The term histiocytic medullary reticulosis first was introduced by Scott and Robb-Smith. It is a clinicopathologic syndrome characterized by wasting, fever, lymphadenopathy, hepatosplenomegaly, pancytopenia, and is often accompanied by jaundice, purpura. Cardinal pathologic feature are systemized proliferation of atypical, neoplastic, erythrophagocytic D. We are here reporting one case which considered compatible for HMR, with a few elementary reviewed literatures.
Fever ; Jaundice ; Lymphatic Diseases ; Pancytopenia ; Purpura

Sirenomelia is rare congenital malformation characterized by fusion of the lower extrimities associated anomalies included absence of urogenital system (bilateral renal agenesis, absent ureter, urinary bladder, absent internal and external genitalia), induced severe oligohydramnios, anorectal atresia, single umbilical artery, pulmonary hypoplasia. The incidence is 1:60000 births. Survival is extremely rare, and only possible, in the absence of bilateral renal agenesis. In view of the dismal prognosis, early diagnosis allows for earlier and less traumatic therapeutic abortion. We report a case of sirenomelia without oligohydramnios diagnosed in early second trimester.
Abortion, Therapeutic ; Early Diagnosis ; Ectromelia* ; Female ; Humans ; Incidence ; Oligohydramnios* ; Parturition ; Pregnancy ; Pregnancy Trimester, Second* ; Prognosis ; Single Umbilical Artery ; Ureter ; Urinary Bladder ; Urogenital System

BACKGROUND: Propofol is used as an induction and maintenance agent for general anesthesia but it can cause adverse reactions like hyperlipidemia, growth of microorganisms, and pulmonary embolisms. Microemulsion propofol was developed to avoid these side effects but incidence and severity of pain on injection is higher than with lipid emulsion propofol. We aimed to compare the effects of sufentanil in analgesic doses for reducing the injection pain of microemulsion propofol. METHODS: The candidates included eighty patients, 19-60 years old and ASA I-II. They were randomly classified into four groups and pretreated with normal saline, sufentanil 0.1 microg/kg, 0.2 microg/kg or 0.3 microg/kg before injection of microemulsion propofol. Five minutes after receiving pretreatment drug, 2 mg/kg of microemulsion propofol was injected and VAS was recorded. RESULTS: There were no significant differences in the incidence of injection pain among the groups. Severity of injection pain was significantly lower in the sufentanil 0.3 microg/kg group than normal saline and sufentanil 0.1 microg/kg group. Significant differences in blood pressure and heart rate were observed in sufentanil groups only after endotracheal intubation. One patient each in sufentanil 0.1 microg/kg and 0.3 microg/kg group experienced mild cough, one from sufentanil 0.3 microg/kg group experienced dizziness and another showed signs of hypoxia. One patient each in normal saline and sufentanil 0.1 microg/kg group showed clinical symptoms of phlebitis in the injection area. CONCLUSIONS: Pretreatment with sufentanil 0.3 microg/kg reduced the severity of microemulsion propofol injection pain without increasing arterial blood pressure and heart rate after endotracheal intubation.
Anesthesia, General ; Anoxia ; Arterial Pressure ; Blood Pressure ; Cough ; Dizziness ; Heart Rate ; Humans ; Hyperlipidemias ; Incidence ; Intubation, Intratracheal ; Phlebitis ; Propofol ; Pulmonary Embolism ; Sufentanil

OBJECTIVE: We investigated the expression of chemokine receptors in human ovarian cancer to understand the role of chemokines in ovarian cancer development and metastasis. METHODS: Twenty-two cases of epithelial ovarian cancer were studied for expression of 13 chemokine receptors such as CXCR1-CXCR5 and CCR1-CCR8 by using semi- quantitative RT-PCR and immunohistochemistry. Moreover, we studied the relationship between the chemokine receptors expression and lymph nodes metastasis of ovarian cancers. RESULTS: As compared with normal ovarian tissues, ovarian cancer tissues showed higher mean expression levels of CCR1,3,4,5,7,8 and CXCR1,3,4. Of chemokine receptors, CCR7 revealed the significantly higher levels of expression in ovarian cancer tissues relative to normal tissues. In the cases of retroperitoneal lymph nodes metastasis, increased expression of CCR2,4 and CXCR 1,3,4 was observed although there was no statistical significance. CONCLUSION: These results suggest that there is a complex chemokine/chemokine receptor network in pathogenesis and the way of lymph node metastasis of ovarian cancer rather than a specific chemokine or chemokine receptor.
Chemokines ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Ovarian Neoplasms* ; Receptors, Chemokine*

