A case of antiphospholipid syndrome with Crohn's disease / 대한내과학회지

Antiphospholipid syndrome has received considerable attention due to its association with a number of serious clinical disorders including arterial and venous throboembolism, acute ischemic encephalopathy, and recurrent pregnancy loss. Thrombotic episodes are well recognized complication of Crohn's disease. Hypercoagulable state of the disease may be responsible for such thrombotic events. The association of IBD and autoimmune condition is also well recognized, even poorly understood. There may be a possible association between antiphospholipid syndrome and hypercoagulable state in Crohn's disease. Few reports on Crohn's diseases associated with antiphospholipid syndrome were documented. We experienced a 31-year-old female patient who was admitted for cerebral infaction and diagnosed of antiphospholipid syndrome with Crohn's disease.

A Case of Nodular Fasciitis Misdiagnosed as Baker's Cyst in a Patient with Rheumatoid Arthritis / 대한류마티스학회지

Nodular fasciitis is rare and benign fibroblastic proliferative disease which tends to be confused microscopically with spindle cell sarcoma. It is a distinctive lesion and a very important one because of its ability to simulate a malignant process. Histopathologically, nodular fasciitis can be grouped into three subtypes based on their relation with the fascia: subcutaneous, fascial, intramuscular. We report a case of nodular fasciitis misdiagnosed as Baker's cyst in a patient with rheumatoid arthritis.

Relationship between Expression of XIAP Protein in Operable Non- small Cell Lung Carcinomas and Apoptosis Index and Postoperative Prognosis / 결핵및호흡기질환

BACKGROUND: Dysregulation of apoptosis plays an important role in carcinogenesis, tumor progression, and resistance to chemotherapy. X-linked inhibitor of apoptosis (XIAP) is considered to be the most potent caspase inhibitor of all known IAP (inhibitor of apoptosis) family members. This study was designed to assess the pattern of expression and the prognostic value of XIAP in radically resected non-small cell lung carcinoma (NSCLC) patients. METHOD: The expression of XIAP and its relationship with clinicopathologic parameters (patient age, TNM stage, TNM-pT, TNM-pN, histologic type, VEGF expression, microvessel density, PCNA index) and overall survival were analysed with formalin-fixed, paraffin-embedded blocks from eighty cases of NSCLC. In addition, the apoptotic index (AI) was also assessed. RESULTS: In a regard to histologic type, squamous cell carcinoma (SCC) showed XIAP expression in 91.3%(42/46) and adenocarcinoma (AC) in 61.8%(21/34). The difference was significant(p=0.001). There was no correlation between XIAP expression and other parameters. In the group of AC, XIAP expression showed the signifcant correlation with older age group > or = 58 years and VEGF expression(p=0.028, p=0.014, respectively). The AI in the group with or without XIAP expression were 2.5+/-4.9% and 18.5+/-28.9%, respectively(p=0.001). Both groups just aforementioned showed no significant difference in median survival time (42.5 months, 29.8 months, respectively). CONCLUSION: This study suggests that the XIAP expression in NSCLCs could have relation to inhibition of apoptosis, and show differential expression according to histologic type. However, its prognostic role during the progression of NSCLC needs to be further defined.

Clinical Significance of Autonomic Neuropathy in Liver Cirrhosis / 대한간학회지

BACKGROUND/AIMS: Autonomic neuropathy is not rare in patients with liver cirrhosis but little is known about the mechanisms and clinical characteristics of it. We evaluated the relationship between the severity of liver disease and that of autonomic neuropathy. METHODS: Sixty patients with liver cirrhosis (age 53+/-8.4, mean+/-SD) were studied. Liver function and prothrombin time were tested and an ultrasonography or CT scan was performed. Liver function reservoir was classified according to Child-Pugh score for all patients. Heart rate variations in response to deep breathing, to Valsalva maneuver, and to orthostatism were also measured and were expressed by E/I index, Valsalva index, and Posture index, respectively. The prevalence was estimated and divided into early involvement and definite involvement using each index. The correlation between the severity of the liver disease and that of autonomic neuropathy was also studied. RESULTS: Evidence of autonomic neuropathy was found in 68.3% (41); early involvement 46.7% (28), and definite involvement 21.7% (13), respectively. The prevalence of autonomic neuropathy was similar in alcohol induced, and virus induced, liver disease (84.6% vs 63.8%). Child-Pugh score showed inverse correlation with E/I index (r=-0.38, p<0.01) and Valsalva index (r=-0.34, p<0.05). On multiple logistic regression analysis, cardiovascular autonomic neuropathy was related to the serum albumin level (odds ratio 0.063, 95% CI). CONCLUSION: In liver cirrhosis the prevalence and the severity of cardiovascular autonomic dysfunction are related to the severity of hepatic dysfunction (Child-Pugh score). It is possible that this complication may be of prognostic significance in patients with liver cirrhosis.