Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

One family with asymmetric septal hypertrophy was reported. The propositus of this family was 31 years old man who was admitted because of transient syncope. His father and one brother were affected but asymptomatic. His sister was suddenly died at age 21 years. The interventricular septal thickness to left ventricular posterior wall thickness ratios were measured using M-mode echocard ogram. In the affected family, echocardiogram revealed asymmetric septal hypertrophy (1.5:1, 2:1, 1.9:1 respectively). In the propositus, cardiac catheterization and simultaneous biventricular cineangiography were performed. Pressure study revealed mild peak systolic pressure gradient within left ventricular apex and left ventricular outflow tract (4mm Hg respectively). Biventricular cineangiogram showed the septal width increased inferiorly, and left ventricular endocardial surface of the septum was straight, while the right ventricular border convex toward the right ventricle.
Adult ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cineangiography ; Fathers ; Heart Ventricles ; Humans ; Siblings ; Syncope

The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. There tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control (p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results (p<0.01). 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Significantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.
Cerebral Infarction ; Dexamethasone* ; Humans ; Hydrocortisone ; Infarction ; Stroke*

BACKGROUND: Prolonged transport or poor accessibility of blood culture equipment during night time may cause delayed entry of blood culture bottles. The effect of prestorage conditions on time to detection (TTD) for the blood culture was evaluated for the important gram-negative lactose nonfermentative bacteria. METHODS: Three different clinical isolates of Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Burkholdera cepacia were diluted to 150 CFU/mL and 15 CFU/mL and inoculated into standard aerobic bottles. These were stored at 25℃ and at 37℃ for 0, 6, 12, 18, and 24 h. They were entered to BacT/Alert 3D Systems (bio-Mérieux Inc.) and TTD was monitored for each condition. RESULTS: At the 150 CFU/mL concentration, P. aeruginosa and A. baumannii showed false-negative for the bottles prestored at 37℃ for 18 h and 24 h, respectively. However, there was no false-negative for S. maltophilia or B. cepacia at any prestorage conditions. There was a significant decrease of TTD for all experimental microorganisms except P. aeruginosa prestored for 24 h either at 25℃ or at 37℃ (P< 0.05). CONCLUSION: Delayed entry may cause false-negative, especially for the high level of bacteremia of P. aeruginosa or A. baumannii when the bottles are stored at 37℃ for ≥18 h. TTD could be reduced by prestorage of the bottles at 37℃ until 12 h without false-negative for nonfermentative bacteria.
Acinetobacter baumannii ; Bacteremia ; Bacteria ; Lactose* ; Pseudomonas ; Pseudomonas aeruginosa ; Sepsis ; Stenotrophomonas maltophilia

The fMRI signals are composed of many various signals. It is very difficult to find the accurate parameter for the model of fMRI signal containing only neural activity, though we may estimating the signal patterns by the modeling of several signal components. Besides the nose by the physiologic motion, the motion of object and noise of MR instruments make it more difficult to analyze signals of fMRI. Therefore, it is not easy to select an accurate reference data that can accurately reflect neural activity, and the method of an analysis of various signal patterns containing the information of neural activity is an issue of the post-processing methods for fMRI. In the present study, fMRI data was analyzed with the Independent Component Analysis(ICA) method that doesn't need a priori-knowledge or reference data. ICA can be more effective over the analytic method using cross-correlation analysis and can separate the signal patterns of the signals with delayed response or motion related components. The Principal Component Analysis (PCA) threshold, wavelet spatial filtering and analysis of a part of whole images can be used for the reduction of the freedom of data before ICA analysis, and these preceding analyses may be useful for a more effective analysis. As a result, ICA method will be effective for the analysis of signal patterns in fMRI and the pre-filtering may be necessary for the reduction of the degree of freedom of the data.
Freedom ; Magnetic Resonance Imaging* ; Noise ; Nose ; Principal Component Analysis

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

The original article was reported by Creutzfeld in 1920, and Jakob in 1921 respectively. CJD is an encephalopathy with worldwide distribution caused by an unidentified unconventional virus. The principal clinical features of CJD are dementia, upper and in some instances, lower motor neuron disorders; basal ganglionic and cerebellar dysfunction; and myoclonus including a heightened startle reaction. The disease is rapidly progressive, leading in several months to stupor, coma, and death. Pathologic changes are widespread, involving the cerebral cortex, basal ganglia, cerebellum, pyramidal tracts, and lower motor neruons of the brain stem and/or spinal cord. This case was 51 years old Korean male, who presented progressive dementia, myoclonus, heightened startle reaction, pyramidal, extrapyramidal symptoms, decerebrated rigidity, and died about 4 months after onset. We diagnosed this case as CJD with typical serial EEG pattern and clinical feature.
Basal Ganglia ; Brain Stem ; Cerebellar Diseases ; Cerebellum ; Cerebral Cortex ; Coma ; Creutzfeldt-Jakob Syndrome* ; Dementia ; Electroencephalography ; Ganglion Cysts ; Humans ; Male ; Middle Aged ; Motor Neurons ; Myoclonus ; Pyramidal Tracts ; Spinal Cord ; Startle Reaction ; Stupor

