Kawasaki disease (KD) is an acute, self-limiting, small-vessel vasculitis with an unknown cause that affects children between the ages of 6 months and 5 years. Its important acute complication is coronary artery aneurysm. Myocardial infarction caused by thrombus formation inside the aneurysm or by organic obstructive lesion following the regression of aneurysm is the principal cause of death in KD. However, coronary artery aneurysms and stenosis requiring surgery are rare in KD. We report an our experience about anesthetic management of child undergone off-pump coronary artery bypass grafting surgery because of coronary artery aneurysm associated with KD.
Anesthesia ; Aneurysm ; Cause of Death ; Child ; Constriction, Pathologic ; Coronary Artery Bypass, Off-Pump ; Coronary Disease ; Coronary Vessels ; Humans ; Infarction ; Mucocutaneous Lymph Node Syndrome ; Myocardial Infarction ; Thrombosis ; Transplants ; Vasculitis

Vulvodynia is the term used to describe unexplained vulvar pain, sexual dysfunction, and the resultant psychological disability. In vulvar vestibulitis, surgery is carried out on patients who have failed conservative therapy. Surgical procedures which is removal of all sensitive vestibular tissue are most effective in patients with pure vestibulitis, but effective surgery is not known in patient with dysesthetic vulvodynia. We experienced one case of vulvar denervation operation in patients with intractable dysesthetic vulvodynia, which have failed conservative therapy. So we report one case with a brief review of literature.
Denervation* ; Humans ; Vulvar Vestibulitis ; Vulvodynia*

Polyarteritis nodosa(PAN) is a multisystem disease characterized by necrotizing vasculitis of small andmedium-sized arteries, and in 50% of all cases there is gastrointestinal involvement. We describe a patient withPAN involving the gastrointestinal tract. A small bowel series showed nodular fold thickening, submucosal fillingdefects, shallow ulcerations, segmental luminal narrowing, and decreased peristalsis at the duodenum, jejunum, andileum; superior mesenteric arteriography showed hypervascularity and microaneurysm. Segmental resection of thesmall bowel indicated the presence of PAN.
Angiography ; Arteries ; Arteritis ; Duodenum ; Gastrointestinal Tract ; Humans ; Jejunum ; Mesenteric Artery, Superior* ; Peristalsis ; Phenobarbital ; Polyarteritis Nodosa* ; Ulcer ; Vasculitis

OBJECTIVES: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. METHODS: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patients and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, WHO Quality of Life scale, and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated ; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. RESULTS: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. CONCLUSION: Through the study, it was confirmed that when hospitalized schizophrenic patients receive continuous day hospital care after being discharged, they receive further out patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients' treatment adherence issues and improvement of treatment outcomes.
Hospitalization ; Humans ; Outpatients ; Patient Care ; Prospective Studies* ; Quality of Life ; Schizophrenia ; Survival Rate ; Track and Field ; Treatment Outcome

OBJECTIVES: This study was designed to investigate the association between the dopamine D2 receptor (DRD2) genetic polymorphism [TaqIB (rs17294542) and TaqID (rs1800498)] and patients with schizophrenia. METHODS: TaqIB (rs17294542) and TaqID (rs1800498) polymorphism of the DRD2 gene were typed in 100 patients with schizophrenia and 109 normal controls. RESULTS: There were no statistical differences in genotype and allele distribution of TaqIB (rs17294542) and TaqID (rs1800498) genetic polymorphism between patients with schizophrenia and normal controls. CONCLUSIONS: These results suggest that the TaqIB (rs17294542) and TaqID (rs1800498) polymorphisms of the DRD2 gene may not be associated with schizophrenia in the Korean population.
Alleles ; Genotype ; Humans ; Polymorphism, Genetic ; Receptors, Dopamine D2 ; Schizophrenia

