Unroofed Coronary Sinus Associated with Persistent Left Superior Vena Cava : Detection by Agitated Saline Contrast Echocardiography

Unroofed coronary sinus with persistent left superior vena cava is an extremely rare congenital anomaly. It can be suspected by the presence of a markedly dilated coronary sinus and can be confirmed by injection of agitated saline into the left antecubital vein during echocardiography. Agitated saline contrast echocardiography can easily visualize the flow in the persistent left superior vena cava communicating with the unroofed coronary sinus hereby creating a shunt into the left atrium. An agitated saline contrast echocardiography may be performed with a low risk of transient complication. We demonstrate the case of a 32-year-old pregnant woman with unroofed coronary sinus and persistent left superior vena cava, confirmed by agitated saline contrast echocardiography.

Subdural Hematoma Occurring in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

Systemic lupus erythematosus (SLE) is an autoimmune disease which may affect different organs and disclose various clinical manifestations. The clinical manifesations of central nervous system involvement in SLE are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among neuropsychiaric disorders encountered in patients with SLE, cerebrovascular disease has relatively been rare complication. We experienced a case of subdural hematoma (SDH) occurring in a SLE patient which presented with headache. She was diagnosed as SDH by neuropsychiatric symptoms, brain CT, and brain MRI, and showed good response to medical treatment.

Carpal Tunnel Syndrome caused by tuberculous tenosynovitis in a patient on long-term hemodiaysis / 대한내과학회지

Carpal Tunnel Syndrome (CTS) in patients undergoing long-term hemodialysis is caused by a variety of etiologic factors. Especially deposition of dialysis-related amyloidosis has been regarded as one of important etiologic factors. Although tuberculosis (TB) of wrist is a rare form of extrapulomary TB occurring in approximately 1% of osteoarticular TB in nonuremic patients, occurrence of the CTS as a result of TB tenosynovitis in these patients has been previously reported. To our best knowledge, TB tenosynovitis in hemodialysis patients has not been reported in spite of high incidence of extrapulmonary TB. We report a case of CTS due to TB tenosynovitis in the 53-year-old male receiving hemodialysis for more than eighteen years, confirmed by biopsy in flexor tendon. Initially we made a hasty conclusion that CTS in the patient was caused by dialysis-related amyloidosis.