We report a patient with multiple simultaneous embolic infarctions with localized hemorrhagic conversion. A 75-year-old male patient had several silent microbleeds (SMBs) exclusively in the cerebral cortex, and underwent angioplasty and stenting for bilateral carotid stenosis. He subsequently experienced embolic infarctions in the cortex and the striatum: the cortical infarction, where an SMB had been present, showed hemorrhagic conversion, whereas the striatal infarction did not. This case suggests that SMBs are indicators of an underlying hemorrhage-prone state.
Aged ; Angioplasty ; Carotid Stenosis ; Cerebral Cortex ; Hemorrhage ; Humans ; Infarction* ; Male ; Stents

We report a patient with multiple simultaneous embolic infarctions with localized hemorrhagic conversion. A 75-year-old male patient had several silent microbleeds (SMBs) exclusively in the cerebral cortex, and underwent angioplasty and stenting for bilateral carotid stenosis. He subsequently experienced embolic infarctions in the cortex and the striatum: the cortical infarction, where an SMB had been present, showed hemorrhagic conversion, whereas the striatal infarction did not. This case suggests that SMBs are indicators of an underlying hemorrhage-prone state.
Aged ; Angioplasty ; Carotid Stenosis ; Cerebral Cortex ; Hemorrhage ; Humans ; Infarction* ; Male ; Stents

Scopulariopsis brevicaulis is a widely distributed soil fungus known as a common saprotroph of biodegradation. It is also an opportunistic human pathogen that can produce various secondary metabolites. Here, we report the first complete mitochondrial genome sequence of S. brevicaulis isolated from air in South Korea. Total length of the mitochondrial genome is 28,829 bp and encoded 42 genes (15 protein-coding genes, 2 rRNAs, and 25 tRNAs). Nucleotide sequence of coding region takes over 26.2%, and overall GC content is 27.6%. Phylogenetic trees present that S. brevicaulis is clustered with Lomentospora prolificans with presenting various mitochondrial genome length.

Scopulariopsis brevicaulis is a widely distributed soil fungus known as a common saprotroph of biodegradation. It is also an opportunistic human pathogen that can produce various secondary metabolites. Here, we report the first complete mitochondrial genome sequence of S. brevicaulis isolated from air in South Korea. Total length of the mitochondrial genome is 28,829 bp and encoded 42 genes (15 protein-coding genes, 2 rRNAs, and 25 tRNAs). Nucleotide sequence of coding region takes over 26.2%, and overall GC content is 27.6%. Phylogenetic trees present that S. brevicaulis is clustered with Lomentospora prolificans with presenting various mitochondrial genome length.

Cerebral microbleeds (CMBs) are tiny, round dark-signal lesions that are most often detected on gradient-echo MR images. CMBs consist of extravasations of blood components through fragile microvascular walls characterized by lipohyalinosis and surrounding macrophages. The prevalence of CMBs in elderly subjects with no history of cerebrovascular disease is around 5%, but is much higher in patients with ischemic or hemorrhagic stroke. Development of CMBs is closely related to various vascular risk factors; in particular, lobar CMBs are thought to be associated with cerebral amyloid angiopathy. The presence of CMBs has been hypothesized to reflect cerebral-hemorrhage-prone status in patients with hypertension or amyloid microangiopathy. Stroke survivors with CMBs have been consistently found to have an elevated risk of subsequent hemorrhagic stroke or an antithrombotic-related hemorrhagic complication, although studies have failed to establish a link between CMBs and hemorrhagic transformation after thrombolytic treatment. A large prospective study is required to clarify the clinical significance of CMBs and their utility in a decision-making index.
Aged ; Aluminum Hydroxide ; Amyloid ; Carbonates ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Humans ; Hypertension ; Macrophages ; Prevalence ; Stroke ; Survivors

Cerebral small vessel disease (SVD), which includes white matter hyperintensities (WMHs), silent brain infarction (SBI), and cerebral microbleeds (CMBs), develops in a conjunction of cumulated injuries to cerebral microvascular beds, increased permeability of blood-brain barriers, and chronic oligemia. SVD is easily detected by routine neuroimaging modalities such as brain computed tomography or magnetic resonance imaging. Research has revealed that the presence of SVD markers may increase the risk of future vascular events as well as deteriorate functional recovery and neurocognitive trajectories after stroke, and such an association could also be applied to hemorrhagic stroke survivors. Currently, the specific mechanistic processes leading to the development and manifestation of SVD risk factors are unknown, and further studies with novel methodological tools are warranted. In this review, recent studies regarding the prognostic impact of WMHs, SBI, and CMBs on stroke survivors and briefly summarize the pathophysiological concepts underlying the manifestation of cerebral SVD.
Blood-Brain Barrier ; Brain ; Brain Infarction ; Cerebral Small Vessel Diseases* ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Permeability ; Prognosis ; Risk Factors ; Stroke* ; Survivors

No abstract available.

