Fewer than one half of patients with acute myocardial infarction is a candidate for thrombolytic therapy. Current data revealed that primary coronary stenting may be useful alternative to intravenous thrombolytic therapy for acute myocardial infarction in these subset of patients. We experienced a patient presenting with acute myocardial infarction and acute promyelocytic leukemia in whom thrombolytic therapy was thought be not eligible due to hemorrhagic tendency. Primary coronary stenting was performed successfully without complications. Follow-up angiography revealed no evidence of restenosis or stent occlusion.
Angiography ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute ; Myocardial Infarction ; Stents* ; Thrombolytic Therapy

This is a case report of pernicious anemia with neurologic deficits. The patient is a 69 years old male with generalized tingling sense. On examination, slight pale conjunctiva and beefy red tongue are noted. Laboratory stud show megaloblastic anemia with low serum vitamin B12 level, positive Schilling test, gastric achlorhydria and mild gastric atrophy. Neurologic examination reveals cerebral, spinal and peripheral involovement and EEG and EMG study support those things. On parenteral vitamin B12, the hematologic and neurological abnormalities are improved dramatically.
Achlorhydria ; Aged ; Anemia, Megaloblastic ; Anemia, Pernicious* ; Atrophy ; Conjunctiva ; Electroencephalography ; Humans ; Male ; Neurologic Examination ; Neurologic Manifestations ; Schilling Test ; Tongue ; Vitamin B 12

Purpose: To report two cases of adult inclusion conjunctivitis masquerading as chronic conjunctivitis.Case summary: (Case 1) A 34-year-old man presented with a foreign body sensation in his right eye for 2 months. At the first visit, slit lamp examination showed follicles on the inferior palpebral conjunctiva. Chlamydia trachomatis immunoglobulin M (IgM) antibody and polymerase chain reaction (PCR) tests were positive. The patient was prescribed doxycycline for 1 week, which improved the symptoms, followed by gentamicin and levofloxacin for an additional 5 days, which further improved the clinical symptoms and conjunctivitis. (Case 2) A 39-year-old man presented with right eye pain and redness for 5 months. At the first visit, slit lamp examination showed follicles on the inferior palpebral conjunctiva. Chlamydia trachomatis IgM antibody and PCR tests were positive. After 1 week of doxycycline treatment, the clinical symptoms and conjunctivitis improved. Conclusions Because adult inclusion conjunctivitis caused by chlamydial infection has non-specific symptoms, it can be misdiagnosed as chronic conjunctivitis. A detailed medical history and appropriate diagnostic tests are necessary to make this diagnosis.

BACKGROUND: It is known that HLA molecule can restrict specific IgE responses, but few studies have documented the association between HLA and sensitization to house dust mite(HDM). OBJECTIVE: To evaluate whether a specific HLA type can be a risk or protective factor for the development of HDM sensitivity. METHOD: Total 146 subjects were genotyped for HLA-DRB1 using PCR-SSP technique and HDM sensitivity, determined by skin prick test using two mite allergens, D. pteronyssinus (Dp) and D. farinae (Df). Subjects were grouped according to Dp or Df sensitivity and linkage analysis between HDM sensitivity and HLA-DRB1 genotype was performed. RESULTS: The data revealed higher allele frequencies of DRB1*07 in Dp or Df sensitive groups compared to insensitive groups (11.6% vs. 2.6% in Dp, 11.5% vs. 3.3% in Df group, p<0.05), but the other allele frequencies showed no difference. CONCLUSION: There was a significant association between HLA-DRB1*07 genotype and HDM sensitization. These results indicate that antigen presentation by HLA class II molecule restricts the development of specific IgE response to HDM.
Allergens ; Antigen Presentation ; Dust* ; Gene Frequency ; Genotype* ; HLA-DRB1 Chains* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Skin

PURPOSE: Although the diagnosis of foreign bodies in the airway can be made early, retained and neglected foreign bodies are a common occurrence. The objective of this study was to characterize the clinical features of children diagnosed beyond 14 days following inhalation of a foreign body, long-standing foreign body in airway(LFB). METHODS: We reviewed the records of 180 cases of airway foreign body, noting the age, symptoms and signs, types and location of foreign body, chest radiographs, and lung perfusion scan findings, and compared these findings of children diagnosed within 14 day(short-term foreign body in airway : SFB, n=130) with those of LFB(n=50). RESULTS: Of chief complaints on admission, sputum was more frequent in LFB(24.0%) than in SFB(6.9%). The age distribution was similar, but the proportion of patients aged 3 to 6 years was higher in LFB(16.0%) compared with SFB(3.9%). Of the types of foreign body, plastic was more common in LFB. Abnormal chest radiographic findings were more frequent in LFB(94.0%) than in SFB(80.6%), while the location within the bronchial tree was similar. Hypoperfusion on lung scan was noted in all patients except one in LFB(93.8%). CONCLUSION: There was some difference in age distribution, sputum production, type of foreign body, and abnormal radiographic and perfusion scan findings between SFB and LFB. This suggests that retained foreign bodies may present atypical clinical manifestation and physicians should be alert to the possibility of airway foreign body in children with chronic respiratory symptoms or signs.
Age Distribution ; Child ; Diagnosis ; Foreign Bodies* ; Humans ; Inhalation ; Lung ; Perfusion ; Plastics ; Radiography, Thoracic ; Sputum

