No abstract available.
Herpesvirus 3, Human* ; Korea*

Eosinophilia accompanied by eosinophilic invasion and organ dysfunction may develope idiopathic hypereosinophilic syndrome. Any organ can be involved including bone marrow, lung, skin, heart, gastrointestinal tract and nervous system. Cough, dyspnea, pleural effusion or chest pain are common pulmonary manifestation, and they may be attributed to parenchymal infiltration, pulmonary embolism or heart failure. We report a 43-year-old woman with idiopathic hypereosinophilic syndrome involving bone marrow, skin, and lung. The patient developed acute dyspnea and chest pain. High resolution CT demonstrated multiple wedge-shaped segmental involvement with pleural effusion thought to be a pulmonary infarction or heart failure. Echocardiography could not find any abnormality. Lung biopsy showed interstitial eosinophilic infiltration with increased eosinophils in BAL fluid. She was treated with high dose corticosteroid and hydroxyurea. Within few days, most of her symptoms disappeared and chest radiography nearly cleared up.
Adult ; Biopsy ; Bone Marrow ; Chest Pain ; Cough ; Dyspnea ; Echocardiography ; Eosinophilia ; Eosinophils ; Female ; Gastrointestinal Tract ; Heart ; Heart Failure ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Lung ; Nervous System ; Pleural Effusion ; Pulmonary Embolism ; Pulmonary Infarction ; Radiography ; Skin ; Thorax

Primary hyperparathyroicism is a state of hypersecretion of PTH by the parathyroid. The etiology has not been established. The three possible etiologies of piimary hyperparathyroidism and incidences are adencena(83%), hyperplasia(15%), and carcinoma(1~2%). Parathyroid carcinoma usually presents in the fourth decades. The hallmark preoperative signs are hypercalcemia(serum calcium 15mg/dl). Palpable neck mass and bane and renal disease. Patients may present with multiple signs and syrnptoms, including recurrent nephrolithiasis, peptic ulcers, mental change, less frequently, extensive bone resorption. However, with greater awareness of the disease and wider use of screening tests, including blood calcium determinations, the diagnosis is frequently made in patients who have no symptoms and minimal, if any, signs of the disease ather than hypercalcemia and elevated levels of parathyroid Hormone. An 38-years-old woman was admitted to the hospital due to pain on the left knee joint. We experienced full-brown symptom pertaining to hyperpara- thyroidism. Thus we report a case herein and also discuss clinical anifestation, histologic features and treatment.
Bone Resorption ; Calcium ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Incidence ; Knee Joint ; Mass Screening ; Neck ; Nephrolithiasis ; Parathyroid Hormone ; Parathyroid Neoplasms ; Peptic Ulcer ; Thyroid Gland

Acute myocardial infarction (MI) is a cardiovascular disease with high mortality. Acute MI is usually divided into ST-segment elevation MI (STEMI) and non ST-segment elevation MI (NSTEMI) based on the electrocardiogram (ECG). NSTEMI is often misdiagnosed in patients presenting to emergency departments with acute chest pain because its clinical course varies and is atypical compared to STEMI. The symptoms can be vague and the ECG is often not diagnostic. In this setting, an early accurate diagnosis and risk stratification could improve the mortality of patients with NSTEMI. Cardiac biomarkers such as high-sensitivity cardiac troponin (hs-cTn) help to diagnose NSTEMI. Serial hs-cTn assays should be considered to differentiate other conditions, especially in an ambiguous clinical situation. If acute MI is strongly suspected based on the symptoms, ECG, and cardiac biomarkers, catheterization laboratory activation should be timely considered to evaluate the coronary arteries and possible revascularization with percutaneous or surgical strategies depending on risk factors. After successful revascularization, antianginal medications, risk factor control, and early recognition of heart failure are essential to improve the cardiovascular prognosis.

