No abstract available.
Gastric Mucosa* ; Helicobacter pylori* ; Helicobacter*

The majority of ptients with ischemic heart disease such as angina pectoris and myocardial infarction have coronary atherosclerosis as a underlying cause. However, in unusual conditions such as variant angina, aortic valvular heart disease, hypertrophic cardiomyopathy, vasculitis, hypercoagulable states, coronary atherosclerosis is not the cause. Polycythemia vesa is a myeloproliferative disease characterized by infrequent thromboembolic complications such as ischemic heart disease. We report a case of polycythemia vera presenting with angina pectoris without coronary artery stenosis with the review of the literature.
Angina Pectoris* ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Polycythemia Vera* ; Polycythemia* ; Vasculitis

BACKGROUND: Viral myocarditis is considered as a cause of dilated cardiomyopathy. At present, two pathogenic mechanisms may be involved in the pathogenesis of viral myocarditis and subsequent cardiomyopathy. First, the virus infection of myocyte may directly lead to either cell death or persistent metabolic dysfunction. Second, virus-induced immune or autoimmune mechanism may play a role. METHODS: To test the therapeutic efficacy of immunosuppression with cyclophophamide(CYP) on coxsackievirus B3(CB3) myocarditis, 10-14 week-old Balb/c mice were inoculated with 4000 plaque-forming units of CB3. In experiment 1, CYP (100mg/kg/day subcutaneous injection, s.c) was administrated daily on days 1-7(group 2, n=16). In experiment 2, CYP 30mg/kg/day s.c(group 3, n=32) or CYP 100mg/kg/day s.c(group 4, n=32) were administrated on days 8-14. The animals of infected controls(group 1, n=26) and group 2, 3, 4 were dissected at days 4, 7, 15, 22 and spleen, heart, thymus and body weights were measured. RESULTS: In experiment 1. survival rate in group 2 on day 7, 15 were low compared with group 1(85%, 0% vs 100%, p<0.05). and myocardial virus titers in group 2 on day 4 was 50 times, and on day 7, 1000 times higher compared with group 1, Histologically, on day 7, focal cellular infiltrations were prominent findings in group 1, but diffuse myocardial necrosis without cellular infiltration were observed in group 2. In experiment 2, survival rate, cardiac histopathology myocardial virus titer and serum neutralizing antibody titers did not differ among groups 1, 3 and 4. In experiment 1 and 2, the spleen-to-body-weight and thymus-to-body-weight ratios were significantly lower in CYP treated groups than those in controls and marked cellular depletions in spleens and thymus were observed in CYP treated groups. CONCLUSIONS: As the results of above, it can be concluded that the immunosuppression during viremic phase of murine viral myocarditis aggravated the myocardial necrosis, and during aviremic phase, the administration of CYP didnot affect the process of viral myocarditis. Thus, direct viral mechanisms in the production of cardiomyocyte injury in CB3-infected mice appear to bo more important than cell mediated immune mechanism. To understand relevant pathogenic mechanisms of clinical myocarditis and dilated cardiomyopathy resulting from viral infection, the experimental study expanding into nonmurine animals and into various models using other infectious agents may be required.
Animals ; Antibodies, Neutralizing ; Body Weight ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cell Death ; Cyclophosphamide* ; Heart ; Immunosuppression ; Injections, Subcutaneous ; Mice ; Muscle Cells ; Myocarditis* ; Myocytes, Cardiac ; Necrosis ; Spleen ; Survival Rate ; Thymus Gland ; Viral Load

