Twelve hyperlipidemic patients taking ginseng extract 1.0 gm daily were studied for sequential changes in blood lipid levels for 16 weeks. Following results were observed. 1. HDL-C was markedly elevated from the beginning through test period while TG is conversely decreased. 2. TC and LDL-C revealed the tendency to decrease but not significant in degree. 3. No remarkable untoward reaction was observed with long term ginseng extract administration. In summary, the beneficial effect of ginseng extract on abnormal blood lipids level is unequivocal and the author recommend the use of ginseng extract to patient being on the verge of atherosclerosis.
Atherosclerosis* ; Humans ; Panax*

No abstract available.
Arteriovenous Fistula* ; Renal Dialysis*

Coronavirus disease 2019 (COVID-19) is a manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its major symptoms include pulmonary complications, such as pneumonia. However, it also involves the cardiovascular system and the developed myocarditis can lead to sudden unexpected death. Herein, we present a case in which a patient died four days after release from isolation due to SARS-CoV-2 infection. SARS-CoV-2 was confirmed again during postmortem (PM) inspection at the scene of death. Autopsy revealed myocarditis and evidence of pulmonary involvement with SARS-CoV-2. Pathological examination revealed myocardial perivascular infiltration of lymphocytes and macrophages with multifocally injured cardiomyocytes. The pathological findings of COVID-19–induced myocarditis differ from those of other viral myocarditis, and we assume that different pathophysiological mechanisms could have been responsible for this manifestation. After a comprehensive PM examination, including gross dissection, microscopic examination, PM computed tomography, and PM laboratory tests, the cause and manner of death were determined to be myocarditis caused by COVID-19 and naturally, respectively. This case highlights the significance of autopsy and comprehensive PM examinations in both forensic and public healthcare systems.

Forensic autopsy is performed to investigate a death. However, this is difficult in some cases, particularly in putrefied bodies. Pulmonary ossification is a rare pathological process, characterized by progressive and metaplastic ossification, which leads to the formation of small bony fragments in the pulmonary tissue. This condition can develop within the pulmonary tissues that are injured due to various causes. Metastatic and dystrophic calcification occur in normal tissues in conditions of deranged calcium metabolism and dead or degenerative tissue, respectively. Here, we describe the case of a 54-year-old man who lived alone and whose putrefied body was discovered by his landlord. A forensic pathologist identified needle-like sharp materials in both the lower lobes of the lungs during autopsy. Microscopic examination revealed dendriform pulmonary ossification with calcification. After autopsy, his medical history, including chronic kidney disease, was recorded by forensic pathologist. A review of his past medical history and comprehensive postmortem examination findings of the gross dissection, microscopic examination, and postmortem laboratory tests led to the determination of the cause of death as renal problems.

BACKGROUND: Differential diagnosis of pleural malignant mesothelioma from secondary metastatic adenocarcinoma is often difficult. A variety of pathologic techniques have been developed to make a differential diagnosis of carcinoma from mesothelioma. Immunohistochemistry detecting diverse antigenic substances such as CEA, Leu-M1, B72-3, S-100 protein, vimentin, CK and EMA has been claimed to be of value as a panel in the differential diagnosis of adenocarcinoma from mesothelioma. The aim of this study was to investigate the suitable antibodies to distinguish mesothelioma from metastatic adenocarcinoma and establish candidate markers in a panel. METHODS: Complete, one-hour immunohistochemical staining using antibodies against cytokeratin (CK), epithelial membrane antigen(EMA), S-100 protein, vimentin, B72-3, Leu-M1, and carcino-embryonic antigen (CEA) was applied to cell blocks from 7 mesotheliomas and 7 adenocarcinomas which were confirmed by electron microscopic and histpathologic methods. RESULTS: All adenocarcinomas and 71.4% of mesotheliomas expressed the cytokeratin and EMA. S-100 protein and vimentin were expressed in 57.1% and 42.9% of mesotheliomas and 14.3% and 28.5% of adenocarcinomas, respectively. B72-3 was expressed in all adenocarcinomas, but in none of mesotheliomas. Leu-M1 was positive in 71.4% of the adenocarcinoma and 14.3% of the mesotheliomas. CEA was positive in all adenocarcinomas and 42.9% of mesotheliomas. Leu-M1 and B72-3 were coexpressed in 71.4% of adenocarcinomas but in none of mesothelioma. B72-3 and CEA were coexpressed in all adenocarcinomas, but in none of mesotheliomas. CONCLUSION: We concluded that B72-3 immunohistochemistry or panel staining of B72-3 and CEA could be recommanded for the differential diagnosis of pleural mesothelioma from metastatic adenocarcinoma.
Adenocarcinoma* ; Antibodies ; Diagnosis, Differential* ; Immunohistochemistry* ; Keratins ; Membranes ; Mesothelioma* ; S100 Proteins ; Vimentin

