The normal corneal endothelial cell count was measured by the non-contact(Nikon, AS-1, Japan) and contact type(Bio-optic, LSM 2000, USA) specular microscopy. The results of two types were compared to investigate the possible differences in types of specular microscopy. No statistically significant differences were found between the results from the non-contact type and those from the contact type; the mean number of normal Korean corneal endothelial cells according to the age was 2795 in the 2nd decade, 2615 in the 3rd decade, 2463 in the 4th decade, 2283 in the 5th decade, 2119 in the 6th decade, 2019 in the 7th decade and 1920 over the 8th decade.
Endothelial Cells* ; Microscopy*

Anemia and malnutrition are common complications of end-stage renal disease. They increase the morbidity and mortality of end-stage renal disease patients and affect their quality of life. However, the mechanisms of anemia and malnutrition are already known, and their therapeutic guidelines are being established. Appropriate iron supplementation and the development of erythropoiesis-stimulating agents have made anemia easier to manage than in the past. In addition, adequate protein and calorie intake have allowed end-stage renal disease patients to maintain a neutral or positive nitrogen balance. These therapeutic approaches have decreased the morbidity and mortality of these end-stage renal disease patients. This review is a summary of the treatment of anemia and nutrition in end-stage renal disease, based on the Kidney Disease Outcomes Quality Initiative (KDOQI) guideline on anemia and other anemia guidelines, and also on the KDOQI guideline on nutrition and European Best Practice Guideline (EBPG) on nutrition.
Anemia ; Hematinics ; Humans ; Iron ; Kidney Diseases ; Kidney Failure, Chronic ; Malnutrition ; Nitrogen ; Practice Guidelines as Topic ; Protein-Energy Malnutrition ; Quality of Life

Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. It can occur in various diseases and conditions involving destruction of muscle membranes, including muscle strain, persistent coma, drug or alcohol abuse, connective tissue disease, excessive exercise, and surgery. Many factors have been implicated in the development of rhabdomyolysis during surgery; these include patient positioning with obstructed blood flow of either a femoral vessel at the hip or a popliteal vessel at the knee. Rhabdomyolysis can also be caused by muscle compression due to operative positioning during prolonged surgery. Surgery performed in the lithotomy position sometimes results in serious complications of rhabdomyolysis and acute renal failure. We report a case of rhabdomyolysis of both calves associated with the lithotomy position for laparoscopic myomectomy.
Acute Kidney Injury ; Alcoholism ; Coma ; Connective Tissue Diseases ; Glycosaminoglycans ; Hip ; Knee ; Membranes ; Muscles ; Necrosis ; Patient Positioning ; Rhabdomyolysis ; Sprains and Strains

Although pathology reports of thyroid tissue in ovarian teratomas are abundant, benign teratomas of the thyroid are extremely rare in adolescents and adults. Therefore, their clinical characteristics are still not well characterized. We report a case of a 54-year-old woman with a growing mass in her neck. Left lobectomy of the thyroid revealed it to be a benign thyroid teratoma composed of tissues from all three germ layers. Preoperative evaluations included thyroid ultrasonography (US), ultrasound-guided fine needle aspiration cytology (FNAC), and computed tomography (CT) of the neck. A 4.7-cm, well defined, predominantly hypoechoic mass intermingled with hyperechoic internal lesions, was observed in the inferior portion of the left thyroid lobe with substernal extension on US. The posterior extent of the nodule was not visualized due to deep attenuation of the echo. US-guided FNAC failed to reveal any thyroid follicular cells, but suggested a benign cystic tumor. Neck CT hinted at the diagnosis of teratoma because the mass contained large amounts of fat, and the margin was well defined. Extrathyroidal extension and cervical lymphadenopathy were not seen. She underwent left thyroid lobectomy, and histologic examination confirmed benign thyroid teratoma. To the best of our knowledge, this is the first case report of benign thyroid teratoma in Korea.
Adolescent ; Adult ; Biopsy, Fine-Needle ; Female ; Germ Layers ; Humans ; Korea ; Lymphatic Diseases ; Neck ; Teratoma ; Thyroid Gland