Aberrant expression of BORIS/CTCFL (Brother of the Regulator of Imprinted Sites/CTCF-like protein) is reported in different malignancies. In this study, we characterized the entire promoter region of BORIS/CTCFL, including the CpG islands, to assess the relationship between BORIS expression and lung cancer. To simplify the construction of luciferase reporter cassettes with various-sized portions of the upstream region, genomic copies of BORIS were isolated using TAR cloning technology. We analyzed three promoter blocks: the GATA/CCAAT box, the CpG islands and the minisatellite region BORIS-MS2. Polymorphic minisatellite sequences were isolated from genomic DNA prepared from the blood of controls and cases. Of the three promoter blocks, the GATA/CCAAT box was determined to be a critical element of the core promoter, while the CpG islands and the BORIS-MS2 minisatellite region were found to act as regulators. Interestingly, the polymorphic minisatellite region BORIS-MS2 was identified as a negative regulator that repressed the expression levels of luciferase reporter cassettes less effectively in cancer cells compared with normal cells. We also examined the association between the size of BORIS-MS2 and lung cancer in a case–control study with 590 controls and 206 lung cancer cases. Rare alleles of BORIS-MS2 were associated with a statistically significantly increased risk of lung cancer (odds ratio, 2.04; 95% confidence interval, 1.02–4.08; and P=0.039). To conclude, our data provide information on the organization of the BORIS promoter region and gene regulation in normal and cancer cells. In addition, we propose that specific alleles of the BORIS-MS2 region could be used to identify the risk for lung cancer.
Alleles ; Clone Cells ; Cloning, Organism ; CpG Islands ; DNA ; Gene Expression* ; Luciferases ; Lung Neoplasms* ; Lung* ; Minisatellite Repeats* ; Promoter Regions, Genetic

BACKGROUND/AIMS: Gallbladder polyps (GBP) are a common clinical finding that can express malignant potential. The aim of this study was to evaluate whether vegetarianism protects against GBP, together with other putative risk factors. METHODS: A retrospective, cross-sectional study was conducted with subjects who received a health check-up from July 2005 to December 2011. Korean Buddhist priests, who are obligatory vegetarians by religious belief, were identified as vegetarians (vegetarian group) and compared with a non-vegetarian control group sampled from those coming for health check-ups at the same institution. RESULTS: Out of 18,483 subjects, GBP were found in 810 (4.4%). Although GBP tended to be less common in the vegetarian group (23 [3.5%] out of 666) than in control group (787 [4.4%] out of 17,817), the difference was insignificant statistically (p=0.233). By logistic regression, old age (OR=1.61, 95% CI=1.19-2.26 for 30-39 years; OR=1.47, 95% CI=1.08-1.98 for 40-49 years), male gender (OR=1.51, 95% CI=1.31-1.75), high BMI (OR=1.18, 95% CI=1.00-1.39 for > or =23.0 kg/m2 and <25.0 kg/m2) and HBsAg positivity (OR=1.53, 95% CI=1.19-1.98) were independent risk factors of GBP. CONCLUSIONS: GBP was significantly associated with old age, male gender, high BMI and HBsAg positivity, but not with vegetarianism.
Adult ; Age Factors ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Female ; Gallbladder Diseases/diagnosis/*epidemiology ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Polyps/*epidemiology/pathology ; Prevalence ; Retrospective Studies ; Risk Factors ; Sex Factors ; Vegetarians

OBJECTIVES: Orphan nuclear receptor small heterodimer partner (SHP) is involved in osteoblastic differentiation. This study was undertaken to demonstrate a role of SHP in in vivo bone development using microcomputed tomographic (microCT) analysis of SHP knockout (KO) mice. MATERIAL & METHODS: Tibia bones were harvested from 1-, 4-, 8- and 20-week-old wild type (WT) and SHP KO mice. The microarchitecture of tibial bone was analyzed using a microCT (Skyscan 1172; Skyscan, Kontich, Belgium). Samples were scanned at a resolution of 17 microm (isotropic). The X-ray was operated with 50 kV, 200 microA of energy, 1.2 sec of exposure time, and a 0.5 mm thick aluminum filter. Projections were acquired over an angular range of 180degrees. For quantification of the bone mineral density (BMD), the microCT was calibrated using 2 standard phantoms with densities of 0.25 and 0.75 g/cm3. The image slices were reconstructed and analyzed using CT analyzer software (CTan, Skyscan). RESULTS: The CT values of tibial trabecular bone were significantly decreased in SHP KO compared to WT at 20-week-old mice determined by microCT; (bone volume / tissue volume [BV/TV, 40%], BMD [80%], and trabecular number [Tb.N, 50%]). However, the CT values were not significantly different between WT and SHP KO in cortical bone. Furthermore, the qualitative indices of trabecular bone such as the structure model index (SMI) and the polar moment inertia (PMI) did not differ between WT and SHP KO mice. CONCLUSION: These microCT results supports that SHP may act as a positive regulator of trabecular bone formation.
Aluminum ; Animals ; Bone Density ; Bone Development ; Child ; Child, Orphaned ; Humans ; Mice ; Mice, Knockout ; Osteoblasts ; Osteogenesis ; Tibia ; X-Ray Microtomography

