No abstract available.
Down Syndrome* ; Humans ; Twins, Monozygotic*

The Epstein-Barr virus(EBV) is known to play a causal role in oncogenesis and to be associated with endemic Burkitt's lymphomas, B cell lymphomas in immunocompromised patients, and nasopharyngeal carcinomas. More recently, EBV has also associated with Hodgkin's disease, B cell lymphomas in non-immunocompromised patients, and T-cell lymphomas. Twenty eight cases of a non-Hodgkin's lymphoma of gastrointestinal tract were investigated to determine both the immunophenotype by using immunohistochemical staining and the incidence of the EBV nuclear antigen by using the polymerase chain reaction. Twenty-four of the 28 cases(85.7%) were B-cell type, and 4 of the 28 cases(14.3%) are of T-cell type. The EBV nuclear antigen was detected in three of the 28 cases(10.7%), including two cases of B-cell lymphoma of the stomach and one case of T-cell lymphoma of the small bowel. The EBV nuclear antigen was more frequently found in malignant lymphomas arising in the intestine(1/4) than in stomach(2/16). EBV positivity (25%) in T-cell NHLs was rather higher than EBV positivity (8.3%) in B-cell NHLs. Further expanded evaluations on the role of EBV in the tumorigenesis of a gastrointestinal malignant lymphomas are necessary because the cases of gastrointestinal lymphomas examined were very limited.
B-Lymphocytes ; Burkitt Lymphoma ; Carcinogenesis ; Gastrointestinal Tract* ; Herpesvirus 4, Human* ; Hodgkin Disease ; Humans ; Immunocompromised Host ; Incidence* ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Lymphoma, T-Cell ; Polymerase Chain Reaction ; Stomach ; T-Lymphocytes

No abstract available.
Cystadenoma, Mucinous* ; Mucins* ; Pancreas*

Small bowel diverticulum, although not common and usually asymptomatic, can give rise to unexpected problems such as malabsorption, perforation, obstruction and bleeding. Bleeding from a diverticulum is often sudden and massive, therefore requiring emergency operation. We report herein a case of a 75-year-old man who presented with massive bleeding from multiple jejunal diverticula. He had been diagnosed with hypertensive end stage renal disease and treated with hemodialysis since 14 years previously. He was admitted with both hematemesis and hematochezia, and treated conservatively at first. However, bleeding continued and the anemia did not improve despite blood transfusions. An gastroduodenofiberscope and selected angiography revealed no bleeding focus. An emergency laparotomy was performed and multiple jejunal diverticula, distributed from 15 to 60cm distal to the ligament of Treitz, were found. A segment of the jejunum containing all diverticula was resected and end to end anastomosis was performed. A histologic examination revealed some dilated blood vessels in the submucosa of the diverticulum, which was compatible with the findings of the angiodysplasia. Based on these findings, we suggest that angiodysplasia was the cause of bleeding from the jejunal diverticula in this case.
Aged ; Anemia ; Angiodysplasia* ; Angiography ; Blood Transfusion ; Blood Vessels ; Diverticulum* ; Emergencies ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Jejunum ; Kidney Failure, Chronic* ; Laparotomy ; Ligaments ; Renal Dialysis

Nasal vestibular stenosis is an uncommon cause of nasal obstruction. There are various causes of the narrowing of vestibule, including previous trauma, surgery, infection, and iatrogenic injury. The disease is characterized by circumferential scar retraction in inlet of nasal cavities which are caused by secondary proliferation of granulation and fibrous tissue. A number of studies were reported on the surgical correction of vestibular stenosis, but no single technique had been widely accepted due to a wide spectrum treatment methods owing to the various causes of disease and deformities of the related anatomy. Here we suggest a new surgical technique for correcting a case of vestibular stenosis caused by trauma.

On PA chest radiography, the anterior junction line(AJL) is seen to project from the upper right to the lowerleft of the upper third of the body of the sternum and represents the visceral and parietal pleura of each lungand a small quantity of mediastinal fat. In a patient with volume loss or expansion of a hemithorax, the AJL showsconsiderable shift and on PA chest radiography may mimic pneumothorax or pneumomediastimum. In such cases,widening and hyperlucency of the retrosternal space, seen on lateral view, which represents herniated lung with ashift of AJL, may be helpful for differentiation from pneumothorax or pneumomediastinum.
Humans ; Lung ; Mediastinal Emphysema ; Pleura ; Pneumothorax ; Radiography ; Sternum ; Thorax

