No abstract available.
Adrenal Hyperplasia, Congenital* ; Adrenogenital Syndrome*

No abstract available.
Congenital Hypothyroidism* ; Diagnosis* ; Prognosis*

No abstract available.
Diarrhea* ; Korea*

BACKGROUND: Vasoconstricting drugs such as dopamine, phenylephrine (PE) and epinephrine constrict normoxic lung vessels preferentially, thereby disproportionately increasing normoxic lung pulmonary vascular resistance (PVR) and inhibit hypoxic pulmonary vasoconstriction (HPV). In this study, we evaluated the effect of PE on HPV and arterial oxygenation. METHODS: This study was performed on 21 patients undergoing thoracotomy. After induction of anesthesia, Swan-Ganz catheter was inserted. After one lung ventilation was started, systolic blood pressure (SBP) of the patient was reduced to 100 mmHg using inhalation anesthetic agent and then the blood pressure was raised up to 140 mmHg by PE infusion. Hemodynamic variables were measured and arterial blood gas was analyzed at the start of one lung ventilation (control), SBP of 100 mmHg and SBP of 140 mmHg. RESULTS: The mean dose of PE infused was 5.9 +/- 3.8 microgram/kg. Infusion of PE did not increase pulmonary vascular resistant index (PVRI) significantly and did not reduce arterial PO2. There was no statistically significant difference in intrapulmonary shunt fraction (Qs/Qt) between the time of low and high blood pressures. CONCLUSION: Pulmonary vasomotor changes induced by PE are minimal and so should not affect the distribution of blood flow during one lung ventilation. On the basis of this result, PE appears to a reasonable vasoconstrictor to be used in patients undergoing thoracotomy.
Anesthesia ; Blood Pressure ; Catheters ; Dopamine ; Epinephrine ; Hemodynamics ; Humans ; Hypertension ; Inhalation ; Lung ; One-Lung Ventilation* ; Oxygen* ; Phenylephrine* ; Thoracotomy ; Vascular Resistance ; Vasoconstriction*

A patient with encephalopathy associated with autoimmune thyroid disease (EAATD), which is one of the most important differential diagnoses of treatable dementia, presents with various neurological symptoms, such as repetitive epileptic seizures, altered mental status, and cognitive dysfunction. Steroid treatment is effective for EAATD. The incidence of EAATD increases considerably with age, particularly in female patients. Most patients with EAATD have normal thyroid function test results or mild hypothyroidism. Patients with EAATD with Graves' disease are very rarely reported. Here, we report a case of a 63-year-old woman who complained of declining cognitive ability and ataxia. She was diagnosed with EAATD accompanied by Graves' disease. Her neurological symptoms improved after intravenous steroid administration.
Ataxia ; Brain Diseases ; Dementia ; Diagnosis, Differential ; Epilepsy ; Female ; Graves Disease* ; Humans ; Hypothyroidism ; Incidence ; Middle Aged ; Thyroid Diseases* ; Thyroid Function Tests ; Thyroid Gland*

Myelodysplastic syndromes (MDS) are a group of refractory anemias resulting from a clonal stem cell disorder often associated with cytogenetic abnormalities. There is increasing recognition of immunological abnormalities in patients with MDS, including defective B- and T-cell function, hyper- or hypogammaglobulinemia and monoclonal gammopathy. MDS have been associated with Sjogren's syndrome, polymyalgia rheumatica, relapsing polychondritis and systemic lupus erythematosus. Although there may be various rheumatologic features, including acute arthritis in MDS, chronic inflammatory arthritis is uncommonly combined. There have been a few reports that described cases of rheumatoid arthritis (RA) concurrent with MDS, but advanced rheumatoid arthritis with typical joint deformities has rarely been reported. We report a case of rheumatoid arthritis with atlantoaxial subluxation combined with refractory anemia in a 31-year-old woman.
Adult ; Arthritis, Rheumatoid/radiography ; Arthritis, Rheumatoid/pathology ; Arthritis, Rheumatoid/complications* ; Arthritis, Rheumatoid/blood ; Case Report ; Female ; Follow-Up Studies ; Human ; Myelodysplastic Syndromes/pathology ; Myelodysplastic Syndromes/complications* ; Myelodysplastic Syndromes/blood