BACKGROUND: The advantages of thallium (Tl)-201 whole body scan in follow-up of patients with thyroid carcinoma include no need to discontinue thyroid hormone replacement, a shorter period of time between injection and imaging, a lower radiation dose, and preservation of affinity for subsequent therapeutic dose of 131I. To evaluate the reliability of whole body scintigraphy using Tl-201 in postoperative follow-up of thyroid carcinoma, this procedure was performed in patients after total thyroidectomy for thyroid carcinoma. The results were compared with those of 131I scintigraphy. METHODS: One hundred nineteen cases (119 patients) with a median age of 43 years (range, 20 85 years) were included in the study. After optimal endogenous thyroid-stimulating hormone stimulation (>50 mIU/mL), 131I (4 mCi) scan and Tl 201 (3 mCi) scan were simultaneously performed. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10 ng/mL) were detected, high dose (150~200mCi) 131I was administered as therapy and then whole body scans were performed repeatedly after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose 131I scan findings. RESULTS: In 12 patients, ll-201 scan revealed positive accumulations which were not found on 131I scan, of whom 9 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 7 cases showed pathologic findings (1 lung, 2 lymph node, 1 bone, and 2 lung and lymph node metastasis, and 1 false positive accumulation of thallium). Metastasis were confirmed histologically in 2 and radiologically in 5 cases. Negative Tl-201 scans, despite of positive 131I scans, occurred in 20 patients, of whom 6 had abnormal thyroglobulin levels. Seventeen cases were interpreted to have thyroid remnant, 2 cases were diagnosed to have thyroid carcinoma metastasis (1 lung, 1 lung and lymph node), and 1 case was not confumed. CONCLUSION: These results suggest that 131I scan is superior to 11-201 scan for detection of residual or metastatic differentiated thyroid carcinoma. However, the use of combined modalities may provide a higher diagnostic yield. TI-201 scan can be useful especially in cases in which 'I scan is negative despite of abnormal thyroglobulin levels.
Follow-Up Studies* ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Radionuclide Imaging* ; Thallium ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Whole Body Imaging

We successfully treated a case of in-stent restenosis, which presented on 6 occasions, resulting in frequent acute inferior wall myocardial infarctions, using a drug-eluting stent. This case demonstrates that drug-eluting stents offer the promise of an effective treatment for frequent in-stent restenosis, and importantly, that the underexpansion of a drug-eluting stent heightens the risk of acute or subacute stent thrombosis.
Coronary Restenosis ; Coronary Vessels* ; Drug-Eluting Stents* ; Inferior Wall Myocardial Infarction* ; Myocardial Infarction ; Stents ; Thrombosis

Supratentorial hemangioblastomas are rare tumors. The first documented case of congenital cystic supratentorial hemangiblastoma associated with intracystic hemorrhage is presented; it occurred in a 38-day-old male infant.
Hemangioblastoma* ; Hemorrhage* ; Humans ; Infant ; Male

OBJECTIVE: To comparatively investigate the expression of several integrins in specimens of human bone metastases and degenerative bone tissue. METHODS: Degenerative cancellous tissue was obtained from a sample of human degenerative spine. Thirteen human specimens were obtained from metastatic spine tumors, whose primary cancer was colon cancer (n=3), hepatocellular cancer (n=3), lung cancer (n=4), and breast cancer (n=3). The expression of vimentin and integrins alphav, beta1, and beta3 was assessed in metastatic and degenerative specimens by immunohistochemistry and real-time reverse transcription-polymerase chain reaction (qRT-PCR). RESULTS: Immunohistochemical staining showed that vimentin and integrin alphav was broadly expressed in all tissues examined. By contrast, integrin beta1 was weakly expressed only in 38.4% (5/13) of tissues. Integrin beta3 was consistently negative in all cases examined. qRT-PCR analysis showed that vimentin gene expression was higher in all metastatic specimens, as compared to degenerative bone. The gene expression of integrin alphav in breast specimen was significantly higher than others (p=0.045). The gene expression of integrin beta1 was also higher in all metastatic specimens than in degenerative bone tissue. The gene expression of integrin beta3 was variable. CONCLUSION: Spinal metastatic tumors have mesenchymal characteristics such as increased expression of vimentin. The increased expression of integrin alphav and beta1 in spine metastatic tumors suggests that adhesive molecules such as integrin may have implications for the prevention of spine metastasis.
Adhesives ; Antigens, CD29 ; Bone and Bones ; Breast ; Breast Neoplasms ; Colonic Neoplasms ; Gene Expression ; Humans ; Immunohistochemistry ; Integrin alphaV ; Integrin beta3 ; Integrins* ; Liver Neoplasms ; Lung Neoplasms ; Neoplasm Metastasis ; Spine* ; Vimentin*

