Vasculitis is a heterogeneous group of diseases that destroy blood vessel walls by inflammation. Approximately half of vasculitis cases are idiopathic, but sometimes associated with genetic factors, medicines, chronic infection, autoimmune diseases, and malignancies. Although the mechanism remains unclear, vasculitis secondary to malignancy, also known as paraneoplastic vasculitis, has been reported. It is generally associated with hematologic malignancies rather than solid malignancies and commonly presents as leukocytoclastic vasculitis or polyarteritis nodosa. We experienced a case of leukocytoclastic vasculitis in a patient with hepatocellular carcinoma and membranous obstruction of the inferior vena cava. Here, we report this case with a brief review of literature.
Autoimmune Diseases ; Blood Vessels ; Carcinoma, Hepatocellular* ; Hematologic Neoplasms ; Humans ; Inflammation ; Polyarteritis Nodosa ; Vasculitis* ; Vena Cava, Inferior*

Tracheal agenesis is an extremely rare and typically lethal congenital disorder. Approximately 150 cases have been described since 1900, and very few cases of survival have been reported. We describe tracheal reconstruction with external esophageal stenting in a patient with Floyd's type II tracheal agenesis. Neither long-term survival nor survival without mechanical ventilation for even a single day has previously been reported in patients with Floyd's type II tracheal agenesis. The infant in the present case survived for almost a year and breathed without a ventilator for approximately 50 days after airway reconstruction using external supportive stents.
Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Humans ; Infant ; Respiration, Artificial ; Stents* ; Trachea ; Ventilators, Mechanical

Blastomyces dermatitidis is a dimorphic fungus that causes the systemic pyogranulomatous disease known as blastomycosis. Blastomycosis most often involves the lungs, skin, and may involve nearly every organ in the body. It is difficult, however, to diagnose blastomycosis in the early stage of pulmonary disease because clinical manifestations are varied from subclinical infection to acute respiratory distress syndrome. Since blastomycosis is often accompanied by granulomatous inflammation in histopathologic findings, differentiation from other etiologic diseases is important. We report a case of a 45-year-old male with pulmonary blastomycosis who had been misdiagnosed with tuberculosis for 3 months.
Asymptomatic Infections ; Blastomyces ; Blastomycosis ; Fungi ; Granuloma ; Humans ; Inflammation ; Lung ; Lung Diseases ; Male ; Middle Aged ; Respiratory Distress Syndrome, Adult ; Skin ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Cardiac troponin I (cTnI) is most recently described and has nearly absolute myocardial tissue specificity, as well as high sensitivity. But an increased value for cTnI that indicates myocardial injury is not always synonym of myocardial infarction or ischemia due to coronary artery disease. METHODS: Retrospective follow-up study for whom underwent coronary angiography for suspected coronary artery disease was done if they had an elevated cTnI value and angiographically normal or minimal disease. RESULTS: 33 patients were qualified. Cut-off value for elevated cTnI was 0.06 ng/mL. Increased cTnI values were attributed to severe congestive heart failure in 7 patients, variant angina in 7 patients, myocarditis in 5 patients, pericarditis in 1 patient, severe myocardial bridge in 1 patient, rhabdomyolysis in 1 patient and cerebral infarction in 1 patient. Tachycardia was precipitating cause in 4 patients (sinus tachycardia, paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation and sustained ventricular tachycardia for each), two of whom had hemodynamic compromise. 2 of 33 patients had no identifiable cause for a rise in cTnI value. There was no acute myocardial infarction at 42+/-34 weeks follow-up. CONCLUSIONS: Although cTnI is a sensitive and specific marker of myocardial injury, an elevation of cTnI value may have a cause other than myocardial infarction or ischemia and may occur without significant angiographic coronary artery disease.
Atrial Fibrillation ; Cerebral Infarction ; Coronary Angiography ; Coronary Artery Disease ; Follow-Up Studies ; Heart Failure ; Hemodynamics ; Humans ; Ischemia ; Myocardial Infarction ; Myocarditis ; Organ Specificity ; Pericarditis ; Retrospective Studies ; Rhabdomyolysis ; Tachycardia ; Tachycardia, Paroxysmal ; Tachycardia, Supraventricular ; Tachycardia, Ventricular ; Troponin I* ; Troponin*

