No abstract available.
Endocarditis* ; Endocarditis, Bacterial ; Humans ; Kidney Failure, Chronic* ; Renal Dialysis

Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment.
Aorta ; Aortic Coarctation* ; Congenital Abnormalities ; Diagnostic Errors ; Heart Failure ; Humans ; Hypertension ; Ischemia ; Male ; Paraplegia* ; Spinal Cord ; Spinal Cord Diseases ; Spinal Cord Ischemia ; Subarachnoid Hemorrhage

OBJECTIVES: This study was performed to investigate the relationship between individual-level social capital and depression. METHODS: Data from the 2009 Community Health Survey were analyzed for this study. We used chi-square tests and hierarchical logistic regression analyses to determine the relationship between individual-level social capital and depression. The Korean version of the Center for Epidemiological Studies-Depression Scale was used to measure depression. RESULTS: After controlling for socio-demographic factors such as, health behavior and chronic illness morbidity, that are associated with individual-level social capital, trust and informal participation significantly affected depression. Respondents with "be trust"(0.536, 95% CI 0.419-0.685) and who participate in "informal groups"(0.657, 95% CI 0.516-0.836) had significantly lower odds ratios of depression. CONCLUSIONS: Considering and introducing measures to increase the social capital of residents, need reduce depression. It is especially necessary to enhance resident empowerment.
Chronic Disease ; Depression ; Health Behavior ; Health Surveys ; Logistic Models ; Odds Ratio ; Power (Psychology) ; Surveys and Questionnaires

Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year-old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.
Acute Disease ; Humans ; Male ; *Mesenteric Veins ; Middle Aged ; Pancreatitis/complications/*diagnosis ; Tomography, X-Ray Computed ; Venous Thrombosis/*diagnosis/etiology/radiography

BACKGROUND: Microbial receptors play an important role in host defense. Microbial receptors- Toll-like receptor 4 (TLR4), CD14, CD11b, and CD18-mediate the responsiveness to Gram-negative lipopolysaccharide (LPS). The host response to LPS is characterized by an influx of inflammatory cells into host tissues, which is mediated, in part, by localized production of cytokines. Although the expression of microbial receptors and production of cytokines in macrophages are well studied, the functional responses of keratinocytes to stimulation with LPS are not well known. OBJECTIVES: We investigated the expression of microbial receptors and production of cytokine in response to LPS in mouse keratinocytes. METHODS: RAW264.7 cells, mouse macrophage cell line, were used as a positive control. Balbc/mk and PAM212 cells, mouse keratinocyte cell lines, were checked for the expression of microbial receptors and production of cytokine in response to LPS stimulation by flow cytometry and ELISA. RESULTS: RAW264.7 cells constitutively expressed high levels of TLR4, CD14, CD11b, and CD18. Balbc/mk and PAM212 cells also constitutively expressed high levels of CD14 and TLR4 similarily with RAW264.7 cells, but the levels of CD11b and CD18 expression was constitutively low. LPS stimulation resulted in increased production of TNF-alpha in RAW264.7 cells and mouse KC in mouse keratinocytes. In addition, LPS stimulation induced up-regulation of TLR4, CD14, CD11b, and CD18 in RAW264.7 cells, and TLR4 and CD14 in mouse keratinocytes. Anti-receptor specific antibodies efficiently blocked mouse KC production in mouse keratinocytes stimulated by low-dose LPS (100ng/ml). CONCLUSION: Taken together, these results indicate that mouse keratinocytes constitutively express microbial receptors and produce cytokine in response to LPS stimulation. Therefore, keratinocytes can actively participate in innate immunity against pathogens by secreting inflammatory cytokines through microbial receptor recognition.
Animals ; Antibodies ; Cell Line ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Immunity, Innate ; Keratinocytes* ; Macrophages ; Mice* ; Toll-Like Receptor 4 ; Tumor Necrosis Factor-alpha ; Up-Regulation

We describe a case of spontaneous bleeding from a branch of the right internal pudendal artery that resulted in massive scrotal swelling in a patient who had underwent primary percutaneous coronary intervention with the use of abciximab concurrent with conventional anticoagulation and dual antiplatelet therapies for the treatment of acute ST-segment elevation myocardial infarction. This unusual complication was promptly identified by percutaneous peripheral arteriography and successfully treated with gel-foam embolization.
Angiography ; Arteries* ; Hemorrhage* ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention*

