No abstract available.
Ductus Arteriosus* ; Indomethacin*

No abstract available.
Down Syndrome* ; Leukemia, Megakaryoblastic, Acute*

We report a case of alpha-fetoprotein (AFP)-producing acinar cell carcinoma (ACC) of the pancreas. The tumor was diagnosed in a 72 yearold female after radical subtotal gastrectomy (Billroth I) due to early gastric cancer six months before. The initial serum AFP levels were increased to 2,254.1 IU/ml and preoperative imaging studies showed a mass with approximately 2.5 cm in diameter near the neck of the pancreas. A pancreaticoduodenectomy was performed. The pathologic examination revealed an ill-defined lobulating tumor confined to the pancreas (T1 stage). Immunohistochemical study showed that the tumor cells expressed AFP. The Adenosine triphosphate-based chemotherapy response assay (ATP-CRA) suggested that cisplatin would be more desirable than gemcitabine in AFP-producing ACC of the pancreas as an adjuvant chemotherapy. However, the adjuvant chemotherapy was not performed due to the early pathological stage. The patient died from carcinomatosis and pneumonia. Even if the tumor was on a relatively early stage, an adjuvant treatment should be considered ACC.
Acinar Cells* ; Adenosine ; alpha-Fetoproteins ; Carcinoma ; Carcinoma, Acinar Cell* ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy ; Female ; Gastrectomy* ; Humans ; Neck ; Pancreas ; Pancreatectomy ; Pancreaticoduodenectomy* ; Pneumonia ; Stomach Neoplasms*

PURPOSE: To report a case of neovascular glaucoma (NVG) with ocular ischemia in superior vena cava syndrome (SVCS). CASE SUMMARY: A 57-year old male who had been treated for small cell lung cancer (SCLC) visited our hospital because of SVCS-like symptoms and decreased visual acuity in the right eye. On the initial examination, best corrected visual acuity was 0.5, intraocular pressure (IOP) was 38 mm Hg and relative afferent papillary defect was positive in the right eye. Slit lamp examination showed mild dilatation and tortuosity of the episcleral vessels and ruobeosis iridis. Gonioscopic examination showed neovascularization of the opened angle. Fluorescein angiography showed delayed choroidal filling and nevascularization of the disc. The patient was diagnosed with NVG with ocular ischemia in SVCS and was treated with chemotherapy and steroid therapy. In addition, intravitreal bevacizumab and IOP lowering eyedrops were administered to the right eye. During follow-up, neovascularizations disappeared and IOP was well controlled. CONCLUSIONS: NVG with ocular ischemia in SVCS should be considered as a possible cause of high IOP in SCLC patients.
Antibodies, Monoclonal, Humanized ; Choroid ; Dilatation ; Eye ; Fluorescein Angiography ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Ischemia ; Male ; Ophthalmic Solutions ; Small Cell Lung Carcinoma ; Superior Vena Cava Syndrome ; Vena Cava, Superior ; Visual Acuity ; Bevacizumab

PURPOSE: Billroth I and II reconstructions are commonly performed after a distal subtotal gastrectomy. However, both may cause duodenogastric and duodenogastroesophageal reflux, which are conditions reported to have carcinogenic potential. This study investigated which reconstructive procedure would be most effective in prevent bile reflux into the gastric remnant after a distal gastrectomy. METHODS: A group of 43 patients who underwent a curative distal gastrectomy for gastric cancer were assigned to three groups prospectively according to the reconstructive procedure undertaken: 14, Billroth I (B-I); 14, Billroth II with Braun anastomosis (B-II with Braun); and 15 Billroth II (B-II). The bile reflux period (percent time) for the gastric remnant was measured using a Bilitec 2000 under standardized conditions. The endoscopic findings for reflux gastritis were classified into four grades. RESULTS: The mean standard error time of bile reflux in B-I, B-II with Braun and the B-II groups was 30.9+/-3.9%, 32.8+/-5.1% , and 60.9+/-7.0%, respectively. The B-II group showed significantly higher levels of the % time of bile reflux than the B-I or B-II with Braun groups (P<0.001). Regarding the endoscopic classification for reflux gastritis, the remnant stomach after B-II showed significantly more severe and extensive gastritis than that after the B-I and B-II with Braun procedures (P=0.003). There was also a positive correlation between the degree of % time of bile reflux and the extent of gastritis in the gastric remnant (P<0.001). CONCLUSION: After a distal subtotal gastrectomy, a B-II reconstruction is associated with a high reflux of duodenal content, whereas a Braun enteroenterostomy after a B-II reconstruction minimized the reflux at the levels of a B-I reconstruction.
Bile Reflux ; Classification ; Duodenogastric Reflux* ; Gastrectomy* ; Gastric Stump ; Gastritis ; Gastroenterostomy ; Humans ; Prospective Studies ; Stomach Neoplasms

PURPOSE: Prostate cancer is rarely diagnosed in men younger than 40 years of age. At present, the available data show a low rate of cancer detection from prostate-specific antigen (PSA) screening of this group of young men. We analyzed the outcome of prostate biopsy results in patients of this age group with a high PSA. MATERIALS AND METHODS: Between October 1997 and August 2008, a total of 81 men less than 40 years of age were referred from the Health Care Promotion Center as the result of elevated PSA levels. Six men with prostatitis were excluded. The remaining 75 men were asymptomatic and had normal findings on the digital rectal examination (DRE) and were selected to have a transrectal ultrasound-guided prostate biopsy for suspected prostate cancer. The patients with sustained high PSA levels underwent repeat biopsies. RESULTS: The median age of the 75 men was 33 years (range, 26-40 years) and the mean PSA level was 6.57 ng/ml (range, 4.32-13.45 ng/ml). The results of the primary biopsy was 1 (1.3%) case of prostate cancer, 70 cases (93%) with benign tissue, 2 cases (2.6%) with inflammation, and 1 case each (1.3%) with high grade intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP). Of the 10 men who underwent a second biopsy, all had benign findings. Three of the men who underwent a third biopsy all had benign tissue findings. CONCLUSIONS: The prostate cancer detection rate in young men less than 40 years of age with high PSA levels and normal DREs was very low. Repeat biopsy for sustained high PSA levels in young men less than 40 years of age may not be indicated.
Biopsy ; Delivery of Health Care ; Digital Rectal Examination ; Humans ; Inflammation ; Male ; Mass Screening ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Prostatitis ; Young Adult

OBJECTIVES: Alexithymia has been regarded as the general personality of psychosomatic disease, but it's controversial. The object of the study is to find out the relationship between alexithymia and alopecia areata. METHODS: Thirty one alopecia areata patients were compared to 31 normal healthy persons in alexithymic tendency using TAS-20K. Also MMPI and SCL-90-R were checked in both groups. Psychiatric diseases were ruled out. RESULTS: The scores of F, K, Hs, D, Hy, Pd, Pa, Pt and Sc of MMPI in alopecia areata patients were different from those in normal healthy persons. The scores of SOM, O-C, I-S, DEP, ANX, HOT, PHOB, PAR, PSY, GSI, PSDI, and PST of SCL-90-R in alopecia areata patients were significantly higher than those in normal healthy persons. In TAS-20K, the scores of Factor 1 and Total in alopecia areata patients were higher than those in normal healthy persons. CONCLUSION: Our results suggest that alopecia areata patients are more alexithymic than normal healthy persons.
Affective Symptoms* ; Alopecia Areata* ; Alopecia* ; Humans ; MMPI

PURPOSE: To analyze functional gains after TKA in patients with hemophilic arthropathy. MATERIALS AND METHODS: From January 1989 to December 1996, 16 total knee replacements were performed in 11 patients with hemophilia. The average age at operation was 30 years and nine months. The average follow-up period was 3.2 years (range, 1 to 7 years). There were 14 knees of hemophilia A and 2 knees of hemophilia B. Preoperatively, all patients complained of severe pain and had marked knee joint deformity of grade IV or V by Arnold and Hilgartner classification. The knee rating scale of Hospital for Special Surgery was used for clinical assessment. RESULTS: The average preoperative range of motion was 87.9 degrees (range, 25-125 degrees) and 94 degrees (range, 70-125 degrees) postoperatively. The average flexion contracture was 20.7 degrees (range, 0-40 degrees) preoperatively and 4.7 degrees (range, 0-15 degrees) postoperatively. The knee rating scale improved from 44.3 points (range, 40-76) to 88.8 points (range, 81-97). There was one case of superficial necrosis of skin. CONCLUSIONS: The range of motion was not improved significantly after total knee replacements in hemophilic patients. However, knee pain and bleeding episodes have decreased prominently.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Classification ; Congenital Abnormalities ; Contracture ; Follow-Up Studies ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Knee Joint ; Knee* ; Necrosis ; Range of Motion, Articular ; Skin

OBJECTIVES: Recently in schizophrenia high incidence of MTHFR(methylenetetrahydrofolate reductase), which is a main relating enzyme that reduce homocysteine level, genetic variations were reported. So we examined serum homocysteine level and MTHFR gene polymorphism in Korean schizophrenics. METHOD: We compared serum homocysteine level and MTHFR polymorphism between 235 schizophrenics (100male, 135female) and 235 normal controls(100male, 135female). C677T and A1298C polymorphism of MTHFR gene were analyzed. RESULTS: 1) C677T genetic mutation(CT and TT) were more frequent in schizophrenia group than normal control group(p<0.01). But the difference of A1298C mutation frequency was not found between two groups. 2) In schizophrenia patients, TT genotype of C677T mutation showed significantly higher homocysteine level (29.99uM/L) than other group(CT : 13.34uM/L, CC : 9.34uM/L p<0.01). 3) MTHFR 677 TT homogeneous mutation genotype showed two times more risk(odds ratio=2.15) than 677CC normal genotype in schizophrenia. CONCLUSION: Some schizophrenia patients with high homocysteine serum level may have C677T TT genotype. In that case, folate ingestion could be a good management for clinical improvement.
Eating ; Folic Acid ; Genetic Variation ; Genotype ; Homocysteine* ; Humans ; Incidence ; Mutation Rate ; Schizophrenia

PURPOSE: This study was conducted in order to evaluate effect and efficiency of selective spinal nerve root block for neuropathic pain patients with lower leg radiating pain. MATERIALS AND METHODS: A total of 113 patients were evaluated and follow-up periods were a minimum of 12 months. They were divided into two groups: group A included 41 patients with neuropathic pain and group B included 72 patients with simple lower leg radiating pain. RESULTS: Fourteen (34.1%) patients in group A and 45 (62.5%) patients in group B had favorable results for selective spinal nerve block (p<0.05). Visual analog scale (VAS) was improved from 7.57 to 5.23 at 12 months in group A and from 7.11 to 3.49 at 12 months in group B. CONCLUSION: The initial treatment period for group A was significantly later than in group B. For patients with neuropathic pain and radiculopathy, early assessment was recommended and early selective spinal nerve block could be a good treatment option for neuropathic pain patients.
Follow-Up Studies ; Humans ; Leg ; Neuralgia* ; Radiculopathy* ; Spinal Nerve Roots* ; Spinal Nerves ; Visual Analog Scale