No abstract available.
Calcium* ; Cholera Toxin* ; Cholera* ; Cytoplasm* ; Humans* ; T-Lymphocytes*

Sick sinus syndrome (SSS) is a disorder characterized by sinus node dysfunction. Although the condition is most common in the elderly, it can occur in children including neonates and its recognition and treatment are important. The diagnosis of SSS is based on the presence of sinus bradycardia, sinus arrest or exit block, combinations of sinoatrial and atrioventricular nodal conduction disturbances, and atrial tachyarrhythmias documented in the Holter recordings. In most children with SSS, previous history of congenital heart malformation or cardiac surgery is noted. SSS is also seen in the children including neonates without heart disease or other contributing factors, however SSS is most often idiopathic. The treatment of SSS depends on the basic rhythm problem, but generally involves the placement of a cardiac pacemaker. We report a case of SSS in extremely low birth weight infant without congenital heart disease and suggest that the treatment system is necessary for preterm infants with SSS.
Aged ; Arrhythmias, Cardiac ; Bradycardia ; Child ; Heart ; Heart Diseases ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Pancreas ; Pancreatic Diseases ; Premature Birth ; Sick Sinus Syndrome ; Tachycardia ; Thoracic Surgery

PURPOSE: We wanted to evaluate the usefulness of modified intravenous analgesia for the management of pain during uterine artery embolization for leiomyomata. MATERIALS AND METHODS: Between April 2004 and July 2004, 15 patients with symptomatic fibroids underwent uterine artery embolization and pain management. Except the three patients for whom the Visual Analogue Scale (VAS) score was not obtained, twelve patients were included in this study. For pain management, epidural PCA (Patient Controlled Analgesia) was used in two patients, intravenous PCA was used in two patients and modified intravenous analgesia injection was used in eight patients. For all the patients, we used the 2.8 Fr coaxial microcatheter and 500-710 μm PVA particles for the embolic materials. The protocol of the modified intravenous analgesia injection was as follow, 1) prior to femoral artery puncture, 30 mg of ketorolac tromethamine (Tarasyn) was injected via an intravenous route. 2) At the time that the one side uterine artery embolization was finished, normal saline mixed 150 mg meperidine (Demerol) was administered through the side port of the intravenous line that was used for hydration. 3) Additional ketorolac tromethamine 30 mg was injected after 6 hour. The VAS score and side effects were then checked. After 12 hours, the VAS score was rechecked. If the VAS score was above 4, this was considered as failure of pain management. The VAS scores, complications and side effects for the modified intravenous analgesia injection were compared with that of IV PCA and epidural PCA. RESULTS: The average VAS score of the modified intravenous analgesia injection, intravenous PCA and epidural PCA was 1.4, 1 and 0, respectively; the number of additional intramuscular injections of analgesia was 0.5, 0.5 and 0, respectively. All the patients who underwent epidural PCA had back pain at the puncture site and 1 patient who underwent modified intravenous analgesia injection experienced mild dyspnea, but they easily recovered with such conservative treatment as an oxygen supply. No serious side effects or complications developed from the modified intravenous analgesia injection. CONCLUSION: Modified intravenous analgesia injection is well tolerated for the pain management of uterine fibroid embolization and it is a relatively inexpensive, safe method as used in our radiologic practice.
Analgesia* ; Back Pain ; Dyspnea ; Femoral Artery ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Ketorolac Tromethamine ; Leiomyoma ; Meperidine ; Oxygen ; Pain Management ; Passive Cutaneous Anaphylaxis ; Punctures ; Uterine Artery Embolization* ; Uterine Artery* ; Uterine Neoplasms

BACKGROUND/AIMS: This is the study to clarify the relation between the mucosal patterns by magnifying endoscopy and the histologic findings in the gastric mucosal elevated lesions. METHODS: The objectives were 51 lesions from 48 patients with gastric mucosal elevated lesions. Gastric mucosal elevated lesions have been magnified up to 80 times by using the magnifying endoscope and were obtained tissue. Magnifying mucosal patterns were classified into 6 types (dot, sulciolar, reticular, irregular, destructive and abnormal vessel pattern) and two group (Group A: dot, sulciolar, reticular pattern-preservation of mucosal arrangement, Group B: irregular, destructive, abnormal vessel pattern-destruction of mucosal arrangement). And then we compared the relation between the mucosal patterns and the histologic findings in the gastric mucosal elevated lesions. RESULTS: In magnifying mucosal patterns, dot, sulciolar, reticular, irregular, destructive, and abnormal vessel pattern were 8, 5, 15, 4, 12, 7, respectively. There was significant difference in the rate of severe dysplasia or carcinoma between two groups (Group A: 0% (0/28), Group B: 70% (16/23) (p<0.05)). The score of intestinal metaplasia and atrophy in group A were less than that of group B (p<0.05). CONCLUSIONS: Irregularity, destruction and abnormal vessel formation of gastric mucosal pattern by magnifying endoscope may be suspected the histologic malignancy in the gastric mucosal elevated lesions.
Atrophy ; Endoscopes ; Endoscopy* ; Humans ; Metaplasia

Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens to cause liver abscess. Because K. pneumoniae is highly virulent, it may cause embolic complications. The rate of metastatic infection has a range of 3.5% to 20%. Thus, a diagnostic work-up for metastatic complications should be employed in K. pneumoniae liver abscess cases, including chest radiography and computed tomography if chest radiographies are abnormal and ophthalmic examination in diabetic patients. Cryptogenic pyogenic liver abscess has been recently reported to potentially signal colorectal cancer, especially in female patients with diabetes. We present a case of liver abscess with endophthalmitis and septic pulmonary embolism, which is associated with silent colon cancer.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Endophthalmitis ; Female ; Humans ; Klebsiella pneumoniae ; Liver Abscess ; Liver Abscess, Pyogenic ; Pneumonia ; Pulmonary Embolism ; Thorax

BACKGROUND/AIMS: To investigate the association between the baseline profiles and dynamics of hepatitis B virus (HBV) DNA polymerase gene mutations and the long-term virological response of lamivudine (LAM)-adefovir (ADV) combination therapy in patients with LAM-resistant chronic hepatitis B. METHODS: Seventy-five patients who received LAM-ADV combination therapy for more than 12 months were analyzed. Restriction fragment mass polymorphism assays were used to detect and monitor the dynamics of LAM- and ADV-resistant mutations. RESULTS: The median duration of LAM-ADV combination therapy was 26 months (range, 12 to 58 months). The baseline mutation profiles, rtM204I (p=0.992), rtM204I/V (p=0.177), and rtL180M (p=0.051), were not correlated with the cumulative virological response, and the baseline HBV DNA level (p=0.032) was the only independent predictive factor for cumulative virological response. Tests for LAM- and ADV-resistant mutations were performed in 12 suboptimal responders in weeks 48 and 96. The population of rtM204 mutants persisted or increased in 8 of 12 patients, and rtA181T mutants newly emerged as a minor population in four patients until 96 weeks. Nevertheless, the viral loads progressively decreased during rescue therapy, and these dynamics did not correlate with virological response. CONCLUSIONS: The baseline profile and dynamics of LAM-resistant mutations during LAM-ADV combination therapy are not associated with a virological response.
Adenine/administration & dosage/*analogs & derivatives/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Antiviral Agents/administration & dosage/*therapeutic use ; DNA-Directed DNA Polymerase/genetics ; Drug Resistance, Viral/genetics ; Drug Therapy, Combination ; Female ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/administration & dosage/*therapeutic use ; Male ; Middle Aged ; Organophosphonates/administration & dosage/*therapeutic use ; Treatment Outcome ; Viral Load/drug effects ; Young Adult

Intrahepatic cholangiocarcinoma is a rare malignancy that originates from the epithelial cells of the intrahepatic bile ducts. Intrahepatic cholangiocarcinoma can metastasize in lymphatic chains, including the hepatoduodenal ligament, and it often invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenal glands, and brain. However, distant skeletal muscle metastasis is very rare. Moreover, a metastatic skeletal muscle tumor rarely shows specific symptoms, making it difficult to identify in a routine examination. A 45-year-old man with a chief complaint of right upper quadrant abdominal pain was admitted to our hospital. Abdominal ultrasound and computed tomography with contrast enhancement showed a malignant mass in the right hepatic lobe, and 2-[18F] fluoro-2-deoxy-D-glucose positron-emission tomography revealed distant skeletal muscle metastases in the thorax and buttock. The patient underwent an ultrasound-guided percutaneous needle biopsy for the metastatic low-echo masses in the skeletal muscle.
Bile Duct Neoplasms/diagnosis/radionuclide imaging/secondary ; Cholangiocarcinoma/diagnosis/radionuclide imaging/secondary ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Neoplasms/*diagnosis/pathology/radionuclide ; Male ; Middle Aged ; Muscle Neoplasms/diagnosis/*radionuclide imaging/secondary ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

Autoimmune cholangitis is a disease with clinicopathologic features of primary biliary cirrhosis without antimitochondrial antibodies and, frequently, with high antinuclear antibody titers. Alternative terms have been suggested, including antimitochondrial antibody-negative primary biliary cirrhosis, immunocholangitis, autoimmune cholangiopathy, and autoimmune hepatobiliary overlap syndrome type 1. The question of whether autoimmune cholangitis is distinct from primary biliary cirrhosis and autoimmune hepatitis or is an antimitochondrial antibody-negative variant of primary biliary cirrhosis and autoimmune hepatitis is controversial. This case report describes the clinical, immunohistochemical, and pathological findings in four patients with autoimmune cholangitis and reviews the literature.
Antibodies ; Antibodies, Antinuclear ; Cholangitis ; Hepatitis, Autoimmune ; Humans ; Liver Cirrhosis, Biliary

Autoimmune cholangitis is a disease with clinicopathologic features of primary biliary cirrhosis without antimitochondrial antibodies and, frequently, with high antinuclear antibody titers. Alternative terms have been suggested, including antimitochondrial antibody-negative primary biliary cirrhosis, immunocholangitis, autoimmune cholangiopathy, and autoimmune hepatobiliary overlap syndrome type 1. The question of whether autoimmune cholangitis is distinct from primary biliary cirrhosis and autoimmune hepatitis or is an antimitochondrial antibody-negative variant of primary biliary cirrhosis and autoimmune hepatitis is controversial. This case report describes the clinical, immunohistochemical, and pathological findings in four patients with autoimmune cholangitis and reviews the literature.
Antibodies ; Antibodies, Antinuclear ; Cholangitis ; Hepatitis, Autoimmune ; Humans ; Liver Cirrhosis, Biliary