This experiment was performed to evaluate the morphological responses of the intestinal gland of the mouse, duodenum inoculated with Ehrlich carcinoma cells, following administration of adriamycin or acriflavine -guanosine composition (AG60, Taerim Pharm. Co. Seoul, Korea). Healthy adult ICR mice weighing 25 g each were divided into normal and experimental groups (experimental control group, adriamycin treated group, and AG60 treated group). In the experimental groups, each mouse was inoculated with 1 x10 7 Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day, 0.2 ml of saline, adriamycin (2 mg/ kg), AG60 (5 mg/kg) or AG60 (30 mg/kg) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of anticancer drugs, each mouse was injected with a single dose of 0.7 microCi/gm of methyl -3 H -thymidine (25 Ci/mmol, Amersham Lab., England) through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed. The number of the labeled epithelial cells of the duodenal crypts (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and calculated. On histological study, in the duodenum of adriamycin treated groups, vesiculated epithelial cells of the intestinal villi, expanded lumen of the intestinal gland (G) and loosely arranged lamina propria were observed. But in the AG60 treated group, morphological changes of the duodenum were not observed. On autoradiographic study, number of the labeled cells of normal control, experimental control, adriamycin -treated, AG60 (5 mg/kg)-, and AG60 (30 mg/kg)-treated groups were 595.3 +/-48.96, 715.+/-89.11, 96.0 +/-15.62, 632.0 +/-83.16 and 370.3 +/-49.65, respectively. In the adriamycin and AG60 30mg/kg -treated group, poorly -labeled cells containing only a few silver grains of 3 H -thymidine were observed more frequently than in those of the normal control group. But in the experimental control group, number of the heavy labeled cells were observed more frequently than in those of the normal control group. From the above results, adriamycin and AG60 (30 mg/kg) may suppress the DNA synthesis of the cells of the duodenal crypts. But AG60 does not result any histological defect on the duodenal mucosa. These results suggest that AG60 is expected as one of most effective anticancer drugs.
Acriflavine ; Adult ; Animals ; Edible Grain ; DNA* ; Doxorubicin* ; Duodenum ; Epithelial Cells ; Epithelium* ; Humans ; Intestinal Mucosa ; Mice* ; Mice, Inbred ICR ; Mucous Membrane ; Seoul ; Silver ; Thymidine ; Veins

BACKGROUND/AIMS: Pathogenesis of functional dyspepsia consists of motor abnormality, sensory abnormality, and psychologic abnormality. Anxiety, depression, and psychosomatic disorders are well known psychopathologies that lead to dyspepsia, and stress seems to be an additional etiology. The aim of this study is to assess whether stress can cause and/or provoke dyspepsia. METHODS: Functional dyspepsia was defined and classified by Rome criteria. SCL-90-R for the detection of psychopathology, measurement of life stress scale by self-administered questionnaire, and measurement of stress coping mechanisms using a multidimensional stress coping scale test were performed in 79 functional dyspeptic patients and 25 normal controls. RESULTS: No significant difference was found in the total amount of stress between functional dyspeptic patients and the normal control. However, the patients were more stressful about issues relating to health and marital relationship among stresses in individual daily life. As the patients become more stressful, they used more negative coping mechanisms such as restraint, fatalism, criticism, religiousness, and negativism. These seem to provoke several psychopathologies including interpersonal sensitivity, depression, anxiety, hostility. However, there was no relationship in the amount of stress, the stress coping mechanism, and psychopathology among the dyspeptic symptoms and subgroups of functional dyspepsia. CONCLUSION: There was no difference in the total amount of stress between functional dyspeptic patients and the normal control. In some individuals who utilize inadequate coping mechanisms against stress, the stress can provoke dyspepsia.
Anxiety ; Depression ; Dyspepsia* ; Hostility ; Humans ; Marriage ; Negativism ; Psychopathology ; Psychophysiologic Disorders ; Stress, Psychological ; Surveys and Questionnaires

BACKGROUND/AIMS: Pathogenesis of functional dyspepsia consists of motor abnormality, sensory abnormality, and psychologic abnormality. Anxiety, depression, and psychosomatic disorders are well known psychopathologies that lead to dyspepsia, and stress seems to be an additional etiology. The aim of this study is to assess whether stress can cause and/or provoke dyspepsia. METHODS: Functional dyspepsia was defined and classified by Rome criteria. SCL-90-R for the detection of psychopathology, measurement of life stress scale by self-administered questionnaire, and measurement of stress coping mechanisms using a multidimensional stress coping scale test were performed in 79 functional dyspeptic patients and 25 normal controls. RESULTS: No significant difference was found in the total amount of stress between functional dyspeptic patients and the normal control. However, the patients were more stressful about issues relating to health and marital relationship among stresses in individual daily life. As the patients become more stressful, they used more negative coping mechanisms such as restraint, fatalism, criticism, religiousness, and negativism. These seem to provoke several psychopathologies including interpersonal sensitivity, depression, anxiety, hostility. However, there was no relationship in the amount of stress, the stress coping mechanism, and psychopathology among the dyspeptic symptoms and subgroups of functional dyspepsia. CONCLUSION: There was no difference in the total amount of stress between functional dyspeptic patients and the normal control. In some individuals who utilize inadequate coping mechanisms against stress, the stress can provoke dyspepsia.
Anxiety ; Depression ; Dyspepsia* ; Hostility ; Humans ; Marriage ; Negativism ; Psychopathology ; Psychophysiologic Disorders ; Stress, Psychological ; Surveys and Questionnaires

