Truncus arteriosus is a rare congenital heart disease which is diagnosed in from 1 to 2 percent of congenital cardiac birth. Whithout surgical intervention, survival beyond infancy is unusual. Unoperated patients who survive to adult life have associated pulmonary stenosis or have developed pulmonary arteriolar disease. We report a case of truncus arteriosus in a 17-year-old man with a review of literature.
Adolescent ; Adult ; Heart Defects, Congenital ; Humans ; Parturition ; Pulmonary Valve Stenosis ; Truncus Arteriosus*

Subclavian steal syndrome caused by an acute thrombus is very rare. We present a case of cerebellar infarction with proximal subclavian artery thrombosis. A 56-year-old woman was admitted for sudden vertigo. One day prior to admission, she received a shoulder massage comprised of chiropractic manipulation. On examination, her left hand was pale and radial pulses were absent. Blood pressure was weak in the left arm. Downbeat nystagmus and a right falling tendency were observed. Brain MRI showed multiple acute infarctions in the left cerebellum. The findings of Doppler ultrasonography in the left vertebral artery were compatible with a partial subclavian artery steal phenomenon. Digital subtraction angiography demonstrated a large thrombus in the left subclavian artery. After heparin infusion, thrombus size markedly decreased. Cerebellar infarction caused by acute subclavian thrombosis following minor trauma is rare, but the thrombus can be successfully resolved with anticoagulation.
Brain Infarction/*diagnosis/etiology/pathology ; Cerebellar Diseases/diagnosis/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Thrombosis/*complications

No abstract available.
Duodenal Ulcer* ; Humans ; Recurrence*

No abstract available.

BACKGROUND AND OBJECTIVES: Epidermal characteristics of cholesteatoma such as invasion, migration, uncoordinated proliferation, and altered differentiation may arise as a result of defectiVe wound healing process, induction of preneoplastic transformation or genetic alteration. To date, a number of genes haVe been shown to be differentially regulated in cholesteatoma, which might be responsible for these clinical characteristics. HoweVer, it is still unclear whether these phenomena is only oVert when cholesteatoma is under specific conditions such as inflammation or infection. If these genetic alterations in the deVelopment of cholesteatoma are transient, the pathology of cholesteatoma may be reVersible. We hypothesized that once cholesteatoma is in the normal environment, the cellular or molecular pathology of cholesteatoma can return to normal epidermal characteristics. The aim of this study was to determine whether common molecular characteristics are reVersible or not after removal of inductive factors in aural cholesteatoma induced gerbils. MATERIALS AND METHODS: We induced canal ligation cholesteatoma using Mongolian gerbils. The treated group was untied and managed for 2 weeks. We examined differences between treated cholesteatoma and untreated cholesteatoma by using a TUNEL staining and immunohistochemical technique with proliferation markers (PCNA, cytokeratin 13/16). RESULTS: With PCNA and CK 13/16, untreated group showed positive staining in the suprabasal cells as well as in the basal cells, but the treated group showed weakly positive staining only in the basal cell layer. With TUNEL staining, positive cells increased more in the untreated group than in the treated group. CONCLUSION: These results encourage our belief that some cholesteatomas, especially cholesteatoma in early stages, might be managed with only minimal treatments such as control of inflammation and maintenance of adequate Ventilation.
Cell Differentiation ; Cholesteatoma* ; Cholesteatoma, Middle Ear ; Gerbillinae* ; In Situ Nick-End Labeling ; Inflammation ; Keratins ; Ligation ; Pathology ; Pathology, Molecular ; Proliferating Cell Nuclear Antigen ; Ventilation ; Wound Healing

Purpose: This paper aims to develop a clinical decision support system (CDSS) that can help detect the stone that is most important to the diagnosis of urolithiasis. Among them, especially for the development of artificial intelligence (AI) models that support a final judgment in CDSS, we would like to study the optimal AI model by comparing and evaluating them. Methods: This paper proposes the optimal ureter stone detection model using various AI technologies. The use of AI technology compares and evaluates methods such as machine learning (support vector machine), deep learning (ResNet-50, Fast R-CNN), and image processing (watershed) to find a more effective method for detecting ureter stones. Results: The final value of sensitivity, which is calculated using true positive (TP) and false negative and is a measure of the probability of TP results, showed high recognition accuracy, with an average value of 0.93 for ResNet-50. This finding confirmed that accurate guidance to the stones area was possible when the developed platform was used to support actual surgery. Conclusions The general situation in the most effective way to the detection stone can be found. But a variety of variables may be slightly different the difference through the term could tell. Future works, on urological diseases, are diverse and the research will be expanded by customizing AI models specialized for those diseases.

