Wernickes encephalopathy is an illness characterized by mental disturbance, paralysis of eye movements and ataxia of gait. The specific factor for most, if not all, of these symptoms is a deficiency of thiamine. Wemicke's encephalopathy mostly occurs in developing countries when the patient is in a state such as nutritionally deprived state, anorexia nervosa, stomach cancer, long duration of parenteral nutrition. Wernickes encephalopathy was recognized as a complication of hyperemesis of pregnancy in 1914. Unfortunately, cases continue to occur. We present here a case of Wernickes encephalopathy in a 36-year-old pregnant woman. We discuss the clinical picture, histopathology, radiology, therapeutic management and prognosis with review of the literature.
Adult ; Anorexia Nervosa ; Developing Countries ; Eye Movements ; Female ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism* ; Paralysis ; Parenteral Nutrition ; Pregnancy ; Pregnant Women ; Prognosis ; Radiation Oncology ; Stomach Neoplasms ; Thiamine ; Wernicke Encephalopathy*

PURPOSE: To determine the usefulness of the fat-suppressed (FS) conventional spin-echo (CSE) sequence for the diagnosis of meniscal tears. MATERIALS AND METHODS: We retrospectively reviewed 323 MR images of the knee, the standard of reference being the findings of arthroscopy. In all knees, fast SE proton density-weighted and T2-weighted sagittal and coronal images and double-echo in steady state (DESS) sagittal images were obtained, and during 202 MR Procedures, FS-CSE T1-weighted sagittal images were also obtained. The results of MR imaging were then correlated with those of arthroscopy, the accuracy with which meniscal tears were diagnosed being compared between two groups: group I (202 knees for which FS-CSE T1-weighted sagittal images were obtained), and group II (121 knees for which these images were not obtained). For statistical analysis the chi-square test was used. RESULTS: In group 1, sensitivity, specificity and accuracy were 94.7%, 92.4% and 93.5%, respectively, for the medial meniscus, and 83.3%, 95.7% and 90.5% for the lateral meniscus. In group II, the corresponding findings were 92.5%, 94% and 93.3%; and 87.3%, 98.2% and 92.5%. The differences between the groups were not statistically significant (p>0.05) CONCLUSION: For meniscal tears of the knee, the addition of FS-CSE T1-weighted MR imaging to the fast SE proton density-weighted, T2-weighted and DESS sequences does not enhance diagnostic accuracy.
Arthroscopy ; Diagnosis ; Knee* ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Protons ; Retrospective Studies ; Sensitivity and Specificity

Authors report the radiologic findings of two cases of multiple bile-duct hamartoma in the liver. Ultrasonography and computed tomography of the liver were performed in two female patients. In one patient, ERCP was performed. Ultrasonography and computed tomography showed scattered multiple hypoechoic and low attenuated lesions, measuring up to 2cm in both lobe and ERCP showed communication of these lesions with the biliary system. Multiple bile-duct hamartoma should be included in the differential diagnosis of multiple small cystic lesions in the liver.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Female ; Hamartoma* ; Humans ; Liver ; Ultrasonography