The tonsillolith is a white or yellow colored calcified lesion that forms in the crypts of the palatine tonsil. Small tonsilloliths are frequently found on tonsils, while giant tonsilloliths are a rare clinical entity. We had a 35-years old female patient, who presented throat discomfort due to a giant tonsillolith. The stone was removed and tonsillectomy was performed. We reviewed the literature on this rare clinical entity.
Female ; Humans ; Palatine Tonsil ; Pharynx ; Tonsillectomy

Seventy four consecutive cementless Tricon-M total knee replacement were followed for two to eight years (average three and half years) at the Department of Orthopedics Kangnam St. Mary's Hospital Catholic University Medical College. Using the Hospital for Sepcial Surgery rating system we found that 86.6 percent of the knee were graded excellent or good, 8 percent fair and 5.4 percent poor. In four cases of complication, two patients had gram negative infection postoperatively and one had one stage revision using gentamycine mixed cement and the other who had delayed infection one year after surgery had arthroscopic irrigation and synovectomy. Other two complications were patella lateral sublugation but the realignment operation had been refused. In radiologic examination there were no radiolucenct loosening sign in any patella or femoral component but tibial radiolucency was seen in only three patients. Thirty four (46%) out of 74, cases showed tibial component subsidency (average 2.2mm) during the first one year follow up period but no further progression was seen in later follow up period. No correlation.between radiolucency or subsidence and knee scores was seen. Cementless fixation of all components in total knee replacement, including the tibia and patella, was highly successful and can be achieved without stress relief of the distal femur.
Arthroplasty, Replacement, Knee ; Femur ; Follow-Up Studies ; Gentamicins ; Humans ; Knee ; Orthopedics ; Patella ; Tibia

The intrauterine fetal death(IUFD) is the death of the fetus prior to complete expulsion or extraction from its mother when the fetus is over 20 weeks gestation or weights more than 500 gm. This is a clinical study of 262 cases of IUFD and 262 control cases among 18542 deli-veries at Chung Goo Sung Sim Hospital during 10 years from 1987 to 1996. The results obtain-ed were as follows: 1. The incidence of IUFD was 1.41%. 2. The risk of IUFD was high in women older. 3. The risk of IUFD was high in women with parity of three or more, there was a previous history of IUFD in 11.2% of the IUFD cases and in 6.3% of the control cases, but there was no difference between the two groups of women in history of spontaneous abortion. 4. The sex ratio of male versus female was 1.24:1 in the IUFD cases, 1.11:1 in the control cases. 5. The low birth weight and preterm infants were much more frequent in the IUFD cases. 6. The mode of delivery IUFD was induced labor(77.5%), laparotomy(12.2%), spontaneo- us delivery(10.3%). The indications for laparotomy were placental abruption, placenta previa, transverse lie, previous cesarean section status, cephalopelvic disproportion and uterine rupture. 7. The most common cause of IUFD was unexplained causes(45.1%). 8. There were 67 cases(25.6%) of maternal complication, and the most common complica- tion was fever(35.8%). 9. In the incidence of abnormal coagulation test, the low platelet count(<100,000/mm3) was 8.0%, the prolonged prothrombin time(>14 seconds) was 7.2%, the prolonged partial thr- omboplastin time was 1.0%, the hypofibrinogenemia(<150mg/dl) was 7.2% and the elevated fibrinogen degradation products(>40 ug/ml) was 8.4%. 10. The risk of IUFD was lowered as the number of antenatal care was increased.
Abortion, Spontaneous ; Abruptio Placentae ; Blood Platelets ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Death* ; Fetus ; Fibrinogen ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Laparotomy ; Male ; Mothers ; Parity ; Placenta Previa ; Pregnancy ; Prothrombin ; Sex Ratio ; Uterine Rupture ; Weights and Measures