Plasmapheresis has been used for some conditions during pregnancy and puerperium, such as hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. We present one case of the HELLP syndrome which was treated with plasmapheresis and also review the indications, complications and guidelines for repetitive plasma exchange.
Blood Platelets ; Female ; HELLP Syndrome* ; Hemolysis ; Liver ; Plasma Exchange ; Plasmapheresis* ; Postpartum Period* ; Pregnancy

No abstract available.
Erythrocyte Membrane* ; Erythrocytes* ; Hydroxyl Radical* ; Lipid Peroxidation* ; Macrophages, Alveolar* ; Mineral Fibers*

In this report, we describe ovarian mixed germ cell tumor in a patient with Turner syndrome. Right ovary was replaced by a 15 x 11 x 10cm teratomatous benign tissue and small area of mixed malignant germ cell tissue. The malignant germ cell portion was composed of embryonal carcinoma and loose reticular area of yolk sac tumor and syncytiotrophoblastic giant cells. Left ovary was streak gonad. This is the first reported case of mixed germ cell tumor with Turner syndrome in Korea.
Carcinoma, Embryonal ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Giant Cells ; Gonads ; Humans ; Korea ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Trophoblasts ; Turner Syndrome*

BACKGROUND AND PURPOSE: Neuropsychiatric symptoms (NPS) such as anxiety, depression, and delusions affect up to 90% of all patients with Alzheimer's disease (AD). NPS is associated with significant caregiver burden and patient distress. Given the severe burden of NPS in AD, it is critical to know potential modifiable risk factors of NPS in AD. This study explores the association between hypertension and NPS in patients with drug-naïve AD. METHODS: We reviewed medical records of 149 patients with AD with (n=80) and without (n=69) hypertension. NPS were assessed using the Korean version of Neuropsychiatric Inventory (K-NPI). Affective, psychotic, and behavior symptom clusters were assessed separately. RESULTS: The total score of K-NPI was not significantly different between patients with AD with and without hypertension. Among K-NPI domains, scores of depression/dysphoria (p=0.045), anxiety (p=0.022), and apathy/indifference (p=0.037) were significantly higher in patients with AD with hypertension. Systolic blood pressure (BP) was associated with higher total K-NPI and affective symptom cluster scores. Diastolic BP was associated with affective symptom cluster scores. CONCLUSIONS: Results suggest that hypertension increases risk of specific NPS in patients with AD. Among NPS, hypertension was associated with affective symptom cluster.
Affective Symptoms ; Alzheimer Disease* ; Anxiety ; Blood Pressure ; Caregivers ; Delusions ; Depression ; Humans ; Hypertension* ; Medical Records ; Risk Factors

PURPOSE: To evaluate a scoring system based on ultrasonographic findings as a means of distinguishing between benign and malignant solid breast masses. MATERIALS AND METHODS: Histopathologically confirmed benign (n=102) and malignant (n=73) breast masses which ultrasonographic findings of histopathologic masses were reviewed for shape, border, internal echo, boundary echo, posterior echo, lateral echo, and ratio of transverse to anteroposterior diameter. There were statistically significant (p < 0.001 ; chi-square test) differences in each feature for benign and malignant lesions. The findings suggesting benignancy, equivocality, and malignancy of the masses were scored as 0, 1, and 2 respectively. The scores for all features were summed for each lesion. An ROC curve was obtained. RESULTS: When the score was 6, five benign and seven malignant cases were found. Scores of 0 and 1 indicated benign masses and a score above 11, malignancy. The turning point was a score of 6, so a score above 7 suggests malignancy. CONCLUSION: A ultrasonographic scoring system can be used to characterise breast masses. A score of a mass above 7 suggests probable malignancy and a score below 5 suggests benignancy.
Breast* ; ROC Curve ; Ultrasonography*

BACKGROUND: Depression and suicide are common in neurological disorders. However, their reported frequencies have varied widely due to heterogeneities in methodology and assessment timing. We evaluated the frequencies of current depression and suicidality in patients with epilepsy, Parkinson's disease (PD), and ischemic stroke (IS). METHODS: We enrolled patients who visited a tertiary care hospital in Seoul between January and December 2013. All of the patients completed the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale-Depression subscale (HADS-D). Any patient with depressive symptoms (defined as a total HADS-D or BDI score of ≥9 or ≥17, respectively) was reassessed with a structured psychiatric interview based on the Mini International Neuropsychiatric Interview Plus 5.0.0 (MINI). RESULTS: In total, 305 patients were recruited, comprising epilepsy (n=92, 30.2%), PD (n=99, 32.4%), and IS (n=114, 37.4%). Depressive symptoms were exhibited by 52 epilepsy patients (56.5%), 56 PD patients (56.6%), and 54 IS patients (47.4%), and these were further evaluated with the aid of the MINI. Seven epilepsy patients were diagnosed as major depressive disorder (MDD), five as dysthymic disorder (DD), and nine as depressive disorder not otherwise specified (DDNOS). Twelve PD patients were diagnosed as MDD, 7 as DD, and 10 as DDNOS. Ten stroke patients were diagnosed as MDD, 7 as DD, and 11 as DDNOS. Most patients with depressive symptoms (91.4%) exhibited suicidality. CONCLUSIONS: Patients with epilepsy, PD, and IS frequently exhibit depression and suicidality. Neurologists should always be concerned about comorbid psychiatric problems when they see patients with neurological disorders.
Anxiety ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Dysthymic Disorder ; Epilepsy* ; Humans ; Nervous System Diseases* ; Parkinson Disease* ; Seoul ; Stroke* ; Suicide ; Tertiary Healthcare

