Although the reported number of malignant lymphoma of the thyroid has been increased, primary malignant lymphoma of the thyroid associated with chronic lymphocytic thyroiditis has been sporadically reported since its first description by Graham in 1931. The apparent coexistence of these two conditions has undoubtedly been noted by other observers. And they suggested that malignant lymphoma of the thyroid might arise from the lymphoid tissue ina wide variety of preexisting thyroidal disease. This report was made to record a case of primary thyroid lymphoma recently seen in this department with special emphasis on the associated thyroiditic changes in the uninvolved portion of the gland, which suggest the antecedent presence of chronic lymphocytic thyroiditis.

Claude syndrome is a well known midbrain syndrome which is characterized by ipsilateral oculomotor nerve palsy and contralateral cerebellar ataxia by the lesion of the red nucleus. Although this syndrome was reported as early as in 1924 by Claude, only a few cases have been reported. Moreover, the midbrain infarction as a cause of Claude syndrome has quite rarely been described. Firstly, we report a 61-year-old patient with partial oculomotor nerve palsy and contralateral cerebellar ataxia who demonstrated an infarction just caudal to the red nucleus on MRI. Secondly, we also discuss the probable vertical fascicular arrangement of the oculomotor nerve in the midbrain.
Brain Stem Infarctions* ; Cerebellar Ataxia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Mesencephalon* ; Middle Aged ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Red Nucleus

Young adult stroke is not rare disease and have diverse causes. We studied 135 young adults aged 15 - 45 years who had been admitted to Severance Hospital with a diagnosis of cerebral infarction from January 1990 to June 1995. The results are as follows. 1. The diverse causes of earshot infarction in young adults have been found in most patients(88.2%). The major causes of cerebral infarction in young adults were atherosclerosis(32.6%) and cardioembolism(32.6%). The causes were significantly different between younger(15 - 30 years old) and older(31 - 45 years old) patients. 2. The major risk factors of atherosclerotic cerebral infarction were hypertension(29 patients), smoking(14 patients), and hyperlipidemia(11 patients). 3. The major causes of cardioembolism were valvular heart disease(21 patients) and prosthetic valve(I0 patients). The mitral valve prolapse was discovered only in one patient. 4. Fourteen patients had non-atherosclerotic vasculopathies. The moyamoya disease was the most common cause of them. 5. The other causes of cerebral infarction were found in 17 patients and the major causes were alcohol intoxication and postoperative thromboembolism. 6. The cerebral infarction occurred mostly in the carotid artery territory(95 patients) and the distribution of the involved vascular territory was not different between younger and older age groups. 7. The clinical outcomes were good in most patients (86, 7%). From the above results, we demonstrated that young adults with cerebral infarction had various causes and showed favorable clinical outcomes. We also found that the causes of cerebral infarction varied between younger and older groups. Our findings suggest that careful and thorough case-by-ease evaluation may be mandatory to clarify the causes of cerebral infarction in young adults.
Carotid Arteries ; Cerebral Infarction* ; Diagnosis ; Heart ; Humans ; Infarction ; Mitral Valve Prolapse ; Moyamoya Disease ; Rare Diseases ; Risk Factors ; Stroke ; Thromboembolism ; Young Adult*

The antihypertensive effect of Doxazocin were evaluated in 20 patients with essential hypertension. Two to eight mg of Doxazocin per day were administered continuously for two or eight weeks. The results were as follows : 1) Doxazocin were effective in 18 out of 20 patients(90%) at the end of 8 weeks treatment. 2) The systolic blood pressure was signigicantly decreased(173+/-20mmHg VS 144+/-33mmHg, P+/-0.001), and the diastolic blood pressure was also decreased(110+/-10mmHg VS 93+/-19mmHg, P<0.01) after treatment. 3) Triglyceride showed a decreasing tendency but statistically significance was not observed. Total cholesteral, HDL-cholesterol, BUN, creatinine, and uric acid did not change significantly before and after treatment with Doxazocin. 4) The side effects were headache in one case and dizziness in to cases. These results suggest that Doxazocin is an effective antihypertensive agent and concerning lipid profile, further long term observation is needed.
Blood Pressure ; Creatinine ; Dizziness ; Headache ; Humans ; Hypertension* ; Triglycerides ; Uric Acid

