ABSTRACT
To date, it has been well documented that there is a relationship between alterations in thyroid hormones and cardiac dysfunction. We experienced a case of a 36-year-old man with dilated cardiomyopathy (DCM) accompanied by undiagnosed primary hypothyroidism. In the current case, there was a significant improvement in the cardiac function following heart failure management and thyroid hormone replacement. Our case highlights that clinicians should consider the possibility of hypothyroidism as a cause of DCM.
ABSTRACT
To date, it has been well documented that there is a relationship between alterations in thyroid hormones and cardiac dysfunction. We experienced a case of a 36-year-old man with dilated cardiomyopathy (DCM) accompanied by undiagnosed primary hypothyroidism. In the current case, there was a significant improvement in the cardiac function following heart failure management and thyroid hormone replacement. Our case highlights that clinicians should consider the possibility of hypothyroidism as a cause of DCM.
Subject(s)
Adult , Humans , Cardiomyopathy, Dilated , Heart Failure , Hypothyroidism , Thyroid Gland , Thyroid HormonesABSTRACT
Myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is a multisystem clinical syndrome manifested by mitochondrial myopathy, encephalopathy, lactic acidosis and recurrent stroke-like episodes. A 27-year-old female with MELAS syndrome presented with cerebral infarction. Echocardiography revealed a thrombus attached to the apex of the hypertrophied left ventricle, with decreased systolic function. The embolism of the intracardiac thrombus might have been the cause of stroke. There should be more consideration given to the increased possibility of intracardiac thrombus formation when a MELAS patient with cardiac involvement is encountered.
ABSTRACT
The title has been spelled incorrectly: "MEALS" should have appeared as "MELAS".
ABSTRACT
Esophageal neuroendocrine carcinomas are very rare and have a poor prognosis. In addition, the optimum treatment has not been established due to the rarity of the condition. An accurate differential diagnosis is important because treatments and clinical courses differ from those of esophageal squamous cell carcinomas. We report a case of a 61-year-old female who underwent endoscopy for dysphagia and was diagnosed with a neuroendocrine carcinoma of the esophagus, which was successfully resected by esophagectomy.
Subject(s)
Female , Humans , Carcinoma, Neuroendocrine , Carcinoma, Squamous Cell , Deglutition Disorders , Diagnosis, Differential , Endoscopy , Esophagectomy , Esophagus , Neuroendocrine Tumors , PrognosisABSTRACT
Myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is a multisystem clinical syndrome manifested by mitochondrial myopathy, encephalopathy, lactic acidosis and recurrent stroke-like episodes. A 27-year-old female with MELAS syndrome presented with cerebral infarction. Echocardiography revealed a thrombus attached to the apex of the hypertrophied left ventricle, with decreased systolic function. The embolism of the intracardiac thrombus might have been the cause of stroke. There should be more consideration given to the increased possibility of intracardiac thrombus formation when a MELAS patient with cardiac involvement is encountered.
Subject(s)
Female , Humans , Acidosis, Lactic , Cerebral Infarction , Echocardiography , Embolism , Heart , Heart Ventricles , MELAS Syndrome , Mitochondrial Myopathies , Muscular Diseases , Stroke , ThrombosisABSTRACT
Myxoma is the most common primary tumor in the heart. Cardiac myxomas can present in various manners including embolization and fever, sometimes simulating endocarditis. However, they are rarely infected. We report here a case of an infected left atrial myxoma that seeded a normal mitral valve and atypically presented with multiple embolic events in the lower extremities along with multiple splenic and a cerebellar infarction.
ABSTRACT
Myxoma is the most common primary tumor in the heart. Cardiac myxomas can present in various manners including embolization and fever, sometimes simulating endocarditis. However, they are rarely infected. We report here a case of an infected left atrial myxoma that seeded a normal mitral valve and atypically presented with multiple embolic events in the lower extremities along with multiple splenic and a cerebellar infarction.
