Teratoma of the heart is very rare and occurs mainly in children. A 44-year-old male patient was admitted due to foreign body sensation on throat and chest discomfort for a month. Chest CT, MRI and trans- thoracic and transesophageal echocardiographies showed 12x10 cm sized cystic mass with septataion and solid nodules, combined with pericardial and pleural effusion. Excision of the tumor was done and the pathologic diagnosis was mature cystic teratoma arising from pericardium.
Adult ; Child ; Diagnosis ; Foreign Bodies ; Heart ; Humans ; Magnetic Resonance Imaging ; Male ; Pericardium ; Pharynx ; Pleural Effusion ; Sensation ; Teratoma* ; Thorax ; Tomography, X-Ray Computed

Succinylcholine (Sch) has long been used to facilitate laryngoscopy and endotracheal intubation for general anesthesia, because of a rapid onset of intense but brief paralysis. However, exaggerated potassium (K+) release following Sch, sufficient to cause ventricular dysrhythmias and cardiac arrest, has sporadically been reported in susceptible conditions, including spinal cord injury, severe burn, massive trauma and neuromuscular disorder. And diazepam has been shown to attenuate the increase in serum K+ following Sch administration. The purpose of this study was to assess the effect of Sch on serum K+ in patients with spinal cord lesions, and to assess the effect of pretreatment with diazepam (0.05 mg/kg IV) on potassium flux. The results were as follows: 1) Baseline K+ values were not significantly different among the groups. 2) The time to peak increases in K+ was 3 minutes following Sch in all groups. 3) The magnitude of maximum increases in K' following Sch were 0.32 Eq/l, 0.63 mEq/l, 0.06 mEq/I and 1,10 mEq/I in group 1, group 2A, group 2B, and group 3, respectively. 4) Diazepam pretreatment attenuated the increases in K+ following Sch. From the above results, it can be concluded that Sch may safely be used to facilitate intubation in paraplegic patients, provided that they are normokalemic and pretreated with diazepam.
Anesthesia, General ; Burns ; Diazepam ; Heart Arrest ; Humans ; Hypnotics and Sedatives ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Paralysis ; Potassium* ; Spinal Cord Injuries ; Spinal Cord* ; Succinylcholine*

Non-Hodgkin's lymphoma (NHL) is a group of neoplasm affecting the lymphoid system. Follicular lymphoma is typically a slow-growing, indolent form of NHL that accounts for 1/3 of all NHL. It is one of the B-cell lymphomas, generally characterized by multiple relapses after responses to a variety of therapies. When lymphoma relapses, it may occur in the same or a different part of the body from where it occurred originally. Recurrence in the primary site is most common but recurrence in other parts is rarely observed. We experienced a rare case of 70-year-old woman who complained of swelling in the left mouth floor and was diagonosed with a recurrent NHL. It recurred in the sublingual gland after a complete remission of the follicular lymphoma.
Aged ; Female ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Follicular* ; Lymphoma, Non-Hodgkin ; Mouth Floor ; Recurrence ; Sublingual Gland*

Making impression is the first step of making hearing aid. Because it needs silicon injection on external auditory canal and lateral side of tympanic membrane, careful evaluation is required regarding the presence of any tympanic perforation or problems of external auditory canal prior to making ear impression. Recently, we experienced encountering one case of foreign body in ear while making impression of hearing aid by a local hearing aid seller. Silicone mold material, impacted into the middle ear, had perforated the tympanic membrane; a metallic foreign body was also found in the eustachian tube. Reporting this case, we suggest that special attention be paid to tympanic membrane and external auditory canal conditions when making an ear impression for hearing aids. Therefore, physical examination by otolaryngologist should precede any application of hearing aid.
Ear ; Ear Canal ; Ear, Middle* ; Eustachian Tube* ; Foreign Bodies* ; Fungi ; Hearing Aids* ; Hearing* ; Physical Examination ; Silicon ; Silicones ; Tympanic Membrane

Multiple sclerosis (MS) is a chronic disease characterized by multiple areas of demyelination, inflammation, and glial scarring in the central nervous system. MS is the most common chronic and usually progressive neurologic disease whose clinical course varies from a benign and symptom-free disease to a rapidly progressive and disabling disorder. MS can be presented with various symptoms, but isolated vertigo, represented in only 5%, is very rare. Nevertheless, in such a case, differential diagnosis of peripheral vestibular disease is very important for neuro-otologist. We recently experienced a 39 year-old female patient of multiple sclerosis with isolated vertigo mimicking vestibular neuritis. We report our case with a review of literature.
Central Nervous System ; Chronic Disease ; Cicatrix ; Demyelinating Diseases ; Diagnosis, Differential ; Female ; Humans ; Inflammation ; Multiple Sclerosis* ; Vertigo* ; Vestibular Diseases ; Vestibular Neuronitis

Since an exact ABO blood type match is essential for transfusion therapy, any ABO discrepancies should be resolved prior to the issuing of blood. The authors confirmed the ABO blood group of a 50-year-old male using genotyping. On a routine blood group test, the cell type was A+; however, anti-B was undetected in his serum. To determine the cause of this ABO discrepancy, an adsorption elution test and saliva test were performed. The presence of a weak B substance was suspected despite no evidence of the B antigen on red blood cells. Polymerase-chain-reaction restriction-fragment-length-polymorphism (PCR-RFLP) and sequencing analysis of exons 6 and 7 demonstrated that his blood type was A1Bweak (the A allele tested as the A105 subtype, while the B allele was most similar to the B302 subtype). Again, using genotyping, we subsequently confirmed the A1Bweak blood type in a leukemic patient who was in complete remission.
Adsorption ; Alleles ; Erythrocytes ; Exons ; Humans ; Leukemia ; Male ; Middle Aged ; Saliva

