No abstract available.
Candidemia* ; Humans

Patients suffering from idiopathic or self-induced edema are uniformly characterized by chronic use of furosemide, which leads to vicious cycle of edema. Among chronic furosemide users who don't have any other specific edema forming diseases, 9 patients from the outpatient clinic(OC) and 6 patients examined at the emergency room(ER) used it mainly for weight reduction and for cyclical edema, respectively. All of the ER group patients were presented with severe hypokalemia(2.04+/-0.2mEq/L; range 1.3 to 2.7 mEq/L) and alkalosis(748+/-0.01; range 7.44 to 7.51) but none from the OC group showed such results. Other baseline parameters including Plasma renin activity(PRA) and aldosterone level on recumbency, and FEn(2)were similar in both groups. In contrast, daily working hours(6.1+/-0.5 vs 10+/-0.6hr, p<0.01), average body weight gain between AM and PM(0.4+/-0.1 vs 0.9+/-0.lkg, p<0.01), peak weight gain interval(9+/-0.8 vs 5+/-0.1day, p<0.05), PRA(7.6+/-1.5 vs 23.5+/-7.2ng/ml/h, p<0.05) and aldosterone level(22.1+/-4.2 vs 64.8+/-10.4 ng/dl, p<0.01) on ambulation, and FEk. on normokalemia(ll+/-2A vs 36+/-7.7%, p<0.01) were statistically different between the two groups. In comparison to the OC group, both the amout of urine(617+/-39 vs 358+/-26ml, p<0.01) and the percent change of PRA(-14+/-4 vs -3+/-2%, p<0.05) and al-dosterone level(-17+/-5 vs -4+/-3%, p<0.05) after saline loading(lL over 1hr, IV) following ambulation were smaller in the Elt group. Moat of the ER group patients(5/6) required aldosterone antagonist (spironolactone) added to K+ supplement, but all of the OC group patients were managed to maintain an edema-free status with conservative treatment. In conclusion, patients with idiopathic edema seem to have more fluid transudation out of intravascular space during orthostasis with a prominent degree of deranged renin-aldosterone axis and K+ metabolism than those with self-induced edema.
Aldosterone ; Axis, Cervical Vertebra ; Body Weight ; Dizziness ; Edema* ; Emergencies ; Furosemide* ; Humans ; Metabolism ; Outpatients ; Plasma ; Renin ; Walking ; Weight Gain ; Weight Loss

The Holt-Oram syndrome or cardiomelic syndrome is characterized by the association of upper limb and heart malformations. Most frequently, abnormalities of the thumb and secundum atrial septal defects are associated with the disease. The mode of inheritance is autosomal dominant. The etiology of this disease is unknown but is most likely of multifactorial origin. Here we report a case Holt-Oram syndrome with affected mother which was diagnosed at 18th gestational weeks by prenatal ultrasonograpy. Fetal ultrasonography revealed abnormalities of upper limbs, and heart. The upper limbs were shorter than normal, syndactyly of both hands were seen and both wrists were markedly angulated. Ventricular septal defect was suspicious. After genetic counselling her pregnancy was terminated at 22nd gestational week.
Hand ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Mothers* ; Pregnancy ; Syndactyly ; Thumb ; Ultrasonography* ; Ultrasonography, Prenatal ; Upper Extremity ; Wills ; Wrist

Fitz-Hugh-Curtis syndrome, a kind of perihepatitis, occurs approximately in 3 to 10 percent of patients with pelvic inflammatory disease. It is not easy to detect in clinical settings due to requirement of invasive methods for diagnosis, for example, like a laparoscopic examination. Now, it has become possible to recognize it easily with the aid of non-invasive methods including an abdominal dynamic CT scan and laboratory tests. Moreover, it can be improved after the oral administration of antibiotics. Therefore, noninvasive diagnosis is desirable. Herein, clinical characteristics of ten cases of Fitz-Hugh-Curtis syndrome are reported, with a review of the literature.
Adolescent ; Adult ; Chlamydia Infections/diagnosis ; Chlamydia trachomatis ; Diagnosis, Differential ; Female ; Humans ; Laparoscopy ; Liver/pathology/radiography ; Pelvic Inflammatory Disease/*diagnosis/drug therapy/etiology ; Peritonitis/*diagnosis/drug therapy ; Syndrome ; Tomography, X-Ray Computed

Closed chest trauma occasionally results in the development of traumatic lung cyst or pulmonary hematocele.Radiologically, this latter rarely mimicks posterior mediastinal mass, which can cause unnecessary surgicalresection, We encountered two cases of pulmonary hematocele simulating posterior mediastinal mass. Multiplicity ofthe lesion, fracture of surrounding bony structure, decrease of mass size at follow-up examination, an acute anglebetween the mass and chest wall, peripheral rim enhancement of the mass, as seen on CT scans, or characteristicsignal intensity suggesting hematoma, as seen on MR images, helped differentiate pulmonary hematocele fromposterior mediastinal mass.
Follow-Up Studies ; Hematocele* ; Hematoma ; Lung ; Male ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

