External Mass Compressing the Left Atrium on Transthoracic Echocardiography

No abstract available.

A case of myocardial infarction with antiphospholipid syndrome / 대한내과학회지

Antiphospholipid syndrome is a multi-system disorder characterized by arterial or venous thromboses and antiphospholipid antibodies, such as lupus anticoagulant or anticardiolipin antibodies. Most common clinical manifestations are recurrent pregnancy losses and deep vein thromboses. Cardiac manifestations in antiphospholipid syndrome include valve abnormalities, occlusive arterial disease, intracardiac emboli, and ventricular dysfunction. Acute myocardial infarction is a rare manifestation of the primary antiphospholipid syndrome. We have experienced a case of myocardial infarction with antiphospholipid syndrome. A 35-year-old man with no cardiovascular risk factors, other than smoking, presented with chest pain. He was diagnosed with an acute myocardial infarction. Our evaluation for coagulapathy revealed elevated lupus anticoagulant antibody. The antiphospholipid syndrome should be considered early in the differential diagnosis as an important cause of unexplained thrombosis in young patients.

A Case of Pulmonary Endometriosis Treated by Resection / 결핵및호흡기질환

Periodic hemoptysis occurring at the time of menstruation (catamenial hemoptysis) is a rare disorder and generally signifies indicates the presence of thoracic endometriosis. A diagnosis of catamenial hemoptysis is usually established based on the clinical history and the exlusion of other causes of the recurrent hemoptysis. Serial computed tomograms of the chest during and in the interval between menstruations periods is a useful confirmatory test. We report the case of a 22 year-old women who suffered from catamenial hemoptysis for 10 months and was treated successfully with a wedge resection of the lesion by video-assisted thoracoscopic surgery(VATS). There was no evidence of recurrence. In conclusion. VATS is a good choice as a for single focus for catamenial hemoptysis.

Four Cases of Non-Hodgkin's Lymphoma in AIDS patients

The incidence of opportunistic infection has decreased since the introduction of highly active antiretroviral therapy, so lymphoma is now far and away the most lethal complication of acquired immunodeficiency syndrome. We have experienced four cases of NHL in AIDS patients. The first patient was a 37 year old male who presented with left sided hemiplegia due to CNS lymphoma. The second patient was a 40 year old male who was admitted because of jaundice; he was diagnosed as having lymphoma that exclusively involved the liver. The third patient was a 38-year-old male who presented with palpable mass in the left cervical region, which was diagnosed as lymphoma. Above three cases were confirmed as diffuse large B cell lymphoma. The fourth patient presented with a protruding swollen chest wall mass on the right side of his chest, this was determined pathologically to be the Burkitt's type. The latter case is the first report of NHL involving the chest wall musculature in a Korean AIDS patient.

A Case of Hyponatremia Due to Angiotensin Converting Enzyme Inhibitor

We describe a patient with hyponatremia induced by the use of angiotensin-converting enzyme (ACE) inhibitor; imidapril HCl. Although the mechanism of severe hyponatremia due to ACE inhibitor is not clear, it is conceivable that ACE inhibitor therapy may complicate the syndrome of inappropriate secretion of antidiuretic hormone and induce hyponatremia. In addition, the possibility should be considered that hyponatremia in our patient is a presumptive interaction between oxcarbazepine and imidapril HCl.

Successful Resolution of Left Renal Artery Stenosis by Interventional Renal Angioplasty with Stent in a Patient with Renal Insufficiency Underlying Ischemic Nephropathy / 대한신장학회잡지

Ischemic nephropathy is defined as renal dysfunction due to renal hypoperfusion mainly through renal artery stenosis. It is a common cause of chronic renal failure in old patients with atherosclerosis and is also a potentially correctable cause of renal failure if diagnosed earlier. We experienced a case of sudden Rt. main renal artery occlusion and renal failure after femoral artery angioplasty in an aged male patient with underlying atherosclerotic bilateral renovascular stenosis associated with ischemic nephropathy. He received successful Lt. renal artery angioplasty with stenting and restored Lt. renal artery blood flow. His blood pressure was more easily controlled with fewer antihypertensive drugs after renal artery revascularization. His renal function was recovered to his baseline level and became stabilized thereafter. Early diagnosis of ischemic nephropathy with MRA and timely renal angioplasty with stenting are beneficial to avoiding progression to irreversible renal failure.

A Case of Primary Hepatic Lymphoma Mimicking Hepatitis / 대한간학회지

We report here on a case of non-Hodgkin's lymphoma in which liver involvement was the predominant clinical manifestation. A healthy 44-year-old man presented with upper abdominal pain, hepatosplenomegaly, thrombocytopenia, elevated AST, ALT and bilirubin, and marked elevation of lactate dehydrogenase and alkaline phosphatase. The abdominal CT scan showed only diffuse hepatosplenomegaly and uneven contrast enhancement of the spleen without any definite mass of the liver and spleen. US-guided aspiration biopsy of liver and the histologic examination confirmed a diagnosis of non-Hodgkin's lymphoma, the diffuse large B cell type. Bone marrow biopsy showed the infiltration of malignant lymphoma cells. PET-CT showed an increased FDG uptake of the liver, spleen and long bones. The patient was treated with combination regimen of cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy. Even in the absence of a mass lesion or lymphadenopathy, primary hepatic or hepatosplenic lymphoma should be considered in differential diagnosis of hepatitis or liver cirrhosis, especially for patients with diffuse hepatosplenomegaly and markedly elevated LDH.

