Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

No abstract available.
Aortic Stenosis, Supravalvular*

No abstract available.
Aged* ; Humans

No abstract available.
Humans

No abstract available.
Humans

Ovarian Pregnacy is a rare form of ectopic pregnacy. Its estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian pregnancy may reveal a high incidence than reported earlier. Ovarian pregnancy occurs in the corpus luteum, and is usually accompanied with the rupture of the ovary and massive hemoperitoneum. It presents as a hemorragic ovary and frequently misdiagnosed as a ruptured corpus luteum. Risk facters to ovarian pregnacy include a history of pelvic inflammatory disease(PID), prior pelvic surgery, and use of an intrauterine contraceptive device(IUD). We have experienced two cases of ovarian pregnancy and reviewed it briefly.
Corpus Luteum ; Diagnosis ; Female ; Hemoperitoneum ; Incidence ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

PURPOSE: This study was to report our experience of the brief survey for teaching journal writing by medical students in a clinical curriculum of family medicine. METHODS: Brief surveys performed by medical students in clinical clerkship of department of family medicine from 1998 to 2000. Medical students determined theme without rein for brief surveys. Lecture about meaning and process of survey was given for sufficient understanding of students, and then surveys were conducted. The subjects of survey were outpatients, nursing person, medical students, nursing students, and other general persons. The subjects of theme were classified to 17 chapters 7 components by international classification of primary care(ICPC). RESULTS: In analysis of brief surveys according to ICPC, the reasons for surveys by components were diagnostic, screening prevention(89.0%), treatment, procedures, medication(5.7%), symptoms, complaints(5.3%). By chapters, there were social(64.6%), psychological(12.6%), metabolic and endocrine(6.5%). Among social problems, there were other social problem(35.4%), health care system/access(20.9%), problem with education(13.9%), relation problems partner(12.7%). Majority of medical students had affirmative response for survey conduction. In conclusion, our finding suggest that teaching journal writing as brief survey seems to be useful in understanding of journal writing of medical students.
Classification ; Clinical Clerkship ; Curriculum* ; Delivery of Health Care ; Education, Medical ; Humans ; Mass Screening ; Nursing ; Outpatients ; Social Problems ; Students, Medical* ; Students, Nursing ; Writing*

We report herein a case of hyperacute onset of spontaneous cervical spinal subdural hematoma treated with methylprednisolone pulse therapy that showed good results. A 57-year-old man was admitted for posterior neck pain and paraparesis which occurred an hour ago. MRI revealed a ventral subdural hematoma distributed from the level of C1 down to T3, compressing the spinal cord. Conservative management with methylprednisolone pulse therapy was administered considering the patient's poor general condition. Although emergent surgical decompression is necessary in most cases of spinal subdural hematoma, conservative management with steroid therapy could be effective.
Cervical Vertebrae/pathology/radiography ; Glucocorticoids/administration & dosage/*therapeutic use ; Hematoma, Subdural, Spinal/*drug therapy/pathology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Methylprednisolone/administration & dosage/*therapeutic use ; Middle Aged ; Paraparesis/drug therapy/pathology/radiography ; Tomography, X-Ray Computed

PURPOSE: Late diagnosis and treatment lead to high mortality and poor prognosis in tuberculous meningitis (TbM). A rapid and accurate diagnosis is necessary for a good prognosis. Neuron-specific enolase (NSE) has been investigated as a biochemical marker of nervous tissue damage. In the present study, the usefulness of NSE was evaluated, and a cut-off value for the differential diagnosis of TbM was proposed. MATERIALS AND METHODS: Patient charts were reviewed for levels of serum and cerebrospinal fluid (CSF) NSE, obtained from a diagnostic CSF study of samples in age- and gender-matched TbM (n=15), aseptic meningitis (n=28) and control (n=37) patients. RESULTS: CSF/serum NSE ratio was higher in the TbM group than those of the control and aseptic groups (p=0.001). In binary logistic regression, CSF white blood cell count and CSF/serum NSE ratio were significant factors for diagnosis of TbM. When the cut-off value of the CSF/serum NSE ratio was 1.21, the sensitivity was 86.7% and the specificity was 75.4%. CONCLUSION: The CSF/serum NSE ratio could be a useful parameter for the early diagnosis of TbM. In addition, the authors of the present study suggest a cut-off value of 1.21 for CSF/serum NSE ratio.
Adult ; Case-Control Studies ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Phosphopyruvate Hydratase/*blood/*cerebrospinal fluid ; Tuberculosis, Meningeal/blood/*diagnosis/metabolism