Intracardiac hemangiopericytomas are rare tumors which originates from the pericyte in the external wall of capillaries. 1) The tumors are known to usually develop in the lower extremities, pelvic cavity and retroperitoneum, 2) but are very rare in the heart. 3) The symptoms and signs of a hemagiopericytoma depend on the size and location of the tumor. 2) A hemagiopericytoma has a high potential for local recurrence and metastasis, so regular follow-up is needed following surgical excision. 2) A 36-year-old man presented with shortness of breath and chest discomfort. Before operating, a chest CT scan showed that a compressive collapse of the left lung had developed next to a large mediastinal tumor. Because of impending respiratory failure due to collapse of the left lung, an operation was performed. The operation showed that the mediastinal tumor was a large loculated hemopericardium accompanied by pericardial bleeding. A hematoma evacuation with a pericardiectomy was performed, and the pathology of the thickened pericardial wall revealed a malignant hemangiopericytoma. The patient has followed up for 6 months without symptoms or sign of tumor recurrence following the radiation therapy.
Adult ; Capillaries ; Dyspnea ; Follow-Up Studies ; Heart ; Hemangiopericytoma ; Hematoma ; Hemorrhage ; Humans ; Lower Extremity ; Lung ; Mediastinal Neoplasms ; Neoplasm Metastasis ; Pathology ; Pericardial Effusion ; Pericardiectomy ; Pericytes ; Recurrence ; Respiratory Insufficiency ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: Increasing degrees of medullary hyperemia induced by ischemia reperfusion injury were associated with renal dysfunction. A possible mechanism may be that ischemia causes alterations in the structure and function of vascular membranes which leads to an aggregation of red blood cells in the medullary vessel. It has been shown that heparin prevents postischemic endothelial cell dysfunction. Aim of this study was to evaluate heparin effects on renal hyperemia induced by ischemia reperfusion injury. METHOD: In this study, fifteen rabbits were randomized to either heparin treatment group(500 IU/kg IV bolus 10 minutes before renal artery occlusion, n=8) or control group(n=7). One side kidney underwent 60 minutes ischemia only by clamping renal pedicle and after that kidney tissue sample was obtained for histologic evaluation. The other side of kidney were permitted 60 minutes ischemia following 60 minutes reperfusion and after that kidney tissue sample was obtained for histologic evaluation. RESULTS: There was significant difference in the degree of congestion(2.6+/-0.2 vs 1.1+/-0.3, P<0.05) between outer medulla of control and heparin treatment group. CONCLUSION: Heparin significantly attenuated outer medullary congestion induced ischemic injury.
Constriction ; Endothelial Cells ; Erythrocytes ; Estrogens, Conjugated (USP) ; Heparin* ; Hyperemia ; Ischemia* ; Kidney ; Membranes ; Rabbits ; Renal Artery ; Reperfusion Injury ; Reperfusion*

PURPOSE: To differentiate fine hyperdense dots mimicking microcalcifications from true microcalcifications on mammography. SUBJECTS AND METHODS: Mammograms showing hyperdense dots in ten patients (mean age, 59 years) were evalvated. Two radiologists were asked to differentiate with the naked eye the hyperdense dots seen on tenmammograms and proven microcalcifications seen on ten mammograms. Densitometry was also performed for all lesions and the contrast index was calculated. The shape and distribution of the hyperdense dots were evaluated and enquiries were made regarding any history of breast disease and corresponding treatment. Biopsies were performed for two patients with hyperdense dots. RESULTS: Two radiologists made correct diagnoses in 19/20 cases(95%). The contrast index was 0.10-0.88 (mean 0.58) for hyperdense dots and 0.02-0.45 (mean 0.17) for truemicrocalcifications. The hyperdense dots were finer and homogeneously rounder than the microcalcifications. Distribution of the hypendense dots was more superficial in subcutaneous fat (seven cases) and subareolar area(six cases). All ten patients with hyperdense dots had history of mastitis and abscesses and had been treated byopen drainage (six cases) and/or folk remedy (four cases). In eight patients, herb patches had been attached. Biopsies of hyperdense dots did not show any microcalcification or evidence of malignancy. CONCLUSION: These hyperdense dots were seen mainly in older patients. Their characteristic density, shape, distribution and clinical history makes differential diagnosis from true microcalcifications easy and could reduce unnecessary diagnostic procedures such as surgical biopsy.
Abscess ; Biopsy ; Breast Diseases ; Densitometry ; Diagnosis ; Diagnosis, Differential ; Drainage ; Female ; Humans ; Mastitis ; Medicine, Traditional ; Subcutaneous Fat

