Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

No abstract available.
Orthognathic Surgery

Since Thomas et al reported the first instance of successful removal of a broken intravascular guidewire without surgical intervention by using a bronchoscopic forceps in 1964, there have been a number of nonsurgical removal of intravascular or intracardiac foreign bodies using the bronchoscopic forceps, loop snare or basket stone catchers. We experienced a successful retrieval of accidentally broken subclavian puncture catheter from right atrium in 76 year old male patient with cerebral infarction admitted to this hospital on May, 1989. By percutaneous catheterization via right basilic vein, using a loop snare which is modified manually by guidewire for PTCA(USIC(R) Teflon coated PTCA Guide wire : ".014"), we removed successfully foreign body from right atrium. Therefore, we report a case of nonsurgical retrieval of foreign body from right atrium with the review of the literature.
Aged ; Catheterization ; Catheters ; Cerebral Infarction ; Foreign Bodies* ; Heart Atria ; Humans ; Male ; Ocimum basilicum ; Polytetrafluoroethylene ; Punctures ; SNARE Proteins ; Surgical Instruments ; Veins

Trichorrhexis nodosa(TN) denotes small node-like swelling with a loss of cuticle of the hair shaft through which the hair readily fractures. The basic cause of TN is mechanical or chemical trauma, and a contributing factor is an inherent weakness of the hair shaft. We report a case of localized TN in a 37-year-old male. He had an ovoid hair patch with multiple small white-gray dotted and stubby hairs localized to the right occipital scalp. TN is known to be the commonest of all hair shaft anomalies (Price, 1975). However TN is rarely reported, and there have been only four reports in Korean dermatological literature, to our knowledge, which might be due to underdiagnosis of this disorder. We postulated that diagnostic difficulty lies in the discrepancy between terminology and gross morphological findings.
Adult ; Fibrinogen ; Hair ; Humans ; Male ; Scalp

A 49-year-old woman with anemia who developed headache and seizure after blood transfusion was diagnosed with posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging showed typical PRES findings including lesions in bilateral parieto-occipital subcortical white matter and overlying cortex. Only a few cases of PRES after transfusion have been reported and this case is unique in that there was a latent period between infusion and development of PRES. We postulate that rapid change of hemoglobin level may disrupt cerebral autoregulation and result in delayed PRES. We suggest that neurological symptoms after blood transfusion should be appropriately investigated.

Takotsubo cardiomyopathy is considered a neurogenic heart disease resulting from impaired autonomic function and is known to be associated with various neurological and medical conditions. To our knowledge, although tetanus is frequently accompanied by autonomic instability, there has been no report of Takotsubo cardiomyopathy in patients with tetanus. Here we describe a patient with Takotsubo cardiomyopathy as a manifestation of autonomic instability in severe tetanus.

No abstract available.
Dislocations*

Total 32 cases of pulmonary atresia were diagnosed radiographically at Seoul National Uniersity Hospital fromMarch 1979 to August 1982. Some characteristic radiological findings were analyzed in chest PA andcineangiograhies. The resusls were as follows; 1. In the evaluation of chest PA, cardiomegaly was noticed in 16cases, dextrocardia in 8 cases, elevated cardiac apex in 7 cases and right-side aortic arch in 6 cases. Thepulmonary vascularties were mildly decreased in 20 cases, markedly decrased in 9 cases and decreased withreticular pattern in 3 cases. 2. As final diagnoses after cineangiography, pulmonary atresia was associated withTetralogy of Fallot variant in 17 cases, transposition of great vessels in 7 cases, single ventricle in 5 cases,tricuspid atresia in 2 cases and intact ventricular septum in 1 case. 3. The classification according to thepattern of pulmonary artery is main pulmonary trunk with PDA(Type Ia) in 10 cases, pulmonary arterial confluencewith PDA(Type Ib) in 10 cases, no pulmonary arterial confluence with PDA (Type Ic) in 5 cases, main pulmonarytrunk without PDA(Ttpe IIa) in 0 case, pulmonary arterial confluence without PDA (Type IIb) in 5 cases, and nopulmonary arterial confluence without PDA (Ttpe IIc) in 2 cases. 4. Pulmonary wedge venography was done andsuccessful in 8 cases. Among them, confluence between right and left pulmonary arteries was noticed in 5 cases. 5.Biventricular cineangiography and/or pulmonary wedge venography, if necessary, is essential for the accuratediagnosis of pulmonary atresia to demonstrate detailed anatomy of pulmonary artery.
Aorta, Thoracic ; Cardiomegaly ; Cineangiography ; Classification ; Dextrocardia ; Diagnosis ; Phlebography ; Pulmonary Artery ; Pulmonary Atresia ; Seoul ; Thorax ; Transposition of Great Vessels ; Ventricular Septum

Although vascular injuries associated with femoral intertrochanteric fractures have been reported infrequently, bleeding due to vascular injury can lead to severe complications that can be potentially life and limb-threatening. The authors report a case of an injury of the ascending branch of the lateral femoral convolutional artery in a patient who underwent surgical treatment for a femoral intertrochanteric fracture. Vascular injury occurred due to the sharp margin of displaced lesser trochanter five weeks after surgery. Percutaneous transcatheter embolization was done and improved without additional complications. Therefore, the surgeons need to be aware of possible associated vascular injuries caused by displaced lesser trochanter fragments in femoral intertrochanteric fractures.

Although vascular injuries associated with femoral intertrochanteric fractures have been reported infrequently, bleeding due to vascular injury can lead to severe complications that can be potentially life and limb-threatening. The authors report a case of an injury of the ascending branch of the lateral femoral convolutional artery in a patient who underwent surgical treatment for a femoral intertrochanteric fracture. Vascular injury occurred due to the sharp margin of displaced lesser trochanter five weeks after surgery. Percutaneous transcatheter embolization was done and improved without additional complications. Therefore, the surgeons need to be aware of possible associated vascular injuries caused by displaced lesser trochanter fragments in femoral intertrochanteric fractures.