No abstract available.

No abstract available.

Intraductal papillary mucinous neoplasms of the bile ducts (IPMNs-B) are uncommon lesions that are characterized by innumerable papillary fronds that contain fine vascular cores, enriched mucin production and bile duct dilatation. IPMNs-B are histologically similar to intraductal papillary mucinous neoplasms of the pancreas and they are occasionally associated with hepatolithiasis. IPMNs-B are considered to be relatively low-grade malignancy and they merit consideration for aggressive surgery. Thus, early and precise diagnosis is important to maximize patient survival. From July 2002 to March 2006, we identified four patients with IPMNs-B at our hospital. In three patients, intrahepatic or extrahepatic bile duct stones were associated with their condition. Computed tomography and magnetic resonance cholangiography were done in all four cases and this demonstrated marked dilatation of the biliary tree. Endoscopic retrograde cholangiography was done in two cases and a large amount of mucin that was draining from the patulous orifice of the duodenal papilla was seen on endoscopy. However, two cases were initially misdiagnosed as intrahepatic cholangiocarcinoma or choledochal cyst with intrahepatic bile duct stones. All the cases underwent ipsilateral hemihepatectomy with caudate lobectomy. Histologically, one case showed to be adenoma, one case was borderline and two cases were invasive adenocarcinoma.
Adenocarcinoma ; Adenoma ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Bile* ; Biliary Tract ; Cholangiocarcinoma ; Cholangiography ; Choledochal Cyst ; Diagnosis ; Dilatation ; Endoscopy ; Humans ; Mucins* ; Pancreas

PURPOSE: Chromosomal abnormalities of abortuses have been used to investigate common etiologies of spontaneous abortion, but the frequencies and types of spontaneous abortions have demonstrated considerable variation among different countries and races. MATERIALS AND METHODS: A cytogenetic analysis of 75 abortuses was performed at GenDix, Inc. from January 2006 to December 2007. RESULTS: The frequency of chromosome abnormalities in abortuses was 32.0% (24/75 cases). Among the chromosomal abnormalities, trisomy was present in 62.5% (15/24 cases) of cases and the most frequent trisomy was trisomy 21 with an occurrence rate of 26.6% (4/15 cases). The following was trisomy 22 (3/15 cases) and trisomy 20 (2/15 cases). The average maternal age for abnormal karyotypes was 34.3+/-3.3. CONCLUSION: Cytogenetic analysis of abortus is important for diagnosis and genetic counseling of patients with spontaneous abortion.
Abnormal Karyotype ; Abortion, Spontaneous ; Chromosome Aberrations ; Chromosomes, Human, Pair 20 ; Chromosomes, Human, Pair 22 ; Cytogenetic Analysis ; Cytogenetics ; Down Syndrome ; Female ; Genetic Counseling ; Humans ; Karyotype ; Maternal Age ; Mosaicism ; Pregnancy ; Trisomy

In the pediatric ICU and operating room, a central venous catheter (CVC) provides accurate hemodynamic information and serves as a reliable route for the administration of vasoactive drugs, fluids and allogeneic blood products. The placement of CVC is associated with a complication rate of 0.4% to 20%, including hemothorax, pneumothorax, thrombosis, infection and cardiac tamponade. We describe a case of CVC being misplaced in the innominate vein after penetrating the subclavian vein during anesthesia induction for arterial switch operation. Our report discusses the mechanisms by which this mishap took place, and reviews the proper positions of the head, arm, thorax and safe depth of venipuncture for the placement of a CVC in neonates.
Anesthesia ; Arm ; Brachiocephalic Veins ; Cardiac Tamponade ; Central Venous Catheters ; Head ; Hemodynamics ; Hemothorax ; Humans ; Hypogonadism ; Infant, Newborn ; Mitochondrial Diseases ; Operating Rooms ; Ophthalmoplegia ; Phlebotomy ; Pneumothorax ; Subclavian Vein ; Thorax ; Thrombosis

