No abstract available.
Diagnosis* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography*

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*

OBJECTIVES: This study was designed to elucidate the psychiatric characteristics and nature of the neuropsychological deficits associated with subclinical hepatic encephalopathy(SHE) in patients with non-alcoholic liver cirrhosis. And also the authors prospectively studied the role of somatosensory evoked potentials(SEP) in the assessment of SHE. METHODS: Beck Depression Inventory(BDI) for measuring depression, State Trait Anxiety Inventory(STAI) for measuring anxiety, and Health-related Quality of Life Questionnaire(HQLQ) for measuring quality of life were administered the 41 non-encephalopathic liver cirrhosis patients(NELC) group and 31 carefully matched normal controls. And a prospective study to compare the performance of NELC group and normal controls on a short but comprehensive cognitive tests was conducted. After several cognitive tests, NELC group was divided into two groups, SHE group and non-SHE group by results of digit symbol substitution test(DSST) and/or trail making test(TMT) A and B. And then median nerve evoked cortical responses in 13 SHE patients group, 11 non-SHE patients group, and 8 normal controls were recorded for latencies of N13, P16, N20, P25, N30, P45, N65, and P95. And also responses for N13-N20 interpeak latency(IPL) and N20-N65 IPL were recorded. RESULTS: There were significant differences between the NELC group and normal controls on BDI, trait anxiety scales in STAI, and almost all HQLQ except for the cognitive function, social interaction and life satisfaction(p<0.05). The NELC group exhibited poor performance in DSST, TMT A and TMT B compared with normal controls(p<0.05). As 17 NELC patients had abnormal cognitive test results, 41.5% of cirrhotic patients had SHE. In SEP assessment, NELC group with SHE and without SHE had higher N20-N65 IPL and only NELC group with SHE had higher N65 latency compared with normal controls(p<0.05). CONCLUSION: This study suggests that the patients with liver cirrhosis exhibit relatively selective deficits in complex attentional and fine motor skills, with preservation of general intellectual ability, memory, language and visuospatial perception. DSST, TMT A and TMT B seem to be useful screening tests for the detection of SHE. And also it is expected that late components and N20-N65 IPLs of SEP are helpful in the assessment of SHE.
Anxiety ; Depression ; Diagnosis* ; Evoked Potentials* ; Evoked Potentials, Somatosensory ; Humans ; Interpersonal Relations ; Liver Cirrhosis ; Liver* ; Mass Screening ; Median Nerve ; Memory ; Motor Skills ; Prospective Studies ; Quality of Life ; Weights and Measures

Osteosarcomas are highly malignant bone tumors which commonly affect metaphyseal portions of long bones and those of the skull are distinctly rare as primary neoplasm. We report a case of recurrent osteosarcoma originated from the skull base which destructed sphenoid bone in two months. The CT and MR images of 28 years old man with headache, dizziness, and loss of touch sense in right buccal area showed 3-cm sized homogenously well-enhancing mass with internal small cystic portions. Craniotomy and mass excision was done and chemotherapy was combined for 1 month. After about 2 month, follow up MR images showed larger recurrent mass in original site and confirmed as the same osteosarcoma after 2nd operation.
Adult ; Craniotomy ; Dizziness ; Drug Therapy ; Follow-Up Studies ; Headache ; Humans ; Osteosarcoma* ; Skull Base* ; Skull* ; Sphenoid Bone

Osteosarcomas are highly malignant bone tumors which commonly affect metaphyseal portions of long bones and those of the skull are distinctly rare as primary neoplasm. We report a case of recurrent osteosarcoma originated from the skull base which destructed sphenoid bone in two months. The CT and MR images of 28 years old man with headache, dizziness, and loss of touch sense in right buccal area showed 3-cm sized homogenously well-enhancing mass with internal small cystic portions. Craniotomy and mass excision was done and chemotherapy was combined for 1 month. After about 2 month, follow up MR images showed larger recurrent mass in original site and confirmed as the same osteosarcoma after 2nd operation.
Adult ; Craniotomy ; Dizziness ; Drug Therapy ; Follow-Up Studies ; Headache ; Humans ; Osteosarcoma* ; Skull Base* ; Skull* ; Sphenoid Bone

A 70-year-old woman developed sick sinus syndrome associated with thyrotoxicosis. Initial T3 was above 800ng/dl and TSH was below 0.05IU/ml. But sinus node dysfunction was resolved upon achieving a euthyroid state. This clinical course suggest that transient reversible sinus node dysfunction could be developed due to thyrotoxicosis.
Aged ; Female ; Humans ; Sick Sinus Syndrome* ; Thyrotoxicosis*

