To see the usefulness of CT in evaluation of response to treatment in patients with mediastinal tuberculous lymphadenitis (MTL), we analyzed the initial CT patterns and follow-up CTs or serial plain radiographs during 18 months antituberculous chemotheraphy in 58 consecutive patients. CT patterns of MTL at the beginning of treatment were categorized into solid type (n=8), low density with peripheral rim enhancement type (n=36), extranodal extension type (n=9) and calcified type (n=5). According to the response to treatment, each patients was categorized into prompt response group (response within the first three months and no residual lymph node after one year), slow response group (response after three months but residual lesion after one year), no response group (no change in size during 18 months treatment) and temporal increase group (temporal increase in size during the treatment but ultimately improved with chemotheraphy). Among 29 cases of prompt response group, 20 cases had large low-density areas, 6 cases had diffuse or extensive node involvement with extranodal extension or tracheal compression. Two patients with acquired immune derfciency syndrome belonged to this group. Fifteen cases of slow response group had low-density nedes in 7 patients and small solid or extranodal-extension nodes in 6 patients. They were associated with disseminated pulmonary tuberculosis, generalized lymphadenopathy or other organ(pericardium, brain, bone or abdomen) involvement. In 5 cases of no response group, there were 3 cases of calcified node and 2 cases of small solid nodes. Nine cases of temporal increase group included low density type of MTL only. And they were associated with disseminated pulmonary of endobronchial tuberculosis. In conclusion, response to antituberculous chemotherapy could be predicted in patients with MTL on the basis of CT findings before treatment.
Brain ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Tuberculosis ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary

No abstract available.
Gastric Emptying* ; Hepatitis B, Chronic* ; Hepatitis, Chronic*

Acute eosinophilic pneumonia is reported as a specific disease entity. But, it is different from chronic eosinophilic pneumonia in its onset, clinical course and recurrence. Badesh et al reported the following diagnostic criteria os acute eosinophilic pneumonia a less than one-month history of symptoms prior to diagnosis, no evidence of asthma, the absence of other organic disease, no obvious etiology and an evidence of recurrent disease. We experienced a case of acute eosinophilic pneumonia in 37 old male. Pathologically eosinophilic pneumonia is confirmed and other features meet Badesh's criteria.
Asthma ; Diagnosis ; Eosinophils* ; Humans ; Male ; Pulmonary Eosinophilia* ; Recurrence

Gestational trophoblastic tumor became one of the curable disease due to the development of chemotherapy, appropriate follow up of beta- human chorionic gonadotropin and others. But metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy and large tumor burden.One of the important prognostic factors determining the prognosis of gestational trophoblastic tumor is antecedent pregnancy, which affects the response to therapy. Choriocarcinoma following term pregnancy is rare one with the incidence of one per 160,000 pregnancies in United States and the prognosis is poor because of late diagnosis and combined high risk prognostic factors.We present a choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to profuse bleeding with brief review of literatures.
Choriocarcinoma* ; Chorionic Gonadotropin ; Delayed Diagnosis ; Drug Therapy ; Emergencies ; Female ; Follow-Up Studies ; Hemorrhage ; Hysterectomy ; Incidence ; Mortality ; Pregnancy ; Pregnancy* ; Prognosis ; Trophoblastic Neoplasms ; United States

While cardiac myxoma is a rare cause of stroke, it needs to be considered so that it can be detect promptly. We report the magnetic resonance imaging (MRI) characteristics of three patients who were histologically confirmed as cardiac myxoma. MRI revealed multiple infarctions in bilateral hemispheres and hemorrhagic transformation including microbleeds and macrobleeds. If either petechial hemorrhage or microbleeds along the cortical border zone are identified in MRI of acute stroke patients, the possibility of cardiac myxoma should be considered.
Cerebral Infarction ; Hemorrhage ; Humans ; Infarction ; Intracranial Embolism* ; Magnetic Resonance Imaging* ; Myxoma* ; Stroke

BACKGROUND: Herpes zoster is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. Central nervous system(CNS) involvements are uncommon complications of herpes zoster. The exact mechanism and risk factors are still unknown. METHODS: We retrospectively reviewed the clinical data of patients who was admitted at our hospital due to herpes zoster from 2003 to 2013. The patients under age 15, herpes zoster infection without skin lesions, and cases not confirmed by a dermatologist were excluded. CNS involvements are defined as meningitis, encephalitis, single or multiple cranial neuropathies and all cases were evaluated with brain magnetic resonance imaging, spinal tapping, serological tests and confirmed by a neurologist. We compared the herpes zoster patients with CNS involvement to those without CNS involvement. Age, sex, body mass index, associated chronic medical illnesses, site and extent of skin lesion and development of post herpetic neuralgia were compared between two groups. RESULTS: Total 1,131 subjects (male 460, female 671) were recruited. A group with CNS involvement was 91(8.04%). Sex, body mass index, associated chronic medical illnesses, extent of skin lesion were not different between two groups. A group with CNS involvement showed younger age(p<0.01), more facial and cervical skin lesions(p<0.01), lesser development of post herpetic neuralgia(p=0.048). CONCLUSIONS: CNS involvement is not a rare complication of herpes zoster and more frequent in patients with younger age and faciocervical zoster.
Blister ; Body Mass Index ; Brain ; Central Nervous System* ; Cranial Nerve Diseases ; Encephalitis ; Exanthema ; Female ; Herpes Zoster* ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Neuralgia ; Retrospective Studies ; Risk Factors ; Serologic Tests ; Skin ; Spinal Puncture ; Virus Diseases

