No abstract available.
Leiomyoma*

BACKGROUND/AIMS: Chronic hepatitis C virus (HCV) infection is often associated with extrahepatic autoimmune disease, and autoantibodies such as anti-nuclear antibody (ANA) or anti-smooth muscle antibody (ASA). The presence of autoantibodies may make discrimination between chronic hepatitis C with autoimmune features and type 1 autoimmune hepatitis difficult. We studied the prevalence of autoantibodies in patients with chronic HCV infection and their clinical significance. MATERIALS AND METHODS: ANA, ASA, anti-mitochondrial antibody (AMA), anti-microsomal antibody (AmA), rheumatoid factor (RF), anti-cardiolipin antibody (aCL) and lupus anti-coagulant (LA) were tested in 116 patients (80 chronic hepatitis C, 36 liver cirrhosis). Genotypes of HCV were determined in 25 patients by INNO LiPA. RESULTS: The overall prevalence of autoantibody was 65.5%. The most common autoantibody was aCL (34.5%), followed by ANA (25%), RF (18%), LA (15.5%), ASA (6.9%), anti-microsomal antibody (6%) and AMA (1%). The positive rate of either ANA or ASA was 30.2%, but both were positive in 1.7% only. There was no difference in the demographic features, biochemistry, HCV genotypes and disease status between autoantibody-positive and autoantibody-negative patients. CONCLUSIONS: Autoantibodies were commonly found in patients with chronic HCV infection. But, the presence of autoantibodies may be a non-specific finding in chronic hepatitis C infection without clinical significance.
Autoantibodies* ; Autoimmune Diseases ; Biochemistry ; Discrimination (Psychology) ; Genotype ; Hepacivirus ; Hepatitis C, Chronic* ; Hepatitis, Autoimmune ; Hepatitis, Chronic* ; Humans ; Liver ; Prevalence* ; Rheumatoid Factor

No abstract available.
Adenoma* ; Humans ; Infant, Newborn*

We report the case of a 5-year-old male patient with multiple aseptic splenic abscesses associated with Behçet's disease. The patient visited Gachon University Gil Hospital with fever, abdominal pain, and acute watery and bloody diarrhea, and reported a 2-year history of chronic abdominal pain and intermittent watery diarrhea. He was treated with antibiotics at a local clinic for fever and cervical lymph node swelling. Additionally, he had recurrent stomatitis. A colonoscopy showed multiple well-demarcated ulcerations throughout the colon, and abdominal computed tomography showed multiple splenic abscesses. Pathergy and HLA-B51 tests were positive. Investigations did not reveal any infectious organisms in the aspirate obtained via ultrasound-guided fine needle aspiration. After steroid treatment, all symptoms and multiple aseptic splenic abscesses resolved. However, oral ulcers, genital ulcers, and abdominal pain recurred after tapering the steroids. Infliximab treatment improved the patient's symptoms. However, 5 months after the treatment, the symptoms recurred. The treatment was changed to include adalimumab. Subsequently, the patient's symptoms resolved and colonoscopic findings improved. No recurrence was noted after 3 months of follow-up.
Abdominal Pain ; Abscess* ; Adalimumab ; Anti-Bacterial Agents ; Behcet Syndrome ; Biopsy, Fine-Needle ; Child* ; Child, Preschool ; Colon ; Colonoscopy ; Diarrhea ; Fever ; Follow-Up Studies ; HLA-B51 Antigen ; Humans ; Infliximab ; Lymph Nodes ; Male ; Oral Ulcer ; Pediatrics ; Recurrence ; Spleen ; Steroids ; Stomatitis ; Ulcer

