Ventricular premature complexes (VPCs) are known to be one of the most benign cardiac arrhythmias when they occur in structurally normal hearts. We experienced a 32-year old man who presented with dyspnea, palpitations and very frequent VPCs (31% of the total heart beats). Echocardiography revealed a dilated left ventricle (LV 66 mm at end-diastole and 57 mm at end-systole) and a decreased ejection fraction (34%). Very frequent VPCs had been detected 10 years previously and he underwent a failed radiofrequency catheter ablation (RFCA) procedure at that time. The patient had been treated with heart failure medications including betablockers, ACE inhibitors and spironolactone for the two most recent years. Six months after we eliminated these VPCs with a second RFCA procedure, the heart returned to normal function and size. Long standing and very frequent VPCs could be the cause of left ventricular dysfunction in a subset of patients who suffer with dilated cardiomyopathy, and RFCA should be the choice of therapy for these patients.
Ventricular Premature Complexes/*complications ; Tachycardia, Ventricular/*etiology/therapy ; Male ; Humans ; *Catheter Ablation ; Cardiomyopathies/*etiology/therapy ; Adult

The tendency of glioblastoma to metastasize to the cerebrospinal fluid (CSF) is well documented, reaching approximately 20% in autopsy series. Nevertheless, clinical symptoms from spinal seeding seem to be infrequent or are at least rarely diagnosed. The authors report a case of a 41-year old female patient with a cerebral glioblastoma multiforme who developed paraplegia due to a pathologically confirmed spinal metastasis.
Adult ; Autopsy ; Cerebrospinal Fluid ; Female ; Glioblastoma* ; Humans ; Neoplasm Metastasis* ; Paraplegia

BACKGROUND: The recognition of bronchial asthma as an inflammatory disease led to a search for soluble markers that would be useful in assessing airway inflammation. Interleukin-6 (IL-6) is a representative proinflammatory cytokine that has been shown to be connected with various inflammatory diseases. IL-6 acts via specific receptors that consist of the IL-6 binding glycoprotein gp80 and the signal transducer gp130. In the search for markers of airway inflammation, we investigated the role of soluble interleukin-6 receptor (sIL-6R) and IL-6 in acute asthma. METHODS: Serum levels of sIL-6R and IL-6 were measured in 78 acute asthmatics, in 15 patients with asymptomatic asthma and in 10 healthy control subjects by a specific ELISA using a murine antihuman IL-6R, IL-6 mAb (Quantikine sIL-6R, IL-6). RESULTS: Serum levels of IL-6 in acute asthmatics significantly exeeded those of control subjects. Those of sIL-6R in acute asthmatics were also significantly increased compared to those of control subjects. The serum concentration of IL-6 obtained in acute asthmatics was elevated as compared with the asymptomatic asthmatics. However, Association between eosinophilic count / IgE and IL-6 / sIL-6R in acute asthma could not found. CONCLUSION: Our results suggest that IL-6 may be involved in the pathogenesis of acute asthma and serum levels of IL-6 and sIL-6R may reflect the severity of airway inflammation.
Asthma* ; Cytokine Receptor gp130 ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Glycoproteins ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-6*

Recently, Harms and Melcher modified Goel's approach, the C1 lateral mass and C2 pedicle screw fixation, and the new technique is currently in favor among neurosurgeons. Comparing to the advantages of Harms construct, the disadvantages were not extensively investigated. We experienced a patient with severe occipital pain developed after the C1 lateral mass screw placement for the traumatic atlantoaxial instability. We reviewed literatures about Harms construct with focus on the occipital neuralgia as a postoperative complication and suggest here technical tips to avoid the troublesome pain.
Humans ; Neuralgia ; Postoperative Complications