Objective: Early identification of dysphagia after stroke helps in preventing aspiration pneumonia. However, data are limited regarding the effectiveness of formal dysphagia screening for reducing the risk of aspiration pneumonia.The current study evaluates the effectiveness of formal dysphagia screening in stroke patients, to prevent future episodes of aspiration pneumonia. Methods: The stroke registry of a tertiary hospital was retrospectively reviewed. We compared clinical variables and the incidence of aspiration pneumonia of patients hospitalized between 2014 and 2015 after formal screening was implemented, and patients hospitalized in 2011 when no established dysphagia screening protocol was in place.Additionally, we identified the incidence of pneumonia according to stroke severity, and evaluated the association with results obtained for incidence of pneumonia and dysphagia screening. Results: A total of 2,902 patients were identified to have suffered acute stroke (2,018 who underwent formal dysphagia screening; 884 without screening). Patients with formal dysphagia screening developed pneumonia less frequently than patients not administered screening (1.3% with formal screening vs. 3.4% no formal screening, P＜0.001).Pneumonia was significantly lower in patients with moderate and severe stroke who underwent formal dysphagia screening. Furthermore, failure of the dysphagia screening test, presentation with severe dysarthria, and conditions where dysarthria could not be evaluated, were independent predictors of pneumonia among patients who underwent formal screening. Conclusion Our findings demonstrate the association of formal dysphagia screening with reduced risk of poststroke aspiration pneumonia, and indicates the efficacy of the procedure in identifying patients at higher risk of contracting pneumonia.

BACKGROUND: In patients with HIV, CD4+ T cell count and viral load are the main laboratory tests performed to assess clinical management. However, they require extensive resources. In this study, we aimed to determine whether hematological parameters measured using a hematology analyzer are useful as surrogate markers of CD4+ T cell count and viral load in HIV-infected patients. METHODS: Peripheral blood samples were obtained from 14 HIV-naïve, 105 HIV-treated, and 103 uninfected individuals. Hematological parameters were measured using the ADVIA 2120i hematology analyzer (Siemens Healthcare Diagnostics, USA). RESULTS: In HIV-naïve and -treated patients, the percentage of large unstained cells (%LUCs) was 2.5±1.6% and 1.9±0.7%, respectively, compared to 1.6±0.5% in HIV-uninfected controls. The %LUCs was higher in HIV patients with low CD4⁺ T cell count below 200/μL (2.4±1.0%) or high viral load ≥200 copies/mL (2.4±0.8%) than in other infected groups. Significant differences in lymphocyte count were observed between the HIV-naïve (1.5±0.6×10⁹/L) and uninfected (2.0±0.6×10⁹/L) groups as well as between HIV patients with CD4⁺ T cells ≥500/μL (2.5±0.6×10⁹/L) and other infected groups. Neutrophil count varied between high viral load (3.0±1.4×10⁹/L) and low viral load (3.7±1.3×10⁹/L) groups. The CD4⁺ T cell count correlated with lymphocyte count (r=0.642, P<0.0001) and %LUCs (r=-0.287, P=0.002). CONCLUSIONS: %LUCs, lymphocyte count, and neutrophil count are probable surrogate markers of CD4⁺ T cells and viral load.
Biomarkers ; Cell Count ; Delivery of Health Care ; Disease Progression* ; Hematology ; HIV Infections* ; HIV* ; Humans ; Lymphocyte Count ; Neutrophils ; T-Lymphocytes ; Viral Load

