No abstract available.
Surgery, Oral*

A 31-year-old woman with a 15-year history of Takayasu's arteritis (TA) and a 13-year history of Hashimoto's thyroiditis presented with hematochezia. She received a diagnosis of Sjögren's syndrome at 1 month before her visit to Kyungpook National University Medical Center. Her colonoscopic findings were compatible with a diagnosis of ulcerative colitis (UC). She was treated with oral mesalazine, and her hematochezia symptoms subsequently disappeared. The coexistence of UC and TA has been reported; however, reports on the coexistence of UC and Sjögren's syndrome, or of UC and Hashimoto's thyroiditis are rare. Although the precise etiologies of these diseases are unknown, their presence together suggests that they may have a common pathophysiologic background. Furthermore, in patients with autoimmune or vascular diseases, including TA, systemic manifestations should be assessed with consideration of inflammatory bowel diseases including UC in the presence of gastrointestinal symptoms such as diarrhea and hematochezia.
Academic Medical Centers ; Adult ; Colitis, Ulcerative* ; Diagnosis ; Diarrhea ; Female ; Gastrointestinal Hemorrhage ; Gyeongsangbuk-do ; Hashimoto Disease ; Humans ; Inflammatory Bowel Diseases ; Mesalamine ; Sjogren's Syndrome ; Takayasu Arteritis* ; Thyroid Gland* ; Thyroiditis* ; Ulcer* ; Vascular Diseases

Corticotrophin-releasing factor (CRF), a key regulator of the hypothalamic-pituitary axis, is expressed in the central nucleus of the amygdala (CeA) and its expression is upregulated in stress-related disorders. We investigated here the effect of noxious colorectal distension (CRD) on the expression of CRF in the CeA of conscious and unconscious rats. Adult male rats with or without general anesthesia were exposed to visceral pain induced by CRD for 5 min; this procedure was repeated 3 times with 1 min resting after each distension. The rats were sacrificed and sections of the CeA were immunostained for CRF as an indicator for anxiety response, and for phosphorylated extracellular signal-regulated kinase (p-ERK) as a marker for pain-specific activation of neurons; sections of lumbosacral spinal cord were immunostained for c-Fos as a marker for activation of spinal neurons. CRD elicited a significant increase in the expression of CRF and p-ERK in the CeA and of c-Fos in the spinal cord. General anesthesia attenuated the increase in CRF and p-ERK in the CeA, but did not affect the expression of spinal c-Fos. These results suggest that conscious recognition of pain at higher brain centers is an important determinant of CRF expression in the CeA.
Amygdala/*metabolism/pathology ; *Anesthesia, General ; Animals ; Colon ; Corticotropin-Releasing Hormone/*metabolism ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Immunohistochemistry ; Male ; Neurons/metabolism ; Pain/prevention & control ; Phosphorylation ; Proto-Oncogene Proteins c-fos/metabolism ; Rats ; Rats, Sprague-Dawley ; Rectum

In Korea, the majority of imported malaria cases are Plasmodium vivax and P. falciparum, but Plasmodium ovale cases are rarely reported. We describe an imported case of P. ovale that was confirmed by peripheral blood smear and nested PCR targeting the small subunit ribosomal RNA (SSU rRNA) gene. A 37-yr-old male had visited the Republic of Ghana in tropical West Africa 3 months ago, and suffered from fever and headache since 2 weeks after his return to Korea. The results of rapid malaria test using SD Malaria Antigen/Antibody Kit (Standard Diagnostics, Korea) were negative, but Plasmodium species was observed in Wright-Giemsa-stained peripheral blood smear. For the evaluation of possible mixed infection and identification of species, we performed a nested PCR targeting the SSU rRNA gene. P. ovale single infection was confirmed by PCR. The sequence analysis of the P. ovale SSU rRNA gene showed that our isolate was P. ovale classic type. We should confirm P. ovale infection for an accurate diagnosis and treatment of imported malaria cases in Korea because the number of travelers to P. ovale-endemic regions has recently increased.
Africa, Western ; Coinfection ; Fever ; Genes, rRNA ; Ghana ; Headache ; Humans ; Korea ; Malaria ; Male ; Plasmodium ; Plasmodium ovale ; Plasmodium vivax ; Polymerase Chain Reaction ; RNA, Ribosomal ; Sequence Analysis

No abstract available.
Hemangioma*

Anisakiasis is a zoonotic parasitic infection associated with consumption of raw fish or uncooked seafood. We report a rare case of suspected esophageal anisakiasis-induced dysphagia. A 66-year-old man patient without any medical history was admitted to our hospital for evaluation of acute dysphagia. Following intake of abalone sashimi for dinner, he experienced sudden difficulty with swallowing the day before his emergency department visit. He developed skin rash and pruritus throughout his body, shortly thereafter. He also had chest and upper abdominal pain and diarrhea. He had experienced similar symptoms after consumption of raw fish on two previous occasions. Dysphagia improved 9 days later. Gastroscopy performed after symptom onset showed small erosions and edematous mucosa in the mid esophagus. Abdominopelvic computed tomography (CT) showed distal esophageal wall thickening and small bowel obstruction with concomitant ascites. We suspected anisakiasis based on the following criteria: 1) Skin rash after the third episode of consumption of raw fish or seafood (anisakiasisspecific immunoglobulin E class 4). 2) CT-documented small intestinal obstruction and ascites. 3) Eosinophil-dominant fluid observed on ascitic fluid analysis. Therefore, it is reasonable to conclude that temporary dysphagia in this patient was attributable to esophageal anisakiasis associated with raw seafood consumption.

Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.

Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.

Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.