PURPOSE: Episodic memory is described as an 'autobiographical' memory responsible for storing a record of the events in our lives. We performed functional brain activation study using H215O PET to reveal the neural basis of the encoding and the retrieval of episodic memory in human normal volunteers. MATERIALS AND METHODS: Four repeated H215O PET scans with two reference and two activation tasks were performed on 6 normal volunteers to activate brain areas engaged in encoding and retrieval with verbal materials. Images from the same subject were spatially registered and normalized using linear and nonlinear transformation. Using the means and variances for every condition which were adjusted with analysis of covariance, t-statistic analysis were performed voxel-wise. RESULTS: Encoding of episodic memory activated the opercular and triangular parts of left inferior frontal gyrus, right prefrontal cortex, medial frontal area, cingulate gyrus, posterior middle and inferior temporal gyri, and cerebellum, and both primary visual and visual association areas. Retrieval of episodic memory activated the triangular part of left inferior frontal gyrus and inferior temporal gyrus, right prefrontal cortex and medial temporal area, and both cerebellum and primary visual and visual association areas. The activations in the opercular part of left inferior frontal gyrus and the right prefrontal cortex meant the essential role of these areas in the encoding and retrieval of episodic memory. CONCLUSION: We could localize the neural basis of the encoding and retrieval of episodic memory using H215O PET, which was partly consistent with the hypothesis of hemispheric encoding/retrieval asymmetry.
Brain ; Cerebellum ; Gyrus Cinguli ; Healthy Volunteers ; Humans* ; Memory ; Memory, Episodic* ; Positron-Emission Tomography ; Prefrontal Cortex

BACKGREOUND: The pneumonectomy may depress the right ventricular (RV) function transiently. The thermodilution ejection/volumetric catheter is known to be most useful method assessing the changes in RV performance during pulmonary resection. The purpose of this study was to examine the RV function during and immediately after pneumonectomy using thermodilution methods. METHODS: 16 patients undergoing pneumonectomy were studied. After induction of anesthesia, a multilumen thermodilution catheter mounted with a rapid response thermister was inserted. Using computer system, RV ejection fraction (RVEF), cardiac output, and RV end-diastolic volume (RVEDV) were measured when the patient was in lateral position (control), after one lung ventilation (OLV) and the main pulmonary artery ligated, and at the completion of resection. Arterial blood gases were analyzed and pulmonary vascular resistance (PVR) was calculated. RESULTS: Systolic pulmonary blood pressure (SPAP)(28.3 +/- 6.2 mmHg) increased compared to the control (24.6 +/- 5.9) without a significant change of PVR. No statistically significant difference was found in either RVEF or RVEDV at each times. CONCLUSIONS: Our study demonstrate the pneumonectomy do not depress the RV function immediately and RVEF do not show any correlation with PVR or RVEDV.
Anesthesia ; Blood Pressure ; Cardiac Output ; Catheters ; Computer Systems ; Gases ; Humans ; One-Lung Ventilation ; Pneumonectomy* ; Pulmonary Artery ; Thermodilution ; Vascular Resistance ; Ventricular Function, Right*

A 46-year-old woman was admitted with an ulcerative lesion on the posterior neck. Four months before admission, the patient took part in a faith healing ritual, which the pastor performed with his fingernails causing wounds. This abnormal method of healing caused repeated injury to the patient in the posterior neck area. Treatment with cefazolin was begun, but the lesion did not improve. Biopsy of the skin lesion and cervical lymph nodes was performed. Microscopical examination revealed findings highly suggestive of syphilis. Serological tests for syphilis were positive and a computed tomographic (CT) scan of the neck showed enlargement of regional lymph nodes and tonsils. A single dose of penicillin G 2.4 million units was given intramuscularly. Two weeks later, the wound had healed. Eight weeks after treatment, the Venereal Disease Research Laboratory titer had decreased and a CT scan of the neck showed a decrease in the size of the lymph nodes. We reasoned that syphilis was non-sexually transmitted, and that the healing ritual was the cause. Our case suggests that skin trauma by scratching with the fingernails may cause an accidental direct inoculation of Treponema pallidum, resulting in extragenital primary syphilis.
Biopsy ; Cefazolin ; Faith Healing ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Nails* ; Neck ; Palatine Tonsil ; Penicillin G ; Serologic Tests ; Sexually Transmitted Diseases ; Skin ; Syphilis* ; Tomography, X-Ray Computed ; Treponema pallidum ; Ulcer ; Wounds and Injuries

Idiopathic restrictive cardiomyopathy is characterized by clinical and hemodynamic findings of restrictive cardiomyopathy in the absence of morphologic cause. The differential diagnosis between idiopathic restrictive cardiomyopathy and noncalcified constrictive pericarditis is difficult but the distinction is crucial because of the therapeutic implication. The diagnosis of idiopathic restrictive cardiomyopathy is aided by echocardiography and cardiac catheterization, cardiac magnetic resonance imaging. The patients should be approached systemically to differentiate from noncalcified constritive pericarditis.
Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Hemodynamics ; Humans ; Magnetic Resonance Imaging ; Pericarditis ; Pericarditis, Constrictive