OBJECTIVE: It is still unclear whether angiogenic potential, which is believed to be a prerequisite for tumor development, is an important prognostic factor in ovarian carcinoma. The current study was designed to examine the relationship among Vascular endothelial growth factor (VEGF) expression, angiogenesis in ovarian neoplasms and clinicopathological prognostic variables. METHODS: A according to the WHO classification and FIGO staging epithelial ovarian carcinoma was classified. Microvessel density and VEGF status were evaluated by immunohistochemistry in 77 epithelial ovarian carcinomas. RESULTS: Positive immunostaining for VEGF was observed in 92.6% (50 out of 54) of ovarian carcinomas, which was significantly higher than that of low malignant potential (LMP) tumors (12 out of 23; 52.2%) (p<0.001). In ovarian carcinomas, positive VEGF immunostaining was also observed more frequently, even though not significantly, in tumor of elder age group (more than 60 years) (p=0.05) and less differentiated (p=0.05). CD34 immunostaining revealed increased microvessel density in ovarian carcinomas larger than 10 cm in size (p=0.029) and in mucinous type tumors (p=0.025). Microvessel counts of epithelial ovarian carcinomas examined were not correlated with VEGF expression. Histologic type (p=0.0428), differentiation (p=0.0083) and FIGO stage (p=0.0004) also influenced overall survival of ovarian carcinomas in univariate analysis. But multivariate analysis revealed that disease stage was the only significant and independent prognostic factor of ovarian carcinomas (p=0.001). In advanced ovarian tumors (stage III/IV), microvessel density was the only significant prognostic factor (p=0.002). CONCLUSION: Therefore, the expression of VEGF could be used as an adjuvant indicator of differing borderline tumor from ovarian carcinoma. And microvessel density of advanced ovarian carcinoma may enhance the predictability of patient at high risk for tumor progression who are potential candidate for further aggressive therapy.
Classification ; Humans ; Immunohistochemistry ; Microvessels* ; Mucins ; Multivariate Analysis ; Ovarian Neoplasms ; Prognosis* ; Vascular Endothelial Growth Factor A*

PURPOSE: The purpose of this study was to evaluate the ultrasonographic and CT findings of various diseases that affect the intraparotid lymph node. MATERIALS AND METHODS: The subjects were 32 patients having various diseases involving the intraparotid lymph node. The final confirmed diagnoses were nonspecified benign inflammatory lymphadenopathy (n=20), metastasis (n=5), tuberculous lymphadenitis (n=4), and lymphoma (n=3). For the nonspecified benign inflammatory lymphadenopathy, there were multiple lesions in five patients and bilateral lesions in two patients, and a total of 26 lesions were included in this study. The pathologic proof of the diagnosis was made for 4 of 26 lesions, and by ultrasound follow-up on 22 of 26 lesions. All the patients underwent ultrasound. Color Doppler imaging was also performed in 19 patients and contrast-enhanced CT was also performed in 8 patients. All cases with metastasis, tuberculous lymphadenitis and lymphoma were pathologically confirmed and these patients were all examined with contrast-enhanced CT. RESULTS: For the nonspecified benign inflammatory lymphadenopathy, all the lesions were seen at the superficial lobe. All twenty six lesions were observed as well-defined ovoid or round hypoechoic nodules with posterior sonic enhancement on ultrasonography. A central echogenic hilum was seen in 12 of 26 inflammatory lymphadenopathies (46%), and a central hilar vascularity was noted in 13 of 19 inflammatory lymphadenopathies (68%) on color Doppler imaging. Contrast-enhanced CT showed well-defined nodules with homogeneous enhancement in most lesions. In 3 lesions, a central low density hilum was seen within a lymph node. In 12 cases with metastasis, tuberculous lymphadenitis and lymphoma, there were multiple lesions in 6 cases. CT revealed intraparotid masses with or without central necrosis and the associated multiple lymph node enlargements in the ipsilateral neck region, and their appearances were similar to that of parotid mass. CONCLUSION: Nonspecified benign inflammatory lymphadenopathy involving intraparotid lymph nodes often demonstrated characteristic ultrasonographic findings, including a central echogenic hilum on gray scale US and central hypervascularity on color Doppler ultrasonography. In the metastasic lesions, the tuberculous lymphadenitis and the lymphomas, the multiplicity of lesions and the associated enlarged lymph nodes in the ipsilateral neck region could be helpful in the differential diagnosis.
Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Neck ; Necrosis ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node ; Ultrasonography ; Ultrasonography, Doppler, Color