BACKGROUND: This study was designed to evaluate the clinical efficasy of lovastatin, HMG-CoA reductase inhibitor, in patients with hypercholesterolemia. METHODS AND RESULTS: Lovastatin 20 to 80 mg were administered once daily for 12 weeks in twenty five patients(11 male, 14 famale ; nine patients with familial hypercholesterolemia) with hypercholesterolemia(>240mg/dl). Compared with pretreatment levels, lovastatin significantly decreased levels of total cholesterol(309+/-46mg/dl versus 201+/-37mg/dl) by 35%, LDL-cholesterol(230+/-48mg/dl versus 125+/-40mg/dl) by 46% and triglyceride(170+/-76 versus 142+/-66mg/dl) by 11% (p<0.05) with significantly decreased levels of total-cholesterol/HDL-cholesterol ratio(7.4+/-2.1 versue 4.6+/-1.5) and LDL-cholesterol/HDL-cholesterol ratio(5.6+/-1.9 versue 2.9+/-1.4) (p<0.005 except triglyceride, respectively). The level of Apo B(183+/-32mg/dl versus 114+/-26mg/dl) was decreased significantly by 37%(p<0.005) with significantly decreased level of Apo A-1(115+/-22 to 122+/-26mg/dl) was increased significantly by 6%(p<0.05). No serious side effects were found. CONCLUSIONS: Results from the present study show that lovastatin is an effective and well-tolerated cholesterol-lowering agent.
Humans ; Hypercholesterolemia* ; Lovastatin* ; Male ; Oxidoreductases ; Triglycerides

BACKGROUND: This study was designed to evaluate the clinical efficacy of pravastatin, HMG-CoA reductase inhibitor, in patients with hypercholesterolemia. Methods and RESULTS: Pravastatin 5 mg was administered twice daily for 12 weeks in twenty five patients(12 male, 13 female) with hypercholesterolemia(>240 mg/dl). Compared with pretreatment levels, pravastatin significantly decreased levels of total cholesterol(281+/-41mg/dl versus 218+/-31mg/dl) by 22% and LDL-cholesterol(199+/-46mg/dl versus 137+/-37mg/dl) by 31% with significantly decreased total-cholesterol/HDL-cholesterol ratio(7.1+/-3.0 versus 5.1+/-1.6) and LDL-cholesterol/HDL-cholesterol ratio(5.1+/-2.5 versus 3.3+/-1.4) (p<0.005, respectively). During pravastatin treatment, the level of Apo B(164+/-38mg/dl versus 123+/-20mg/dl) was decreased significantly by 24% with significantly decreased Apo B/Apo A-1 ratio(1.4+/-0.5 versus 1.0+/-0.3) (p<0.005, respectively). No serious side effects were found. CONCLUSIONS: Results from the present study show that pravastatin is an effective and well-tolerated cholesterol-lowering agent.
Humans ; Hypercholesterolemia* ; Male ; Oxidoreductases ; Pravastatin*

BACKGROUND: The purpose of this study was to investigate the differences of cerebral glucose metabolism between narcoleptic patients and normal controls. METHODS: We enrolled 24 patients with narcolepsy who underwent night polysomnography and multiple sleep latency tests to confirm the narcolepsy. 18F-fluorodeoxy glucose positron emission tomography scan was performed in all narcoleptic patients and 24 normal age-sex matched controls. To compare the cerebral glucose metabolism between the two groups, statistical parametric mapping (SPM99) was used. RESULTS: Patients with narcolepsy showed significant decreases of cerebral glucose metabolism in the bilateral rectal and subcallosal gyri, right superior frontal gyrus, right medial frontal gyrus, bilateral precuneus, right inferior parietal lobule, and left supramarginal gyrus of the parietal lobe at the uncorrected P<0.001. The bilateral posterior hypothalami and mediodorsal thalamic nuclei showed glucose hypometabolism at the level of corrected P<0.05 with small volume correction. CONCLUSIONS: This study showed cerebral glucose hypometabolism of hypothalamus-thalamus-orbitofrontal pathways in narcoleptic brains. The distribution of abnormal glucose metabolism is concordant to the cerebral pathways of the hypocretin system.
Brain ; Glucose* ; Humans ; Hypothalamus ; Metabolism* ; Narcolepsy* ; Parietal Lobe ; Polysomnography ; Positron-Emission Tomography ; Rabeprazole ; Thalamic Nuclei ; Thalamus ; Orexins

Technetium-99m methoxyisobutylisonitrile(99m-Tc MIBI), a new myocardial imaging agent, was used in myocardial perfusion scan in 23 patients who had been diagnosed as myocardial infarction to assess its usefulness in elvaluation of coronary artery disease. All patients undertook left ventriculography (LVG) and coronary arteriography (CAG). Gated blood pool scan, plannar scintigraphy and SPECT were also done using 99m-Tc MIBI. After then SPECT image was reconstructed to short axis view of the heart at the level of the base, mid and apex. The data from these studies were compared with the results of EKG, LVG and CAG. Diagnostic sensitivity of myocardial scan using 99m-Tc MIBI was 91.3%. In localization of infarction site and evaluation of its extent, myocardial scan was superior to EKG. CAG revealed significant stenosis at the arteries supplying the area in which the scan showed perfusion defect. In detecting abnormal wall motion, the sensitivity and the specificity were 81.9% and 93.7% respectively. Perfusion defect were found in 75%, 82.5%, and 100% of hypokinetic, akinetic, and dyskinetic segments, respectively. Myocardial perfusion scan using 99m-Tc MIBI was an useful noninvasive test in localizing the site and the extent of infarct and detecting the abnormal left ventricular wall motion.
Angiography ; Arteries ; Axis, Cervical Vertebra ; Constriction, Pathologic ; Coronary Artery Disease ; Electrocardiography ; Heart ; Humans ; Infarction ; Myocardial Infarction* ; Myocardial Perfusion Imaging* ; Perfusion ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon