Angiolipoma is a rare benign soft tissue tumor, an unusual variant of lipoma,consisting of fatty and vascular components and located in the subcutis, usually in the trunk and extremities. We report a case of posterior mediastinal angiolipo-ma extending into the spinal canal and showing both fat and angiomatous fea-tures on CT scan.
Aged ; Angiolipoma/pathology/*radiography ; Case Report ; Female ; Human ; Mediastinal Neoplasms/pathology/*radiography ; Spinal Canal/*pathology ; Tomography, X-Ray Computed

The isolation of fetal cells from maternal circulation has the potential to allow relativelyself prenatal diagosis for all pregnant women. The present technology, however, has notreached the accuracy required for clinical diagnosis because of maternal cell contaminationSo we published a new method for enrichment of nRBC in a fetal cell isolation(1996).In this study, attempted to FISH analysis of nRBC which was isolated by our ownmethods. We evaluated the efficiency of FISH.As the results, we have successfully used FISH on enriched nRBC.We were able to identified 2 abnormal fetus which were confirmed by conventionalcytogenentic study as Down syndrome(Fig.1) and Klinefeltre syndrome(Fig.2). And thesensitivity and specificity for FISH was 86%(49/57) and 92.3%(36/39), respectively.According to our results, fetal cell analysis by FISH can be reliable used for prenatalaneuploidy diagnosis. However, the problems of enrichment of the fetal cell and FISH probeor condition should be over come before analyze.
Aneuploidy ; Diagnosis ; Erythroblasts* ; Female ; Fetus ; Fluorescence* ; Humans ; Pregnant Women ; Sensitivity and Specificity

Terlipressin has splanchnic vasoconstrictive effects, and is generally used for the management of gastroesophageal variceal bleeding secondary to liver cirrhosis. Terlipressin is a synthetic arginine vasopressin (AVP) analog containing a nonapeptide sequence. Terlipressin has increased selectivity for the V1 receptor, compared with AVP; hence, it is considered to be a safe vasoconstrictor. However, side effects such as hyponatremia and seizure, although very rare, have been reported. Hyponatremia related to terlipressin may be caused by the syndrome of inappropriate antidiuresis (SIAD), which is a disorder of sodium and water balance characterized by hypotonic hyponatremia without elevation of the antidiuretic hormone level. Here, we report a case of hyponatremic seizure induced by an infusion of terlipressin in a 52-year-old female who had isolated gastric variceal bleeding secondary to alcoholic liver cirrhosis.
Arginine Vasopressin ; Esophageal and Gastric Varices ; Female ; Hemorrhage* ; Humans ; Hyponatremia ; Liver Cirrhosis* ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Receptors, Vasopressin ; Seizures* ; Sodium

BACKGROUND: Recently, G1 cells, characterized by distinctive doughnut-like shape with blebs have been reported as a reliable marker for glomerular hematuria. We investigated the validity of the urinary G1 cells in distingushing glomerular from non-glomerular hematuria. In addition, we evaluate the influence of urine osmolality, pH and proteinuria on dysmorphic erythrocytes and G1 cells. METHODS: One hundred and twenty patients with hematuria including 60 glomerular (GH) and 60 non- glomerular hematuria (NGH) were examined. The percentage of urinary dysmorphic erythrocytes and G1 cells using phase-contrast microscopy was determined. Urine osmolality, pH, and spot urine protein/ creatinine ratio were examined. RESULTS: The proportion of G1 cells differed significantly between the two group (7.8+/-16.0% in GH vs. 0% in NGH, p<0.05). At the cut-off value of 50 % dysmorphic erythrocytes, the sensitivity and specificity for the detection of GH was 88.3% and 93.3%, respectively. At the cut-off value of 1% G1 cells, sensitivity and specificity were 60.0% and 100%, respectively. When both of 50% dysmorphic erythrocytes and 1% G1 cells were considered as the cut-off value, the sensitivity and specificity were 91.0% and 100%, respectively. There was a significant difference in the percentage of dysmorphic erythrocytes and G1 cells at different urine pH. There was a significant correlation between urine osmolality and dysmorphic erythrocytes (r=0.41, p< 0.05), but not for G1 cells. No significant correlations were observed between G1 cells and proteinuria or pH. CONCLUSION: Evaluation of both urinary G1 cell and dysmorphic erythrocytes at the same time could improve the diagnostic value for differentiating glomerular hematuria.
Blister ; Creatinine ; Erythrocytes ; Hematuria* ; Humans ; Hydrogen-Ion Concentration ; Microscopy, Phase-Contrast ; Osmolar Concentration ; Proteinuria ; Sensitivity and Specificity

