We report a case of hepatocellular carcinoma presented with severe hypoglycemia. Computerized tomography and ultrasonography revealed a massive bilateral tumor with portal vein thrombosis. The levels of IGF-I (113 ng/mL) and IGFBP- (815 ng/mL) measured in the plasma, were lower than normal range. There was strong immunoreactivity of IGF- and IGF-I in immunohistochemical stain of tumor cells.
Carcinoma, Hepatocellular* ; Carrier Proteins* ; Fibrinogen* ; Hypoglycemia* ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Plasma ; Reference Values ; Ultrasonography ; Venous Thrombosis

Objectives: Dental caries and periodontal disease are infectious and chronic diseases. The aim of the study was to investigate the antimicrobial effect of mentha extracts against Streptococcus mutans (S. mutans ) and Porphyromonas gingivalis (P. gingivalis ). Methods: This activity of mentha extracts were confirmed by the disk diffusion test and minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and colony forming unit (CFU) assays. Results: S. mutans and P. gingivalis showed the highest antimicrobial activity within the inhibition zones. The antimicrobial activity was interrupted as the MIC and MBC of the herbal extracts against the two bacteria were 1 mg/ml and 10 mg/ml, respectively. The antimicrobial effect was determined by the CFU assay. Conclusions Mentha herb extract demonstrated potential antimicrobial activity against S. mutans and P. gingivalis that cause dental caries and periodontal disease.

Background: We investigated cardiovascular disease (CVD), risk factors for CVD, and applicability of the three known CVD risk equations in the Korean human immunodeficiency virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) cohort. Materials and Methods: The study parcitipants were HIV-infected patients in a Korean HIV/ AIDS cohort enrolled from 19 hospitals between 2006 and 2017. Data collected at entry to the cohort were analyzed. The 5-year CVD risk in each participant was calculated using three CVD risk equations: reduced CVD prediction model of HIV-specific data collection on adverse effects of anti-HIV drugs (R-DAD), Framingham general CVD risk score (FRS), and Korean Coronary Heart Disease Risk Score (KRS). Results: CVD events were observed in 11 of 586 HIV-infected patients during a 5-year (median) follow-up period. The incidence of CVD was 4.11 per 1,000 person-years. Older age (64 vs. 41 years, P = 0.005) and diabetes mellitus (45.5% vs. 6.4%, P <0.001) were more frequent in patients with CVD. Using R-DAD, FRS, and KRS, 1.9%, 2.4%, and 0.7% of patients, respectively, were considered to have a very high risk (≥10%) of 5-year CVD. The discriminatory capacities of the three prediction models were good, with c-statistic values of 0.829 (P <0.001) for R-DAD, 0.824 (P <0.001) for FRS, and 0.850 (P = 0.001) for KRS. Conclusion The FRS, R-DAD, and KRS performed well in the Korean HIV/AIDS cohort. A larger cohort and a longer period of follow-up may be necessary to demonstrate the risk factors and develop an independent CVD risk prediction model specific to Korean patients with HIV.

A selective posterior rhizotomy(SPR) was done for reducing spasticity in 18 patients with cerebral palsy. Based on a standard techniques developed by Fasano(Lumbar SPR) and Heimberger(Cervical SPR), we dissected L1-S1 dorsal rootlets through T12, L1 laminectomy in 10 patients and C5-C8 dorsal rootlets through C5-C7 laminectomy in 8 patients. All the rootlets from each root were electrically stimulated with bipolar electrodes(1 sec, 1-50 mV). The muscle responses were observed visually and recorded by intraoperative 8-channel electromyography. The rootlets showing abnormal motor responses visually and electromyopraphically were divided and cut. The Patients were accessed preoperatively and postoperatively in terms of clinical, functional, electrophysiological evaluations. Reduction of spasticity was observed in 9 patients in Lumbar SPR, and 5 patients cervical SPR. Recurrence was seen in 3 patients in Lumbar SPR, and 3 patients in cervical SPR. It was noticed that the reasons for the bad outcomes was due to improper division and selection of the rootlets which should be cut. These results was shown that SPR could be effective for treating spasticity in the patients of cerebral palsy and more selective section of the rootlets based on neurophysiologic monitoring during operation might maximize its effectiveness on SPR in the treatment of spasticity.
Cerebral Palsy* ; Electromyography ; Humans ; Laminectomy ; Muscle Spasticity* ; Neurophysiological Monitoring ; Recurrence