Using KAIS 0.15 Tesla magnetic resonance imaging system, ECG gated magnetic resonance image (MRI) of cardiovascular system was obtained in 8 normal volunteers and 10 patients with various cardiovascular diseases diagnosed at Seoul National University Hospital. The findings of cardiovascular MRI were analysed and the results were as follows ; 1) ECG gated MRI revealed datailed normal anatomy of heart including both atrioventricles and great vessels in axial, sagittal and coronary sections with natural contrast of moving blood without contrast media. 2) Dynamic changes of both ventricular walls in systolic and diastolic phase were revealed in sequential axial MRI, and increased signals were detected in left ventricle and descending aorta due to slow flow in end diastole. 3) Left ventricular aneurysm and myocardial thinning were shown in 2 cases of myocardial infarction. Enlarged left atrium was noted in 1 cases of mitral stenosis. Segmental analysis was possible in 3 cases of corrected transposition of great vessels. 4) Enlarged lumen, intimal flap and irregular luminal narrowing were detected in each of ascending aortic aneurysm, dissecting aneurysm and Takayasu's arteritis respectively. Pericardial effusion due to lymphoma revealed low signal encircling heart in contrast with neighboring mediastinal structures and cardiac wall. 5) MRI is a new promising modality in the diagnosis of cardiovascular system, which has potentiality to give a hemodynamic information in addition to the anatomical detalis.
Aneurysm ; Aneurysm, Dissecting ; Aorta, Thoracic ; Aortic Aneurysm ; Cardiovascular Diseases ; Cardiovascular System* ; Contrast Media ; Diagnosis ; Diastole ; Electrocardiography ; Healthy Volunteers ; Heart ; Heart Atria ; Heart Ventricles ; Hemodynamics ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Mitral Valve Stenosis ; Myocardial Infarction ; Pericardial Effusion ; Phenobarbital ; Seoul ; Takayasu Arteritis ; Transposition of Great Vessels

PURPOSE: This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. MATERIALS AND METHODS: A total of 21 cats were divided into three groups according to the PVA particle size injected: group I(n=7), embolized with 45-150 micrometer PVA; group II(n=7), with 150-250 micrometer PVA; and group III(n=7), with 350-500 micrometer PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. RESULTS: On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group Iand in two of the seven (29%) in group II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 +/-1 . 37 % in group Iand 5.18 +/-1 . 77% in group II( P <0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries(MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II. No group IIIcat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175 micrometer in Group Iand 258 micrometer in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. CONCLUSION: Small PVA particles had a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150 micrometer in size are appropriate.
Animals ; Brain ; Carotid Artery, Common ; Cats* ; Cerebral Arteries* ; Infarction ; Particle Size* ; Polyvinyl Alcohol* ; Polyvinyls*

PURPOSE: This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. MATERIALS AND METHODS: A total of 21 cats were divided into three groups according to the PVA particle size injected: group I(n=7), embolized with 45-150 micrometer PVA; group II(n=7), with 150-250 micrometer PVA; and group III(n=7), with 350-500 micrometer PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. RESULTS: On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group Iand in two of the seven (29%) in group II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 +/-1 . 37 % in group Iand 5.18 +/-1 . 77% in group II( P <0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries(MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II. No group IIIcat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175 micrometer in Group Iand 258 micrometer in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. CONCLUSION: Small PVA particles had a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150 micrometer in size are appropriate.
Animals ; Brain ; Carotid Artery, Common ; Cats* ; Cerebral Arteries* ; Infarction ; Particle Size* ; Polyvinyl Alcohol* ; Polyvinyls*

PURPOSE: The purpose of this study is to analyze the sonographic features of lipoma of the neck. MATERIALS AND METHODS: The cases of 13 patients (35 to 70 years old, nine males and four females) with lipoma of the neck were retrospectively reviewed. Lipomas were confirmed pathologically in six patients, and by CT and MR in seven. RESULT: Lipomas were well-defined in 11 cases (85%), and elliptical shaped masses in 12 (92%) with the longest diameter parallel to the skin surface. As compared with adjacent muscles, 54% of all lipomas (n=7) were hyperechoic, 15% (n=2) were isoechoic and 31% (n=4) were hypoechoic. In 11 cases (85%), lipomas were insinuated into intermuscular space or were found between muscle and adjacent organs. CONCLUSION: The sonographic feature of lipoma of the neck are a well-defined elliptical shaped mass parallel to the skin surface, with linear echogenic lines and either insinuated into intermuscular space or lying between muscle and adjacent organs. The echogenicity of the mass varied.
Aged ; Deception ; Humans ; Lipoma* ; Male ; Muscles ; Neck* ; Retrospective Studies ; Skin ; Ultrasonography*

There are virtually no cognitive and systemic side-effects associated with vagus nerve stimulation (VNS), which makes it a valuable treatment modality for patients with a poor tolerance to antiepileptic drugs. The safety of VNS therapy have been established in clinical studies, but there are few reports on the cardiac side effect associated with the intraoperative lead testing for implantation of the device for VNS. We report a patient with refractory epilepsy who experienced a complete atrioventricular block intraoperatively as a result of inadvertently high current intensity during the initial testing for implantation of a left vagus nerve stimulator.
Anticonvulsants ; Atrioventricular Block ; Epilepsy ; Humans ; Vagus Nerve Stimulation* ; Vagus Nerve*