Subject(s)
Endocarditis , Fever , Heart , Infarction , Lower Extremity , Mitral Valve , Myxoma , SeedsABSTRACT
OBJECTIVES: This study was performed to investigate the changes in the prevalence and its related factors of the Clonorchis sinensis(C.S.) in the inhabitants at Goksung-Gun along Sum-Jin river after C.S. control intervention. METHODS: The subjects were 416 among 699 in the 8 same villages selected by stratified cluster sampling in 1999. The formalin-esther sedimentaion technic was used for the C.S. egg detection and the questionnare for the related factors. The study was carried on from February, 2005 to March, 2005. RESULTS: The prevalence of C.S. decreased significantly from 19.0% in 1999 to 11.3% in 2005. The signicicant factors in 1999 such as sex, age, area, raw fish eating habit and drink habit were not significant statistically. On the other hand factors such as the awareness of C.S. and the health behavior were changed significantly(p=0.034, p=0.021). CONCLUSIONS: These results suggest that C.S. prevalence became lower than previous study five years ago. But its control intervention should be extened to the general population regardless of sex, age, area, raw fish eating habits, drink habit and we need to make an effort to improve the awareness and the health behavior of C.S..
Subject(s)
Clonorchis sinensis , Eating , Hand , Health Behavior , Ovum , Prevalence , RiversABSTRACT
OBJECTIVE: The aim of this study is to extend the indications of hysteroscopic myomectomy. METHODS: Total 304 women who had undergone hysteroscopic myomectomy between February 2001 and March 2005, were selected. Clinical characteristics, laboratory data and postoperative results were analyzed. RESULTS: Mean size of myoma is 3.5 cm, mean op. time is 47 minutes, mean deficit of distension media is 193 cc, types of distension media is URIONE(R) and normal saline, average duration of hospitalization is 4.9 days, average changes of Hb. is 1.5 g/dL, complications of op. were happended in 14 cases, that is uterine perforation (n=8), hyponatremia (n=2), pulmonary edema (n=2), delayed bleeding (n=2). CONCLUSION: The indications of hysteroscopic myomectomy can be extended. In case that patient want to preserve the uterus, deep myometrial embedded or pure intramural myoma might be resected hysteroscopically by single- or multi-step procedure. Hysteroscopic myomectomy performed at observational period may be alternative to hysterectomy in selected cases. In case of recurrence, repeat procedure may reduce the chance of hysterectomy. Intraoperative ultrasonographic guidance is an important procedure in hysteroscopic myomectomy. It lower the complications and morbidity rate.
Subject(s)
Female , Humans , Hemorrhage , Hospitalization , Hyponatremia , Hysterectomy , Myoma , Pulmonary Edema , Recurrence , Uterine Perforation , UterusABSTRACT
Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common, however, carcinoid tumors or adenocarcinomas arising in mature cystic teratoma are uncommon, especially simultaneously. We present an unusual case of premenopausal woman having carcinoid tumor and mucinous adenocarcinoma simultaneously arising in ovarian muture cystic teratoma.
Subject(s)
Female , Humans , Adenocarcinoma , Adenocarcinoma, Mucinous , Carcinoid Tumor , Carcinoma, Squamous Cell , Mucins , Neoplasms, Germ Cell and Embryonal , Ovary , TeratomaABSTRACT
Extrapelvic endometriosis is a fairly rare phenomenon. The majority of extrapelvic endometriosis involves scar tissue following obstetric/gynecologic procedures. Cesarean section scar endometriosis may be more common than reflected in the literature and has a distinct presentation and treatment. One patient with history of cesarean section presented with a painful, enlarging mass involving the cesarean section scar. The pain was cyclic and strongest just prior to menstruation. This patient was treated with surgical excision and specimens had endometriosis confirmed by histopathology. This case was reported with a brief review of the concerned literatures.
Subject(s)
Female , Humans , Pregnancy , Cesarean Section , Cicatrix , Endometriosis , Menstruation , Subcutaneous TissueABSTRACT
Extrapelvic endometriosis is a fairly rare phenomenon. The majority of extrapelvic endometriosis involves scar tissue following obstetric/gynecologic procedures. Cesarean section scar endometriosis may be more common than reflected in the literature and has a distinct presentation and treatment. One patient with history of cesarean section presented with a painful, enlarging mass involving the cesarean section scar. The pain was cyclic and strongest just prior to menstruation. This patient was treated with surgical excision and specimens had endometriosis confirmed by histopathology. This case was reported with a brief review of the concerned literatures.