This experiment was performed to evaluate the morphological responses of 5-fluorouracil or mitomycin C on the gastric parietal cells of mouse. 5 -fluorouracil (30 mg/kg) or mitomycin C (400 micro gram/kg) were injected subcutaneously every other day, and the animals were sacrificed at 4th day and 7th day following the first injection. Pieces of the tissue were taken from the stomach, prefixed with 2.5% glutaraldehyde -1.5% paraformaldehyde, followed by post-fixation with 1% osmium tetroxide. The ultrathin sections were stained with uranyl acetate and lead citrate. In both of the 5-fluorouracil or the mitomycin C treated groups, most parietal cells showed severely reduced luminal spaces of the intracellular canaliculi, since microvilli of intracellular canaliculi were very irregular shaped and nearly contacted with each other, and the cytoplasmic tubulovesicular membranes were disintegrated and indistinct. The changes in the 5-fluorouracil treated group were more indistinct than in those of the mitomycin C treated group. In the 5-fluorouracil treated group, balooning of the cytoplasm, focal cytolysis, myelin figures, lysosomes and multivesicular bodies in the parietal cells were observed more frequently than in those of the mitomycin C treated group. Above results suggest that the 5-fluorouracil or mitomycin C treated animals might suffer from reduced acid secretion of the parietal cell, since the collapsed lumen of the intracellular canaliculi, the disintegration of the tubulovesicular membranes, and the reduction of cell organelles in the parietal cells are occurred within a few days following injections. 5-fluorouracil was proved more harmful on the parietal cell than mitomycin C does.
Animals ; Citric Acid ; Cytoplasm ; Fluorouracil* ; Gastric Mucosa ; Glutaral ; Lysosomes ; Membranes ; Mice* ; Microvilli ; Mitomycin* ; Multivesicular Bodies ; Myelin Sheath ; Organelles ; Osmium Tetroxide ; Parietal Cells, Gastric* ; Phenobarbital ; Rabeprazole ; Stomach

BACKGROUND: Gastroesophageal reflux disease (GERD) is considered to be less common in the Orient compared to the West, but epidemiological data on GERD in Korea are rare. The aim of this study was to determine the prevalence of symptoms of gastroesophageal reflux in routine check-up subjects. METHODS: We analyzed 2243 subjects (male 716, female 1527; age range 20-69 yr) visited health promotion center for routine check-up. Subjects were given a validated self-reported questionnaire, which measured the presence, duration and severity of typical symptoms (heartburn, acid regurgitation); and the presence of atypical symptoms. At least weekly symptoms of heartburn and/or acid regurgitation were characterized as the definition of GERD. RESULTS: The prevalence of heartburn for at least monthly, at least weekly and at least daily episodes was 6.2%, 3.4% and 3.1%, respectively. The corresponding figures for acid regurgitation were 6.1%, 2.1% and 0.7%. The prevalence of GERD was 8.5%, and was more common in female (p< 0.01). Sixty eight percent of subjects with GERD reported the symptoms as having been present for less than 5 years. Seventy four percent of subjects with GERD reported these symptoms to be mild to moderate in severity. Heartburn and acid regurgitation were significantly associated with dyspepsia, chest pain, dysphagia and globus sensation (p< 0.01), but not with hoarseness or chronic cough. CONCLUSION: The prevalence of heartburn and/or acid regurgitation experienced at least weekly is 8.5% in routine check-up subjects. Heartburn and acid regurgitation were associated with epigastric pain, chest pain, dysphagia and globus sensation.
Chest Pain ; Cough ; Deglutition Disorders ; Dyspepsia ; Epidemiology ; Female ; Gastroesophageal Reflux* ; Health Promotion ; Heartburn ; Hoarseness ; Humans ; Korea ; Prevalence* ; Sensation ; Surveys and Questionnaires

K+ -selective ion channels were studied in excised inside-out membrane patches from human osteoblast-like cells(G292). There classes of K+ channels were present and could be distinguished on the basis of conductance. Conductances were 270+/-27 pS, 113+/-12 pS, 48+/-8 pS according to their approximate conductances in symmetrical 140 mM KCI saline at holding potential of -80 mV. It was found that the small conductance (48 pS) K+ channel activation was dependent on membrane voltage. In current-voltage relationship, small conductance K+ channel showed outward rectification, and it was activated by the positive potential inside the membrane. In recordings, single channel currents were activayed by a negative pressure outside the membrane. The membrane pressure increased P(open) of the K+ channel in a pressure-dependent manner. In the excised-patch clamp recordings, G292 osteoblast-like cells have been shown to contain three types of K+ channels. Only the small conductance (48 pS) K+ channel is sensitive to the membrane stretch. These findings suggest that a hyperpolarzing current, mediated in part by this channel, may be associated with early events during the mechanical loading of the osteoblast. In G292 osteoblast-like cells, K+ channel is sensitive to membrane tension, and may represent a unique adaptation of the bone cell membrane to mechanical stress.
Cell Membrane ; Humans ; Ion Channels ; Membranes ; Osteoblasts ; Stress, Mechanical