Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

Objectives: To assess the satisfaction of dementia patients with telemedicine services. Underlying factors were extracted from a satisfaction dataset, and possible associations among factors were investigated to determine their statistical relevances. Methods: A survey was conducted using a questionnaire to determine satisfaction with telemedicine services of patients with dementia in 9 public health centers and 5 designated hospitals in 8 provinces in Gangwon-do from 20 July 2020 to 31 October 2020. Four hundred and ninety-seven users responded to the survey. Factor analysis was performed on survey data and multiple linear regression was used to extract relevant factors. Results: The percentage of subjects satisfied with telemedicine services was 78.8%. Thirty-five items of the satisfaction survey indicated that the five factors, that is, necessity (Cronbach’s α 0.952), satisfaction (Cronbach’s α 0.929), medical system reliability (Cronbach’s α 0.924), medical staff reliability (Cronbach’s α 0.924), and geographic vulnerability (Cronbach’s α 0.922), were related to satisfaction with telemedicine services, and that of these, geographic vulnerability was most associated with the need for telemedicine services. Conclusion This study shows that dementia patients with experience of telemedicine services were generally satisfied with treatment. Despite its limitations, the satisfaction survey was found to provide a reliable and valid scale for assessing user satisfaction.

The objective of this study is to identify any differences in disease status between foreign patients staying in Korea and Korean patients. The study results are : First, more foreign stayers than Korean in their 20's and 30's seek medical services but those after age of 60 show the opposite pattern. This difference seems to feflect cultural difference in the concept of medical services and health seeking behavior. Second, foreign pateints were much more frequently(almost threee times) diagnosed as having an acute disease, and the fact that the most common diseases were "diseases of the respiratory system" can suggest the seriousness of air pollution problem in Korea. And, the fact that foreign stayers, especially those from developed countries, tend to take more periodic general physical examina-tion indicated that their health maintenance efforts place emphasis on prevention. Foreign patients seek more medical services during the spring and summer time when compared to Korean patients, and Korean patients visited the clinic more frequently during the autum time. Also, the review of the number of outpatients seeking medical services and the average duration of outpatient follow-up mainten-ance after discharge suggest that foreigners suffer less severe diseases than Koreans do. Finally, in contrast to the usual practice of Koreans of coming to the center without prior calling for reservation, most foreign patients tend to make reservations before coming(usually a day before) in general. This is also reflective of cultural difference related to the way of utilizing medical services.
Acute Disease ; Air Pollution ; Developed Countries ; Emigrants and Immigrants ; Follow-Up Studies ; Humans ; Korea ; Outpatients

Transformation and progression of breast cancer are thought to be caused by an accumulation of complex genetic alterations, but little is known about specific changes. In this study, the author has undertaken a genome-wide screening to detect genetic changes in 20 cases of breast cancer among Koreans, including 16 infiltrating ductal carcinomas, 2 medullary carcinomas, 1 invasive lobular carcinoma, and 1 borderline phyllodes tumor. Comparative genomic hybridization (CGH) was used to screen for DNA sequence gains and losses across all human chromosomes. Simultaneous immunohistochemical staining for c-erbB-2 (Her-2/neu), c-myc, cyclin D1, and p53 protein was done to make comparisons with nuclear grade and that with CGH results. Biotin-labeled tumor DNA and digoxigenin-labeled normal DNA were hybridized to normal metaphase cells. The fluorescence signals were captured by fluorescence microscope after detection by avidin-FITC and anti-digoxigenin rhodamine. Then, the ratio of fluorescence was calculated by an image analyzer. The immunohistochemical staining was done in paraffin-embedded tissue with an LSAB kit and avidin-biotin complex (ABC) method. The CGH results showed gains on chromosomes 8q (40%), 1q (30%), 17q (15%), 20q (15%), 18q (15%), 5p (15%), and 13q (15%). Deletions were on chromosomes 17p (45%) and 22q (20%). High-level amplifications (green/red ratio >1.5) were noted on chromosomes 1p31, 1q, 3q25-qter, 5p, 7q31-qter, 8q, 9p22-qter, 10p, 11p, 11q22-qter, 12p, 12q24, 14q21-qter, 15q23-qter, 17q, 18p, 18q12-qter, 20p, and 20q. By comparison with infiltrating ductal carcinoma, the two medullary carcinomas showed high-level amplification on chromosomes 1p31, 1q, 8q, 10p, 11p and 12p. c-erbB-2, c-myc, cyclin D1, and p53 protein expression was immunohistochemically detected in 9 of 20 (45%), 8 of 20 (40%), 10 of 20 (50%), and 13 of 20 (65%), respectively. The results indicate that the amplification on chromosome 8q, 1q and the deletions on chromosomes 17p and 22q are the most frequent genetic alterations in breast cancers among Koreans. The results reveal a different pattern of genetic alteration from previous studies. The CGH results were not correlated with the immunohistochemical profiles. The amplification pattern of medullary carcinomas was quite different from the pattern of infiltrating ductal carcinomas. The CGH was thought to be very useful in the screening of genetic alterations of solid tumors.
Base Sequence ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Carcinoma, Medullary ; Chromosomes, Human ; Comparative Genomic Hybridization* ; Cyclin D1 ; DNA ; Fluorescence ; Humans ; Mass Screening ; Metaphase ; Phyllodes Tumor ; Rhodamines

