No abstract available.
Animals ; Linoleic Acid* ; Macrophages, Peritoneal* ; Mice*

Communication between coronary arteries and cardiac chambers or large vessels is unusual type of congenital malformation. Aneurysmal formation of a coronary arteriovenous fistula is even rare. We report a case of 83-year-old women with giant aneurysm of the coronary arteriovenous fistula from the left anterior descending coronary artery treated by percutaneous deployment of embolization coil.
Aged, 80 and over ; Aneurysm* ; Arteriovenous Fistula* ; Coronary Vessels ; Embolization, Therapeutic ; Female ; Humans

Acute pancreatitis (AP) is an inflammatory disorder and the severity range from mild to severe form. The mortality of severe form of AP is still high despite of tremendous improvement of diagnostic modalities and therapeutic options. Although pathogenesis of AP is still not fully understood, autodigestion theory is regarded as an initial common pathophysiologic mechanism of AP for about 2 centuries. However, it is obscure which mechanisms are involving the disease severity. Upregulation of adhesion molecules, leukocytes, proinflammatory cytokines and chemokines are also concerned local injury, systemic exacerbation of inflammation and ultimately organ failure. In addition, transcription factor Nuclear factor-kappa B is also influence the severity through upregulate the proinflammatory genes. The patterns of acinar cell death are closely correlated with disease severity of AP. The degree of acinar cell apoptosis is reversed correlated whereas necrotic cell death is proportionate to severity.
Acinar Cells ; Apoptosis ; Cell Death ; Chemokines ; Cytokines ; Inflammation ; Leukocytes ; Mortality ; Pancreatitis* ; Transcription Factors ; Up-Regulation

BACKGROUND: Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxilla-mandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. CASE PRESENTATION: In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. CONCLUSIONS: Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis.
Diagnosis ; Humans ; Hypertension ; Mandibular Reconstruction ; Mouth Neoplasms ; Postoperative Complications ; Preexisting Condition Coverage ; Renal Insufficiency ; Rhabdomyolysis ; Surgery, Oral ; Transplants

PURPOSE: Electrical shock is not always followed by a perfusing rhythm, and multiple shock failure (MSF) is common during CPR. We sought to investigate its risk factors and prognostic implications. METHODS: Adult OHCA patients with emergency department (ED) ACLS attempts were identified from a tertiary hospital OHCA registry extending from 2008 to 2012. Shock failure was defined as any electrical shock attempt not followed by a pulse-generating rhythm. Patients were assigned to one of three groups based on the number of shock failures: 1) MSF: ≥3 electrical shock failures before the first ROSC or CPR termination (if there was no ROSC), 2) early shock success (ESS): pulse-generating rhythm achieved within 3 electrical shock attempts and 3) others: all remaining patients. Baseline characteristics, initial laboratory measurements, and outcomes were compared. RESULTS: A total of 590 patients were included. There was no significant difference in baseline characteristics between the MSF group (n=49) and the early shock success group (n=50) except in its higher proportion of presumed cardiac aetiology. The MSF group showed less severe metabolic acidosis and coagulopathy on ED arrival and better renal function and higher haematocrit and serum albumin levels compared with the ESS group. MSF was associated with less sustained ROSC, but was also associated with more survival discharge and better long-term neurologic outcomes after sustained ROSC. CONCLUSION: MSF may indicate heart-specific problems rather than severe metabolic derangements. Better long-term outcomes can be expected once sustained ROSC is achieved, therefore, this phenomenon warrants more focused research.
Acidosis ; Adult ; Cardiopulmonary Resuscitation ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Resuscitation* ; Risk Factors* ; Serum Albumin ; Shock* ; Tertiary Care Centers ; Ventricular Fibrillation

Both duodenal ulcer and gastric cancer are common, and it is well known that the pathophysiology of the two is different. The presence of a duodenal ulcer is believed to protect against the development of a gastric malignancy. However gastric cancer may occur in the presence of active or chronic duodenal ulcer disease. Although rare in incidence of coexistence of duodenal ulcer and gastric cancer, physician must be alert to the strange association of duodenal ulcer and gastric cancer. Here, we present 3 cases with coexistence of duodenal ulcer and gastric cancer, diagnosed by endoscopy.
Duodenal Ulcer* ; Endoscopy ; Incidence ; Stomach Neoplasms*

