PURPOSE: To evaluate the outcome of coronary lesions for efficacy of dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD). METHODS: Retrospective studies were performed on 438 cases of KD treated with one or two episode of high-dose IVIG and 24 cases with dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD) at this hospital from June 2000 to January 2004. 2D echocardiogram was done at admission, 2 months later and every 2 or 3 months when coronary lesion had improved more than 2 months later. RESULTS: In 108(24.7%) of 438 cases with IVIG therapy only, 10(41.7%) of 24 cases with dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD), coronary abnormality had been shown by initial 2D-echocardiogram examined at acute stage. In 10(2.3%) of 438 patients with IVIG therapy only, and in 3(12.5%) of 24 cases with additional IVIG retreatment, coronary lesions were still remained at follow-up echocardiogram. Even though it had tendency to increase the coronary lesions in the group with dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD), there was no significant differences about the incidence of coronary lesions between two groups. There was no significant differences in age, sex, and other clinical findings between two groups. CONCLUSION: The combination therapy with high doses of IVIG and aspirin in KD is the standard treatment but not always effective. The dexamethasone therapy may be another treatment of choice after additional immunoglobulin(IVIG) retreated in IVIG- resistant Kawasaki disease(KD).
Aspirin ; Dexamethasone* ; Follow-Up Studies ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Retreatment ; Retrospective Studies

PURPOSE: The purpose of this study is to evaluate the role of plasma brain natriuretic peptide(BNP) concentraion in Kawasaki disease(KD) and to evaluate the relationship of BNP and Tissue doppler imaging(TDI) in ventricular function. METHODS: Plasma BNP concentration was obtained in the acute phases of KD(n=49) and non-KD(n=36). TDI and conventional echocardiography were performed in 49 patients in acute phase of KD. E' velocity, A' velocity at the lateral mitral annulus, interventricular septum, lateral tricuspid annulus were measured. RESULTS: The mean plasma BNP concentration in patients with KD in the acute phase was significantly higher than non-KD(61.1+/-100.9 pg/mL vs 13.2+/-9.5 pg/mL, P<0.05). There was significant negative correlation with BNP and E' velocity, E/E' ratio at lateral mitral annulus in the aucte phase of KD. CONCLUSION: The level of plasma BNP significantly increased in aucte phase of KD. But, there was no definite level of plasma BNP to diagnosis of KD. Diatolic ventricular function was decreased in acute phase of KD which BNP is elevated by TDI.
Brain* ; Diagnosis ; Echocardiography ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Natriuretic Peptide, Brain* ; Plasma* ; Ventricular Function

Antiphospholipid syndrome (APS) is an autoimmune hypercoagulability syndrome. The clinical feature of the antiphospholipid syndrome is characterized by venous or arterial thromboses, recurrent fetal losses and/or thrombocytopenia with evidence of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies. Although APS is most commonly associated with systemic lupus erythematosus or related autoimmune disease (secondary APS), APS also has been identified in patients with vaso-occlusive disease without any other manifestations of connective tissue disease (primary APS). In primary APS, aortic thrombosis has been rarely reported. We report a case of thrombosis of abdominal aorta in primary APS.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Aorta, Abdominal ; Autoimmune Diseases ; Connective Tissue Diseases ; Humans ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Thrombocytopenia ; Thrombophilia ; Thrombosis*

Cutaneous papillomas or acrochorda usually appear after the 4th decade of life in areas with skin folds. Conventional methods of removal are associated with bleeding problems, pain and prolonged sequelae. Thus, acrochorda removal with lasers has gained attention. In this study, we compared the efficacy of two popular laser types with different wavelengths and pulse widths for removal of skin tags. A 60-year-old Korean male noticed skin tags on his neck bilaterally. All tags were treated in a single session, on one side with a picosecond (ps)-domain 532 nm Nd:YAG laser and on the contralateral side with a long-pulsed (LP) 755 nm alexandrite laser. The endpoint for the ps-532 laser was immediate whitening, while that for the LP and quasi-LP (QLP) 755 lasers were visible changes on the surface of the lesion. Antibiotic ointment was applied, dressing was done and clinical photographs were taken. Both lasers effectively removed the skin tags at all settings in a single session without bleeding and with minimal discomfort. Crust formation occurred on both sides with natural shedding within 1 to 2 weeks. Transient erythema lasted longer in the tags treated with the ps-532 laser. At the 5th month of follow-up, residual lesions were detected on the field treated with the ps-532 laser. No persistent side effects such as scarring or postinflammatory hyperpigmentation (PIH) were observed. In conclusion, both the ps-532 nm Nd:YAG and the 755 nm alexandrite lasers ensured safe and effective removal of skin tags in a single session without adverse sequelae.

PURPOSE: The purpose of this study was to compare the success rate of re-excision and breast-conserving surgery (BCS) between patients who received neoadjuvant chemotherapy and those who did not. METHODS: In this retrospective cohort study, 256 women who had clinical T2 breast cancer and planned to receive, as initial treatment either BCS (n=197) or neoadjuvant chemotherapy (n=59) between January 2009 and December 2012 were included. The data, including age, initial tumor size, mammographic microcalcification, ultrasound multifocality and axillary nodal status, were collected. The pathologic tumor size, p-multifocality, histologic type, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, ductal carcinoma in situ (DCIS) and extensive intraductal component (EIC) were also reviewed. The re-excision and BCS success rates were investigated. Univariate analysis and regression model were used. To reduce the effect of selection bias, propensity score matching-based analysis was also performed. RESULTS: Of the 256 patients, 178 patients (90.4%, 178/197) in the non-neoadjuvant group and 56 patients (94.9%, 56/59) in the neoadjuvant group received BCS (p=0.406). In propensity-matched cohorts (n=118), the re-excision rate was similar in the two groups (35.6% in neoadjuvant group vs. 35.6% in non-neoadjuvant group, p=1.000). BCS success rate was slightly higher in neoadjuvant group (94.9%, 56/59) than in non-neoadjuvant group (86.4% [51/59], p=0.205). In logistic regression model, clinicopathologic factors associated with re-excision were pathologic multifocality (odds ratio [OR], 4.56; p=0.0142), high Ki-67 (≥50%) (OR, 0.7; p=0.0243) and DCIS component (OR, 2.67; p=0.0261). CONCLUSION: This study showed that neoadjuvant chemotherapy could increase the success rate of BCS but could not decrease that of re-excision. The re-excision rate is more associated with pathologic finding rather than the effect of neoadjuvant chemotherapy.
Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Cohort Studies ; Drug Therapy* ; Estrogens ; Female ; Humans ; Logistic Models ; Mastectomy, Segmental ; Propensity Score ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Retrospective Studies ; Selection Bias ; Ultrasonography

Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient's condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.
Carotid Arteries ; Carotid Artery, Internal ; Cerebral Arteries ; Constriction, Pathologic ; Endarterectomy, Carotid ; Humans ; Stents ; Thrombosis

No abstract available.
Actinobacillus* ; Aggregatibacter actinomycetemcomitans* ; Apoptosis* ; Humans ; Jurkat Cells*