Patients with multilevel atherosclerotic disease represent a difficult surgical challenge. In the 5 decades that have relapsed since the introduction of initial methods of revascularization, a wide variety of the therapeutic options have been developed and advocated for management of aortoiliac disease. With the aid of dramatic advance of endovasular technique, various nonoperative catheter based endoluminal therapies have been accentuated in recent years by the explosive growth in vascular surgical procedures. A combination of iliac PTA and distal surgical revascularization would appeal to be a logical and potentially advantageous methods of revascularization in selected patients. This report is a retrospective review of 20 patients who were treated using a combination of lilac transluminal angioplasty and/or stent and infrainguinal reconstruction. They were 19 males and 1 female with an average of 69 years (range : 48 to 74 years). Follow-up period ranged from 1 month to 92 months( median : 28 months). These patients had cormorbid disease including heart disease (35%), hypertension(35%), diabetes mellitus(15%), hyperlipidemia(15%); 90% of the patients were smokers. Ten patients were treated for rest pain or tissue loss, while ten were treated for moderate or severe claudication. Distal operation included 7 femorofemoral bypass, 11 femoropopliteal(AK) bypass, 4 femoropopliteal(BK) bypass, 1 pop-tibial bypass. A mean resting iliac artery pressure gradient of 27.6+/-22.8 mmHg pre-PTA was reduced to 3.1+/-4.3 post PTA. Mean pretreatment ankle/brachial index of 0.36+/-0.28 increased to 0.80+/-0.16 after operation(P<.001). By Kaplan-Meier method, the 5-year primary patency rate of the distal surgical procedures was 72%. The procedures were well tolerated with no mortality and two complication occurred, but all were sucessfully corrected by stent insertion for intimal dissection and Urokinase infusion for thrombosis. Two patients underwent amputation due to preoperative wide skin ulcer and knee joint infection. We conclude that in selected patients, combined use of iliac PTA or stent insertion and distal surgical reconstructions is safe and effective modality for managing the patients with severe multilevel occlusive disease.
Amputation ; Angioplasty ; Angioplasty, Balloon ; Catheters ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Iliac Artery ; Knee Joint ; Logic ; Male ; Mortality ; Retrospective Studies ; Skin Ulcer ; Stents ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vascular Surgical Procedures

Extraskeletal mesenchymal chondrosarcomas (EMCs) are relatively uncommon, and a location in the upper extremity, especially in the shoulder or axillary region, is rare. Furthermore, the radiographic findings of EMCs do not show any features that distinguish them from other neoplasms, and therefore, definitive diagnoses are made based on histological features. EMC is an aggressive tumor with a poor prognosis, and requires wide surgical excision. However, its treatment may involve peculiarities such as a difficulty in obtaining a proper surgical margin in the axillary region or shoulder. In this report, the authors present two rare cases of EMCs in the axillary region.
Axilla ; Chondrosarcoma, Mesenchymal ; Prognosis ; Shoulder ; Upper Extremity

PURPOSE: This study was performed in order to compare unenhanced CT with diffusion-weighted, T2-weight-ed,and fast FLAIR MR imaging in the detection of hyperacute cerebral ischema induced in a dog and to deter-mine whichmodality first detected cerebral ischemia. MATERIALS AND METHODS: Experimental cerebral infarction was induced bythe occlusion of intracerebral arter-ies using embolic materials (polyvinyl-alcohol, 300 -6 00 micro) introducedthrough a microcatheter into the internal carotid artery of five dogs weighing 12 -20 kg. Serial CT and MR imageswere obtained at one hour intervals from one to five hours after occlusion, and were analyzed independently by tworadiologists. We assessed changes in attenuation, as seen on unenhanced CT and the signal intensity of the lesionon each MR image, and measured the contrast-to-noise ratio (CNR) of the lesions. RESULTS: Ischemic lesions weredetected on unenhanced CT 1 -3 hours after occlusion of cerebral arteries. In all dogs, the lesions were detectedearliest on diffusion-weighted images obtained at 1 hour. They were detect-ed on T2-weighted images at 3 -5 hoursand on fast FLAIR images of 2 -5 hours. The CNR of ischemic lesions increased gradually during the 5-hour period.It was highest on diffusion-weighted images, while on unen-hanced CT, T2-weighted, and fast FLAIR images it wassimilar. CONCLUSION: Hyperacute ischemic lesions were detected earliest on diffusion-weighted images, and earlieron unenhanced CT than on fast FLAIR or T2-weighted MR image.
Animals ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction* ; Dogs* ; Magnetic Resonance Imaging*