Symptomatic pacing lead-associated thrombosis is very uncommon occurring in 0.5-3.5% of pacemaker implants. Especially thrombisis-induced total occlusion occures almost in late stage over several months to years but acute thrombosis occurring several days after venous pacing has not been reported. In this case, We performed upper limb venography in the patient who presented edema and pain of neck, left upper limb and headache as well as intermittent cough occurring in bending forward. A venogram confirmed acute thrombus completely occluding the left brachiocephalic vein and the patient received intravenous heparin and was maintained on warfarin. Repeated veno- graphy after treatment for 30 days revealed persistent thrombus with total occlusion which not be improved signi- ficantly copmpared to previous venogram and collateral veins diverting the blood to the contralateral side and into the superior vena cava was developed. The patient's symptoms resolved almost and that is likely to be due to the development of collateral venous channels.
Brachiocephalic Veins* ; Cough ; Edema ; Headache ; Heparin ; Humans ; Neck ; Phlebography ; Thrombosis* ; Upper Extremity ; Veins ; Vena Cava, Superior ; Warfarin

Insulin therapy is indicated in the treatment of gestational diabetic women and overt diabetic pregnant women for hyperglycemia after failure to respond to the diets and exercise regimens. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50% of the total daily insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin (RI). Hypoglycemia is a well-recognized complication of intensive insulin therapy in patients with Type II diabetes. Recently, it has been reported that insulin-lispro, an analogue of regular human insulin with a peak insulin action achieved with a 1 hour after injection improves postprandial glucose concentration in non-pregnant diabetic patients. Treatment of gestational or diabetic pregnant women with NPH and insulin-lispro has significantly lower postprandial glucose levels without an increase in hypoglycemic events. Here, we report 2 cases of hyperglycemic control with four times daily administration of NPH & insulin-lispro on diabetes in pregnancy, with brief reviews.
Diabetes Mellitus ; Diet ; Female ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia* ; Insulin Lispro* ; Insulin* ; Meals ; Pancreas ; Pregnancy* ; Pregnant Women

OBJECTIVE: Our purpose was to determine whether abnormal triple marker in the second trimester may be associated with adverse pregnancy outcomes. METHODS: Between November 1996 and April 1998, we evaluated 1,158 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. The pregnancy outcomes of 48 women with false positive screens were compared with 1,158 screen negative controls. The pregnancy outcomes were obtained from hospital delivery records. RESULTS: Women with abnormal triple marker showed increased risks for low birth weight(p<0.01). But there was no significant differences between study and control groups with respect to preterm labor, pregnancy induced hypertension, oligohydroamnios, premature rupture of membrane, placenta previa, abruptio placenta, fetal death in utero. CONCLUSION: Abnormal triple marker in the second trimester was associated with low birth weight.
Female ; Fetal Death ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening* ; Membranes ; Obstetric Labor, Premature ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnancy, High-Risk* ; Pregnant Women ; Rupture

OBJECTIVE: Frozen section evaluation of gynecologic tumors can be used to establish a histopathologic diagnosis and guide the surgeon to perform the appropriate surgical procedure. A retrospective study was conducted to determine the accuracy of frozen section diagnosis of gynecologic tumors. METHODS: We compared the result of 459 consecutive gynecologic frozen section diagnosis with their final diagnosis by paraffin sections from January 1996 to August 2001. RESULTS: 459 gynecologic tumors that underwent frozen section evaluation were studied. Frozen section was accurate in 94.9% of 390 ovarian tumors and inaccurate in 5.1%. The sensitivity, specificity, positive predictive value, and negative predictive value for frozen section in ovarian tumors were 86.7%, 97.8%, 84.4%, 97.7%. There was three false-positive and twelve false-negative cases. And frozen section was accurate in 68 of 69 uterine tumors. CONCLUSION: Frozen section diagnosis has important implications regarding the type and extent of surgery performed at the initial operation and this method can obtain the highest accuracy when there is cooperation between experienced surgeons and reliable, careful pathologists. Most incompatible frozen section diagnosis occurred especially in mucinous ovarian tumor. Performing multiple section is recommended in the frozen section diagnosis of mucinous ovarian tumors.
Biopsy* ; Diagnosis* ; Frozen Sections* ; Mucins ; Paraffin ; Retrospective Studies ; Sensitivity and Specificity