A 38-year-old man was admitted to the hospital because of abrupt left flank pain. He had no fever and physical examination revealed tenderness of the left costovertebral angle. Laboratory data revealed white blood cell 16,060/microL, C-reactive protein 0.93 mg/dL. Urinalysis showed more than 1/2 red cells per high-power field with severe proteinuria (4+). Enhanced computed tomography (CT) showed the thickened abdominal aorta wall with partial thrombus. The thickened aorta wall compressed the left renal vein and it caused left renal vein thrombosis. Abdominal CT findings suggested aortitis of the abdominal aorta with complication of left renal vein. We could exclude other types of aortitis including autoimmune aortitis, Takayasu's arteritis, giant cell arteritis, and infectious causes based on a serologic test and the history of the patient. Therefore, the patient was diagnosed with idiopathic aortitis and treated with glucocorticoid. After treatment, his symptoms disappeared and a follow-up CT showed decreased mural thickening of the abdominal aorta. Isolated idiopathic aortitis presented with renal vein thrombosis is extremely rare and has not been reported in Korea yet. We present a rare case report on idiopathic aortitis of the abdominal aorta with complication of left renal vein thrombosis.
Adult ; Aorta ; Aorta, Abdominal ; Aortitis* ; C-Reactive Protein ; Fever ; Flank Pain ; Follow-Up Studies ; Giant Cell Arteritis ; Humans ; Inflammation ; Korea ; Leukocytes ; Physical Examination ; Proteinuria ; Renal Veins* ; Serologic Tests ; Takayasu Arteritis ; Thrombosis* ; Tomography, X-Ray Computed ; Urinalysis

Congenital factor VII deficiency is a rare hemorrhagic disorder, and invasive procedures are likely to cause excessive bleeding in these patients. Endoscopic submucosal dissection (ESD) has been accepted as a curative treatment modality for gastric adenoma, early gastric cancer (EGC) and any other mucosal and submucosal tumors. The most important complications of ESD are bleeding and perforation. The use of antiplatelet agents or coagulopathies are risk factors for these complications. There are only few reports of successful ESD with coagulation disorders. We report a case of a 70-year-old female patient who was diagnosed with a gastric adenoma and factor VII deficiency. The patient was successfully treated with ESD. Before ESD, recombinant Coagulation factor VIIa was injected, and the procedure was performed successfully without any complications. In conclusion, ESD can be performed successfully in patients with factor VII deficiency, when recombinant human factor VIIa is administered properly.
Adenoma* ; Aged ; Endoscopy ; Factor VII Deficiency* ; Factor VIIa ; Female ; Hemorrhage ; Hemorrhagic Disorders ; Humans ; Platelet Aggregation Inhibitors ; Risk Factors ; Stomach Neoplasms

Behcet's disease is a multisystem disorder characterized by oral and genital ulcers, uveitis, and skin lesions. Renal involvement has rarely been observed in Behcet's disease. However, pathological reports have revealed various lesions, especially, amyloidosis, focal and segmental glomerulonephritis with crescents, and IgA nephropathy. A 49-year old female with Behcet's disease was admitted to evaluate proteinuria and microscopic hematuria, and renal biopsy showed IgA nephropathy (subclass V). Immunohistology revealed mesangial deposits of IgA and staining for C3. We report a case of IgA nephropathy which was diagnosed by renal biopsy in a patient with Behcet's disease.
Amyloidosis ; Biopsy ; Female ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Middle Aged ; Proteinuria ; Skin ; Ulcer ; Uveitis

Calcium channel blockers are widely used antihypertensive drugs, which are uncommonly associated with cutaneous reactions, such as pruritus, urticaria, or alopecia. Photosensitivity presenting with telangiectasia has rarely been described. We present here a case of photodistributed telangiectasia induced clinically by amlodipine and histologically by enlarged capillaries in the upper dermis without signs of vasculitis.
Alopecia ; Amlodipine ; Antihypertensive Agents ; Calcium Channel Blockers ; Capillaries ; Dermis ; Pruritus ; Telangiectasis ; Urticaria ; Vasculitis