Time intervals and indices of left ventricular diastolic filling were studied by M-mode and pulsed Doppler Echocardiography in 18 dilated cardiomyopathy patients. After one two hours captopril(capril(R)) 25mg medication. 1)Systolic blood pressure, Diastolic blood pressure, Heart rate were significantly decreased. 2) Dimensions of LVSD, LVDD, LA, Aorta and EF were not changed measured by M-mode echocardiography. 3) IRT measured by M-mode and Pulsed Doppler echocardiography were significantly increased(45+/-33msec VS 74+/-35msec. 84+/-32msec VS 100+/-22msec P<0.05). 4) A2-E measured by M-mode and Pulsed Doppler echocardiography were significantly increased(114+/-45msec VS 134+/-46msec, 156+/-46msec VS 194+/-48msec, P<0.05). 5) Deceleration time was significantly increased(137+/-36msec VS 205+/-40msec P<0.05). 6) Transmitral peak flow velocities were not changed significantly. In summary captopril influences early diastolic time intervals with dilated cardiomyopathy patients and we interpreted these effects be beneficial on diastolic filling pattern.
Aorta ; Blood Pressure ; Captopril ; Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans

Organ transplantation has become a' widely accepted treatment modality for end-stage organ disease. The shortage of allogenic donors for organ transplantation has brought about the necessity of xenotransplantation as an unlimited source of organ donation. However, organ transplantation between different species have never been successful because of hyperacute rejection. Although the mechanism of this phenomenon is not fully understood, many researchers believe that the natural antibodies present in the recipient's serum may bind to the graft and induce the activation of complement cascade triggering the process of hyperacute rejection. ...continue...
Antibodies ; Complement System Proteins ; Heterografts ; Humans ; Organ Transplantation ; Tissue and Organ Procurement ; Tissue Donors ; Transplantation, Heterologous ; Transplants

OBJECTIVE: We have studied the factors that influence the pregnancy rate in ovarian hyperstimulation and intrauterine insemination (IUI) in infertility patients. METHODS: Seventy two patients who visited the infertility clinic in Dongguk University Kyong-ju hospital from January 2002 to December 2003 underwent IUI after 99 cycles of ovarian hyperstimulation. We administered clomiphene with exogenous gonadotropin from cycle day 3 and then IUI was performed. The variables selected for retrospective analysis were patient's age (<35 years), duration (<6 years) and type (primary or secondary) and etiology of infertility, number of treatment cycles (>or=2), number of follicles (>or=2), size of dominant follicle (>or=18 mm), total sperm counts (>or=10 X 10(6)). Chi-square test, Fisher's exact test and a multiple logistic regression analysis were used to detect differences between groups in each variable. RESULTS: The pregnancy rate per patient was 29.2% (21/72) and 21.2% (21/99) per cycle. Factors that influenced pregnancy rate were age, number of treatment cycles, number of preovulatory follicles (>or=16 mm), and total inseminated motile sperm counts, all of which showed significant differences (p<0.05). Multiple logistic regression analysis identified significant predictors as age (<35 vs. >or=35), number of treatment cycles (2 cycle vs. 1 cycle), number of preovulatory follicles (>or=16 mm) (>or=3 vs. 1), and total inseminated motile sperm counts (>or=40 X 10(6) vs. <10 X 10(6)). The odds ratio of each of these variables were 12.6, 3.37, 11.64, and 10.59. CONCLUSION: For successful pregnancy rates in IUI after ovarian hyperstimulation, the patient's age, number of treatment cycles, number of preovulatory follicles, and total inseminated motile sperm counts should be considered.
Clomiphene ; Gonadotropins ; Gyeongsangbuk-do ; Humans ; Infertility ; Insemination* ; Logistic Models ; Odds Ratio ; Pregnancy Rate* ; Pregnancy* ; Retrospective Studies ; Sperm Count