BACKGROUND/AIMS: Repeat endoscopy with biopsy is often performed in patients with previously diagnosed gastric cancer to determine further treatment plans. However, biopsy results may differ from the original pathologic report. We reviewed patients who had a negative biopsy after referral for gastric cancer. METHODS: A total of 116 patients with negative biopsy results after referral for biopsy-proven gastric cancer were enrolled. Outside pathology slides were reviewed. Images of the first and second endoscopic examinations were reviewed. We reviewed the clinical history from referral to the final treatment. RESULTS: Eighty-eight patients (76%) arrived with information about the lesion from the referring physician. Among 96 patients with available outside slides, the rate of interobserver variation was 24%. Endoscopy was repeated at our institution; 85 patients (73%) were found to have definite lesions, whereas 31 patients (27%) had indeterminate lesions. In the group with definite lesions, 71% of the lesions were depressed in shape. The most common cause of a negative biopsy was mistargeting. In the group with indeterminate lesions, 94% had insufficient information. All patients with adequate follow-up were successfully treated based on the findings in the follow-up endoscopy. CONCLUSIONS: A negative biopsy after referral for biopsy-proven gastric cancer is mainly caused by mistargeting and insufficient information during the referral.
Adult ; Aged ; Aged, 80 and over ; Biopsy/statistics & numerical data ; Diagnostic Errors/*statistics & numerical data ; Female ; Gastroscopy/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Observer Variation ; Referral and Consultation/statistics & numerical data ; Reoperation/statistics & numerical data ; Republic of Korea ; Retrospective Studies ; Stomach/*pathology ; Stomach Neoplasms/*pathology ; Young Adult

BACKGROUND/AIMS: CpG island methylator phenotype (CIMP)- high colorectal cancers (CRCs) have distinct clinicopathological features from their CIMP-low/negative CRC counterparts. However, controversy exists regarding the prognosis of CRC according to the CIMP status. Therefore, this study examined the prognosis of Korean patients with colon cancer according to the CIMP status. METHODS: Among a previous cohort population with CRC, a total of 154 patients with colon cancer who had available tissue for DNA extraction were included in the study. CIMP-high was defined as 3/5 methylated markers using the five-marker panel (CACNA1G, IGF2, NEUROG1, RUNX3, and SOCS1). RESULTS: CIMP-high and CIMP-low/negative cancers were observed in 27 patients (17.5%) and 127 patients (82.5%), respectively. Multivariate analysis adjusting for age, gender, tumor location, tumor stage and CIMP and microsatellite instability (MSI) statuses indicated that CIMP-high colon cancers were associated with a significant increase in colon cancer-specific mortality (hazard ratio [HR], 3.23; 95% confidence interval [CI], 1.20 to 8.69; p=0.02). In microsatellite stable cancers, CIMP-high cancer had a poor survival outcome compared to CIMP-low/negative cancer (HR, 2.91; 95% CI, 1.02 to 8.27; p=0.04). CONCLUSIONS: Regardless of the MSI status, CIMP-high cancers had poor survival outcomes in Korean patients.
Adult ; Age Factors ; Aged ; Colorectal Neoplasms/*genetics/*mortality ; CpG Islands/*physiology ; *DNA Methylation ; Female ; Humans ; Male ; Microsatellite Instability ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; *Phenotype ; Prognosis ; Republic of Korea ; Sex Factors ; Survival Analysis

Henoch-Schonlein purpura(anaphylactoid purpura) is a necrotizing vasculitis of small vessels in which systemic manifestation include palpable purpura on the lower extremities and buttocks due to leukocytoclastic vasculitis of dermal vessels; arthralgia of large joints, usually the knees and ankles; gastronitestinal involvement with colic and bleeding; and renal ievolvement, usually with a focal necrotizing glomerulonephritis. Gastrointestinal involvement occurs in about two thirds of all pediatric cases and in about,one third of adult cases, Any bowel segment may be involved, but the jejunum and ileum are most frequently affected. With a brief review of the literature, we report a case of H-S purpura involving stomach and duodenum.
Adult ; Ankle ; Arthralgia ; Buttocks ; Colic ; Duodenum ; Glomerulonephritis ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Joints ; Knee ; Lower Extremity ; Purpura* ; Stomach ; Upper Gastrointestinal Tract* ; Vasculitis