Subject(s)
Female , Humans , Pregnancy , Cesarean Section , Cicatrix , Endometriosis , Menstruation , Subcutaneous TissueABSTRACT
Two-hundred and twelve cases of pelviscopic operation were performed at Pusan St. Benedict Hospital from November, 1992 to December, 1995. The results were as follows; The common indications were ovarian cyst(32.2%), ectopic pregnancy(16.9%), and endometriosis(14.7%). Frequent types of surgery were salpingo-oophorectomy(22.6%), salpingectomy(10.8%), and oophorectomy(10.0%). The mean age of the patients was 33.4 years. The mean parity of the patients was 1.0. The mean duration of hospitalization was 4.8 days. The most common complication was hemorrhage at the trocar sites. In our conclusions, pelviscopic surgery made minimal postoperative hemorrhage with postoperative discomfort, low incidence of complications, and short duration of hospitalization. Pelviscopic surgery was useful and recommended for the treatment of gynecologic diseases.
Subject(s)
Female , Humans , Genital Diseases, Female , Hemorrhage , Hospitalization , Incidence , Parity , Postoperative Hemorrhage , Surgical InstrumentsABSTRACT
This study was performed to evaluate the diagnostic value of colposcopy by comparing colposcopic findings with cytology, histology of colposcopically directed biopsy and final biopsy result on hysterectomy. From January 1, 1988 to August 31, 1996, the colposcopic examinations was undertaken in 1200 patients, excluding grossly visible carcinoma of the cervix. The result were as follows : 1. Colposcopic examinations were satisfactory in 95.4% and unsatisfactory in 4.58%. 2. The accuracy rate of cytologic diagnosis was 73.1% and colposcopic impression was 93.1%. 3. The false negative rate of colposcopic impression was 2.6%, much less than 24,7% of cytologic examination. 4. The cytologic accuracy rate in cervicitis was higher than that of colposcopic impression but the accuracy rate of colposcopic impression in diagnosis of cervical intraepithelial neoplasia was higher than that of cytology. 5. Among 97 cases in which colposcopically directed biopsy were performed, more advanced lesion were disclosed in 12 cases(12.4%).
Subject(s)
Female , Humans , Biopsy , Uterine Cervical Dysplasia , Cervix Uteri , Colposcopy , Diagnosis , Early Diagnosis , Hysterectomy , Uterine Cervical Neoplasms , Uterine CervicitisABSTRACT
This study was primarily undertaken to assess the value of xylocaine as spinal analgesic particularly for the C-section due to the availability and price in Korea. However, Xylocaine has not become popular for spinal anesthesia in spite of the fact that the use of xylocaine was first reported several years ago. Since that time, 750 cases of spinal anesthesia using 5% xylocaine were recorded from the Dong San Medical Center, describing both the merits and complications involved. The 5% xylocaine was prepared by Dong San Hospital pharmacy and Dae Won pharmaceutical company (pH 6.5, S.G. 1032) As a result of this study, we can come to the following conclusion.1. 5% xylocaine is an excellent substitute for pontocaine to obtain an analgesia for C-section patients. 2. The average analgesic effect lasts about 1.5 hours and can be prolonged from 1.5 to 2.0 hours by adding epinephrine, (0.2 mg), which is time enough to carry out a normal section operation. 3. The dosage range between 1.5cc to 2.0cc (75mg-100 mg) and is most suitable for average Korean adult. When a dosage below l. 5cc was used the analgesic effect was not quite sufficient when more than 2cc was used hypotension was dangerously profound. 4. Of the total cases were given vasopressor, mainly ephedrine, of 10~20 mg, which was administered intravenously without any side effects of Apgar score disturbance. 5. The incidence of nausea and vomiting during the procedure was around 20%. It was possible to control this by giving ephedrine to maintain normal blood pressure, atropine to decrease G.I. secretion and motility and nembutal for sedation before ergotrate was administered. 6. The xylocaine appears to have the one disadvantage of poor fixation behavior and, therefore, there is an increased possibility of high spinal anesthesia.
