Absence status consists of prolonged episodes during which there is a disturbance of mental function in association with a continuous repetitive or intermittent spike and wave pattern on the electroencephalography. We report a 14 year-old male who had previous history of partial to secondiary generalized seizure, showed absence status during acute phase of brainstem infarction.
Adolescent ; Brain Stem Infarctions* ; Brain Stem* ; Electroencephalography ; Humans ; Male ; Seizures ; Status Epilepticus*

Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.
Aneurysm, False* ; Catheterization ; Catheters ; Coronary Angiography ; Femoral Artery ; Humans ; Middle Aged ; Peripheral Nervous System Diseases ; Renal Dialysis ; Rupture* ; Shock, Hemorrhagic* ; Thrombin

OBJECTIVE: To measure gynecologic resources required to care for women who have unscheduled vaginal bleeding while using hormone replacement therapy. MATERIALS AND METHODS: Between January 1996 to December 1998, women presenting with abnormal withdrawal bleeding on HRT were identified and associated clinic visits and gynecologic procedures were recorded during a mean follow-up of 2 years. RESULTS: Among women using cyclic HRT, 28.9% had> OR =1 visit for unscheduled vaginal bleeding 8.7% had> OR =1 endometrial biopsy. Among women using continuous combined HRT, 19.3% had> OR =1 visit for unscheduled vaginal bleeding and 6.4% had> OR =1 endometrial biopsy. The gynecologic procedures used in women using cyclic HRT were 20% of reassurance, 50% of ultrasonograpy, 30% of endometrial biopsy and in women using continuous combined HRT were 50% of reassurance, 16.6% of ultrasonograpy, 33.3% of endometrial biopsy. The results of endometrial biopsy were reported all the benign condition. CONCLUSION(S): Unscheduled vaginal bleeding markedly decreased after 12 months of therapy in women using continuous combined HRT but did not decline among those using cyclic HRT.
Ambulatory Care ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Hormone Replacement Therapy* ; Humans ; Uterine Hemorrhage*

Coil migration is an extremely rare but hazardous complication of aneurysmal coil embolization. Only 1 case report has described coil migration following endovascular exclusion to gastrointestinal (GI) tract. We report the experience of a case of colon penetration caused by embolization coil placed for internal iliac aneurysm. A 66-year-old man visited the Emergency Department for hematochezia that had persisted for 3 months. Stent insertion and coil embolization of left internal iliac artery aneurysm had been performed on the patient 18 months ago. Colonoscopy was performed. It suggested penetration of sigmoid colon by embolization coil and diverticulum. Angiography revealed extravasation of contrast media at left internal iliac artery. Covered stent deployment was done in the left internal iliac artery. One week after the stent insertion, the patient underwent anterior resection, aneurysm resection, and coil removal. The patient recovered without complications. He was discharged at 2 weeks after the operation.
Aged ; Aneurysm ; Angiography ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Diverticulum ; Embolization, Therapeutic ; Emergency Service, Hospital ; Endovascular Procedures ; Extravasation of Diagnostic and Therapeutic Materials ; Gastrointestinal Hemorrhage ; Humans ; Iliac Aneurysm* ; Iliac Artery ; Intestinal Perforation ; Stents

Hepatocellular carcinoma (HCC) with portal vein invasion has a poor prognosis. Treatments such as transarterial chemoembolization (TACE), radiation therapy (RT), sorafenib are done as a first line treatment. But in case of incomplete response to first line treatment, there's no established guideline about salvage treatment. We present a 47 year-old male who was diagnosed as HCC with portal vein invasion. He was treated with RT and repeated TACE, but remnant viable tumor was observed. Surgical resection was performed as a salvage treatment, and HCC was completely removed. He has been followed up over 3 years, but there was no recurrence.
Carcinoma, Hepatocellular* ; Humans ; Male ; Portal Vein* ; Prognosis ; Recurrence ; Salvage Therapy ; Thrombosis

PURPOSE: Transarterial embolization has been known as an effective nonsurgical treatment for selected patients with intraabdominal hemorrhage. This study was conducted to evaluate the clinical outcomes of transarterial embolization after emergency operation in the blunt abdominal trauma patients with hemoperitoneum. METHODS: Between January 2004 and December 2008, a total of 13 consecutive blunt abdominal trauma patients with intraabdominal hemorrhage who received transarterial embolization after abdominal surgery were included. The characteristics, procedures, and the clinical outcomes of patients were analyzed, retrospectively. RESULTS: There were 6 males and 7 females. Age ranged between 21 and 77 years (mean 42.3 years). The most common injured organ was the liver (10 patients, 76.9%), and the most common embolized artery was hepatic artery (8 patients, 61.5%). Transarterial embolizations were intended to control the continued bleeding (9 patients, 69.2%), delayed bleeding (3 patients), and arteriovenous fistula (1 patient). Further, technical success was achieved in all 13 patients. One of 13 patients died of multiorgan failure. No procedure-related complications were observed. CONCLUSION: Angiography has a high detection rate of bleeding sites in patients with intraabdominal hemorrhage after blunt abdominal trauma. Transarterial embolization is considered as an effective and safe method in the management of intraabdominal hemorrhage after abdominal surgery in trauma patients.
Angiography ; Arteries ; Arteriovenous Fistula ; Emergencies ; Female ; Hemoperitoneum ; Hemorrhage ; Hepatic Artery ; Humans ; Liver ; Male