BACKGROUND/AIMS: In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives. METHODS: This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed. RESULTS: A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm2/sec vs. 1.57 mm2/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities. CONCLUSIONS: ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.
Animals ; Equipment and Supplies ; Feasibility Studies* ; Models, Animal ; Quality Control

Chylopericardium is a rare disease entity characterized by the accumulation of chylous fluid in the pericardial sac. It usually arises from mediastinal neoplasms, thrombosis of the subclavian vein, tuberculosis, nonsurgical trauma, thoracic or cardiac surgery. The spectrum of symptoms for chylopericardium varies from an incidental finding of cardiomegaly to dyspnea, upper abdominal discomfort, cough, chest pain, palpitation, fatigue. However, most of the patients are asymptomatic. The main purpose of treatment of chylopericardium is the prevention of cardiac tamponade and prevention of metabolic, nutritional, and immunological compromise due to chyle leak. Here, we report a case of chylopercardium secondary to lymphangiomyoma with review of the literature.
Cardiac Tamponade ; Cardiomegaly ; Chest Pain ; Chyle ; Cough ; Dyspnea ; Fatigue ; Humans ; Incidental Findings ; Lymphangioma ; Lymphangiomyoma ; Mediastinal Neoplasms ; Pericardial Effusion ; Rare Diseases ; Subclavian Vein ; Thoracic Surgery ; Thorax ; Thrombosis ; Tuberculosis

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.
Aneurysm ; Angiography ; Brachial Artery ; Contusions ; Dilatation ; Rare Diseases ; Ultrasonography, Doppler ; Upper Extremity

BACKGROUND: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. METHODS: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. RESULTS: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. CONCLUSION: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.
Ambulatory Care Facilities ; Arteriovenous Fistula ; Fistula* ; Follow-Up Studies ; Humans ; Hypertension ; Internal Medicine ; Ligation* ; Postoperative Complications ; Renal Dialysis ; Retrospective Studies ; Veins*

We report a case of congenital and familial antithrombin III deficiency developing massive pulmonary thromboembolism. A 44-year-old man was admitted to our hospital because of sudden chest pain and severe dyspnea. Five years ago, he was operated due to a mesenteric vein thrombosis of unknown cause. On admission, radioisotopic venogram showed deep vein thrombosis and lung scintigram showed multiple segmental perfusion defects. His plasma antithrombin III level was 10.5 mg/dL which was less than 50% of normal and those of a son and two daughters were also decreased. After treatment with tissue plasminogen activator, heparin and coumadin, his symptom and lung scintigram were significantly improved. As far as we reviewed, there were very rare reports with congenital antithrombin III deficiency presenting as pulmonary thromboembolism in Korea.
Adult ; Antithrombin III ; Antithrombin III Deficiency* ; Chest Pain ; Dyspnea ; Heparin ; Humans ; Korea ; Lung ; Mesenteric Veins ; Nuclear Family ; Perfusion ; Plasma ; Pulmonary Embolism* ; Thrombosis ; Tissue Plasminogen Activator ; Venous Thrombosis ; Warfarin