OBJETIVE: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. MATERIALS OF METHODS: The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. RESULTS: The mean ages of the patients with leiomyomas and the control group were 43.1+/-5.6 and 40.6+/-7.2 years, the weights were 63.4+/-7.3 and 59.4+/-8.1 kg, and their heights were 155.4+/-4.8 and 159.3+/-4.8 cm respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. 17beta-estradiol, 5-AT, 11-keto ET, 11beta-hydroxy An, 11beta-hydroxy Et, THS, THA, THE, alpha-cortolone, alpha-cortol, beta-cortol, 11beta-OH Et/11beta-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. 17beta-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. 17beta-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). CONCLUSION: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.
Female ; Gas Chromatography-Mass Spectrometry ; Healthy Volunteers ; Humans ; Leiomyoma* ; Steroids ; Ultrasonography ; Uterus* ; Weights and Measures

Nasal septal perforation is a defect of cartilage, bone, or mucosa of the nasal septum. Nasal septal perforation has several potential causes such as previous septal surgeries, trauma, malignancy, inflammation, or drugs. According to previous studies, successful surgical outcome is affected by the size and location of the perforation. Although many surgical techniques have been reported, there is no standardized nor consistent surgical method for repairing nasal septal perforation. This report suggests a new surgical technique of repairing septal perforation using a posterior perforation-margin-based hinge flap.
Cartilage ; Inflammation ; Methods ; Mucous Membrane ; Nasal Septal Perforation ; Nasal Septum ; Surgical Flaps

Background: The anti-oxidative, anti-inflammatory, and anti-apoptotic effects of erythropoietin may provide neuroprotective effects. Erythropoietin also modulates autophagy signaling that may play a role in anesthesia-induced neurotoxicity (AIN). Herein, we investigated whether AIN can be attenuated by the neuroprotective effect of erythropoietin in the Caenorhabditis elegans (C. elegans). Methods: Synchronized worms were divided into the control, Iso, EPO, and EPO-Iso groups. The chemotaxis index (CI) was evaluated when they reached the young adult stage. The lgg-1::GFP-positive puncta per seam cell were used to determine the autophagic events. The erythropoietin-mediated pathway of autophagy was determined by measuring the genetic expression level of let-363, bec-1, atg-7, atg-5, and lgg-3. Results: Increased lgg-1::GFP puncta were observed in the Iso, EPO, and EPO-Iso groups. In the Iso group, only the let-363 level decreased significantly as compared to that in the control group (P = 0.009). bec-1 (P < 0.001), atg-5 (P = 0.012), and lgg-3 (P < 0.001) were expressed significantly more in the EPO-Iso group than in the Iso groups. Repeated isoflurane exposure during development decreased the CI. Erythropoietin could restore the decreased CI by isoflurane significantly in the EPO-Iso group. Conclusions Erythropoietin showed neuroprotective effects against AIN and modulated the autophagic pathway in C. elegans. This experimental evidence of erythropoietin-related neuroprotection against AIN may be correlated with the induced autophagic degradation process that was sufficient for handling enhanced autophagy induction in erythropoietin-treated worms.

OBJECTIVE: As for the method of surgical correlation of the central type of anterior vaginal wall defects, there are anterior repair, anterior repair with prolene mesh, and internal anterior repair. The object of this study was to compare the recurrence rates, complications and the clinical efficacy of the three surgical procedures. METHODS: We identified one hundred and thirty-eight patients who underwent operations for the central type of anterior vaginal wall defects from March 1999 to May 2005. We retrospectively collected data from the medical records and reviewed the outcomes. We investigated the characteristics of patients, recurrence rates and complication rates for the results, and compared them by ANOVA test and Kruskal-Wallis test. RESULTS: The number of cases of anterior repair, anterior repair with the mesh, and internal anterior repair were seventy-two, twenty-eight and thirty-eight consecutively. There was no significant difference in the characteristics of age, menopause status, parity, BMI (Body mass index) and history of pelvic surgery and the medico-surgical illness among the three groups. There were statistically no significant differences in fever, vaginal erosion, detrusor overactivity and voiding difficulty after the operations. The incidence of the postoperative urinary tract infections was increased significantly in the group of the anterior repair with prolene mesh (p=0.018), and drop in hemoglobin, operation time and wound infection were increased significantly in the group of the internal anterior repair (p=0.0001, 0.004 and p=0.028). The recurrence rate of the disease was significantly higher in internal anterior repair group than in anterior repair or anterior repair with the mesh groups (18.4% vs. 1.4% and 0%). The recurrence rate was increased in proportion to the duration after the surgery. CONCLUSION: The recurrence rate of the disease after internal anterior repair was significantly higher than when anterior repair or anterior repair with the mesh was done. As for the complications, urinary tract infection was increased after the anterior repair with prolene mesh and drop in hemoglobin and wound infection were increased after the internal anterior repair. We concluded that the conventional anterior repair is more suitable method for the correction of the central type of anterior vaginal wall defects than anterior repair with mesh and internal anterior repair.
Female ; Fever ; Humans ; Incidence ; Medical Records ; Menopause ; Parity ; Polypropylenes* ; Recurrence ; Retrospective Studies ; Urinary Tract Infections ; Wound Infection