No abstract available.
Cerebrospinal Fluid* ; Electroconvulsive Therapy* ; Hydroxyindoleacetic Acid* ; Schizophrenia* ; Serotonin*

Multiple biliary papillomatosis involves an epithelial field change of the intrahepatic and extrahepatic portions of the biliary tree. Pathologically it is benign, occasionally with dysplasia, but the clinical behavior is regarded as having a low-grade malignant potential. Such malignancy is rare but the prognosis is poor if it is impossible to remove the tumor completely. Here, we report one case of multiple biliary papillomatosis in the biliary tree.
Biliary Tract ; Papilloma* ; Prognosis

Short umbilical cord syndrome, also known as the limb-body wall malformation complex and the body stalk anomaly, is a poorly defined sporadic group of congenital anomaly charaterized by a complex set of disruptive abnormalities having in common the failured closure of the ventral body wall. This disorder is charaterized by a short or absent umbilical cord and disruption of the lateral body wall, spine, limbs, face, and cranium, isolated or in combination. Recently, we present a case of short umbilical cord syndrome which found in a term baby, so we report a case of short umbilical cord syndrome with brief review of literature.
Extremities ; Skull ; Spine ; Umbilical Cord*

BACKGROUND: Exercise testing is an importnat diagnostic and prognostic procedure in the assessment of patients with ischemic heart disease. But standard ST-segment depression criteria was not high enough to estimate coronary srtery disease. Recently, the heart rate adjustment of ST segment depression, ST segment/heart rate slope and index, have been proposed as a more accurate criteria for diagnosing significant coronary artery disease. The objective of this study was to compare the discriminating power of proposed ST segment/heart rate slope and index with that of a standard method of assessing exercise-induced ST segment depression for estimating coronary artery disease. METHODS: Sixty nine patients with ischemic heart disease were studied with exercise treadmill testing and coronary angiography. Computer-measured ST-segment amplitudes were obtained and analysis of the heart rate-adjusted ST segment depression(ST/HR slope and big up tri, Delta ST/HR index) was done. The sensitivity, specificity, and extent of coronary artery disease on each criteria were compared. RESULTS: 1) The sensitivity of big up tri, Delta ST/HR index partition of 1.6uV/beats/min was slightly higher(83%) and the specificity of ST/HR slope partition of 2.4uV/beats/min was higher(87%) than the standard exercise electrocardiographic criteria. 2) Early onset of ischemic ST-segment depression, profound ST-segment depression(> or =2mm), and downsloping ST-segment were associated with more extensive coronary artery disease. 3) On ST/HR slope, no CAD was 1.7+/-0.26uV/beats/min, one vessel disease was 2.6+/-0.34 uV/beats/min, two vessel disease was 2.7+/-1.36uV/beats/min, one vessel disease was 2.8+/-0.35uV/beats/min, and on big up tri, Delta ST/HR index, no CAD was 1.8+/-0.38uV/beats/min, one vessel disease was 2.8+/-1.36uV/beats/min, two vessel disease 3.4+/-1.44uV/beats/min, and three vessel disease was 3.7+/-2.95uV/beats/min. The increment of ST/HR slope and big up tri, Delta ST/HR index were associated with the coronary artery disease and its severity, but the correlations were not high enough. CONCLUSION: The heart rate adjustment of ST segment depression was not high enough for improved detection of coronary artery disease, compared with standard ST-segment depression criteria. But these indexes can be improved the clinical usefulness of the treadmill exercise test for coronary aretry disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Depression* ; Electrocardiography ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Myocardial Ischemia* ; Sensitivity and Specificity

Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

STUDY DESIGN: A case report. OBJECTIVES: To report a case of diagnostic, clinical and radiologic follow-up of a non-traumatic atlanto-axial rotatory subluxation. SUMMARY OF LITERATURE REVIEW: Atlanto-axial rotatory subluxation, caused by a non-traumatic inflammation or infectious diseases, has been branded as "Grisel's syndrome". However, the pathophysiology of the syndrome has not been clearly understood, and its diagnostic criteria and appropriate treatment plans are not established. MATERIALS AND METHODS: The patient suffering from antlanto-axial subluxation without any neurological symptoms was treated with halter traction and Miami J brace. RESULTS: The patient maintained a normal reduction state, and a normal cervical movement was observed after undergoing 4 weeks of non-surgical treatment. CONCLUSION: Early detection and treatment are essential and critical in avoiding catastrophic outcomes. It requires a combination of clinical assessment and appropriate radiographic imaging.
Communicable Diseases ; Follow-Up Studies ; Humans ; Inflammation ; Stress, Psychological ; Traction