BACKGROUND: The presence of late potentials on the signal-averaged electrocardiography (SAECG) is predictive of ventricular tachycardia and sudden cardiac death. We investigated the acute effect of HD on the SAECG in patients with end-stage renal disease (ESRD). METHODS: Twenty HD patients with normal sinus rhythm on a routine ECG were enrolled. SAECGs were recorded immediately before, within 30 minute after, and then 24 hour after the completion of HD. Serum electrolyte, BUN, calcium, echocardiogram and body weight were examined before and after the HD. RESULTS: Positive late potentials on SAECG were detected in 8 patients (40%) before HD, 12 patients (60%) at 30 minute after HD, and 5 patients (25%) at 24 hour after HD. There was a significant change in QRSd (QRS duration) after HD: (110.3+-9.7 msec before HD; 112.3+-9.3 msec at 30 minute after HD; 109.5+-8.6 msec at 24 hour after HD) (p<0.05). The reduction of serum potassium was greater in positive late potential (n=12) than in negative late potential group after HD (n=8) (p<0.05). A significant negative correlation was seen between the changes of dialysis-induced serum total CO2 and QRSd changes (r=-0.534, p<0.05). CONCLUSION: SAECG parameters tended to be aggravated after HD in patient with ESRD. Prolongation of QRSd after HD could be explained by the changes of potassium and bicarbonate.
Body Weight ; Calcium ; Death, Sudden, Cardiac ; Electrocardiography* ; Humans ; Kidney Failure, Chronic* ; Potassium ; Renal Dialysis* ; Tachycardia, Ventricular

BACKGROUND/AIMS: For the endoscopic treatment of benign biliary strictures (BBS), it has been a drawback to use plastic stents or uncovered self-expandable metal stents. We investigated the efficacy and safety of temporary placing fully covered self-expandable metal stents (FCSEMS) in BBS. METHODS: We enrolled 12 cases that followed up more than 6 months after insertion of a FCSEMS in BBS via ERCP. The cohort consisted of 9 patients with recurrent cholangitis, 2 patients with postcholecystectomy and 1 patient with chronic pancreatitis. The efficacy was assessed according to the resolution of strictures and also the restricture after stent removal, and the safety was evaluated according to the complications associated with stent placement. Finally, the removability of FCSEMSs was assessed. RESULTS: The median time of FCSEMS placement was 6.0 months. Resolution of the BBS was confirmed in 8 cases (67%) after a median post-removal follow-up of 8.5 months. Restricture after stent removal happened in 4 cases (33%). The complications were severe abdominal pain (n=2), pancreatic abscess (n=1) and stent migration (n=6). In 7 cases, all the FCSEMSs were successfully removed by grasping them with forceps. CONCLUSIONS: Temporary placement of a FCSEMS in BBS showed good therapeutic effects, relative safety and easy removability. Further evaluation is needed for determining the causes of restricture and for developing a new stent with antimigration features.
Abdominal Pain ; Abscess ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cohort Studies ; Constriction, Pathologic ; Follow-Up Studies ; Hand Strength ; Humans ; Pancreatitis, Chronic ; Plastics ; Stents

Hemobilia, in patients with the diagnosis of polyarteritis nodosa, is rare at clinical presentation and has a grave prognosis. We describe a case of massive hemobilia, due to aneurysmal rupture, in a patient with polyarteritis nodosa. A 39-year-old man was admitted to the hospital with upper abdominal pain. The patient had a history of partial small bowel resection, for intestinal infarction, about 5 years prior to this presentation. Abdominal computed tomography demonstrated multiple high attenuation areas in the bile duct and gallbladder. Hemobilia with blood seepage was visualized on endoscopic retrograde cholangiopancreatography; this bleeding stopped spontaneously. The following day, the patient developed a massive gastrointestinal bleed with resultant hypovolemic shock. Emergent hepatic angiogram revealed multiple microaneurysms; a communication was identified between a branch of the left hepatic artery and the bile duct. Hepatic arterial embolization was successfully performed. The underlying disease, polyarteritis nodosa, was managed with prednisolone and cyclophosphamide.
Rupture/*complications ; Polyarteritis Nodosa/*physiopathology ; Male ; Humans ; Hepatic Artery/*pathology ; Hemobilia/diagnosis/*etiology ; *Embolization, Therapeutic ; Aneurysm, Ruptured/*complications/therapy ; Adult

