Paneth cell-rich carcinoma is essentially an adenocarcinoma with a predominance of Paneth cells. A 60-year-old male patient was admitted with a history of abdominal distension for several months. Endoscopic examination revealed a large ulceroinfiltrative tumor involving most of the areas of the stomach. The biopsy of the lesion confirmed poorly differentiated adenocarcinoma and total gastrectomy was followed. The submitted total stomach contained a diffuse infiltrative Borrmann type IV mass with ulceration, 8.0 3.5 cm, at the body along the lesser curvature. Microscopically, it was composed of Paneth cell differentiated cancer cells and poorly differentiated tubular adenocarcinoma cells. The Paneth cell differentiation was characterized by cytoplasmic coarse eosinophilic granules, which were PAS-positive and positive reaction for lysozyme. Electron microscopic examination showed numerous, spherical, electron-dense, homogeneous granules corresponding to those in Paneth cells as well as mucin granules in the signet-ring cells, and various intermediate forms in some cancer cells, which might be immature in the Paneth cell lineage.
Adenocarcinoma ; Biopsy ; Cell Differentiation ; Cell Lineage ; Cytoplasm ; Eosinophils ; Gastrectomy ; Humans ; Male ; Middle Aged ; Mucins ; Muramidase ; Paneth Cells ; Stomach* ; Ulcer

PURPOSE: To analyze the factors that affected continuous curvilinear capsulorhexis (CCC) remodeling to different shapes after CCC widening with Nd:YAG laser. METHODS: The medical records of patients who underwent CCC widening with Nd:YAG laser between January 2002 and December 2010 in our clinic were retrospectively reviewed. Eyes that underwent phacoemulsification surgery alone or combined phacoemulsification surgery and vitrectomy were eligible for the study. A remodeled CCC with a nearly complete circle was classified as type a, starfish-shape as type b, and not remodeled CCC as type c, The factors that affected CCC remodeling were analyzed. RESULTS: Among 424 eyes of 316 patients, the type of CCC remodeling had a significant correlation with the time period from phacoemulsification surgery to Nd:YAG CCC widening. There was no significant correlation with age, sex, diabetes, type of intraocular lens, type of surgery and indications for surgery. CONCLUSIONS: CCC widening using Nd:YAG laser was effective and had minimal complications. The sooner the procedure was performed, the more circular CCC remodeling occurred. The capsule's elasticity may influence CCC remodeling, but more studies are needed to clarify other factors.
Capsulorhexis* ; Elasticity ; Humans ; Lenses, Intraocular ; Medical Records ; Phacoemulsification ; Retrospective Studies ; Vitrectomy

Decrease of occlusal vertical dimension (OVD) due to loss of teeth structure and destruction of the occlusal plane by severely worn dentition may cause cross bite or temporomandibular joint disorder by following change of facial feature or the loss of anterior guidance. Full mouth rehabilitation via an increase of the OVD can be considered to avoid this problem and proper evaluation of patient's OVD is essential. An 80 year old male visited for overall prosthodontic treatment, cross bite due to continuous wear and following decrease of the OVD were observed. We analyzed the existing occlusal relationship using the diagnostic cast, the radiographic evaluation and clinical test, and then proper increase of OVD was selected. The new OVD on diagnostic wax up was placed by the temporary restoration. After 3 months of observation period, final restoration with fixed partial dentures and implant overdenture were made. Throughout the follow-up period of 8 months, the aesthetic and functional improvement can be obtained.
Dental Occlusion ; Dentition ; Denture, Overlay ; Denture, Partial, Fixed ; Follow-Up Studies ; Humans ; Male ; Malocclusion ; Mouth Rehabilitation* ; Mouth* ; Prosthodontics ; Temporomandibular Joint Disorders ; Tooth Loss* ; Tooth* ; Vertical Dimension*