PURPOSE: The study was conducted to determine if there is a corneal astigmatic changes after upper eyelid surgery by using corneal topography and if these changes are the reason why some patients note a decrease in visual acuity. METHODS: Twenty four eyes of 12 patients with dermatochalasis who had undergone upper eyelid blepharoplasty, and 24 eyes of 12 patients who had undergone aesthetic double fold formation were included. We performed corneal topography during the postoperative 3 months and also evaluated the corneal refractive index change on thirteen points of the central cornea, which were located in the center of the corneal apex and apart from it by 1.5, 2.5, 3.5 mm along each axis corresponding to the 0 degrees, 90 degrees, 180 degrees, 270 degrees respectively. RESULTS: Corneal topography demonstrated increase in with-the-rule astigmatism by 38, 33, and 12% for dermatochalasis patients at 1week, 1month, and 3months after surgery, and by 25%, 17%, and 13% for double fold patients. However the increase in with-the-rule astigmatism seemed to be temporary, showing gradual regression. The refractive index change of thirteen points of central cornea was not significant except a few eyes with astigmatic changes greater than 1D until 1 month after surgery. There was alsoincreased astigmatism after surgery in vector-corrected analysis. CONCLUSIONS: There was a tendency of increase in with-the-rule astigmatism and those changes were temporary and regressed gradually. No patient showed significant refractive index change on the 13 points of central cornea but some showed changes greater than 1 D in the early postoperative period, causing visually significant astigmatic changes temporarily.
Astigmatism ; Axis, Cervical Vertebra ; Blepharoplasty ; Cornea ; Corneal Topography* ; Eyelids* ; Humans ; Postoperative Period ; Refractometry ; Visual Acuity

PURPOSE: We evaluated the prevalence and characteristics of breakthrough cancer pain (BTcP) in Korean patients admitted with cancer pain. MATERIALS AND METHODS: In-hospital patients with cancer pain completed a questionnaire concerning severity of background cancer pain (BCP), prevalence and treatment for BTcP, sleep disorders, and satisfaction with cancer pain treatment. Medical records showing medications for BCP and BTcP were also evaluated. RESULTS: Total 609 patients with controlled BCP enrolled. Mean age of the patients was 59.5 years old, and 59% were male. Of all patients, 177 (29%) complained of BTcP. No clinical characteristic predicted BTcP. Of the 177 patients with BTcP, 56% did not receive treatment for BTcP. Patients with BTcP showed significant association with a sleep disorder and dissatisfaction with pain control, compared to those without BTcP (p < 0.0001 and p=0.0498, respectively). Oxycodone-immediate release was the most commonly used short-acting analgesic, followed by intravenous morphine. CONCLUSION: The prevalence of BTcP was 29% in patients admitted with controlled BCP. Although the patients had well-controlled BCP, BTcP showed association with a lower quality of life in patients with cancer. More medical attention is needed for detection and management of BTcP.
Humans ; Inpatients* ; Male ; Medical Records ; Morphine ; Prevalence ; Quality of Life ; Sleep Disorders

Congenital laryngeal cleft is a rare anomaly, which can cause serious problems of airway and repeated aspiration pneumonia. It is due m failure of fusion of the posterior cricoid cartilage lamina. Dysphagia with aspiration of food is commonly seen w1h resultant bouts of pneumonia. Detection of an unsuspected minor cleft may be difficult, but the pediatrician should suspect the possibility of deft from the clinical features. This paper includes. a detailed case report of one patient with congenital laryngeal cleft and the review of literatures.
Cricoid Cartilage ; Deglutition Disorders ; Humans ; Pneumonia ; Pneumonia, Aspiration

Paragangliomas (PGs) of the thyroid are very rare tumors. Based on the medical literature, thyroid PGs invariably affected women and they were always thought to be benign, and they have always been mistaken for other more common lesions. We report here on the first case of PG of the thyroid in a 45-year-old man in Korea. Ultrasonographically, the tumor showed hypoechoic features. Microscopically, the tumor showed the typical zellballen pattern. The small to medium-sized tumor cells contained moderate amounts of finely granular eosinophilic cytoplasm and round to oval nuclei with fine chromatin. The tumor invaded the thyroid capsule and the extrathyroidal tissue with vascular and perineural invasion. Immunohistochemically, the tumor showed positivity for chromogranin, S-100 protein, CD56a, and synaptophysin and negativity for calcitonin, thyroglobulin, galectin-3, p53, CK19, and EMA. The Ki-67 labeling Index was 10%. We concluded that our case has a high potential of metastasis, and a close follow up would be important.
Female ; Male ; Humans

