Six patients of sick sinus syndrome were described with review of literatures, who demonstrated either persistent unexpected sinus bradycardia (5 patients) with sinus arrest in one patients or bradycardia-tachycardia syndrome (1 patient). These occurred due to disorders of sinoatrial conduction and depression of atrioventricular junctional escape pacemaker system. Singificant atrioventricular block was not present. Coronary heart disease, hypertension, valvular heart disease, and tetanus were demonstrated where etiology could be determined, but in one patient no clear etiologic diagnosis could be established. Syncope and dizziness were common sympotms and in one patients with atrial fibrillation occurred cerebral embolism.
Atrial Fibrillation ; Atrioventricular Block ; Bradycardia ; Coronary Disease ; Depression ; Diagnosis ; Dizziness ; Heart Valve Diseases ; Humans ; Hypertension ; Intracranial Embolism ; Sick Sinus Syndrome* ; Syncope ; Tetanus ; United Nations

No abstract available.

No abstract available.
Hand* ; Regional Blood Flow*

No abstract available.

The indication of CT for the breast lesions are 1) Unusually extensive or small breast caused technicaldifficulties in performing mammograms. 2) Questionable mammographic findings, especially in dense proliferativebreast parenchyme, 3) Microcancer. 4) Suspicious regional lymph node enlargement of invasion of the chest wall bybreast cancer. The diagnosis of breast CT in breast cancer is based on pathologic anatomic change andcharacteristic increase of mean CT No. of lesion following contrast enhancement. Authors analysed CT of the 34patients who were clinically suspected breast cancer, and compared with mammography. The results are as follows:1. Pathological diagnosis of 34 cases were 27 cases of breast cancer, 4 cases of fibrocystic disease, 2 cases offibroadenoma, and 1 case of intraductal pupilloma. The diagnostic accuracy of CT in 27 breast cancer was 93%(25cases) and mammography 71%(19 cases). 2. Corect diagnosis of CT in 7 benign breast disease is in 5 cases andmammography in 5 cases. 3. The most importment finding of CT in breast cancer is characteristic increase of CT No.of lesion following contrast enhancement (200ml, 65%): over average 50HU in 19 cases of 27 breast cancers, 30-50HUin a 6 cases, 20-30HU in 2 cases with tumor necrosis. 4. Compared with mammography, other more valuable CTfindings of breast cancer are axillary lymph node enlargement and adjacentic pectoral muscle invasion. 5. Inconclusion, Breast CT is considered as a valuable diagnostic tool in evaluation of breast cancer, but not of benign breast disease.
Breast Diseases ; Breast Neoplasms ; Breast ; Diagnosis ; Lymph Nodes ; Mammography ; Necrosis ; Thoracic Wall

In this study, we investigated the potential protective effects of (+)-afzelechin (AZC), a natural compound that is derived from Bergenia ligulata, on lipopolysaccharide (LPS)-induced inflammatory responses. AZC is known to have antioxidant, anticancer, antimicrobial, and cardiovascular protective properties. However, knowledge regarding the therapeutic potential of AZC against LPS-induced inflammatory responses is limited. Thus, we investigated the protective attributes of AZC against inflammatory damage caused by LPS exposure. We examined the effects of AZC on heme oxygenase (HO)-1, cyclooxygenase (COX)-2, and inducible nitric oxide synthase (iNOS) in LPS-activated human umbilical vein endothelial cells (HUVECs). In addition, the effects of AZC on the expression of iNOS, tumor necrosis factor (TNF)-α, and interleukin (IL)-1β were analyzed in the lung tissues of LPSinjected mice. Data revealed that AZC promoted the production of HO-1, inhibited the interaction between luciferase and nuclear factor (NF)-κB, and reduced the levels of COX-2/PGE2 and iNOS/NO, thereby leading to a decrease in the signal transducer and activator of transcription (STAT)-1 phosphorylation. Moreover, AZC facilitated the nuclear translocation of Nrf2, increased the binding activity between Nrf2 and the antioxidant response elements (AREs), and lowered the expression of IL-1β in the LPS-treated HUVECs. In the animal model, AZC significantly reduced the expression of iNOS in the lung tissue structure and the TNF-α level in the bronchoalveolar lavage fluid. These findings demonstrate that AZC possesses anti-inflammatory properties that regulate iNOS through the inhibition of both NF-κB expression and p-STAT-1. Consequently, AZC has potential as a future candidate for the development of new clinical substances for the treatment of pathological inflammation.

