Acute gastric mucosal lesions (AGM lesions) is a general term applied to conditions characterized by the acute development of mucosal lesions in the form of erythema, mucosal hemorrhage, erosions and ulcerations in the mucosa of the stomach and duodenum. Although the pathopphysiological events leading to the formation of these lesions remain unknown, we do know that they are after preceded by one of many situations. It has become traditional to use the term stress ulcer to describe AGM lesions proceded by a major stress such as that of an operation or of severe thermal burns or hemorrhagic shock. The silent clinical manifestation of acute gastric mucosal lesions, regardless of their cause, is bleeding. AGM lesions were experimentally produced by brain injury and administration of steroid. This experimental study was conducted in order to study the so called AGM lesions, especially on production and pathology of them. This experimental animals, normal adult rate, were divided into 4 groups the first group of brain injury, the second group of brain injury and administration of steroid, the third group of administration of steroid only, and the fourth group of normal control with administration of normal saline and normal rats. The frequency of AGM lesions was studied in relation to each experimental group, experimental period and grade of lesions. The AGM lesions were divided into 3 grades depending on the macroscopic and microscopic findings. 1. AGM lesions were observed in 34 out of 63 all experimental animals except for control group of animal. Majority of the lesions were found in the glandular portion of the stomach. 2. In the brain injured group, the lesions that was erythematous and superficial mucosal erosion were found in 3 out of 21(14.3%), which were observed only in experimental period of 3-5 days. 3. In the group with brain injury and steroid administration, the lesions were found in 16 out of 21 animals(76.2%) among them grade 1 was in 2 out of 16, grade 2 in 10 and grade 3 in 4, which observed in the period of 2-7 days. 4. In the group with administration of steroid, the lesions were found in 15 out of 21 animals(71.4%), among them grade 1 was 2 out of 15, grade 2 in 11 and grade 3 in 2, which started to be observed form 2nd day through out the experimental period. 5. No lesions were investigated in the control group. No correlation between the variety of brain injury and production of AGM lesion was studied.
Adult ; Animals ; Brain ; Brain Injuries ; Burns ; Duodenum ; Erythema ; Hemorrhage ; Humans ; Mucous Membrane ; Pathology ; Rats ; Shock, Hemorrhagic ; Stomach ; Ulcer

By the expansion of stalk of laminaria inserted into the right epidural space of the rabbit head, cerebral compression and edema were produced. The studies of the occurrence and changes of experimental brain edema have been observed by weighing the wet and dry brain tissue, and by calculating the percentage of water content and that of swelling, with rate of per cent water content to that of control group. The percentage of water content and swelling of cerebral gray and white matters in the compressed site showed higher values than those in control and in non-compressed groups. As compared with normal group, the rate of per cent water content of cerebral gray matter at the site of compression showed gradually increasing tendency as time elapsed by 12 hours, while that of white matter demonstrated a increase of it by 24 hours and decreased gradually thereafter. Cerebral edema induced by laminaria compression was more evident and severe in the white matter than in the gray. Oxygen and glucose that are utilized the brain are two of the most important substances and play very important roles in the brain to form high energy bond and nucleic acid. Authors have attempted to measure oxygen consumption in normal rabbit brain and diseased brain that are produced by the expansion of stalk of laminaria in the intracranial epidural space. The value of oxygen consumption of cerebral gray and white matters in the compressed hemispheres showed higher values than those in control group, and they revealed a tendency of rather rapid increases at early experimental stages, an of gradual decrease thereafter.
Brain Edema* ; Brain* ; Edema ; Epidural Space ; Glucose ; Head ; Laminaria ; Oxygen ; Oxygen Consumption

An enterogenous cyst lying ventral to the spinal cord in the lower cervical region is presented in a woman aged 56 years. The clinical course and radiological and histological findings are discussed.
Deception ; Female ; Humans ; Magnetic Resonance Imaging ; Spinal Cord ; Spinal Cord Compression

