There had been few reports of arachnoid cyst accompanying psychiaric disturbance and no report treated with low-dose resperidone administration. We report a patient, developed first-transient psychotic episode considered to be provoked by an arachnoid cyst, responsive to risperidone, which was found in the middle cranial fossa as follows. A 57-year-old man was admitted by suddenly developed headache, auditory hallucination, delusion of persecution and, an arachnoid cyst in the anteromedial aspect of middle cranial fossa was found on MRI after admission. The psychotic episode was first to him and he was also negative to other clinical evaluation including endocrine abnormality, his psychotic symptom was suspected to be induced by arachnoid cyst and was well controlled to low-dose risperidone administration. He left hospital free from psychotic symptoms on 14 hospital days.
Arachnoid* ; Cranial Fossa, Middle ; Delusions ; Hallucinations ; Headache ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Psychotic Disorders* ; Risperidone*

No abstract available.
Malaria*

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

Pneumomediastinum is a relatively uncommon, infrequently reported entity, In the evaluation of these entity, it is important to exclude pathological causes, including Boerhaave's syndrome which carries a high mortality. Spontaneous pneumomediastinum is related to excessive intraalveolar pressure leading to rupture of perivascular alveoli in the setting of a Valsalva maneuver without communication to gut material. So, it has a benign self-limited course and rarely requires medical intervention. On the contrary, secondary pneumomediastinum caused by instrumental, traumatic, and spontaneous perforation of esophagus. Although the prognosis have been improved since the advent of broad-spectrum antibiotics and nutritional support, pneumomediastinum due to esophageal perforation still has a high morbidity and mortality. The most important prognostic factor is the time interval between perforation and initiation of therapy, and an awareness and a high clinical suspicion is critical in the early diagnosis and treatment. Recently, we have experienced 2 cases of pneumomediastinum, one case was spontaneous pneumomediastinum and the other may be caused by instrumental esophageal perforation. We report the clinical course of the patients with a current literature review.
Anti-Bacterial Agents ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Fibrinogen ; Humans ; Mediastinal Emphysema* ; Mortality ; Nutritional Support ; Prognosis ; Rupture ; Valsalva Maneuver

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.
Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Humans ; Transmyocardial Laser Revascularization

No abstract available.
Galactitol* ; Galactosemias* ; Humans ; Infant* ; Mass Screening*

No abstract available.
Gram-Positive Bacterial Infections* ; Teicoplanin*

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*