After aseptic or septic meningitis, some neurologic complications such as convulsions, delirium, rigidity, cerebral infarctions and cerebral hemorrhage can be developed. The cerebral infarction after meningitis is caused by arterial or venous occlusions. Involvement of small perforating arteries leads to ganglionic infarcts while severe sapsm of major vessels may lead to massive infarctions in the distribution of middle and/or anterior cerebral arteries. Cortical venous and/or dural thrombosis (especially in the superior sagittal sinus) produces typical features, including multiple areas of white matter hemorrhagic infarction. These neurologic complications are common in bacterial meningitis and very rare in aseptic meningitis. We experienced a case of cerebral infarction in MCA/ACA territory and subdural hemorrhage in occipital lobe after aseptic meningitis in 10 month-old-boy. We report a case with a brief review of related literature.
Anterior Cerebral Artery ; Arteries ; Cerebral Hemorrhage ; Cerebral Infarction* ; Delirium ; Ganglion Cysts ; Hematoma, Subdural* ; Infarction ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Occipital Lobe ; Seizures ; Thrombosis

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

No abstract available.

The antiphospholipid antibodies are characterized by prolonged phospholipid-dependent coagulation test (known as APTT or Russel viper venom), thrombosis, thrombocytopenia, and fetal loss. The association of antiphospholipid antibodies with one or more of these characteristic clinical features has been termed the i antiphospholipid syndrome. We have experienced a case of successful live birth after treated a woman with heparin and aspirin who has experienced spontaneous abortion four times with antiphospholipid antibodies and present it with the review of literature.
Abortion, Spontaneous ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Aspirin ; Female ; Heparin ; Humans ; Live Birth* ; Pregnancy ; Thrombocytopenia ; Thrombosis

OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy of the early pelviscopic intervention in the acute pelvic inflammatory disease of reproductive aged female. METHODS: A clinical evaluation for 30 women who underwent pelviscopic pus drainage in the pelvic inflammatory disease from September 2001 to December 2004 was done. This study group was compared with the control group that 34 cases of intravenous antibiotics treatment performed and we evaluated the clinical and laboratory findings were recorded for all patients before and after treatment. RESULTS: The mean hospital stay was 7.8 days and 6.9 days respectively (p=0.25). There was statistical difference in regarding to febrile status period, that is febrile status was significantly improved in pelviscopy group. The febrile status of the study group was normalized within postoperative third day except 1 case that postoperative hematoma was formed in cul de sac, but it was not normalized within hospital fifth day in 6 cases (27%) of the control group (p=0.05). But there was no statistical difference between the two groups in regarding to clinical symptom free period except febrile status, WBC count change, and ESR/CRP count change. CONCLUSION: In this study, no significant difference was found between the two groups in regarding to clinical progress. But this study suggested that the early pelviscopic pus drainage was effective first line treatment method for the acute pelvic inflammatory disease with less complications and relatively rapid clinical improvement. However further study with more expanded cases that early pelviscopic intervention was done for the prevention of long term complications of pelvic inflammatory disease will be needed.
Anti-Bacterial Agents ; Drainage* ; Early Intervention (Education)* ; Female ; Hematoma ; Humans ; Length of Stay ; Pelvic Inflammatory Disease* ; Suppuration*

Ectopic pregnancies accout for 1% of all pregnancies and abdominal pregnancies account for almost 1% of ectopic pregnancies. The causes of abdominal pregnancy are two. First is primaries implantation of gestational sac in the abdomen, second is migration of the embryo through a fistulous tract of the tube or uterus. Their early symptom is absent and diagnosis by ultrasonography is difficult. Thus the mortality is very high because of complications such as hemorrhage and infection due to delayed diagnosis. The accurate diagnosis mostly made by laparoscopy or laparotomy is usual. Nowadays the treatment of choice must be laparoscopy according to the development of efficient laparoscopic instrumentation and accumulating experience and skill of laparoscopic surgeon. Here we report a case of uterine serosal pregnancy at 8(+1) weeks with both ovarian cysts which was undergone pelviscopy at the impression of right tubal pregnancy. At local gynecologic clinic, they guessed the patient's lower abdominal pain was due to the torsion of both ovarian masses and transferred the patient for an operation. beta-hCG was 52,509 mIU/mL. By ultrasonographic finding both ovarian cysts and 2 cm sized gestational sac with fetal pole and fetal heart tone were found nearby right fallopian tube. Under the impression of right tubal pregnancy she underwent the emergent pelviscopic operation. Mass consisted with the gestational sac and placenta was attatched to the posterior surface of uterus and minimal amount of fresh blood in the posterior cul de sac was observed. Both tubes and the uterus were intact, and both ovarian cysts were not torted or ruptured. The mass was detached and the bed of implantation was biopsyed. Gestational sac contained the intact embryo within.
Abdomen ; Abdominal Pain ; Delayed Diagnosis ; Diagnosis ; Embryonic Structures ; Fallopian Tubes ; Female ; Fetal Heart ; Gestational Sac ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Liability, Legal ; Mortality ; Ovarian Cysts* ; Placenta ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Ultrasonography ; Uterus

