Mitral regurgitation (MR) is the most common heart disease in small-breed dogs. Mitral repair, which comprise artificial chorda tendineae implantation and mitral annuloplasty, has become the mainstay of treatment in the veterinary field. We report on two small dogs who underwent mitral repair surgery for MR. A Hegar dilator was used during mitral annuloplasty for accurate and reproducible surgery. In both cases, mitral regurgitant flow almost disappeared after surgery, and clinical signs improved. The treatment regimen was terminated 3 months after the surgery. We concluded that using a Hegar dilator may facilitate mitral valve repair surgery.

Human anisakiasis is a disease caused by an infestation of the third stage larvae of family anisakidae. The ingested larvae invade the gastrointestinal wall, causing clinical symptoms that include abdomen pain, nausea, and vomiting. Although enteric anisakiasis is extremely rare, it can induce intestinal obstruction. We report a case in which emergency surgery was needed due to intestinal obstruction that coincided with symptoms related to anisakiasis, along with a brief literature review.
Abdomen ; Anisakiasis* ; Emergencies ; Humans ; Intestinal Obstruction ; Jejunum* ; Larva ; Nausea ; Vomiting

BACKGROUND/AIMS: Anti-C-reactive protein (CRP) antibody has been introduced as a potential biologic marker in Systemic lupus erythematosus (SLE). The aim of study is to evaluate the level of anti-CRP antibody in patients with SLE. METHODS: This study investigated the relationship between levels of anti-CRP antibodies and disease activity markers, such as complement, anti-double-stranded DNA antibody, and SLE disease activity index in 34 patients with SLE. RESULTS: The serum anti-CRP antibody levels of the patients with SLE were significantly higher than those of the healthy controls (11.3 ± 5.6 µg/mL vs. 9.1 ± 2.8 µg/mL). The percentages of the positive anti-CRP antibody were 52.9% in SLE and 27.8% in controls. Disease duration of SLE showed significant correlation with the anti-CRP antibody (r = 0.234, p = 0.026). However no significant relationship was observed between the levels of anti-CRP antibodies and disease activity markers. CONCLUSIONS: These data show that the anti-CRP antibody levels of the patients with SLE were significantly higher than those of healthy controls. We observed that the presence of the anti-CRP anti-CRP antibody was not associated with disease activity of SLE.
Antibodies ; Biomarkers ; Complement System Proteins ; DNA ; Humans ; Lupus Erythematosus, Systemic*

OBJECTIVE: Low cholesterol is associated with depression among western countries. The objective of this study was to examine the relationship between cholesterol and depression in Korean population with low levels of serum cholesterol. METHODS: The data of about 740,000 individuals, aged 30-64 years at entry in the Korean Cancer Prevention Study, were used. Total cholesterol levels were measured in 1992. Depression was measured using the modified DSM-IV (Diagnostic Criteria of Major Depressive Episode in Diagnostic and Statistical Manual of Mental Disorders-IV) scale. Total cholesterol was classified into four groups (quartile). Odds Ratios of low level of cholesterol were evaluated using multi-variable logistic models. RESULTS: The prevalence of major depression was 7.7% in men and 10.4% in women. After adjustment for various confounding variables, an inverse association was detected between cholesterol levels and depression intensity among men and women. The odds ratio (95% confidence interval) of the lowest quartile of cholesterol was 1.16 (1.13-1.20) on major depression compared with the highest quartile of cholesterol in men. The corresponding odds ratio among women was 1.09 (1.04-1.15). The strongest association among 9 items of depression was found at "decreased appetite and lost weight" in both men (OR=1.68) and women (OR=1.43). CONCLUSION: Low cholesterol is associated with major depression in men and women. Further studies are necessary to evaluate the cross-validation, to explore the biological mechanism, and to identify the clinical implication.
Appetite ; Cholesterol ; Confounding Factors (Epidemiology) ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Female ; Humans ; Logistic Models ; Male ; Odds Ratio ; Prevalence

Neuroendocrine tumor (NET) of the colon and rectum has been reported to have a low incidence and aggressive progression; it is frequently misdiagnosed and its treatment is not well documented. Four NET cases were collected at our hospital during the previous year of a colon cancer survey. Endoscopic mucosal biopsy of the colon was done for each case and all the cases proved to be adenocarcinomas. Curative surgery was conducted after the preoperative diagnostic and staging evaluation was completed. The locations of the primary lesions of the patients were all different; cecum, ascending colon, splenic flexure colon and sigmoid colon. The disease was advanced in all cases and the first postoperative diagnosis was poorly differentiated adenocarcinoma. Immunohistochemical tests followed and all the cases were positive for chromogranin A staining. A retrospective study was then conducted.
Adenocarcinoma ; Biopsy ; Cecum ; Chromogranin A ; Colon* ; Colon, Ascending ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Diagnosis ; Humans ; Incidence ; Neuroendocrine Tumors* ; Rectum ; Retrospective Studies

Hydrops describes the infant who has generalized edema due to accumulation of excess fluid. In severe case, massive edema with ascites and pleural and pericardial effusions are commonly combined. The main etiology of hydrops fetalis has been changed from immune type which is caused by fetomaternal blood group incompatibility to nonimmune type. Although cardiovascular diseases are the most common (23% to 38%) causes for nonimmune hydrops fetalis, fetal tumors still compromise 5% to 7% of the diseases. We report a case of nonimmune hydrops fetalis due to intraperitoneal hemangioma. The newborn infant was managed surgically and had excellent outcome.
Ascites ; Blood Group Incompatibility ; Cardiovascular Diseases ; Edema ; Hemangioma* ; Humans ; Hydrops Fetalis* ; Infant ; Infant, Newborn ; Pericardial Effusion