Remifentanil, an ultra-short acting opioid, exhibits at low doses distinct sedative properties that may be useful for supplementation of regional or local anesthesia. We described two patients suffered from serious underlying medical problems who underwent unilateral inguinal herniorrhaphy. One of them was 61 year-old male patient who had type B viral hepatitis, Child class B liver cirrhosis and rheumatoid arthritis with severe joint deformity including instability of cervical vertebrae. The other patient was 73 year-old man who had severe coronary artery occlusive disease which was recently managed with coronary stent and was underwent hemodialysis three times a week due to chronic renal failure. Monitored anesthesia care (MAC) with remifentanil through target controlled infusion (TCI) and local infiltration and ilioinguinal-hypogastric nerve block (IHNB) were done for herniorrhaphy. The operations were performed successfully without any complications such as respiratory depression or hypoxia and all patients and surgeon were very satisfied with MAC.
Anesthesia ; Anesthesia, Local ; Anoxia ; Arthritis, Rheumatoid ; Cervical Vertebrae ; Child ; Congenital Abnormalities ; Coronary Vessels ; Female ; Hepatitis ; Herniorrhaphy ; Humans ; Joints ; Kidney Failure, Chronic ; Liver Cirrhosis ; Male ; Nerve Block ; Piperidines ; Renal Dialysis ; Respiratory Insufficiency ; Stents

BACKGROUND/OBJECTIVES: This study was conducted to assess the potential of St. John's Wort (Hypericum perforatum) to prevent obesity and abnormalities in lipid metabolism induced by ovariectomy in a rat model without stimulatory activity on uterus. MATERIALS/METHODS: Ovariectomized (OVX) rats were treated for 6 weeks with 70% ethanol extracts of Hypericum perforatum [HPEs: whole plant (WHPE) and flower and leaves (FLHPE)], beta-estradiol-3-benzoate at a dose of 50 microg/kg/day (E2) or vehicle (distilled water). RESULTS: As expected, OVX increased body weight gain and adiposity and showed higher food efficacy ratio. OVX also increased the serum cholesterol as well as insulin resistance, while reducing uterus weight and uterine epithelial proliferation rate. HPEs (WHPE and FLHPE) showed estrogen-like effect on body weight gain, adipose tissue weight and food efficacy ratio in OVX rats. HPEs prevented hypercholesterolemia induced by OVX more effectively than E2. E2 increased uterus weight and epithelial proliferation rate in OVX rats, while HPEs maintained them at the level of the sham-operated animals. CONCLUSIONS: Our finding demonstrates that HPEs can be considered as an effective agent to prevent OVX-induced obesity without stimulatory activity on uterus.
Adipose Tissue ; Adiposity ; Animals ; Body Weight ; Cholesterol ; Ethanol ; Female ; Flowers ; Hypercholesterolemia ; Hypericum* ; Insulin Resistance ; Lipid Metabolism* ; Models, Animal ; Obesity* ; Ovariectomy ; Plants ; Rats* ; Uterus

Although central vein stenosis associated with vascular access is relatively common in a hemodialysis patient, innominate vein stenosis is very rare. We here report a case of innominate vein occlusion treated successfully by percutaneous transluminal angioplasty with endovascular stent in a hemodialysis patient. A 61-year-old woman on hemodialysis developed progressive swellingof and headache. She had an history of subclavian vein catheterization. Venography disclosed totally obstructed left innominate vein, multiple collaterals and retrograde flow into left internal jugular vein. Percutaneous transluminal angioplasty with endovascular stent was performed. Venography performed after this procedure showed complete resolution of collaterals and no residual stenosis and arm swelling and headache disappeared.
Angioplasty* ; Arm ; Brachiocephalic Veins* ; Catheterization ; Catheters ; Constriction, Pathologic ; Female ; Headache ; Humans ; Jugular Veins ; Middle Aged ; Phlebography ; Renal Dialysis* ; Stents* ; Subclavian Vein ; Veins