No abstract available.
Child* ; Humans ; Interleukin-6* ; Nephritis* ; Purpura, Schoenlein-Henoch*

Small cell neuroendocrine carcinoma is a high-grade and poorly differentiated tumor typically presenting as primary pulmonary neoplasm. Extrapulmonary small cell carcinoma is rare. Primary small cell neuroendocrine carcinoma of the breast (SCNCB) is extremely rare, with an incidence of less than 0.1% of all breast cancers. Herein, we report imaging features of SCNCB incidentally diagnosed in a 58-year-old woman along with a literature review. The tumor was observed to be a round and circumscribed mass with rim enhancement, heterogeneous intra-tumoral enhancement, and peritumoral edema on MRI. The patient underwent breast-conserving surgery with adjuvant chemotherapy and radiation therapy. No tumor recurrence was observed during the 2-year follow-up visits after surgery.

Heterotopic pregnancy occurs when an intrauterine pregnancy co-exists with an ectopic pregnancy. It is a potentially fatal condition, rarely occuring in natural conception cycle. But its incidence is increased since the rise in PID, pelvic surgery, IUD, and advent of assisted reproductive technology involving use of superovulatory drugs and/or in vitro-fertilization. We present a case of intrauterine twin pregnancy and right tubal pregnancy following treatment with in vitro-fertilization. The right tubal pregnancy was diagnosed after rupturing at 6th gestational weeks, and resected via laparoscopy. And healthy twin babies were delivered without complication at 38th gestational week. So we report this case with a brief review of the literatures.
Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Pregnancy, Twin ; Reproductive Techniques, Assisted

The antiarrhythmic efficacy if low dose amiodarone treatment was studied in 30 cases of ventricular premature beats(VPBs). Amiodarone was administered 600mg daily in three divided doses for for initial 7-10 days as loadihg dosage,then 100-200mg once daily as maintenance. The results obtained were as follow : 1) The complete control of VPBs was achieved by amiodarone treatment in 90%, 27cases of 30 cases(all 11 cases with simple VPBs and 16 cases of the remainders with complex VPBs). 2) The QT interval and QTc were significantly prolonged, whereas heart rate was reduced significantly after amiodarone treatment. 3) In 27 cases of responder, the frequency of VPBs began to decrease overtly 2-3 days after amiodarone administration, then relatively stablized in 6 days, and complete cnotrol of VPBs was achieved in all cases about 10 days after treatment. 4) No significant side-reaction was observed except the decrease of serm T3 level after treatment.
Amiodarone* ; Arrhythmias, Cardiac* ; Heart Rate ; Selective Estrogen Receptor Modulators

A 31-year-old male who had been treated for Churg-Strauss syndrome (CSS) presented with sudden onset of dysarthria. Brain magnetic resonance imaging (MRI) showed acute multifocal bilateral cerebral infarctions suggesting embolic causes. Cardiac MRI showed dilated cardiomyopathy with severe biventricular dysfunction with intracardiac thrombi, and multiple high signal intensity spots in myocardium of the left ventricle with multifocal delayed enhancement suggesting multifocal myocarditis due to small vessel vasculitis associated with CSS. After anticoagulation therapy, treatments for heart failure, and immunosuppressive therapy including parenteral steroids and cyclophosphamide to control CSS, the symptoms and signs of heart failure and cardiac function of the patient were improved. Considering the pathophysiologic mechanism of cardiac involvement in CSS, immunosuppressive therapy to control the disease activity of CSS should be taken into account, besides usual management for heart failure.
Adult ; Brain ; Cardiomyopathy, Dilated* ; Cerebral Infarction ; Churg-Strauss Syndrome* ; Cyclophosphamide ; Dysarthria ; Heart Failure ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Male ; Myocarditis ; Myocardium ; Prognosis ; Steroids ; Vasculitis

Embolization of the occlusion device after percutaneous closure of atrial septal defect (ASD) is a potential disastrous complication. The usual site of embolization is the right side of the heart including pulmonary artery, but the device embolization to the extracardiac aorta is extremely rare. Here, we report a successful percutaneous retrieval case of the embolized Amplatzer Septal Occluder (ASO) to the descending thoracic aorta after the successful deployment of two ASO devices in a patient with double ASD. Competition between the two devices to obtain a stable position may be an explanation for the migration of ASO.
Adult ; Device Removal/*methods ; Embolism/*etiology/*surgery ; Heart Septal Defects, Atrial/*complications/surgery ; Humans ; Male ; Septal Occluder Device/*adverse effects ; Treatment Outcome

Stress cardiomyopathy (SCMP) is characterized by a transient left ventricular dysfunction associated with apical ballooning and compensatory hyperkinesias of the basal segments after emotional or physical stress, but inverted or mid-ventricular variants of SCMP have also been described. Although catecholamine excess has been suggested as a possible pathophysiologic mechanism of SCMP, the etiology of SCMP is still unknown. Here, we report a case of inverted type of SCMP with clinical presentation mimicking acute coronary syndromes. The cause or precipitating stressor was unclear initially, but pheochromocytoma has been demonstrated as a cause of SCMP during clinical follow-up at out-patient clinic in the present case. Catecholamine-producing tumors should be included in the evaluation or management of SCMP, even though initial clinical manifestations are not suggestive for pheochromocytoma.
Acute Coronary Syndrome ; Cardiomyopathies ; Follow-Up Studies ; Humans ; Hyperkinesis ; Outpatients ; Pheochromocytoma* ; Takotsubo Cardiomyopathy* ; Ventricular Dysfunction, Left