BACKGROUND/AIMS: The prevalence and clinical characteristics of entecavir (ETV) resistance is not well known. The aim of this study was to determine the frequency of genotypic resistance in nonresponders and virologic breakthrough (VBT) patients. METHODS: The medical records of 76 chronic hepatitis B patients treated for a least 6 months from October 2006 to October 2008 were reviewed retrospectively. We divided patients into two groups: nucleoside analogue (NA)-naive patients (n=38) and LAM experienced patients (n=38). NA-naive and LAM experienced patients received ETV at 0.5 and 1.0 mg/day, respectively. The virologic response and VBT were investigated in both groups. We used the multiplex restriction fragment mass polymorphism (RFMP) method to test genotypic resistance at the rtI169, rtT184, rtS202, rtM204, and rtM250 sites. RESULTS: Age, gender, serum ALT, and HBV DNA level before treatment did not differ between the groups. Neither VBT nor nonresponse was observed in the NA-naive group, whereas VBT and nonresponse were observed in three patients each in the lamivudine (LAM)-experienced group; all six patients had YMDD mutation at study enrollment, all three patients with VBT had genotypic resistance to ETV, but the three nonresponse patients did not have genotypic resistance to ETV. CONCLUSIONS: We suspect that VBT is mostly associated with genotypic resistance to ETV. However, nonresponse might be associated with the continuance or reselection of the YMDD mutant in LAM-experienced patients.
Adult ; Antiviral Agents/*therapeutic use ; Drug Resistance, Viral/genetics ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/therapeutic use ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; RNA-Directed DNA Polymerase/genetics ; Retrospective Studies

Objectives ; This study was conducted to reveal the health effects of aircraft noise on the residents live near the military airport. METHODS: We sampled systematically 87 residents as the high exposed group, 58 residents as the low exposed group according to the geographical distance from the airport. We also sampled 67 residents as the control group lived far from the airport. Noise levels were measured for conform the exposures. Self-administered questionnaires for symptoms, air conduction hearing threshold level, blood pressure blood cholesterol with health examinations, and SCL-90-R were introduced to get the data from the residents. RESULTS: The Ld/n at the area near the airport was 72.4 dB, however that of control area was 67. 7 dB. The value of pure tone average, high pure tone average, and threshold of 4,000 Hz were decreased with exposure level significantly. Linear regression analysis showed that the noise exposure level of the airport was related to the hearing threshold at pure tone average, threshold of 4,000 Hz, and high pure tone average. The systemic and diastolic blood pressure showed dose-response relationship with noise exposure. The prevalence of hypertension was higher in exposed group, but not statistically significant. In linear regression, noise level was related to systolic and diastolic blood pressure with other variables such as age, sex, BMI (Body Mass Index), and family history of hypertension. SCL-90-R showed that exposed group had higher score significantly in neurotic and psychologic variable and felt the various somatic symptoms. CONCLUSIONS: These results suggest that aircraft noise would influence hearing loss at low frequencies as well as 4,000 Hz and higher frequencies, systolic and diastolic blood pressure, and psychological response.
Aircraft* ; Airports* ; Blood Pressure ; Cholesterol ; Hearing ; Hearing Loss ; Humans ; Hypertension ; Linear Models ; Military Personnel ; Noise* ; Prevalence ; Questionnaires

Appendiceal intussusception is a rare disease with variable clinical findings, ranging from acute appendicitis to chronic recurrent abdominal pain or rectal bleeding. Occasionally, it is incidentally discovered with no symptoms. Because a preoperative diagnosis is difficult, it can be diagnosed either after surgery, in the case of acute appendicitis, or after a polypectomy, based on being mistaken for a polyp. During a colonoscopy, an appendiceal intussusception should be suspected if the appendiceal orifice is not observed at the cecum and there is a polypoid lesion at the location where the appendiceal orifice is expected. Treatments are usually determined according to preceding diseases. It is important that the colonoscopist avoid careless endoscopic removal by mistaking the intussusception for a polyp.
Abdominal Pain ; Appendicitis ; Cecum ; Colonoscopy ; Hemorrhage ; Intussusception ; Polyps ; Rare Diseases