Cases of metastases to the thyroid gland seem to be increasing in recent years. The clinical and ultrasonographic findings of diffuse metastases have been sparsely reported. Thirteen cases of diffuse metastases to the thyroid gland were documented by thyroid ultrasonography-guided fine needle aspiration cytology between 2004 and 2013. We retrospectively reviewed the patients with diffuse thyroid metastases. The most common primary site was the lung (n=9), followed by unknown origin cancers (n=2), cholangiocarcinoma (n=1), and penile cancer (n=1). Eleven patients were incidentally found to have thyroid metastases via surveillance or staging FDG-PET. Other 2 patients were diagnosed during work-up for hypothyroidism and palpable cervical lymph nodes. On ultrasonography, the echogenicity of the enlarged thyroid gland was heterogeneously hypoechoic or isoechoic, and reticular pattern internal hypoechoic lines were observed without increased vascularity found by power Doppler ultrasonography (3 right lobe, 2 left lobe, and 8 both lobes). In the 8 patients who had involvement of both lobes, 3 had hypothyroidism. In conclusion, ultrasonographic finding of diffuse metastasis is a diffusely enlarged heterogeneous thyroid with reticular pattern internal hypoechoic lines. Thyroid function testing should be performed in all patients with diffuse thyroid metastases, especially those with bilateral lobe involvement.
Aged ; Bile Duct Neoplasms/pathology ; Biopsy, Fine-Needle ; Cholangiocarcinoma/pathology ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Hypothyroidism/complications ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Penile Neoplasms/pathology ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Thyroid Function Tests ; Thyroid Gland/pathology/*ultrasonography ; Thyroid Neoplasms/pathology/secondary/*ultrasonography

Metformin is a well-established drug for the treatment of type 2 diabetes mellitus. The incidence of metformin-induced lactic acidosis is low, but the estimated mortality rate is approximately 50% in cases with lactic acidosis in combination with metformin therapy. Lactic acidosis occurs most often in patients with compromised cardiac, pulmonary, hepatic, and/or renal function. Acute kidney injury is a relatively frequent problem in cirrhosis patients. Hepatorenal syndrome is a diagnosis of exclusion, making its diagnosis difficult in the clinical field. We report a case of metformin-induced lactic acidosis with acute kidney injury that was misdiagnosed as hepatorenal syndrome in a cirrhosis patient.
Acidosis ; Acidosis, Lactic ; Acute Kidney Injury ; Diabetes Mellitus, Type 2 ; Fibrosis ; Hepatorenal Syndrome ; Humans ; Incidence ; Liver Cirrhosis ; Metformin

BACKGROUND: We aimed to validate a pilot study of photodiagnosis using near infrared (NIR) transillumination and assess the clinical efficacy of hypericin-mediated photodynamic therapy (HYP-PDT) in a rabbit laryngeal cancer model in order to develop a novel therapeutic modality with complete remission and preservation of the functional organ. METHODS: (1) In vitro study: VX tumor cells were subcultured and subjected to HYP-PDT. (2) In vivo study: A laryngeal cancer model was developed in which 12 rabbits were inoculated with a VX tumor suspension in the submucosal area of the left vocal fold using a transoral approach. All rabbits underwent NIR transillumination using light with a wavelength of 780 nm. The survival periods of the three treatment groups (6 rabbits in Group A: HYP-PDT, 3 each in Groups B and C: laser irradiation or HYP administration only) were analyzed. RESULTS: The higher the HYP concentration, the lower the VX cell viability in response to HYP-PDT using 590 nm LED. Following HYP-PDT, small tumors in Group A-1 rabbits healed completely and the animals demonstrated a long survival period, and larger tumors in Group A-2 healed partially with a survival period that extended over 3 weeks after inoculation. The survival of Groups B and C were not different over the first 3 weeks of the study, and were shorter than in Group A. CONCLUSION We found HYP-PDT could be a curative therapy for early-stage cancers that may also preserve organ function, and may inhibit tumor progression and metastasis during advanced stages of laryngeal cancer.