A 66-year-old woman was transferred to our hospital due to her right breast cancer. Preoperative breast MRI shows 1.9 cm malignancy on her right breast (cT1N0M0) and incidentally found osteosclerotic change of left coststernoclavicular region. Bone scintigraphy showed hot uptake and the possibility of bone metastasis was not excluded. However, because the bone metastasis is not common in early stage cancer and the costosternoclavicular region is not common site, other possibility should be considered. SAPHO syndrome can be diagnosed even in the absence of dermatosis when there is an axial or appendicular osteitis and hyperostosis, especially in costosternoclavicular region. Though breast imaging specialists are not accustomed to this disease entity, awareness and diagnosis of the SAPHO syndrome can help differentiate bone metastasis.
Acquired Hyperostosis Syndrome* ; Aged ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Hyperostosis ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Osteitis ; Radionuclide Imaging ; Skin Diseases ; Specialization

BACKGROUND: Many patients with isoniazid and rifampin-resistant pulmonary tuberculosis have organisms that are also resistant to other first-line drugs. Despite of aggressive retreatment chemotherapy, the results are often unsuccessful, with a failure rate approaching 40%. Recently, there has been a revival of resectional surgery for the treatment of multidrug-resistant pulmonary tuberculosis. METHODS: A retrospective analyses of the case records and radiographic findings were done. Between January 1991 and December 1995, 14 human immunodeficiency virus (HIV)-seronegative patients with multidrug-resistant pulmonary tuberculosis were selected for resection to supplement chemotherapy. All patients had organisms resistant to many of the first-line drugs, including both isoniazid and rifampin. RESULTS: Despite of aggressive therapy for median duration of 9.5 months, 12 of the 14 patients (86%) were still sputum smear and/or culture positive at the time of surgery. The disease was generally extensive. Although main lesions of the disease including thick-walled cavities were localized in one lung, lesser amounts of contralateral disease were demonstrated in 10 of 14 (71%). Types of surgery performed were pneumonectomy including extrapleural pneumonectomy in six patients, lobectomy or lobectomy plus in six patients, and segmentectomy in two patients. The resected lung appeared to have poor function; preoperative perfusion lung scan showed only 4.8% of the total perfusion to the resected portion of the lung. There were no operative deaths. Two patients had major postoperative complicatioas including empyema with bronchopleural fistula and prolonged air leak, respectively, Of the 14 patients, 13 (93%) remained sputum-culture-negative for M. tuberculosis for a median duration of 23 months and one remained continuously sputum smear and culture positive for M. tuberculosis. CONCLUSION: On the basis of comparison with historical controls, adjunctive resectional surgery appears to play a significant beneficial role in the management of patients with multidrug-resistant pulmonary tuberculosis if the disease is localized and there are adequate reserve in pulmonary function.
Drug Resistance ; Drug Therapy ; Empyema ; Fistula ; HIV ; Humans ; Isoniazid ; Lung ; Mastectomy, Segmental ; Perfusion ; Pneumonectomy ; Retreatment ; Retrospective Studies ; Rifampin ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

No abstract available.
Cardioplegic Solutions* ; Ischemia*

Fifty-two Korean patients with Behcet's syndome were typed for HLA antigens. 52 apparently healthy Korean subjects were used as controls; 42 for HLA-A, B, C and all 52 for HLA-DR typing. HLA-B5 and DRw8 presented significantly high frequencies in all patiens. According to Shimizu's classification, HLA-B5 and DRw8 were significantly increased in the complete type; B5 in the incomplete type; DR3 in the suspected-possible type. According to Lehner's classification, HLA-DR3 was significantly increased in the neurological type; B5 in the ocular type; B5 in the ocular type. We confirmed the association of HLA-B5 with the severity of Beh et's syndrome. A relation might exist between DRw8, DR3 and Behcet's syndrome.
Adolescent ; Adult ; Behcet Syndrome/*immunology ; Female ; HLA Antigens/*analysis/classification ; Human ; Korea ; Male ; Middle Age ; Support, Non-U.S. Gov't