The incidence of life-threatening anaphylactoid reactions during anesthesia has been increasing. Specific allergic reactions during anesthesia are usually due to muscle relaxants, barbiturates, local anesthetics, narcotics, radiocontrast media, antibiotics, and colloids. Thrombokinase, a hemostatic agent, has been used widely in clinical practice and severe anaphylactoid reactions to thrombokinase can occur rarely. We experienced two cases of anaphylactoid reactions after thrombokinase administration.
Anesthesia ; Anesthetics, Local ; Anti-Bacterial Agents ; Barbiturates ; Colloids ; Contrast Media ; Factor Xa* ; Hypersensitivity ; Incidence ; Narcotics ; Pharmacology

Gastrointestinal autonomic nerve tumors (GANT) are uncommon neoplasms of the gastrointestinal tract. The GANT is a specialized form of stromal neoplasm with the feature of myenteric plexus derivation. We report a patient with a GANT of the small intestine and liver metastasis. The patient was admitted for evaluation of hematochezia and a palpable abdominal mass. A CT of the abdomen showed an exophytic mass arising from the distal ileum and exhibiting deep ulceration and air-cavity formation, and a huge cystic mass in the right lobe of the liver. The gross appearance of a surgical specimen of the liver showed a huge cystic mass, containing liquified hemorrhagic fluid, with an irregular nodular peripheral portion. Its capsule was intact. An ileal mass, measuring 9x5 cm and arising from the submucosal layer, with deep ulceration was seen. Histological examination of the liver and the ileal mass revealed a malignant stromal tumor with neural differentiation on immunohistochemical staining.
Abdomen ; Autonomic Pathways* ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans ; Ileum ; Intestine, Small ; Liver* ; Myenteric Plexus ; Neoplasm Metastasis ; Ulcer

Peliosis hepatis is an uncommon liver condition involving abnormal dilation of hepatic sinusoids, eventually leading to blood-filled cavities within the hepatic parenchyma. Although the pathogenesis is not understood fully, peliosis hepatis has usually been associated with the use of anabolic steroid therapy, oral contraceptives, various malignancies or tuberculosis. We report a case of 59-year-old patient with cholangiocarcinoma with peliosis hepatis. The patient was admitted for evaluation of abdominal pain and fever. Abdomen CT showed a round cytic and solid mass with peripheral duct dilatation in liver. Grossly, the spongy-like solid mass and cyst was noted. Microscopically, the solid mass was composed of tubular and solid adenocarcinoma in fibrotic stroma and a blood-filled cavity with dilated sinusoids was noted.
Abdomen ; Abdominal Pain ; Adenocarcinoma ; Cholangiocarcinoma* ; Contraceptives, Oral ; Dilatation ; Fever ; Humans ; Liver ; Middle Aged ; Peliosis Hepatis* ; Tuberculosis

BACKGROUND: Severe iron deficiency anemia (IDA) can cause developmental and growth problems in children and disease severity is more than cognitive disorder or diabetic neuropathy according to the disability weight (DW).METHODS: Severe IDA is defined as serum hemoglobin (Hb) level less than 7.0 g/dL in younger than 4 years of age and less than 8.0 g/dL in older than 5 years, which has been caused by iron deficiency. Among 2,336 patients with IDA, 130 (5.6%) were diagnosed as severe IDA. The exclusion criteria were other hematologic diseases, history of preterm birth or low birth weight and acute blood loss due to trauma.RESULTS: The rate of severe IDA among IDA patients was higher in female than male. Patients from age 1 to 6 and adolescents over the age of 13 outnumbered others, and the majority of adolescent patients were female. Among weight groups, low weight-for-ages (less than 3rd percentile) was prevail (20%). There were no statistical differences between laboratory results of symptomatic patients and those of asymptomatic ones (25.4%). The common causes of severe IDA were; long-term exclusive breast feeding (13.0%), menorrhagia (10.0%), H. pylori gastritis (9.2%), upper GI bleeding (9.2%) and malnutrition (8.5%). All were treated with oral or intravenous iron replacement therapy and after 3 months, laboratory results were significantly improved. In cases of H. pylori gastritis, iron replacement therapy in conjunction with H. pylori eradication showed better efficacy in treatment.CONCLUSION: The importance of severe IDA should not be underestimated. Especially with female adolescents, H. pylori gastritis patients, and athletes, it is still more important to make prompt diagnosis and early treatment.
Adolescent ; Anemia, Iron-Deficiency ; Athletes ; Breast Feeding ; Child ; Diabetic Neuropathies ; Diagnosis ; Female ; Gastritis ; Hematologic Diseases ; Hemorrhage ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Iron ; Male ; Malnutrition ; Menorrhagia ; Premature Birth