PURPOSE: This retrospective study was conducted to evaluate the value of adminstration of IV gadopentetate dimeglumine for MR imaging of tuberculous spondylitis. MATERIALS AND METHODS: The authors reviewed MR images both with and without contrast enhancement of 22 patients with tuberculous spondylitis. Evaluation of signal characteristics, enhancement patterns, and difference of delineation between pre- and postcontrast enhancement was made on 4 compartments the vertebral body, intervertebral disc, paravertebral space, and extradural space. RESULTS: The spinal tuberculous lesions revealed relatively low or isosignal intensity on T1-weighted image and high signal intensity on T2-weighted image. The tuberculous lesions of vertebral body showed enhancement of mixed pattern, and rim enhancement pattern was predominant in the other 3 compartment, suggesting abscess. The contrast enhanced MR image showed better demarcation of the extents of tuberculous lesions comparing with noncontrast image, especially at the vertebral body and intervertebral disc. The nature of tuberculous involvement was better visualized at the extradural space and paravertebral space on postcontrast image. CONCLUSION: We conclude Gd-DTPA enhanced MR image can give informations for more detailed delineation, extents, and nature of involvement in the tuberculous spondylitis.
Abscess ; Gadolinium DTPA ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylitis*

The choristoma is a tumor like mass of normal cells in an abnormal location. Intraoral osseous and cartilaginous choristoma is distinctly uncommon. The etiology of choristoma is unknown. It is suggested that the intraoral choristoma is a developmental lesion. Correct diagnosis can be obtained only after histopathologic examination. The treatment of choice is surgical excision. We present a case of osseous and cartilaginous choristoma, occurred on the tongue base and treated by peroral excision, with review of the literatures.
Choristoma* ; Diagnosis ; Tongue*

Numerous reports have documented cardiac arrhythmias in animals and man during halothane anesthesia, Cardiac arrhythmia may occur regularly with halothane anesthesia, being related to several factors; fright, overdoasge of atropine, surgical stimvlation in light anesthesia, hypercapnia and intravenous injection of epinephrine. The authors experienced a case of severe cardiac arrhythmia induced by fialothane anesthesia and treated by change of anesthetic agent to ether.
Anesthesia* ; Animals ; Arrhythmias, Cardiac* ; Atropine ; Epinephrine ; Ether ; Halothane* ; Hypercapnia ; Injections, Intravenous

Chronic atrophic gastritis is a result of chronic inflammation characterized by the replacement of oxyntic and antral gastric glandular structures by connective tissue or by glandular structures inappropriate for location such as metaplastic atrophy. Chronic atrophic gastritis is considered as one of the major risk factors for noncardiac gastric cancer or mucosa associated lymphoid tissue lymphoma. Since chronic inflammation is generally considered to be triggered by Helicobacter pylori infection, many studies have evaluated whether H. pylori eradication therapy could make histologic improvement or reversal. However, it is controversial whether eradication of H. pylori improves atrophy or metaplasia. There has been a lot of conflict, but many previous studies including meta-analyses tend to demonstrate that it is possible that gastric atrophy could be improved after H. pylori eradication in the corpus but not in the antrum. Also, intestinal metaplasia seems to be irreversible even after H. pylori eradication.
Atrophy ; Carbamates ; Connective Tissue ; Gastritis, Atrophic ; Helicobacter pylori ; Inflammation ; Lymphoma, B-Cell, Marginal Zone ; Metaplasia ; Organometallic Compounds ; Risk Factors ; Stomach Neoplasms

Chronic atrophic gastritis is a result of chronic inflammation characterized by the replacement of oxyntic and antral gastric glandular structures by connective tissue or by glandular structures inappropriate for location such as metaplastic atrophy. Chronic atrophic gastritis is considered as one of the major risk factors for noncardiac gastric cancer or mucosa associated lymphoid tissue lymphoma. Since chronic inflammation is generally considered to be triggered by Helicobacter pylori infection, many studies have evaluated whether H. pylori eradication therapy could make histologic improvement or reversal. However, it is controversial whether eradication of H. pylori improves atrophy or metaplasia. There has been a lot of conflict, but many previous studies including meta-analyses tend to demonstrate that it is possible that gastric atrophy could be improved after H. pylori eradication in the corpus but not in the antrum. Also, intestinal metaplasia seems to be irreversible even after H. pylori eradication.
Atrophy ; Carbamates ; Connective Tissue ; Gastritis, Atrophic ; Helicobacter pylori ; Inflammation ; Lymphoma, B-Cell, Marginal Zone ; Metaplasia ; Organometallic Compounds ; Risk Factors ; Stomach Neoplasms

Hyperthyroidism is a well known cause of atrial fibrillation. It is also known that control of hyperthyroidism can usually curb thyrotoxic atrial fibrillation and restore sinus rhythm. In this study, 282 patients with hyperthyroidism were investigated to quantify the incidence of atrial fibrillation, and to identify the vulnerable groups. In addition, we compared two groups of subjects with atrial fibrillation-one group with hyperthyroidism and the other group without
Aged ; Atrial Fibrillation ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Hyperthyroidism ; Incidence ; Male ; Sex Ratio ; Thyroid Gland

