Antithrombin deficiency is a rare condition among the numerous conditions that can lead to a hypercoagulable state, and can manifest as deep vein thrombosis, portal or mesenteric venous thrombosis, pulmonary thromboembolism and cerebrovascular accidents. In this report, we present a case of acute renal infarction and multiple venous thrombosis in a 36-year-old man with a family history of thromboembolism. He presented with a sudden onset of pain in the right flank and was admitted to the emergency room for evaluation. On computed tomography and renal angiography, the diagnosis of acute renal infarction concurrent with portal, splenic and superior mesenteric venous thrombosis was made. Laboratory data revealed parallel decreases in activity and antigen concentration of antithrombin despite normal liver and renal functions. He was treated with intravenous heparin and fresh frozen plasma followed by concomitant warfarin therapy. Taken together, the etiology of acute renal infarction and multiple venous thrombosis was considered to be associated with type I inherited antithrombin deficiency.
Adult ; Angiography ; Antithrombin III Deficiency ; Emergencies ; Heparin ; Humans ; Infarction ; Kidney ; Liver ; Plasma ; Pulmonary Embolism ; Stroke ; Thromboembolism ; Thrombosis ; Venous Thrombosis ; Warfarin

No abstract available.
Histiocytosis, Langerhans-Cell* ; Scabies*

No abstract available.
Eczema* ; Hand* ; Rubber*

Neuroleptic malignant syndrome (NMS) is a rare but potentially lethal outcome caused by sudden discontinuation or dose reduction of dopaminergic agents. We report an extremely rare case of NMS after deep brain stimulation (DBS) surgery in a cerebral palsy (CP) patient without the withdrawal of dopaminergic agents. A 19-year-old girl with CP was admitted for DBS due to medically refractory dystonia and rigidity. Dopaminergic agents were not stopped preoperatively. DBS was performed uneventfully under monitored anesthesia. Dopaminergic medication was continued during the postoperative period. She manifested spasticity and muscle rigidity, and was high fever resistant to anti-pyretic drugs at 2 h postoperative. At postoperative 20 h, she suffered cardiac arrest and expired, despite vigorous cardiopulmonary resuscitation. NMS should be considered for hyperthermia and severe spasticity in CP patients after DBS surgery, irrespective of continued dopaminergic medication.
Anesthesia ; Cardiopulmonary Resuscitation ; Cerebral Palsy* ; Deep Brain Stimulation* ; Dopamine Agents ; Dystonia ; Female ; Fever ; Globus Pallidus* ; Heart Arrest ; Humans ; Muscle Rigidity ; Muscle Spasticity ; Neuroleptic Malignant Syndrome ; Postoperative Period ; Young Adult

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

Background: Non-alcoholic fatty liver disease (NAFLD) recently became a leading liver disease that threatens health worldwide. Low muscle strength, obesity, insulin resistance, and metabolic syndrome are recognized key factors for NAFLD. However, the impact of low muscle strength itself in different metabolic conditions has not been widely studied. Methods: A cross-sectional analysis was performed of a sample of 5,427 participants from the 2019 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (rHGS, defined as handgrip strength/body mass index) was used to assess muscle strength. The cut-off values for a low rHGS were 1.405 for men and 0.850 for women. NAFLD was diagnosed if the Hepatic Steatosis Index was >36. Participants were stratified according to insulin resistance, metabolic syndrome, and central obesity for the subgroup analyses. Results: Complex sample multivariate logistic regression analysis revealed a significant association between low muscle strength and NAFLD after the adjustment for other confounders (odds ratio [OR], 1.92; P<0.001). In the insulin resistance, metabolic syndrome, and central obesity subgroups, a significant association between low muscle strength and NAFLD remained (OR, 1.66–4.19 depending on subgroup; all P<0.05), whereas it did not in the no central obesity group. Conclusion This study demonstrated that low muscle strength is correlated with a risk of NAFLD. This relationship was independent of insulin resistance and metabolic syndrome but was dependent on the presence of central obesity.

