Pulmonary tumors exhibiting neuroendocrine differentiation are classified as typical carcinoid, atypical carcinoid, and small cell lung carcinoma(SCLC). Travis et al. proposed a fourth category of large cell neuroendocrine carcinoma, which is characterized by light microscopic neuroendocrine appearance, cells of large size, polygonal shape, low nuclear cytoplasmic ratio, coarse nuclear chromatin, with prominent nucleoli high mitotic rate and frequent necrosis; and neuroendocrine features by immunohistochemistry or electron microscopy. High grade neuroendocrine carcinoma (LCAC-NE) revealed aggressive clinical course. We report two cases of neuroendocrine tumors of the lung characterized by a trabecular pattern of large pleomorphic cells with frequent mitoses and wide necrosis. The frequent metastatic sites of atypical carcinoid were liver, bone and brain. One of our case is presented, at first, as an ovarian mass, which shows multifocal rosettes and revealed metastasis from lung. Both cases expressed neuroendocrine differentiation by light microscopy and immunohistochemistry. However clinical neuroendocrine symptom were not present.
Brain ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Chromatin ; Cytoplasm ; Female ; Immunohistochemistry ; Liver ; Lung* ; Microscopy ; Microscopy, Electron ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Ovary

Myocardial infarction is almost regularly associated with severe and widespread obstructive coronary artery disease. Recently, there have been some reports of myocardial infarction with normal of near normal coronary arteries on cineangiography. The following report concerns 6 cases (4% of a series of 142 consecutively studied patients with myocardial infarction) of myocardial infarction proved on clinical grounds with normal or near normal coronary arteries at coronary angiography obtained several months later. The clinical data was shown in Table 1 and Table 2. All 6 patients were male. Three were in the fifth, two in the sixth, and one in the seventh decade. Multiple risk factors were present in only one patient. Areas of localized dyskinesia or hypokinesia were demonstrated in five on the left ventricular cineangiography. The left ventricular end-diastolic pressure was greater than 12 mmHg in all 6 patients. One patient had hypertrophic cardiomyopathy and the remaining 5 patients had no underlying heart diseases. One patient had moderate congestive heart tailure. It is possible that prolonged, localized coronary artery spasm or platelet thrombi that subsequently resolved are a part of the pathogenic mechanism.
Blood Platelets ; Cardiomyopathy, Hypertrophic ; Cineangiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dyskinesias ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Humans ; Hypokinesia ; Male ; Myocardial Infarction* ; Risk Factors ; Spasm

Conventional dual chamber pacing (DDD) preserves atrioventricular synchrony but depend on appropriate sinus node function to achieve physiological heart rate with exercise by atrial tracking. Other indirect indicators of metabolic demand have been used to modulate pacing rate increases with exercise including sensing of pH, respiratory rate, ventricular repolarization and oxygen saturation. The activity sensing approach is unique in that noise generated by activity modulates the response and empirical programming of the unit allows for attaining the desired rate for a given level of activity. Physiologic rate increases can be obtained in patients with sinus node dysfunction or even atrial fibrillation. The lead can either be positoned in the atria for patients without atrial fibrillation or AV conduction disturbance or in the ventricle. We present two cases of rate responsive pacing using the Activitrax.
Atrial Fibrillation ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Noise ; Oxygen ; Respiratory Rate ; Sick Sinus Syndrome ; Sinoatrial Node

Coronary arterivenous fistula(CAVF) is an uncommon congenital coronary anomaly-Bilateral CAVFs that originate from both coronary arteries are very rare. Coronary arteriography performed in recent years has clarified the incidence and various features of this lesion. Baim et al.1) reported that only 5% of the coronary artery fistulas arose from bilateral coronary arteries. In this report, we present a case of bilateral coronary artery pulmonary artery fistulas associated with atypical chest pain.
Angiography ; Arteries* ; Chest Pain ; Coronary Vessels ; Fistula* ; Incidence ; Pulmonary Artery

PURPOSE: This descriptive research study aims to investigate influential factors on human papillomavirus vaccines, among parents who have elementary school daughters. METHODS: This study was conducted with 210 parents whose children are elementary school girls, aged 9 to 12 years, in G Metropolitan City. Data were collected from August 17 to September 12, 2015 using structured questionnaires. A descriptive statistical analysis, a t-test, a χ2-test, a Fisher's exact test, and a logistic regression using SPSS/WIN 21.0. RESULTS: The influential factors on the human papillomavirus vaccination intention were confirmed to be three variables: cervical cancer knowledge, perceived sensitivity, and perceived barriers. CONCLUSION: An intervention program, both to increase the sensitivity of vaccination and to decrease barriers, should be developed so as to improve parents' health beliefs towards human papillomavirus vaccination.
Child ; Female* ; Humans* ; Intention* ; Logistic Models ; Nuclear Family ; Papilloma ; Papillomavirus Vaccines ; Parents* ; Uterine Cervical Neoplasms ; Vaccination*

BACKGROUND: A stenosis of left main coronary artery has critical prognostic importance. Recent reports on successful left main stenting are now challenging traditional treatment patterns for this lesion. We evaluated recent four-year trends in incidence, clinical, angiographic findings and treatment modalities in patients with left main coronary artery stenosis(LMS). METHODS: Patients who were diagnosed as a significant LMS at Yonsei cardiovascular hospital between 1996 and 1999 were analyzed retrospectively. RESULTS: The incidence of LMS during the period of 1996 to 1999 was 3.3%(n=24) and it was significantly higher than that of previous 15 years before 1996(p<0.01). The incidence of isolated ostial lesion was 0.28% and this lesion was more prevalent in young female patients with less risk factors compared with other types of LMS(p<0.01). After exclusion of the patients with an isolated ostial lesion, patients were grouped according to the lesion site: ostium, shaft, and shaft lesion extended to distal vessels. There were no differences in clinical and hemodynamic findings among these groups. Coronary artery bypass graft was performed in 141 patients(63%) and stent implantation in 16 patients(14%). CONCLUSION: The incidence of LMS has been increased. There was no difference in clinical and hemodynamic findings according to the types of LMS. Surgery is still a standard treatment, but in selected patients percutaneous coronary intervention can be another treatment option.
Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Hemodynamics ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Transplants