BACKGROUND: Semantic dementia (SD) is a temporal variant of frontotemporal lobar degeneration (FTLD), which is characterized by naming difficulty, decreased comprehension of words, prosopagnosia and object visual agnosia. We report clinical features, neuropsychological and neuroimaging findings of 4 patients with SD. METHODS: Of 55 patients diagnosed as having FTLD between Jan 1995 and May 2001 at Samsung Medical Center, four patients fulfilled the diagnostic criteria of SD proposed by consensus on FTLD diagnostic criteria. We investigated their clinical features such as presenting symptoms and abnormal behaviors, neuropsychological and neuroimaging findings. Neuropsychological tests included the Seoul Neuropsychological Screening Battery, the Korean-version of Western Aphasia Battery and Hanja reading and writing. All patients underwent brain MRI and FDG-PET. RESULTS: All of the patients showed naming difficulty as a presenting symptom. Language assessments showed severe naming and compre-hension difficulties with preserved fluency and repetition, which were compatible with transcortical sensory aphasia. Whereas Hangul reading aloud and writing were intact, three patients were impaired at Hanja reading and writing. Other neuropsychological tests were remarkable for prosopagnosia, object visual agnosia and memory loss. Brain MRI showed asymmetric temporal atrophies, mainly left antero-inferior temporal cortices. FDG-PET also showed hypome-tabolism in bilateral anterior temporal lobes, more severe on the left. CONCLUSIONS: Our SD patients had characteristic neuropsychological and neuroimaging findings, which can be differentiated from other neurodegenerative diseases. We also found Hanja alexia and agraphia in SD patients, which has not been reported yet.
Agnosia ; Agraphia ; Aphasia ; Aphasia, Wernicke ; Atrophy ; Brain ; Comprehension ; Consensus ; Dyslexia ; Frontotemporal Dementia* ; Frontotemporal Lobar Degeneration ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Memory Disorders ; Neurodegenerative Diseases ; Neuroimaging* ; Neuropsychological Tests ; Prosopagnosia ; Semantics* ; Seoul ; Temporal Lobe ; Writing

To determine whether the PPARalpha agonist fenofibrate regulates obesity and lipid metabolism with sexual dimorphism, we examined the effects of fenofibrate on body weight, white adipose tissue (WAT) mass, circulating lipids, and the expression of PPARalpha target genes in both sexes of high fat diet-fed C57BL/6J mice. Both sexes of mice fed a high-fat diet for 14 weeks exhibited increases in body weight, visceral WAT mass, as well as serum triglycerides and cholesterol, although these effects were more pronounced among males. Feeding a high fat diet supplemented with fenofibrate (0.05% w/w) reduced all of these effects significantly in males except serum cholesterol level. Females on a fenofibrate-enriched high fat diet had reduced serum triglyceride levels, albeit to a smaller extent compared to males, but did not exhibit decreases in body weight, WAT mass, and serum cholesterol. Fenofibrate treatment resulted in hepatic induction of PPAR alpha target genes encoding enzymes for fatty acid beta-oxidation, the magnitudes of which were much higher in males compared to females, as evidenced by results for acyl-CoA oxidase, a first enzyme of the beta-oxidation system. These results suggest that observed sexually dimorphic effects on body weight, WAT mass and serum lipids by fenofibrate may involve sexually related elements in the differential activation of PPARalpha.
Adipose Tissue/drug effects/metabolism ; Animals ; Body Composition/drug effects ; Body Weight/drug effects ; Diet ; Dietary Fats/pharmacology ; Female ; Gene Expression Regulation/drug effects ; Lipids/blood/*metabolism ; Liver/drug effects/metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Obesity/*metabolism/pathology ; Organ Weight/drug effects ; Procetofen/*pharmacology ; Receptors, Cytoplasmic and Nuclear/*agonists ; *Sex Characteristics ; Time Factors ; Transcription Factors/*agonists

Diagnostic exome sequencing (DES) is a powerful tool to analyze the pathogenic variants leading to development delay (DD) and intellectual disability (ID). Recently, heterozygous de novo mutation of the histone acetyltransferase encoding gene KAT6B has been recognized as causing a syndrome with congenital anomalies and intellectual disability, namely Say-Barber-Biesecker-Young-Simpson (SBBYS) syndrome. Here we report a case of SBBYS syndrome in a third generation Korean family affected with a missense mutation in KAT6B, c.2292C>T p.(His767Tyr) identified by DES. This is the first confirmed familial inherited mutation of the KAT6B reported worldwide. Our case emphasizes again the importance of basic physical examination and taking a family history. Furthermore, advances in genetic diagnostic tools are becoming key to identifying the etiology of DD and ID. This allows a physiatrist to predict the disease's clinical evolution with relative certainty, and offer an appropriate rehabilitation plan for patients.
Exome* ; Family Characteristics* ; Histone Acetyltransferases ; Humans ; Intellectual Disability ; Mutation, Missense ; Physical Examination ; Rehabilitation