Pulmonary thromboembolism is a leading cause of morbidity and mortality. Many patients dying of pulmonary thromboembolism have serious underlying illness such as cancer and congestive heart failure. Cancer patients are prone to both thrombotic and tumor embolism. In cancer patients, tumor pulmonary embolism and thrombotic pulmonary embolism can be associated with dyspnea, cor pulmonale and pulmonary hypertension. We presented a female patient of 63 year-old age of a hepatoma with inferior vena cava thrombosis. She had been transferred to the intensive care umt in state of refractory hypoxemia with 100% oxygen inhalation. Perfusion scan showed 60.71% defect in right lung and 39.28% defect in left lower lung field. Heparin infusion was done with the impression of pulmoary embolism without effect. Initial hemodynamic data with insertion of pulmonary ery catheter showed that cardiac index, 1.62 L/minute/M2, right atrial pressure, 28 mmHg, pulmonary capillary wedge pressure 14 mmHg. Cardiac index did not increase in spite of dobutamine and dopamine infusion. Right atrial pressure increased to 29 mmHg but pulmonary capillary wedge pressure was 11 mmHg with fluid administration. Echocardiogram revealed that mass, 7X8 cm of size, was in right heart in connection to inferior vena cava thrombus. Tumor embolism from hepatoma would be suspected in our patient, but we did not confirm that case with the biopsy or autopsy. Echocardiography with pulmoary artery catheter insertion would be helpful to diagnose the disease which was suspected of pulmonary embolism and tumor embolism in cancer patient.
Anoxia ; Arteries ; Atrial Pressure ; Autopsy ; Biopsy ; Carcinoma, Hepatocellular* ; Catheters ; Dobutamine ; Dopamine ; Dyspnea ; Echocardiography ; Embolism ; Female ; Heart Failure ; Heart* ; Hemodynamics ; Heparin ; Humans ; Hypertension, Pulmonary ; Inhalation ; Critical Care ; Lung ; Middle Aged ; Mortality ; Neoplastic Cells, Circulating* ; Oxygen ; Perfusion ; Pulmonary Embolism ; Pulmonary Heart Disease ; Pulmonary Wedge Pressure ; Thrombosis* ; Vena Cava, Inferior*

It is generally accepted that seroconversion of hepatitis B virus (HBV) surface antigen (HBsAg) to an antibody to HBsAg (anti-HBs) indicates clearance of HBV. Here we report a case of severe hepatitis that manifested during chemotherapy in a female patient with chronic lymphocytic leukemia (CLL) who had been initially seronegative for HBsAg and seropositive for anti-HBs. The patient received chlorambucil and prednisolone for the treatment of CLL. After 6 months the serum levels of aminotransferases were increased, and HBsAg and HBV DNA were present in serum. Lamivudine was administered immediately after confirming the HBV reactivation, which considerably improved jaundice and aminotransferase levels after 3 weeks. The patient was able to resume the chemotherapy whilst continuing lamivudine treatment. This case report highlights the need for physicians to be aware of the potential risk of HBV reactivation even in an HBsAg-negative person but with detectable anti-HBc and/or anti-HBs, underscoring the need for future studies that explore the role of antiviral prophylaxis in this setting.
Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Chlorambucil/*therapeutic use ; Female ; Hepatitis B/*diagnosis/virology ; Hepatitis B Antibodies/*blood/immunology ; Hepatitis B Surface Antigens/*blood/immunology ; Hepatitis B virus/isolation & purification/physiology ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell/complications/*drug therapy ; Prednisolone/*therapeutic use ; Virus Activation