PURPOSE: There was an outbreak of aseptic meningitis in Busan and Kyoungsangnamdo area from April to July, 2002. In this study, we reported the clinical manifestations, laboratory data and causative viruses. METHODS: 184 children with aseptic meningitis who had been admitted to Department of Pediatrics, Inje Paik Hospital in Kaegum and Dongrae between April and July 2002 were assessed. Virus isolation and serotype identification were performed by cell culture and reverse transcription-polymerase chain reaction(RT-PCR) of cerebrospinal fluid. RESULTS: The peak incidence was noted in May. Male-to-female ratio was 2:1. The age ranged from 2 years to 16 years. Mean age was 8.7+/-7.1 years. Clinical manifestations were fever(95.1%), headache(91.8%) and vomiting(89.7%). Mean duration of fever was 2.6 days. The numbers of peripheral blood leukocytes were 1,400-20,000/mm3 and mean value was 9,829/mm3. On cerebrospinal fluid examinations, leukocyte count was in range of 10-2,000(mean 301)/mm3, protein level in range of 10-196(mean 36.7)mg/dL and glucose level from 17 to 155(mean 58.3)mg/dL. Viruses were isolated 13(8.4%) out of 154 patients and serotypes were 6 cases of echovirus 6, 3 cases of echovirus 9, 1 case of echovirus 13, 2 cases of echovirus 25 and 1 case of echovirus 30. CONCLUSION: Aseptic meningitis was prevalent in Busan and Kyoungsangnamdo area from April to July, 2002. We thought that causative viruses were echovirus 6, 9, 13, 25, 30.
Busan* ; Cell Culture Techniques ; Cerebrospinal Fluid ; Child ; Echovirus 6, Human ; Echovirus 9 ; Enterovirus B, Human ; Fever ; Glucose ; Gyeongsangnam-do* ; Humans ; Incidence ; Leukocyte Count ; Leukocytes ; Meningitis, Aseptic* ; Pediatrics

Paraganglioma of the cauda equina or filum terminale is rare tumor and was first described in 1970. The authors present a case of paraganglioma of the cauda equina in a 55 year-old-man with nonspecific back pain. To our knowledge, there has been only a few report of MRI of a paraganglioma of the cauda equina. Diagnosis can be made with immunohistochemical study and electron microscopy after surgical removal. Because of frequent recurrence, total excision is mandatory.
Back Pain ; Cauda Equina* ; Diagnosis ; Magnetic Resonance Imaging ; Microscopy, Electron ; Paraganglioma* ; Recurrence

Systemic sclerosis is an intractable clinical subset characterized by diffuse fibrosis, vasculopathy, and immune abnormalities. Diffuse cutaneous systemic sclerosis has a variety of symptoms depending on the internal organs involved, such as the lungs, heart, kidneys, and gastrointestinal system. Gastrointestinal involvement is frequent and one of the major cause of morbidity and mortality. There is no sustained, effective therapy for treating the active gastrointestinal involvement of systemic sclerosis. Although immunoglobulin is commonly used in the treatment of other autoimmune diseases, its effects in the treatment of the gastrointestinal involvement in systemic sclerosis are unclear. Here, we report a patient with a severe cough caused by uncontrolled gastrointestinal involvement in diffuse cutaneous systemic sclerosis treated with immunoglobulin.
Autoimmune Diseases ; Cough ; Fibrosis ; Heart ; Humans ; Immunoglobulins* ; Kidney ; Lung ; Mortality ; Scleroderma, Diffuse ; Scleroderma, Systemic*

An 8-month old intact male Turkish Angora cat was referred to the Veterinary Medical Teaching Hospital (VMTH), Seoul National University, for an evaluation of anorexia and severe dyspnea. The thoracic radiographs revealed significant pleural effusion. A cytology evaluation of the pleural fluid strongly suggested a lymphoma containing variable sized lymphocytes with frequent mitotic figures and prominent nucleoli. The feline leukemia virus and feline immunodeficiency virus tests were negative. The cat was euthanized at his owner's request and a necropsy was performed. A mass was detected on the mediastinum and lung lobes. A histopathology evaluation confirmed the mass to be a lymphoma. Immunohistochemistry revealed the mass to be CD3 positive. In conclusion, the cat was diagnosed as a T-cell mediastinal lymphoma.
Animals ; Cat Diseases/*diagnosis/pathology ; Cats ; Lymphoma/diagnosis/pathology/*veterinary ; Male ; Mediastinal Neoplasms/diagnosis/pathology/*veterinary