The clinical triad of relapsing iritis, ulcers of the mouth and genitalia was first described in 1939 by Hulusi Behcet. This entity, originally confined to the above triad of symptoms appears to be systemic disease manifested by skin lesion, thrombophlebitis, neurologic, cardiovascular or visceral symptoms. The vascular involvement in Behcet's syndrome has been reported since Mischima first described a case in 1961, four types of vascular lesion are freuqnetly observed most commonly on the inferior or superior vena cava. Treatments consist of anticoagulation and administering oral steroids. We report a case of SVC obstruction in 36 years old female patient with Behcet's syndrome.
Adult ; Behcet Syndrome* ; Female ; Genitalia ; Humans ; Iritis ; Mouth ; Skin ; Steroids ; Thrombophlebitis ; Ulcer ; Vena Cava, Superior

PURPOSE: To evaluate clinical usefulness of magnetic resonance angiography(MRA) as a diagnostic modality and for treatment planning of intracranial arteriovenous malformations(AVM). METHODS AND MATERIALS: In 14 patients with intracranial AVM which were confirmed by operations, radiologic studies and clinical evaluations, magnetic resonance imaging(MRI), MRA and conventional angiography(CA) were retrospectively reviewed with specific regards to nidus depiction, detectability of feeding arteries and draining veins, and number and anatomic consistency of these vessles. MRA was obtained by 3 D TOF, 2 D PC, and 3 D methods with adequate VENC selection. RESULTS: Nidus of AVM was well demonstrated in MRI and MRA, and no remarkable difference in detection and size estimation of nidus among MRI, MRA and CA except 2 cases of associated intracranial hemorrhage, in which 3 D PC MRA well depicted nidus that were not visualized on MRI because of subacute hemorrhage. Feeding arteries were well demonstrated on 3 D TOF and 3 D PC MRA. Dilated draining veins were well depicted on 3 D PC MRA by scannig with adequate VENC selection, and the results were no remarkable difference compared with the ones on CA. CONCLUSION: MRA of a consecutive scan after MRI is a excellent modality for evaluation and treatment planning of intracranial AVM, and possible substitutive method for CA except for radiotherapy or transarterial embolization.
Arteries ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Intracranial Hemorrhages ; Magnetic Resonance Angiography* ; Magnetic Resonance Imaging ; Radiotherapy ; Retrospective Studies ; Veins

PURPOSE: The purpose of this study was to assess the importance of prenatal care of the unmarried mothers. METHODS: Clinical characteristics of 131 newborn babies of unmarried mothers who were hospitalized at National Medical Center from April, 1998 to August, 1999 were compared to 131 newborn babies of married mothers who were also hospitalized at National Medical Center from June, 1999 to August, 1999 by reviewing their medical records retrospectively. RESULTS: Average age of mothers were 20.1+/-4.0 years in unmarried group and 28.8+/-4.4 years in married group, which was statistically significant. In unmarried group, the highest rate of maternal age (55.8%) was below 20 years of age, which showed increased tendency compared to previous report. In cesarean section rate, there was significant difference; 11.4% in unmarried group and 48.1% in married group. In the birth order, the first baby was most frequent in both groups. The sex ratio showed 1.78 : 1 with male preponderance in unmarried group and 1 : 1.02 with slight female preponderance in married group. In average gestational age, birth weight, height, head circumference, chest circumference, 5 minutes Apgar score, and admission rate, there was no significant difference. The unmarried group had more babies in postmaturity and meconium-stained condition. CONCLUSION: There was no significant difference in growth and morbidity rate between newborn babies from unmarried mothers who had prenatal care and those from married mothers.
Apgar Score ; Birth Order ; Birth Weight ; Cesarean Section ; Female ; Gestational Age ; Head ; Humans ; Illegitimacy* ; Infant, Newborn* ; Male ; Maternal Age ; Medical Records ; Mothers ; Pregnancy ; Prenatal Care ; Retrospective Studies ; Sex Ratio ; Single Person* ; Thorax

PURPOSE: To evaluate the clinical outcome of vertebroplasty, and to analyze the causes of poor results. MATERIALS AND METHODS: The radiological and clinical results of thirty-eight patients who were followed for more than one year after vertebroplasty for painful osteoporotic compression fractures were retrospectively analyzed. RESULTS: There were 10 recollapses and 6 fractures of adjacent vertebrae. Most of these occurred in the thoracolumbar junction (9 and 5 respectively). Pain was significantly improved in the immediate postoperative period, that is, from 9.3+/-0.7 points on a 10-point pain scale preoperatively to 2.0+/-0.7 points postoperatively (p<0.001). However, at the last follow-up, this was aggravated to 3.9+/-3.3, and eleven (29%) patients had moderate (5-7 points) or severe (8-10) pain. The main causes of aggravation of pain were recollapses (5 cases) and/or fractures of adjacent vertebrae (5). CONCLUSION: Vertebroplasty resulted in excellent relief from pain in the immediate postoperative period, but the more-than-one-year follow-up results were less satisfactory, and this was particularly true in the thoracolumbar junction. The possibility of recollapse or of fractures of adjacent vertebrae must be kept in mind.
Follow-Up Studies ; Fractures, Compression ; Humans ; Osteoporosis ; Postoperative Period ; Retrospective Studies ; Spine ; Vertebroplasty*