The esophageal electrocardiogram is of increasing significance in the study and diagnosis of cardiac arrhythmia and of posterior myocardial disease. We used both bipolar and unipolar esophageal recording leads and standard electrocardiogram equipment, and compared the effectiveness of esophageal electrocardiogram with co nventional electrocardiogram. The effectiveness of esophageal electrocardiogram were as follows: 1) Differentiation of sinus, atrial, junctional, or ventricular rhythm. 2) Differentiation of origin of premature beats. 3) Differentiation of atrial flutter and fibrillation. 4) Detection of retrograde atrial conduction of extraventricular systole. 5) Detection of electrical alternance of QRS amplitude. 6) Diagnosis of posterior myocardial infarction. The results reported here indicate that the esophageal electrocardiogrm seems to be a valid method in the diagnosis of cardiac arrhythmias without invasiveness.
Arrhythmias, Cardiac ; Atrial Flutter ; Cardiac Complexes, Premature ; Cardiomyopathies ; Diagnosis ; Electrocardiography* ; Myocardial Infarction ; Systole

Scrub typhus can invade central nervous system. The most common findings of CNS involvement are those of low grade meningitis, however, meningoencephalitis with coma and generalized seizure are also reported to occur in scrub typhus but only rarely. A 47-year old male was admitted to our hospital because of consciousness disturbance. The patient had a fever and rash for seven days before admission. He had been treated for diabetes mellitus for three years. Generalized seizure occurred six times after admission. CSF revealed increase of leukocytes (648/mm3) and protein level, and diffuse slow wave was found on electroencephaolography. The magnetic resonance image of the brain showed dural thickening. We diagnosed his illness as tsutsugamushi disease complicated by meningoencephalitis. After treatment with clarithromycin and an anticonvulsant, he recovered without neurological sequelae. O. tsutsugamushi should be considered as one of the causes of meningoencephalitis in endemic areas.
Brain ; Central Nervous System ; Clarithromycin ; Coma ; Consciousness ; Diabetes Mellitus ; Exanthema ; Fever ; Humans ; Leukocytes ; Male ; Meningitis ; Meningoencephalitis* ; Middle Aged ; Scrub Typhus* ; Seizures

PURPOSE: To document the radiologic characteristics of Korean Gaucher disease. MATERIALS AND METHODS: Fifteen bone marrow biopsy and laboratory data confirmed Gaucher disease patients (age 1 -21, mean 10.9 yr) wereundertaken plain X ray and MRI. Number of type I were 10, type II, 2, type III, 3. Seven were splenectomized oninitial evaluation or during follow up. Five enzyme treated patient were undertaken follow-up MR examinationduring 6 -40 month with 6 month interval. Conventional T1 and T2WI of spine and femur was performed and FMPSPGR inand out of phase image was also done. Volume of liver and spleen were measured, and bone marrow infiltration andpresence of infarction were scored according to 6 scale scoring system. Clinical data were also reviewed andcorrelated with the MR findings. RESULTS: Marrow infiltration was noted in 71.4% of all patients in MRI, while itwas in 45.7% with plain radiography. Type I group showed marrow infiltration in all but one cases, which wasparallel with ages, SGPT, and presence of osteopenia, reversely correlated with spleen size. Severe bonecomplications (infarction or fracture) were noted in 7 of 10 type I group, and 6 patients showed severe growthretardation (below 3rd percentile). Follow up MR examination of 5 patient showed decrease in liver and spleen sizefirst without bone change until 6 months. There showed bone regeneration in 2 patient 1 year after, and increasedfat signal in one patient 3.5 years after. In and out of phase images couldn't help in quantifying fatcomposition in bone marrow. CONCLUSION: Korean Gaucher patients revealed as more severe skeletal complicationsthan others reported from Western groups. MR examination is a effective modality to evaluate and monitor ofGaucher patients.
Alanine Transaminase ; Biopsy ; Bone Diseases, Metabolic ; Bone Marrow ; Bone Regeneration ; Femur ; Follow-Up Studies ; Gaucher Disease* ; Humans ; Infarction ; Liver ; Magnetic Resonance Imaging ; Metabolism ; Radiography ; Spine ; Spleen

The incidence of hypercalcemia in terminal cancer patients is rare but if it is not treated, the consequence is dismal. Hydration, diuretics, corticosteroids are not so effective for the treatment of hypercalcemia in this situation. Pamidronate (synthetic bisphosphonate analogue of pyrophosphonate) decreases the activity and the life span of the osteoclasts. It results in decrease in resorption of bone mineral, directly and indirectly. There are only a few reports on the usage of pamidronate in children. We experienced a case with hypercalcemia in patient with Wilms tumor who was treated with pamidronate. A 5-year-old male patient was admitted to Ajou University Hospital due huge abdominal mass. Abdominal CT revealed a huge mass originating from right kidney (size: 18 11 8 cm) with lung metastasis. The chemotherapy according to National Wilms Tumor Study (NWTS)-4 was started but there was no response after 4 months. Right nephrectomy with mass removal was done and the pathologic finding revealed diffuse anaplastic type. The serum calcium level increased to be 16.7 mg/dL at 7 days after operation which was not responsive to hydration and furosemide. Pamidronate was given at the dose of 1 mg/kg and the serum calcium decreased to 8.0 mg/dL 24 hours later. The pulmonary lesion progressed and the patient died 4 months after operation but the serum calcium level remained within normal range thereafter.
Adrenal Cortex Hormones ; Calcium ; Child ; Child, Preschool ; Diuretics ; Drug Therapy ; Furosemide ; Humans ; Hypercalcemia* ; Incidence ; Kidney ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Osteoclasts ; Reference Values ; Tomography, X-Ray Computed ; Wilms Tumor*