A Case of Coccidioidomycosis Showing Cutaneous and Pulmonary Nodules / 대한의진균학회지

Coccidioidomycosis is a systemic infection caused by inhalation of airborne spores of Coccidioides immitis, a fungus found in soil in the southwestern area of United States and in parts of Mexico and South America. Although its human infection has not been reported infrequently in nonendemic areas, it has rarely been done in Korea since first report of a case of systemic coccidioidomycosis with cutaneous lesions. The patient was a 32-year-old male with granulating cutaneous nodules on left side of upper back for 1 month. Three months ago, he had stayed at northern area of Mexico for 2 months with mild transient upper respiratory symptoms during his stay. After he returned to Korea, cervical lymphadenopathy and skin lesions developed. He had also respiratory symptoms such as chest discomfort and mild chest pain and chest X-ray revealed a solitary nodule. The cutaneous nodules of walnut size were removed surgically and he was recieved daily oral medication of itraconazole 400 mg for 10 months showing good clinical response. Even though lung nodule was not disappeared in radiological exam, repeated CT guided biopsy and fungal tissue culture of lung nodule were undertaken with no growth throughout 10 months. After 10 months itraconazole therapy, there was no evidence of clinical relapse and no change on chest film for following 16 months. We report a case of disseminated coccidioidomycosis involving lung, skin and lymph node simmultaneously and successfully treated with both surgical excision and systemic antifungal therapy.

A Case of Infective Endocarditis Complicated with Mycotic Aneurysm of Superior Mesenteric Artery / 감염

Mycotic aneurysm of mesenteric artery is an uncommon complication of infective endocarditis. Early diagnosis is important and surgical intervention is often needed for effective treatment of mycotic aneurysm of mesenteric artery because of the high incidence of aneurysmal rupture. We experienced a case of infective endocarditis complicated with mycotic aneurysm of the superior mesenteric artery in a 54-year old man, who was admitted because of pain on the right lower quadrant of abdomen. Echocardiography showed mitral regurgit-ation and vegetations on the mitral valve and viridans streptococcus was identified from blood cultures. He was successfully treated with ceftriaxone and gentamicin for the initial 2 weeks, then ceftriaxone alone for two weeks more without surgical intervention. To our knowledge, this is the first case of infective endocarditis complicated with superior mesenteric artery aneurysm in Korea.

Relation between left artrial size and atrial fibrillation in rheumatic mitral stenosis

No abstract available.

Comparisons of Electrocardiograms and Echocardiograms in Soccer Players before and after Intensive Training

BACKGROUND: In athlete's heart, functional and structural alteration are main features. We studied electrocardiograms(ECG's) and echocardiograms(UCG's) in soccer players before and after intensive training. METHODS: Fifteen soccer players with the mean age and career of 19.3 and 8.5 years,respectively,underwent intensive training for 5-5.5 months, which included running of 2 km daily during the last 2-2.5 months. Comparisons of ECG's and UCG's recorded before and after the training were made. RESULTS: The major abnormal finding in pre-training ECG's was high voltage being seen in 40% of the cases, and in UCG's left ventricular(LV) dilatation and/or hypertrophy or asymmetrical septal hypertrophy(ASH) were noted in approximately 80% of the cases. The incidences of these finding after the intensive training were essentially unchanged, and the mean of pre-and post-training fractional shortening(FS) and LV and left atrial dimensions were similar. The high voltage in ECG's showed no close correlation with LV dilatation or hypertrophy on UCG's. After the training, however, the mean values of the thickness of LV posterior wall and ventricular septum along with LV mass were significantly increased, and the right ventricular dimension was significantly decreased. CONCLUSIONS: The most frequent finding in ECG's and UCG's in soccer players, before and after intensive training,were high voltage, LV dilatation and /or hyperophy with or without ASH. The intensive training of 5-5.5 months duration caused no change in F8,but caused significant increase in the thickness of LV posterior wall and ventricular septum, and LV mass.

The Studies on the Contractile Response of Serotinin in Rat Aorta

The mechanism of serotonin(5-HT) induced contraction and Ca++ mobilization was investigated in right cut from rat aorta. Since it is known that 5-HT can interact with alpha-adrenoceptors in addition to a specific action on 5-HT receptors, the effects alpha-adrenoceptors antagonists on these contractile responses to 5-HT were investigated. The results are as follows : 1) 5-HT produced a strong transient contraction and a concentration dependent contraction. 2) The contractile tension to 5-HT increased with extracellular Ca++ concentration (0.1-5mM). 3) The response produced by rings exposed to Ca++-free PSS was significantly weaker than that produced by rings exposed to calcium containing PSS. When rings of aorta that had been stimulated with 5-HT once for 30 min in Ca++-free TBT were washed 4 times for at least; 20 min in zero Ca++PSS to remove 5-HT, than reexposed to 5-HT in Ca++-free TBT, a phasic contraction was not seen during the second stimulation with 5-HT. 4) The contractile response of 5-HT was inhibited by alpha-adrenergic receptor blocker, phenoxybenzamine and phentolamine. Phentolamine(10(-8)M) antagonized response to high concentrations of 5-HT but responses to low concentrations of 5-HT were not antagonized. 5) The contraction induced by 5-HT in Ca++-free PSS was investigated with phentolamin, methysergide. It was blocked by methysergide but not blocked by phentolamine. 6) These results suggest that 5-HT -induced contraction is the effect of both transmembrane Ca++ influx and the mobilization of intracellular Ca++. Low concentration of 5-HT act on specific 5-HT receptors but high concentration of 5-HT also act on alpha-adreno-receptors.