BACKGROUND: Eruptive pseudoangiomatosis (EPA) is a rare, benign, spontaneously regressing childhood exanthem. It is characterized by the sudden onset of several bright red angioma-like papules surrounded by pale halos with a distinct histopathology from true angiomas. OBJECTIVE: This study was performed to evaluate the clinical and histopathologic characteristics of EPA occuring in adults. METHODS: Ten adult patients who visited Pusan National University Hospital and Mok Hye-Soo . Jang Ho-Sun Dermatology Clinic from March 2005 to September 2006 were evaluated. We prospectively evaluated the sex, age, onset season, past medical history including immunosuppressive abnormalities, systemic disorders and other diseases including allergies. We also investigated the relations of mosquito biting, patients' occupations and outdoor activities to occurrence of EPA. In addition, simultaneous occurrence in family members, the clinical, histopathologic, laboratory findings, disease courses and responses to treatment were evaluated. Based on medical records, photographs and pathologic slides, we retrospectively diagnosed another 20 EPA patients suspected as insect bite from October 2003 to March 2005. The same questions were inquired as for the 10 patients who prospectively underwent evaluation. RESULTS: In the study, female predominance (76.7%) was observed and the average age of onset was 54.2 years. Interestingly, there was no child patient during the period of study. Multiple, 2~5 mm sized, red angiomatous papules surrounded by pale halos occurred on exposed areas such as the arms (86.7%), legs (50%), and face (46.7%), although it could also occur to a non-exposed area. EPA occuring in adults usually appeared in summer (80%). The mean disease duration was 3.4 weeks. Although EPA spontaneously regressed, it had the potential of recurrence (46.7%). Histopathologic findings showed dilated dermal blood vessels without the evidence of increase in numbers, and perivascular lymphocytes infiltration. Inside the lumen of dermal blood vessels, plump endothelial cells were found. CONCLUSION: EPA occuring in adults usually happened to exposed sites in summer, so it can be misdiagnosed as insect bite. We suggest that dermatologists should be concerned about EPA in adults and conduct further investigation to have a better understanding of the disease.
Adult ; Age of Onset ; Arm ; Blood Vessels ; Busan ; Child ; Culicidae ; Dermatology ; Endothelial Cells ; Exanthema ; Female ; Hemangioma ; Humans ; Hypersensitivity ; Insect Bites and Stings ; Leg ; Lymphocytes ; Medical Records ; Occupations ; Prospective Studies ; Recurrence ; Retrospective Studies ; Seasons

PURPOSE: This study was conducted in order to investigate the effect of Sargassum confusum extracts on the reduction of body fat for eight weeks in overweight women (BMI > or = 23 kg/m2). METHODS: Subjects were classified by double-blind randomized trial as the control group (C group, n = 14) and the Sargassum confusum extract supplementation group (SC group, n = 16), which consumed 12 tablets per day. Questionnaires related to their health status were assessed twice (week 0 and week 8). Their dietary intake status was evaluated by 24-recall method and body compositions were measured using a bioelectrical impedance analyzer. In addition, we assessed the anti-obesity effect and the occurrence possibility of health risk factors during the supplementation periods by hematological and clinical analysis of blood. RESULTS: Waist circumference and body fat (%) were significantly decreased in the SC group. Serum leptin level was also significantly decreased in the SC group. Defecation frequency was significantly increased in the SC group. The above results indicate that Sargassum confusum extract supplementation improves overweight on visceral fat and blood leptin level by increasing bowel movement. These results imply a decrease of health risk factors in overweight women. Seven subjects withdrew from the study due to adverse events; however, no differences regarding adverse events were observed between the control and treatment group. CONCLUSION: Therefore, Sargassum confusum extract is a plausible effective agent for body fat reduction in humans.
Adipose Tissue* ; Body Composition ; Defecation ; Electric Impedance ; Female ; Humans ; Intra-Abdominal Fat ; Leptin ; Overweight ; Surveys and Questionnaires ; Risk Factors ; Sargassum* ; Tablets ; Waist Circumference

Zonisamide (ZNS) has been proven as a safe, effective, and well-tolerated antiepileptic drug. We report an epilepsy patient who had a severe, dose-dependent, memory deficit after ZNS administration. A 65-year-old man visited our epilepsy clinic due to the occurrence of nocturnal convulsions. Despite the absence of seizures, he developed a severe impairment of verbal and visual memory functions after the increment of ZNS dosage from 200 mg/day to 300 mg/day. We substituted 1,000 mg/day valproic acid for ZNS. His cognitive performances were returned to original levels.
Aged ; Epilepsy ; Humans ; Isoxazoles ; Memory ; Memory Disorders ; Seizures ; Valproic Acid