BACKGROUND: Long menstrual cycle is a risk factor for developing type 2 diabetes and cardiovascular disease in women. We aimed to evaluate the association between existing type 2 diabetes and oligomenorrhea before diagnosis of diabetes, and to observe the differences in this association among obese and non-obese Korean women. METHODS: Patients with type 2 diabetes (n=118) and without any clinical evidence of abnormal glucose regulation (n=258) who attended the outpatient clinic of a university hospital and were over age 30. Patients self-reporting a menstrual cycle over 40 days during their 20s were defined as oligomenorrhea before diagnosis of diabetes. Obesity was defined as having a body mass index (BMI) over 25 kg/m2. RESULTS: The frequency of oligomenorrhea before diagnosis of diabetes was almost two-fold higher in women with type 2 diabetes than in the control group (16.1% vs. 8.5%, P=0.03). Oligomenorrhea was associated with type 2 diabetes after adjusting for age, BMI, systolic blood pressure, triglycerides, and high density lipoprotein cholesterol (odds ratio, 3.89; 95% confidence interval, 1.37 to 11.04). Among women with oligomenorrhea before diagnosis of diabetes, the frequency of type 2 diabetes was significantly higher in obese subjects than in their non-obese counterparts (90.9% vs. 30.0%, P=0.03). CONCLUSION: Having a long menstrual cycle could be a risk factor for the development of type 2 diabetes, especially in obese women.
Ambulatory Care Facilities ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Female ; Glucose ; Humans ; Lipoproteins ; Menstrual Cycle ; Obesity ; Oligomenorrhea ; Risk Factors ; Triglycerides

BACKGROUND: Many people experience varying levels of discomfort when confronted with the prospect of dental treatment. Dental treatment can be a traumatic experience, especially for children and adolescents with dental anxiety. In this age group, dental fear causes a significant problem in dental management and has been related to severe dental caries and dental pain. The Dental Fear Survey ( DFS ) is the most widely used measure of dental fear. This study was undertaken to develop the Korean version of the DFS ( K-DFS ) and test its reliability and validity. METHODS: The K-DFS, which uses projective techniques to measure children's and adolescents' dental fear, was developed. The DFS was translated into Korean and participants were selected via convenience sampling. Reliability and validity were tested using data from a sample of 813 middle school students in Gyeonggi Province, selected from the Self questionnaire survey. The K-DFS was administered twice to 102 adolescents aged 12-15 years. RESULTS: The K-DFS had high internal consistency reliability (99.1%) but low test-retest reliability. CONCLUSIONS: The results indicate that the Korean versions of the DFS have good internal consistency reliabilities and test-retest validities. However, we need to further examine the test-retest reliability of the K-DFS and replicate the current study in different samples covering various age groups.
Adolescent ; Anxiety ; Child ; Dental Anxiety* ; Dental Caries ; Gyeonggi-do ; Humans ; Projective Techniques ; Reproducibility of Results*

BACKGROUND: There are few previous studies investigating the relationship of dental fear and anxiety (DFA) with dental pain among children and adolescents. To address this issue, we examined the literature published between November 1873 and May 2015 to evaluate the prevalence of DFA and dental pain among children and adolescents, and their relationships with age and sex. METHODS: We performed a broad search of the PubMed database using 3 combinations of the search terms dental fear, anxiety, and dental pain and prevalence. A large proportion of the identified articles could not be used for the review due to inadequate end points or measures, or because of poor study design. Thirty-two papers of acceptable quality were identified and reviewed. RESULTS: We found that the prevalence of DFA was estimated to be 10%, with a decrease in prevalence with age. It was more frequently seen in girls, and was related to dental pain. CONCLUSIONS: We concluded that dental fear, anxiety, and pain are common, and several psychological factors are associated with their development. In order to better understand these relationships, further clinical evaluations and studies are required.
Adolescent* ; Anxiety* ; Child* ; Dental Anxiety* ; Female ; Humans ; Prevalence ; Psychology

