A case of tonic pupil in a 32 years-old Korean male has been reported. This is a rare disease and hitherto it is not reported in Korea. A brief review of literatures has also been described.
Adult ; Humans ; Korea ; Male ; Rare Diseases ; Tonic Pupil*

BACKGROUND: Several recent studies have reported that generation of inflammatory cytokines and activation of complements may be associated with febrile nonhemolytic transfusion reactions (FNHTR). However, few data are available for whole blood, which is still commonly utilized for massive transfusion and for autologous transfusion. METHODS: A total of 15 whole blood units from healthy adult donors was collected and stored at 4degrees C for 35 days. During the storage time, samples for analyses of cytokines including interleukin-1alpha (IL-1alpha), IL-2, IL-6, IL-8, and tumor necrosis factor alpha (TNFalpha) and anaphylatoxins such as C3a and C5a were obtained on day 0, 1, 3, 5, 7, 14, 28, and 35. Cytokines were measured by enzyme-linked immunosorbent assay and anaphylatoxins by radioimmunoassay. RESULTS: IL-1alpha (<0.5 pg/mL), IL-2 (<7 pg/mL), and TNFalpha (<4.4 pg/mL) were not detectable. IL-6 was measured in 4 units with low level (1.1-4.0 pg/mL) and IL-8 showed slightly higher level (10.5 pg/mL) on day 35. Anaphylatoxins (C3a and C5a) were detectable at the level of 1350.0 ng/mL on day 21 and of 14.6 ng/mL on day 14, respectively, which were significantly increased levels compared with those on day 0. The levels of C3a and C5a reached 2513.3 ng/mL and 18.4 ng/mL on day 35, respectively. CONCLUSIONS: It is not likely that cytokines generated during storage of whole blood under normal blood banking condition could explain FNHTR. However, anaphylatoxins are elevated in whole blood after 2 weeks of storage, which might be due to complement activation by the plastic surface of blood bag.
Adult ; Anaphylatoxins* ; Blood Banks* ; Blood Group Incompatibility ; Complement Activation ; Complement System Proteins ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1alpha ; Interleukin-2 ; Interleukin-6 ; Interleukin-8 ; Plastics ; Radioimmunoassay ; Tissue Donors ; Tumor Necrosis Factor-alpha

Primary adrenal insufficiency is a rare disease which can lead to fatal outcomes when complicated in pregnancy. The vague symptoms such as nausea, fatigue and abdominal pain may interfere with its diagnosis. But once the diagnosis is made after a simple ACTH stimulation test, a successful pregnancy and delivery can be accomplished by replacement of steroids. It is to be noted that proper management in crises such as labor, delivery, operation and postpartum is very important. We report a case of successful delivery of a woman with primary adrenal insufficiency with a brief review of literature.
Abdominal Pain ; Addison Disease* ; Adrenocorticotropic Hormone ; Diagnosis ; Fatal Outcome ; Fatigue ; Female ; Humans ; Nausea ; Postpartum Period ; Pregnancy* ; Rare Diseases ; Steroids

OBJECTIVE: Many countries including U.S. have established their own Antenatal Screening Guideline suitable for their actual state to help Obstetricians detect pregnancy-related problems in clinical conditions. However, even investigations on the actual condition of Antenatal Screening in clinical conditions are not thoroughgoing enough in Korea. Therefore, this study was to survey the actual condition of Antenatal Screening in Obstetric Clinics in Korea. METHODS: Among 868 Obstetric Clinics, in which 100 or more cases of delivery were performed per annum according to an aggregate summary of the National Health Insurance Corporation in 2001, 848 clinics representing their correct address were selected to carry out a cross-sectional descriptive survey and understand the actual state of Antenatal Screening with literature review. RESULTS: Antenatal Screening Tests have been carried out in a diverse forms in Obstetric Clinics; some items (CBC, Urine analysis, VDRL test, ABO and Rh typing, HBs Ag and HBs Ab test, Triple test, Ultrasound, Rubella Ig M and Ig G test, Oral Glucose Tolerance test) of the test were performed as a basic test in 80% or higher of Obstetric Clinics; some items (Chlamydia test, PAPP-A, Chest X-ray, BUN, Creatinine, EKG, Cervix culture for Gonococcus) of the test were performed routinely in 10% or less of Obstetric Clinics or selectively in high-risk pregnant women; and some items (PAP smear, Blood chemistry, Nuchal translucency) of the test were performed on the basis of physician's experience or given conditions. CONCLUSION: According to the findings of this study, the role of Antenatal Tests as a screening test in clinical conditions is not evaluated properly under the current state. Thus, clinical assessment should be performed for each item of Antenatal Tests with respect to a screening test and systematic and efficient Antenatal Screening Guideline suitable for Korean conditions should be established in future studies.
Cervix Uteri ; Chemistry ; Creatinine ; Electrocardiography ; Female ; Glucose Tolerance Test ; Humans ; Korea* ; Mass Screening ; National Health Programs ; Pregnancy-Associated Plasma Protein-A ; Pregnant Women ; Prenatal Diagnosis* ; Rubella ; Thorax ; Ultrasonography

