No abstract available.
Child* ; Humans

Ticlopidine hydrochloride is world-wide used antiplatelet agent that inhibit ADP pathway. Its clinical side effects are the change of the blood picture, allergic skin reaction and gastrointestinal symptoms. We report three patients with severe cholestatic hepatitis caused by ticlopidine. They developed jaundice about 20days after taking ticlopidine (500 mg/day). Infectious and immunological etiologies were excluded by serology. There was no history of alcohol or drug abuse. Their symptoms were gradually subsided for a few months after discontinuing ticlopidine.
Adenosine Diphosphate ; Hepatitis* ; Humans ; Jaundice ; Skin ; Substance-Related Disorders ; Ticlopidine

PURPOSE: To identify the brain centers associated with visually evoked sexual arousal in the human brain, and to investigate the neural mechanism for sexual arousal using functional MRI (fMRI). MATERIALS AND METHODS: A total of 20 sexually potent volunteers consisting of 10 males (mean age: 24) and 10 females (mean age: 23) underwent fMRI on a 1.5 T MR scanner (GE Signa Horizon). The fMRI data were obtained from 7 slices (10 mm slice thickness) parallel to the AC-PC (anterior commissure and posterior commissure) line, giving a total of 511 MR images. The sexual stimulation consisted of a 1-minute rest with black screen, followed by a 4-minute stimulation by an erotic video film, and concluded with a 2-minute rest. The brain activation maps and their quantification were analyzed by the statistical parametric mapping (SPM 99) program. RESULTS: The brain activation regions associated with visual sexual arousal in the limbic system are the posterior cingulate gyrus, parahippocampal gyrus, hypothalamus, medial cingulate gyrus, thalamus, amygdala, anterior cingulate gyrus, insula, hippocampus, caudate nucleus, globus pallidus and putamen. Especially, the parahippocampal gyrus, cingulate gyrus, thalamus and hypothalamus were highly activated in comparison with other areas. The overall activities of the limbic lobe, diencephalon, and basal ganglia were 11.8%, 10.5%, and 3.4%, respectively. In the correlation test between brain activity and sexual arousal, the hypothalamus and thalamus showed positive correlation, but the other brain areas showed no correlation. CONCLUSION: The fMRI is useful to quantitatively evaluate the cerebral activation associated with visually evoked, sexual arousal in the human brain. This result may be helpful by providing clinically valuable information on sexual disorder in humans as well as by increasing the understanding of the neuroanatomical correlates of sexual arousal.
Amygdala ; Arousal* ; Basal Ganglia ; Brain ; Caudate Nucleus ; Diencephalon ; Female ; Globus Pallidus ; Gyrus Cinguli ; Hippocampus ; Humans ; Hypothalamus ; Hypothalamus, Middle ; Limbic System* ; Magnetic Resonance Imaging* ; Male ; Parahippocampal Gyrus ; Putamen ; Thalamus ; Volunteers

Percutaneous needle aspiration biopsy is a relatively simple and safe procedure for the diagnosis of lung and mediastinal lesions. Systemic air embolism during and after percutaneous needle aspiration biopsy of the lung is very rare; however, it is still a complication that can cause fatal outcomes, such as cerebral infarction and myocardial infarction. Here, we report a 72-year-old woman who suffered a change in consciousness immediately after receiving a percutaneous needle aspiration biopsy for the pathologic examination of pulmonary nodules found during a routine health medical examination. She had left side weakness and ST segment elevation on an electrocardiogram. After a high concentration of oxygen, she recovered from neurological symptoms and electrocardiographic abnormalities. The authors report a case of air embolism occurring simultaneously in the brain and coronary arteries after percutaneous needle aspiration biopsy.
Aged ; Biopsy ; Biopsy, Needle* ; Brain ; Cerebral Infarction ; Consciousness ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Embolism ; Embolism, Air* ; Fatal Outcome ; Female ; Humans ; Intracranial Embolism ; Lung* ; Myocardial Infarction ; Needles* ; Oxygen

BACKGROUND: The aim of this study was to investigate the value of colonoscopy for assessment of colonic mucosal lesions and for microbial identification in patients with acute diarrhea. METHODS: From March 2000 to August 2000, forty-one patients with watery or bloody diarrhea lasting less than 15 days were participated after the exclusion of patients who had previous history or presumption of inflammatory bowel disease, radiation colitis, ischemic colitis, or pseudomembranous colitis. Both biopsy specimens and colonic luminal fluid were taken during the colonoscopy and used for bacterial cultures. RESULTS: Male and female ratio was 22:19 and mean age was 45+/-20 years. The extent of acute colitis was as followed: the normal colonoscopic finding in five cases (12.2%), involvement of one segment in 3 cases (7.3%), involvement of two or more segments in 14 cases (34.1%), pancolitis in 10 cases (24.4%) and pancolitis with terminal ileitis in 9 cases (22.0%). In culture study, identification of more than one pathogen was in 19/41 (46.3%) and the common pathogens were Enterobacter (11 cases), Salmonella species (6 cases), Citrobacter freundii complex (2 cases), Klebsiella oxytoca (2 cases) and Morganella morganii (1 case). Pathogen could be identified in 11.8% with stool specimen, 46.2% with biopsy specimen and 62.5% with intraluminal fluid, but without statistical significance. CONCLUSION: Colonoscopy was useful in the evaluation of extent and severity of acute infectious colitis. Obtaining the biopsy specimens and intraluminal fluid during colonoscopy seemed to assist in identifying the pathogen in patients with acute diarrhea.
Biopsy* ; Citrobacter freundii ; Colitis ; Colitis, Ischemic ; Colon ; Colonoscopy* ; Crohn Disease ; Diarrhea* ; Enterobacter ; Enterocolitis, Pseudomembranous ; Female ; Humans ; Inflammatory Bowel Diseases ; Klebsiella oxytoca ; Male ; Morganella morganii ; Phenobarbital ; Salmonella

