No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

PURPOSE: The purpose of this study is to investigate the differences Quality of Life(QOL) according to menopausal symptoms in middle aged women. METHOD: The subjects consisted of 578 women(45-60 years old) residing in urban area by convenience sampling from March 15 to May 30, 2002. The data were collected by structured questionnaire that included general characteristics, menopausal symptoms and QOL scale. the collected data were analyzed by the SPSS 11.0 program that included descriptive statistics, t-test and ANOVA. RESULT: The averaged age of menopause of subjects was 48.29 4.66 years and 74.8% in the subjects complained menopausal symptoms. As for the orders of complained menopausal symptom, it was fatigue, hot flashes, benumbed hands and feet, and irritability. The mean score of the QOL scale was showing above average level of quality of life. Religion was significantly different to the score for activity of QOL, monthly income was different to the score for activity and physical well-being of QOL. Menopausal status was significantly different to the QOL. CONCLUSION: This study suggests that a replicate study is needed. The results are also useful in developing various programs for health promotion of middle aged women.

Four cases of incontinentia pigmenti (Bloch-Sulzberger type) in a mother and three her daughter were presented and literatures were reviewed. In all three daughters vesicles appeared on toes at three weeks after birth and ehanged to pigmented patches surrounded by erythematous verrucous margin, which were then gradually spread to whole body. Pigmentation is dirty, irregular and bizarr. Severe itching sensation was complained and vesicles or bulla were formed easily due to scratching and external trauma. In mother, onset of the disease was not clear but generalized dirty pigmentation is showed. Dentition was delayed in 3rd daughter (Dental eruption was begun at 10 month old and 11 teeth was showed at now, 2 year old). Histopathological findings are compatible with incontinentia pigmenti and epidermo-dermaI separation is observed in a experimentally induced bullae, indicating a characterized epidermolysis bullosa. Strict limitation in the occurence of disease in females of one family, accompanying with epidermolysis bullosa simplex is unusual and interesting in genetical aspects and pathogenesis.
Dentition ; Epidermolysis Bullosa ; Epidermolysis Bullosa Simplex ; Female ; Humans ; Incontinentia Pigmenti* ; Infant ; Mothers ; Nuclear Family ; Parturition ; Pigmentation ; Pruritus ; Sensation ; Toes ; Tooth

BACKGROUND: Several studies have shown that people with diabetes are vulnerable to infection. This study compared the risk of infection-related hospitalizations, intensive care unit (ICU) admission, and deaths between the person with diabetes and the generalpopulation in South Korea.METHODS: We conducted a cohort study of 66,426 diabetes and 132,852 age-sex-region-matched non-diabetes controls from the general population using a sample of data from the National Health Insurance Service-National Sample Cohort. The cohort was followed up for 9 years. Infections were classified into 17 separate categories. We used Poisson regression, with adjustment for household income and other comorbidities, to estimate incidence rate ratios (IRRs) in order to compare of infection-related hospitalizations, ICU admissions, and deaths.RESULTS: Compared to non-diabetes controls, diabetes group had a greater risk of almost all the types of infections considered, with the adjusted IRRs (aIRRs) for infection-related hospitalizations being the highest for hepatic abscess (aIRR, 10.17; 95% confidence interval [CI], 7.04 to 14.67), central nervous system (CNS) infections (aIRR, 8.72; 95% CI, 6.64 to 11.45), and skin and soft tissue infections other than cellulitis (SSTIs) (aIRR, 3.52; 95% CI, 3.20 to 3.88). Diabetes group also had a greater risk of ICU admission and death due to SSTIs (aIRR, 11.75; 95% CI, 7.32 to 18.86), CNS infections (aIRR, 5.25; 95% CI, 3.53 to 7.79), and bone and joint infections (aIRR, 4.78; 95% CI, 3.09 to 7.39).CONCLUSION: In South Korea, people with diabetes has a considerably higher incidence of infection-related hospitalizations and deaths than the general population.
Cellulitis ; Central Nervous System ; Cohort Studies ; Comorbidity ; Diabetes Mellitus ; Family Characteristics ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Joints ; Korea ; Liver Abscess ; National Health Programs ; Skin ; Soft Tissue Infections

