Eosinophilia accompanied by eosinophilic invasion and organ dysfunction may develope idiopathic hypereosinophilic syndrome. Any organ can be involved including bone marrow, lung, skin, heart, gastrointestinal tract and nervous system. Cough, dyspnea, pleural effusion or chest pain are common pulmonary manifestation, and they may be attributed to parenchymal infiltration, pulmonary embolism or heart failure. We report a 43-year-old woman with idiopathic hypereosinophilic syndrome involving bone marrow, skin, and lung. The patient developed acute dyspnea and chest pain. High resolution CT demonstrated multiple wedge-shaped segmental involvement with pleural effusion thought to be a pulmonary infarction or heart failure. Echocardiography could not find any abnormality. Lung biopsy showed interstitial eosinophilic infiltration with increased eosinophils in BAL fluid. She was treated with high dose corticosteroid and hydroxyurea. Within few days, most of her symptoms disappeared and chest radiography nearly cleared up.
Adult ; Biopsy ; Bone Marrow ; Chest Pain ; Cough ; Dyspnea ; Echocardiography ; Eosinophilia ; Eosinophils ; Female ; Gastrointestinal Tract ; Heart ; Heart Failure ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Lung ; Nervous System ; Pleural Effusion ; Pulmonary Embolism ; Pulmonary Infarction ; Radiography ; Skin ; Thorax

The clinical evaluation was done in eighteen eyes of nine patients with bilateral BRVO in aspects of onset, visual acuity, interval between onset of one eye and the other, sex ratio, associated systemic diseases, location of the affected vein, the effect of macular edema on visual acuity and ocular complications. The onset of age was from fifty one to sixty eight years. Eight patients were women, and one patient was man. Hypertension was the most common associated systemic disease. Ten eyes (55.5%) of bilateral BRVO were affected the superior temporal branch vein, the sites of occlusion were not more than two disc diameters from the optic disc in fifteen eyes (83.3%). The complications of seevere visual loss had macular edema, macular capillary nonperfusion, retinal neovascularization and vitreous hemorrhage. Among of six numbers who could be followed up more than one year, and visual acuity of five eyes with macula edema were decreased than five other eyes developed one year or later. Eyes that were more than five disc diameters of capillary nonperfusion, as visualized with fluorescence angiography were thirteen (72.2%). Of these eyes, six (46.1 %) eyes occured retinal neovascularization, five of those had macular capillary nonperfusion. four of those were 0.1 in final vision. Three of four eyes with vitreous hemorrhage were very slowly improved in visual acuity, but another was decreasing in visual acuity due to other ocular complications We thought that woman with history of BRVO due to hypertension in sixth and seventh decades should be followed up the other eye for three years.
Capillaries ; Edema ; Female ; Fluorescein Angiography ; Humans ; Hypertension ; Macular Edema ; Retinal Neovascularization ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Sex Ratio ; Veins ; Visual Acuity ; Vitreous Hemorrhage

No abstract available.
Biopsy*

From October 1991 to April 1996, 27 patients underwent aortocoronary bypass graft. There were 17 men, 10 women. The mean age was 65 years(range 45 to 76). The preoperative clinical status were chronic stable angina in 11 cases, unstable angina in 13 cases and postinfarction angina in 3 cases. The involved risk factors were as follows: Hypertension in 7 cases, Diabetes Mellitus in 5 cases and any other diseases in 3 cases. We divided these patients into two groups in this survey: The A group was 15 patients who were managed with cardioplegia from 1991 to 1994. The B group of 12 patients was done with intermittent aortic clamping without cardioplegia from 1995 to 1996. The mean numbers of graft per patient was 2.0 in A group and 2.83 in B group. The ischemic time per graft was 27.3 minute in A group and 18.5 minute in B group respectively. The morbidity was occlusion of grafted vessel in one patient and one of postoperative angina in A group. The total mortality was 14.8%(4/27), but mortality of B group was 8.3%(1/12).
Angina, Stable ; Angina, Unstable ; Constriction ; Coronary Artery Bypass* ; Coronary Vessels* ; Diabetes Mellitus ; Female ; Heart Arrest, Induced ; Humans ; Hypertension ; Male ; Mortality ; Risk Factors ; Transplants