Chronic hepatitis B viral infection causes membranous nephropathy and membranoproliferative glomerulonephritis. Patients with positive serum HBsAg with membranous nephropathy or membranoproliferative are considered as hepatitis B virus associated glomerulonephritis(HBV-GN) in epidemic areas of hepatitis B viral infection. To elucidate the clinical difference between hepatitis B virus-associated membranous nephropathy and membranoproliferative glomerulonephritis, and idiopathic membranous nephropathy and membranoproliferative glomerulonephritis, the authors conducted a clinical study including 71 cases of patients with renal biopsy proven diagnoses. Among the patients with hepatitis B virus antigenemia, the pathologic diagnoses were 7 membranous nephropathy(HBV-MN), 13 membranoproliferative glomerulonephritis(HBV-MPGN) but patients with mixed pattern of both membranous nephropathy and membranoproliferative glomerulonephritis were excluded. For the patients with idiopathic glomerulonephritis, 35 of membranous nephropahty(MN) and 16 cases of membranoproliferative glomerulonephritis (MPGN) were enrolled in this study. The patients of HBV-GN groups had more than 80% of HBe antigenemia. The nephrotic range proteinuria presented more frequently in HBV-MN(86%) than in MN group(54%). The cases of HBV-MPGN group(4 cases, 31%) showed nephrotic range proteinuria less frequently than those with MPGN(69%, p< 0.05) and significant discrepancy existed in HBV- MN vs HBV-MPGN and HBV-MPGN vs MPGN. The cases with decreased serum C3 level below normal were over 50% of HBV-GN and MPGN group except MN group. Serum levels of SGOT and SGPT were significantly elevated in HBV-MN and HBV- MPGN groups than those of MN and MPGN groups, respectively(p<0.05). The number of cases with increased SGOT, SGPT and gamma-GTP were 4(57%), 2 (29%) and 1(16%) in HBV-MN and 15(83%), 12(67%) and 9(75%) cases in HBV-MPGN group, in respectively. The cases developed progressive renal functional impairment during follow-up period of at least one year were 3 of 5(60%) in HBV-MN, 2 of 8 (25%) in MPGN and 3 of 9(33%) in HBV-MPGN groups which were significantly more than 2 of 22 cases(9%) in MN group(respectively p<0.05, not in HBV-MPGN vs MN). The renal functional impairment rate defined by the ratio of patients with their serum creatinine elevated above 2mg/dL over 3 months in each group was more rapidly increased in HBV-MPGN and HBV-MN than the idiopathic groups by Kaplan-Meier statistic analysis. We suggest that the patients with HBV-associated glomerulonephropathy seem to have worse prognosis in terms of renal functional impairment than those with idiopathic types of glomerulonephropathy with same pathology.
Alanine Transaminase ; Aspartate Aminotransferases ; Biopsy ; Creatinine ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative* ; Glomerulonephritis, Membranous* ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Pathology ; Prognosis ; Proteinuria

BACKGROUND: ABO antibody titration is useful for the evaluation of ABO-incompatible bone marrow or solid organ transplantations, yet the results quite vary between different test methods used. We compared the results of microcolumn agglutination and tube methods. METHODS: Anti-A and anti-B isoagglutionin titers were determined in 63 healthy individuals (23 O, 20 A, and 20 B blood groups) using 4 different methods: immediate spin tube (tube), microcolumn agglutination without anti-human globulin (AHG) (CAT), tube with AHG (tube-AHG) and microcolumn agglutination with AHG (CAT-AHG). RESULTS: The median (range) titers of anti-A and anti-B in group O individuals by tube, CAT, tube-AHG, and CAT-AHG methods were 64 (8-512), 64 (8-512), 128 (8-2,048), and 128 (16-2,048); 64 (16-128), 128 (16-256), 128 (16-512), and 256 (16-512), respectively. The median (range) titers of anti-A in group B and anti-B in group A individuals by the four methods were 64 (16-128), 128 (8-128), 128 (8-256), and 256 (8-256); 64 (8-128), 64 (8-128), 32 (8-128), and 64 (8-256), respectively. The isoagglutinin titer measured by CAT-AHGmethod was the highest. The titers measured by CAT and CAT-AHG methods were 0-1 titer higher than those by tube and tube-AHG methods, respectively. Whatever method was used, the isoagglutinin titers were higher in women than in men. CONCLUSIONS: CAT-AHG was the most sensitive method among the four methods tested. Since AHG titer values are critical for the clinical management and CAT has less manual procedures than tube method, CAT-AHG method could be used for the standardization of ABO antibody titration in different institutions.
Agglutination ; Animals ; Bone Marrow ; Cats ; Female ; Humans ; Organ Transplantation ; Transplants

We report the case of a 32-year-old female who developed polymyositis associated with scrub typhus. She exhibited the eschar with high titer of anti-Rickettsia(R)-tsutsugamushi antibody, severe muscle weakness, markedly elevated serum levels of muscle enzymes, EMG changes, and infiltration of macrophages in a muscle biopsy specimen. Initiation of appropriate antibiotic therapy resulted in complete healing of scrub typhus and disappearance of symptoms and signs of polymyositis within 1 month after high dose steroid therapy. We suggest that scrub typhus also be included within the causes of idiopathic inflammatory polymyositis.
Adult ; Biopsy ; Female ; Humans ; Macrophages ; Muscle Weakness ; Polymyositis* ; Scrub Typhus*