Diffusely infiltrating primary colorectal carcinoma is a rare disease. This type of carcinoma extensively spreads beneath the mucosal layer. Clinically, it resembles inflammatory colorectal disease and metastatic carcinoma and is difficult to diagnosis. Moreover, the prognosis is extremely poor. A 66-year-old man was admitted to our hospital because of lower abdominal pain. Barium enema showed circumferential long segment narrowing in the proximal sigmoid colon without definite mass or ulceration and abdominal CT demonstrated colonic wall thickening. So it was diagnosed as inflammatory condition by image study. Colonoscopic examination showed hypertrophied mucosa and luminal narrowing on the 40 cm from the anal verge, but the oral side couldn't be examined because of stenosis. Biopsy revealed poorly differentiated adenocarcinoma, and left hemicolectomy was done. The pathology showed diffusely infiltrating adenocarcinoma with metastasis in regional lymph node and mesentry involvement.
Abdominal Pain ; Adenocarcinoma ; Aged ; Barium ; Biopsy ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms* ; Colorectal Neoplasms ; Constriction, Pathologic ; Diagnosis ; Enema ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Pathology ; Phenobarbital ; Prognosis ; Rare Diseases ; Tomography, X-Ray Computed ; Ulcer

Objective: To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patientswith breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventionaldiffusion-weighted imaging (cDWI). Materials and Methods: Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm2 (cDWI800and cDWI1500) and sDWI at b-values of 1000 and 1500 s/mm2 (sDWI1000 and sDWI1500). Qualitative analysis (normal glandulartissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI setsand the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI setin 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test,one-way analysis of variance, and Cochran’s Q test. Results: All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasingb-values, regardless of the type of imaging (synthetic or conventional) (p< 0.001). Additionally, sDWI1500 provided better lesionconspicuity than cDWI1500 (3.52 ± 0.92 vs. 3.39 ± 0.90, p< 0.05). Although cDWI1500 showed better normal glandular tissuesuppression and overall image quality than sDWI1500 (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively;p< 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater insDWI1500 than in cDWI1500 (0.63 ± 0.17 vs. 0.55 ± 0.18, p< 0.001). Conclusion sDWI1500 can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity,better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI1500.

Androgen receptor (AR) signaling is important for prostate cancer (PCa) cell proliferation. Here, we showed that proliferation of hormone-sensitive prostate cancer cells such as LNCaP was significantly enhanced by testosterone stimulation whereas hormone-insensitive prostate cancer cells such as PC3 and VCaP did not respond to testosterone stimulation. Blocking of AR using bicalutamide abolished testosterone-induced proliferation of LNCaP cells. In addition, knockdown of AR blocked testosterone-induced proliferation of LNCaP cells. Basal expression of low-density lipoprotein receptor-related protein 6 (LRP6) was elevated in VCaP cells whereas stimulation of testosterone did not affect the expression of LRP6. However, expression of LRP6 in LNCaP cells was increased by testosterone stimulation. In addition, knockdown of LRP6 abrogated testosterone-induced proliferation of LNCaP cells. Given these results, we suggest that androgen-dependent expression of LRP6 plays a crucial role in hormone-sensitive prostate cancer cell proliferation.
Cell Proliferation* ; Low Density Lipoprotein Receptor-Related Protein-6* ; Prostatic Neoplasms* ; Receptors, Androgen ; Testosterone

Intubating patients with a huge, fixed supraglottic mass causing an obstruction of the glottis is difficult to most anesthesiologists. We attempted awake fiberoptic orotracheal intubation assisted by Glidescope(R) Videolaryngoscope (GVL) following topical anesthesia with 4% lidocaine spray and remifentanil infusion. The glottis could not be identified by the GVL view. However, by entering toward the right side of the mass with bronchoscope, the glottis was found. Due to stiffness of the mass, we were unable to further enter the area using the bronchoscope. Alternatively, we attempted to expose the glottis by GVL blade and then successfully intubated the patient by manually pressing the cricoids cartilage. GVL is nonetheless an excellent instrument in airway management compared to fiberoptic bronchoscope for patients with a huge and fixed supraglottic mass.
Airway Management ; Anesthesia ; Bronchoscopes ; Cartilage ; Glottis ; Humans ; Intubation ; Lidocaine ; Piperidines