BACKGROUND/AIMS: Sleep disorder (SD) is associated with an increased risk of cardiovascular disease and is more prevalent among individuals with type 2 diabetes mellitus. These health problems not only frequently coexist but also exacerbate each other. We conducted a cross-sectional study to estimate the prevalence of SD among diabetic patients and to investigate the relationship between SD and cardiovascular risk among these patients. METHODS: We recruited 784 patients with type 2 diabetes and conducted a self-administered questionnaire. We assessed sleep quality using the Pittsburgh Sleep Quality Index and the risk of obstructive sleep apnea (OSA) using the Berlin Questionnaire. Additional information included blood pressure and metabolic profiles. RESULTS: Of the 784 diabetic patients, 301 (38.4%) patients had poor sleep quality, and 124 (15.8%) were at high risk for OSA. Patients at increased risk for OSA were more obese; they also had higher blood pressure, fasting plasma insulin levels, insulin resistance assessed by homeostasis model assessment (HOMA-IR), and serum triglycerides levels (p < 0.05). The frequency of risk for OSA was higher among obese patients compared with non-obese patients (34.8% vs. 9.4%, p < 0.05). Logistic regression analysis revealed that male sex and bone mass index were independent predictors of risk for OSA. CONCLUSIONS: SD was prevalent among type 2 diabetic patients, and OSA could aggravate their risk for cardiovascular disease. Clinical treatment of these patients should include evaluation and intervention for SD.
Adult ; Aged ; Analysis of Variance ; Body Mass Index ; Cardiovascular Diseases/*epidemiology ; Chi-Square Distribution ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Obesity/epidemiology ; Prevalence ; Questionnaires ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Sex Factors ; Sleep Apnea, Obstructive/epidemiology ; Sleep Disorders/diagnosis/*epidemiology

PURPOSE: To correlate high-resolution CT (HRCT) findings with smoking history and pulmonary function test (PFT) in patients with idiopathic pulmonary fibrosis (IPF) with or without coexisting emphysema. MATERIALS AND METHODS: The study included 24 patients who had undergone HRCT and in whom IPF had been confirmed pathologically (n=7) and clinically (n=17). The patients included 19 men and 5 women aged between from 44 and 78 (mean 59) years. HRCT findings were reviewed by two radiologists and assessed for the presence and extent of emphysema (CT emphysema score ; CES) and honeycombing (CT honeycombing score ; CHS). CES and CHS were retrospectively correlated with smoking status and pulmonary function test. RESULTS: Evidence of emphysema was seen on HRCT in 20 of 24 patients with IPF (83 %). CES was 14.3 and CHS was 18.1 in smokers with IPF, as compared with 1.8 and 6.7 in nonsmokers (p < 0.01). Pulmonary function tests showed lower percent predicted FEV1 (69.3 %), FVC (64.7 %), TLC(73.7 %), and RV (77.3 %), a lower percent predicted diffusing capacity of carbon monoxide (58.2%), and normal FEV1/FVC (99.1%). The pulmonary function test in smokers showed higher TLC and RV than in nonsmokers. Eight of nine patients whose CES was higher than their CHS, as seen on HRCT, were smokers and had a smoking history of 33.1 pack-years. Seven of 15 whose CHS was higher than their CES were smokers and had a smoking history of 16.8 pack-years. In patients with a higher CES than CHS pulmonary function test results showed normal TLC (85 %) and RV (100.7%) ; this contrasted with decreased TLC (72 %) and RV (68 %) in patients whose CHS was higher than their CES. CONCLUSION: Emphysema is a frequently associated finding in patients with IPF, as seen on HRCT, and emphysema is more frequent and extensive in smokers with IPF than non-smokers. HRCT is useful for detecting emphysema in patients with IPF, and the extent of emphysema on HRCT correlates with the results of the pulmonary function test and smoking status.
Carbon Monoxide ; Emphysema* ; Female ; Humans ; Idiopathic Pulmonary Fibrosis* ; Male ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking

STATEMENT OF PROBLEM: Because dental impression can be a cross-infection source, disinfection, such as immersion disinfection is nessecary. However, the disinfection process may change the volume of the impression cast. PURPOSE: The purpose of this study is to find out the effects on dimensional change of different storage times and methods, of agar-alginate impression when immersed in a 5% idophor disinfectant. MATERIAL AND METHODS: An agar-alginate impression was made from a mandible model and then was disinfected and stored according the experimental conditions and a stone model was produced. Measurements were taken between reference points on the original mandible model and they were compared to measurements taken between reference points on the stone model. The study was divided into 4 groups. In group 1, the impression was stored in a 100% humidor for 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, 12 hours and 24 hours and stone models were made at each time. In group 2, the impression was immersed in 5% idophor disinfectant and then stored in a 100% humidor for the same length of times as group 1, and stone models were made at each time. In group 3, the impression was stored in extend-A-pourR, a special storage solution for 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, 12 hours, 24 hours 3 days, and 7 days and stone models were made at each time. In group 4, the impression was immersed in 5% idophor disinfectant and then stored in stored in extend-A-pourR, a special storage solution for the same length of times as group 3, and stone models were made at each time. 5 impressions and stone models were made at each time to make a total of 180. The Student-t test (P < .05) was used to do a statistical analysis of the measurements of the mandible model and stone models. The repeated-measure 2-way analysis of variance (P < .05) was used to do a statistical analysis of the difference in the 4 groups. RESULTS: The percent liner dimensional change was from 0.25+/-0.03% (group 1, 30 minutes) to 0.34+/-0.06% (group 4, 7 days). No significant change was noticed between the 4 groups. CONCLUSION: According to the above study, in both methods, least dimensional change was recorded when the storage times were short and in both methods, immersion in 5% idophor disinfectant did not effect dimensional change in the agar-alginate impression.
Disinfection* ; Immersion ; Mandible

PURPOSE: To examine the effect of bosentan, a dual endothelin receptor (ER) antagonist, on the development of monocrotaline (MCT)-induced pulmonary hypertension in rats by especially focusing on the pulmonary vascular morphology changes. METHODS: Sprague-Dawley rats were treated as follows: controls received a subcutaneous saline injection, MCT-treated rats received a subcutaneous MCT injection, and bosentan-treated rats received a MCT injection followed by treatment with bosentan (20 mg/kg/day). To assess the effects of ER blockade on the time course, the animals were exsanguinated, and their hearts and lungs were dissected after 7, 14, or 28 days. RESULTS: The mean body weights of the MCT- and bosentan-treated rats were significantly lower than that of the control rats on days 7, 14, and 28. Bosentan administration significantly inhibited the progression of right ventricular hypertrophy on day 28 (right ventricle/[left ventricle+septum]: 0.71+/-0.10 in MCT-treated rats vs. 0.49+/-0.09 in bosentan-treated rats; P<0.05). Quantitative analysis of peripheral pulmonary arteries revealed that the increase in medial wall thickness after MCT injection was significantly attenuated in the bosentan-treated rats on day 28 (49.96+/-10.06% in MCT-treated rats vs. 47.09+/-10.48% in bosentan-treated rats; P<0.05). In addition, the increase in the number of intra-acinar muscular arteries after MCT injection was reduced by bosentan on days 14 and 28. CONCLUSION: Bosentan administration in intermediate doses exerts inhibitory effects on lung vascular hypertrophy and right ventricular hypertrophy during the development of MCT-induced pulmonary hypertension in rats.
Animals ; Arteries ; Body Weight ; Endothelins ; Heart ; Hypertension, Pulmonary ; Hypertrophy ; Hypertrophy, Right Ventricular ; Lung ; Monocrotaline ; Pulmonary Artery ; Rats ; Rats, Sprague-Dawley ; Receptors, Endothelin ; Sulfonamides