No abstract available.
Mesenteric Artery, Superior*

Mycobacterium marinum (M. marinum) is a nontuberculosis mycobacterium that is normally associated with cutaneous lesions. Most cases occur after an individual has suffered minor trauma in association with contaminated fresh or salt water. In immunocompromised patients, M. marinum can cause osteomyelitis, synovitis and/or disseminated infection, which can be mistaken for rheumatoid arthritis (RA) or remitting seronegative symmetrical synovitis with pitting edema (RS3PE). Therefore, precise history taking and specimen culture are very important for early diagnosis and appropriate treatment. We report an unusual case of septic polyarthritis due to M. marinum that was diagnosed by culture and improved with antibiotic therapy.
Arthritis ; Arthritis, Rheumatoid ; Early Diagnosis ; Edema ; Immunocompromised Host ; Mycobacterium ; Mycobacterium Infections, Nontuberculous ; Mycobacterium marinum ; Osteomyelitis ; Synovitis

No abstract available.

We report a non-obese patient suffering from spastic gait and right leg paresis caused by thoracic spinal cord compression secondary to spinal epidural lipomatosis. Although spinal epidural lipomatosis is most often associated with the administration of exogenous steroid or endogenous Cushing syndrome, obesity also has been reported as a possible cause. However, idiopathic(non-glucocorticoid induced) spinal epidural lipomatosis in non-obese healthy man is an extremely rare disease and dose not have any good explanation for the abnormal fat deposition in spinal epidural space. We recently experienced a patient with idiopathic thoracic epidural lipomatosis in whom MRI and histopathology established the specific diagnosis. With a case report, brief review of the disease including clinical feature, diagnostic procedure and therapeutic considerations is described.
Cushing Syndrome ; Diagnosis ; Epidural Space ; Gait Disorders, Neurologic ; Humans ; Leg ; Lipomatosis* ; Magnetic Resonance Imaging ; Obesity ; Paresis ; Rare Diseases ; Spinal Cord Compression

PURPOSE: To evaluate the usefulness of cerebral blood flow measurement applied to perfusion weighted image with short-scan time single shot gradient echo-planar technique in measuring cerebral blood volume(rCBV) of normal rabbits. MATERIALS AND METHODS: With 2.1-3.6 kg weighted rabbits, image is acquired when they are in supine position in children positioner. Perfusion weighted image is acquired to 44 seconds per 1 second successively. After 4 seconds later, Gd-DTPA 2ml are injected into int. jugular vein with 2 ml per second and normal saline is also injected after that. Same technique is applied 2 times per 30 minites in same rabbit. After Image is obtained in two part of cerebral cortex at vertex, convexity, in one of basal ganglia with choosing about 3-5mm2 areas. Curve of signal intensity changes in time sequence is drawn. After this images are transmitted by PC and software IDL, regional cerebral blood volume is measured with imaging processing program made by us. RESULTS: With 22 of 24 rabbits, satisfactory 1-2 signal intensity versus time curve is made. Cerebral blood capacity and contrast media stay time (ST) is measured in two cerebral cortex and basal ganglia refering in parietal cerebral cortex. Mean focal cerebral blood flow capacity ratio in cortex was 0.97+/-0.35 and in basal ganglia, 0.99+/-0.37, mean contrast media stay time in cortex was 9.83+/-1.63 sec and in basal ganglia, 9.42+/-1.14 sec, but there was no statistically significant difference between two areas (p=0.05). CONCLUSION: In cerebral cortex and basal ganglia, there is no difference in mean focal blood volume and mean contrast stay time. Therefore, PWI is useful in cerebral blood flow and early diagnosis, prognosis of cerebral ischemic disease. Hereafter, it is helpful in analysing cerebral blood flow changes with comparison difference in rCBV between normal tissue and ischemic tissue, and that with DWI finding in infarcted patient.
Basal Ganglia ; Blood Volume* ; Cerebral Cortex ; Child ; Contrast Media ; Early Diagnosis ; Gadolinium DTPA ; Humans ; Jugular Veins ; Perfusion ; Prognosis ; Rabbits* ; Rabeprazole ; Supine Position

BACKGROUND: An oral glucose tolerance test (OGTT) is the current method used for screening and diagnosis of gestational diabetes mellitus (GDM). OGTT is a relatively complicated procedure and is expensive. Thus, new strategies that do not require fasting or more than a single blood draw may improve the diagnosis of GDM and increase the rate of GDM testing. We investigated the utility of monitoring glycosylated hemoglobin (HbA1c) levels for the diagnosis of GDM. METHODS: The data from 992 pregnant women with estimated gestational ages ranging from 24 to 28 weeks were retrospectively reviewed. There were 367 women with plasma glucose levels > or =140 mg/dL 1 hour after a 50-g OGTT. GDM was diagnosed according to the Carpenter-Coustan criteria for a 3-hour 100 g OGTT. A HbA1c assessment was performed at the same time. RESULTS: We enrolled 343 women in this study, and there were 109 women with GDM. The area under the curve the receiver operating characteristic curve for HbA1c detection of GDM was 0.852 (95% confidence interval, 0.808 to 0.897). A HbA1c cutoff value > or =5.35% had maximal points on the Youden index (0.581). The sensitivity was 87.2% and the specificity was 70.9% for diagnosing GDM. A threshold value > or =5.35% indicated that 163 patients had GDM and that 68 (41.7%) were false positive. The positive predictive value was 58.3% at this threshold value. CONCLUSION: Despite substantial progress in methodology, HbA1c values cannot replace OGTT for the diagnosis of GDM.
Blood Glucose ; Diabetes, Gestational* ; Diagnosis* ; Fasting ; Female ; Gestational Age ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Humans ; Mass Screening ; Pregnancy ; Pregnant Women ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

