BACKGROUND AND PURPOSE: Platelet aggregation plays an important role in thrombogenesis. Thus antiplatelet agents, such as aspirin and ticlopidine, have been in usage to prevent for recurrent ischemic stroke. Triflusal is known to selectively inhibit cyclooxygenase in platelet rather than in vessel wall. And thus can be more beneficial in its antiplatelet aggregatory effect. There has been no comparative study between triflusal and ticlopidine on its antiplatelet aggregatory effect and side effects till now. Our comparative study between these two agents is to provide useful information on clinical utilization. METHODS: Triflusal(900mg/day) and ticlopidine(500mg/day) were administered in 31 and 37 patients, who suffered from acute ischemic stroke. Their efficacy in platelet aggregation and the incidence of clinical and laboratory side effects were compared in one week and one month after the administration of the drugs. RESULTS: Platelet aggregation was more effectively inhibited in triflusal group, especially induced by collagen or epinephrine(p<0.01). No significant difference was noted in the incidence of side effects in both groups. In five patients of the ticlopidine group, the drug was withdrawn due to skin rash and/or increased liver enzymes. CONCLUSION: Triflusal had more effectively inhibited platelet aggregation in this study. Severe side effects even requiring discontinuation of the drug were noted in five patients of ticlopidine group.
Aspirin ; Blood Platelets ; Collagen ; Exanthema ; Humans ; Incidence ; Liver ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; Prostaglandin-Endoperoxide Synthases ; Stroke ; Ticlopidine*

Antiphospholipid antibody syndrome (APS) has been considered as a distinct clinical entity, usually associated with systemic lupus erythematosus (SLE) or with other connective tissue disease. Prominent clinical features include venous thrombosis, arterial occlusions, thrombocytopenia, hemolytic anemia, recurrent fetal loss, livedo reticularis and neurologic manifestations. Antiphospholipid antibodies (aPL) represent a spectrum of phospholipid-binding antibodies, including the lupus anticoagulant(LA), anticardiolipin antibody (aCL), and the biologic false-positive serologic test for syphilis (BFP-STS). Primary antiphospholipid syndrome (PAPS) which has been recently described is a complication of autoimmune aPL with lack of serologic and clinical features of SLE. We present a young female patient with PAPS who showed progressive dementia, diffuse cerebral atrophy, renal arteriolar occlusions, livedo reticularis, and valvular heart disease. To our knowledge, our patient is the first described with the clinical and mangetic resonance imaging(M-RI) findings in this entity.
Anemia, Hemolytic ; Antibodies ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Atrophy* ; Brain* ; Connective Tissue Diseases ; Dementia* ; Female ; Heart Valve Diseases ; Humans ; Livedo Reticularis ; Lupus Erythematosus, Systemic ; Neurologic Manifestations ; Serologic Tests ; Syphilis ; Thrombocytopenia ; Venous Thrombosis

Metastatic tumors occur more frequently in the liver than in any other organ, Guided percutaneous fine-needle aspiration (FNA) of the liver is often recommended for confirmative diagnosis of the metastatic lesion, because of its simplicity, high yield, and reasonable safety. The authors studied retrospectively cytologic findings of 110 cases of metastatic tumors to the liver. The frequent primary sites were the stomach (23 cases), pancreas (19 cases), gallbladder (12 cases), and periampullary lesions (6 cases). Most of the metastases were carcinoma (106 cases). There were only 4 cases of sarcoma. The characteristic cytologic findings of FNA of meatastatic tumors were dirty background, abrupt change between hepatocytes and malignant cells, and desmoplasia. Some tumors displayed rather distinctive cytologic appearance that suggests primary sites. For example, the colonic adenocarcinoma showed tall columnar cells with a palisading arrangement, adenocarcinoma of gallbaldder showed focal squamous differentiation in some cases, and metastatic renal cell carcinoma and neuroblastoma showed also distinctive cytologic findings. Because the cytologic features of metastatic tumor are very similar to those of primary tumor, correct cytologic typing may be helpful in pursuit of an occult primary site of metastatic liver lesions, reducing extensive diagnostic investigation in poor prognostic patients.
Adenocarcinoma ; Biopsy, Fine-Needle ; Carcinoma, Renal Cell ; Colon ; Diagnosis ; Gallbladder ; Hepatocytes ; Humans ; Kidney Diseases* ; Kidney* ; Liver ; Melanoma, Amelanotic ; Neoplasm Metastasis ; Neuroblastoma ; Pancreas ; Retrospective Studies ; Sarcoma ; Stomach ; Vagina

