Behcet's disease is a multisystemic disease, in which vascular involvement occurs in 7. 7-60% of patients. There are three forms of vascular involvement such as venous occlusion, arterial occlusion and arterial aneurysm. Venous lesions are more common than arterial lesions and the common sites of venous thrombosis are inferior vena cava, superior vena cava, and superficial or deep veins of extremities. Thrombosis of cerebral venous sinus is an infrequent complication of Behcet's disease and it seems to be rare that both deep vein thrombosis and cerebral venous sinus thrombosis occured at the same time. We experienced a case of Behcet's disease complicated with thromboses of left common femoral vein and right transverse sinus. A 29-year-old man presented with persistent dull nature headache, nausea, vomiting, blurred vision and left lower leg swelling. Duplex ultrasonography of lower extremity showed thrombus in the left common femoral vein. Magnetic resonance imaging of brain showed isodense signal intensity lesions in right transverse sinus on Tl weighted image. On magnetic resonance angiography, the right transverse, sigmoid sinus and right internal jugular vein were not visualized. The patient showed substantial improvement after treatment with steroid, cyclosporine A and anticoagulants.
Adult ; Aneurysm ; Anticoagulants ; Brain ; Colon, Sigmoid ; Cyclosporine ; Extremities ; Femoral Vein ; Headache ; Humans ; Jugular Veins ; Leg ; Lower Extremity ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Nausea ; Sinus Thrombosis, Intracranial* ; Thrombosis ; Ultrasonography ; Veins ; Vena Cava, Inferior ; Vena Cava, Superior ; Venous Thrombosis* ; Vomiting

Extragonadal germ cell tumors are rare. accounting for approximately 38 of all germ cell tumors. Debate continues over whether these lesions originate from extragonadal site or are metastatic disease from an undetected testis primary tumor. Recently. we experienced a case of extragonadal mixed germ cell tumor in a 26-year-old male who showed complete response by combination chemotherapy with cisplatin. etoposide. and bleomycin(PVpB) and have remained disease tree for about 14 months since diagnosis. Herein we report the case with brief review of the literature.
Adult ; Cisplatin ; Diagnosis ; Drug Therapy, Combination ; Etoposide ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Testis

Spontaneous rupture of the kidney with subcapsular or perinephric hemorrhage usually occurs secondary to various kinds of underlying diseases such as benign malignant tumor. vascular disease and infection etc. We experienced 2 cases of spontaneous rupture of the kidney secondary to renal cell carcinoma in a 44-year-old female and adult Wilms' tumor in a 17-year-old male.
Adolescent ; Adult ; Carcinoma, Renal Cell ; Female ; Hemorrhage ; Humans ; Kidney* ; Male ; Rupture, Spontaneous* ; Vascular Diseases ; Wilms Tumor

To observe the characteristics of the posterior aortic wall motions of the patients with various valvular heart diseases the aortic root echocardiogram of the 60 patients with various valvular diseases were examined. 15 cases in each group of patients with mitral stenosis, mitral insufficiency, mitral stenoinsufficiency or aortic insufficiency. Thirty normal subjects were served as a control group. In each, the total amplitude of the aortic posterior wall motion(OV), the amplitude of the motion evented at atrial systole(AV), AV/OV ratio, atrial emptying index(AEI), left atrial and aortic root dimensions (LAD and AOD), and LAD/AOD were measured. The results were as follows ; 1) The AV was significantly increased in mitral stenosis(P<0.01) and decreased in mitral insufficiency(P<0.05) compared with control group. 2) The OV was increase in mitral insufficiency and aortic insufficiency(p<0.01, p<0.05), but decreased in mitral stenosis(p<0.05). 3) The AV/OV was increased in mitral stenosis(p<0.01) and decreased in mitral insufficiency and aortic insufficiency(p<0.01). 4) The AEI was decreased in all patient groups(p<0.01) and LAD was increase in all compared with control group(p<0.01). 5) The AOD was increased only in aortic insufficiency(p<0.01). 6) The LAD/AOD ratio was increased in all patient groups(p<0.01).
Heart Valve Diseases* ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis

Terephthaloyl chloride, a chemical of low molecular weight, is used as an intermediate by a fabric manufacturing industry. It is known to cause gastrointestinal, respiratory and skin irritation. However, it has not been reported as a cause of occupational asthma till now. We report a case of occupational asthma caused by prolonged exposure to terephthaloyl chloride in the workplace. A 38 year-old man visited at the Allergy Clinic because of cough, dyspnea and wheezing for 5 years. He had worked at a factory for 15 years where he was involved in the process of manufacturing fabrics. At presentation, he had no symptoms and showed no abnormality on physical examination. When challenged with vapor of terephthaloyl chloride, he experienced sneezing and paroxysmal cough in a couple of minutes, followed by dyspnea and wheezing at 10 min. He also experienced urticarial rashes on the face and chest. The pulmonary function tests showed an atypical prolonged immediate airway response. PC20 methacholine decreased from 5 mg/ml to 0.79 mg/ml 24 hours after the challenge. Light microscopic examination of bronchial biopsies showed loss of epithelium, thickening of basement membrane, submucosal fibrosis, and increased inflammatory cell infiltration. The immediate drop in FEV1 and urticarial rash to terephthaloyl chloride suggests the possibility of an immediate hypersensitivity immune reaction. Further studies are needed to clarify the exact mechanism of terephthaloyl chloride induced asthma.
Adult ; Asthma ; Asthma, Occupational* ; Basement Membrane ; Biopsy ; Cough ; Dyspnea ; Epithelium ; Exanthema ; Fibrosis ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Methacholine Chloride ; Molecular Weight ; Physical Examination ; Respiratory Function Tests ; Respiratory Sounds ; Skin ; Sneezing ; Thorax

Gastrointestinal hemorrhage is a recognized complica tion of chronic pancreatitis and has been reported to occur in up to 20% of cases. Visceral vessel aneurysm such as gastroduodenal artery aneurysm associated with chronic pancreatitis is rare but clinically important vascular lesion because it carries a high mortality, making early diagnosis and treatment essential. The conventional treatment has been surgical liga tion or resection of aneurysm which is associated with high mortality and morbidity. So transarterial emboliza tion has been used recently in preference to surgery to stop the hemorrhage from this aneurysm. We report a case in which bleeding from a gastroduo denal artery aneurysm, caused by chronic pancreatitis, was successfully treated by embolization using a metallic micro coil.
Aneurysm* ; Arteries* ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Hemorrhage ; Mortality ; Pancreatitis, Chronic* ; Rupture*

BACKGROUND/AIMS: Peritoneoscopy allows the clinician to assess the activity of the surface of the liver and helps him to make a prognosis in cases of liver disease by judging the structural changes of the surface. In chromoperitoneoscopy using an intravenous injection of indocyanine green (ICG), hepatic parenchyme is stained after intravenous injection of ICG while interstitial connective tissue, fatty deposition and hepatoma are not. So diagnostic accuracy is, therefore believed to be elevated in chromoperitoneoscopy than conventional peritoneoscopy or blind liver biopsy. This study was performed to assess the clinical usefulness of chromoperitoneoscopy in various chronic liver diseases. METHODS: Intravenous ICG was administered at 2 mg/Kg mixed with 20 cc of saline in 30 cases with several kinds of hepatic disorders during conventional peritoneoscopic examinatians. Liver surface was examined 5 minutes after ICG injection.
Biopsy ; Carcinoma, Hepatocellular ; Connective Tissue ; Indocyanine Green* ; Injections, Intravenous* ; Laparoscopy ; Liver Diseases* ; Liver* ; Prognosis

PURPOSE: This study was designed to investigate the effects of polyamines on rabbit seminal vesicular contractility. MATERIALS AND METHODS: The polyamines; putrescine, spermidine and spermine, were added to deepithelized and precontracted seminal vesicle strips, with either 10 4M norepinephrine (NE), 10 4M acetylcholine (ACh) or 70mM KCl, in organ chambers to obtain cumulative concentration response curves. A whole cell mode patch clamp study was also performed to observe the effects of the polyamines on the L-type calcium channel activities. RESULTS: The polyamines elicited concentration-dependent relaxations of the precontracted strips with the NE, ACh and KCl. The spermine showed the most potent relaxation response. Both extracellular and intracellular application of the spermine decreased the L-type calcium channel currents. CONCLUSIONS: Spermine more potently inhibited the seminal vesicle contraction than putrescine or spermidine, which suggests the polyamines may play a role in maintaining the basal tonicity of seminal vesicle in a flaccid state. The spermine-induced relaxation response seems to be related with an inhibition of the L-type calcium channel activities.
Acetylcholine ; Calcium Channels, L-Type ; Norepinephrine ; Polyamines* ; Putrescine ; Relaxation* ; Seminal Vesicles* ; Spermidine ; Spermine