Polymyositis (PM) is a chronic inflammatory disease that predominantly affects muscles. Systemic organ involvement, including the respiratory and gastrointestinal tracts, is frequently observed in PM, but renal involvement is rare. Herein, we report the case of a 56-year-old woman presenting with weight gain, edema, and generalized myalgia. Laboratory tests revealed elevated creatinine kinase level, hypoalbuminemia, and proteinuria. Histopathological examination of muscle biopsy revealed inflammatory myositis, and a renal biopsy confirmed immunoglobulin A (IgA) nephropathy. Based on the clinico-pathological results, the patient was diagnosed with PM with IgA nephropathy. This is a report of a rare occurrence of IgA nephropathy in a patient with PM presenting with chronic glomerulonephritis.
Biopsy ; Creatinine ; Edema ; Female ; Gastrointestinal Tract ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Humans ; Hypoalbuminemia ; Immunoglobulin A* ; Immunoglobulins* ; Middle Aged ; Muscles ; Myalgia ; Myositis ; Phosphotransferases ; Polymyositis* ; Proteinuria ; Weight Gain

No abstract available.
Gene Expression* ; Humans* ; Insulin-Like Growth Factor I* ; Thyroid Gland*

A patient who underwent a transfusion due to an aplastic anemia subsequently experienced secondary hemochromatosis, which is very rare in Korea. The 56 year old female was admitted to our hospital with complaints of general weakness, fatigue, a brown-colored facial complexion, dyspnea upon exertion, and abdominal distension. Laboratory examination disclosed functional impairment of the liver and echocardiography revealed a congestive heart failure pattern. Gastrofiberscopy revealed brown colored gastric mucosa, and a fundal mucosa biopsy revealed a hemosidt pigment in iron stain.
Anemia, Aplastic ; Biopsy ; Dyspnea ; Echocardiography ; Fatigue ; Female ; Gastric Mucosa ; Heart Failure ; Hemochromatosis* ; Humans ; Iron ; Korea ; Liver ; Middle Aged ; Mucous Membrane

No abstract available.
Bone Marrow/pathology ; Chromosomes, Human, Pair 12 ; Chromosomes, Human, Pair 9 ; Core Binding Factor Alpha 2 Subunit/*genetics ; DNA/metabolism ; Gene Rearrangement ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/*genetics ; Male ; Middle Aged ; Oncogene Proteins, Fusion/*genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Translocation, Genetic

BACKGROUND/AIMS: Portal-vein thrombosis (PVT) develops in 10-25% of cirrhotic patients and may aggravate portal hypertension. There are few data regarding the effects of anticoagulation on nonmalignant PVT in liver cirrhosis. The aim of this study was to elucidate the safety, efficacy, and predictors of response to anticoagulation therapy in cirrhotic patients. METHODS: Patients with liver cirrhosis and nonmalignant PVT were identified by a hospital electronic medical record system (called BESTCARE). Patients with malignant PVT, Budd-Chiari syndrome, underlying primary hematologic disorders, or preexisting extrahepatic thrombosis were excluded from the analysis. Patients were divided into two groups (treatment and nontreatment), and propensity score matching analysis was performed to identify control patients. The sizes of the thrombus and spleen were evaluated using multidetector computed tomography. RESULTS: Twenty-eight patients were enrolled in this study between 2003 and 2014: 14 patients who received warfarin for nonmalignant PVT and 14 patients who received no anticoagulation. After 112 days of treatment, 11 patients exhibited significantly higher response rates (complete in 6 and partial in 5) compared to the control patients, with decreases in thrombus size of >30%. Compared to nonresponders, the 11 responders were older, and had a thinner spleen and fewer episodes of previous endoscopic variceal ligations, whereas pretreatment liver function and changes in prothrombin time after anticoagulation did not differ significantly between the two groups. Two patients died after warfarin therapy, but the causes of death were not related to anticoagulation. CONCLUSIONS: Warfarin can be safely administered to cirrhotic patients with nonmalignant PVT. The presence of preexisting portal hypertension is a predictor of nonresponse to anticoagulation.
Aged ; Anticoagulants/*therapeutic use ; Female ; Humans ; Liver Cirrhosis/complications/*diagnosis ; Male ; Middle Aged ; Portal Vein ; Propensity Score ; Severity of Illness Index ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*drug therapy/pathology ; Warfarin/therapeutic use