No abstract available.

BACKGROUND: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. METHODS: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. RESULTS: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients' B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. CONCLUSIONS: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Basal Ganglia ; Brain* ; Cerebellum ; Cerebral Cortex ; Emergencies ; Hand ; Humans ; Hypoxia-Ischemia, Brain ; Intensive Care Units ; Magnetic Resonance Imaging* ; Neuroimaging ; Out-of-Hospital Cardiac Arrest* ; Putamen ; Retrospective Studies ; Survivors

BACKGROUND: To compare the diagnostic usefulness of dobutamine stress echocardiography(DSE) and 99mTc-methoxyisobutyl isonitrile SPECT (MIBI SPECT), two studies were performed simultaneously. METHOD: Fifty-six consecutive patients undergoing coronary angiogram and MIBI SPECT for clinical indications without clincal evidence of myocardial infarction were studied prospectively. During the DSE, MIBI was injected at peak stress, and post-stress images of MIBI SPECT were required on hour later. Both echocardiographic and MIBI SPECT images were visually analysed in a blind fashion. RESULTS: On the basis of coronary angiographic findings, the sensitivites of the DSE and MIBI SPECT (n=36) were 89% and 86%, respectively. The specificities of those (n=20) were 90% and 85%, respectively. Among 33 patients without resting perfusion defect on MIBI SPECT, resting regional wall motion abnormalities on DSE were found in only one patient, whereas, resting perfusion defect on MIBI SPECT were found in 9 patients among 41 patients without resting regional wall motion abnormalities on DSE. Among 17 patients who had resting perfusion defects with partial reversibility on MIBI SPECT, resting wall motion abnormalities were present in 11 patients and five of them showed improvement in the regional wall motion during low dose dobutamine infusion. CONCLUSION: Both dobutamine stress echocardiography and MIBI SPECT are useful methods in the detection of the coronary artery disease, however, MIBI SPECT seems to overestimate the regional ischemic myocardium with contractile reserve that can hardly be evaluated with MIBI SPECT.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Myocardial Infarction ; Myocardium* ; Perfusion ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Humans ; Myocardium* ; Tomography, Emission-Computed, Single-Photon*

To know the correlation between glomerular and tubulointerstitial lesion and to define the characteristics of interstitial inflammatory cell in IgA nephropathy and classified according to WHO classification and graded tubulointerstitial lesion as mild, moderate and severe. Paraffin-embedded 5u sections were stained with UCHL-l, L26 and CD68 antibodies. More than 20 fields were examined in each case under the high power microscopy and the number of positive cells were counted. There was positive correlation between the severity of glomerular and that of tubulointerstitial lesion. The mostcommoninflammatory cells in the interstitiuin were UCHL-l positive cells followed by CD68 and L26 positive cells. As the WHO grade or tubulointerstitial lesion increased, the numbers of positive cells were increased in all three groups. The proportion of UCHL-1 Positive cells were increased in cases with high WHO grade whereas that of L26 positive cells incases with severe tubulointerstitial lesion Proteinuria was correlated with the degree of inflammatory cell infiltration, especially with that of L26 positive cells.

Adult Clonorchis sinensis were collected from the biliary passage of nine cases of medico-legal autopsies. The worms were washed repeatedly with tap water and rinsed twice with physiological saline. Incubation took place in Tyrode's medium in order to recover live worms. The number of worms surviving in the medium was determined. The rate of surviving worms showed an unexpectedly high percentage (22.8%) in those cases autopsied 2 days after death. The surviving worm burden dropped sharply to 6.3 and 9.2 percent for those samples taken 5 days after death.
parasitology-helminth-trematoda ; Clonorchis sinensis ; autopsy

The authors analyzed data from 15 patients with idiopathic dilated cardiomyopathy to evaluate the hemodynamic changes and left ventricular cineangiogram as compared with normal control. Mean right atrial pressure, right ventricular systolic pressure, mean pulmonary artery pressure and mean pulmonary wedge pressure were signigicantly elevated in patients with dilated cardiomyopathy. Left ventricular enddiastolic volume was increased in idiopathic dilated cardiomyopathy(139.9+/-58.73 ml/m2). Cardiac index, left ventricular ejection fraction and circumferential fiber shortening were significantly reduced in patients with dilated cardiomyopathy as compared with normal control(p<0.001). Hypokinetic, diffuse wall motion abnormalities of left ventricle were common in idiopathic dilated cardiomyopathy. A few cases of akinetic or dyskinetic segmental wall motion abnormalities were present. Left ventricular configurations in patients with idiopathic dilated cardiomyopathy were globe shape(53.4%) as compared with pear core shape(90%) of normal control. Associated mitral regurgitations in patients with idiopathic dilated cardiomyopathy confirmed by left ventricular cineangiogram were 53.3 percent. Mild to moderate mitral regurgitations were often present(46.6%).
Atrial Pressure ; Blood Pressure ; Cardiomyopathy, Dilated* ; Heart Ventricles ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Pyrus ; Stroke Volume

In accidents, the spines are generally subjected to one of five types of violence; pure flexion, flexion and rotation, extention, vertical compression, or direct shearing force by Holdsworth's report. Flexion and rotational violence, so-called, unstable rotational fracture-dislocation results in paraplegia commonly. The treatment of the fracture-dislocations of the thoracic and lumbar spine had varied widely during the past 100 years, including conservative and operative treatment, but there is no definitive study that convincingly show the superiority of either operative or nonoperative treatment till now. Ten cases of the unstable thoracolumbar vertebral fracture or fracture-dislocations during the past two years were reported in this paper. In unstable types on the thoracolumbar vertebral fracture or fracture-dislocations, direct blow was the most common cause of injury and the thoracolumbar junction extending from T10 to L1 was the most common location of injury in this report. Three among four paraplegic patients were received flexion and rotational violence and the remaining one, direct shearing force. All four paraplegic parients were operated. Among them two cases, the one who was performed open reduction and simple wire fixation and the other open reduction and Harrington instrumentation, recovered almost completely except mild motor weakness of lower extremities. All cases complained of remaining back pain more or less without relation to the method of treatment.
Back Pain ; Clinical Study ; Humans ; Lower Extremity ; Methods ; Paraplegia ; Spine ; Violence

No abstract available.

Epidermolytic keratosis palmaris is a rare disease which shows clinical findings of Unna Thost keratoderma and histopathologic of epidermolytic hyperkeratosis. We report herein a case of epidermolytic keratosis palmaris et plantaris in a 16-month-old female baby. Light microscopy shows marked hyperkeratosis, large irregular keratohyalin granules, and large clear spaces in the granular and upper spinous layers. Eletron microscopic findings shows that the clear spaces are areas of cytoplasm filled with a fibrillar material and cellular organelles. Abnormal clumping of tonofilament and keratohyalin is also present.
Cytoplasm ; Female ; Humans ; Hyperkeratosis, Epidermolytic ; Infant ; Intermediate Filaments ; Keratoderma, Palmoplantar* ; Keratosis* ; Microscopy ; Organelles ; Rare Diseases