Polycythemia vera (PV) is a chronic myeloproliferative disease characterized by an increase in the total mass of red cells. Leukocyte and platelet counts are often elevated as well. The most common complication is thrombosis, which usually involves brain, heart, gastrointestinal tract, and kidneys, but rarely involves spleen. The cornerstone of therapy for this disease is phlebotomy and it is associated with an increased risk of thrombosis, especially for patients older than 70 years, those with a history of thrombosis, and those requiring an increased frequency of phlebotomy. Concurrent treatment with myelosuppressive agents decreases the risk of thrombotic complications.Recently we experienced a case of multiple splenic infarction in PV treated phlebotomy alone in a 42-year old woman who had complained of massive splenomegaly, left upper quadrant abdominal pain and fever. CT scan of abdomen showed multiple hypodense areas suggesting splenic infarction. She was managed with hydroxyurea and salicylate instead of phlebotomy and showed a clinical improvement with lowering the platelet count and reducing splenomegaly. PV with a assive splenomegaly is prone to thrombosis and phlebotomy in such patients may contribute to the thrombotic complications by increasing platelet counts. When it is necessary to lower the platelet count or reduce splenomegaly, hydroxyurea may be more useful than phlebotomy.
Abdomen ; Abdominal Pain ; Adult ; Brain ; Female ; Fever ; Gastrointestinal Tract ; Heart ; Humans ; Hydroxyurea ; Kidney ; Leukocytes ; Phlebotomy* ; Platelet Count ; Polycythemia Vera* ; Polycythemia* ; Spleen ; Splenic Infarction* ; Splenomegaly ; Thrombosis ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: As shown in previous studies, pentraxin 3 (PTX3) can be a useful inflammatory marker for metabolic syndrome and central obesity. Serum PTX3 levels are also an independent factor associated with visceral fat area. The aim of this study was to assess the role of PTX3 as an inflammatory maker in patients with central obesity undergoing primary percutaneous coronary intervention (PCI) following an ST-segment elevation myocardial infarction (STEMI). SUBJECTS AND METHODS: From December 2007 to June 2008, 40 subjects (mean age: 61+/-11 years, M : F=34 : 6) with STEMI who underwent primary PCI were enrolled. We determined waist circumference, waist/hip ratio, body mass index (BMI), and visceral and total fat area via fat computed tomography (FAT-CT), and compared them with serum PTX3 concentrations. RESULTS: The serum PTX3 concentration was closely related to FAT-CT-estimated visceral fat area (r=0.41, p<0.01) and total fat area (r=0.38, p=0.01), respectively. The serum PTX3 concentration was not related to waist circumference (r=0.27, p=0.20), waist circumference/hip ratio (r=0.25, p=0.16), BMI (r=0.04, p=0.80) and lipid profiles, respectively. Among the parameters determining metabolic syndrome, an increasing visceral fat area had the strongest association with PTX3 concentrations. CONCLUSION: In patients with STEMI, PTX3 is associated with central obesity and it is significantly and independently correlated with visceral fat area. FAT-CT-estimated visceral fat area is the most reliable factor associated with serum PTX3 levels in patients with STEMI and central obesity.
Body Mass Index ; C-Reactive Protein ; Humans ; Intra-Abdominal Fat ; Myocardial Infarction ; Obesity, Abdominal ; Percutaneous Coronary Intervention ; Serum Amyloid P-Component ; Waist Circumference

We demonstrate herein that silibinin, a polyphenolic flavonoid compound isolated from milk thistle (Silybum marianum), inhibits LPS-induced activation of macrophages and production of nitric oxide (NO) in RAW 264.7 cells. Western blot analysis showed silibinin inhibits iNOS gene expression. RT-PCR showed that silibinin inhibits iNOS, TNF-alpha, and IL1beta. We also showed that silibinin strongly inhibits p38 MAPK phosphorylation, whereas the ERK1/2 and JNK pathways are not inhibited. The p38 MAPK inhibitor abrogated the LPS-induced nitrite production, whereas the MEK-1 inhibitor did not affect the nitrite production. A molecular modeling study proposed a binding pose for silibinin targeting the ATP binding site of p38 MAPK (1OUK). Collectively, this series of experiments indicates that silibinin inhibits macrophage activation by blocking p38 MAPK signaling.
Adenosine Triphosphate ; Binding Sites ; Blotting, Western ; Gene Expression ; Macrophage Activation* ; Macrophages* ; MAP Kinase Signaling System ; Milk Thistle ; Models, Molecular ; Nitric Oxide ; p38 Mitogen-Activated Protein Kinases* ; Phosphorylation ; Tumor Necrosis Factor-alpha

Here, we show that radicicol, a fungal antibiotic, resulted in marked inhibition of inducible nitric oxide synthase (iNOS) transcription by the pancreatic beta cell line MIN6N8a in response to cytokine mixture (CM: TNF-alpha, IFN-gamma, and IL-1beta). Treatment of MIN6N8a cells with radicicol inhibited CM-stimulated activation of NF-kappaB/Rel, which plays a critical role in iNOS transcription, in a dose-related manner. Nitrite production in the presence of PD98059, a specific inhibitor of the extracellular signal-regulated protein kinase-1 and 2 (ERK1/2) pathway, was dramatically diminished, suggesting that the ERK1/2 pathway is involved in CM-induced iNOS expression. In contrast, SB203580, a specific inhibitor of p38, had no effect on nitrite generation. Collectively, this series of experiments indicates that radicicol inhibits iNOS gene expression by blocking ERK1/2 signaling. Due to the critical role that NO release plays in mediating destruction of pancreatic beta cells, the inhibitory effects of radicicol on iNOS expression suggest that radicicol may represent a useful anti-diabetic activity.
Flavonoids ; Gene Expression ; Imidazoles ; Insulin-Secreting Cells ; Macrolides ; Negotiating ; Nitric Oxide Synthase Type II ; Pyridines ; Tumor Necrosis Factor-alpha