Medullary carcinoma of the thyroid gland is a malignant neuroendocrine tumor arising from calcitonin producing-parafollicular cells. The tumor is clinically divided into sporadic and familial form, constituting about 80% and 20%, respectively. Recently, we experienced a case of unilateral and solitary sporadic medullary carcinoma of the left thyroid gland. The patient was a 9 year-old female, who presented with a palpable mass on the anterior lateral neck of 8 months duration without any familial and personal history of neuroendocrine disease. The cytopathologic findings showed spindle cells and plasmacytoid cells in the background of colloid-like materal. The nuclei were eccentrically located, mildly hyperchromatic and pleomorphic, showing speckled chromatin pattern without nuclear inclusion or prominent nucleoli. The cytoplasm was abundant and had a pale granular cyanophilic appearance. No amyloid materal could be identified.
Amyloid ; Calcitonin ; Carcinoma, Medullary* ; Child* ; Chromatin ; Cytoplasm ; Female ; Humans ; Intranuclear Inclusion Bodies ; Neck ; Neuroendocrine Tumors ; Thyroid Gland*

OBJECTIVE: To investigate the hemispheric contributions to prosody recognitions and interference effects of semantic processing on prosody for stroke patients by using the Korean language. METHODS: Ten right hemisphere damaged patients (RHD), nine left hemisphere damaged patients (LHD), and eleven healthy controls (HC) participated. In pure prosody recognition task, four semantically neutral sentences were selected and presented in both sad and happy prosodies. In interference task, participants listened to emotionally intoned sentences in which the semantic contents were congruent or incongruent with prosody. Participants were asked to rate the valence of prosody while ignoring the semantic contents, and thus, reaction time and accuracy were estimated. RESULTS: In pure prosody recognition task, RHD showed low accuracy as compared to HC (p=0.013), and the tendency of group response showed that RHD performed worse than HC and LHD with regards to accuracy and reaction time. In interference task, analysis of accuracy revealed a significant main effect of groups (p=0.04), and the tendency implied that RHD is less accurate as compared to LHD and HC. The RHD took longer reaction times than HC in congruent and incongruent items (p<0.001). CONCLUSION: Right hemispheric laterality to prosody processing of Korean language in stroke patients was observed. Interference effects of semantic contents to prosody processing were not observed, which suggested unique characteristics of prosody for Korean language. These results could be referred as preliminary data for future researches on Korean languages.
Functional Laterality ; Humans ; Reaction Time ; Semantics ; Speech Disorders ; Speech Perception ; Stroke*

Isolated rabbit aortic ring with intact endothelial cell preparations precontracted with NE (10(-7) M) were relaxed by vanadate in a dose dependent manner (from 0.2 to 2 mM). Application of vanadate and ACh during the tonic phase of high K+(100 mM)-induced contraction showed a slight relaxation in contrast to that in NE-induced contraction, but sodium nitroprusside (10 microM) more effectively relaxed the aortic ring preparations in high K+ contraction than that of vanadate. Vanadate-induced relaxation in NE-contracted aortic rings was reversed by application of BaCl2 (50 microM) or glibenclamide (10 microM). Furthermore, Vanadate hyperpolarized membrane potential of smooth muscle cells in endothelium-intact aortic strips and this effect was abolished by application of glibenclamide. The above results suggest that vanadate release EDHF (Endothelium-Derived Hyperpolarizing Factor), in addition to EDRF (Endothelium-Derived Relaxing Factor) from endothelial cell. This EDHF hyperpolarize the smooth muscle cell membrane potential via opening of the ATP-sensitive K+ channel and close a voltage dependent Ca++ channel. So it is suggested that the vanadate-induced relaxation of rabbit thoracic aortic rings may be due to the combined effects of EDRF and EDHF.
Animal ; Aorta/drug effects/physiology ; In Vitro ; Membrane Potentials/drug effects ; Potassium/pharmacology ; Potassium Channels/physiology ; Rabbits ; Support, Non-U.S. Gov't ; Tetraethylammonium Compounds/pharmacology ; Vanadates/*pharmacology ; Vasodilation/*drug effects