Pick's disease is a rare neurodegenerative disorder presenting cortical type of dementia. Pick's disease shows unique clinical and pathological features, that are due to a degeneration of fronto-temporal lobes of the cerebrum. The authors experienced a case of Pick's disease in a 58-year-old male patient who had dementia symptoms for five years. The patient showed compulsive behavior since five years ago. Memory decline started from four years ago and progressed. Brain CT disclosed lobar atrophy of the cerebral gyri in frontal and temporal lobes. He died of septicemia associated with aspiration pneumonia. At autopsy, both cerebral hemispheres showed marked encephalomalacia. The gyral atrophy was moderately severe in prefrontal and anterior temporal lobes. Coronal section disclosed moderate dilatation of the lateral ventricles. Microscopically, there were marked neuronal loss in prefrontal and anterior temporal cortices. Also noted were Pick's cells and Pick's body in occasional pyramidal cells preserved.
Atrophy ; Autopsy* ; Brain ; Cerebrum ; Compulsive Behavior ; Dementia ; Dilatation ; Encephalomalacia ; Humans ; Lateral Ventricles ; Male ; Memory ; Middle Aged ; Neurodegenerative Diseases ; Neurons ; Pick Disease of the Brain* ; Pneumonia, Aspiration ; Pyramidal Cells ; Sepsis ; Temporal Lobe

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is a major problem associated with liver cirrhosis which has high mortality. Increased production of inflammatory mediators, such as tumor necrosis factor-a (TNF-a) and interleukin- (IL-) may be associated with development of renal impairment, one of the most important prognostic parameters in SBP. The aim of this study is to investigate the changes of these cytokines in ascitic fluid and plasma in patients with SBP and the relationship between these cytokines and development of renal impairment. METHODS: Forty patients with liver cirrhosis and ascites were studied 21 with SBP and 19 with sterile ascites. TNF-a and IL- levels in ascitic fluid and plasma were determined by ELISA at the time of diagnosis in both groups and 48 hours after antibiotics treatment in SBP patients. RESULTS: TNF-and IL- levels in ascitic fluid and plasma were significantly higher in patients with SBP than those without SBP (ascitic fluid TNF-a: 2.5+/-0.5 vs. 1.6+/-0.2; plasma TNF-a: 2.3+/-0.5 vs. 1.5+/-0.2; ascitic fluid IL-: 3.8+/-0.5 vs. 3.0+/-0.4; plasma IL-: 3.4+/-0.5 vs. 2.3+/-0.3, log pg/mL)(p<0.001). In patients with SBP, levels of TNF-a and IL- in ascitic fluid and plasma decreased 48 hours after antibiotics treatment. Eleven patients with SBP (11/21, 52%) developed renal impairment. Patients with renal impairment had significantly higher ascitic fluid and plasma TNF-a levels than those without renal impairment (median 2.5 vs. 2.1 for ascitic fluid, p=0.006; median 2.4 vs. 2.0, log pg/mL for plasma, p=0.04). Although four out of eleven (36%) patients who developed renal impairment died during hospitalization, all the patients without renal impairment survived (p=0.09). CONCLUSION: Our results suggest that the levels of TNF-a and IL- in ascitic fluid and plasma are increased in SBP and elevated levels of TNF-a in ascitic fluid and plasma may be associated with development of renal impairment, thus indicating poor prognosis in patients with SBP.
Anti-Bacterial Agents ; Ascites ; Ascitic Fluid* ; Cytokines ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Hospitalization ; Humans ; Liver Cirrhosis ; Mortality ; Necrosis* ; Peritonitis* ; Plasma* ; Prognosis