OBJECTIVE: To evaluate the association between transient bradycardia following cordocentesis and adverse pregnancy outcome. METHODS: 117 cordocentesis was performed at Samsung Cheil hospital and women's healthcare center, between January 1, 2000, and December 31, 2002. Clinically significant bradycardia was defined as a drop in the heart rate to less than 120 bpm. The adverse outcome included major anomaly, chromosomal abnormality, intrauterine growth restriction, preterm birth, and intrauterine fetal death. RESULTS: Bradycardia following cordocentesis was observed in 13 cases (11.1 per cent). The fetal heart rate before (149.2 +/- 0.7 bpm) and after (144.7 +/- 2.8 bpm) cordocenteis was significantly different. The adverse outcome rate was 50.0 per cent (6/12) in cases with bradycardia and 27.7 per cent (26/94) in those without bradycardia (RR=2.6, P=NS). CONCLUSION: Our result is that the association between transient bradycardia following cordocentesis and adverse pregnancy isn't statistically significant, even though adverse outcome is more frequent in pateints with bradycaredia. Therefore, patient with bradycardia following cordocentesis need periodic fetal surveillance.
Bradycardia* ; Chromosome Aberrations ; Cordocentesis* ; Delivery of Health Care ; Female ; Fetal Death ; Heart Rate ; Heart Rate, Fetal ; Humans ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth

OBJECTIVE: To evaluate the association between transient bradycardia following cordocentesis and adverse pregnancy outcome. METHODS: 117 cordocentesis was performed at Samsung Cheil hospital and women's healthcare center, between January 1, 2000, and December 31, 2002. Clinically significant bradycardia was defined as a drop in the heart rate to less than 120 bpm. The adverse outcome included major anomaly, chromosomal abnormality, intrauterine growth restriction, preterm birth, and intrauterine fetal death. RESULTS: Bradycardia following cordocentesis was observed in 13 cases (11.1 per cent). The fetal heart rate before (149.2 +/- 0.7 bpm) and after (144.7 +/- 2.8 bpm) cordocenteis was significantly different. The adverse outcome rate was 50.0 per cent (6/12) in cases with bradycardia and 27.7 per cent (26/94) in those without bradycardia (RR=2.6, P=NS). CONCLUSION: Our result is that the association between transient bradycardia following cordocentesis and adverse pregnancy isn't statistically significant, even though adverse outcome is more frequent in pateints with bradycaredia. Therefore, patient with bradycardia following cordocentesis need periodic fetal surveillance.
Bradycardia* ; Chromosome Aberrations ; Cordocentesis* ; Delivery of Health Care ; Female ; Fetal Death ; Heart Rate ; Heart Rate, Fetal ; Humans ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth

"Purple toe" syndrome is an extremely rare complication of warfarin therapy. The occurrence of purple toe syndrome is characterized by a sudden appearance of purplish discoloration of toes and the sides of feet. The skin lesions usually develop 3-8 weeks after beginning anticoagulation. The pathogenesis was not clearly defined but the presence of atherosclerosis in most of patients led to suggest that the mechanism was related to cholesterol emboli from the atherosclerotic plaques and warfarin- induced bleeding into the plaques. These microemboli are commonly associated with irreversible organ dysfunction such as renal failure, distal gangrene, pancreatitis, and multifocal myocardial necrosis. Therefore purple toe syndrome may be considered as a sentinel of cholesterol crystal embolism. Once established, anticoagulation and thrombolysis are contraindicated. Necrosis and gangrenous changes may result in loss of limb and occasional mortality has been reported. We report a case of purple toe syndrome associated with acute renal failure after warfarin therapy with a review of literatures.
Acute Kidney Injury* ; Atherosclerosis ; Cholesterol ; Embolism ; Embolism, Cholesterol ; Extremities ; Foot ; Gangrene ; Hemorrhage ; Humans ; Mortality ; Necrosis ; Pancreatitis ; Plaque, Atherosclerotic ; Renal Insufficiency ; Skin ; Toes* ; Warfarin*

BACKGROUND: Due to its less invasive nature and superior visual field, video-assisted thoracoscopic excision of mediastinal mass is thought to be comparable to open thoracotomy. MATERIAL AND METHOD: From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy. RESULT: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2 +/-35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6+/-7.0 minutes, mean postoperative tube stay was 4.2+/-0.4 days, mean postoperative hospital stay was 5.2+/-0.4 days, and mean number of injection of analgesics was 1.9+/-0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of video- assisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. CONCLUSION: As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.
Analgesics ; Chylothorax ; Female ; Humans ; Length of Stay ; Male ; Mediastinal Cyst ; Mediastinal Neoplasms ; Medical Records ; Paralysis ; Pathology ; Patient Discharge ; Phrenic Nerve ; Postoperative Complications ; Retrospective Studies ; Thoracoscopy ; Thoracotomy ; Visual Fields