Cavernous lymphangioma in mediastinum is a rare congenital malformation of lymphatic system and is caused by lack of adequate drainage from the sequestrated lymphatic vessels to the venous system due to insufficiency or atresia of the efferent lymphatic channels The authors experienced 10 month-old male patient with cavernous lymphangioma in mediastinum documented by chest CT and open biopsy The review of the literature was made briefly.
Biopsy ; Drainage ; Humans ; Infant ; Lymphangioma* ; Lymphatic System ; Lymphatic Vessels ; Male ; Mediastinum* ; Tomography, X-Ray Computed

Purpose: The purpose of this study was to measure and compare the strain value exerted on the cervical area using different screw tightening protocols in implant-supported, screw-retained 3-unit prostheses. Materials and methods: Strain gauges were attached to four implants: two external and two internal. Thereafter, two study model were designed each type using acrylic resin. CAD-CAM was used to design hex and nonhex abutments for each group (EH, ENH, IH, and INH group) and Screw-cement-retained prostheses were also designed using a nonprecious base metal. Abutment was fixed with 10 Ncm torque, and the prosthesis was cemented. Screws were fixed with 30 Ncm torque using different three protocols. After 5 min, the strain gauge level was measured, and group analysis was performed (α=.05). Results: External group showed significantly lower strain values than internal group and the EH group showed significantly lower strain values than the ENH group (P<.05). There was no difference in strain value based on the types of screw tightening protocols in same group (P>.05). The IH group exhibited significantly higher strain values than the INH group and the IH group showed a significant difference in strain values based on the types of screw tightening protocols used (P<.05). Conclusion There was no significant effect on the external type in the implant-supported, screw-retained prostheses. However, strain values were high in the internal type, and the types of screw tightening protocol significantly affected these implants.

No abstract available.
Disseminated Intravascular Coagulation* ; Plasma* ; Scrub Typhus*

BACKGROUND: The autonomic nervous control of the cardiovascular system has been thought to have a diurnal variation in its activity. This variation could be an important underlying mechanism for the circardian distribution of cardiac events such as angina pectoris attack, transient myocardial ischemia, and some arrhythmia. The vagal cardiac function is commonly impaired in patients with coronary artery disease. Recently, an assessment of parasympathetic and sympathetic activities is now possible using neart rate spectral analysis. The spectral density of R-R interval variability contains two major components, high frequency (HF) power spectral density (<0.25Hz) and low frequency (LF) power spectral density (<0.15Hz), which have magnitudes that are quantitative markers of cardiac vagal activity and sympathetic activity with vagal modulation, respectively. METHODS: We analyzed the spectral components of R-R interval variability from 24 hour ambulatory holter monitoring in 20 controls and 20 patients with angina pectoris. The patients had no clinical evidence of hypertension, acute myocardial infarction, heart failure, arrhythmia or diabetes mellitus. Recording continued for 24 hours while the subject undertook his normal work and leisure activities. For power spectral analysis, 1024 hours beats was sampled at early morning, afternoon, evening and during sleeping. RESULTS: The spectral component of R-R interval variability was unaffected by the time of day during the waking period, althought a significant decrease in LFCCV and HFCCV was observed during sleeping in controls(p<0.001). In comparison of two groups, patients with angina pectoris showed markedly diminished HFCCV values during waking period except during sleeping period. The R-R interval and LF/HFCCV and LF/HFCCV ratio at transient ischemic attack in patients with angina pectoris. CONCLUSION: Autonomic cardiac control during the waking period shows little variation with the time of day in both groups. We observed that vagal cardiac function was reduced in patients with coronary artery disease by heart rate spectral analysis. It is suggested that ischemic changes in patients with coronary artery disease underlying reduced vagal cardiac function is associated with increased sympathetic activity.
Angina Pectoris* ; Arrhythmias, Cardiac ; Cardiovascular System ; Coronary Artery Disease ; Diabetes Mellitus ; Electrocardiography, Ambulatory ; Heart Failure ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Ischemic Attack, Transient ; Leisure Activities ; Myocardial Infarction ; Myocardial Ischemia

Loeffler's endocarditis is a recognized complication of diseases associated with eosinophilia. This disease is considered to be a part of the idiopathic hypereosinophilic syndrome, which is characterized by persistently elevated blood eosinohil counts with symptoms and signs of organ involvement especially in the heart, nervous system, and bone marrow. We have experienced a case of Loeffler's endocarditis in a 51 years old man who complained of leg pain due to acute closure of left iliac artery by emboli. We found left ventricular mural thrombus by echocardiography and confirmed Loeffler's endocarditis by endomyocardial biopsy. We present a case with the review of literatures.
Biopsy ; Bone Marrow ; Echocardiography ; Eosinophilia ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Iliac Artery* ; Leg ; Middle Aged ; Nervous System ; Thromboembolism ; Thrombosis