BACKGROUND AND OBJECTIVES: Apical hypertrophic cardiomyopathy (AHCM) is an uncommon variant of hypertrophic cardiomyopathy with a relatively benign course. However, the prognostic factors of AHCM-particularly those associated with coronary artery disease (CAD) and its anatomical subtypes-are not well known. SUBJECTS AND METHODS: We enrolled 98 consecutive patients with AHCM who underwent coronary angiography or coronary computed tomography scanning at two general hospitals in Korea from January 2002 to March 2012. Patient charts were reviewed for information regarding cardiovascular (CV) risk factors, symptoms, and occurrence of CV events and/or mortality. We also reviewed echocardiographic data and angiography records. RESULTS: The mean age at the time of enrollment was 61.45+/-9.78 years, with female patients comprising 38.6%. The proportions of mixed and pure types of AHCM were 34.4% and 65.6%, respectively. CAD was found in 31 (31.6%) patients. The mean follow-up period was 53.1+/-60.7 months. CV events occurred in 22.4% of patients, and the mortality rate was 5.1%. The mixed-type was more frequent in CV event group although this difference was not statistically significant (50% vs. 30%, p=0.097). The presence of CAD emerged as an independent risk factor for CV events in univariate and multivariate Cox regression analysis after adjusting for other CV risk factors. CONCLUSION: Coronary artery disease is an independent risk factor for CV events in AHCM patients. However, AHCM without CAD has a benign natural course, comparable with the general population.
Angiography ; Cardiomyopathy, Hypertrophic* ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Echocardiography ; Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Korea ; Mortality ; Multidetector Computed Tomography ; Prognosis* ; Risk Factors

BACKGROUND AND OBJECTIVES: Obesity is a cause of cardiac dysfunction. We analyzed the change of diastolic function with the increase of the body mass index (BMI) for the early detection of cardiac dysfunction in overweight and obese patients. To analyze the diastolic function, we measured the mitral valve early and late diastolic inflow velocities with performing Doppler studies (E, A) and the early and late mitral annulus velocities with performing tissue Doppler studies (E', A'). SUBJECTS AND METHODS: From January 2005 to October 2007, 2,684 cases were enrolled in this study. The patients had a normal cardiac size, normal systolic function, no regional wall motion abnormalities and no significant valve disease. Those patients with a history of congenital heart disease, renal failure and congestive heart failure were excluded. The BMI was checked and Doppler echocardiographic analysis, including tissue Doppler, was done. RESULTS: The left ventricle (LV) mass index (normal: 89.1+/-19.1, overweight: 95.7+/-18.4, obese: 97.2+/-18.9 g/m2, p<0.01), and the E/E' (8.84+/-2.81, 10.02+/-3.03, 10.84+/-3.66, respectively, p<0.01) were higher, and the E (72.4+/-16.7, 68.6+/-16.0, 71.5+/-17.0 cm/sec, respectively, p<0.01), and E' (8.78+/-2.77, 7.27+/-2.19, 7.17+/-2.62 cm/sec, respectively, p<0.01) were lower in the overweight (BMI> or =25 kg/m2) and obese groups (BMI> or =30 kg/m2) than that of the normal group. On multiple logistic regression analysis, overweight was an independent risk factor for diastolic dysfunction with considering other risk factors such as hypertension, diabetes mellitus, age and gender. The risk of LV diastolic dysfunction was increased 2.13 times in the overweight group and 3.1 times in the obese group as compared with the normal group. CONCLUSION: With an increase of weight, diastolic function was worsened before the development of systolic dysfunction. This change was apparent in the overweight group. Tissue Doppler study on the mitral annulus is more sensitive to detect the change of diastolic function in overweight and obese patients.
Body Mass Index ; Diabetes Mellitus ; Echocardiography ; Echocardiography, Doppler ; Heart Diseases ; Heart Failure ; Heart Ventricles ; Humans ; Hypertension ; Logistic Models ; Mitral Valve ; Obesity ; Overweight ; Renal Insufficiency ; Risk Factors ; Ventricular Function ; Ventricular Function, Left