Leptomeningeal metastsis (LM) is a disease where the tumor cells involves the leptomeninges. Breast cancer, of all solid tumors, is the primary tumor most frequently associated with leptomeningeal metastasis. Leptomeningeal metastasis originating from breast cancer is usually detected at an advanced stage, so its evaluation and aggressive treatment are difficult. Leptomeningeal metastasis, from solid tumors, has been reported to inexorably lead to death within 4 to 6 weeks if left untreated. Intrathecal or Intraventricular chemotherapy and radiotherapy are the mainstays of treatment. Even though controversial, systemic chemotherapy, with regional radiotherapy, can also improve the neurological outcome and survival, without neurotoxicity. Here, two patients with leptomeningeal metastasis, originating from breast cancer, their clinical course and treatment modalities are reported.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Neoplasm Metastasis* ; Radiotherapy

BACKGROUND AND SIGNIFICANCE: Frontotemporal dementia is a behavioral disorder arising from nonAlzheimer's disease atrophy of frontal and anterior temporal lobe. Clinical manifestations include frontal lobe dysfunction. Kluver-Bucy syndrome or progressive language impairments. Two types of histological change underline, the atrophy. The commoner pathology is nerve cell loss and spongiform change with astrocytic gliosis. The second one is typical Pick-type histology characterized by intraneuronal inclusion body and astrocytic gliosis. We report a case with biopsy proved Pick's disease presenting with progressive nonfluent speech. CASE: A 41-years, old right-handed woman developed progressive language impairment over a period of 6 months. Brain MRI revealed asymmetric frontotemporal cortical atrophy more severe on the left side and 18F-FDG-brain, PET showed hypometabolism in the same area. Neuropsychological test including Korean version-Western Aphasia Battery revealed non-fluent speech as well as frontal lobe, dysfunction. A biopsy from left frontal lobe, demonstrate neuronal loss and diffuse astrogliosis. In the cytoplasm of remaining neurons are eosinophilic inclusion bodies which are neurofilament-positive with immunostaining. Senile plaque, neurofibrillary tangle and cortical Lewy body were absent. COMMENT: We report a case presenting with progressive nonfluent speech whose imaging and pathological findings are compatible with Pick's disease, which may be the first biopsy proven case in Korea.
Aphasia ; Atrophy ; Biopsy ; Brain ; Cytoplasm ; Eosinophils ; Female ; Frontal Lobe ; Frontotemporal Dementia ; Gliosis ; Humans ; Inclusion Bodies ; Kluver-Bucy Syndrome ; Korea ; Lewy Bodies ; Magnetic Resonance Imaging ; Neurofibrillary Tangles ; Neurons ; Neuropsychological Tests ; Pathology ; Pick Disease of the Brain* ; Plaque, Amyloid ; Temporal Lobe

BACKGROUND: Combination effects of various beta-lactam antibiotics with vancomycin or teicoplanin against methicillin-resistant Staphylococcus aureus (MRSA) that were detected as pos-sible hetero-vancomycin resistant Staphylococcus aureus (hetero-VRSA) by the Mu-3 agar method, were evaluated. METHODS: Twenty-four strains of MRSA (possible hetero-VRSA) from 22 inpatients of Dankook University Hospital from July through November 1998, were subjected to the study. Minimum inhibitory concentrations (MICs) of antibiotics, alone or in combination, were tested with the agar dilution method and the fractional inhibitory concentration (FIC) indices were calculated to estimate the combination effects. RESULTS: Six strains of 24 MRSA were estimated as hetero-VRSA by population analysis. The aver-age FIC index of imipenem (I), flomoxef (F), cephalothin (C), cefpirome (E) in combination with van-comycin (V) and teicoplanin (T) were 0.584 for I-V, 0.200 for I-T, 0.747 for F-V, 0.230 for F-T, 0.633 for C-V, 0.374 for C-T, 0.773 for E-V, and 0.386 for E-T, respectively. The presence of synergy and addi-tivity in beta-Lactams were observed as 5.3% (16/304) and 90.1% (274/304) for the combination of van-comycin with I, F, C, or E, respectively, and 29.3% (164/560) and 69.8% (391/560) for the combina-tion of teicoplanin with I, F, C, or E, respectively. CONCLUSIONS: We concluded that the selected beta-lactam antibiotics with vancomycin or teicoplanin showed effective against possible hetero-VRSA, as the combination effects were syner-gistic or additive with the average of the FIC index and the frequency of synergy and additivity in this study.
Agar ; Anti-Bacterial Agents* ; beta-Lactams ; Cephalothin ; Humans ; Imipenem ; Inpatients ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Staphylococcus aureus* ; Staphylococcus* ; Teicoplanin* ; Vancomycin*