No abstract available.
Infarction*

Mesenteric and omental cysts are rare intra-abdominal lesions in childhood, and may present various clinical features such as an asymptomatic mass or an acute abdomen. Therefore, these entities are frequently misdiagnosed preoperatively or are found only incidentally at operation for other conditions. We analyzed our experiences of 19 cases in a 19 year period from 1981 to 1999, at College of Medicine, Catholic University of Korea. There were 12 boys and 7 girls with a mean age of 4.8 years (range, 3 days to 15 years). Common presenting symptoms were abdominal pain (47%), abdominal distension (31%), abdominal mass (24%), vomiting (15%) and fever (10%). Ultrasonography was the most preferred method of diagnosis. Other diagnostic modalities include CT, MRI, and abdominal ascites tapping in selected patients. Location of the mesenteric cysts was small bowel mesentery in nine, the right mesocolon and retroperitoneum in one, the left mesocolon in one, and the jejunum, sigmoid-colon mesentery in one. Most of the patients underwent cyst excision, but six patients required concomitant bowel resection for complete removal of the lesions, and two patients underwent unroofing and simple aspiration respectively. There was one mortality case due to sepsis.
Abdomen, Acute ; Abdominal Pain ; Ascites ; Child* ; Diagnosis ; Female ; Fever ; Humans ; Jejunum ; Korea ; Magnetic Resonance Imaging ; Mesenteric Cyst ; Mesentery ; Mesocolon ; Mortality ; Sepsis ; Ultrasonography ; Vomiting

Ovarian metastases represent about 3-5% of all ovarian malignancies. Most of these tumors originate in the digestive tract and cholangiocarcinoma rarely involves the ovary. A 60-year-old woman was admitted for the investigation of abdominal distension that had lasted 1 week. One and a half years prior, the patient had undergone choledochal cyst excision, Roux-en Y hepaticojejunostomy and cholecystectomy. Computed tomography scans of the abdomen revealed a papillary mass in the remnant distal common bile duct and enlargement of both ovaries with a huge amount of ascites. An explorative laparotomy disclosed no peritoneal seeding with resectable cholangiocarcinoma and bilateral ovarian mass. Pylorus-preserving pancreatoduodenectomy and bilateral salphingo-oophorectomy with hysterectomy were performed. Histologically, it was a well-differentiated adenocarcinoma and all surgical margins were free of tumor. Both ovarian masses were consistent with metastatic adenocarcinoma from the common bile duct. The patient received six cycles of postoperative adjuvant systemic chemotherapy, dying after 10 months due to pulmonary embolism.
Abdomen ; Adenocarcinoma ; Ascites ; Cholangiocarcinoma ; Cholecystectomy ; Choledochal Cyst* ; Common Bile Duct* ; Drug Therapy ; Female ; Gastrointestinal Tract ; Humans ; Hysterectomy ; Laparotomy ; Middle Aged ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Ovary ; Pancreaticoduodenectomy ; Pulmonary Embolism

BACKGROUND/AIMS: Treatment of chronic hepatitis B with interferon results in a sustained loss of hepatitis B virus DNA and hepatitis B e antigen (HBeAg) and remission of liver disease only in a proportion of cases. Recently, mutations of hepatitis B virus (HBV) core gene have been reported as being related to the failure of interferon treatment in chronic hepatitis B. This study investigated whether core gene mutations of HBV are related to non-response to interferon therapy and whether the recurrence of HBeAg and HBV DNA in initial responders to interferon therapy is associated with the emergence of HBV core gene mutants. METHODS: The precore/core gene sequence was determined by polymerase chain reaction (PCR) and direct sequencing of PCR product in serum samples obtained before interferon treatment from 10 responders and 10 non-responders to interferon therapy. In addition, precore/core gene sequence was determined in serum samples obtained before interferon treatment and after recurrence from 10 patients who showed recurrence of HBeAg and HBV DNA after initial response to interferon therapy. RESULTS: In samples from 10 responders, there were 7 missense mutations and 71 silent mutations. However, there were 43 missense mutations and 109 silent mutations in samples from 10 non-responders. In samples obtained before interferon treatment from the 10 patients who showed recurrence after initial response, 8 missense mutations and 74 silents mutations were found. The nucleotide sequences from the samples obtained after the recurrence showed 6 silent nucleotide substitutions compared with the sequences from the samples obtained before interferon treatment. CONCLUSIONS: Mutations in the core protein of HBV occur more frequently in non-responders than responders to interferon therapy of chronic hepatitis B and may be a factor responsible for the failure of interferon treatment. The recurrence of HBeAg and HBV-DNA in initial responders to interferon therapy is not associated with the emergence of the HBV core gene mutants.
Adolescent ; Adult ; Antiviral Agents/*therapeutic use ; DNA, Viral/genetics ; English Abstract ; Female ; Hepatitis B Virus/*genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Human ; Interferon-alpha/*therapeutic use ; Male ; *Mutation ; Viral Core Proteins/*genetics