OBJECTIVES: The purposes of this study were to assess the smoking status, knowledge and attitude related to smoking and smoking cessation activity of the physicians in a community, and to identify their predictors of smoking cessation activity. METHOD: All physicians employed by various health facilities in a community were surveyed using a structured questionnaire. Of the physicians surveyed, 523 (69.6%) returned completed questionnaires. RESULTS: The smoking rate of physicians was 29.3% (34.2% in males, 3.6% in females) and the knowledge and attitude scores to smoking were 22.5+/-2.4 and 65.4+/-6.9, respectively. The self-efficacy score was 3.4+/-1.0 and the smoking cessation activity score was 65.4+/-6.9. The smoking cessation activity was statistically significant with working place, specialty, knowledge and attitude to smoking and self-efficacy. In stepwise multiple regression, smoking cessation activity was predicted by doctors' working place, specialty, attitudes related to smoking issues, and self-efficacy of counseling knowledge and skills. CONCLUSION: Physicians need to participate routinely and actively in smoking cessation activity. For doctors to effectively counsel and intervene in patients regarding smoking cessation, it is essential to integrate education on smoking cessation intervention into curricula in formal education and to offer continuing education including smoking cessation intervention.
Counseling ; Curriculum ; Education ; Education, Continuing ; Health Facilities ; Humans ; Male ; Methods ; Smoke* ; Smoking Cessation* ; Smoking*

OBJECTIVE: The aim of the this study was to compare the effects of clonidine (a alpha2-adrenoceptor and imidazoline receptor agonist), yohimbine (a selective alpha2-adrenoceptor antagonist) and idazoxan (a alpha2-adrenoceptor and imidazoline receptor antagonist) on extracellular monoamines and their metabolites by using the awakening animal microdialysis and high-performance liquid chromatography with electrochemical detection (HPLC-ECD) in brain regions, which are suggested to have regulatory role in depression. METHODS: We used intracerebral microdialysis in awakening rats by inserting probe through the dorsal hippocampus and occipital cortex especially in primary visual cortex, We studied respective effects of 2.0 mg/kg of clonidine, 5.0 mg/kg of yohimbine, and 5.0 mg/kg of idazoxan on the release of MHPG (a major metabolite of norepinephrine), norepinephrine (NE), DOPAC (a major metabolite of dopamine), and 5-HIAA (a main metabolite of serotonin) by intraperitoneal administration. RESULTS: Clonidine decreased the release of MHPG, NE, DOPAC, and 5-HIAA in both dorsal hippocampus and occipital cortex regions, and there were no significant differences in releasing pattern of all monoamines and their metabolites. Both yohimbine and idazoxan enhanced the release of MHPG, NE, DOPAC, and 5-HIAA in both brain regions, but there were significant differences in releasing pattern of NE and 5-HIAA. Idazoxan induced the delayed and higher efflux of NE and 5-HIAA in the primary visual cortex than yohimbine, but not in the hippocampus. CONCLUSION: This study shows that the selective alpha2-adrenoceptor antagonists increase basal monoamine output and enhance the metabolism of them in the hippocampus and primary visual cortex, and the imidazoline receptor has modulatory role in the regulation of monoamine release in primary visual cortex than hippocampus. It also suggests that high turnover rate of serotonin and norepinephrine in primary visual cortex may contribute to the pathophysiological role in depression.
3,4-Dihydroxyphenylacetic Acid ; Animals ; Brain ; Chromatography, Liquid ; Clonidine ; Depression ; Hippocampus* ; Hydroxyindoleacetic Acid ; Idazoxan ; Metabolism ; Methoxyhydroxyphenylglycol ; Microdialysis ; Norepinephrine ; Rats* ; Serotonin ; Visual Cortex* ; Yohimbine