BACKGROUND: The nucleus tractus solitarius (NTS), the region of the brain stem in which primary baroreceptor afferents teminate, is critically important in the normal regulation of arterial pressure (AP). In the NTS, excitatory amino acids such as L-glutamate serve as the main neurotransmitter in the regulation of AP. However, the function of GABA in the NTS has not been established. To test the function of GABA, we applied GABAergic agents to the NTS. METHODS: The experiments were conducted on adult male Sprague-Dawley rats weighing 300-500g. A cannula (PE-50 tubing filled with heparinized saline) was inserted into the femoral artery for recording of AP and heart rate(HR). Another cannula was inserted into the femoral vein for administration of nitroprusside or phenylephrine. After rats were placed on a sterotaxic instrument, the dorsal surface of the medulla was exposed, and with the aid of a surgical microscope, the NTS was visualized. Drug injections were made into the NTS using single- or three-barreled grass micropipettes pulled to an outer diameter of 80-100(micro)m and connected to a 1(micro)l Hamilton syringe. RESULTS: The follwing results were obtained in this experiment. Injection into the NTS of 10 or 20 nmol nipecitic acid, a selective inhibitor of GABA untake, produced an increase in AP. The pressor responses evoked by two doses of nipecotic acid were not significantly different. Injection of GABA(A) agonist, musciml(5 pmol in 80 nl artificial CSF) and GABA(B) agonist, baclofen (20 pmol in 80 nl) into the NTS of urethane-anesthetized rats prodused an increase in AP of 16.6+/-1.3 and 27.6+/-1.5 mmHg, respectively. Thus the pressor response to GABA(B) agonist was greater than to GABA(A) agonist. On the other hand, microinjection of GABA(A) antagonist, bicuculline and GABA(B) antagonist, phaclofen into the NTS decreased AP by approximately 13.4+/-1.0 and 20.9+/- mmHg, respectively. Thus injection of nipecotic acid into the NTS was greater in control group compared with the muscimiol or baclofen groups. The AP changes caused by i.v. injection of nitroprusside or phenylephrine were smallest in control group and greatest in the baclofen group. When calculated as baroreflex sensitivity, the change was greatest in control group and smallest in the baclofen group. CONCLUSION: From these results it was concluded that GABA in the NTS plays an important role in the regulation of AP, especially through GABA(B) receptors, and have an inhibitory effect on baroreceptor reflex.
Adult ; Animals ; Arterial Pressure ; Baclofen ; Baroreflex ; Bicuculline ; Blood Pressure ; Brain Stem ; Catheters ; Excitatory Amino Acids ; Femoral Artery ; Femoral Vein ; GABA Agents ; gamma-Aminobutyric Acid* ; Glutamic Acid ; Hand ; Heart ; Heparin ; Humans ; Male ; Microinjections ; Neurotransmitter Agents ; Nitroprusside ; Phenylephrine ; Poaceae ; Pressoreceptors ; Rats ; Rats, Sprague-Dawley ; Solitary Nucleus* ; Syringes

The diagnosis of internal jugular vein thrombosis (IJVT), a vascular disorder, can be easily overlooked. Disruption of blood flow through the internal jugular vein can take place in a variety of clinical settings. CT and ultrasonography are useful diagnostic tools. Recently, we experienced a case of IJVT after deep neck infection. This case showed sore throat, odynophagia and swelling of right submandibular area. CT scan revealed diffuse neck swelling and incomplete occlusion of the right internal jugular vein at the thyroid level. Treatment began with antibiotics and hydration. We present a case of IJVT after deep neck infection with literature review.
Anti-Bacterial Agents ; Diagnosis ; Jugular Veins* ; Neck* ; Pharyngitis ; Thrombosis* ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVE: To compare ultrasonography guided versus blind approach in a randomized trial examining the efficacy of suprascapular nerve block in patients with non-specific shoulder pain. METHOD: A total of 20 patients with shoulder pain lasting for more than 1 month were included in this study. After 1:1 randomization, patients were included either in the blind group (n=10) or in the ultrasonography guided group (n=10) of suprascapular nerve block. All patients were evaluated before and after treatment, in terms of shoulder pain and disability index (SPADI) and nerve conduction study. RESULTS: Significant improvements were seen in all pain scores and disability after both types of nerve block, with no significant difference in the improvement of pain and disability between the two approaches. However, amplitude changes of nerve conduction study were larger in ultrasonography guided approach than blind approach. CONCLUSION: This study suggests ultrasonography guided approach of suprascapular nerve block could place the needle closer to the nerve compared to blind approach.
Humans ; Hypogonadism ; Mitochondrial Diseases ; Needles ; Nerve Block ; Neural Conduction ; Ophthalmoplegia ; Random Allocation ; Shoulder Pain

OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p <0.05) and 6-month follow-up (p <0.05). Control group showed no significant difference at follow-up (>0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Hand ; Humans ; Shock