Subacute thyroiditis is a self-limiting inflammation of the thyroid, presenting with painful thyroid swelling, thyrotoxicosis and low radioactive iodine uptake. The characteristic US findings for this disease are focal ill-defined hypoechoic areas in one lobe or diffuse hypoechoic areas in both lobes. Thyroid carcinomas should be included in the differential diagnosis for a lesion with focal hypoechoic areas and have been rarely reported to coexist with subacute thyroiditis. Takayasu's arteritis is an autoimmune disease that affects the aorta and its branches as well as pulmonary arteries. Subacute thyroiditis associated with Takayasu's arteritis is extremely rare, with only three cases being reported. We report here on the first case with the simultaneous diagnosis of subacute thyroiditis, papillary thyroid carcinoma and Takayasu's arteritis.
Aorta ; Autoimmune Diseases ; Carcinoma ; Diagnosis, Differential ; Inflammation ; Iodine ; Pulmonary Artery ; Takayasu Arteritis ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis, Subacute ; Thyrotoxicosis

Myasthenia gravis(MG) is an autoimmune disorder characterized by the presence of anti-acetylcholine receptor antibody and weakness of voluntary muscles. The pathogenesis of MG is decreased numbers of acetylcholine receptors at postsynaptic membranes of neuromuscular junctions. It has been reported that MG often coexists with other autoimmune disorders. This is a case report of systemic lupus erythematosus coexisting with MG in a 23 year old female patient presenting with dysarthria, dysphagia, and limb weakness. We report the case with relevant literature review.
Deglutition Disorders ; Dysarthria ; Extremities ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Membranes ; Muscle, Skeletal ; Myasthenia Gravis* ; Neuromuscular Junction ; Receptors, Cholinergic ; Young Adult

BACKGROUND: This study assessed the early results of endovascular repair of acute type B aortic dissection and the aortic wall changes following endovascular repair. MATERIAL AND METHOD: From July 2008 to May 2009, the preoperative and follow-up computed tomography (CT) scans of 5 patients with acute type B aortic dissection were evaluated, and these patients had underwent stent graft implantation within 13 days of the onset of dissection (mean: 7 days; range: 3~13). The whole lumen (WL), true lumen (TL) and false lumen (FL) diameters were measured at the proximal (p), middle (m) and distal (d) third of the descending thoracic aorta. RESULT: The study included four men and one woman with an average age of 59.4+/-20.1 years (age range: 37~79 years). The follow-up CT was performed and evaluated at 7 days and 6 months. The primary tear was completely sealed in all the patients. No paraplegia, paresis or peripheral ischemia occurred and none of the patients died. No endoleaks developed in any of the patients during follow-up. The TL diameters increased from 20.4 to 33.5 mm in the proximal third (p/3), from 19.5 to 29.8 mm in the middle third (m/3) and from 15.2 to 23.5 mm in the distal third (d/3). The FL diameters decreased from 18.7 to 0 mm in the p/3, from 15.4 to 0 mm in the m/3 and from 21.4 to 8.7 mm in the d/3. The changes in the TL diameter were statistically significant in the middle and distal aorta, and those changes in the FL diameter were not statistically significant. There was a decrease in the WL after repair, but this was not statistically significant. In three patients, the false lumen disappeared completely on follow-up CT at 6 months. Two patients had patent false lumens and no thrombosis. CONCLUSION: The early results showed that endovascular repair was effective in treating acute type B aortic dissection, and endovascular repair promoted positive aortic wall changes.
Aorta ; Aorta, Thoracic ; Endoleak ; Female ; Follow-Up Studies ; Humans ; Ischemia ; Male ; Paraplegia ; Paresis ; Stents ; Transplants