No abstract available.
Female ; Fetomaternal Transfusion* ; Pregnancy

The development of food frequency questionnaire (FFQ) is based on food use and/or dish use. Regardless of potential effect of oils and seasonings on chronic diseases, most of food-based FFQs do not include oils and seasonings in calculation of nutrient intake. This study examined the effect of added (seasoning) oils and seasonings on the distribution of subjects by relative nutrient intake using a dish-based FFQ. The subjects were 1,303 persons (men 478, women 825) aged over 20 years old, who completed FFQ composed of 121 items. Three types of daily nutrient intake were calculated; 1) total nutrient intake with oils and seasonings, 2) nutrient intake without oils, and 3) nutrient intake without oils and seasonings. The correlation and agreement of classification of subjects by relative nutrient intake were examined. All analyses were performed using absolute nutrient intakes and total energy-adjusted nutrient intakes by residual method. Comparing total nutrient intake with the nutrient intake without oils, energy, vegetable fat and vitamin E intake were significantly decreased and kappa values were 0.95 (kappa w = 0.98), 0.64 (kappa w = 0.81), and 0.59 (kappa w = 0.79), respectively. Comparing total nutrient intake with the nutrient intake without oils and seasonings, most of nutrients intake except animal fat, animal protein, retinol and cholesterol were significantly decreased, and kappa values of vegetable fat (kappa = 0.64, kappa w = 0.81), vitamin E (kappa = 0.59, kappa w = 0.79) and sodium (kappa = 0.61, kappa w = 0.80) were under 0.80. After total energy was adjusted, agreement was lower than before total energy adjustment. Excluding oils and seasonings to assess nutrient intake underestimated vegetable fat, vitamin E and sodium intake and affected the distribution of subjects by their relative nutrient intake. Therefore, we suggest that research focused on these nutrients need to be cautious about the interpretation of the results.
Aged ; Animals ; Cholesterol ; Chronic Disease ; Female ; Humans ; Oils ; Surveys and Questionnaires ; Seasons ; Sodium ; Vegetables ; Vitamin A ; Vitamin E ; Vitamins

PURPOSE: This study was conducted to evaluate clinical competency of nursing students and to examine the validity and reliability of the scale. METHODS: The Clinical Competency Scale was formed through modification of Lee's Clinical Competency Scale that was originally developed in 1990. The Clinical Competency Scale was applied to 203 nursing students. Construct validity, item convergent and discriminant validity, concurrent validity, and internal consistency reliability of the scale were evaluated. RESULTS: Exploratory factor analysis supported the construct validity with a five factor solution; that explained 63.6% of the total variance. Concurrent validity was demonstrated with the Nursing Competence Scale (r=.78, p < .001). Cronbach's α coefficient for the scale was .96. CONCLUSION: The results of this study suggest that the Clinical Competency Scale has relatively acceptable reliability and validity and can be used in clinical research to assess clinical competency for nursing students.
Clinical Competence ; Humans ; Mental Competency ; Nursing ; Psychometrics ; Reproducibility of Results ; Students, Nursing

Metastases to the thyroid gland are not frequently observed in clinical practice, although an overall incidence of secondary thyroid malignant tumors has been reported to range from 1.25% to 24% in autopsy series. Generally, patients with metastatic thyroid cancer present with euthyroidism and they do not develop thyroid dysfunction. Thyroid dysfunctions, including hypothyroidism and hyperthyroidism, rarely occur in patients with metastatic thyroid cancer. We describe here a case of hypothyroidism induced by thyroid metastasis from cancer of an unknown primary site in a 53-year-old man and another case of thyrotoxicosis induced by thyroid metastasis from lung cancer in a 65-year-old man.
Aged ; Autopsy ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Thyroid Gland ; Thyroid Neoplasms ; Thyrotoxicosis

Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.
Administration, Oral ; Adult ; Anti-Arrhythmia Agents/therapeutic use ; Humans ; Hypokalemic Periodic Paralysis/*diagnosis/drug therapy/etiology ; Male ; Organotechnetium Compounds/chemistry/diagnostic use ; Potassium Chloride/therapeutic use ; Propranolol/therapeutic use ; Radiopharmaceuticals/diagnostic use ; Thyroiditis/*complications/radiography/ultrasonography ; Thyrotoxicosis/*diagnosis/etiology

PURPOSE: The use of implantable cardioverter defibrillators (ICDs) to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. METHODS: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. RESULTS: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was 14.5+/-5.4 years (range, 2 to 22 years). The follow-up duration was 28.9+/-20.4 months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1), cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years). Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia. During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. CONCLUSION: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.
Adolescent ; Cardiomyopathies ; Channelopathies ; Child ; Convulsive Therapy ; Death, Sudden ; Death, Sudden, Cardiac ; Defibrillators ; Defibrillators, Implantable ; Early Diagnosis ; Follow-Up Studies ; Heart ; Heart Arrest ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Korea ; Long QT Syndrome ; Pediatrics ; Retrospective Studies ; Shock ; Sympathectomy ; Syncope ; Tachycardia, Supraventricular ; Tachycardia, Ventricular