A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function.
Adult ; Female ; Fetus ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism ; Liver* ; Pregnancy ; Risk Factors ; Thiamine ; Thyroid Crisis* ; Thyroid Gland* ; Wernicke Encephalopathy*

No abstract available.
Plasma*

In order to elucidate the biological effects of pulsating magnetic field in in vitro culture system we designed a pulsating magnetic apparatus using 120 Hertz, 24 Volt direct current. It can generate 63~225 Gauss in the experimental area of 90 mm petri dish, and has little thermal effect on the culture media in 37.5oC, 5% CO2. Human osteogenic sarcoma (HOS) cells were cultured in the pulsating magnetic field and the nuclear changes of cultured cells were observed routinely by hematoxylin staining, and apoptotic change was detected by ApopTag staining using both peroxidase and fluorescein labelings. Compared to the control group which formed well organized whorling pattern of HOS cell line in 3 days culture, the HOS cells cultured in the pulsating magnetic field for 12 hours or 24 hours grew irregularly and showed increased number of apoptotic cells. When the flow of pulsating magnetic field was interrupted by insertion of strong permanent magnetic bar (1000 Gauss, 5530 mm) beneath the petri dish during in vitro culture, the area of sparse pulsating magnetic field showed active proliferation and aggregation of HOS cells even in 24 hour exposure group. These data suggest that the pulsating magnetic field may play a role in inducing growth retardation and apoptosis of HOS cells. Furthermore, the hazardous effects of pulsating magnetic field can be lessened or nullified by the interruption of pulsating magnetic field with a strong permanent magnetic bar.
Apoptosis ; Cell Line* ; Cells, Cultured ; Culture Media ; Fluorescein ; Hematoxylin ; Humans* ; Magnetic Fields* ; Osteosarcoma* ; Peroxidase

A 19 yar-old male patient was admitted to the department of neurology in Severance hospital beause of slowly progressive spastic paraparesis. On examination, dark brown skin color, sparse hair, spastic weakness and hypesthesia of lower extremities were noted. The laboratory studies showed high serum ACTH level with lowest normal limit of serum cortisol level. Brain MRI scan revealed high signal intensities in bilateral corticospinal tracts on T, Weighted images with gadolinium enhancement and T2eighted images. The results of three modal evoked potential studies(SEP. BAEP. VEP) were abnormal bilaterally. Nerve conduction studies and sural nerve biopsy suggested the presence of peripheral neuropathy.
Adrenocorticotropic Hormone ; Adrenoleukodystrophy* ; Biopsy ; Brain ; Evoked Potentials ; Gadolinium ; Hair ; Humans ; Hydrocortisone ; Hypesthesia ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Muscle Spasticity ; Neural Conduction ; Neurology ; Paraparesis, Spastic ; Peripheral Nervous System Diseases ; Pyramidal Tracts ; Skin ; Sural Nerve

Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.
Aorta ; Arteries ; Bradycardia ; Cause of Death ; Chest Pain ; Diagnosis ; Emergencies ; Heart Rupture* ; Hematoma ; Humans ; Infarction ; Myocardial Infarction ; Rupture ; Shock ; Transplants

No abstract available.
Anaphylaxis* ; Animals ; Hypersensitivity* ; Immunoglobulin E* ; Interferons* ; Mice*

No abstract available.
Humans

No abstract available.
Genes, ras* ; Humans*

May-Thurner syndrome is deep vein thrombosis (DVT) of the iliofemoral vein due to compression of the left common iliac vein (CIV) by the overlying right common iliac artery (CIA). In contrast to the right CIV, which ascends almost vertically to the inferior vena cava (IVC), the left CIV follows a more transverse course. Along this course, it underlies the right CIA, which may compress it against the lumbar spine. A 69-year-old man with squamous cell lung cancer presented with acute onset painful left leg swelling. He had been undergoing chemotherapy with gemcitabine and cisplatin as a 2nd line treatment after concurrent chemoradiation. Physical examination revealed left leg edema with tenderness and warmth. The D-dimer level was elevated and a lower extremity computed tomographic angiogram (CTA) showed a DVT involving the left infrapopliteal vein to the common iliac vein with collapsed junction between the CIV and IVC. Systemic anticoagulation with low molecular weight heparin (LMWH) and an IVC filter insertion was performed to prevent further thrombosis, such as a PTE. After IVC filter placement, mechanical thrombectomy was performed on the left femoral vein and left CIV. A vascular stent was then deployed in the left CIV. Left leg swelling seemed to be improved after heparinization, but he had a 2nd episode one week later. Therefore, he underwent a 2nd mechanical thrombectomy and stent deployment of the left external iliac vein. His leg swelling was gradually relieved. He has received LMWH for 3 months, and has received 2 cycles of pemetrexed followed by erlotinib
Aged ; Cisplatin ; Deoxycytidine ; Edema ; Femoral Vein ; Fibrin Fibrinogen Degradation Products ; Glutamates ; Guanine ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Iliac Artery ; Iliac Vein ; Leg ; Lower Extremity ; Lung ; Lung Neoplasms ; May-Thurner Syndrome ; Physical Examination ; Quinazolines ; Spine ; Stents ; Thrombectomy ; Thrombosis ; Veins ; Vena Cava, Inferior ; Venous Thrombosis ; Erlotinib Hydrochloride ; Pemetrexed

PURPOSE: To see the stability and error in the diffusion-weighted magnetic resonance (MR) imaging technique in the experimental models and to observe the signal intensities in the early cerebral lesions of the animal models. MATERIALS AND METHODS: Diffusion coefficients of acetone and distilled water were measured by diffusion-weighted MR image and were compared with actual values. Differentiation of diffusion from perfusion were done at the resin flow phantom. The signal intensities caused by early parenchymal changes were measured in normal, hypovolemic, and embolic, and dead animal models by using diffusion-weighted image and compared with pathoIogic finding and vital staining. RESULTS: Diffusion coefficients of acetone and distilled water were 4.48 x 10-3 and 2.72 x 10-3 which were very close to the actual values. Diffusion-weighted MR image obtained at flow phantom was not affected by flow (perfusion) at the 100-400 of b-factor range. Animal study done at that b-factor range revealed a significant signal difference between the left and right sides only at the embolic model induced by polyvinyl alchol particles (p<0.05). These changes were not detected in microscopic finding but could be identified in vital staining. CONCLUSION: Diffusion-weighted MR image can be used to detect early parenchymal change when the appropriate b-factor range was applied.
Acetone ; Animals ; Diffusion* ; Hypovolemia ; Models, Animal ; Models, Theoretical* ; Perfusion ; Polyvinyls ; Water