Metformin is a well-established drug for the treatment of type 2 diabetes mellitus. The incidence of metformin-induced lactic acidosis is low, but the estimated mortality rate is approximately 50% in cases with lactic acidosis in combination with metformin therapy. Lactic acidosis occurs most often in patients with compromised cardiac, pulmonary, hepatic, and/or renal function. Acute kidney injury is a relatively frequent problem in cirrhosis patients. Hepatorenal syndrome is a diagnosis of exclusion, making its diagnosis difficult in the clinical field. We report a case of metformin-induced lactic acidosis with acute kidney injury that was misdiagnosed as hepatorenal syndrome in a cirrhosis patient.
Acidosis ; Acidosis, Lactic ; Acute Kidney Injury ; Diabetes Mellitus, Type 2 ; Fibrosis ; Hepatorenal Syndrome ; Humans ; Incidence ; Liver Cirrhosis ; Metformin

BACKGROUND: The vocal cord tissue consists of three anatomical layers from the surface to deep inside: the epithelium that contains almost no collagen, the lamina propria that is composed of abundant collagen, and the vocalis muscle layer. It is clinically important to visualize the tissue microstructure using a non-invasive method, especially in the case of vocal cord nodules or cancer, since histological changes in each layer of the vocal cord cause changes in the voice. Polarizationsensitive optical coherence tomography (PS-OCT) enables phase retardation measurement to evaluate birefringence of tissue with varied organization of collagen fibers in different tissue layers. Therefore, PS-OCT can visualize structural changes between normal and abnormal vocal cord tissue.METHOD: A rabbit laryngeal tumor model with different stages of tumor progression was investigated ex-vivo by PSOCT. A phase retardation slope-based analysis, which quantifies the birefringence in different layers, was conducted to distinguish the epithelium, lamina propria, and muscle layers. RESULTS: The PS-OCT images showed a gradual decrease in birefringence from normal tissue to advanced tumor tissue.The quantitative analysis provided a more detailed comparison among different stages of the rabbit laryngeal tumor model, which was validated by the corresponding histological findings. CONCLUSION Differences in tissue birefringence was evaluated by PS-OCT phase retardation measurement. It is also possible to indirectly infer the dysplastic changes based on the mucosal and submucosal alterations.

BACKGROUND: The vocal cord tissue consists of three anatomical layers from the surface to deep inside: the epithelium that contains almost no collagen, the lamina propria that is composed of abundant collagen, and the vocalis muscle layer. It is clinically important to visualize the tissue microstructure using a non-invasive method, especially in the case of vocal cord nodules or cancer, since histological changes in each layer of the vocal cord cause changes in the voice. Polarizationsensitive optical coherence tomography (PS-OCT) enables phase retardation measurement to evaluate birefringence of tissue with varied organization of collagen fibers in different tissue layers. Therefore, PS-OCT can visualize structural changes between normal and abnormal vocal cord tissue.METHOD: A rabbit laryngeal tumor model with different stages of tumor progression was investigated ex-vivo by PSOCT. A phase retardation slope-based analysis, which quantifies the birefringence in different layers, was conducted to distinguish the epithelium, lamina propria, and muscle layers. RESULTS: The PS-OCT images showed a gradual decrease in birefringence from normal tissue to advanced tumor tissue.The quantitative analysis provided a more detailed comparison among different stages of the rabbit laryngeal tumor model, which was validated by the corresponding histological findings. CONCLUSION Differences in tissue birefringence was evaluated by PS-OCT phase retardation measurement. It is also possible to indirectly infer the dysplastic changes based on the mucosal and submucosal alterations.