Crohns disease is a granulomatous isease of the gastrointetin 1 tract, especially terminal ileum, but may involve the lip, mouth, anus, skin, liver and bone. The skin is a common site of extraintestinal involvement in Crohns disease, with the perianil, perineal, and peristomal areas most frequently affected. Vulvar involvement, however, is an uncommon extraintestinal manifestantion of Crohns disease. We report a case of a 16-year-old girl with Crohns disease of the vulva and perianal region. A histopathologic study of the descending colon and vulvar skin showed noncaseating granulomatous reactions composed of lymphocytes, epithelioidell and giant cells. We were able to make the diagnosis of Crohns disease of the vulvar and the patient was treated with prednisolone and metronidazole.
Adolescent ; Anal Canal ; Colon, Descending ; Crohn Disease* ; Diagnosis ; Female ; Giant Cells ; Humans ; Ileum ; Lip ; Liver ; Lymphocytes ; Metronidazole ; Mouth ; Prednisolone ; Skin ; Vulva*

No abstract available.
Postoperative Complications*

No abstract available.
Cluster Headache ; Trigeminal Autonomic Cephalalgias ; Trigeminal Nerve Diseases

No abstract available.
Burns* ; Ear*

The renin-angiotensin system (RAS) is an important regulator of cirrhosis and portal hypertension. As hepatic fibrosis progresses, levels of the RAS components angiotensin (Ang) II, Ang-(1–7), angiotensin-converting enzyme (ACE), and Ang II type 1 receptor (AT1R) are increased. The primary effector Ang II regulates vasoconstriction, sodium homoeostasis, fibrosis, cell proliferation, and inflammation in various diseases, including liver cirrhosis, through the ACE/Ang II/AT1R axis in the classical RAS. The ACE2/Ang-(1–7)/Mas receptor and ACE2/Ang-(1–9)/AT2R axes make up the alternative RAS and promote vasodilation, antigrowth, proapoptotic, and anti-inflammatory effects; thus, countering the effects of the classical RAS axis to reduce hepatic fibrogenesis and portal hypertension. Patients with portal hypertension have been treated with RAS antagonists such as ACE inhibitors, Ang receptor blockers, and aldosterone antagonists, with very promising hemodynamic results. In this review, we examine the RAS, its roles in hepatic fibrosis and portal hypertension, and current therapeutic approaches based on the use of RAS antagonists in patients with portal hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Cell Proliferation ; Fibrosis* ; Hemodynamics ; Humans ; Hypertension, Portal* ; Inflammation ; Liver Cirrhosis ; Mineralocorticoid Receptor Antagonists ; Receptors, Angiotensin ; Renin-Angiotensin System* ; Sodium ; Vasoconstriction ; Vasodilation

OBJECTIVES: This study was performed to investigate the effect of genetic polymorphisms on the oxidative genetic damage caused by benzene exposure in workers. METHODS: We measured urinary t,t-muconic acid levels as a biomarker for benzene exposure and measured the level of urinary 8-OHdG to assess oxidative DNA damage in benzene-exposed healthy male workers. Genetic polymorphisms of ALDH2 and CYP2E1 were determined by TaqMan assay. We estimated Pearson correlation coefficients between urinary t,t-muconic acid and 8-OHdG according to the genetic polymorphisms of CYP2E1 and ALDH2. RESULTS: There was a significant relationship between urinary t,t-muconic acid and 8-OHdG concentrations in overall subjects (R=0.532, p<0.001). Smokers showed a higher correlation coefficient between the markers than nonsmokers did (R=0.520 vs. 0.010). Individuals with CYP2E1 c1/c1 genotype also showed a higher correlation coefficient between them than those with CYP2E1 c1/c2 or c2/c2 genotypes (R=0.670 vs. -0.145). In multiple linear regression analysis including smoking status, sorbic acid intake, age and genetic polymorphisms of CYP2E1 and ALDH2 as the independent variables, urinary t,t-muconic acid showed a significant association with urinary 8-OHdG. CONCLUSIONS: There was a significant correlation between urinary 8-OHdG and urinary t,t-muconic acid in benzene-exposed workers. This relationship was affected by genetic polymorphisms of CYP2E1and ALDH2.
Benzene ; Cytochrome P-450 CYP2E1* ; DNA Damage ; Genotype ; Humans ; Linear Models ; Male ; Polymorphism, Genetic* ; Smoke ; Smoking ; Sorbic Acid