We studied the disease status by question-naire in seoul of the pupils in two primary schools on May, 1991 and carried out statistical analysis of their results. The following results were observed: 1) Total number of answered pupil was 2330; 1103 were male and 1227 were female and the ratio of male to female was 1:1.1. Average age was 9.27 years. 2) Number of the pupil with any present described was 499(21.4%) Majority was as follows: (1) Respiratory system diseases; 358(71.1%) (2) Skin & Subcutaneous tissue diseases; 36(7.2%) (3) Circulatory system diseases; 14 (2.8%) (4) Infectious diseases; 11 (2.2%) (5) Trauma; 7 (1.4%) 3) Number of the pupil with any disease on treatment was 225 (9.7%). Majority was as follows: (1) Respiratory system diseases; 108 among 358 (2) Skin & Subcutaneous diseases; 22 among 36 (3) Infectious diseases; 11 among 11 (4) Trauma; 3 among 7 (5) Mental disorders; 1 among 6 4) Number of the pupils with the past history of diseases described was 561 (24.1%). Majority was as follows: (1) Respiratory system diseases; 217 (38.7%) (2) Infectious diseases; 105 (18.7%) (3)Trauma; 74 (13.2%) (4) Nervous system & Sense organ diseases; 39 (7.0%) (5) Digestive system diseases; 27 (4.8%) 5) Number of the pupils with the past hospitalization history was 190 (8.2%). Majority was as follows: (1) Respiratory system diseases; 48 (25.3%) (2) Trauma; 41 (21.6%) (3) Infectious diseases; 18 (9.5%) (4) Genitourinary system diseases; 9 (4.7%) (5) Digestive system diseases; 6 (3.2%) 6) Number of the pupils with the past history fo sugery was 362 (15.5%). The types of surgery of the causative diseases requiring surgery were as follows: (1) Circumcision; 98 (4.2%) (2) Trauma; 73 (3.1%) (3) Tonsillectomy & Adenectomy; 46 (2.0%) (4) Inguinal herniectomy; 25 (1.1%) (5) Appendictomy; 10 (0.4%) (6) Intussusception; 10 (0.4%) 7) Number of the pupils with hearing disturbance was 498 (21.4%), with present illness of otitis media 19 (0.82%) and with the past history of otitis media 15 (0.64). 8) Number of the pupils with visual disturbance was 498 (21.4%), with myopia 233 (10%), with hyperopia 49 (2.1%), with strabismus 16 (0.7%), color blindness 7 (0.3%). 9) Number of the pupils hoping to consult with the physicians were 446 (19.1%). The contents of their consultation were as follows: (1) Dental problems; 81 (18.0%) (2) Extremity pain; 56 (13.0%)(3) Abdominal pain; 52 (12.0%) (4) Skin disease; 34 (7.6%) (5) Headache; 30 (6.7%) 10) Number of the pupil sttended to school inspite of disease was 846 (36.3%). The caustive diseases were as follows: (1) Upper respiratory infection; 217 (25,7%) (2) Abdominal pain; 27 (3.2%) (3) Fever; 24 (2.8%) (4) Trauma; 8 (0.9%) (5) Infection (Measles, Mumps, Chicken pox et.); 6 (0.7%) .
Abdominal Pain ; Chickenpox ; Circumcision, Male ; Color Vision Defects ; Communicable Diseases ; Digestive System Diseases ; Extremities ; Female ; Fever ; Headache ; Hearing ; Hope ; Hospitalization ; Humans ; Hyperopia ; Intussusception ; Male ; Mental Disorders ; Mumps ; Myopia ; Nervous System ; Otitis Media ; Pupil* ; Surveys and Questionnaires* ; Respiratory System ; Sense Organs ; Seoul* ; Skin ; Skin Diseases ; Strabismus ; Subcutaneous Tissue ; Tonsillectomy ; Urogenital System

Primary malignant melanornn of the vagina is rare, with only about 130 reported cases worldwide. They presumably arise from melanocytes that are present in the vagina in 3% of normal wornen. Vaginal melanoma accounts for less than 1% of melanomas and less than 3% of primary malignant tumors of the vagina. Most of patients complain vaginal bleeding, vaginal discharge, foreign body sensation in order. The best treatment of vaginal melanoma rernains eni.gmatic, Many authors indicate that radical surgery may be the pcferred approach and the number of reported cases treated with radical surgery is increasing. But other author comment that no significant change in survival is apparent with radical surgery. Overall prognosis is poor as most patients have deeply penetrating lesions at the time of diagnosis. Recently, not only the effort to increase the survival rate but the quality of life including sexual function after treatment is becoming an important issue about treatment ot cancer patients. We experienced a case of primary malignant melanoma of the vagina treated with radical surgery and restored the sexual function by vulvovaginal reconstruction using gracilis myocutaneous flap. So we report this case with brief literature review.
Diagnosis ; Foreign Bodies ; Humans ; Melanocytes ; Melanoma* ; Myocutaneous Flap ; Prognosis ; Quality of Life ; Sensation ; Survival Rate ; Uterine Hemorrhage ; Vagina* ; Vaginal Discharge

Thymic cyst is relatively rare tumor which usually occurs in the neck or mediastinum. Cervical thymic cyst is usually situated laterally and deep to the anterior border of the sternocleidomastoid muscle, simulating a branchial cyst. Thymic cyst of the mediastinum is usually detected incidentally and differential diagnoses include cystic degeneration of thymoma, and cystic teratoma. Two case of a cervical and a mediastinal thymic cysts were reported. The one was a cervical thymic cyst developed slowly growing mass in a 53-year-old male a for 10 years. The cyst was unilocular and measures 5.4x2.9x2.8 cm with columnar or squamous cell linings. The other is a mediastinal thymic cyst developed in a 37-year-old female with chest discomfort for 7 months. The cyst was uniocular and measures 2.8x2.2x2.0 cm. The epithelial lining of the cyst was largely desquamated and covered by macrophages with cholesterol granuloma. Involutional thymic stissue in their walls were noted in both cysts. In both cases presence of thymic tissue in the wall of the cyst thought to be the most important diagnostic feature.
Female ; Male ; Humans ; Diagnosis, Differential ; Cysts