Molecular Genetic Study for FMR-1 Gene in Autistic Children / 신경정신의학

OBJECTIVES: To elucidate an association of the fragile X syndrome with autism, Southern blot analysis was performed in 66 autistic children aged from 2 years to 11 years. METHODS: Subjects were 66 autistic children with of autistic disorder diagnosed by DSM-IV criteria and Childhood Autism Rating Scale-Korean version. Genomic DNA was extracted from peripheral blood and DNA was used to detect a FMR (Fragile Mental Retardation)-1 gene. Xho/PstI probes and two restriction enzymes (EcoRI, EagI)were used for Southern blot analysis. RESULTS: There were one boy with a methylated mosaic pattern and 3 boys and 2 girls with an unmethylated premutation band. But there was no full mutation pattern. CONCLUSION: Although the possibility of the relationship between autistic disorder and FMR-1 gene has been suggested, the results from this study do not provide any definite association of FMR-1 gene with autism in autistic children.

Impact of Family History on Gender Differences of Clinical Features in Schizophrenics / 신경정신의학

OBJECTIVE: This study examined gender differences on sociodemographic factor and clinical feature among patients with schizophrenia and the impact of family history on gender differences of clinical course and clinical characteristics. METHOD: Patients who admitted to Seoul National Mental Hospital from March 1996 to September 1996 and met the diagnostic criteria for schizophrenia by DSM-N were studied. The number of patients was 177(92 men and 85 women), among them with family history of first degree relatives schizophrenia was 33(13 men 20 women). Sociodemographic factor, age of onset, duration of illness, number of admission, dosage of antipsychotics(chlorprormazine equivalent), past history of suicidal attempts and clinical symptoms assessed by Brief psychiatric Rating Scale(BFRS) and Positive and Negative Syndrome Scale(PANSS) were compared by gender. Furthermore, gender differences of clinical features were compared by presene or absence of family history. RESULTS: There were no gender differences in education, religions, occupational status, family history, duration of illness, number of admission, dosage of drugs, suicidal attempts and clinical subtypes, but more female schizophrenic patients were married and age of onset was significantly earlier in male patients. In clinical symptoms were compared with PANSS, negative type is significantly more in male patients but positive type is more in female, with BPRS, perceptul-thought disturbance factor and anxiety-depression factor were significantly higher in female patients. The age of onset was no significantly different in family history positive group but significantly earlier onset of male patients in negative group. Clinical symptoms with BFRS were no significant differences in family history positive group, but perceptual-thought disturbance factor and anxiety-depression factor were higher in female patients in negative group. CONCLUSIONS: The findings coupled with reports from other investigators, support that both gender and genetic loading contribute to the heterogeneity of schizophrenia.

A Study of Depressive Symtoms in Chronic Schizophrenia / 대한정신약물학회지

OBJECTIVES: For the understanding and effective treatment of depressive symptoms in chronic schizophrenia, this study investigated the frequency of depressive symptoms and examined associations between depressive symptoms and positive symptoms, negative symptoms, general psychopathology in chronic schizophrenia. METHOD: The authors assessed the frequency of depressed schizophrenia with 30 or higher scores of HRSD in 135 DSM-IV chronic schizophrenia. We measured PANSS, BPRS in depressed(n=37) and non-depressed schizophrenia(n=37) who were matched in sex, age and dose of antipsychotics to compare positive, negative symptoms and other psychopathology. Also, we evaluated correlation between depressive symptoms and positive symptoms, negative symptoms, other psychopathology in depressed schizophrenic patients. RESULTS: 1) The depressive symptoms were present in 27.4% of chronic schizophrenia. 2) The positive scale of PANSS were significantly higher in depressed than in non-depressed schizophrenia(p<.01), and the negative scale of PANSS were higher in depressed schizophrenia but there were no statisical significance. Thinking disturbance and depressive-anxiety factors of BPRS were significantly higher in depressed than in non-depressed schizophrenia(p<.01, p<.01). 3) The positive and negative scale of PANSS correlated with HRSD in depressed schizophrenia(p<.01, p<.05), and thinking disturbance and depressive-anxiety factors correlated with HRSD in depressed schizophrenia(p<.01, p<.01). CONCLUSION: The depressive symptoms are relatively commom and important part of schizophrenic symptomatology, and they are more related to positive symptoms than negative symptoms of schizophrenia. Thus this study suggest that appropriate assessment and therapeutic intervention for depressive symptoms is especially necessary to the schizophrenic patients with severe positive symptoms.