BACKGROUND AND OBJECTIVES: The atherosclerotic plaque in the thoracic aorta has been considered as potential source of cerebral embolization. The aim of this study was to evaluate the relation of atherosclerotic plaque burden and aortic distensibility by combined transesophageal echocardiography(TEE) and acoustic quantification(AQ) in patients with cerebral infarction without cardiac origin of emboli. METHODS: The maximal intimal-medial thickness and distensibility of descending thoracic aorta using TEE (a 7.5 MHz multiplane transducer, Hewlett Packard Sonos 2500) and AQ were prospectively measured in 36 patients(mean age ; 61+/-9 years) with cerebral infarction without cardiac origin of emboli and compared with 87 controls(mean age ; 56+/-11 years) without history of cerebral infarction. After the quality of the short-axis images of the aorta was optimized, a software of AQ was activated and gain controls were adjusted. A region of interest was mannually traced around the descending thoracic aorta and then integrated software was used to compute and instantaneously display arotic lumen area as a function of time. Maximal and minimal cross sectional area and fraction area change were calculated as an average from five consecutive heart cycle. RESULTS: There were no statistically significant differences between two groups in gender, hyperlipidemia and smoking, but hypertension and diabetes were more common in the cerebral infarction group. The atherosclerotic intimal-medial thickness above grade 3 was found in 13(36.1 %) out of 36 patients with cerebral infarction and 15(17.2%) out of 87 controls(p<0.05). Aortic areas normalized for body surface area were not statistically different between patients and normal controls, but there were significant differences for elastic indices except compliance. Patients with cerebral infarction had a lower fractional area change(5.7+/-3.2% vs. 7.8+/-4.1%, p<0.05) and higher stiffness index(12.2+/-7.7 vs. 8.0+/-5.1, p<0.05) compared with control group. There was an inverse relationship between the aortic intimal-medial thickness and the fractional area change of descending aorta(r=-0.380, p<0.01). CONCLUSION: The data suggest that the aortic distensibility noninvasively measured by TEE and AQ predicts the atherosclerotic burden. Thus the aortic distensibility may be an additive risk factor for cerebral infarction.
Acoustics* ; Aorta ; Aorta, Thoracic ; Body Surface Area ; Cerebral Infarction* ; Compliance ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Plaque, Atherosclerotic ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Transducers

BACKGROUND AND OBJECTIVES: The atherosclerotic plaque in the thoracic aorta has been considered as potential source of cerebral embolization. The aim of this study was to evaluate the relation of atherosclerotic plaque burden and aortic distensibility by combined transesophageal echocardiography(TEE) and acoustic quantification(AQ) in patients with cerebral infarction without cardiac origin of emboli. METHODS: The maximal intimal-medial thickness and distensibility of descending thoracic aorta using TEE (a 7.5 MHz multiplane transducer, Hewlett Packard Sonos 2500) and AQ were prospectively measured in 36 patients(mean age ; 61+/-9 years) with cerebral infarction without cardiac origin of emboli and compared with 87 controls(mean age ; 56+/-11 years) without history of cerebral infarction. After the quality of the short-axis images of the aorta was optimized, a software of AQ was activated and gain controls were adjusted. A region of interest was mannually traced around the descending thoracic aorta and then integrated software was used to compute and instantaneously display arotic lumen area as a function of time. Maximal and minimal cross sectional area and fraction area change were calculated as an average from five consecutive heart cycle. RESULTS: There were no statistically significant differences between two groups in gender, hyperlipidemia and smoking, but hypertension and diabetes were more common in the cerebral infarction group. The atherosclerotic intimal-medial thickness above grade 3 was found in 13(36.1 %) out of 36 patients with cerebral infarction and 15(17.2%) out of 87 controls(p<0.05). Aortic areas normalized for body surface area were not statistically different between patients and normal controls, but there were significant differences for elastic indices except compliance. Patients with cerebral infarction had a lower fractional area change(5.7+/-3.2% vs. 7.8+/-4.1%, p<0.05) and higher stiffness index(12.2+/-7.7 vs. 8.0+/-5.1, p<0.05) compared with control group. There was an inverse relationship between the aortic intimal-medial thickness and the fractional area change of descending aorta(r=-0.380, p<0.01). CONCLUSION: The data suggest that the aortic distensibility noninvasively measured by TEE and AQ predicts the atherosclerotic burden. Thus the aortic distensibility may be an additive risk factor for cerebral infarction.
Acoustics* ; Aorta ; Aorta, Thoracic ; Body Surface Area ; Cerebral Infarction* ; Compliance ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Plaque, Atherosclerotic ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Transducers