BACKGROUND: A decreased level of serum arginine vasopressin(AVP) and an increased sensitivity to an exogenous AVP is expected in patients with septic shock who often require a high infusion rate of catecholamines. The goal of the study was to determine whether an exogenous AVP infusion to the patients with septic shock would achieve a significant decrement in infusion rate of catecholamine vasopressors while maintaining hemodynamic stability and adequate urine output. METHODS: Eight patients with septic shock who require a high infusion rate of norepinephrine had received a trial of 4-hour AVP infusion with simultaneous titration of norepinephrine. Hemodynamic parameters and urine output were monitored during the AVP infusion and the monitoring continued up to 4 hours after the AVP infusion had stopped. RESULTS: Mean arterial pressure showed no significant changes during the study period(p=0.197). Norepinephrine infusion rate significantly decreased with concurrent AVP administration(p=0.001). However, beneficial effects had disappeared after the AVP infusion was stopped. In addition, hourly urine output showed no significant changes throughout the trials(p=0.093). CONCLUSION: Concurrent AVP infusion achieved the catecholamine vasopressor sparing effect in the septic shock patients, but there was no evidence of the improvement of renal function. Further study may be indicated to determine whether AVP infusion would provide an organ-protective effect to the septic shock patients.
Arginine* ; Arterial Pressure ; Catecholamines ; Hemodynamics ; Humans ; Norepinephrine ; Shock, Septic*

Biliary-enteric fistula is a rare disease, and the common causes of biliary-enteric fistula are gallstone, peptic ulcer, malignancy and trauma. It is known that the most common type of biliary-enteric fistula is the cholecysto-duodenal fistula, yet the combination of choledocho-duodeno-colonic fistula is a rare finding. A 78-year-old woman was admitted because she had suffered with right upper quadrant pain, a febrile sense and chills for 2 days. We confirmed the choledocho-duodeno-colonic fistula by performing gastroduodenoscopy, abdominal CT and an upper GI series. So, we report here on an usual case of choledocho-duodeno-colonic fistula, along with a review of the relevant literatures.
Aged ; Biliary Fistula ; Chills ; Female ; Fistula* ; Gallstones ; Humans ; Peptic Ulcer ; Rare Diseases ; Tomography, X-Ray Computed

Although the age-adjusted Framingham risk score (AFRS), flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and free fatty acid (FFA) can predict future cardiovascular events (CVEs), a comparison of these risk assessments for patients with stable angina has not been reported. We enrolled 203 patients with stable angina who had been scheduled for coronary angiography (CAG). After CAG, 134 patients showed significant coronary artery disease. During 4.2 yr follow-up, 36 patients (18%) showed CVEs, including myocardial infarction, de-novo coronary artery revascularization, in-stent restenosis, stroke, and cardiovascular death. ROC analysis showed that AFRS, FMD, baPWV, and hsCRP could predict CVEs (with AUC values of 0.752, 0.707, 0.659, and 0.702, respectively, all P<0.001 except baPWV P=0.003). A Cox proportional hazard analysis showed that AFRS and FMD were independent predictors of CVEs (HR, 2.945; 95% CI, 1.572-5.522; P=0.001 and HR, 0.914; 95% CI, 0.826-0.989; P=0.008, respectively). However, there was no difference in predictive power between combining AFRS plus FMD and AFRS alone (AUC 0.752 vs. 0.763; z=1.358, P=0.175). In patients with stable angina, AFRS and FMD are independent predictors of CVEs. However, there is no additive value of FMD on the AFRS in predicting CVEs.
Adult ; Aged ; Angina, Stable/*physiopathology ; Biological Markers/analysis/blood ; Blood Flow Velocity ; Coronary Artery Disease/*diagnosis ; Endothelium, Vascular ; Female ; Heart/*physiopathology ; Humans ; Male ; Middle Aged ; Myocardial Infarction/physiopathology ; Predictive Value of Tests ; Proportional Hazards Models ; Pulsatile Flow ; Pulse Wave Analysis/*methods ; ROC Curve ; Risk Assessment ; Risk Factors

