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Hyperthyroidism has been associated with changes in muscle function such as thyrotoxic myopathy, thyrotoxic periodic paralysis and thyroid opthalomopathy, but rarely rhabdomyolysis. Usually serum creatinine kinase is either normal or low in hyperthyroidism. Only 3 reports described association between rhabdomyolysis and hyperthyroidism, no previous literatures have thyrotoxic periodic paralysis associated rhabdomyolysis. Patients with hypokalemic periodic paralysis sometimes elevated serum muscle protein during recovery from paralytic attack, but the mechanism was not well known. We report a patient who presented with clinical feature of thyrotoxic periodic paralysis and increasing serum CK, myoglobin during recovery from paralysis.
Creatinine ; Humans ; Hyperthyroidism ; Hypokalemic Periodic Paralysis ; Muscle Proteins ; Muscular Diseases ; Myoglobin ; Paralysis* ; Phosphotransferases ; Rhabdomyolysis* ; Thyroid Gland

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A case of primary hepatic angiosarcoma: Report of a case and review of previous Korean cases.

Yung Seok LEE ; Jun Young HWANG ; Kyung Sik PARK ; Kwang Bum CHO ; Jae Seok HWANG ; Sung Hoon AHN ; Yu Na KANG

Korean Journal of Medicine.2004;66(2):224-229.

Primary hepatic angiosarcoma, which is malignant tumor originated from endothelial cell of vessel, is rare condition and is found at only one of fifty thousand autopsy cases. Six cases of hepatic angiosarcoma have been reported in Korea. Two of them were thought as be metastasized from spleen and other four were primary. In spite of foreign reports that lung and spleen is frequent metastatic sites of this tumor, metastatic case had not been reported in Korea yet. So we report a case of primary hepatic angiosarcoma presenting as hemoptysis and metastasized to lung and spleen with review of previously reported cases.
Autopsy ; Endothelial Cells ; Hemangiosarcoma* ; Hemoptysis ; Korea ; Lung ; Neoplasm Metastasis ; Spleen

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A case of calcium pyrophosphate dihydrate deposition disease causing compressive cervical myelopathy.

Jae Il KIM ; Hyun Jung SEOK ; Son Mi CHUNG ; Eun Young LEE ; Chang Keun LEE ; Bin YOO ; Hee Bom MOON

Korean Journal of Medicine.2004;66(2):219-223.

Calcium pyrophosphate dihydrate (CPPD) deposition disease is an inflammatory arthropathy that is defined by the deposition of CPPD crystals in articular and periarticular structure. Spinal involvement in CPPD deposition disease is rare. We reported a rare case of CPPD deposition disease that caused compressive cervical myelopathy. A 57-year-old woman was admitted to the hospital with 1 week history of progressive paresis of the right upper and lower extremities. Computed tomography showed the round and nodular calcified ligamentum flavum. Magnetic resonance imaging showed a low intensity epidural mass pressing and distorting the cervical cord at C-4 and 5 levels on both T1 and T2- weighted images. Radiographic findings were consistent with calcification of the ligamentum flavum in the C-4 and 5 levels causing cord compression. The lesion was eventually removed by hemilaminectomy. The mass was composed of a very hard crystal like calcified deposition in the ligamentum flavum. The histopathological evaluation of the exicised ligamentum flavum revealed the characteristic crystals of CPPD.
Calcium Pyrophosphate* ; Calcium* ; Chondrocalcinosis* ; Female ; Humans ; Ligamentum Flavum ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Spinal Cord Compression ; Spinal Cord Diseases*

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A case of the overlap syndrome of primary biliary cirrhosis and autoimmune hepatitis.

Sang Joon AHN ; Byong Pyo KWON ; Sang Hwa LEE ; Tae Young LEE ; Jin Seok JANG ; Jin Sook JEONG ; Sang Young HAN

Korean Journal of Medicine.2004;66(2):214-218.

Primary biliary cirrhosis and autoimmune hepatitis are the two main immune-mediated liver diseases. They are generally differentiated easily on the basis of clinical, biochemical, serological, and histological findings. Occasionally, the normally distinctive features overlap and classification of a given patient's chronic liver disease is difficult. Series of such patients with Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome were reported. We report a case of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome proven by clinicopathology. The patient showed hepatitic features including easy fatigability, icteric sclera. Markers of hepatitis B and C virus were absent. The liver biopsy showed chronic hepatitis with piecemeal necrosis, infiltration of inflammatory cell surrounding bile duct. The clinical data of high titers of antinuclear antibodies and antimitochondral antibodies, elevated serum IgM, suggest mixed features of primary biliary cirrhosis-autoimmune hepatitis. The patient as given only ursodeoxycholic acid (600 mg/day), then was observed follow-up regularly.
Antibodies ; Antibodies, Antinuclear ; Bile Ducts ; Biopsy ; Classification ; Follow-Up Studies ; Hepatitis ; Hepatitis B ; Hepatitis, Autoimmune* ; Hepatitis, Chronic ; Humans ; Immunoglobulin M ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Necrosis ; Sclera ; Ursodeoxycholic Acid

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A case of large cell neuroendocrine carcinoma of gallbladder presenting with pyogenic liver abscess.

