No abstract available.
Polycythemia*

No abstract available.
Autopsy* ; Statistics as Topic*

The diagnosis of acute pancreatitis occurred in CAPD patients is quite difficult due to its clinical similarity with acute peritonitis. Delayed diagnosis and treatment of acute pancreatitis in CAPD patients may result in fatal complication. We experienced a case of acute pancreatitis in a CAPD patient. A 62 years old female visited the hospital with acute abdominal pain and cloudy effluent for 3 days. She has been on CAPD for 3 years and had two episodes of peritonitis at 6 months and 1 year before the admission. The causative organism was Streptococcus viridans in each episode. The peritonitis symptoms and peritoneal leukocyte count incresed despite of using Vancomycin(R) and Netilmicin(R). Causative organism was not isolated from dialysis. Serum amylase concentrations increased from 105mg/dL at the admission to 1,052mg/dL on day 10 of admission. Abdominal ultrasonography and abdominal computerized tomogram revealed fat infiltration, focal necrosis and multiple cyst formation at pancreas area. Computerized tomogram guided aspiration cytology revealed acute inflammation and necrosis. Bacteria were not found in the aspirate. Clinical symptoms were improved after discontinuation of CAPD and intraperitoneal use of antibiotics. The patient restarted CAPD on the day 18 and remained without complications. We report this case with a brief review of literatures.
Abdominal Pain ; Amylases ; Anti-Bacterial Agents ; Bacteria ; Delayed Diagnosis ; Diagnosis ; Dialysis ; Female ; Humans ; Inflammation ; Leukocyte Count ; Middle Aged ; Necrosis ; Pancreas ; Pancreatitis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Viridans Streptococci

No abstract available.
Lymphoma, Non-Hodgkin*

The bleeding duodenal varices ia uncommon and frequeintly present a difficult diagnostic problem While the bleeding duodenal varices is a complication of portal hypertension, the possibility of bleeding duodenal varices in the absence of eaophageal varix bleeding should be kept mind. For the surgeon, the mikin technical problem is that even when identified by frequently impalpable, and invisible to the naked eye unless they are actively bleeding at the time of surgery. We described simple intra-operative endoscopic technique successfully to identify and bleeding varices in the duodenal third portion prior to the partial duodenal resection. This report summarized our experience and review of literature.
Endoscopy* ; Hemorrhage* ; Hypertension, Portal ; Varicose Veins*

PURPOSE: The current study was designed to investigate the relationship of dietary calcium and riboflavin and their main dietary source (milk and dairy products) with the risk of periodontitis using data from 2007 to 2010 Korea National Health and Nutrition Examination Surveys. METHODS: A total of 1,690 adults aged > or = 40 years were included. We used results of dental examination regarding all sextant information on probing depth of at least two index teeth, nutritional assessment by a single 24-hour dietary recall, and demographic and medical information. The periodontitis group was defined as those who had 3-4 points, and the normal group was defined as those who had 0 points of Community Periodontal Index at all locations of six examination sites using a probe. RESULTS: Using multiple logistic regression analysis, after adjustment for age, body mass index, energy intake, income, smoking, and alcohol drinking, we found an inverse relationship between consumption of dairy products and risk for periodontitis (OR: 0.465, 95% CI: 0.224-0.964) and between dietary riboflavin intake more than the estimated average requirements and risk for periodontitis (OR: 0.535, 95% CI: 0.300-0.954) in males. CONCLUSION: Adequate intake of milk dairy products and riboflavin may be recommended for prevention of periodontitis in the Korean male population.
Adult* ; Alcohol Drinking ; Body Mass Index ; Calcium* ; Calcium, Dietary ; Dairy Products* ; Energy Intake ; Humans ; Korea ; Logistic Models ; Male ; Milk* ; Nutrition Assessment ; Periodontal Index ; Periodontitis* ; Riboflavin* ; Smoke ; Smoking ; Tooth

BACKGROUND: QT dispersion(QTD=QTmax-QTmin) on the 12 lead ECG has been known to reflect regional variation of ventricular repolarization, and thus a marker of an increased risk of arrhythmia events. Late potential(LP) on signal averagina ECG(SAECG) is independent risk factor of ventricular arrhythmia following acute myocardial infaction(AMI). However, the relation between LP and QTD as indicator of electrophysiologic instability in AMI remains to be determined. METHOD: To determine whether there is a difference in QTD between in parients with AMI during acute phase and in normal control and whether thrombolytic therapy is assiciated with a reduction in QTD, and to determine the relationship between change of QTD and late potential on SAECG, we studied 71 patient with AMI(male 54, female 14, mean age 57yrs) and 23 controls(malw 17, female 6, mean age 58yrs). QT interval was measured on a standard 12 lead ECG in patients with AMI on admission, 2 hours after urokinase IV and 10-14 days post-AMI, and QT dispersion was calculated by difference of maximal and minimal corrected QT interval(QTmax-QTmin). A signal averaged ECG was recorded in 36 patients before discharge and coronary angiogeaphy(CAG) was performed in all patients 10-14 days post-AMI. RESULT: QTD is significantly increased in AMI compared to control(78.7+/-39.5ms vs. 24.6+/-22.3ms, P < 0.01). In patients who received thrombolytic therapy with urokinase, QTD is decreased from 75.0+/-34.4ms to 53.9+/-36.0ms(P < 0.01), whereas there is no significant change in patients who did not received thrombolytic therapy(84.8+/-47.6ms vs. 78.9+/-36.2ms, NS). There in no difference in QTD between patients with positive LP(68.4+/-23.6ms) and those with negative LP(77.8+/-32.1ms) on admission, those with positive LP(66.6+/-27.6ms) and those with negative LP(56.0+/-26.4ms) after 10-14days post-AMI. But magnitude of change of 10-14 days post-AMI QTD in patients with negative LP is larger than those with positive LP(-21.7+/-33.4ms vs. -1.8+/-15.2ms, P=0.06). CONCLUSION: QTD in acute phase of AMI is significantly reduced by the thrombolytic therapy. Patients with negative late potential tent to have greater QTD reduction within 14 days after AMI. These finding suggest that QT dispersion in patients with AMI can be reduced by early recanalization and its reduction is associated with the presence of late potential.
Arrhythmias, Cardiac ; Electrocardiography ; Female ; Humans ; Myocardial Infarction* ; Risk Factors ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator

BACKGROUND: QT dispersion(QTD : QTmax-QTmin) or JT dispersion(JTD:JTmax-JT-min)in 12 leads ECG has been known to reflect regional variations in ventricular repolarization and has been reported to bel one of the marker of regional myocardial ischemia. To evaluate the significance of QTD or JTD of exercise ECG in diagnosis of coronary artery disease, we studied 106 patients(mean age, 56.9 years old, male 63) who were referred for the evaluation of chest pain on exertion. METHOD: Treadmill exercise stress test with modified Bruce protocol and coronary angiography were performed in 106 patients with chest pain on exertion. ST-segment depression by >1.0 mm 0.08 second after J-point during or after exercise in exercise test and >50% stanosis of epicardial artery in coronary angiogram were defined as positive. Of 106 patients, 41 had positive exercise ECG and positive coronary angiogram(true positive, TP), 20 had positive exercise ECG and negative coronary angiogram(false positive, FT), 20 had negative exercise ECG and positive coronary angiogram(faalse negative, FN), and 23 had negative exercise ECG and negative coronary angiogram(true negative, Tn). QT and JT interval in 12 leads were measured at baseline and peakexercise and were corrected for heart rate using Bazett's formula. QTD and JTD were measured by calculation the difference between the maximum QT and mininum QT and that between maximum JT and minumum JT. RESULTS: QTD at baseline for TP(72.8ms)was prolonged compared to Tn(52.2ms,P<0.01), but was not different from that for FT(70.2 ms). At peak exercise, QTD for TP(81.3 msec) was significantly prolonged(p<0.01), while QTD for FP(71.2 msec) was not different from that for TN(56.8 msec). JTD at baseline(78.4 msec) and at peak exercise(88.2 msec) for TP were significantly prolonged compared to those for TN(55.2msec and 55.1msec p<0.01,p<0.01, respectively), but those for FP were not porlonged(77.0msec and 79.0msec, respectively). QTD and JTD at peak exercise were more markedly prolonged in patients with sever stenosis of coronary artery(p=0.053 and p<0.05, repectively) and multivessels diseases(p<0.01, 0<0.05) than those with less severe disease and single vessel disease. Patients with left anterior descending artery lesion had greater QTD and JTD at peak exercise than those with other vessels lesion(p<0.01). In addition to standard criteria with ST segment displacement in exercise EGC, inclusion of exercise induced QTD of more than 60msec increased the sensitivity of exercise ECG from 66.7% to 83.3%, and JTD of more than 70msec increased the specificity from 52% to 76.0%. CONCLUSION: Measurement of QT dispersion and JT dispersion of exercise ECG may be useful method to identify the severity of coronary artery disease and to improve diagnostic accuracy of exercise ECG in coronary artery disease.
Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Depression ; Diagnosis ; Electrocardiography* ; Exercise Test ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Sensitivity and Specificity