PURPOSE: We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. MATERIALS AND METHODS: Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2 mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The complications were investigated during the follow up period. RESULTS: Stent placement was successful in all the patients. After stent placement, the symptoms improved in all but one patient. During the follow up, stent migration occurred in one patient (3%) at 34 days after the procedure. Despite the stent migration, the patient was able to resume a soft diet. Six patients developed recurrent symptoms of obstruction with tumor overgrowth at a mean of 145 days after the procedure; all the patients underwent coaxial placement of an additional stent with good results. One patient showed recurrence of obstruction due to tumor in-growth, and this was treated by placement of a second stent. Two patients with stent placement in the duodenum suffered from jaundice 26 days and 65 days, respectively, after their procedures. CONCLUSION: Placement of the newly designed complex expandable nitinol stent seems to be effective for the palliative treatment of malignant gastroduodenal obstructions. The new stent also seems to help overcome the disadvantage of the increased migration observed for the covered stent.
Diet ; Duodenal Obstruction ; Duodenum ; Eating ; Female ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Jaundice ; Male ; Nylons ; Palliative Care ; Recurrence ; Stents*

The steroid cell tumor, not otherwise specified, constitutes only 0.1% of ovarian malignancies and was asymptomatic in 3.3-25% In Korea, three reported cases of steroid cell tumors were endocrinologically symptomatic and were managed with laparotomy. However, there was no reports of such case without any endocrinologically symptoms. We present a 17 years old patient with huge pelvic mass that were managed with combined ultrasonographically guided drainage and laparoscopically excision and proven to be an asymptomatic steroid cell tumor of ovary, with brief review of literature.
Adolescent ; Drainage ; Female ; Humans ; Korea ; Laparoscopy ; Laparotomy ; Ovary

We aimed to identify blood lymphocytes as a prognostic factor for survival in patients with locally advanced stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (CCRT). This is a secondary study of 196 patients enrolled in the Korean Radiation Oncology Group 0903 phase III clinical trial to evaluate the prognostic significance of circulating blood lymphocyte levels. The median total lymphocyte count (TLC) reduction ratio during CCRT was 0.74 (range: 0.29-0.97). In multivariate analysis, patient age (p=0.014) and gross tumor volume (GTV, p=0.031) were significant factors associated with overall survival, while TLC reduction (p=0.018) and pretreatment neutrophil-to-lymphocyte ratio (NLR; p=0.010) were associated with progression-free survival (PFS). In multivariate logistic regression analysis, pretreatment NLR, GTV, and heart V20 were significantly associated with TLC reduction. Immunohistochemical analysis of programmed death ligand 1 and CD8 expression on T cells was performed on 84 patients. CD8 expression was not significantly associated with the pretreatment lymphocyte count (p=0.673), and PDL1 expression was not significantly associated with OS or PFS. Univariate analysis revealed that high CD8 expression in TILs was associated with favorable OS and was significantly associated with favorable PFS (p=0.032). TLC reduction during CCRT is a significant prognostic factor for PFS, and heart V20 is significantly associated with TLC reduction. Thus, in the era of immunotherapy, constraining the volume of the radiation dose to the whole heart must be prioritized for the better survival outcomes.