The first case of chyle ascites in childhood was reported by Morton in 1683. Its reported incidence varies between 1 in 50,000 to 100,000 in hospital admissions. The clinical picture is similar to that of acute diffuse peritonitis, and is most commonly mistaken as perforated appendicitis. Paracetesis, if performed, is the most useful diagnostic option. Treatment modalities fall into four areas-: Exploratory laparotomy with either direct ligation or drainage, A medium chain triglyceride diet, NPO and hyperalimentation or Venoperitoneal shunting. An 11-years old boy was admitted with RLQ pain. He had diffuse abdominal guarding. The initial diagnosis was perforated appendicitis, and appendectomy was performed. During the operation, the abdomen was found to contain 750cc of a thin, milky fluid. It was later diagnosed as chyle ascites. The small bowel mesentery and transverse colon were thickened and edematous, with a pale white subserosal exudate. The laboratory analysis of the ascites was as follows-: protein 4.6 g/dL, albumin 3.0 g/dL, triglyceride 700 mg/dL, cholesterol 113 mg/dL, glucose 209 mg/dL, LDH 848 U/L, and amylase 32 U/dL, with a pH of 9.0. An appendectomy was performed, and two drains placed in the pelvic cavity. In the postoperative-work-up from the abdominal CT scan, the results were normal. The patient-recovered and was discharged without complication 21 days postoperatively.
Abdomen ; Amylases ; Appendectomy ; Appendicitis* ; Ascites* ; Child ; Cholesterol ; Chyle* ; Colon, Transverse ; Diagnosis ; Diet ; Drainage ; Exudates and Transudates ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Laparotomy ; Ligation ; Male ; Mesentery ; Peritonitis ; Tomography, X-Ray Computed ; Triglycerides

Barrett's esophagus is a premalignant condition of esophageal adenocarcinoma. Inducible nitric oxide synthase (iNOS) is induced by cytokines and can generate locally high concentrations of nitric oxide (NO), whose metabolites can mediate genotoxicity and influence multistage carcinogenesis by causing DNA damage. Therefore, we evaluated the immunolocalization and expression of iNOS in surgically induced rat Barrett's esophagus. Esophagoduodenal anastomosis was performed in rats for inducing reflux of duodenal contents. Rats were killed at postoperative 10, 20, 30 and 40 weeks. We examined histologic changes and iNOS expression in esophagus by immunohistochemistry and reverse transcription-poly-merase chain reaction. Eighty six percent of experimental rats showed Barrett's esophagus above esophagoduodenal junction. iNOS immunoreactivity was clearly observed in the epithelial cells of Barrett's esophagus, predominantly at the apical surface of epithelial cells. Cytoplasmic staining was also seen only in atypical Barrett's esophagus. iNOS mRNA was detected only in the lower esophagus of experimental group. In conclusion, this study suggests that iNOS has some roles on Barrett's esophagus formation.
Anastomosis, Surgical ; Animals ; Barrett Esophagus/*enzymology/*surgery ; Cytoplasm/metabolism ; DNA Damage ; Disease Models, Animal ; Duodenum/*enzymology/surgery ; Esophagus/metabolism ; Immunohistochemistry ; Male ; Models, Anatomic ; Neoplasms, Experimental/pathology ; Nitric Oxide/metabolism ; Nitric-Oxide Synthase/*biosynthesis ; RNA/metabolism ; RNA, Messenger/metabolism ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors

Evidence indicates that hypoxia and oxidative stress can control metabolic reprogramming of cancer cells and other cells in tumor microenvironments and that the reprogrammed metabolic pathways in cancer tissue can also alter the redox balance. Thus, important steps toward developing novel cancer therapy approaches would be to identify and modulate critical biochemical nodes that are deregulated in cancer metabolism and determine if the therapeutic efficiency can be influenced by changes in redox homeostasis in cancer tissues. In this review, we will explore the molecular mechanisms responsible for the metabolic reprogramming of tumor microenvironments, the functional modulation of which may disrupt the effects of or may be disrupted by redox homeostasis modulating cancer therapy.
Anoxia ; Homeostasis* ; Metabolic Networks and Pathways ; Metabolism* ; Oxidation-Reduction ; Oxidative Stress ; Tumor Microenvironment

Reconstruction of the soft tissue defects on the plantar foot continues to be a difficult challenges because of the unique anatomical features. It should endure constant weight loading or alternate stimulus of shoes while standing or walking. The methods used for reconstruction of the soft tissue defects on the plantar foot are skin graft, local flap, cross leg flap, myocutaneous flap, neurovascular island and free flap. However, it is verb difficult to find a proper method to reconstruct the soft tissue defect of the first toe plantar area. The ideal reconstruction should provide tissue as durable yet sensitive, provide tissue components similar to the original lost tissue, be reliable, result in a donor site that is well tolerated, and entail one operative procedure with minimal morbidity Although the medial plantar flap was initially described to surface heel defects, many surgeons haute used this flap as a cross leg flap or a free flap to recover the first toe plantar area. Its use has always required a secondary surgical procedure or a difficult technique. In order to overcome this inconvenience, we used the flap based on the principle of reversing the direction of blood flow in a distal vascular pedicle to restore a defect of the anteromedial aspect of the foot. We haute experienced 3 cases of reverse medial plantar flap for the reconstruction of the great toe plantar area. Good functional and aesthetic results were obtained.
Foot ; Free Tissue Flaps ; Heel ; Humans ; Leg ; Myocutaneous Flap ; Shoes ; Skin ; Surgical Procedures, Operative ; Tissue Donors ; Toes* ; Transplants ; Walking