PURPOSE: Previously, Epstein-Barr virus (EBV) infection was diagnosed by serological examination; currently, many EBV antigen detection methods have been developed and applied clinically for diagnosing EBV infection. To delineate the clinical characteristics of EBV infection, clinical and laboratory findings were evaluated for patients who tested positive in EBV polymerase chain reaction (PCR). METHODS: EBV PCR was conducted in 352 patients admitted to the pediatric ward from January 2004 to December 2006, with more than 2 clinical signs such as fever (> or =37.5degrees C), exudative throat infection, lymphadenopathy, hepatitis of unknown etiology, and splenomegaly. The EBV viral gene was detected by PCR in 115 patients (32%), and the clinical characteristics of these patients were evaluated. Laboratory findings such as leukocytosis, thrombocytopenia, atypical lymphocyte, and alteration in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in peripheral blood were examined. The EBV-specific immunoglobulin M antibody (EBV-IgM Ab) was also tested. RESULTS: Most of the children were younger than 8 years (89%), and the male to female ratio was 1.3:1. Exudative throat infection and fever (> or =37.5degrees C) were observed in all patients. Cervical lymph node enlargement was seen in 36 patients (31%); leukocytosis (WBC> or =10,000/mm3), in 54 patients (47%); and atypical lymphocyte (> or =20%), in 28 patients (24%). EBV-IgM Ab was positive in 33 patients (29%). The younger patients had higher ALT levels and higher incidence of positive EBV-IgM Ab than the older patients. CONCLUSION: The cumulative number of patients diagnosed to have EBV infection by PCR increased markedly for those under 8 years. ALT was higher and EBV-IgM Ab was detected more in younger patients with EBV infection.
Alanine Transaminase ; Aspartate Aminotransferases ; Child ; Epstein-Barr Virus Infections ; Female ; Fever ; Genes, Viral ; Hepatitis ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Incidence ; Leukocytosis ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Male ; Pharynx ; Polymerase Chain Reaction ; Splenomegaly ; Thrombocytopenia

BACKGROUND: Valvular heart surgery (VHS) utilizing cardiopulmonary bypass (CPB) is inevitably associated with ischemic-reperfusion injury, which is known to depend on oxygen tension during reperfusion. The aim of this study was to evaluate the effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing VHS. METHODS: Fifty-six patients undergoing isolated VHS were randomly exposed to an oxygen fraction of 0.7 (hyperoxic group, n = 28) or 0.5 (normoxic group, n = 28) during reperfusion. All patients received an oxygen fraction of 0.7 during CPB. In the normoxic group, the oxygen fraction was lowered to 0.5 from the last warm cardioplegia administration to 1 minute after aortic unclamping, and was then raised back to 0.7. Hemodynamic data were measured after induction of anesthesia, weaning from CPB, and sternum closure. The frequency of cardiotonic medications used during and after weaning from CPB, and the short-term outcomes during the hospital stay were also assessed. RESULTS: The frequency of vasopressin and milrinone use during weaning from CPB, but not norepinephrine, was significantly less in the normoxic group. The post-operative cardiac enzyme levels and short-term outcomes were not different between the groups. CONCLUSIONS: Normoxic reperfusion from the last cardioplegia administration to 1 minute after aortic unclamping in patients undergoing VHS resulted in significantly less frequent use of vasopressin and inotropics during weaning from CPB than hyperoxic reperfusion, although it did not affect the post-operative myocardial enzyme release or short-term prognosis.
Anesthesia ; Cardiopulmonary Bypass ; Heart ; Heart Arrest, Induced ; Hemodynamics ; Humans ; Length of Stay ; Milrinone ; Norepinephrine ; Oxygen ; Prognosis ; Reperfusion ; Reperfusion Injury ; Sternum ; Thoracic Surgery ; Vasopressins ; Weaning

This report details the CT, MR, and angiography findings of a solitary fibrous tumor involving the larynx of a 34-year-old man. A precontrast CT scan revealed a well-defined isodense mass in the submucosal region of the supraglottic larynx. The tumor appeared as a mixed intensity lesion on the T1- and T2-weighted MR images. A T2-weighted MR image showed a central, round, and low signal intensity area within the mass. For both the CT and MR images, the mass demonstrated heterogeneous enhancement following the administration of contrast material. The angiography showed a hypervascular tumor with heterogeneous persistent staining.
Adult ; Angiography ; Humans ; Laryngeal Neoplasms/blood supply/*diagnosis ; Magnetic Resonance Imaging ; Male ; Solitary Fibrous Tumors/blood supply/*diagnosis ; Tomography, X-Ray Computed