Myasthenia gravis is an autoimmune disorder characterized by antibodies against acetylcholine receptors in skeletal muscle. Myocardial involvement can present as myocarditis, ventricular tachycardia, heart failure and sudden death. However, advanced heart block is a very rare symptom. We report the case of a 69-year-old male who experienced dizziness and ptosis for one-month prior. He was diagnosed with myasthenia gravis and thymoma accompanied by complete atrioventricular block. The dizziness disappeared after implantation of a permanent pacemaker and the advanced heart block was resolved after surgical removal of the thymoma.
Aged ; Antibodies ; Atrioventricular Block ; Death, Sudden ; Dizziness ; Heart Block* ; Heart Failure ; Heart* ; Humans ; Male ; Muscle, Skeletal ; Myasthenia Gravis* ; Myocarditis ; Receptors, Cholinergic ; Tachycardia, Ventricular ; Thymoma*

Silica is known as a promising osteoconductive material, and polycaprolactone is a bioactive and degradable material. The purpose of this study was to monitor the differentiation of MC3T3-E1 cells cultured on the layer-built silica/poly caprolactone non-woven fabric produced by electrospinning. Non-woven fabric (silica, polycaprolactone, PSP, SPS) was made by electrospinning and they were inserted in the 48 well cell culture plate. MC3T3-E1 cells were prepared by subculture. Cells were seeded to each well 1x10(5) concentration per well. Dulbecco's modified eagle medium with 10% FBS and 1% antibiotic-antimycotic solution was used. Confocal laser scanning microscope was taken 4 hours after incubation (95% air, 5% CO2, 37degrees C). Cell proliferation was monitored by spectrophotometer on 1, 7, 14 days, and the morphology of the growing cells was observed by field emission scanning electron microscope. To monitor the differentiation of osteoblasts on the materials, MC3T3-E1 cells were incubated in 48 well culture plate after seeding with the density of 1x10(5) concentration. Then ELISA kit & EIA kit were used on to assess osteocalcin and osteopontin expression respectively. The other conditions were the same as above. MC3T3-E1 cells were proliferated well on all of the materials. There were no statistical differences among them. The osteopontin expression of silica, PSP, SPS was significantly higher than other groups on day 3 (p<0.05), but after that time, there were no statistically signigicant differences. The osteocalcin expression was significantly higher in silica and PSP than other groups on day 14. These findings show that PSP was as good as silica on the effect of osteoblast differentiation. The PSP non-woven fabric may have the possibility as bone graft materials.
Cell Culture Techniques ; Cell Proliferation ; Eagles ; Enzyme-Linked Immunosorbent Assay ; Osteoblasts ; Osteocalcin ; Osteopontin ; Silicon Dioxide ; Transplants

A nasal NK/T cell lymphoma is a very aggressive form of lymphoma. Patterns of relapse after treatment have not been systematically evaluated, and mediastinal nodal relapse at a primary site has never been documented. We describe here a 40-year old man who presented with a nasal obstruction caused by a protruding mass that was identified as a nasal NK/T cell lymphoma. The initial work-up, including chest and abdominopelvic computed tomography (CT) and positron emission tomography (PET), showed no regional or distant metastasis. A CT scan performed following three cycles of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) showed that the mass had nearly disappeared. Radiation therapy undertaken following chemotherapy was given to the primary site. However, PET performed following radiotherapy revealed a single mediastinal lymphadenopathy, with no evidence of residual tumor in the nasal cavity. A biopsy using video-assisted thoracoscopy (VATS) showed the presence of a recurrent NK/T cell lymphoma with an immunophenotype identical to that of the primary nasal lymphoma. An additional three cycles of CHOP chemotherapy were administered, and the patient remains alive, with no evidence of disease 30 months after the initial relapse. These findings indicate that early detection with PET and prompt surgical excision with the use of VATS can lead to successful treatment of a relapsed nasal NK/T cell lymphoma.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Doxorubicin/administration & dosage ; Humans ; Lymphatic Metastasis ; Lymphoma, Extranodal NK-T-Cell/*diagnosis/*therapy ; Male ; Nose Neoplasms/*diagnosis/*therapy ; Positron-Emission Tomography ; Prednisolone/administration & dosage ; Radiotherapy, Adjuvant ; Tomography, X-Ray Computed ; Vincristine/administration & dosage