PURPOSE: To classify perivascular change in the celiac trunk and SMA occurring in pancreatic disease and toevaluate its significance in differential diagnosis. MATERIALS AND METHODS: In 73 patients with pancreaticdisease (42, acute pancreatitis; 14, chronic pancreatitis; 17, panreatic cancer) abdominal CT findings wereretrospectively reviewed. We defined " infiltration" as linear or irregular density and "thickening" as presenceof a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors forthe differential diagnosis of pancreatic diseases. RESULTS: In 13/42 cases of acute pancreatitis (31%), 4/14 ofchronic pancreatitis (28.6%), and 6/17 of pancreatic cancer (35.3%), periceliac infiltration was observed; thefrequencies were not statistically significant (p=0.916). Peri-SMA infiltration was demonstrated in 9/42 of acutepancreatitis (21.4%), 4/14 of chronic pancreatitis (28.6%), and 5/17 of pancreatic cancer (29.4%); again, thesefrequencies were not statistically significant (p=0.758). Thickening of the celiac trunk and SMA was observed onlyin pancreatic cancer, in 3/17 (17.6%) and 7/17(41.2%) cases, respectively, with statistical significance (p<0.05). CONCLUSION: Thickening of the celiac trunk and SMA is a valuable finding in the differential diagnosis ofpancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreaticdisease, perivaseular change should be classified as either infiltration or thickening.
Diagnosis, Differential* ; Humans ; Mesenteric Arteries* ; Pancreatic Diseases* ; Pancreatic Neoplasms ; Pancreatitis ; Pancreatitis, Chronic ; Tomography, X-Ray Computed

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.
Abdominal Pain ; Adult ; Aged ; Colon ; Diverticulitis* ; Diverticulum ; Duodenum ; Esophagus ; Female ; Fever ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Intussusception* ; Jejunum ; Leiomyoma* ; Mortality ; Pathologic Processes ; Polyps* ; Stomach ; Tomography, X-Ray Computed

BACKGROUND: It was demonstrated that ultraviolet(UV) B light induces the release of IL-1α in cultured human epithelial cell line and augmentation of GM-CSF production by UVB is reported to be mediated by IL-1α in the murine keratinocyte cell line Pam 212. OBJECTIVE: The purpose of this study was to evaluate the effects of UVB on kinetic profile of IL-1 and GM-CSF mRNA expression and to see whether synthesis of GM-CSF by UVB can be completely inhibited by blocking IL-1α mediated pathway. METHODS: We used a competitive RT-PCR for measuring cytokine gene expression in epithelial cell line after UV radiation. RESULTS: The IL-1α mRNA increased as early as 1h after UV irradiation, and then decreased at 3h after the irradiation. Thereafter, the response of IL-1α mRNA was upregulated with a second peak at 6h after the UV irradiation. However, mRNA for GM-CSF increased at 1h after UV light exposure and anti-IL-1α antibodies could only partially inhibit UV-augmented GM- CSF production. CONCLUSION: UVB induced GM-CSF production seemed to be mainly mediated by UVB induced IL-1α but these results suggest that UVB may also induce GM-CSF production through an IL-1α independent pathway.
Antibodies ; Cell Line ; Epithelial Cells* ; Gene Expression ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Humans ; Interleukin-1 ; Keratinocytes ; RNA, Messenger ; Ultraviolet Rays ; Up-Regulation*

Medtronic CapSureFix MRI 5086 pacing lead (5086; Medtronic, Inc., Minneapolis, MN, USA) has been reported to be associated with increased cardiac perforation and lead dislodgement. This study aimed to compare the incidence of cardiac perforation and lead dislodgement within 30 days after pacemaker implantation between 5086 MRI lead and previous Medtronic CapSureFix Novus 5076 non-MRI pacing lead. This was a nationwide, multicenter retrospective study in which we compared the incidence of adverse events between 277 patients implanted with 5086 lead and 205 patients implanted with 5076 lead between March 2009 and September 2014. Cardiac perforation within 30 days of pacemaker implantation occurred in 4 patients (1.4%) with the 5086 lead and in no patient with the 5076 lead (P = 0.084). Lead dislodgement occurred in 8 patients (2.9%) with the 5086 lead and in 5 patients (2.4%) with the 5076 lead (P = 0.764). On multivariate logistic regression analysis, age was significantly associated with cardiac perforation. Congestive heart failure and implantation of right atrial (RA) lead at RA free wall or septum were significant factors for the incidence of lead dislodgement and lead revision. The incidence of cardiac perforation and lead dislodgement were not statistically different between the patients with 5086 lead and the patients with 5076 lead. However, careful attention for cardiac perforation may be needed when using the 5086 MRI lead, especially in elderly patients.
Aged ; Heart Failure ; Humans ; Incidence ; Logistic Models ; Magnetic Resonance Imaging ; Retrospective Studies

A paraffin injection is regarded as to be a simple and effective method of breast augmentation. However, there are few reports on the long-term complication of a paraffin injected breast. The generation of breast cancer from a paraffinoma of the breast is rare, even though there is no clear evidence to suggest any relationship between a paraffin injection and breast cancer. We encountered a case of infiltrative ductal carcinoma arising from paraffinoma tissues. A 49-year-old woman had undergone bilateral breast augmentation by paraffin injection 20 years earlier. She presented with bilateral diffuse painless palpable masses with reddish discoloration and painful swelling in her left breast. She had been managed with a bilateral simple mastectomy including the mass. After discharge, the pathology report showed infiltrative ductal carcinoma of the left breast mass. The patient was readmitted for additional surgery, and she underwent a modified radical mastectomy. Ultrasonography is a useful diagnostic tool for detecting a breast mass, particularly in a dense breast. However, ultrasonography has a limitation in the case of a paraffinoma. Through this case, it is necessary to review the radiological (mammography, ultrasonography, magnetic resonance imaging, plain film) appearances and the histopathological feature to help make an accurate diagnosis and to differentiate between a carcinoma and a paraffinoma. In rare cases, a breast ductal carcinoma can be combined with a paraffinoma. Therefore, a paraffinoma must be carefully managed due to the potential risk of a carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Middle Aged ; Paraffin ; Pathology ; Ultrasonography

A paraffin injection is regarded as to be a simple and effective method of breast augmentation. However, there are few reports on the long-term complication of a paraffin injected breast. The generation of breast cancer from a paraffinoma of the breast is rare, even though there is no clear evidence to suggest any relationship between a paraffin injection and breast cancer. We encountered a case of infiltrative ductal carcinoma arising from paraffinoma tissues. A 49-year-old woman had undergone bilateral breast augmentation by paraffin injection 20 years earlier. She presented with bilateral diffuse painless palpable masses with reddish discoloration and painful swelling in her left breast. She had been managed with a bilateral simple mastectomy including the mass. After discharge, the pathology report showed infiltrative ductal carcinoma of the left breast mass. The patient was readmitted for additional surgery, and she underwent a modified radical mastectomy. Ultrasonography is a useful diagnostic tool for detecting a breast mass, particularly in a dense breast. However, ultrasonography has a limitation in the case of a paraffinoma. Through this case, it is necessary to review the radiological (mammography, ultrasonography, magnetic resonance imaging, plain film) appearances and the histopathological feature to help make an accurate diagnosis and to differentiate between a carcinoma and a paraffinoma. In rare cases, a breast ductal carcinoma can be combined with a paraffinoma. Therefore, a paraffinoma must be carefully managed due to the potential risk of a carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Middle Aged ; Paraffin ; Pathology ; Ultrasonography