The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation

BACKGROUND: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. METHODS: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. RESULTS: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. CONCLUSIONS: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.
Arm ; Arthroplasty ; Arthroscopy ; Asian Continental Ancestry Group ; Body Mass Index ; Female ; Follow-Up Studies ; Hematologic Tests ; Humans ; Humerus ; Incidence* ; Liver ; Male ; Pilot Projects* ; Pulmonary Embolism ; Shoulder* ; Thrombosis ; Ultrasonography ; Veins ; Venous Thromboembolism* ; Venous Thrombosis

Forty cases of infiltrating duct carcinoma of the breast were examined immunohistochemically for expression of TGF-beta and angiogenesis in order to analyze significant correlation with prognostic parameters including tumor size, axillary lymph node metastasis, clinical stage, histologic grade, estrogen receptor and progesterone receptor status. The TGF-beta expression was observed in tumors center and advancing edges of tumors. To determine microvessel density for angiogenesis, we stained endothelial cells for Factor VIII related antigen and counted microvessel within tumor. The results were as follows: 1) The strong immunohistochemical expression of TGF-beta and higher counts of microvessels were observed in advancing edges of tumors (p<0.05). 2) The TGF-beta expression in the advancing edges of tumors was closely related to clinical stage and presence of axillary lymph node metastasis (p<0.05). 3) The mean microvessel counts were significantly higher in tumors from patients with axillary lymph node metastasis and increased with increasing clinical stage (p<0.05). 4) The TGF-beta expression was not related to histologic grade, estrogen receptor and progesterone receptor status(p>0.05). Therefore, the results suggested that the TGF-beta expression and angiogenesis in infiltrating duct carcinoma of the breast may play an important part in prognostic factors, closely related to the lymph node metastasis and clinical stage.
Neoplasm Metastasis

No abstract available.
Carcinoma, Hepatocellular* ; Collagen* ; Liver Cirrhosis* ; Liver*

PURPOSE: To compare the efficacy, predictability, safety, and stability of Laser epithelial keratomileusis (LASEK) with conventional Laser in situ keratomileusis (LASIK) for correction of low to moderate myopia. METHODS: In this study, LASIK-treated 31 eyes of 17 patients and LASEK-treated 33 eyes of 17 patients were followed for 6 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, IOP, topography, keratometry, pachymetry and specular examination were performed. RESULTS: Postoperative mean UCVA was logMAR 0.02+/-0.09 in LASIK group and logMAR 0.01+/-0.09 in LASEK group. Postoperative mean refraction was 0.04+/-0.36D in LASIK group and 0.07+/-0.28D in LASEK group and there was no significant difference between 2 groups (P>0.05). 71.0%(22 of 31) of LASIK eyes and 81.8%(27 of 33) of LASEK eyes had an uncorrected visual acuity of 20/20 or better at 6 months after surgery. 87.1%(27 of 31) of LASIK eyes and 97.0%(32 of 33) of LASEK eyes achieved predictability within +/-0.5D at 6 months follow up. There was no decrease in best-corrected visual acuity of two Snellen lines or more in both groups. CONCLUSIONS: In this study, there was no difference in postoperative mean UCVA and mean refraction in LASIK and LASEK group. However, LASEK group had better results in UCVA of more than 20/20 and predictability but there was no significant difference between 2 groups.
Follow-Up Studies ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ* ; Myopia* ; Visual Acuity

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited syndrome with characteristic clinical and radiological manifestations. Many reports on MEN1 have been published; however, no cases of radiologically diagnosed MEN1 have been reported. Therefore, we report on a radiologically diagnosed case of MEN1 with clinical symptoms of gastroduodenal ulcer.
Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 1 ; Peptic Ulcer ; Pituitary Neoplasms

Thyrotoxic periodic paralysis (TPP) is a rare disease of muscle paralysis associated with hypokalemia and thyrotoxicosis. Hypokalemic periodic paralysis can be caused by potassium channelopathy or thyroid dysfunction. Thyrotoxic hypokalemic periodic paralysis is far more common in Asian males aged between 20 to 40 years and rare in children and adolescents. Clinical symptoms with motor paralysis were recovered just after treatment of potassium, propranolol, and methimazole. However, thyroid function tests were not normalized until 3 month treatment of methimazole and propranolol. We report a 17-year-old patient diagnosed with Graves' disease with TPP. Thyroid function test should including in periodic paralysis patient's evaluation.
Adolescent ; Aged ; Asian Continental Ancestry Group ; Channelopathies ; Child ; Graves Disease ; Humans ; Hyperthyroidism ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Male ; Methimazole ; Muscles ; Paralysis ; Potassium ; Propranolol ; Rare Diseases ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis

PURPOSE: In advanced prostate cancer, malignant cells generally tend to spread into the bone, and metastasis into nonregional lymph nodes (NRLNs) at the time of initial diagnosis is relatively rare. We investigated the prognostic significance of NRLN metastasis in patients receiving hormonal therapy and chemotherapy. MATERIALS AND METHODS: From February 2005 to August 2011, we identified 105 patients who had metastatic prostate cancer. First, we assessed the prognostic effect of NRLN metastasis on the prostate-specific antigen response through logistic regression and the progression-free time to castration-resistant prostate cancer (CRPC) by using the Cox proportional hazard regression model. Second, we investigated the prognostic influence of NRLN metastasis on the chemotherapy response through logistic regression and on cancer-specific survival of CRPC patients receiving chemotherapy by using Cox proportional analysis. RESULTS: Of these 105 patients, 12 patients (11.4%) had only NRLN metastases without bone metastases. Progression-free time to CRPC was significantly less in patients with NRLN metastases by Cox proportional hazard regression multivariate analysis (p=0.020). However, NRLN metastasis was not an independent factor for predicting the response to chemotherapy in CRPC patients, and NRLN metastasis did not reduce cancer-specific survival in the multivariate analysis. CONCLUSIONS: Twelve (11.4%) of 105 patients with NRLN metastases had lymph node metastases without bone metastases. In addition, NRLN metastasis was a significant prognostic factor for predicting reduced progression-free time to CRPC. Thus, although we speculate that prostate cancer with NRLN metastasis exhibits unique tumor biology, additional molecular and genetic studies are needed.
Biology ; Humans ; Logistic Models ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms

Acute recurrent pancreatitis (ARP) refers to a clinical condition characterized by repeated episodes of acute pancreatitis, diagnosed retrospectively after at least the second episode of acute pancreatitis. It is still controversial that acute pancreatitis can progress to chronic pancreatitis, and acute, acute recurrent and chronic pancreatitis is a continuum of disease. The causes of ARP can be divided into mechanical, hereditary and metabolic factor. Despite recent advances in diagnostic technologies, the etiology of ARP still remains unknown in up to 30% of cases. Especially in recurrent episode of idiopathic pancreatitis, a clinician should be considered not only the common causes of ARP, such as gallstone disease and alcohol, but also rare causes of ARP. The common causes of 'idiopathic' recurrent pancreatitis are microlithiasis, sludge, sphincter of oddi dysfunction, pancreas divisum and hereditary pancreatitis. Various treatment options, such as cholecystectomy, endoscopic sphincterotomy, medical and surgery can be applied according to the identified etiology of ARP and treatment should be individualized. Currently, endoscopic treatment is increasingly performed and served as a curative treatment strategy. The medical treatment can be an option in microlithiasis and sludge, but it has limitation in terms of systemic side effect, efficacy and lack of long term outcome. Endoscopic treatment should be considered in selected patients with identifiable cause, and post procedural complication should be considered before endoscopic treatment.
Cholecystectomy ; Diagnosis ; Gallstones ; Humans ; Pancreas ; Pancreatitis* ; Pancreatitis, Chronic ; Retrospective Studies ; Sewage ; Sphincter of Oddi Dysfunction ; Sphincterotomy, Endoscopic

Lateral femoral cutaneous neuropathy occurring during spinal surgery is frequently related to iliac bone graft harvesting, but meralgia paresthetica (MP) can result from the patient being in the prone position. Prone position-related MP is not an uncommon complication after posterior spine surgery but there are only few reports in the literature on this subject. It is usually overlooked because of its mild symptoms and self-limiting course, or patients and physicians may misunderstand the persistence of lower extremity symptoms in the early postoperative period to be a reflection of poor surgical outcome. The authors report a case of prone position-related MP after posterior lumbar interbody fusion at the L3-4 and reviewed the literature with discussion on the incidence, pathogenesis, and possible risk factors related to this entity.
Humans ; Incidence ; Lower Extremity ; Nerve Compression Syndromes ; Postoperative Period ; Prone Position ; Risk Factors ; Spine ; Transplants