Acute mobile thrombus of the abdominal aorta after chemotherapy is a very unusual finding, which can be a potential source of arterial embolism. We report here on a case of an acute mobile aortic thrombus with renal infarction. We successfully treated the patient with hybrid operation-open surgical and endovascular approach. Our case shows that hybrid treatment using wire-directed balloon catheter thrombectomy is a feasible, minimally-invasive treatment for a mobile aortic thrombus.
Angioplasty ; Aorta ; Aorta, Abdominal ; Catheters ; Chimera ; Embolism ; Humans ; Infarction ; Thrombectomy ; Thrombosis

Triple X syndrome is a relatively rare sex chromosomal anomaly, and its association with psychopathology is not well understood. The authors report one case of obsessive-compulsive disorder(OCD)with karyotype-confirmed triple X syndrome, 47,XXX. She had incomplete sexual development, seconddary amenorrhea and multiple obsessive-compulsive symptoms. Magnetic resonance imaging of the brain revealed left occipital white matter hyperintensity lesion. The patient's multiple obsessive-compulsive symptoms were responded partially with fluoxetine and adjunctive buspirone treatment, however, her overall psychological functions were much improved. With the literature reviews, the authors suggest the possibility that a certain type of sex chromosome aneuploidy might be susceptible to obsessive-compulsive spectrum disorders(OCSDs)or OCD.
Amenorrhea ; Aneuploidy ; Brain ; Buspirone ; Female ; Fluoxetine ; Humans ; Magnetic Resonance Imaging ; Obsessive-Compulsive Disorder* ; Psychopathology ; Sex Chromosomes ; Sexual Development

Tuberculosis of the puboischium is an uncommon entity. The two constant features in tubereulosis of the pubis are limping and abscess formation. This disesse should be differentiated from other diseases such as osteitis pubis, suppurative osteomyelitis, postpartum synphysiolysis, and adolescent osteochondritis. Kirker advocated that wide excision of the lesion for the treatment of this disease is the best method. However, Nicholson(1953) reported that the lesion has a good prognosis snd responds well to simple curettage. Since the first reports by Thilesen(1855) and by Heinnies(1888), there were paucity of reports. Also in Korea, there have been no report about this disease. The five patients who were treated at the Ksng-Nsm St. Marys Hospitsl between 1982 and 1987 were reported. The results were as follows ; 1. Four patients were boys and one was a female. 2. All cases had clinically abscess, tenderness at the lesion, and limp. 3. Lesions in four cases responded well to simple curettage and18 months of chemotherapy. However, in one case fusion of the symphysis using a plate was performed because of tuberculosis-induced instability of the sacroiliac joint. 4. In a child, destroyed symphysis pubis was well restituted after treatment. Through the cases it is concluded that simple curettage and anti-tuberculous chemotherapy are good treatment modality for tuberculosis of the puboischium.
Abscess ; Adolescent ; Child ; Curettage ; Drug Therapy ; Female ; Humans ; Korea ; Methods ; Osteitis ; Osteochondritis ; Osteomyelitis ; Postpartum Period ; Prognosis ; Pubic Bone ; Sacroiliac Joint ; Tuberculosis

In recent years, the interest in minimally invasive surgery has grown, and the same trend is observed in vascular surgery and interventional radiology, leading to what is called endovascular surgery. Since the first use of a stent-graft for the endovascular exclusion of an abdominal aortic aneurysm (AAA), endovascular aneurysm repair (EVAR) has greatly expanded, and more than 50,000 devices have been implanted until now. The endovascular graft can be implanted from a remote access site in the groin with a less anesthetic requirement. The endovascular graft is advanced over guidewires up the femoral and iliac arteries. Once in position, the graft is deployed immediately distal from the renal arteries. The aorta is not clamped and the blood loss is less than with open surgery. EVAR for AAA offers an important new alternative to open surgical procedure. The mortality rates after EVAR are reported between 0~5%. Long-term follow-up reports are not available, but mid-term follow-up of EVAR reveals an incidence of re-intervention between 10~20% and a rate of late rupture of between 0.5~1.5% per year. The problems of endoleaks and graft failure continue to be the challenges that require technological innovations. Based on the currently available evidence, EVAR is an appropriate treatment for selected patients, especially those at high risk for open surgical repair.
Aneurysm* ; Aorta ; Aortic Aneurysm, Abdominal ; Endoleak ; Groin ; Humans ; Iliac Artery ; Incidence ; Inventions ; Mortality ; Radiology, Interventional ; Renal Artery ; Rupture ; Stents ; Surgical Procedures, Minimally Invasive ; Transplants

