There are several EKG changes in cerebrovascular disease(CVD). The wide prominent of inverted T wave is frequently developed in patients with CVD. There were case reports for CVD in patient with ST-segment elevation without myocardial infarction, but the exact mechanism is unknown. EKG abnormalities associated with subarachnoid hemorrhage were first described by Byer et al, in 1947.1 We report the case of 72 years old female patient who developed subarachnoid hemorrhage and intraventricular hemorrhage with ST-segment elevation.
Aged ; Electrocardiography ; Female ; Hemorrhage ; Humans ; Myocardial Infarction ; Subarachnoid Hemorrhage*

A 69-year-old man was admitted to the hospital because of flu-like symptoms and fatigue for 2 weeks. Computed tomography revealed ground glass opacity and consolidation in both the lungs as well as pleural effusion. The patient was diagnosed with pneumonia and was hospitalized. At the time of hospitalization, he complained of shortness of breath and coughed-up blood-tinged sputum. Two days after admission, he died suddenly. An autopsy was performed; cardiomegaly was noted, and further examination revealed that the aortic valve had been destroyed by multiple, irregular vegetations. Herein, we report an autopsy case of infective endocarditis with a review of the relevant literatures.
Aged ; Aortic Valve ; Autopsy* ; Cardiomegaly ; Dyspnea ; Endocarditis* ; Fatigue ; Glass ; Hospitalization ; Humans ; Lung ; Pleural Effusion ; Pneumonia ; Sputum

STUDY DESIGN: A case report. OBJECTIVES: To report a case of cauda equine syndrome due to a lumbar intradural disc herniation. SUMMARY OF LITERATURE REVIEW: IDH is rare but there is a higher incidence of neurologic deficit in IDH. Therefore, it should be treated immediately. MATERIALS AND METHODS: A 34-year-old male patient was presented with cauda equina syndrome due to a lumbar intradural mass and underwent surgical excision. RESULTS: Operative findings and the histologic study revealed an intradural disc herniation. CONCLUSIONS: IDH is very rare lesion but should be considered in a differential diagnosis if preoperative MRI demonstrates an intradural lesion.
Adult ; Diagnosis, Differential ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Polyradiculopathy

No abstract available.
Wilms Tumor*

Malignant mixed mullerian tumor (MMMT) arising from female internal genitalia is rare with the uterine corpus being the most prevalently affected site. It is even more rare when it occurs on both uterus and ovary at the same time. We describe a case of synchronized occurrence of MMMT on ovary and uterine adenosarcoma with review of literature.
Adenosarcoma ; Female ; Genitalia ; Humans ; Ovary ; Uterine Neoplasms ; Uterus

PURPOSE: To evaluate contrast enhancement patterns of hemangioma according to size, as seen during thearterial and portal venous phase of spiral CT. MATERIAL AND METHODS: During a recent six month-period, 52patients with hemangiomas underwent two-phase spiral CT examination with 10mm collimation at 10mm/sec table speed,and with 100mL of contrast material(37g iodine) injected at a rate of 2.5 mL/sec. CT images of the hepaticarterial and portal venous phase were obtained with 30-second and 65-second delay, respectively. In 52 patients,82 hemangiomas were seen. The diameter of the tumors were as follows ; < or =10 mm(n=31), 11-20 mm(n=19), and> or =21mm(n=32). The enhancement patterns of tumors compared with attenuation of surrounding liver parenchyma weredivided into four types : peripheral high, uniform high, iso, and low. RESULTS: Overall, the most commonenhancement pattern was peripheral high(44/82, 53.7%), during the arterial and portal venous phase. The second andthird most common patterns were uniform high(11/82, 13.4%) and peripheral high-uniform high(9/82, 11.0%), alsoduring the arterial and portal venous phase. Sixty-one(74.4%) showed peripheral high attenuation andeleven(13.4%), uniform high attenuation, during the arterial and/or portal venous phase. In tumors smaller than20mm, low-low attenuation was seen in eight(9.8%), and iso-low attenuation in two(2.4%), during the arterial andportal venous phase, respectively. CONCLUSION: On two-phase spiral CT, the most common enhancement pattern ofhemangioma was peripheral high, seen during the arterial and portal venous phase. However, a small hemangioma lessthan 2 cm may show atypical patterns, including low and iso attenuation.
Hemangioma* ; Liver ; Tomography, Spiral Computed*

Chronic granulomatous disease in childhood is a rare inheritable disorder of phagocytic cells in which defective production of the reactive intermediates of oxygen predisposes the patient to severe recuring pyogenic infections. The lung is the most common site of infection and pulmonary disease is the primary cause of death for greater than 50% of children with chronic granulomatous disease. Although the role of surgery in management of this disease remains undefined, rapid diagnosis of the underlying pulmonary problem is crucial to determine the most appropriate antimicrobial therapy and surgical techniques such as lobectomy of involved areas lead to more rapid recovery and thus allow the antibiotics to be more efficacious in these cases. We have treated a one month old male baby who had the chronic granulomatous disease with pulmonary infection. Wide surgical resection of the affected lobe and use of antibiotics and antifungals were carried out with good clinical results. He was well after the operation.
Anti-Bacterial Agents ; Cause of Death ; Child ; Diagnosis ; Granulomatous Disease, Chronic* ; Humans ; Lung ; Lung Diseases ; Male ; Oxygen ; Phagocytes