Myung Jin KANG ; Kyung Young NAMGUNG ; Hong Mok IM ; Byung Sung KO ; Hyun Taek AHN ; Jong Riul LEE ; Jong Ok KIM

Korean Journal of Medicine.2004;66(2):209-213.

Pyogenic liver abscess is a rare but highly lethal disease. The diagnosis and treatment of pyogenic liver abscess has been evolving owing to specific antibiotic therapy, ultrasonography, abdominal computed tomography with improved percutaneous and operative techniques. However, pyogenic liver abscess may present as a rapidly fatal outcome. These unfavorable results are mainly attributed to the increasing numbers of patients with malignant disease and biliary tract disease. Carcinoma of the gallbladder has remained an uniformly fatal neoplasm characterized by early metastasis and rapid fatal course. In early stage, the symptom is nonspecific and often mimics benign biliary tract disease. We experienced a case of the gallbladder carcinoma presenting with pyogenic liver abscess in a 78-year-old female patient. Surgical drainage and cholecystectomy were done. The microscopic finding of resected gallbladder revealed large cell neuroendocrine carcinoma of gallbladder.
Aged ; Biliary Tract Diseases ; Carcinoma, Neuroendocrine* ; Cholecystectomy ; Diagnosis ; Drainage ; Fatal Outcome ; Female ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic* ; Neoplasm Metastasis ; Ultrasonography

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A case of Sheehan's syndrome presented by recurrent ventricular tachycardia.

Kyoung Hee KWEON ; Hyun Jung KIM ; Bong Joon YANG ; Seung Hun BAEK ; Myeung Su LEE ; Byoung Hyun PARK ; Chung Gu CHO

Korean Journal of Medicine.2004;66(2):204-208.

Electrocardiographic abnormalities commonly associated with hypopituitarism are low QRS voltage, ST-segment depression, inverted T waves and a prolonged QT interval. Although the mechanism remains unclear, glucocorticoid therapy, an intracelluar-extracellular electrolyte imbalance of myocytes, and histopathological changes in the myocardium are thought to play a role in this disorder. We discribe a 64 year old woman with recurrent ventricular tachycardia associated with QT prolongation in Sheehan's syndrome. Ventricualr tachycardia was treated by lidocain and direct current cardioversion. Sheehan's syndrome was confirmed by past history, anterior pituirary stimulation test and brain MRI showed empty sella. After hormone replacement treatment, inverted T waves and prolonged QT interval was normalized and ventricular tachycardia did not recur.
Brain ; Depression ; Electric Countershock ; Electrocardiography ; Female ; Humans ; Hypopituitarism* ; Magnetic Resonance Imaging ; Middle Aged ; Muscle Cells ; Myocardium ; Tachycardia ; Tachycardia, Ventricular*

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A case of bullous pyoderma gangrenosum associated with refractory acute biphenotypic leukemia.

Hee Jung KANG ; Jae Lyun LEE ; Kyung Hee LEE ; Myung Soo HYUN ; Dong Hoon SHIN ; Jin Woo PARK ; Hee Soon CHO

Korean Journal of Medicine.2004;66(2):200-203.

Pyoderma gangrenosum is a neutrophilic dermatosis that may be associated acute leukemia. We report a case of pyoderma gangrenosum associated refractory acute biphenotypic leukemia wherein the malignant cells show a phenotype specific for myelogenous and lymphocytic leukemia. Histopathologic examination revealed moderate perivascular infiltrate consisting mainly of neutrophils and lymphocytes without involvement of leukemic cells in the skin lesions. Treatment with systemic steroid was followed by a characteristically rapid healing of the skin lesions.
Leukemia ; Leukemia, Biphenotypic, Acute* ; Leukemia, Lymphoid ; Lymphocytes ; Neutrophils ; Phenotype ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Skin Diseases

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A case of hypertrophic obstructive cardiomyopathy complicated by infective endocarditis and treated by surgical intervention.

Yu Ri KIM ; Seung In HA ; Dae Kwan LIM ; Su Hong KIM ; Seong Man KIM ; Seung Jae JOO ; Jae Woo LEE

Korean Journal of Medicine.2004;66(2):195-199.

Infective endocarditis complicates hypertrophic obstructive cardiomyopathy in 5~9% of cases. It's incidence is higher in those with obstruction or left atrial enlargement. Early surgical intervention is usually needed in patients with acute infective endocarditis and progressive congestive heart failure. We reported a case of hypertrophic obstructive cardiomyopathy complicated by infective endocarditis, which was diagnosed by echocardiography and was treated by surgical intervention.
Cardiomyopathy, Hypertrophic* ; Echocardiography ; Endocarditis* ; Heart Failure ; Humans ; Incidence

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