ABSTRACT
BACKGROUND/AIMS: Adefovir dipivoxil (ADV) resistance in patients with lamivudine-resistant chronic hepatitis B is not well understood. This study examined the initial virologic response (IVR) to ADV, the rate of ADV resistance and the factors associated with ADV resistance. METHODS: Eighty one lamivudine-resistant HBeAg-positive patients were enrolled in this study. IVR was defined as HBV DNA or = 4 log10 copies/mL after 6 months of therapy) were associated with ADV resistance.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Adenine/analogs & derivatives , Alanine Transaminase/blood , Antiviral Agents/therapeutic use , DNA, Viral/blood , Drug Resistance, Viral , Hepatitis B e Antigens/blood , Hepatitis B virus/drug effects , Hepatitis B, Chronic/drug therapy , Lamivudine/therapeutic use , Phosphorous Acids/therapeutic use , Predictive Value of Tests , Retrospective StudiesABSTRACT
Chest pain of a non-cardiac origin is frequently seen in medical practice. This kind of chest pain is often difficult to differentiate from chest pain of a cardiac origin. Esophageal anisakis is a rare finding, but it can cause chest pain. We report here on a patient who had a history of acute myocardial infarction and who also had one stent inserted in his left anterior descending coronary artery two month previously. The patient presented with substernal chest pain that mimicked anginal chest pain. Endoscopic examination revealed a whitish linear worm that had had invaded the esophagogastric junction, and we removed the worm with biopsy forceps. We report here on a patient with an esophageal anisakiasis as a rare cause of noncardiac chest pain that mimicked anginal chest pain.
Subject(s)
Humans , Anisakiasis , Anisakis , Biopsy , Chest Pain , Coronary Vessels , Esophagogastric Junction , Myocardial Infarction , Stents , Surgical Instruments , ThoraxABSTRACT
Spontaneous internal biliary fistulas are not an uncommon complication of primary biliary disease. Almost 90% of the abnormal biliary-enteric communications between the gallbladder and the duodenum are caused by perforation via gallstones into an otherwise normal duodenum. However, biliary-enteric communications that are caused by primary duodenal ulcer disease are much less common. We experienced a case of duodenal peptic ulcer disease that perforated into the common bile duct in a 45-year-old woman.
Subject(s)
Female , Humans , Middle Aged , Biliary Fistula , Common Bile Duct , Duodenal Ulcer , Duodenum , Fistula , Gallbladder , Gallstones , Peptic UlcerABSTRACT
BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Subject(s)
Humans , Acute Coronary Syndrome , Aspirin , Cell Proliferation , Constriction, Pathologic , Coronary Angiography , Disease-Free Survival , Follow-Up Studies , Heparin , Heparin, Low-Molecular-Weight , Infarction , Myocardial Ischemia , Nadroparin , Prospective Studies , Stents , Thrombosis , TiclopidineABSTRACT
Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal bronchial wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. Its incidence ranges from 0.1 to 5%. This anomaly is usually diagnosed incidentally during bronchoscopy or bronchography in patients with various respiratory problems. Tracheal bronchus may be associated with other bronchopulmonary anomalies such as tracheal stenosis, pulmonary agenesis, pulmonary sequestration, abnormal lobulation, and Down's syndrome. In patients without specific clinical symptoms, a incidentally diagnosed tracheal bronchus does not require any treatment. We report a case of 59-year-old man incidentally detected accessory tracheal bronchus associated with bronchial asthma with review of literatures.