PURPOSE: To assess the effect of a rectal enema on interfraction prostate movement in bone alignment (BA) for prostate radiotherapy (RT), we analyzed the spatial difference in prostates in a bone-matched setup. MATERIALS AND METHODS: We performed BA retrospectively with data from prostate cancer patients who underwent image-guided RT (IGRT). The prostate was identified with implanted fiducial markers. The setup for the IGRT was conducted with the matching of three fiducial markers on RT planning computed tomography images and those on two oblique kV x-ray images. Offline BA was performed at the same position. The coordinates of a virtual prostate in BA and a real prostate were obtained by use of the ExaxTrac/NovalisBody system, and the distance between them was calculated as the spatial difference. Interfraction prostate displacement was drawn from the comparison of the spatial differences. RESULTS: A total of 15 patients with localized prostate cancer treated with curative hypofractionated IGRT were enrolled. A total of 420 fractions were analyzed. The mean of the interfraction prostate displacements after BA was 3.12+/-2.00 mm (range, 0.20-10.53 mm). The directional difference was profound in the anterior-posterior and supero-inferior directions (2.14+/-1.73 mm and 1.97+/-1.44 mm, respectively) compared with the right-left direction (0.26+/-0.22 mm, p<0.05). The required margin around the clinical target volume was 4.97 mm with the formula of van Herk et al. CONCLUSIONS: The interfraction prostate displacement was less frequent when a rectal enema was performed before the procedure. A rectal enema can be used to reduce interfraction prostate displacement and resulting clinical target volume-to-planning target volume margin.
Enema* ; Fiducial Markers ; Humans ; Prostate* ; Prostatic Neoplasms ; Radiotherapy* ; Retrospective Studies

The coronary vasospasm has usually been readily reversible by sublingual, intravenous or intracoronary nitroglycerin. Relief of spasm, either spontaneous or following nitrate therapy, results in reperfusion. Occurence of ventricular tachyarrhythmia during release of coronary spasm is attractive as a possible cause of sudden death because of significant proportion of sudden death victims do not have acute myocardial infarction. Recently, we experienced a 36 year old man who developed spontaneous coronary vasospasm, and the patients suffered from repetitive reperfusion ventricular tachyarrhythmia, and died suddenly in spite of administration of isosorbide dinitrate, lidocaine and several trials of cardioversion and cardiopulmonary resuscitation, and we report.
Adult ; Cardiopulmonary Resuscitation ; Coronary Vasospasm ; Death, Sudden* ; Electric Countershock ; Humans ; Isosorbide Dinitrate ; Lidocaine ; Myocardial Infarction ; Nitroglycerin ; Reperfusion* ; Spasm ; Tachycardia*

PURPOSE: To analyze the effect of various parameters used in PEIT on the short-term results of this procedurefor the treatment of small HCC. MATERIALS AND METHODS: Among 76 lesions in 63 patients with HCCs, 66 werediagnosed by tissue biopsy (n=30) or according to clinical features, tumor marker, and the results of angiographyand other diagnostic imagings (n=36). These patients underwent PEIT between November 1993 and October 1996 ; theindications for PEIT were nodular lesions less than 3cm in size, less than three in number, and unsuitable forsurgical resection or transcatheter arterial chemoembolization therapy. The effect of PEIT was evaluated by twophase spiral CT one month later (64 lesions) or by serial ultrasound for 6 months. We analyzed and graded theshort-term effect of PEIT on HCCs as complete remission (CR), partial remission (PR) or no change/aggravation(NC/AG). We also evaluated the correlation between the short-term results of PEIT and variable parameters such assize of the lesion, frequency of PEI per session, Child classification of the patient, the ratio of amount ofinjected ethanol per volume of the lesion, and (alpha-fetoprotein level before the procedure. RESULTS: Thetherapeutic effect of PEIT was CR in 45 lesions (59.2%), PR in 18(23.7%) and NC/AG in 13(17.1%). The size of thetumor, Child-Pugh class, number of injections per session and ratio of injected volume of ethanol to tumor volumewere factors affecting the therapeutic result (p <0.05). CONCLUSION: Sufficient knowledge of prognostic factorsaffecting the short-term results of PEIT might help improve the effects of therapy in patients ith small HCCs.
Biopsy ; Carcinoma, Hepatocellular* ; Child ; Classification ; Ethanol* ; Follow-Up Studies* ; Humans ; Tomography, Spiral Computed ; Ultrasonography