BACKGROUND: Spinal muscular atrophy (SMA) is the second most common disease with autosomal recessive mode of inheritance in children and characterized by degeneration of anterior horn cells of the spinal cord resulting in weakness and wasting of voluntary muscles. This disease is caused by deletion of many candidate genes including SMN, p44, NAIP on chromosome 5q11.2-13.3. Although molecular characteristics of candidate genes were identified, genotype-phenotype correlation has not been clearly elucidated yet. Nevertheless, gene conversion, previously described as simply as gene deletion, appears to be very important mechanism as a molecular pathogenesis, and even makes more difficult to pursue the correlation. PURPOSE: This study was aimed to define the correlation between genotype and phenotype of SMA in Korean patients. The significance of SMN gene as well as NAIP gene, p44 gene in the progress of disease process and phenotypic correlation with gene conversion was evaluated. This study was also undertaken to determine the frequency of gene rearrangements in normal population. METHOD: Eight type I SMA patients and two type II SMA patients were studied. SMN, NAIP, and p44 gene deletion were analyzed by PCR amplification and restriction enzyme digestion with DraI, DdeI and AluI, respectively. p44 gene was also analyzed by SSCP. Gene conversion was defined by centromeric and telomeric SMN gene exon 7 to exon 8 PCR amplification followed by DdeI restiction enzyme digestion. RESULT: 1) Five of eight type I patients showed deletion of SMN, NAIP and p44 gene, while the rest of type 1 and all type II patients showed deletion of SMN gene only. 2) We examined SMN and NAIP gene deletion on 100 normal newborns, which showed the deletion of centromeric SMN gene in two newborns, the relative frequency of 2% in gene rearrangement. 3) There was one case of type I SMA showing deletion of telomeric SMN exon 7 but not SMN exon 8 suggestive of gene conversion occurred during the recombination as a molecular pathogenesis. CONCLUSION: The major deletion of SMA candidate genes, SMN, NAIP, and p44 gene appear to be involved in severe phenotype since these three candidate genes deletion were noted only in type 1 cases. However, SMN gene deletion only identified both in type 1 and type 2 explains that SMN gene may plan an major role in the pathogenesis of SMA and also suggests that other factors may be affecting the severity in spinal muscular atrophy. One patient with type I which showed the conversion of the centromeric SMN gene to the teleomeric gene strongly supports that SMN gene copy number may not be correlated with the severity in SMA. Our molecular findings suggest that phenotype is not clearly correlated with genotype. Prenatal screening should be carefully undertaken to interpretate because of high frequency of gene rearrangements in normal populations.
Anterior Horn Cells ; Child ; Digestion ; Exons ; Gene Conversion ; Gene Deletion ; Gene Dosage ; Gene Rearrangement ; Genetic Association Studies ; Genotype* ; Humans ; Infant, Newborn ; Muscle, Skeletal ; Muscular Atrophy, Spinal* ; Phenotype* ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Prenatal Diagnosis ; Recombination, Genetic ; Spinal Cord ; Wills

BACKGROUND: Pain on injection of rocuronium is a common clinical problem. We compared the efficacy of lidocaine, ketorolac, and the 2 in combination as pretreatment for the prevention of rocuronium-induced withdrawal movement. METHODS: For this prospective, randomized, placebo-controlled, double-blind study a total of 140 patients were randomly allocated to one of 4 treatment groups to receive intravenously placebo (saline), lidocaine (20 mg), ketorolac (10 mg), or both (n = 35 for each group), with venous occlusion. The tourniquet was released after 2 min and anesthesia was performed using 5 mg/kg thiopental sodium followed by 0.6 mg/kg rocuronium. The withdrawal response was graded on a 4-point scale in a double-blind manner. RESULTS: The overall incidence of withdrawal movements after rocuronium was 34.3% with lidocaine (P = 0.001), 40% with ketorolac (P = 0.004), and 8.6% with both (P < 0.001), compared with 74.3% with placebo. There was a significantly lower incidence of withdrawal movements in patients receiving the lidocaine/ketorolac combination than in those receiving lidocaine or ketorolac alone (P = 0.009 and 0.002, respectively). The incidence of moderate to severe withdrawal movements was 14.3% with lidocaine, 17.2% with ketorolac, and 2.9% with lidocaine/ketorolac combination, as compared to 45.7% with the placebo. There was no significant difference in withdrawal movement between the lidocaine group and the ketorolac group. CONCLUSIONS: Ketorolac pretreatment had an effect comparable to that of lidocaine in attenuating rocuronium-induced withdrawal movements and the lidocaine/ketorolac combination pretreatment, compared with lidocaine or ketorolac alone, effectively reduced withdrawal movements during rocuronium injection.
Androstanols ; Anesthesia ; Double-Blind Method ; Humans ; Incidence ; Ketorolac ; Lidocaine ; Prospective Studies ; Thiopental ; Tourniquets