No abstract available.
Estradiol* ; Female ; Menstrual Cycle* ; Superovulation*

We performed a electrophoresis to determine the serum level of isoenzyme of creatine phosphokinase in 30 patients with head injuries. The present study was undertaken to examine whether the measurement of serum level of brain type isoenzyme(CPK-BB) and heart type isoenzyme(CPKMB) were valuable in evaluating the clinical status of head injuries. All patients were diagnosed by Glasgow coma scale score, CT scan and then we performed a serial blood sampling during the first 7days. Brain type creatine phosphokinase(CPK-BB) was detected in the serum in 4 of 30 patientts(13.3%) and heart type creatine phosphokinase(CPK-MB) was detected in the serum in 8 of 30 patients(26.7%). These findings were seen within 48 hours after head injuries. The higher level were associated with severe brain damage; hemorrhagic contusion, subdural hemorrhage, subarachnoid hemorrhage and pneumocephalus.
Brain ; Contusions ; Craniocerebral Trauma* ; Creatine Kinase* ; Creatine* ; Electrophoresis ; Glasgow Coma Scale ; Head* ; Heart ; Hematoma, Subdural ; Humans ; Isoenzymes* ; Pneumocephalus ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

No abstract available.
Prognosis* ; Subarachnoid Hemorrhage, Traumatic*

Infective endocarditis is rare in end-stage renal disease (ESRD) patients, who have a poorer prognosis than the general population. Candida endocarditis is rare and has a poor prognosis among causes of infective endocarditis. A 45-year-old male was admitted with sepsis combined with a hematoma on his right back. Candida famata was cultured in his blood. We treated him with antifungal agents. Echocardiography was performed to identify vegetations and diagnose endocarditis. In this case, surgical therapy was impossible because the patient's condition had deteriorated. We also administered antibiotics because methicillin-resistant Staphylococcus aureus was cultured from his sputum and a perianal abscess. The symptoms did not improve despite the ongoing treatment. Metabolic acidosis, hypotension, and a decreased state of consciousness developed and he died. We report a rare case of Candida endocarditis in an ESRD patient on hemodialysis.
Abscess ; Acidosis ; Anti-Bacterial Agents ; Antifungal Agents ; Candida* ; Consciousness ; Echocardiography ; Endocarditis* ; Hematoma ; Humans ; Hypotension ; Kidney Failure, Chronic* ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Prognosis ; Renal Dialysis ; Sepsis ; Sputum

After von Rokitansky's description in 1984 of a calcified chronic subdural hematoma, the number of such lesions has reached so far a total of 108. The majority of patients reported have been children and young adults. On review of the literature, elderly patients reported over the age of sixty five years are only 5, so far as we know. A 68-year-old Korean male with a calcified chronic subdural hematoma is reported. He was admitted to our department because of a status epilepticus. During Korean war (1950), abut 37 years before admission, he had been suffered from a blunt head injury, but mistreated then, and afterwards th had several episodes of convulsion. Neurological examination on admission revealed only a drowsy consciousness and mild papilledema on the left. Plain skull X-ray films and brain CT scan demonstrated a left sided biconvex type of intracranial calcification. A left frentoparietal craniotomy was performed. After opening the dura mater, the thickened outer membrane, the subdural hematoma and the thin bone like plate were removed thoroughly. Content of the subdural hematoma was brown muddy substance. In the eight months following the operation, the generalized seizure did not appear. Postoperative CT scan demonstrated complete re-expansion of the brain parenchyme.
Aged* ; Brain ; Child ; Consciousness ; Craniotomy ; Dura Mater ; Head Injuries, Closed ; Hematoma, Subdural ; Hematoma, Subdural, Chronic* ; Humans ; Korean War ; Male ; Membranes ; Neurologic Examination ; Papilledema ; Seizures ; Skull ; Status Epilepticus ; Tomography, X-Ray Computed ; X-Ray Film ; Young Adult

The literature concerning cerebral vasospasm associated with subarachnoid hemorrhage(SAH) due to ruptured intracranial aneurysm contains no definitive study of patients to determine whether there is (1) any clinical picture consistently present coincident with known cerebral vasospoasm, (2) any relationship between mortality and known vasospasm, and (3) any relationship between serious brain damage(morbidity) and known vasospasm. To answer these important questions, experience with 138 consecutive acute SAH patients due to ruptured intracranial aneurysm was studied. The results were (1) The vasospasm was seen in 61 patients(44.2%) and the clinical vasospasm was seen in 41 patients(29.8%);(2) The average interval between last SAH and vasospasm was 8.3 days;(3) The most common neurological deficit was a hemiparesis or a hemiplegia;(4) There is no relationship between mortality and vasospasm.
Brain ; Humans ; Intracranial Aneurysm* ; Mortality ; Paresis ; Vasospasm, Intracranial

