No abstract available.
Child* ; Endoscopy* ; Humans

The cardiovascular manifestations in hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial flutter, atrial fibrillation, atrioventricular block, bundle branch block(especially right bundle branch block), angina pectoris, heart failure and cardiomyopathy. Of these, angina pectoris is commonly seen in hyperthyroidism with coronary artery disease and the potential mechanisms have been attributed to the increased metabolic demand and consequently increased cardiac work which result in the more demand of coronary blood flow than that can be delivered via a fixed atherosclerotic coronary artery stenosis. Hyperthyroidism associated anginas without underlying coronary artery stenosis have also been reported where the mechanism of these was suspected to be the coronary vasospasm. Ventricular fibrillation may occur in the thyrotoxic patients due to myocardial ischemia such as variant angina, but it is very rare in the condition without previous heart disease. A 30-year-old male was admitted to the hospital because of palpitation, weight loss and proptosis for the previous 3 months. There was no history of effort related chest pain, syncope, drug abuse or medical illnesses such as diabetes mellitus, hypertension. The laboratory results were, TSH: 0.38uU/mL(0.4~5,0 uU/mL), free T4: 8.9ng/dL(0.8~1.9ng/dL), TSH receptor antibody: 43.6%(-15~15%), antiTPO antibody: 5000 IU/mL(0~100 IU/mL). The initial EKG showed normal sinus rhythm. He was diagnosed as Graves disease with ophthalmopathy, class 3a and was put on propylthiouracil 200 mg po tid, propanolol 40 mg po tid and started solumedrol pulse therapy for the exophthalmos on the first day of admission. He was found to have generalized tonic seizure with apnea attack on second hospital day and twice thereafter. Ventricular fibrillation was documented at that time. DC cardioversion was performed with successful response. After the attack, he was treated as accelerated hyperthyroidism namely with increased dosage of propylthiouracil, dexamethasone and Lugols solution, The echocardiogram, treadmill test, ergonovine echocardiography, coronary angiography and electrophysiologic study disclosed no abnormalities. Further episodes of ventricular fibrillation didnt occur after being euthyroid state. In conclusion, we report a case of ventricular fibrillation associated with hyperthyroidism itself without underlying coronary artery disease with brief review of literatures.
Adult ; Angina Pectoris ; Apnea ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block ; Cardiomyopathies ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vasospasm ; Dexamethasone ; Diabetes Mellitus ; Echocardiography ; Electric Countershock ; Electrocardiography ; Ergonovine ; Exercise Test ; Exophthalmos ; Graves Disease ; Heart Diseases ; Heart Failure ; Humans ; Hypertension ; Hyperthyroidism ; Male ; Methylprednisolone Hemisuccinate ; Myocardial Ischemia ; Propranolol ; Propylthiouracil ; Receptors, Thyrotropin ; Seizures ; Substance-Related Disorders ; Syncope ; Tachycardia, Sinus ; Tachycardia, Supraventricular ; Ventricular Fibrillation* ; Weight Loss

When ultrasound or computed tomographic (CT) scans demonstrate a focal mass within the pancreas, the radiologist or gastroenterologist assumes that it is carcinoma. Statistically this is the correct diagnosis. However, distinguishing pancreatitis from carcinoma by ultrasound and CT is occassionally impossible. Similarly, abnormalities seen on ERCP, such as simultaneous obstruction of both the common bile duct and adjacent pancreatic duct (double duct sign), has been shown to occur in pancreatitis as well as in the more commonly diagnosed pancreatic carcinoma. We experienced 3 cases af focal pancreatic masses that mistaken a carcinoma. And so, knowledge that such a mass can be benign in a clinical setting sbould result in an organiged approach to the correct diagnosis and avoidance of any unnecessary operations.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Inflammation* ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Ultrasonography

Juvenile xanthogranuloma is characterized by one, or oftener many, yellow, re3dish yellow, or, brown 4-to-20 mm papules or nodules on the face, scalp, trunk, and mostly, extensor surfaces. It may involve internal organ besides the skin such as eye, gastrointestinal and genitourinary tracts. anthogranuloma in adult is usually solitary and dose not involve organs other than skin, and generally dose ncit resolve without treatment. Histopathologically, characteristic Touton giant cells usually appear numerously. We report a case of juvenile xanthogranulorna which occured on scalp of 49 year-old male showing typical clinical and histopathological findings.
Adult* ; Giant Cells ; Humans ; Male ; Middle Aged ; Scalp* ; Skin ; Xanthogranuloma, Juvenile

No abstract available.
Cardiomyopathy, Dilated*

Small hepatoma is defined as hepatocellular carcinoma less than 3cm in maximum diameter and fewer than 3 innumber. To assess the ability of ultrasound to detect small hepatomas, a prospectively study was done in a groupof patients with HBsAg-positive chronic hepatitis and liver cirrhosis. Herein, we present 4 hypoechoic smallhepatomas detected on ultrasound and emphasize the role of real-time ultrasonography as a practical test formonitoring hepatoma high-risk, subjects.
Carcinoma, Hepatocellular ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Mass Screening ; Prospective Studies ; Ultrasonography

No abstract available.
Nephrotic Syndrome* ; Venous Thrombosis*

No abstract available.
Cystitis* ; Lymphoma, Non-Hodgkin* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Ki-1 monoclonal antibody is a well known marker for Reed-Sternberg cells in Hodgkin's disease, but also occasionally reacts with activated lymphoid cells of either benign or malignant nature. Recently, Ki-1 antibody positive Non-Hodgkin's lymphoma, usually of large cell and/or polymorphous type, has been reported in the lymph nodes, skin, soft tissue, and stomach, but not in the bone. We report a case of multifocal primary bone lymphoma in a seven-year old body involving the left shoulder and right frontal bone, which proved to be a large cell, polymorphous lymphoma, helper T-cell type expressing Ki-1 antigen.
Child ; Male ; Female ; Humans

To understand better the complex natural course of HBV infection, the expression patterns of HBcAg and HBsAg in the liver of 51 inactive serum HBsAg carriers (24 CPH and 27 NPD) were studied by immunohistochemical methods. The inactive serum HBsAg carriers were devided into 3 groups by the following expression patterns of serum HBeAg/anti-HBe status and tissue HBcAg and HBsAg. Pattern A (18 cases) : HBeAg+, cHBcAg+ (94.4%), mHBsAg+ (61.1%), pATTERN B (14 cases) : anti-HBe+, nHBcAg+, cHBsAg+, Pattern C (19 cases) : anti-HBe+, HBcAg-, cHBsAg+ (89.5%). There were no significant differences between CPH and NPD, lthough the core free pattern was more common in the latter. The cHBcAg was expressed in 17 of 18 (94.4%) HBeAg seropositive cases but only one of 33 cases with serum anti-HBe, suggesting that the cHBcAg is intimately related to HBeAg. Since the inactive HBsAg carriers also expressed cHBcAg and/or mHBsAg, the necro-inflammatory activity of HBV infected liver is assumed to depend on the host immune response rather than their presence alone