BACKGROUND: To meet the need for a subspecialized skin type system, the Baumann skin type (BST) system was proposed. OBJECTIVE: To evaluate the distribution of BST types and influencing factors among Korean women. METHODS: BST questionnaires were administered to 1,000 Korean women. The possible responses were as follows: oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). The correlations of the BST with the subjects' age, location, ultraviolet (UV) ray exposure, drinking and smoking habits, and blood type were assessed. RESULTS: The OSNT, DSNT, DRNT, and OSNW skin types were the most common skin types (55.3%). The O, S, P, and W types accounted for 46.6%, 68.8%, 23.2%, and 31.9%, respectively. The proportion of the O and S type was the highest in Gyeongsangbuk-do (55.0%) and Seoul (77.2%). The proportion of the P and W type was the highest in Gyeongsangbuk-do (33.0%) and Chungcheong-do (39.0%). The O type decreased in the higher age group, whereas the P and W type showed a reversed tendency. In smokers, the proportion of W type was significantly higher than in the non-smokers (66.3% vs. 24.1%, p<0.05). CONCLUSION: The 4 most common BST types were OSNT, DSNT, DRNT, and OSNW. In the comparison across the 4 BST parameters according to the age, region, smoking and drinking habits, occupation, blood type, and UV exposure, significant differences were observed. Individualized and customized skin care is required according to the personal skin type.
Drinking ; Female* ; Gyeongsangbuk-do ; Humans ; Occupations ; Seoul ; Skin Care ; Skin* ; Smoke ; Smoking ; Surveys and Questionnaires

OBJECTIVE: To determine the clinical value of human papillomavirus deoxyribonucleic acid(HPV DNA) testing by polymerase chain reaction(PCR), specifically to examine whether HPV testing could identify the women with Pap smears read as mostly atypical squamous cells of undetermined significance(ASCUS) or more. METHODS: HPV DNA testing by PCR for 3 high-risk cancer associated genotypes(HPV 16, 18, 33), repeat Pap smears and colposcopically directed punch biopsies were performed concurrently on 169 women referred for cervical cancer screening test with a previous Pap smear read as ASCUS or more. RESULTS: HPV DNA testing positivity was significantly associated with abnormal cytology and high-grade squamous intraepithelial lesion(HSIL) and squamous cell carcinoma(SCC) in histology(P=0.034). The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) of Pap smear and HPV testing for identifying 38 cases of histologically confirmed HSIL and carcinoma by different triage protocols(HPV positive or HSIL or SCC) among 169 women were 65.8%(25/38), 85.5%(112/131), 56.8%(25/44) and 89.6%(112/125), respectively. Also sensitivity, specificity, PPV and NPV were varied by ages and more higher in older. CONCLUSION: HPV DNA testing by PCR appears to offer an effective means by which women whose cervical Pap smears have been read as ASCUS or more could be triaged for colposcopically directed biopsy. The sensitivity for HSIL could be maintained in high and specificity markedly improved by HPV genotypes 16, 18, 33.
Biopsy ; Chromosome Aberrations* ; Female ; Genotype ; Human Papillomavirus DNA Tests ; Humans ; Mass Screening ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Triage ; Uterine Cervical Neoplasms

PURPOSE : Since the year 2000, lung cancer has been the leading cause of cancer death in South Korea and also in many other parts of the world. MATERIALS AND METHODS : We developed a multidisciplinary (MD) care system for lung cancer patients in 1996. Here, we report the results obtained in the process of development of MD team (MDT). RESULTS : The MDT was launched with including medical doctors, chest surgeons, radiation oncologists, radiologists, nuclear medicine specialists and physician assistants. To facilitate co-operation between the MDT members, a specialized out-patient clinic was located within a sector of the hospital. A common ward was allocated for lung cancer patients regardless of the department of the attending physician. Shared electronic medical record forms that were specialized for lung cancer were developed. The MDT operates weekly lung cancer conferences and multidisciplinary out-patient clinics. To make diagnostic or therapeutic decisions early on, the electronic medical records of the patients were previewed or consulted by the specialists before they meet the individual patients. CONCLUSION : Despite every effort, we still need to shorten the waiting time from presentation to the first treatment and we need to improve the patients' satisfaction. We also have a mission to develop our own regulations and guidelines for our lung cancer MD care system. Clinical trials and basic research should also be encouraged along with improving the quality of life of the team members
Congresses as Topic ; Electronic Health Records ; Humans ; Lung ; Lung Neoplasms ; Missions and Missionaries ; Nuclear Medicine ; Outpatients ; Physician Assistants ; Quality of Life ; Republic of Korea ; Social Control, Formal ; Specialization ; Thorax