The literature concerning cerebral vasospasm associated with subarachnoid hemorrhage(SAH) due to ruptured intracranial aneurysm contains no definitive study of patients to determine whether there is (1) any clinical picture consistently present coincident with known cerebral vasospoasm, (2) any relationship between mortality and known vasospasm, and (3) any relationship between serious brain damage(morbidity) and known vasospasm. To answer these important questions, experience with 138 consecutive acute SAH patients due to ruptured intracranial aneurysm was studied. The results were (1) The vasospasm was seen in 61 patients(44.2%) and the clinical vasospasm was seen in 41 patients(29.8%);(2) The average interval between last SAH and vasospasm was 8.3 days;(3) The most common neurological deficit was a hemiparesis or a hemiplegia;(4) There is no relationship between mortality and vasospasm.
Brain ; Humans ; Intracranial Aneurysm* ; Mortality ; Paresis ; Vasospasm, Intracranial

BACKGROUND: To assess the myocardial perfusion state after myocardial infarction, Tl-201 SPECT (Thallium-201 Single Photon Emission Computed Tomography) with a repeated "booster" injection before the acquisition of delayed redistribution image is more sensitive and more effective than conventional 4 hour redistribution image. However, this protocol has several disadvantages such as patient inconvenience, additional Tl-201 dose and compromised quantitative analysis. In this study, we compared 4 hour nitrate-augmented redistribution protocol with standard 24 hour delayed redistribution protocol with reinjection to evaluate the usefulness of sublingual nitrate to augment myocardial perfusion and the effectiveness of myocardial assessment for each protocol. METHODS: In 20 myocardial infarction patients, stress-redistribution Tl-201 SPECT was performed. Immediately after resting redistribution image was taken, each patient was administered 0.6 mg of nitroglycerin sublingually without additional Tl-201 and nitrate-augmented SPECT was taken after 30 minutes. Each patient then returned the next day and was injected with a booster dose of Tl-201 30 minutes before the delayed redistribution SPECT acquisition. For the analysis of SPECT study, the myocardium was divided into 22 segments, and the perfusion to each segment was scored on a four-point scale by consensus. An overall cardiac perfusion score was derived by summing the perfusion score for each segment. RESULTS: Reduced stress perfusion was identified in 258 segment among total 440 segments: 61 (23.6%) had improved perfusion after rest redistribution; 145 (56.2%) had improved perfusion after nitrate-augmented redistribution; 140 (54.2%) had improved perfusion after 24 hour delayed redistribution after Tl-201 reinjection. The cardiac perfusion score after stress was 38.2+/-13.1. The score increased to 41.5+/-13.1 after rest redistribution. The perfusion score were improved to 46.3+/-10.4 (p< or =0.05 vs. rest redistribution) after nitrate augmentation. The cardiac perfusion score, 46.2+/-10.8, did not improve further after delayed redistribution. CONCLUSION: Tl-201 SPECT with sublingual nitrate-augmented redistribution is as same or better than 24-hour delayed redistribution with reinjection to detect viable myocardium. Therefore, Tl-201 SPECT with sublingual nitrate-augmented redistribution has economic and time sparing advantage over traditional 24 hour delayed redistribution with reinjection.
Consensus ; Humans ; Myocardial Infarction ; Myocardium* ; Nitroglycerin ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

We report an uncommon case of pyogenic hepatic abscess with hepatobronchial fistula. A 59 year-old male was admitted because of purulent sputum and cough. Ultrasonography and abdominal computed tomography showed an abscess on the superior segment of right hepatic lobe. Diagnostic and therapeutic percutaneous trans-hepatic abscessography disclosed hepatobronchial fistula. Liver abscess with hepatobronchial fistula was managed with percutaneous abscess drainage and antibiotics. The abscess was resolved and he is being on the follow-up with symptom free status.
Abscess ; Anti-Bacterial Agents ; Cough ; Drainage ; Fistula* ; Follow-Up Studies ; Humans ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Male ; Middle Aged ; Sputum ; Ultrasonography

We report an uncommon case of pyogenic hepatic abscess with hepatobronchial fistula. A 59 year-old male was admitted because of purulent sputum and cough. Ultrasonography and abdominal computed tomography showed an abscess on the superior segment of right hepatic lobe. Diagnostic and therapeutic percutaneous trans-hepatic abscessography disclosed hepatobronchial fistula. Liver abscess with hepatobronchial fistula was managed with percutaneous abscess drainage and antibiotics. The abscess was resolved and he is being on the follow-up with symptom free status.
Abscess ; Anti-Bacterial Agents ; Cough ; Drainage ; Fistula* ; Follow-Up Studies ; Humans ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Male ; Middle Aged ; Sputum ; Ultrasonography