Abdominal actinomycosis is a rare chronic suppurative infection that is difficult to diagnose precisely without an operation. It also tends to be misdiagnosed as a malignancy, intestinal tuberculosis, diverticular disease, or Crohn's disease. A 54-year-old man presented with loose stools, hematochezia, and vague abdominal pain in the right lower quadrant. He had had a history of hematochezia and recurrent colon ulcers on colonoscopy seven times within the past 3 years. A colonoscopy at admission revealed multiple, variably sized and shaped ulcerations in the terminal ileum, cecum, and ascending and transverse colons. Biopsies from the cecal ulcer demonstrated sulfur granules. This is the first cases of abdominal actinomycosis presenting as a recurrent lower gastrointestinal hemorrhage due to ileocolic ulcerations in Korea.
Abdominal Pain ; Actinomycosis ; Biopsy ; Cecum ; Colon ; Colon, Transverse ; Colonoscopy ; Crohn Disease ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Ileum ; Korea ; Middle Aged ; Sulfur ; Tuberculosis ; Ulcer

OBJECTIVES: Chronic asthma has a number of characteristic feature; the increased airway responsiveness and bronchial inflammation. Although these mechanisms are not clear, activated T-cell has had an important role in migration and activation of inflammatory cells. In order to evaluate the role of T-lymphocyte and T-cell subsets in the development of asthmatic symptoms and the posibility for predicting the therapeutic response, we performed bronchoalveolar lavage from asymptomatic and symptomatic asthmatic subjects and inflammatory cell count, T-cell subset, activated T-lymphocyte were analysed and they were compared with healthy controls. METHOD: 76 bronchial asthmatics and 54 healthy controls were enrolled in this study. Asthmatic patients were classified into symptomatic and asymptomatic group according to symptom severity. Symptomatic group was divided into two groups according to therapeutic response ; early responder(ER) and late responder(LR). Lymphocytes(T-lymphocytes subsets and activation marker) in bronchoalveolar lavage(BAL) cells were analyzed using a flow-cytometry. RESULTS: The counts of eosinophil and neutrophil in BAL fluid were significantly higher in both asymptomatic and symptomatic asthmatic patient than those of healthy controls (p<0.05). The number of T3, T4, and T8 lymphocytes were significantly higher in symptomatic asthmatic patient than those of healthy controls, and the counts of T3-IL2R+, T4-IL2R+, and T8-IL3R+ lymphocytes were significantly higher in symptomatic subsets than in healthy controls(p<0.05). Although there were no significant differences in the number of lymphocyte, eosinophil and neutrophil between the ER and LR of symptomatic patients(p>0.05), the numbers of T3 and T4 lymphocyte subsets were significantly higher in LR than in healthy controls, and the number of T3-IL2R+, T4-IL2R+ lymphocytes were significantly higher in ER than in healthy controls(p<0.05). CONCLUSION: We could conclude that the infiltration and activation of T-lymphocytes might be associated with the development of asthmatic symptoms and responsiveness to therapy.
Asthma ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes ; Cell Count ; Emigration and Immigration ; Eosinophils ; Humans ; Inflammation ; Lymphocytes ; Neutrophils ; T-Lymphocyte Subsets ; T-Lymphocytes*

Primary testicular tumors are the most common causes of cancer in male dogs. Overall, the majority of canine patients should be cured by testicular surgery. However, tumor markers are not well-known in veterinary medicine. We sought to determine using immunohistochemistry whether the combined human testicular tumor markers (placental alkaline phosphatase, OCT3/4, CD30, alpha-fetoprotein, inhibin-alpha, vimentin, c-KIT, and desmin) are expressed in canine seminomas and Sertoli cell tumors (SCTs). We examined 35 canine testicular tumors, 20 seminomas and 15 SCTs. c-KIT was expressed markedly in canine seminomas. Both inhibin-alpha and vimentin were expressed significantly in canine SCTs. The results of this study demonstrate differences and similarities between tumor marker expression of testicular tumors in dogs and humans. All the main markers in current routine use are discussed as well as potential useful markers for benign and malignant tumors, and tumor progression.
Animals ; Dog Diseases/*pathology ; Dogs ; Immunohistochemistry/*veterinary ; Male ; Seminoma/metabolism/pathology/*veterinary ; Sertoli Cell Tumor/metabolism/pathology/*veterinary ; Tumor Markers, Biological/metabolism