BACKGROUND: With variable symptoms and nonspecific radiographic appearances, pulmonary embolism (PE) is a frequent and often undiagnosed cause of mortality and morbidity. The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study suggested that the majority of patients undergoing ventilation-perfusion (V-Q) scan would require additional studies to establish or to exclude the diagnosis of PE. Pulmonary angiography has been regarded as gold standard for diagnosis of PE. However, it is an invasive procedure that may be associated with significant notable mo rbidity and mortality. Thus, availability of an accurate, noninvasive screening examination is highly desirable. METHOD: From October 1994 to February 1997, twenty patients (male 13, female 7, range 23-91 years, median 58 years) who were suspected as pulmonary embolism on the basis of clinical evidence and underwent the spiral volumetric computed tomography (spiral CT), were studied retrospectively to evaluate the effectiveness of spiral CT as a diagnostic tool in PE. RESULTS: PE could be excluded with spiral CT in 4 patients; diagnoses of these patients were lung cancer, pneumonia with lung abscess, bilateral pleural effusion due to congestive heart failure, nonspecific pulmonary abnormality retrospectively. One patient who disclosed high probability in V/Q scan, could be diagnosed as pneumonia with lung abscess and underlying emphysema with spiral CT. Among 4 patients who showed intermediate and low probability in V/Q scan, 3 patients could be confirmed as PE with spiral CT. Spiral CT were helpful in 3 patients, in whom V/Q scan could not be performed due to other reasons (e.g. night time, mechanical ventilation) to confirm the diagnosis of PE. Spiral CT could demonstrate embolus above lobar artery level in 11 patients, and up to segmental artery level in 5 patients. CONCLUSION: This study demonstrated that spiral CT could allow accurate demonstration of thrombotic clots in centrally localized embolism. Spiral CT could be effective, specific, noninvasive and useful diagnostic screening modality for the diagnosis of pulmonary embolism.
Angiography ; Arteries ; Cone-Beam Computed Tomography ; Diagnosis ; Embolism ; Emphysema ; Female ; Heart Failure ; Humans ; Lung Abscess ; Lung Neoplasms ; Mass Screening ; Mortality ; Pleural Effusion ; Pneumonia ; Pulmonary Embolism* ; Retrospective Studies ; Tomography, Spiral Computed*

BACKGROUND: With variable symptoms and nonspecific radiographic appearances, pulmonary embolism (PE) is a frequent and often undiagnosed cause of mortality and morbidity. The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study suggested that the majority of patients undergoing ventilation-perfusion (V-Q) scan would require additional studies to establish or to exclude the diagnosis of PE. Pulmonary angiography has been regarded as gold standard for diagnosis of PE. However, it is an invasive procedure that may be associated with significant notable mo rbidity and mortality. Thus, availability of an accurate, noninvasive screening examination is highly desirable. METHOD: From October 1994 to February 1997, twenty patients (male 13, female 7, range 23-91 years, median 58 years) who were suspected as pulmonary embolism on the basis of clinical evidence and underwent the spiral volumetric computed tomography (spiral CT), were studied retrospectively to evaluate the effectiveness of spiral CT as a diagnostic tool in PE. RESULTS: PE could be excluded with spiral CT in 4 patients; diagnoses of these patients were lung cancer, pneumonia with lung abscess, bilateral pleural effusion due to congestive heart failure, nonspecific pulmonary abnormality retrospectively. One patient who disclosed high probability in V/Q scan, could be diagnosed as pneumonia with lung abscess and underlying emphysema with spiral CT. Among 4 patients who showed intermediate and low probability in V/Q scan, 3 patients could be confirmed as PE with spiral CT. Spiral CT were helpful in 3 patients, in whom V/Q scan could not be performed due to other reasons (e.g. night time, mechanical ventilation) to confirm the diagnosis of PE. Spiral CT could demonstrate embolus above lobar artery level in 11 patients, and up to segmental artery level in 5 patients. CONCLUSION: This study demonstrated that spiral CT could allow accurate demonstration of thrombotic clots in centrally localized embolism. Spiral CT could be effective, specific, noninvasive and useful diagnostic screening modality for the diagnosis of pulmonary embolism.
Angiography ; Arteries ; Cone-Beam Computed Tomography ; Diagnosis ; Embolism ; Emphysema ; Female ; Heart Failure ; Humans ; Lung Abscess ; Lung Neoplasms ; Mass Screening ; Mortality ; Pleural Effusion ; Pneumonia ; Pulmonary Embolism* ; Retrospective Studies ; Tomography, Spiral Computed*