OBJECTIVES: In previous studies, the significant correlations between depression-anxiety symptoms and positive symptoms had been reported in schizophrenia. However, it is suggested that these correlations reflect the common influence of third variable, and akathisia-associated dysphoria may be the strong mediator of these relationships. The aim of this study is to investigate the correlations between depression-anxiety symptoms and the schizophrenic symptoms including direct measures of drug-induced akathisia. METHODS: The subjects were 57 patients with chronic schizophrenia. All patients were functioning cognitively at a level to understand and complete the several self-report inventories. Akathisia was rated using Barnes akathisia rating scale (BARS), and depression-anxiety symptoms were assessed by two self-report measures, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The symptoms of schizophrenia were assessed using Manchester Scale. RESULTS: In the whole group of subjects, the scores on BDI and dysphoria composite index were significantly correlated with total positive symptom scores and all subscale scores of positive symptoms. In akathisia group, the scores on BDI and dysphoria composite index were still significantly correlated with total positive symptom scores and the subscale scores of delusion. In non-akathisia group, however, there were no significant correlations between self-report depression, anxiety symptoms and total positive symptom scores. CONCLUSION: These results suggest that the akathisia is the important factor in correlations between dysphoric symptoms and positive symptoms. Therefore, the caution is necessary in the interpretation of previous studies which report the direct correlations between depression and positive symptoms. Future research is needed to investigate the associations in akathisia, depression, and the schizophrenic symptom complexes.
Akathisia, Drug-Induced ; Anxiety ; Delusions ; Depression ; Equipment and Supplies ; Humans ; Psychomotor Agitation* ; Schizophrenia

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has increased after wider use of assisted reproductive technology. The rising incidence presents a serious problem as the diagnosis of this potentially fatal condition is often missed. Careful pelvic examination combined with serial beta-hCG determinations, and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in vitro fertilization and embryo transfer(IVF-ET) with a brief review of literature.
Diagnosis ; Early Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gynecological Examination ; Incidence ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted

In the treatment of fractures of the thoracolumbar junctiion area, surgical intervention was performed when posterior part of veretbral body, posterior structure supporting ligaments were involved and body compression more than 40%. Number of cases satisfying above criteria were seven between Aug. 1990 and Jun. 1991. Age distribution ranged from 15 to 57 years. Sex ratio was 4:3(F:M). Four patients presented with nerve root sign, one patient with cauda equina signs, and two patients were normal neurologically. In all cases, spinal canal decompression, internal instrument fixation, and bone fusion with iliac bone were performed via anterolateral approach. After surgical treatment, neurological deficits disappeared and kyphotic angle returned to normal range of thoracolumbar junction area in all cases. Percentage of body compression was improved from preop. 55% to postop. 21% in average. According to above results, we concluded that anterior instrumental fixation combined with bone fusion using iliac bone was supperior to posterior approach in providing biomechanical stability and decompression of protruding ventral bone fragments.
Age Distribution ; Cauda Equina ; Decompression ; Humans ; Ligaments ; Reference Values ; Sex Ratio ; Spinal Canal

OBJECTIVES: In an attempt to identify the demographic characteristics and the factors influencing long-term hospitalization of chronically mentally-ill patients, a survey on the chronically mentally-ill patients who had been staying longer than 1 year in mental health facilities was conducted. METHODS: Checklist including some demographic data that were regarded as independent variables was applied to 3,477 subjects through administration system of Pusan Metropolitan City. Statistical analyse were done using distribution-free, non-parametric tests. RESULTS: 1)Subjects who had been staying longer than 1 year were 70.7% of the total inpatients of mental health facilities, and median duration of their hospitalization was 5.5 years. 2)In mental hospitals and asylums, the ratio of chronically mentally-ill subjects to the total inpatients in each facilitiy was 46.3% and 95.1%, respectively. 3)All of the 10 independent variables had an influence on the hospitalization duration. CONCLUSIONS: These results indicated that many indirect, extramedical factors had an influence the long-term hospitalization of chronically mentally-ill patients, and it is likely to reflect the underdevelopment of mental health services in Korea.
Busan ; Checklist ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Inpatients ; Korea ; Mental Health Services ; Mental Health*

Metastases to the skin from internal malignancy are very rare and have been reported to occur in 0.9% to 8% of patients with cancer. Particularly there are few cutaneous metastatic carcinomas from the urinary bladder and their incidence is 1% to 2% of the cutaneous metastasis. A 76-year-old man developed cutaneous metastasis six months later after the diagnosis of carcinoma of the bladder had been made. He was presented with asymptomatic erythematous indurated plaques on the left thigh and the inguinal area. This lesion was diagnosed histologically as poorly differentiated transitional cell carcinoma. We report a case of cutaneous metastasis from carcinoma of the urinary bladder showing the unusual clinical feature of an erythematous indurated plaque.
Aged ; Carcinoma, Transitional Cell ; Diagnosis ; Humans ; Incidence ; Neoplasm Metastasis* ; Skin ; Thigh ; Urinary Bladder*