PURPOSE: The aim of this study was to evaluate the association between coronary angiography (CAG) with or without percutaneous coronary intervention (PCI) and the survival outcome of patients successfully resuscitated from out-of-hospital cardiac arrest. METHODS: We used the Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiological Surveillance database, which is out of hospital cardiac arrest (OHCA) cohort of 27 emergency departments in Korea, between February 2014 and January 2015. The inclusion criteria were all OHCA patients who receive cardiopulmonary resuscitation in an emergency department and return of spontaneous circulation. Univariable analysis and multivariable logistic regression analysis were conducted to assess the associations between CAG and outcomes (favorable neurological outcome and survival-to-discharge). Moreover, similar analysis was conducted between PCI and no-PCI subgroups within the CAG group. RESULTS: Of the 1,616 patients, 707 patients were return of spontaneous circulation. The number of patients who conducted CAG was 204 (28.9%) and the number of patients who conducted PCI was 75 (10.6%). In OHCA patients, the CAG group had a more significant good survival discharge outcome with an odds ratio (OR) of 4.61 (95% confidence interval [CI], 2.64-8.05) and good neurologic outcomes with an OR of 7.82 (95% CI, 4.37-14.00). In CAG patients, the PCI group had no significant relationship with survival discharge with an OR of 0.99 (95% CI, 0.36-2.70) and with neurologic outcomes with an OR of 1.15 (95% CI, 0.46-2.88) compared with no PCI group. CONCLUSION: In OHCA patients, the CAG group had a more significant good prognosis (survival discharge rate and good neurologic outcomes) compared with the no-CAG group. In CAG patients, the PCI group had no significant association with good prognosis compared with the no-PCI group.
Cardiopulmonary Resuscitation ; Cohort Studies ; Coronary Angiography* ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Korea ; Logistic Models ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Percutaneous Coronary Intervention* ; Prognosis

Eosinophilic fasciitis (EF) is a rare fibrosing disorder characterized by painful swelling and induration of the limbs and trunk, characteristic histology with sclerosis and lymphocytic inflammation affecting the fascia. The cause and pathogenesis of EF are still unknown and current therapies include glucocorticoids with or without use of immunosuppressive agents. Recently, there have been several case reports documenting the efficacy of a TNF alpha inEosinophilic fasciitis (EF) is a rare fibrosing disorder characterized by painful swelling and induration of the limbs and trunk, characteristic histology with sclerosis and lymphocytic inflammation affecting the fascia. The cause and pathogenesis of EF are still unknown and current therapies include glucocorticoids with or without use of immunosuppressive agents. Recently, there have been several case reports documenting the efficacy of a TNF alpha inhibitor in EF following a steroid-resistant disease course. However, there has been no report on the experience in treatment of EF with a TNF alpha inhibitor in Korea. Hence, we report a case of steroid and methotrexate-resistant EF which was successfully treated with adalimumab, along with a review of the relevant articles.
Antibodies, Monoclonal, Humanized ; Eosinophilia ; Eosinophils ; Extremities ; Fascia ; Fasciitis ; Glucocorticoids ; Immunosuppressive Agents ; Inflammation ; Korea ; Sclerosis ; Adalimumab

A primary thyroid lymphoma is rare among all types of thyroid malignancy. Usually, a thyroid lymphoma is associated with underlying chronic autoimmune thyroiditis. Recently, we experienced a primary thyroid mucosa-associated lymphoid tissue(MALT) lymphoma, with an incidental micropapillary thyroid carcinoma, but lacking evidence of autoimmune thyroiditis. A female patient visited our hospital for further evaluation of a rapidly enlarging, painless thyroid mass which had been stable for 8 years. Lymphocytic thyroiditis or a lymphoma was suspected from fine needle aspiration performed at another hospital. The thyroid function test and other routine laboratory tests were normal. The histopathological findings after a total thyroidectomy revealed a MALT lymphoma with a micropapillary thyroid carcinoma. There was no evidence of chronic autoimmune thyroiditis. This is, to the best of our knowledge, the first case report of a MALT lymphoma arising from the thyroid gland without evidence of chronic autoimmune thyroiditis in Korea
Biopsy, Fine-Needle ; Female ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis, Autoimmune*

A primary thyroid lymphoma is rare among all types of thyroid malignancy. Usually, a thyroid lymphoma is associated with underlying chronic autoimmune thyroiditis. Recently, we experienced a primary thyroid mucosa-associated lymphoid tissue(MALT) lymphoma, with an incidental micropapillary thyroid carcinoma, but lacking evidence of autoimmune thyroiditis. A female patient visited our hospital for further evaluation of a rapidly enlarging, painless thyroid mass which had been stable for 8 years. Lymphocytic thyroiditis or a lymphoma was suspected from fine needle aspiration performed at another hospital. The thyroid function test and other routine laboratory tests were normal. The histopathological findings after a total thyroidectomy revealed a MALT lymphoma with a micropapillary thyroid carcinoma. There was no evidence of chronic autoimmune thyroiditis. This is, to the best of our knowledge, the first case report of a MALT lymphoma arising from the thyroid gland without evidence of chronic autoimmune thyroiditis in Korea
Biopsy, Fine-Needle ; Female ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis, Autoimmune*