Neuroblastoma is the most common intraabdominal malignant tumor of childhood, with 40% arising from the adrenal gland. Bilateral adrenal involvement from synchronous development or metastatic spread of tumor is rarely seen in children with neuroblastoma. The patient was born with a spontaneous vaginal delivery. Birth weight was 3,200 g. Fetal ultrasonography showed a left adrenal cystic mass. At two weeks of age, she was admitted due to a massive abdominal distension and tachypnea. Percutaneous ultrasonography guided biopsy of the left adrenal mass was performed. The result of the biopsy was neuroblastoma. Vincristine and cyclophosphamide were administerd intravenously and 450 cGy of irradiation was added. Left adrenalectomy was accomplished and postoperative course was uneventful. The patient received cancer chemotherapy with a combination of carboplatin, ifosfamide and VP-16 and is now being followed up for three months. We have experienced a case of congenital bilateral neuroblastoma and report the case with brief review of related literatures.
Adrenal Glands ; Adrenalectomy ; Biopsy ; Birth Weight ; Carboplatin ; Child ; Cyclophosphamide ; Drug Therapy ; Etoposide ; Humans ; Ifosfamide ; Neuroblastoma* ; Tachypnea ; Ultrasonography ; Ultrasonography, Prenatal ; Vincristine

OBJECTIVE: The role of community mental health centers (CMHCs) in Korea is quite different than that of these centers in Western countries due to nation-specific health care system characteristics. For example, CMHCs of Korea are expected to provide services for serious mental illness in addition to other services in response to community needs, such as internet addiction of adolescents. Consequently, it is important to determine service priorities of CMHCs and to define standard service performances in order to maximize their effectiveness with limited resources. The present study aimed to generate expert consensus on service priorities and to identify standard service performances of CMHCs in South Korea. METHODS: Forty-five mental health professionals participated as experts in a Delphi survey. We made a survey questionnaire based on Korean and international data and guidelines of some countries such as the UK and Australia. Experts answered the first and second round questionnaires and their answers were analyzed using frequency analysis. RESULTS: For the question about future directions of CMHCs, twenty-two experts (49%) answered that the growth of services for serious mental illness should be preferred to other areas. The service for chronic mental illness was thought to be the most important service area (27.1%) and, early psychosis (10.5%) is included, the services for serious mental illness should be regarded as the most important service area of Korean CMHCs. It is followed by child and adolescent services (13.2%) and mental health promotion services (10.8%). The relative importance of service performances on each service domain were given by answers of experts. CONCLUSION: CMHCs in Korea should focus their priority on the management of serious mental illness. Service standardization by the relative importance of service performances on each service domain is needed.
Adolescent ; Australia ; Child ; Community Mental Health Centers ; Consensus ; Delivery of Health Care ; Humans ; Internet ; Korea ; Mental Health ; Psychotic Disorders ; Surveys and Questionnaires ; Republic of Korea

BACKGROUND & SIGNIFICANCE: The neurological manifestations associated with Epstein-Barr viral (EBV) infection includes meningoencephalitis, Guillain Barre syndrome (GBS), Bell's palsy, myelopathy, and radiculopathy. To the best of our knowledge, the neurological manifestation associated with EBV infection has never been reported in Korea. Cases & RESULTS: We have found five patients (3 men, 2 women, mean age 28.4 years ; range 23-42) with EBV-associated neurological illness between August 1994 and July 1995. Serum enzyme immunoassay (EIA) tests for anti- early antigen(EA) IgM and anti-Epstein Barr nucleic acid (EBNA) IgG was positive in all patients, suggestive of reactivated EBV reaction. They showed a wide spectrum of neurological manifestations: 2 meningoecnephalomyelitis, 1 meningoencephalitis and cervical radiculopathy, 1 meningoencephalitis, and 1 GBS. T2-weighted brain magnetic resonance imaging studies showed high signal intensity lesions in three of the four patients who had meningoencephalitis. Outcomes were excellent in all but one patient. CONCLUSIONS: We present five patients with a wide spectrum of neurological manifestations associated with EBV infection. We suggest that one should suspect the EBV infection in a variety of neurological diseases of uncertain etiology.
Bell Palsy ; Brain ; Epstein-Barr Virus Infections ; Female ; Guillain-Barre Syndrome ; Herpesvirus 4, Human ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Magnetic Resonance Imaging ; Male ; Meningoencephalitis ; Neurologic Manifestations* ; Radiculopathy ; Spinal Cord Diseases