An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.
Aged, 80 and over ; Aortic Aneurysm ; Diagnosis ; Emergencies ; Esophageal Fistula ; Fistula* ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Syncope

Systemic lupus erythematosus and myasthenia gravis are autoimmune disorders in which genetic, environmental and hormonal as well as immunological factors have been implicated. We experienced a case of 24 year-old female patient developed SLE(anemia, leukopenia, facial malar rash, high titers of anti-DNA and anti-nuclear antibody) 3 years following successful therapeutic thymectomy for myas thenia gravis. A review of the world-wide literature revealed 8.3% to 24.3% association between myasthenia gravis and SLE. However there has been no controlled epidemiological study to prove a real association between these two disease. The differential diagnosis of fatigue and fever in patient with SLE should always include the possibility of myasthenia gravis.
Diagnosis, Differential ; Exanthema ; Fatigue ; Female ; Fever ; Humans ; Immunologic Factors ; Leukopenia ; Lupus Erythematosus, Systemic* ; Mya ; Myasthenia Gravis* ; Thymectomy ; Thymoma* ; Young Adult

Because of the magnetic property that attracts magnets to one another, the swallowing of magnets could provoke perforation, obstruction, and formation of fistula in the gastrointestinal tract. Here, the authors describe two cases of gastrointestinal complication caused by swallowed magnets in children. The first case occurred in a 12-year-old boy who swallowed multiple magnetic educational instruments; the patients presented with duodeno-colic and colo-colic fistula. In the second case, a 7-year-old boy swallowed two magnets and developed a jejuno-jejunal fistula associated with perforation of the jejunum. In accidental swallowing of the magnet, especially multiple pieces, the follow-up plain abdominal X-ray film should be checked, and an emergency exploration could be considered.
Child* ; Deglutition ; Eating* ; Emergencies ; Fistula ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Jejunum ; Male ; X-Ray Film

PURPOSE: Pancreatectomy can impair production of endocrine and exocrine hormones. In this study, we evaluated: 1) the incidence rate of diabetes in patients undergoing distal pancreatectomy; 2) the correlation between the occurrence of pancreatic diabetes and the extent of the resected pancreas; and 3) factors associated with the development of pancreatic diabetes. METHODS: We retrospectively reviewed the cases of 26 patients who could be compared in abdominal computed tomography before and after distal pancreatectomy for benign or malignant lesions between January, 1999 to June, 2010. RESULTS: The incidence of pancreatic diabetes was 19.2%. Obese patients (BMI>25.0 kg/m2) had a higher incidence (p=0.029) of pancreatic diabetes after distal pancreatectomy than non-obese patients. The diabetes group had larger volumes of resected pancreas, but the difference was not statistically significant (p=0.105). CONCLUSION: Several factors may be associated with the development of pancreatic diabetes after distal pancreatectomy. It is necessary to closely follow-up development of pancreatic diabetes regardless of the extent of resection.
Diabetes Mellitus ; Follow-Up Studies ; Humans ; Incidence ; Pancreas ; Pancreatectomy ; Retrospective Studies ; Risk Factors

PURPOSE: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity caused by obstruction or rupture of the peritoneal or retroperitoneal lymphatic drainage system. Postoperative chylous ascites is a rare complication of abdominal surgery. In the present study, we analyzed patients who developed postoperative chylous ascites after gastrectomy. METHODS: From February 2003 to June 2006, we treated 7 cases of chylous ascites that occurred after gastrectomy for gastric cancer. We reviewed the medical charts of these patients retrospectively. RESULTS: The incidence of chylous ascites after gastrectomy was 1.7%. Mean triglyceride concentration of the ascitic fluid was 437 mg/dl (range: 128 mg/dl~816 mg/dl). Total parenteral nutrition and somatostatin were administered to 6 patients, and 1 patient was treated with oral diuretics and serial paracentesis. CONCLUSION: The incidence of chylous ascites is low, but may increase with more aggressive surgery. Surgeons should consider chylous ascites if the character of drainage is milky. Conservative management is usually effective for the treatment of postoperative chylous ascites. If conservative management fails, surgical management should be considered.
Ascitic Fluid ; Chylous Ascites ; Diuretics ; Drainage ; Gastrectomy ; Humans ; Incidence ; Parenteral Nutrition, Total ; Peritoneal Cavity ; Rupture ; Somatostatin ; Stomach Neoplasms