Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

Many synthetic coating materials had been reported in the literature. One of them, ethyl, 2-cyanocrylate is known to the most avaliable material in coating aneurysms. We have recently used it in the treatment of 5 cases of intracranial aneurysms at various sites with successful results, and in following situations much advantages and need seem to be there. First, reinforcement of incomplete simple aneurysmal clipping because of each shape, configuration, site, broad neck and surrounding vital vessels which enter and leave the aneurysmal sac. Second, under surgical microscopic field, to reinforce the incidental microaneurysm, the local thining and dilation of regional arterial well. And last, for preventing of the possible slipping of clip in itself.
Aneurysm ; Intracranial Aneurysm* ; Neck

BACKGROUND: As lack of myocardial perfusion was demonstrated on myocardial contrast echocardiography(MCE) despite angiographic documentation of reflow, patency of infarct related artery (IRA) after acute myocardial infarction(AMI) does not guarantee myocardial tissue perfusion. Myocardial enhancement on MCE is associated with myocardial perfusion and microvascular integrity. We are to assess myocardial perfusion immediately after thrombolysis and to correlate myocardial enhancement with functional recovery of postischemic dysfunctional myocardium. METHODS: MCE was performed by intracoronary injection of hand-agitated Ioxaglate in 17 consecutive AMI patients immediately after thrombolysis. Myocardial enhancement of 37 infarct segment was quantified as corrected peak videointensity(PI) by videodensitometry and the PI ratio of infarct to normal segments was used to assess myocardial reperfusion. Viable myocardium was defined as the presence of functional recovery on follow-up echocardiography. RESULTS: 1) MCE was performed in 37 segments of 17 AMI patient and functional recovery was noted in 28 segments of 12 patients on follow-up echocardiography. 2) Six infarct segments with no reflow on MCE showed severe fixed perfusion defect in thallium scan and no functional recovery in follow-up echocardiography. 3) The peak cardiac enzyme level was significantly higher in patients without functional recovery(p<0.005), but mean PI ratio(p<0.005) and patency of IRA(p<0.05) were significantly higher in patient with functional recovery. Age, sex, time to thrombolysis and stenosis of IRA were not associated with functional recovery. 4) Apical segment(p<0.01), TIMI grade 2 patency(p<0.01) and LAD territory(p<0.05) were significantly associated with nonviable myocardium, and PI ratio(p<0.001) was significantly correlated to viable myocardium. The PI ratio was the most significant predictor of myocardial functional recovery on multiple logistic regression analysis. CONCLUSION: Myocardial contrast echocardiography immediately after thrombolysis can be used for assessment of myocardial reperfusion, decision of revascularization and prediction of functional recovery.
Arteries ; Constriction, Pathologic ; Echocardiography* ; Follow-Up Studies ; Humans ; Ioxaglic Acid ; Logistic Models ; Myocardial Reperfusion* ; Myocardium* ; Perfusion ; Thallium

BACKGROUND: As lack of myocardial perfusion was demonstrated on myocardial contrast echocardiography(MCE) despite angiographic documentation of reflow, patency of infarct related artery (IRA) after acute myocardial infarction(AMI) does not guarantee myocardial tissue perfusion. Myocardial enhancement on MCE is associated with myocardial perfusion and microvascular integrity. We are to assess myocardial perfusion immediately after thrombolysis and to correlate myocardial enhancement with functional recovery of postischemic dysfunctional myocardium. METHODS: MCE was performed by intracoronary injection of hand-agitated Ioxaglate in 17 consecutive AMI patients immediately after thrombolysis. Myocardial enhancement of 37 infarct segment was quantified as corrected peak videointensity(PI) by videodensitometry and the PI ratio of infarct to normal segments was used to assess myocardial reperfusion. Viable myocardium was defined as the presence of functional recovery on follow-up echocardiography. RESULTS: 1) MCE was performed in 37 segments of 17 AMI patient and functional recovery was noted in 28 segments of 12 patients on follow-up echocardiography. 2) Six infarct segments with no reflow on MCE showed severe fixed perfusion defect in thallium scan and no functional recovery in follow-up echocardiography. 3) The peak cardiac enzyme level was significantly higher in patients without functional recovery(p<0.005), but mean PI ratio(p<0.005) and patency of IRA(p<0.05) were significantly higher in patient with functional recovery. Age, sex, time to thrombolysis and stenosis of IRA were not associated with functional recovery. 4) Apical segment(p<0.01), TIMI grade 2 patency(p<0.01) and LAD territory(p<0.05) were significantly associated with nonviable myocardium, and PI ratio(p<0.001) was significantly correlated to viable myocardium. The PI ratio was the most significant predictor of myocardial functional recovery on multiple logistic regression analysis. CONCLUSION: Myocardial contrast echocardiography immediately after thrombolysis can be used for assessment of myocardial reperfusion, decision of revascularization and prediction of functional recovery.
Arteries ; Constriction, Pathologic ; Echocardiography* ; Follow-Up Studies ; Humans ; Ioxaglic Acid ; Logistic Models ; Myocardial Reperfusion* ; Myocardium* ; Perfusion ; Thallium

BACKGROUND: Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.
Academic Medical Centers ; Asian Continental Ancestry Group ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypokalemia ; Hypophosphatemia ; Male ; Medical Records ; Muscle, Skeletal ; Paralysis* ; Physical Examination ; Potassium ; Precipitating Factors ; Prevalence ; Prognosis ; Recurrence ; Thyroid Function Tests ; Thyroid Gland

Respiratory bronchiolitis associated interstitial lung disease is a rare condition among current or ex-smokers, which has features consistent with interstitial lung disease. The presentations are non-specific, but symptoms generally include a cough and dyspnea on exertion, and its pathology is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles and adjacent air spaces, and is associated with mild thickening of the peribronchiolar interstitium. Recently, the case of a 54-year-old woman passive smoker, diagnosed as having respiratory bronchiolitis associated interstitial lung disease, was experienced at our institution.
Bronchioles ; Bronchiolitis* ; Cough ; Dyspnea ; Female ; Humans ; Lung Diseases, Interstitial* ; Macrophages ; Middle Aged ; Pathology ; Tobacco Smoke Pollution*