Ongoing advances in the treatment of very-low-birth-weight infants have confronted us with a growing number of infants susceptible to acquired illnesses of the gastrointestinal tract. Although necrotizing enterocolitis has been regarded as the major cause of gastrointestinal perforation in preterm infants, the incidence of spontaneous perforation occurred in an apparently normal bowel is increasing. The risk factors for spontaneous intestinal perforation include prematurity, twin pregnancies, perinatal asphyxia, prior use of umbilical artery catheter, use of indomethacin and/or steroid, and bacterial or fungal sepsis. We report a case of spontaneous ileal perforation occurred in very low birth weight infant who was successfully treated with emergency operation.
Asphyxia ; Catheters ; Emergencies ; Enterocolitis, Necrotizing* ; Gastrointestinal Tract ; Humans ; Incidence ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Intestinal Perforation ; Pregnancy, Twin ; Risk Factors ; Sepsis ; Umbilical Arteries

PURPOSE: Multiple methods are used to diagnose acute appendicitis. However, with the current practice, the negative laparotomy rate for acute appendicitis is from 15% up to 30%. This study was designed to evaluate various pathologies of the appendix and other intraabdominal organs of patients preoperatively diagnosed with acute appendicitis and to analyze clinically the difference between acute appendicitis and other intraabdominal inflammatory diseases. METHODS: We reviewed the pathologic reports of 833 patients who underwent laparotomies for acute appendicitis from January 1997 to December 2001. We grouped these patients by pathology. Group I included patients with a negative appendectomy and no other intraabdominal pathology, group II included those with lesions within the appendix, and group III, those with intraabdominal lesions other than in the appendix. We also analyzed the age, sex distributions, the typical symptoms of appendicitis, the duration of symptoms, fever, and leukocytosis of 100 patients with typical appendicitis by random sampling to find the clinical differences that existed between pelvic inflammatory disease and cecal diverticular disease presented as appendicitis. RESULTS: The diagnostic accuracy for acute appendicitis was 79.7%, and the negative appendectomy and negative laparotomy rates were 17.4% and 15.5%, respectively. The percents of patients in group I, II, and III were 10.4%, 82.6%, and 7.0%, respectively. CONCLUSIONS: It is important to consider the possibility of various pathologies during diagnostic and operative procedures for an acute abdomen, especially one occurring in the right lower quadrant.
Abdomen, Acute ; Appendectomy ; Appendicitis* ; Appendix ; Diagnosis, Differential* ; Female ; Fever ; Humans ; Laparotomy ; Leukocytosis ; Pathology* ; Pelvic Inflammatory Disease ; Sex Distribution ; Surgical Procedures, Operative

The reactive airway dysfunction syndrome (RADS), a subset of irritant-induced asthma, has been described following exposure to various irritant gas. We describe a case of RADS occuring following a single exposure to high levels of chlorine gas in the workplace. No documented pre-existing respiratory illness and atopy was identified. Cough, dyspnea, and wheezing were developed with the single accidental exposure to chlorine gas and methacholine provocation test was positive. He was completely recovered with the treatment of corticosteroid and oxygen therapy.
Angioedema ; Asthma ; Cellulitis ; Chlorine* ; Cough ; Dyspnea ; Eosinophilia ; Hypereosinophilic Syndrome ; Methacholine Chloride ; Oxygen ; Respiratory Sounds

PURPOSE: Actinomycosis is still a relatively rare infection, characterized by multiple abscesses, draining sinuses and the appearance of sulfur granules, which are valuable in aiding the diagnosing the discharge of involved tissues. In most instances, the onset of an abdominal disease is preceded by inflammatory or a traumatic incident resulting in the perforation of the mucosa of the gastrointestinal tract. Intensive and prolonged antimicrobial therapy, and wide surgical excision of involved tissues are the two general principles of therapy. METHODS: We experienced 8 cases of abdominal actinomycosis after a laparotomy between March 1997 and February 2002. RESULTS: The results were as follows: 1) There was a 1: 1 male to female ratio of abdominal actinomycosis, and a mean age of 47 years. 2) The clinical features were different for each involved organ, -but, most of the clinical symptoms were nonspecific to suspect actinomycosis. 3) The frequently involved organs were mainly located lower abdomen, such as the appendix and cecum, sigmoid colon and small bowel. 4) In 60% of the patients, the predisposing factors were identifiable, these being: a previous abdominal operation, IUD and abdominal injury. 5) The preoperative diagnoses included: acute appendicitis, and periappendiceal and intra-abdominal abscesses. The pre-exploratory diagnoses were made by ultrasound and abdominal CT. 6) Explorations were performed in all patients, depending on their diagnosis, to afford the proper surgical treatment and correct diagnosis. After the operation, all the patients were treated with oral antibiotics for long period. CONCLUSION: The authors conclude that pre-exploratory cytological or culture studies, with careful history taking, for low abdominal tumors or abscesses may increase the rate of correct diagnosis, as could proper explorations.
Abdomen ; Abdominal Abscess ; Abdominal Injuries ; Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Appendicitis ; Appendix ; Causality ; Cecum ; Colon, Sigmoid ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Laparotomy ; Male ; Mucous Membrane ; Sulfur ; Tomography, X-Ray Computed ; Ultrasonography