BACKGROUND: The prognosis of syncope is related to the severity of the underlying disease, including cerebral disease, rather than of the syncope itself. The aim of this study was to identify the clinical factors related to the cerebral comorbidity confirmed on brain imaging of syncope patients. METHODS: We retrospectively reviewed the medical records of patients who were diagnosed as syncope and underwent brain magnetic resonance [MR] imaging between January 2011 and December 2014. An abnormal MR lesion was defined as the presence of one or more of the following: (1) ischemic lesion, (2) major cerebral artery occlusion or stenosis over 50%, (3) cerebral aneurysm or vascular abnormalities, and (4) other traumatic or parenchymal lesion. The findings of electroencephalography and clinical factors that might be related to abnormal lesions in brain MR images were investigated. RESULTS: Of 347 (mean age 50.5 years, 48.1% females) patients, abnormal imaging findings were observed in 48 (13.8%). The clinical factors related to abnormal findings were age, hypertension, diabetes mellitus, and coronary artery disease. Independent factors for an abnormal MR lesion were age (odds ratio=1.05, 95% confidence interval [CI] 1.03-1.08, p <0.001) and hypertension (odds ratio=2.73, 95% CI 1.34-5.60, p=0.006). Abnormal electroencephalography findings were noted in 52 (20.3%) of 256 investigated patients. Generalized or focal slowing was observed more frequently in elderly patients (p<0.001) and in the presence of abnormal brain MR lesions (p=0.013). CONCLUSIONS: In syncope patients with hypertension or who are elderly, a brain MR image may be helpful for detecting comorbid brain lesions.
Aged ; Brain ; Cerebral Arteries ; Comorbidity ; Constriction, Pathologic ; Coronary Artery Disease ; Diabetes Mellitus ; Electroencephalography ; Humans ; Hypertension ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Medical Records ; Neuroimaging ; Prognosis ; Retrospective Studies ; Syncope*

The Alstrom syndrome is inherited autosomal recessive disorder, characterized by obesity, diabetes mellitus, pigmentary retinal degeneration, normal intelligence, sensorineural hearing loss, baldness, acanthosis nigricans, male hypogonadism, hyperuricemia and hypertriglyceridemia. There is no reported case of Alstrom syndrome in Korea yet. We experienced a 29-year-old female patient with clinical characteristics similar to Alstrom syndrome who was admitted due to poorly controlled diabetes mellitus and diabetic retinopathy with hemorrhage. We report this case with the review of literatures.
Acanthosis Nigricans ; Adult ; Alopecia ; Alstrom Syndrome* ; Diabetes Mellitus ; Diabetic Retinopathy ; Female ; Hearing Loss, Sensorineural ; Hemorrhage ; Humans ; Hypertriglyceridemia ; Hyperuricemia ; Hypogonadism ; Intelligence ; Korea ; Male ; Obesity ; Retinal Degeneration

BACKGROUN: Recently there has been notion that fluids bathing tumors might contain higher levels of carcinoembryonic antigen (CEA) than those found in the blood. Thus, we evaluated the diagnostic role of biliary CEA in patients with pancreatobiliary diseases. METHODS: One hundred and twenty one patients were prospectively studied. The patients were grouped as control (n=21), benign diseases (n=57), and malignant diseases (n=43). All patients underwent endoscopic or percutaneous biliary drainage. Bile was obtained and analyzed for CEA concentration on the next day of biliary drainage procedure. RESULTS: The mean biliary CEA were significantly different among the groups: control, 3.6 +/- 6.5 ng/mL; benign diseases, 35.4 +/- 59.2 ng/mL; malignant diseases, 77.9 +/- 126.6 ng/mL. But, there was considerable overlap among the groups. With a cut-off level of 22 ng/mL, the sensitivity and specificity were 58.1% and 60.5%, respectively. Among the variables, biliary CEA, total bilirubin, and gamma-GT were directly correlated with presence of malignancy. However, multivariate analysis revealed that biliary CEA was not enough to differentiate malignant diseases from benign diseases. CONCLUSION: Although biliary CEA levels might be predictive of malignancy, it is very difficult to differentiate with fair certainty between the two diseases because of the considerable overlap. Thus, biliary CEA appears to have a limitation for routine clinical application in distinguishing between benign and malignant diseases.
Baths ; Bile ; Biliary Tract Diseases ; Bilirubin ; Carcinoembryonic Antigen* ; Drainage ; Humans ; Multivariate Analysis ; Pancreatic Diseases ; Prospective Studies ; Sensitivity and Specificity

Takayasu's arteritis is one of the most important causes of the renovascular hypertension in orientals. Among the multiple treatment modalities, percutaneous transluminal renal angioplasty(PTRA) has become the treatment of the choice for major renal artery stenosis and is a safe, repeatable, effective procedure for the treatment of renovascular hypertension due to Takayasu's arteritis. We experienced a case of percutaneous transluminal balloon angioplasty of Takayasu's arteritis involving the proximal left renal artery. After PTRA, clinical and angiographical improvements were achieved.
Angioplasty* ; Angioplasty, Balloon ; Hypertension, Renovascular ; Renal Artery Obstruction* ; Renal Artery* ; Takayasu Arteritis*