This paper describes the epidemiological characteristics of bovine brucellosis in Korea during January 2000~September 2004, which encompasses the period when the incidence of bovine brucellosis increased abruptly. Data from the National Animal Infectious Disease Data Management System were used for this study. A range of epidemiological measures was calculated including annual herd and animal incidence. During the study period, there were 1,183 outbreaks on 638 farms. In beef cattle, annual herd incidence increased from 0.2 (2000) to 11.5 (2004, to September) outbreaks per 10,000 and annual animal incidence varied between 3.4 (2000) and 105.8 (2004, to September) per 100,000, respectively. On 401 (62.9%) infected farms during this period, infection was eradicated without recurrence. Recurrence of infection was significantly higher on farms where abortion was reported (53.3%), compared to farms where it was not (30.0%). On beef cattle farms, infection was introduced most frequently through purchased cattle (46.2%). Based on the results of this study, the establishment and spread of brucellosis in the Korean beef cattle population were mainly due to incomplete or inappropriate treatment of aborted materials and the movement of infected cattle.
Animals ; Brucellosis ; Brucellosis, Bovine ; Cattle ; Communicable Diseases ; Disease Outbreaks ; Incidence ; Korea ; Recurrence

BACKGROUND: Primary nodal marginal zone B-cell lymphoma (MZBL) is recently divided into mucosa-associated lymphoid tissue (MALT) type and splenic type. Herein, we analyzed clinicopathologic differences of those two types of nodal MZBL. METHODS: Histologic and clinical findings of eleven cases of primary nodal MZBL lymphoma were reviewed. Immunohistochemical stains for IgD, Ki-67, CD3, and CD20 were performed. RESULTS: The cases were classified as splenic type in four, MALT type in five, and unclassified in two. The age at presentation was 36.7 years old (range: 16-73) in splenic type and 48 years old (range: 31-68) in MALT type. Two patients with splenic type and one with MALT type had a long history of lymphadenopathy up to 9 years. Whereas tumors of splenic type showed nodular infiltration of tumor cells with follicular colonization and hyperplastic germinal center, tumors of MALT type showed mainly sinusoidal or parafollicular infiltration and atrophic germinal centers. All the patients with splenic type were alive at last follow-up and one patient with MALT type died of disease at 5 months after diagnosis. CONCLUSIONS:Although the number of cases we analyzed was small, splenic type seems to be distinct from MALT type and lower grade neoplasm.
Colon ; Coloring Agents ; Diagnosis ; Follow-Up Studies ; Germinal Center ; Humans ; Immunoglobulin D ; Lymphatic Diseases ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Pathology

BACKGROUND AND OBJECTIVES: Parapharyngeal space tumors are extremely rare head and neck tumors. Therefore, there are just a few reports about them. The purpose of this study was to report our experiences of parapharyngeal space (PPS )tumors regarding clinicopathological features and management. SUBJECTS AND METHOD: This study included 51 patients with PPS tumors which were diagnosed from January 1990 through June 2004. Medical records were reviewed retrospectively. RESULTS: The male-to-female ratio was close to 1:1. The mean age was 47 years (6 mo -83 Y ). The most frequent presenting manifestation was asymptomatic neck mass. All patients were subjected to CT scan, while 31 patients underwent MRI in addition. Diagnostic accuracy of fine needle aspiration cytology of 28 cases matched with pathologic reports by 50%. Salivary gland neoplasms occupied the biggest parts (43.1%, 53.8%)of both benign and malignant PPS tumors. Thirteen patients (25.5%)had malignant lesions. Surgical excision was performed in 39 cases (76.5%). The transcervical (30.8%)and the transcervical-transparotid approaches (38.5%)were commonly performed surgical procedures. Overall postoperative morbidity rate was 23.1%. There were 3 recur-rences (42.8%)in malignant tumors and no recurrence in benign ones after surgical excision during the mean follow-up period of 35 months (13 -89 mo ). Close observation, sclerotherapy and radiotherapy were only applicable for a few selected benign lesions. CONCLUSION: Most benign PPS tumors could be removed surgically with low complication and recurrence rates. Optimal surgical approach based on transcervical approach allows safe removal of various types of PPS tumors.
Biopsy, Fine-Needle ; Follow-Up Studies ; Head ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neck ; Neurilemmoma ; Paraganglioma ; Parotid Neoplasms ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salivary Gland Neoplasms ; Sclerotherapy ; Tomography, X-Ray Computed