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

No abstract available.
Electrocardiography, Ambulatory*

Invasive carcinoma of the cervix during the pregnancy is relatively uncommon , It must be considered fetal viability, tumor control as well. If the carcinoma is diagnosed in the first or second trimester, treatment should be undertaken immediately. At the third trimester, treatment should be undertaken until the fetus is viable.
Cervix Uteri ; Female ; Fetal Viability ; Fetus ; Humans ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Uterine Cervical Neoplasms

A survey of intestinal parasites was performed in South Vietnam. Samples were collected from 717 Vietnameses, 1,933 U.S. Forces, 433 stool specimens of Korean Troops in South Vietnam. And 114 of Korean Army patients in home land were also examined as a control. Findings were discussed with others and summarized as follows: A parasitic rate, incidence in general, was 44.8 %. Koreans in South Vietnam showed 82.4 % of infection rate, Vietnamese 64.6% and U.S. Forces 26.1 %. Korean home patients revealed 93.9 %. Following 10 species of helminths ova and 5 kinds of protozoa were found: Ascaris lumbricoides, Hookworm, Trichocephalus trichiurus, Strongyloides stercoralis, Trichostrongylus orientalis, Enterobius vermicularis, Metagonimus yokogawai, Clonorchis sinensis, Hymenolepis nana, Taenia sp., Entamoeba histolytica, Entamoeba coli, Endolimax nana, Giardia lamblia and Trichomonas hominis. The incidence of Ascaris lumbricoides among Koreans in South Vietnam was 15.9 %, much less than Korean home patients. The infection rate of A. lumbricoides in Saigon residents was 47.2% but in Chulai 36.8% and in Quinhon 35.8 %. Trichocephalus trichiurus was most frequently found in Koreans. Quinhon residents showed 78.7 % positive in hookworn infection and Chulai 24.7 %. In Saigon, on the contrary, infection rate was only 3.1 %. No Strongyloides stercoralis, but two cases of Trichomonas hominis were found among Koreans in South Vietnam. U.S. Forces showed higher incidences than Koreans and Vietnameses in the incidences of Entamoeba histolytica and Endolimax nana. Most of the U.S. Forces revealed single infection. Korean home patients showed the highest per centage of polyparasitism. Non-autochthonous infections in Korea could not be found among Koreans in this survey.
parasitology-epidemiology ; stool examination ; Vietnam ; U.S. Forces ; Ascaris lumbriocides ; Hookworm ; Trichocephalus ; trichiurus ; Strongyloides stercoralis ; Trichostrongylus orientalis ; Enterobius vermicularis ; Metagnimus yokogawai ; Clonorchis sinensis ; Hymenolepis nana ; Taenia sp. ; Entamoeba histolytica ; Entamoeba coli ; Endolimax nana ; Giardia lamblia ; Trichomonas hominis

A parasitological study was performed with 452 malaria patients evacuated from South Vietnam by examinations of their peripheral blood. Results were as follows: The peripheral blood examinations revealed that 52.0% of the examined have parasitemia, of which 95.3% was P. falciparum, one case of P. vivax and the other 10 patients were mixed infected. Neither P. malaria nor P. ovale were found. A total of 1,500 thick and thin blood films was prepared and 707 slides of them (47.1%) showed positive. In P. falciparum, ring forms were found most frequently and the next was gametocytes. Eighty slides (50%) showed mixed together with both ring form and gametocytes. All of the erythrocytic stages were seen in three slides of P. vivax. Weekly periodical examinations showed 233.8 parasite density every 1,000 W.B.C count in average, while occasional at fever attacks 531.7.Size of gametocytes in P. falciparum was 9.31(+/-0.89) by 2.16(+/-0.53) in macrogametocyte and 6.61(+/-0.82) by 2.51(+/-0.35) in microgametocyte. Their sex ratio was 100 : 92. Repeated blood examinations showed increased detection rates. The positive rate of parasitemia was 52.0% in single examination, increasing in succession with repetitions.
parasitology-protozoology-malaria ; Plasmodium falciparum ; Plasmodium vivax ; Plasmodium ovale ; Plasmodium malariae ; ring form gametocyte ; epidemiologyk Vietnam ; parasitemia

Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as a result of partial or complete obstruction of the bile duct, and may manifest clinically severe from of disease, rapidly deterioration to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying causes were 12 benign diseases(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis (n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients improvement of general condition and failed in three patients. The procedures were preterminated due to the patient's condition in two and biliary-porto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggests that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.
Bile Ducts ; Cholangitis* ; Clonorchiasis ; Decompression ; Drainage* ; Emergencies ; Fistula ; Humans ; Sepsis*

Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.
Arteries ; Constriction, Pathologic ; Humans ; Hypertension ; Hypertension, Renovascular ; Intermittent Claudication ; Intracranial Aneurysm ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Rhabdomyolysis* ; Sturge-Weber Syndrome* ; Vascular Diseases

