The diagnosis of dilated cardiomyopathy associated with pheochromocytoma was made in a 24 year old male on the basis of symptoms and signs, measurements of metabolites of catecholamine,echocardiography and radionuclide ventriculography were preformed and demonstrated. The presence of a tumor on both adrenal glands without definite distant metastasis was demonstrated by abdominal ultrasonography, CT scanning and 131I-MIBC scintigraphy. Surgical removal was performed after proper preoperative preparation with a-adrenergic blocker. During the surgery, neither significant arrhythmia nor severe change of blood pressure was observed. After surgery, cardiac function of the patient improved slowly and progressively.
Adrenal Glands ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiomyopathy, Dilated* ; Diagnosis ; Humans ; Male ; Neoplasm Metastasis ; Pheochromocytoma* ; Radionuclide Imaging ; Radionuclide Ventriculography ; Thoracic Surgery ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

The purpose of this study was to obtain the basic information for the improvement of dental environment by investigating the presence of methicillin- or vancomycin-resistant Staphylococcus aureus (MRSA or VRSA) isolated from dental health care workers (DHCWs) and environment of the Chosun University Dental Hospital (CUDH) and a private dental clinic (control group). Staphylococcus aureus (S. aureus) was isolated from anterior nares of 42 DHCWs and 38 sites, unit chairs, x-ray devices, computers, etc., at 10 departments of the CUDH and 20 DHCWs and 11 sites at the private dental clinic. S. aureus was isolated on mannitol salt agar plate and confirmed by PCR with S. aureus species-specific primer. Antimicrobial susceptibility test of clinical isolates of S. aureus against several antibiotics including methicillin (oxacillin) was performed by investigating minimum inhibitory concentration (MIC) using broth microdilution assay. In addition, PCR was performed to detect the methicillin- or vancomycin-resistant gene. The data showed that one strain of S. aureus was isolated from DHCWs of the CUDH and three strains of S. aureus was isolated from 3 samples of the private dental clinic, respectively. All of the isolates from the CUDH and the private dental clinic had resistance to penicillin G, amoxicillin and vancomycin and susceptibility to oxacillin and ciprofloxacin. The S. aureus strains were already obtained the resistance to penicillin G and amoxicillin. These results suggest that two dental clinics were under relatively safe environment.
Agar ; Amoxicillin ; Anti-Bacterial Agents ; Ciprofloxacin ; Delivery of Health Care ; Dental Clinics ; Mannitol ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxacillin ; Penicillin G ; Polymerase Chain Reaction ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin

BACKGROUND: This study was to investigate the feasibility of real-time 3-dimensional echocardiography (RT3DE) for the analysis of biventricular ejection fractions and volume measurements in patients with cor pulmonale and the correlations of RT3DE results with 64-slice multi-detector cardiac computed tomography (64-MDCT) results. METHODS: This study included a total of 22 patients (59.3 +/- 16.6 years of age; 10 males and 12 females) who showed flattening or reverse curvature of the interventricular septum and severe pulmonary hypertension [mean right ventricular (RV) systolic pressure = 66.8 +/- 19.7 mmHg] on 2-dimensional transthoracic echocardiography due to cor pulmonale. Biventricular end-diastolic and end-systolic volumes were measured by RT3DE and 64-MDCT. The severity of D-shaped deformation was evaluated by using left ventricular (LV) eccentricity index (ratio of diameters parallel/perpendicular to the interventricular septum on parasternal short axis images of the papillary muscle level). RESULTS: There were moderate correlations between biventricular volumes measured by RT3DE and 64-MDCT except for LV end-systolic volume (59.8 +/- 17.1 vs. 73.2 +/- 20.2 mL, r = 0.652, p = 0.001 for LV end-diastolic volume; 30.6 +/- 9.1 vs. 30.8 +/- 12.5 mL, r = 0.361, p = 0.099 for LV end-systolic volume; 110.1 +/- 42.9 vs. 171.1 +/- 55.3 mL, r = 0.545, p = 0.009 for RV end-diastolic volume; and 80.9 +/- 35.0 vs. 128.7 +/- 45.1 mL, r = 0.549, p = 0.005 for RV end-systolic volume respectively). CONCLUSION: This study suggests that RT3DE may be a modest method for measuring distorted biventricular end-systolic and end-diastolic volumes in patients with cor pulmonale.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography ; Echocardiography, Three-Dimensional ; Humans ; Hypertension, Pulmonary ; Male ; Papillary Muscles ; Pulmonary Heart Disease

BACKGROUND AND PURPOSE: The coexistence of carotid atherosclerosis in ischemic stroke patients with small-vessel disease (SVD) or intracranial large-vessel disease (ICLVD) was investigated using carotid duplex ultrasonography, and whether its coexistence affected the clinical prognosis was determined. METHODS: Ischemic stroke patients with SVD or ICLVD were enrolled (n=103). Risk factors, demographic data, and National Institutes of Health Stroke Scale (NIHSS) scores were obtained for all of the subjects. Early neurological progression was defined by an increase in NIHSS score during the first 7 days. Carotid ultrasonography was performed to measure the intima-media thickness (IMT) and carotid plaques. RESULTS: Among the 103 patients who were retrospectively enrolled in this study (56 with SVD and 47 with ICLVD), 66 (64.1%) had an atherosclerotic plaque and 23 (22.3%) had increased IMT. Increased IMT was observed more frequently in ICLVD than in SVD [15/47 (31.9%) vs. 8/56 (14.3%), p=0.032]. An atherosclerotic plaque was observed on subsequent carotid ultrasonographic examination in 28 (50%) of the 56 patients whose computed tomography angiography scans of the neck vessels were interpreted as normal. There was no association between presence of atherosclerotic change and early neurologic progression (p=0.94). CONCLUSIONS: A coexisting atherosclerotic plaque or increased IMT was observed in 71.8% of patients with SVD or ICLVD. Whether the coexistence of carotid atherosclerotic change with either of these conditions affects the clinical prognosis remains to be elucidated.
Angiography ; Atherosclerosis ; Carotid Artery Diseases ; Humans ; National Institutes of Health (U.S.) ; Neck ; Plaque, Atherosclerotic ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke

he purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for deceting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(l4 brain tumor, 15 head and neck cancer, 23 gynecologic cancer). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specific it of CI were 78% and 68% CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the Serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively. We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnositic methods.
Biopsy ; Brain Neoplasms ; Follow-Up Studies ; Head and Neck Neoplasms ; Humans ; Magnetic Resonance Imaging ; Pathology ; Positron-Emission Tomography ; Recurrence* ; Sensitivity and Specificity ; Thyroid Gland ; Biomarkers, Tumor

We report an 8-year-old girl with leukoencephalopathy who demonstrated serologic evidence of Mycoplasma pneurnoniae infection. She suffered from a lobal pneurnonia 10 days prior to the admission, when sornnolence developed. The patient progressed to stupor over a few days and long tract signs appeared. She began to improve on the seventh hospital day only with conservative therapy. Magnetic resonance irnaging on the third hospital day revealed multiple white matter changes r including brain stern. Electroencephalography showed normal sleep pattern. Cerebrospinal fluid exarnirlation for anti-mycoplasma antibody was positive with minimal elevation of cells and protein. She fully recovered with erythromycin therapy. A followup magnetic resonance irnaging revealed almost complete resolution of previous lesion in the rnidbrain, but the other white matter lesion unchanged. The patient was diagnosed as having leukoencephalopathy complicated by a Mycoplasma pneumoniae infection.
Brain ; Cerebrospinal Fluid ; Child ; Electroencephalography ; Erythromycin ; Female ; Follow-Up Studies ; Humans ; Leukoencephalopathies* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pneumonia, Mycoplasma ; Stupor

OBJECTIVE: To determine whether local estrogen production takes place in adenomyosis and in normal endometrium. METHODS: The study included 23 cases of adenomyosis and 17 cases of normal uterine endometrium obtained through hysterectomy or curettage at Kangnam Cha Hospital. The frozen tissue specimens were examined by immunohistochemistry using P450 arom. RESULTS: P450 arom was immunolocalized exclusively in the cytoplasm of glandular cells of adenomyotic tissue. However, no apparent staining was observed in stromal cells. Aromatase was expressed in the ectopic glands (82.6%), but also in the eutopic endometrium of patients with adenomyosis (23.5%). In the case of normal endometrium, P450arom was not detected. CONCLUSION: These results suggest that the aromatase activity is correlated to the pathophysiology of adenomyosis.
Adenomyosis* ; Aromatase* ; Curettage ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Cytoplasm ; Endometrium ; Estrogens ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Stromal Cells

OBJECTIVE: The aims of this study were to compare the efficacy and morbidity of optimal debulking operation with those of suboptimal operation for patients with advanced gynecologic malignancies and to establish the precluding factors for performing the optimal cytoreductive surgery. METHODS: From January 1998 to December 2003, debulking operation for advanced gynecologic malignancy was performed in thirty-nine patients with ovarian cancer (32), tubal cancer (4), and primary peritoneal carcinoma (3) at the department of obstetrics and gynecology, Ghil Medical Center. Of them, 38 patients had FIGO Stage IIIC disease and only one patient had FIGO Stage IV disease. Most informations were obtained by hospital records and were analyzed retrospectively. RESULTS: The mean follow-up was 23 months (range, 1-62 months). The optimal debulking operation could be performed in 25 patients (64.1%). In multivariate analysis, the largest diameter of residual tumor was the most important prognostic factor. Two-year overall survival rate of optimally debulked patients was 86.5% and that of suboptimally debulked patients was 41.3% (p=0.015). Two-year disease free survival rates were 75.9% and 7.1%, respectively (p=0.0003). Complication rates associated with surgery were 40% in optimally debulked patients and 35.7% in suboptimally debulked patients (p=0.083). Major causes of suboptimal surgery were old age (>69 yrs), poor medical condition (cardiac problem, intraoperative unstable vital sign, bronchiectasis), no submission of permission, and involvement of the base of mesentery and small bowel. CONCLUSION: Optimal debulking operation is possible if there were no significant clinical problem and involvement of base of mesentery and small bowel. It appears acceptable surgical morbidity and better prognosis. Therefore, the surgeon should use every technique aimed at removing the tumor as much as possible.
Disease-Free Survival ; Follow-Up Studies ; Gynecology ; Hospital Records ; Humans ; Mesentery ; Multivariate Analysis ; Neoplasm, Residual ; Obstetrics ; Ovarian Neoplasms ; Prognosis ; Retrospective Studies ; Survival Rate ; Vital Signs