PURPOSE: The purpose of this study was to evaluate the spectrum of MR characteristics of cystic acoustic neurinomas and to correlate with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the MR findings of 12 patients with cystic acoustic neurinomas. The signal intensity and enhancement pattern of the cystic components as well as the location relative to the tumors were analyzed. RESULTS: A total of 30 cysts were found in 15 acoustic neurinomas;28 were intratumoral cysts and the remaining two were extratumoral cysts. The signal intensity of all 28 intratumoral cysts was higher than that of CSF on Tl-weighted images, and isointense to CSF on T2-weighted images, while the signal intensity of the two extratumoral cysts was same as CSF on both Tl-weighted and T2-weighted images. Rim enhancement was seen in 27 of 28 intratumoral cysts but in none of the two extratumoral cysts. CONCLUSION: We concluded that intratumoral cyst was due to tumoral necrosis, hemorrhage or degenerative change and extratumoral cyst due to secondary arachnoid cyst formation.
Acoustics* ; Arachnoid ; Hemorrhage ; Humans ; Necrosis ; Neuroma, Acoustic* ; Retrospective Studies

OBJECTIVE: To describe normal postoperative MR findings and MR findings of postoperative discitis in patients who underwent operation due to herniated intervertebral disc. MATERIALS AND METHODS: We retrospectively reviewed normal postoperative MR findings and MR findings of discitis in 30 patients(21-61yrs.) (13 cases dignosed as discitis and 17 cases as normal) who previonsly underwent laminectomy and discectomy, or bony fusion. We analyzed signal intensity of end plate and disc, end plate destruction, and enhancement of end plate and disc on T1- and T2-weighted images(WI) of 1.5T MRI. RESULTS: Among 14 out of 17 patients with no evidence of discitis, 7 patients showed high signal of the posterior portion of disc on T1- and T2-WI and 11 patients revealed enhancement at the same sites. In all 13 patients suspected of having discitis, end plate and disc showed low signal on T1-WI, high signal on T2-WI, heterogeneous enhancement, and irregular destruction of end plate. Meanwhile, 3 cases with no evidence of postoperative discitis clinically who underwent bony fusion showed similiar findings to those of the above 13 patients, except for homogeneous enhancement of end plate and vertebral body. CONCLUSION: The MR findings of postoperative discitis were low signal on T1-WI, high signal on T2-WI, and heterogeneous enhancement of and plate and disc, and destruction of end plate.
Discitis* ; Diskectomy ; Humans ; Intervertebral Disc* ; Laminectomy ; Magnetic Resonance Imaging ; Retrospective Studies

BACKGROUND: The proper management of the patients with hypotention remains a difficult clinical problem. This study was designed to evaluate the efficacy and safety of gepefrin in the treament of symptomatic hypotensive patients in outpatient clinic of university hospital. METHODS: Thirty milligrams of Gepefrin was given twice daily for 4 weeks in 30 patients with hypotension(6 males, 24 females ; 23-60 years of age). Blood pressure, heart rate, subjective symptoms and side effects were checked before medication and at the end of 1st, 2nd, 3rd, 4th week of medication. RESULTS: 1) Grpefrin increased sitting systolic blood pressure significantly(p<0.05) by the end of 1st week and thereafter. 2) Hypotensive symptoms were improved in 76% of hypotensive patients and overall rate of usefulness was 70%. 3) Heart rate did not change significantly. 4) One patient complained of loose bowel movement and another one, of anorexia among 30 study patients and all laboratory parameters were within normal limits before and after drug treatment, thus the rate of safety was 93%. CONCLUSION: Results from this study suggests that gepefrin 60mg daily increases the blood pressure mildly and improves the symptoms moderately in symptomatic hypotensive patients.
Ambulatory Care Facilities ; Anorexia ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hypotension* ; Male ; Quality of Life

No abstract available.
Angiography* ; Head* ; Necrosis*