BACKGROUND: Myocardial contrast two-dimensional echocardiography(MC-2DE) has been known to have the real time capabilities for repeat in vivo assessment of ischemic risk areas and for evaluation of the myocardial perfusion. The aims of this investigation are (1) to evaluate the feasibility of MC-2DE for the delineation and quantitation of the area at risk. (2) to determine the relationship between the extent of the echocontrast defect area(EDA) during reperfusion and the size of myocardial infarction as determined by post-mortem tissue examination, and (3) to observe serial changes in the time echo-intensity characteristics of MC-2DE during coronary occlusion and reperfusion. METHODS: Myocardial contrast echocardiographic images were made by injecting bolus 5mL of two-syringe-agitated mixture of sodium meglumine ioxaglate(Hexabrix(R)) and normal saline(2 : 3 by volume) into the aortic root before and during coronary occlusion of the left anterior descending coronary artery, distal to the first diagonal branch and during reperfusion on eight open-chest dogs. Two-dimensional echocardiographic short axis views were obtained at four anatomic levels : the apex, the low papillary muscle, the high papillary muscle and the mitral valve. The changes in EDA and echo-intensity with its wash-out half time(WHT) at the high papillary muscle level during coronary occlusion and reperfusion were measured every 15 minutes. The total EDA was measured by planimetry at 3 minutes after coronary occlusion and at 60 minutes after reperfusion. Evans blue or methylene blue were used for the measurement of the anatomic area at risk and triphenyl-tetrazolium chloride(TTC) for the measurement of the infarct area. RESULTS: The EDA measured 30 minutes after coronary occlusion(19.6%) was smaller than that at 3 minutes after coronary occlusion(24.0%, p<0.01). Then EDA at 3 minutes occlusion was strongly predictive of the anatomic extent of area at risk(EDA=0.48 Area at risk+16.95, r=0.84, p<0.05). The EDA at 60 minutes after reperfusion, which showed an irregular margin and was located within the subendocardium of the area at risk, also correlated well with the infarct area(IA)(EDA=0.78 IA+3.32, r=0.82, p=0.09). The peak echo-intensity in the ischemic area during coronary occlusion was significantly low(14.2+/-6.5 vs 73.8+/-31.7 in the non-ischemic area, p<0.01) and the WHT was delayed more in the ischemic area than in the non-ischemic area(23.2+/-2.8 sec vs 8.1+/-3.3sec, p<0.01). During the period of reperfusion, WHT in the previously ischemic area was markedly delayed compared to that in the non-ischemic area (p<0.01), although the peak echo-intensity in the ischemic area at 3 minutes after reperfusion increased modestly compared to that in the non-ischemic area(80.9+/-22.8 vs 72.7+/-8.4), suggesting the impairment in the transit of microbubbles is probably due to microvascular damage after reperfusion. There were no adverse hemodynamic or electrocardiographic effects after injection of the contrast agent. CONCLUSIONS: These findings suggest that myocardial contrast echocardiography was useful as a non-invasive technique, first, to delineate the area at risk in vivo during coronary occlusion and, after reperfusion, the infarct area, and secondly, to evaluate indirectly the state of myocardial perfusion during coronary occlusion and reperfusion.
Animals ; Axis, Cervical Vertebra ; Coronary Occlusion* ; Coronary Vessels ; Dogs ; Echocardiography* ; Electrocardiography ; Evans Blue ; Hemodynamics ; Meglumine ; Methylene Blue ; Microbubbles ; Mitral Valve ; Myocardial Infarction ; Papillary Muscles ; Perfusion* ; Reperfusion* ; Sodium

Angiodysplsia of the small bowel is uncommon, but provably remains frequently undiagnosed. In the small intestine, angiodysplasia presents a taxing surgical problem and is uauslly diagnosed for unexplained gastrointestinal bleeding. For the surgeon, the main technical problem is that even when identified by frequently impalpable, and invisible to the naked eye unless they are actively bleeding at the time of surgery. Ensocopy is often unfruitful because the majority of lesions are submucosal and rarely exceed a few milimeters in diameter. We described a simple intraoperative endoscopic transillumination technique used successfully to identify an angiodysplasia in the jejunum prior to the small bowel resection. This report summarized our experience and review of literature.
Angiodysplasia* ; Hemorrhage ; Intestine, Small ; Jejunum* ; Taxes ; Transillumination*