A case of multiple myeloma with massive pleural effusion is reported. A 53 year-old previous known multiple myeloma patient vistited our hospital complaining of cough with sputum. Radiologic study revealed multiple osteolytic bony lesions and left side pleural effusion. The effusion were bloody exudates containing numerous atypical plasma cells. The tumor cells showed pleomorphism, eccentric nuclei, prominent nucleoli, perinuclear halo, multincleation, and chromatin patterns of occasional cart-wheel appearance. The cytological examination of pleural fluid established the malignant nature of the effusion with multiple myeloma.
Biopsy* ; Chromatin ; Cough ; Enzyme Assays* ; Exudates and Transudates ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Lung ; Lymphoma, T-Cell, Peripheral ; Middle Aged ; Multiple Myeloma ; Plasma Cells ; Pleural Effusion ; Sputum

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position

Recently therapeutic efficacy of stomach cancer was greatly improved due to early diagnosis and irnproved diagnostic and therapeutic modalities. Especially in early gastric cancer, 5 year survival rate is near 100%. Recarrence of early gastric cancer after curative surgery is rarely reported. Recently authors experienced one case of recurrent stomach cancer arising from remmnant stomach 14 years after gastrectomy of EGC type I(m), so we reports it here with review of literatures.
Early Diagnosis ; Gastrectomy* ; Stomach Neoplasms* ; Stomach* ; Survival Rate

Foreign bodies of the upper gastrointestinal tract are found in all age groups, and the foreign bodies can be ingested incidentally or intentionally. They are usually common in children, but they have also been discovered in adults with esophageal disease, artificial teeth, mental retardation, in patients seeking secondary gains and in alcoholics. The types of foreign bodies vary for different social and cultural conditions, and can include coins, corks, toys, fish bones, toothbrushes, needles, nails and pens. Foreign bodies of the upper gastrointestinal tract are usually passed into the intestinal tract spontaneously, but sometimes intervention is required. We report a case of an 80-year-old man with a past medical history of depressive disorder that had ingested adhesives. The adhesives present in the esophagus were removed by the use of therapeutic endoscopy. However, the adhesives in the stomach were too large to remove by the use of an endoscopic procedure, and gastrotomy was performed.
Adhesives ; Adult ; Aged, 80 and over ; Alcoholics ; Child ; Cyanoacrylates ; Depressive Disorder ; Eating ; Endoscopy ; Esophageal Diseases ; Esophagus ; Foreign Bodies ; Humans ; Intellectual Disability ; Intention ; Nails ; Needles ; Numismatics ; Play and Playthings ; Stomach ; Tooth, Artificial ; Upper Gastrointestinal Tract

Peritubular capillary (PTC) C4d staining represents a marker for acute humoral rejection, however, the impact of positive staining on chronic allograft dysfunction has received little attention. Ninety-three renal allograft biopsies from 93 patients were selected from a total of 174 renal allograft biopsies, which were obtained 6 months or more after transplantation (median: 89 months). Fresh frozen renal tissue was stained with monoclonal antibody against C4d. Sixteen of 93 biopsies showed C4d staining in PTC. C4d staining was positive in 40% of acute rejection cases (n=15) and 21% of chronic rejection cases (n=24). When the samples were divided according to C4d positivity, the C4d (+) group had a higher proportion of acute rejection than the C4d (-) group. However, no significant difference was observed between the two groups in terms of the prevalence of chronic rejection. Degrees of histological injury including tubulitis, interstitial inflammation and interstitial fibrosis were not significantly different between C4d (+) and C4d (-) groups. However, the 2-year graft survival rate after biopsy was lower in the C4d (+) group than in the C4d (-) group (24.8% versus 59.0%, p=0.1255). C4d staining in PTC is associated with late acute rejection, but not with chronic rejection based on conventional morphologic criteria in patients with chronic allograft dysfunction.
Adult ; Capillaries/metabolism ; Chronic Disease ; Complement 4b/*analysis ; Female ; Graft Rejection/*diagnosis ; Humans ; *Kidney Transplantation ; Male ; Middle Aged ; Peptide Fragments/*analysis ; Research Support, Non-U.S. Gov't ; Staining and Labeling ; Transplantation, Homologous

Most cardiac tumors are metastases, and primary cardiac tumors are rare; even among primary cardiac tumors, primary cardiac neuroendocrine tumors (NETs) are extremely rare. Herein, we report a case of a patient presenting a left atrial mass without past medical history. Because of the location and movement of the mass, as well as the patient's cerebral infarction episode, the mass was initially suspected to be a thrombus. However, the mass was surgically diagnosed as NET.

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital cardiac anomaly that can be difficult to detect and often remains undiagnosed. PAPVR is diagnosed using non-invasive imaging techniques such as echocardiography, CT, and MRI. Image data are reviewed on a 2-dimensional (D) monitor, which may not facilitate a good understanding of the complex 3D heart structure. In recent years, 3D printing technology, which allows the creation of physical cardiac models using source image datasets obtained from cardiac CT or MRI, has been increasingly used in the medical field. We report a case involving a 3D-printed model of PAPVR with a biatrial connection. This model demonstrated separate drainages of the right upper and middle pulmonary veins into the lower superior vena cava (SVC) and the junction between the SVC and the right atrium, respectively, with biatrial communication through the right middle pulmonary vein.