From Feb. 1985 to Aug. 1996, 450 patients underwent open heart surgery with hypothermic cardiopulmonary bypass. In 450 cases of open heart surgery, 222 cases(49.3%) were congenital heart diseases and 228 cases(50.7%) were acquired heart diseases. In 222 cases of congenital heart diseases, there were 201 cases of acyanotic heart disease and 21 cases of cyanotic heart diseases. Among the 228 cases of acquired heart diseases, most cases were valvular heart diseases in which 206 valves were implanted. There were 32 cases of ischemic heart disease and the average graft anastomoses were 2.37 sites per operation. The operative mortality of congenital and acquired disease was 9.0% and 10.1% respectively and then overall mortality rate was 9.6%.
Cardiopulmonary Bypass ; Heart Diseases ; Heart Valve Diseases ; Heart* ; Humans ; Mortality ; Myocardial Ischemia ; Thoracic Surgery* ; Transplants

Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.
Amyloidosis ; Anemia, Hemolytic* ; Delayed Diagnosis ; Diagnosis ; Diagnostic Errors ; Glomerulonephritis* ; Hemolytic-Uremic Syndrome ; Humans ; Infant* ; Lupus Erythematosus, Systemic ; Male ; Purpura, Thrombotic Thrombocytopenic ; Thrombocytopenia*

Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.
Amyloidosis ; Anemia, Hemolytic* ; Delayed Diagnosis ; Diagnosis ; Diagnostic Errors ; Glomerulonephritis* ; Hemolytic-Uremic Syndrome ; Humans ; Infant* ; Lupus Erythematosus, Systemic ; Male ; Purpura, Thrombotic Thrombocytopenic ; Thrombocytopenia*

Tuberculous spondylitis, also known as Pott's disease, is a disease involving the spine with progressive destruction. It most commonly involves the thoracic and lumbosacral spine and may result in severe deformity or neurologic deficit. Although cervical spine involvement is rare, it can cause life threatening event. Recently, 70-year-old man presented with progressive dyspnea and dysphagia. Physical examination and radiologic studies showed a huge retropharyngeal abscess with bony erosion and sclerotic change at the adjacent cervical spine. After incision and drainage, it was finally confirmed as a tuberculous abscess. Herein, we report our experience with literature review.

Tuberculous spondylitis, also known as Pott's disease, is a disease involving the spine with progressive destruction. It most commonly involves the thoracic and lumbosacral spine and may result in severe deformity or neurologic deficit. Although cervical spine involvement is rare, it can cause life threatening event. Recently, 70-year-old man presented with progressive dyspnea and dysphagia. Physical examination and radiologic studies showed a huge retropharyngeal abscess with bony erosion and sclerotic change at the adjacent cervical spine. After incision and drainage, it was finally confirmed as a tuberculous abscess. Herein, we report our experience with literature review.
Abscess ; Aged ; Congenital Abnormalities ; Deglutition Disorders ; Drainage ; Dyspnea ; Humans ; Neurologic Manifestations ; Physical Examination ; Retropharyngeal Abscess ; Spine ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

Acromegaly is a rare endocrine disorder caused by excessive secretion of the growth hormone. There is a wide range of clinical manifestations from somatic symptoms to respiratory or cardiac failure. Among them, cardiovascular involvement is a leading cause of morbidity and mortality. There are relatively few cases reporting cardiac magnetic resonance imaging (CMR) findings of cardiomyopathy in patients with acromegaly. Thus, we report a case of acromegaly showing dilated cardiomyopathy focusing on the findings of CMR.
Acromegaly ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Growth Hormone ; Heart Failure ; Humans ; Magnetic Resonance Imaging ; Mortality