Tricuspid valve endocarditis accounts for 5% to 10% of cases of infective endocarditis. It commonly occurs in intravenous drug abusers, intravenous catheters, alcoholism, immune deficiency and genital sepsis. But right sided infective endocarditis without predisposing factor is very rare. S. aureus is the usual pathogen. We experienced a case of tricuspid valve endocarditis in a 32 year old female with vegetation in a non drug addict without underlying cardiac disease. The vegetation on the septal cusp of tricuspid valve and tricuspid regurgitation were found by TTE & TEE. S. aureus was identified in 4 bottles of blood cultures. The diagnosis was delayed because the cardiac manifestations of the disease were subtle, and pleuropulmonary manifestations predominant. So we report a case of tricuspid valve endocarditis in a non drug addict without underlying cardiac disease with a review of literature.
Adult ; Alcoholism ; Catheters ; Causality ; Diagnosis ; Drug Users ; Endocarditis* ; Female ; Heart Diseases* ; Humans ; Sepsis ; Tricuspid Valve Insufficiency ; Tricuspid Valve*

Massive and untreated hemoptysis is associated with a >50% mortality rate. Since bleeding has a bronchial arterial origin in most patients, bronchial artery embolization (BAE) has become an accepted treatment in massive hemoptysis. The possibility of bleeding from pulmonary artery should be considered in patients in whom the bleeding focus cannot be found by Bronchial angiogram. Indeed, the bleeding occurs from a pulmonary artery in approximately 10% of patients with massive hemoptysis. The most common causes of bleeding from the pulmonary artery are pulmonary artery rupture associated with a Swan-Ganz catheter, infectious diseases and vasculitis. We report a rare case of a fistula between the right upper lobar pulmonary artery and the right upper lobar bronchus in a 71-year-old woman who presented with massive hemoptysis.
Aged ; Bronchi ; Bronchial Arteries ; Catheters ; Communicable Diseases ; Female ; Fistula* ; Hemoptysis* ; Hemorrhage ; Humans ; Mortality ; Pulmonary Artery ; Rupture ; Tuberculosis, Pulmonary* ; Vasculitis

OBJECTIVES: Mediastinal tumors are not uncommon but almost half of them are asymptomatic because of the potential space of the mediastinum. Recently owing to the routine screening chest roentgenography and frequent chest CT scans the incidence have increased. Mediastinal masses are both benign or malignant. Even benign masses may continue to enlarge and compromise vital organ function or rupture, bleed, and become infected. Mediastinal tumors have their own predilection site. There are different incidences of these masses in adults and children, sexes, and there may be difference in incidence between races. There are only a few reports about these tumors in Korea, and we are interested in the clinical manifestations of mediastinal tumors in Korea, METHODS: We retrospectively reviewed medical records of 286 cases of mediastinal tumors which were pathologically confirmed at Keimyung, Kyungpook, and Yeungnam University Hospital in Taegu from 1985 to 1994 but excluded metastatic lesion, tuberculosis, and tumor originated from esophagus, heart, and large vessels. RESULTS: Mediastinal tumors were more frequent in male(60.8%) than female and age distribution was relatively even. Thymoma was most common mediastinal tumor(107 cases, 37.4%). The most common tumor in anterior mediastinum was thymoma (107/212, 50.5%). In posterior mediastinum, neurogenic tumor was the most common(52/67, 77.6%) and teratodermoid tumor was common in middle mediastinum(3/7, 42.9%). The most common symptom was chest discomfort(129 cases, 45.1%) and 67 cases were asymptomatic(23.4%). Benign tumors were more common(175 cases, 61.1%) than malignant tumors. In therapies, complete or partial resections were done in 190 cases(79.8%), chemotherapy or radiotherapy in 71 cases(29.8%), in 24 cases(10.1%) only biopsy was taken without any treatment. Neurogenic tumors have been reported as the most common tumors in western countries and neurogenic and teratodermoid tumor were found to be the most common tumors in the past Korean reports. But thymoma was the most common tumor in this study. CONCLUSION: Thymoma was the most common mediactinal tumor in this study. And thymoma was the most common tumor in anterior mediastinum neurogenic tumor in posterior rnediastinum and teratodermoid tumor in middle mediastinum
Adult ; Age Distribution ; Biopsy ; Child ; Continental Population Groups ; Daegu ; Drug Therapy ; Esophagus ; Female ; Gyeongsangbuk-do ; Heart ; Humans ; Incidence ; Korea ; Mass Screening ; Mediastinum ; Medical Records ; Radiography ; Radiotherapy ; Retrospective Studies ; Rupture ; Thorax ; Thymoma ; Tomography, X-Ray Computed ; Tuberculosis

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of 138,000/mm3, activated partial thromboplastin time (aPTT) of 10?s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.
Acute Kidney Injury* ; Aged ; Atrial Fibrillation ; Cerebral Infarction ; Colonoscopy ; Creatinine ; Dabigatran ; Dialysis ; Disseminated Intravascular Coagulation ; Embolism ; Erythrocytes ; Fissure in Ano ; Gastrointestinal Hemorrhage ; Hematuria ; Hemorrhage ; Hemostasis ; Humans ; International Normalized Ratio ; Kidney ; Partial Thromboplastin Time ; Plasma ; Prothrombin Time ; Recurrence ; Renal Dialysis ; Renal Insufficiency ; Stroke ; Thrombin ; United States Food and Drug Administration