Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.
Bradycardia ; Cardiomyopathies* ; Coronary Angiography ; Coronary Artery Disease ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Hormone Replacement Therapy* ; Humans ; Hypopituitarism ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; Takotsubo Cardiomyopathy ; Thyroxine

PURPOSE: Though it is a general and common method to temporarily stop breast feeding and use whole milk instead for neonatal breast milk jaundice, it may cause some difficulties in continuing breast feeding after the recovery. We study the effect of continuing breast feeding on the treatment of breast milk jaundice and the success of breast feeding afterwards. METHODS: We retrospectively analyzed the medical records of 59 neonates who were admitted to Cheil general hospital from Jan 2008 to Aug 2012 for phototherapy due to breast milk jaundice. Subjects were divided into two groups, one with continuing breast feeding (35 cases) during treatment and the other with stopping breast feeding (24 cases). We examined and compared the changes in the level of serum total bilirubin between two groups, as well as the difficulties the mothers might had in continuing or restarting breast feeding after the discharge. RESULTS: There was no significant difference in times of treatment (until reaching the level of serum total bilirubin <13 mg/dL) between two groups (P=0.066). However, the group with temporary stop of breast feeding had difficulties such as nipple confusion and breast engorgement compared to breast feeding group (P=0.001). In long-term follow up, the breast feeding duration (P=0.017) and the rate of exclusive breast feeding for 6 months (P=0.024) were also significantly higher in breast feeding group. CONCLUSIONS: We suggest that continuing breast feeding while treating breast milk jaundice is helpful both for successfully continuing breast feeding and preventing problems after discontinuing breast feeding.
Bilirubin ; Breast Feeding* ; Breast* ; Follow-Up Studies ; Hospitals, General ; Humans ; Infant, Newborn ; Jaundice* ; Medical Records ; Methods ; Milk ; Milk, Human* ; Mothers ; Nipples ; Phototherapy ; Retrospective Studies

A stenotic spinal canal in the cervical or lumbar region is a well-known clinical entity. However, stenosis involving a thoracic vertebra is rarely mentioned in the literature. Improved neuroimaging facilities, especially MRI, let us detect the thoracic canal stenosis not so infrequently as in the past years. The authors are reporting six operative cases of thoracic myelopathy associated with thoracic spinal stenosis. Motor & sensory abnormalities were found in all cases during the clinical course. Magnetic resonance imaging and Metrizamide CT scanning were useful in the diagnosis of thoracic spinal stenosis. Treatment consited of wide posterior decompression resulting in symptomatic improvement in five of six patients.
Constriction, Pathologic ; Decompression ; Diagnosis ; Humans ; Linear Energy Transfer ; Lumbosacral Region ; Magnetic Resonance Imaging ; Metrizamide ; Neuroimaging ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spine ; Tomography, X-Ray Computed

BACKGROUND: The Korean Red Cross (KRC) has stored blood donor samples for 10 years under -20degrees C since 2004. These samples have been used for investigating transfusion related infections and for Look-back studies. We designed an experimental scheme to verify the stability of stored blood samples. METHODS: We collected and prepared samples such as blood donor samples (HBV, HCV, HIV nucleic acid positive; n=90), the HIV infected patient samples (n=20), the WHO nucleic acid international standards serologic positive samples (HBsAg, anti-HCV, anti-HIV; n=120) and the negative samples (n=20). The samples were aliquoted in cryo tubes with volumes of 0.5~5 mL and they were stored at -20~-30degrees C and -70~-80degrees C. We used enzyme immunoassay, chemiluminescence immunoassay and quantitative PCR for the base line and the follow up studies. The linear mixed statistical model using SAS 9.1 for windows was used for statistical analysis. RESULTS: The results of the baseline test of the stored samples showed a variable range of viral load (10(1)~10(7) IU/mL or copies/mL) and optical density (S/CO 3.0~500). The results of the stored samples after 6 month (n=82) did not show any significant differences compared to the baseline data for the viral loads (P>0.05) and the qualitative serologic tests. CONCLUSION: We established an experimental scheme to verify the stability of the stored blood donor samples. From now on, the stability of the stored samples is going to be monitored by every 6 month for 10 years.
Blood Donors ; Follow-Up Studies ; HIV ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Luminescence ; Models, Statistical ; Phenothiazines ; Polymerase Chain Reaction ; Red Cross ; Serologic Tests ; Viral Load