Rectus sheath hematoma is an uncommon entity of the anterior abdominal wall and an unusual cause of painful abdominal mass. Rectus sheath hematoma have been in association with trauma, infections, debilitating disease, collagen vascular disease, pregnancy. and the puerperium. Sudden disruption of a deep epigastric vessel may result in an abdominal wall hematoma, which depending upon its location and size, can produce symptoms and clinical findings compatible with a variety of acute intra-abdominal conditions. Such hematoma are infrequently encountered and early accurate diagnosis could prevent surgical intervention. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed under the belief that intra-abdominal pathology is present. The diagnosis was confirmed at surgery in both patient. We present two cases of rectus sheath hematoma which were diagnosed by clinical & ultrasound examination preoperatively.
Abdominal Wall ; Collagen Diseases ; Diagnosis ; Hematoma* ; Humans ; Laparotomy ; Pathology ; Postpartum Period ; Pregnancy ; Ultrasonography ; Vascular Diseases

No Abstract available

Elephantiasis nostras, the result of recurrent skin infection or chronic lymphedema is characterized by marked skin fibrosis and massive enlargement of a body part. We present a case of elephantiasis nostras due to chronic recurrent erysipelas which affected the lower extremities in a 62-year-old man. The patient had had persisting non-pitting edema, and tender multiple verrucous brownish plaques and nodules on both lower legs for 1 year. On histological examination, there was hyperkeratosis and papilomatosis in the epidermis, fibroplasia, dilated thick walled venules and collagen fibers oriented vertical to the skin surface, and hyperplasia of eccrine ducts in the dermis.
Collagen ; Dermis ; Edema ; Elephantiasis* ; Epidermis ; Erysipelas ; Fibrosis ; Humans ; Hyperplasia ; Leg ; Lower Extremity ; Lymphedema ; Middle Aged ; Skin ; Venules

PURPOSE: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-gamma release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON(R)-TB Gold In-Tube (QFT-GIT) and compared their results. METHODS: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. RESULTS: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the non-intrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFT-GIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. CONCLUSION: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.
Adolescent ; Child ; Follow-Up Studies ; Humans ; Interferon-gamma Release Tests ; Korea ; Latent Tuberculosis ; Outpatients ; Skin ; Skin Tests ; Tuberculin ; Tuberculosis

No abstract available.
Cisplatin* ; Drug Therapy, Combination* ; Fluorouracil* ; Stomach Neoplasms*

The model of lymphocyte differentiation described for Lukes-Collins' classification of non-Hodgkin's lymphoma is related particularly to morphological alterations of nuclei of follicular center lymphocytes by antigenic stimulation. The authors carried out ultrastructural and morphometric studies to investigate morphological alterations during lymphocyte transformation on the nuclear profiles of follicular center, parafollicular and mantle zone lymphocytes in ten tonsillectomy cases of chronic hypertrophic tonsillitis. The nuclear parameters measured included nuclear area, contour index, frequency invagination and cleft, depth of invagination and nuclear diameters. Follicular centers contained a mixed population of lymphocytes consisting of untransformed (type 1), partially transformed (type 2) and fully transformed (type 3) lymphocytes. During lymphocyte transformation in both follicular, and parafollicular and mantle zones, the nuclei had a gradual and progressive increase in size. The nuclear contour index of type 2 nuclei of both follicular and parafollicular and mantle zones tended to be higher than those of type 1 and 3, indicating a greater degree of irregularity and variability of nuclear profiles. Invaginated and cleaved lymphocytes were not confined to me transformed lymphocytes. A considerable portion of lymphocytes had invaginations and clefts in parafollicular and mantle zone as well as follicular center. No difference on the depth of invagination was noted in type 1, type 2 and type 3 lymphocytes. The results indicate that some promise of the Lukes-Collins conepts of follicular center cells and the process of lymphocyte transformation in follicular centers may be necessary to revise

Idiopathic calcinois of the scrotum which was described by Shapiro et al. in 1970 is a rare cutaneous disorder and it seems that this is tbe first case reporting in Korean literature. A 26-year old male was well until age 25 when a few, small nodule developed on the scrotal area and, thereafter, have increased in the numbers and size of the nodules progressively. The skin lessions showed multiple, yellowish, firm, round, smooth nodul ranging in size from that of the head of a pin to that of a pea. Clinica,lly they seemed to be steatoma, but histologic findings showed several islands of calcified amorphous material without: any evidence of residual cysts. He appeared to be in good general health and had an apparently normal skin except for hie scrotum.
Adult ; Calcinosis* ; Head ; Humans ; Islands ; Male ; Peas ; Scrotum* ; Skin

No abstract available.
Seminal Vesicles* ; Ureter*