Previous studies have shown that tricuspid regurgitation (TR) can be developed in patients with atrial fibrillation (AF) due to annular dilatation. This study aimed to investigate the incidence and predictors of the progression of TR in patients with persistent AF. A total of 397 patients (66.9±11.4 years, 247 men; 62.2%) with persistent AF were enrolled between 2006 and 2016 in a tertiary hospital, and 287 eligible patients with follow-up echocardiography were analyzed. They were divided into two groups according to TR progression (progression group [n=68, 70.1±10.7 years, 48.5% men] vs. non-progression group [n=219, 66.0±11.3 years, 64.8% men]). Among 287 patients in the analysis, 68 had worsening TR severity (23.7%). Patients in the TR progression group were older and more likely to be female. Patients with left ventricular ejection fraction ＜50% were less frequent in the progression group than those in the non-progression group (7.4% vs. 19.6%, p=0.018). Patients with mitral valve disease were more frequent in the progression group. Multivariate analysis with COX regression demonstrated independent predictors of TR progression, including left atrial (LA) diameter ＞54 mm (HR 4.85, 95%CI 2.23-10.57, p＜0.001), E/e’ (HR 1.05, 95%CI 1.01-1.10, p=0.027), and no use of antiarrhythmic agents (HR 2.20, 95%CI 1.03-4.72, p=0.041). In patients with persistent AF, worsening TR was not uncommon. The independent predictors of TR progression turned out to be greater LA diameter, higher E/e’, and no use of antiarrhythmic agents.

PURPOSE:The aim of this study was to compare the perinatal outcome of preterm infants born to severe pregnancy induced hypertension (PIH) mothers according to the presence or absence of HELLP syndrome. METHODS:A retrospective analysis was done in 314 premature live infants born to 302 severe PIH mothers who admitted at Chonnam National University Hospital from January 2002 to May 2008. Maternal and neonatal characteristics and their outcome were compared between the groups. Statistical analysis was performed by SPSS program using Student's t test, Chi-square analysis, Fisher's exact test, and logistic regression test. RESULTS:Among 302 severe PIH mothers (single pregnancy 270, twin pregnancy 32), 84 (27.8%) were associated with HELLP syndrome. Among their 334 fetuses (singleton 270, twins 64), total 20 (6.0%) resulted in fetal death and the rate of fetal death was higher in HELLP syndrome group compared to the control group (12.2% vs. 3.4%, P=0.006). Among the 314 live premature infants, 86 (27.4%) were born to severe PIH with HELLP syndrome (study group) and 228 (72.6%) were born to the control group. There were no differences in maternal and neonatal characteristics, maternal death, neonatal morbidity and neonatal death between the groups. However, the duration of mechanical ventilation (12.2+/-14.5 vs. 7.6+/-9.9 days, P=0.019) and hospitalization (25.6+/-12.3 vs. 13.0+/-10.5 days, P=0.013) were longer in the study group. CONCLUSION:Most of severe PIH mothers complicated by preterm birth, and especially combined with HELLP syndrome showed higher fetal and perinatal death than without HELLP syndrome. Moreover, their live-born premature infants needed longer duration of mechanical ventilation and hospitalization. These results indicate that careful fetal monitoring and delivery with the co-operations of obstetricians and neonatologists is essential to improve the perinatal outcome.
Female ; Fetal Death ; Fetal Monitoring ; Fetus ; HELLP Syndrome ; Hospitalization ; Humans ; Hypertension, Pregnancy-Induced ; Infant ; Infant, Newborn ; Infant, Premature ; Logistic Models ; Maternal Death ; Mothers ; Pregnancy ; Pregnancy, Twin ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Twins

PURPOSE: We evaluated the usefulness of Re-188 sulfur colloid for radiation synovectomy and therapy of intraperitoneal metastasis. MATERIALS AND METHODS: We investigated the labeling efficiency of Re-188 sulfur colloid on various conditions. The stability of Re-188 sulfur colloid was observed at room temperature for 24 h and in human serum and synovial fluid for 72 h. The particle size distribution of Re-188 sulfur colloid was rneasured by filtering with various pore size filters. Animal experiment was performed in mice and rabbits. RESULTS: The labeling efficiency of Re-188 sulfur colloid was 64,5+/-5.8% (n=5) at the conditions of sodium thiosulfate 40 mg, EDTA Na2.2H2O 0,8 mg, KReO4 0.8 mg at pH l. After purification, the radiochemical purity was higher than 99%. The stability of Re-188 sulfur colloid was high (>99%) at room temperature for 24 h and in human serum and synovial fluid for 72 h. The particle size distribution of Re-188 sulfur colloid was 0.3% (<1 micrometer), 11.2% (1~5 micrometer), 35.8% (5~10 micrometer) and 52.8% (>10 micrometer). In mice, 1 h postinjection of Re-188 sulfur colloid into tail vein, uptakes in lung, liver and muscle were 37.30+/-5.36, 32.33+/-5.79, 6.60+/-0.02% 1D/organ respectively. After I.p. injection in rnice, the uptakes of extraperitonial organs of Re-188 sulfur colloid at 1 and 24 h were 0.1+/-0.1, 0.4+/-0.1% ID/organ, and the excretions through urine and feces (~70 h) were low (2.68+/-0.80, 0.95+/-0.17%). When Re-188 sulfur colloid was injected to synovial space of rabbit, the uptake in other organs except knee was very low. CONCLUSION: Re-188 sulfur colloid showed high labeling efficiency, stability and potency for clinical use.
Animal Experimentation ; Animals ; Colloids* ; Edetic Acid ; Feces ; Humans ; Hydrogen-Ion Concentration ; Knee ; Liver ; Lung ; Mice ; Neoplasm Metastasis ; Particle Size ; Rabbits ; Sodium ; Sulfur ; Synovial Fluid ; Veins