OBJECTIVES: Automobile exhaust gases contain benzene and toluene, which are excreted in human urine as trans,trans-muconic acid and hippuric acid, respectively. Sorbic acid and benzoic acid, used as food preservatives, are also metabolized into trans,trans-muconic acid and hippuric acid in the human body. The purpose of this study is to estimate the level of benzene and toluene exposure according to the commuting mode and duration, residential environment, and preservative-added foods intake in university students who are not occupationally exposed to benzene or toluene. METHODS: Spot urine samples were collected from 211 university students who had no occupational exposure to volatile organic compounds. Information about their smoking history, residence type, traffic environments, commuting mode and duration, and their intake of bottled or canned food or beverages was gathered through a self-administered questionnaire. Urinary concentrations of trans,trans-muconic acid and hippuric acid were measured and statistically correlated to the individual's life style factors. RESULTS: There was no significant difference in the urinary concentrations of trans,trans-muconic acid or hippuric acid according to the smoking history. Mean urinary concentration of hippuric acid in females was higher than that found in males. Subjects living in districts with a population density of 1,000~4,999 people/km2 showed the highest urinary hippuric acid level; individuals living in cities of 5,000~9,999 people/km2 population density were next. The mean urinary trans,trans-muconic acid concentration was higher in students who were living where traffic jams are common compared to those who did not, and in subjects whose residence were within 149 m from a 4-lane road compared to those whose residence was not. However, neither mode nor duration of the commute showed any effect on the urinary trans,trans-muconic acid or hippuric acid concentrations of the students. Urinary hippuric acid levels increased when consuming canned fruit or canned coffee, and urinary trans,trans-muconic acid levels increased when consuming fruit juices or pickled radishes. CONCLUSIONS: The inhalation of vehicle exhaust and the ingestion of canned or pickled food may increase urinary hippuric acid and trans,trans-muconic acid levels in individuals who are not occupationally exposed to benzene or toluene.
Benzene ; Benzoic Acid ; Beverages ; Coffee ; Eating ; Female ; Food Preservatives ; Food, Preserved ; Fruit ; Gases ; Hippurates ; Human Body ; Humans ; Inhalation ; Life Style ; Male ; Occupational Exposure ; Occupations ; Population Density ; Questionnaires ; Smoke ; Smoking ; Sorbic Acid ; Toluene ; Transportation ; Vehicle Emissions ; Volatile Organic Compounds

Background: Considering the interactions between heavy metals, a comprehensive evaluation of the effects of exposure to various types of co-interacting heavy metals on health is required.This study assessed the association between dyslipidemia markers and blood mercury, lead, cadmium, iron, zinc, and nickel levels in residents of an abandoned refinery plant. Methods: A total of 972 individuals (exposed group: 567, control group: 405) living near the Janghang refinery plant in the Republic of Korea were included. Blood mercury, lead, cadmium, iron, zinc, nickel, cholesterol, and triglyceride levels were measured. The combined effect of the six heavy metals on dyslipidemia markers was evaluated using a Bayesian kernel machine regression (BKMR) model and compared with the results of a linear regression analysis. The BKMR model results were compared using a stratified analysis of the exposed and control groups. Results: In the BKMR model, the combined effect of the six heavy metals was significantly associated with total cholesterol (TC) levels both below the 45th percentile and above the 55th percentile in the total population. The combined effect range between the 25th and 75th percentiles of the six metals on TC levels was larger in the exposed group than that in the total population. In the control group, the combined effects of the changes in concentration of the six heavy metals on the TC concentration were not statistically significant. Conclusion These results suggest that the cholesterol levels of residents around the Janghang refinery plant may be elevated owing to exposure to multiple heavy metals.

Leiomyomatosis refers to benign smooth muscle cell tumors that often arise from unusual growth patterns and include benign metastasizing leiomyoma, disseminated peritoneal leiomyomatosis, and intravenous leiomyomatosis. Intravenous leiomyomatosis is the extension of a vascular tumor into the venous channels, whereas disseminated peritoneal leiomyomatosis is characterized by multiple leiomyomas growing along the submesothelial tissues of the abdominopelvic peritoneum. It is extremely rare for intravenous leiomyomatosis and disseminated peritoneal leiomyomatosis to occur simultaneously. A 42-year-old female presented with disseminated peritoneal leiomyomatosis and intravenous leiomyomatosis extended through the inferior vena cava into the right side of the heart. The patient underwent one-stage surgery under simultaneous sternotomy and laparotomy, and radical excision of the tumor was achieved using cardiopulmonary bypass. Here we describe a case in which complete removal of a leiomyomatosis with an unusual growth pattern was successfully performed using one-stage surgery.
Adult ; Cardiopulmonary Bypass ; Female ; Heart* ; Humans ; Laparotomy ; Leiomyoma ; Leiomyomatosis* ; Myocytes, Smooth Muscle ; Peritoneum ; Sternotomy ; Vena Cava, Inferior

Noonan syndrome is an autosomal dominant disorder characterized by dysmorphic facial features, congenital heart defects and short stature. To date, renal artery stenosis has not been associated with Noonan syndrome. We report the case of a 27-year old male who presented with malignant hypertension associated with renal artery stenosis, dysmorphic facial features, pectus excavatum, pulmonary stenosis and hypertrophic cardiomyopathy who was diagnosed with Noonan syndrome.
Adult* ; Balloon Valvuloplasty ; Cardiomyopathy, Hypertrophic ; Funnel Chest ; Heart Defects, Congenital ; Humans ; Hypertension, Malignant* ; Male ; Noonan Syndrome* ; Pulmonary Valve Stenosis ; Renal Artery Obstruction