla and groin confirmed by molecular biological techniques, the authors present it with review of literature.
Axilla ; Base Sequence ; Coinfection ; DNA ; Foot ; Groin ; Humans ; Hygiene ; Nutritional Status ; Polymorphism, Restriction Fragment Length ; Tinea ; Tinea Pedis ; Weights and Measures

The Overlap syndrome is characterized by a combination of the major hepatobiliary autoimmune diseases such as autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis. It is frequently accompanied by inflammatory bowel disease. Chronic lymphoplasmacellular osteomyelitis is characterized by recurrent episodes of bacterial osteomyelitis and is associated with autoimmune diseases (especially inflammatory bowel disease). We report the case of a girl who was diagnosed with ulcerative colitis and autoimmune hepatitis at 4 years of age and with the overlap syndrome with primary sclerosing cholangitis at 6 years. At 9 years, she was diagnosed with chronic lymphoplasmacellular osteomyelitis.
Autoimmune Diseases ; Child* ; Cholangitis, Sclerosing ; Colitis, Ulcerative ; Female ; Hepatitis, Autoimmune ; Humans ; Inflammatory Bowel Diseases ; Liver Cirrhosis, Biliary ; Osteomyelitis

PURPOSE: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. METHODS: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. RESULTS: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. CONCLUSION: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.
Child* ; Endoscopy ; Esophagus ; Foreign Bodies* ; Humans ; Intestines ; Medical Records ; Numismatics ; Parents ; Retrospective Studies ; Stomach

PURPOSE: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. METHODS: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. RESULTS: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. CONCLUSION: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.
Child* ; Endoscopy ; Esophagus ; Foreign Bodies* ; Humans ; Intestines ; Medical Records ; Numismatics ; Parents ; Retrospective Studies ; Stomach

BACKGROUND AND OBJECTIVES: Despite the proven benefit of cholesterol- lowering therapy in patients with CAD, there is no consensual opinion on guideline of cholesterol-lowering therapy in patients with CAD in Korea. The aim of this study is to evaluate the risk of CAD according to the cholesterol level and to consider current guideline of cholesterol-lowering therapy for the secondary prevention in patients with CAD. MATERIALS AND METHODS: Consecutive 600 patients were assigned into two groups - coronary artery disease group (364 patients) and normal coronary artery group (236 patients) - depending on the coronary angiographic findings. Lipid profiles (total cholesterol, Triglyceride, HDL-cholesterol, LDL-cholesterol) were obtained and the odd ratio of CAD was evaluated according to the national cholesterol education program treatment guideline (NCEP: LDL cholesterol > or = 130 mg/dl) and the national heath insurance treatment guideline (NHI: total cholesterol > or = 220 mg/dl) by multi-variate logistic regression analysis. RESULTS: According to the NHI and NCEP guideline, the proportion of patients with CAD indicated on cholesterol-lowering therapy were 25%, 36.5% respectively and the odd ratio of CAD was 1.00 (95% CI 0.52 - 1.89, p=0.99), 4.89 (95% CI 2.78 - 8.60, p< 0.01) respectively . CONCLUSIONS: Our data showed that LDL-cholesterol > or = 130 mg/dl only reflected the risk of CAD in both guidelines and more proportion of the patients were indicated on cholesterol-lowering therapy in NCEP guideline than in NHI guideline.
Cholesterol ; Cholesterol, LDL ; Coronary Artery Disease* ; Coronary Vessels* ; Education ; Humans ; Insurance ; Korea ; Logistic Models ; Secondary Prevention ; Triglycerides

OBJECTIVE: To evaluate female sexual function after colpoperineoplasty. METHODS: Women who visited regional clinic for colpoperineoplasty from June. 2004-Aug. 2004. filled in FSFI (The Female Sexual Function Index) questionnarie before and 4 months after surgery. Six weeks after surgery, they start pelvic muscle training with HMT 2000 (Korea, electric stimulator). RESULTS: Frequency of coitus, sexual desire, arousal, lubrication and orgasm was increased after colpoperineoplasty. Percentage of patients who had coitus more than once a week increased from 18% to 63%. In sexual desire, about 18% felt sexual arousal more than or about half the time before surgery, but increased to 45% after surgery. In sexual arousal, percentage of who felt sexually aroused during more than half of sexual activity increased from 34% before surgery to 69% after surgery. In Lubrication, percentage of who became lubricated during more than half of sexual activity increased from 44% before surgery to 82% after surgery. Who reached orgasm more than half of sexual activity increased from 29% before surgery to 70%. CONCLUSION: Colpoperineoplasty increased female sexual activity.
Arousal ; Coitus ; Female* ; Humans ; Lubrication ; Orgasm ; Sexual Behavior

Henoch-Schonlein purpura is a common form of vasculitis primarily involving the skin, the gastrointestinal tract, the joints, the kidneys, and the nervous system. During the course of Henoch-Schonlein purpura diverse gastrointestinal manifestations can occurr, but there were only few reports on the gastrointestinal endoscopic findings, hemorrhagic ascites, and Helicobacter pylori infection as complications. We report herein a 75-year-old man with Henoch-Schonlein purpura complicated by hemorrhagic ascites, multiple upper gastrointestinal bleeding associated with gastric Helicobacter pylori infection. The purpuric rashes, the gastrointestinal hemorrhage, and the hemorrhagic ascites were improved after systemic glucocorticoid and Helicobacter pylori irradication with amoxycillin treatment.
Aged ; Amoxicillin ; Ascites* ; Exanthema ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Helicobacter pylori ; Hemorrhage* ; Humans ; Joints ; Kidney ; Nervous System ; Purpura, Schoenlein-Henoch* ; Skin ; Vasculitis