In the present study, we investigated the role of peripheral ionotropic receptors in artemin-induced thermal hyperalgesia in the orofacial area. Male Sprague-Dawley rats weighting 230 to 280 g were used in the study. Under anesthesia, a polyethylene tube was implanted in the subcutaneous area of the vibrissa pad, which enabled drug-injection. After subcutaneous injection of artemin, changes in air-puff thresholds and head withdrawal latency time were evaluated. Subcutaneous injection of artemin (0.5 or 1 µg) produced significant thermal hyperalgesia in a dose-dependent manner. However, subcutaneous injection of artemin showed no effect on air-puff thresholds. IRTX (4 µg), a TRPV1 receptor antagonist, D-AP5 (40 or 80 µg), an NMDA receptor antagonist, or NBQX (20 or 40 µg), an AMPA receptor antagonist, was injected subcutaneously 10 min prior to the artemin injection. Pretreatment with IRTX and D-AP5 significantly inhibited the artemin-induced thermal hyperalgesia. In contrast, pretreatment with both doses of NBQX showed no effect on artemin-induced thermal hyperalgesia. Moreover, pretreatment with H-89, a PKA inhibitor, and chelerythrine, a PKC inhibitor, decreased the artemin-induced thermal hyperalgesia. These results suggested that artemin-induced thermal hyperalgesia is mediated by the sensitized peripheral TRPV1 and NMDA receptor via activation of protein kinases.
Anesthesia ; Animals ; Head ; Humans ; Hyperalgesia* ; Injections, Subcutaneous ; Male ; N-Methylaspartate ; Polyethylene ; Protein Kinases ; Rats* ; Rats, Sprague-Dawley ; Receptors, AMPA

OBJECTIVES: Cyberbullying has recently become a major concern in Korea and especially poses a serious threat to adolescents. The object of this study is to examine the psychopathology of perpetrators and victims of cyberbullying. METHODS: In a cross-sectional study, 490 middle school students completed questionnaires on bullying and victimization experiences in cyberspace. Korean-Youth Self Report (K-YSR) was included to evaluate the psychopathology of the students. RESULTS: The prevalence rates of victims and perpetrators of cyberbullying were 6.92% and 3.33%, respectively. Among 9 sub-scales of K-YSR, the scores of depressed/anxious (p=0.049), thought problems (p=0.002), and attention problems (p=0.039) were significantly different between victim, perpetrator, victim/perpetrator, and control group. Multinomial logistic regression indicated that the victim group was associated with depressed/anxious [odds ratio (OR)=1.10], social immaturity (OR=1.24), thought problems (OR=1.32), and self-destructive identity problems (OR=1.16). The perpetrator group was associated with thought problems (OR=1.37) and attention problems (OR=1.21). The victim/perpetrator group was associated with delinquent behavior (OR=2.04). CONCLUSION: Middle school students involved in cyberbullying were associated with psychopathologies including depression, anxiety, thought problems, attention problems, and delinquent behaviors. The risk of cyberbullying is escalating with the rapid advancement in technology. Therefore, a comprehensive approach should be employed for prediction and prevention of cyberbullying in adolescents.
Adolescent ; Anxiety ; Bullying* ; Crime Victims ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Logistic Models ; Prevalence ; Psychopathology* ; Surveys and Questionnaires ; Self Report

The present study investigated the role of spinal glutamate recycling in the development of orofacial inflammatory pain or trigeminal neuropathic pain. Experiments were carried out on male Sprague-Dawley rats weighing between 230 and 280 g. Under anesthesia, a polyethylene tube was implanted in the atlanto-occipital membrane for intracisternal administration. IL-1β-induced inflammation was employed as an orofacial acute inflammatory pain model. IL-1β (10 ng) was injected subcutaneously into one vibrissal pad. We used the trigeminal neuropathic pain animal model produced by chronic constriction injury of the infraorbital nerve. DL-threo-β -benzyloxyaspartate (TBOA) or methionine sulfoximine (MSO) was administered intracisternally to block the spinal glutamate transporter and the glutamine synthetase activity in astroglia. Intracisternal administration of TBOA produced mechanical allodynia in naïve rats, but it significantly attenuated mechanical allodynia in rats with interleukin (IL)-1 β-induced inflammatory pain or trigeminal neuropathic pain. In contrast, intracisternal injection of MSO produced anti-allodynic effects in rats treated with IL-1β or with infraorbital nerve injury. Intracisternal administration of MSO did not produce mechanical allodynia in naive rats. These results suggest that blockade of glutamate recycling induced pro-nociception in naïve rats, but it paradoxically resulted in anti-nociception in rats experiencing inflammatory or neuropathic pain. Moreover, blockade of glutamate reuptake could represent a new therapeutic target for the treatment of chronic pain conditions.
Amino Acid Transport System X-AG ; Anesthesia ; Animals ; Astrocytes ; Chronic Pain ; Constriction ; Glutamate-Ammonia Ligase ; Glutamic Acid* ; Humans ; Hyperalgesia ; Inflammation ; Interleukins ; Male ; Membranes ; Methionine Sulfoximine ; Models, Animal ; Neuralgia* ; Polyethylene ; Rats* ; Rats, Sprague-Dawley ; Recycling*