We successfully closed the isolated patent ductusarteriosus(PDA) in 2 female patients using the Rashkind Double-Disc Occlusion system. nonsurgical closure of PDA usin plug was introduced by Porstmann in 1968 through transfemoral artery catheter and using umbrella by Rashkind in 1977 througth venous site. There has been continued improvement and simplification of the equipment as well as in the implantation technique. Nowaday, a multicenter study was conducted to test the safety and effectiveness of this interventioal method in States. Successful closure rate was high but some problems were reported such as embolization, abnormal deployment and residual shunt. Residual shunt was visualized by aortography in our both cases immediately after intervention but continuous murmur could not be heard in both cases. Oxygen step-up disappeared immediately after occluder implantation in both cases. Complete occlusion was expected with thrombus in near future.
Aortography ; Arteries ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Humans ; Oxygen ; Thrombosis

Verapamil is highly effective in terminating paroxysmal supraventricular tachycardia(PSVT) by its depressive action on the AV node. In other countries it is already the drug of choice if vagal manevers fail for conversion of PSVT. We evaluated therapeutic efficacy of intravenous verapamil in 30 patients with PSVT who visited Severance Hospital from november 1978 to November 1984. Twenty six of 30 patients(86.7%) had a restoration of normal sinus rhythm by intravenous verapamil without significant side effects. Thus intravenous verapamil is safe and extremely effective in terminating most PSVT.
Atrioventricular Node ; Humans ; Tachycardia, Supraventricular* ; Verapamil*

PURPOSE: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. Vitamin D and interleukin-31 (IL-31) are known to be related to the pathogenesis of AD with pruritus. The purpose of this study was to investigate the relationship between serum levels of 25-hydroxyvitamin D (25(OH)D) and IL-31 and the disease severity of AD in children with AD. METHODS: We recruited 160 children with AD and 42 controls. We used the SCORing Atopic Dermatitis (SCORAD) index to measure the severity of AD. Serum IL-31 and 25(OH)D levels were assayed using enzyme-linked immunosorbent assay and high-performance liquid chromatography, respectively. Serum levels of total IgE, specific IgE to common allergens and peripheral blood total eosinophil count were carried out in children with AD. RESULTS: Serum IL-31 level was significantly higher in AD group compared to control group and 25(OH)D level was significantly lower in AD group than control group. Serum IL-31 level showed the highest level in severe AD group followed by moderate and mild AD group, whilst serum 25(OH)D level was the lowest in severe AD group compared to moderate and mild AD group. There was no difference in serum IL-31 level between AD group and nonatopic dermatitis group. IL-31 level was positively correlated with subjective SCORAD index indicating pruritus in children with AD, and 25(OH)D was inversely correlated with SCORAD index. CONCLUSION: IL-31 and vitamin D may be related to the pathogenesis of AD, especially with regard to the pruritus.
Allergens ; Child* ; Chromatography, Liquid ; Dermatitis ; Dermatitis, Atopic* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Humans ; Immunoglobulin E ; Pediatrics ; Pruritus ; Skin Diseases ; Vitamin D

PURPOSE: Viral infection is the most common aggravating factor for childhood asthma. Asthma may be a risk factor for severe respiratory symptoms in children with lower respiratory tract infections of viral etiology. Influenza A infection enhances Th2-polarization to house dust mites during the acute phase and leads to lung dysfunction in a mouse model. However, there are no data on the relationship between atopic sensitization and H1N1 (Influenza A) infection in humans. To investigate whether atopic sensitization is associated with the severity of H1N1 pneumonia, we compared clinical features and the atopic sensitization rate between children with and without H1N1 infection. METHODS: Using reverse transcription-polymerase chain reactions, we investigated H1N1 virus infection in 214 children who were hospitalized with high fever and respiratory symptoms from September 2009 to February 2010. We also performed immunoassays for total and specific IgEs to six common aeroallergens. Atopy was defined as positivity for more than one specific IgE. The clinical severity of pneumonia was evaluated based on intensive care unit admission, oxygen therapy, steroid therapy, and atelectasis. RESULTS: There were 70 H1N1-positive children, 42.9% of whom had pneumonia. Children with H1N1 infection were older and had a higher prevalence of atopic sensitization and pneumonia compared with H1N1-negative children. The rate of atelectasis was higher in children with H1N1 pneumonia than in children with non-H1N1 pneumonia. Among children with H1N1 viral infection, those with atopic sensitization had a higher prevalence of intensive care unit admission and oxygen therapy, and a longer duration of hospitalization than non-atopic children. There were no differences between atopic and non-atopic children without H1N1 viral infection. CONCLUSIONS: The prevalence of H1N1-induced severe lower respiratory tract diseases is higher in children with atopic sensitization.
Animals ; Asthma ; Child ; Fever ; Hospitalization ; Humans ; Immunoassay ; Immunoglobulin E ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Intensive Care Units ; Lung ; Mice ; Oxygen ; Pneumonia ; Prevalence ; Pulmonary Atelectasis ; Pyroglyphidae ; Respiratory System ; Respiratory Tract Diseases ; Respiratory Tract Infections ; Risk Factors