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

BACKGROUND: The emergence of multidrug-resistant strains of Mycobacterium tuberculosis presents a significant challange to the treatment and control of tuberculosis, and there is an urgent need to understand the mechanisms by which strains acquire multidrug resistance. Recent advances in molecular methods for the detection of M. tuberculosis genetic targets have approached the sensitivity of culture Furthermore the prospect of determining resistance in mycobacteria at the nucleic acid level particulary to first-line drugs like rifampin, isoniazid has provided a glimps of the next generation of sensitivity test for M. tuberculosis. Previous studies in RMP resistant M. tuberculosis have shown that mutation in beta subunit of RNA polymerase is main mechanism of resistance. METHOD: In this study, rpoB gene for the ~3 subunit of RNA polymerase from M. tuberculosis of 42 cultured samples (32 were RMP resistant and 10 were sensitive cases) were isolated and characterised the mutations. Direct sequencing data were compared with the results of INNO-LiPA Line Probe Assay (LiPA, Innogenetics, Belgium), commercial RMP resistance detecting kit using reverse hybridization method. RESULTS: All of the RMP resistant samples were revealed the presence of mutation by LiPA. In 22 samples (68.8%) out of 32 RMP resistant cases, the mutation types were confirmed by the positive signal at one of 4 mutation bands in the strip. The most frequent type was R5 (S53 IL) which were 17 cases (77.3%). Results of direct sequencing were identified the exact characteristics of 8 mutations which were not comfirmed by LiPA. S522W type point mutation and 9 base pair deletion at codon 513-515 were new identified mutations for the first time. CONCLUSION: Mutations in rpoB gene is the main mechanism of RMP resistance in M. tuberculosis and LiPA is a very useful diagnostic tool for the early diagnosis of RMP resistance in M. tuberculosis.
Base Pairing ; Codon ; DNA-Directed RNA Polymerases ; Drug Resistance, Multiple ; Early Diagnosis ; Isoniazid ; Mycobacterium tuberculosis ; Point Mutation ; Rifampin ; RNA Polymerase I ; Tuberculosis*

Inhibitory motor seizure or ictal hemiparesis is very infrequent seizure type and sometimes difficult to differentiate from acute cerebrovascular disease. We report two patients with hemiparesis as manifestation of status epilepticus. One patient showed epileptic discharge on midline frontocentral region by EEG-Video monitoring, another patient showed continuous slowing wave associated with hyperperfusion findings of brain SPECT on left fronto-temporo-parietal region. Both patients showed normal brain imaging.
Brain ; Humans ; Neuroimaging ; Paresis* ; Seizures ; Status Epilepticus* ; Tomography, Emission-Computed, Single-Photon

Proximal tibial osteotomy is an effective, well-established treatment for unicompartmental arthritic knee with varus or valgus deformity. Four basic types are commonly described: lateral closing wedge osteotomy, medial open wedge osteotomy, dome osteotomy, and medial opening hemicallotasis. The objective of this procedure is to realign the weight-bearing axis through the knee by redistributing the forces of weight to the less involved compartment of the knee. With thorough preoperative planning and careful selection of patients, optimal outcome can be expected with preservation of the patient's joint. In this article, we reviewed selection of patients, surgical planning, surgical technique, complications, pre- and post-operative change in mechanics, and long term surgical outcome of closing wedge osteotomy. Optimal outcome is expected in patients with young age (younger than 60), stable knee, medially confined osteoarthritis, and good range of motion. According to the literature, average 10-year survival rate is expected to be 60% to 90%. Closing wedge osteotomy allows for rapid bone healing, early weight bearing, rehabilitation, and low rates of correction loss. Surgeons should keep in mind that optimal indication, preoperative planning, and use of safe operative technique are essential to achievement of best results.
Axis, Cervical Vertebra ; Congenital Abnormalities ; Humans ; Joints ; Knee ; Mechanics ; Osteoarthritis* ; Osteotomy* ; Range of Motion, Articular ; Rehabilitation ; Survival Rate ; Tibia* ; Weight-Bearing

Background: The Forgotten Joint Score (FJS) is a newly developed patient-reported outcome measure designed to evaluate clinical outcome after total knee arthroplasty (TKA). The FJS is known as a sensitive test with a low ceiling effect. It has been recently translated into many languages. However, no study has reported the validity or reliability of a Korean version of the FJS (K-FJS). Thus, the purpose of this study was to address this issue. Methods: According to guidelines for cross-cultural adaptation, translation of the English version of the FJS was performed. After obtaining a license from the original developer, 150 patients who had undergone TKA at more than 1 year to less than 5 years ago completed the K-FJS, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), and the 36-Item Short Form (SF-36) health survey. To measure test-retest reliability, the K-FJS was completed twice by telephone survey for 100 patients. Responsiveness was retrospectively calculated based on a survey of 50 patients at 3 months and 1 year after surgery. Results: The K-FJS exhibited an excellent reliability (Cronbach's α, 0.967; intraclass correlation coefficient, 0.958; 95% confidence interval, 0.930–0.974). The ceiling effect of the K-FJS was 8.7% (n = 13), which was lower than the WOMAC's ceiling effect (10%).There was no floor effect. The correlation coefficients with WOMAC and SF-36 (physical function) were 0.708 and 0.682, respectively, indicating good construct validity. However, its correlation with mental health subscale of SF-36 was low (r = 0.143). At 3 to 12 months after TKA, the standardized response mean (SRM) was 0.67, which was lower than the SRM of WOMAC (1.03) obtained in the same period. The K-FJS demonstrated strong measurement properties in terms of good construct validity and reliability. Conclusions This study suggests that the K-FJS is an excellent instrument that can be used to monitor clinical outcomes after TKA. Using this standardized K-FJS, it would be possible for medical institutions to share more accurate clinical results.