BACKGROUND: The concept of myocardial injury after coronary occlusion is changing in recent years. Brief episode of ischemial induces reversible myocardial injury and repeated brief ischemic insults might cause myocardial necrosis due to cummulative damages. Recent observations showed that brief episodes of ischemia have protective effects on the myocardium increasing the myocardial tolerance to a subsequent sustained ischemic insult. This phenomenon is termed ischemic preconditioning and can be noticed after a variety of protocols in multiple species of experimental animals. This study was planned to 1) measure the changes of hemodynamic parameters and the ischemic damage of insulted myocardium during ischemic preconditioning, and 2) compare the infarct sizes with or without preconditioning. METHODS: Using canine model of a single 90 minutes' occlusion of left anterior descending coronary artery and 240 minutes' reperfusion, 14 mongrel dogs were randomized to with(n=7) or without(n=7) ischemic preconditioning such as four 5 minutes' occlusion and 5 minutes' reperfusion, Changes of hemodynamic parameters and extents of the ischemic myocardial damages during preconditioning were observed. And using in vitro myocardial staining with monastral blue and triphenyl tetrazolium chloride, we compared the infarct sizes and risk areas in two groups of occlusion and reperfusion canine model with and without preconditioning. RESULTS: 1) Heart rate was significantly decreased after first 5 minutes' occlusion compared with those of basal control(151+/-27 VS 163+/-25 BPM, p<0.05) without further changes in subsequent ischemic insults. Left ventricular systolic pressure was significantly decreased after first 5 minutes' occlusion(109.0+/-19.9 VS 130.6+/-23.3mmHg, p<0.005), and after first 5 minutes' reperfusion and second 5 minutes' occlusion compared with those of basal control(111.3+/-29.8, 109.9+/-17.2 VS 130.6+/-23.3mmHg respectively, p<0.05), without further changes during remaining ischemia. Left ventricular end diastolic pressure and maximum +dp/dt were not changed. Peak -dp/dt was decreased significantly after first and second 5 min occlusion(943.7+/-294.4, and 962.1+/-281.5) from basal control level(1168.2+/-358.8mmHg, p<0.05). Thereafter no change was noted during remaining preconditioning. The changes in rate-pressure product were same as those of left ventricular systolic pressure(first 5 minutes occlusion ; 17.3+/-3.7 VS 21.2+/-3.5, p<0.005, second 5 minutes' occlusion ; 17.9+/-5.3, 18.1+/-3.4 VS 21.2+/-3.5, p<0.05). 2)Transmyocardial lactate extraction ratio was significantly decreased in early phase of ischemic preconditioning(17.5+/-11.3 VS 25.2+/-9.9%, p<0.05). 3) Hemodynamic parameters such as heart rate, left ventricular systolic pressure, left ventricular end-diastolic pressure, maximum +dp/dt, peak -dp/dt and rate-pressure product were changed similarly in both control and precontioned groups. 4) There was no significant difference of mean myocardial blood flows in infarct zones, which represent collateral blood flow, after 5 minutes' brief occlusion and 60 minutes of sustained occlusion in preconditioned group. 5) The infarct area/risk area ratio was significantly reduced in preconditioned group(27.0+/-9.6 VS 5.6+/-3.1%, p<0.005), but the risk area/left ventricular area ratio showed no difference in the two groups. CONCLUSIONS: These findings suggest that, in the early phase of brief repeated occlusion and reperfusion, myocardial ischemic damage accompaning systolic and diastolic myocardial dysfuctions develops and myocardial protective effect of ischemic preconditioning was obtained at the same time. Ischemic preconditioning group demonstrated reduced infarct sizes compared to those of control group after 90 minutes' sustained ischemia and reperfusion in canine acute myocardial infarction model.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Heart Rate ; Hemodynamics ; Ischemia ; Ischemic Preconditioning* ; Lactic Acid ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Necrosis ; Reperfusion

Objectives: The purpose of study is to evaluate serial MR imaging of myocardial infarction using non-surgical model of myocardial infarction after percutaneous transcatheter coronary arterial embolization in dogs. MATERIALS AND METHODS: We evaluated serial pre- and post-contrast MR images with Gd-DTPA (gadolinium-diethylenetriamine-pentaacetic acid) of heart of the eleven mongrel dogs (immediate group (n=3), one week group (n=3), three weeks group (n=5)) after making non-surgically induced myocardial infarction. We confirmed the infarct with TTC staining and microscopically. The location and extents of the myocardial infarction were correlated. RESULTS: A total of 24 MR images were archived; 11 images of the immediate post-embolic period, 8 images of one-week follow-up, and five of 3-week follow-up images. Comparing with the signal intensity of normal myocardium, immediate post-embolic MR images showed low or iso signal intensities (SI) of the infarct area on T1-weighted images (T1WI) and high SI on T2-weighted images (T2WI). No contrast enhancement with Gd-DTPA was made in all cases of the immediate post-embolic MRI. One-week and 3-week follow-up MR images showed low or iso SI on T1WI and slight high or iso SI on T2WI. Contrast enhancement images in both one-week and 3-week follow-up MRI showed denser enhancement of infarct area in one-week follow-up. The myocardial wall thinning was seen in 5 of eight dogs after one week and in 3 of five after 3 weeks. CONCLUSION: In non-surgical animal models of myocardial infarction, MR images showed low or iso SI on T1WI, and high SI on T2WI in various stages, and contrast enhancement was maximum after one week and gradual decrease to 3 weeks. The myocardial wall thinning was seen in one-to 3-week follow-up MR images.
Animals* ; Dogs ; Follow-Up Studies ; Gadolinium DTPA ; Heart ; Magnetic Resonance Imaging* ; Models, Animal* ; Myocardial Infarction* ; Myocardium

No abstract available.
Kidney* ; Perfusion* ; Radionuclide Imaging*