No abstract available.
Arnold-Chiari Malformation* ; Diagnosis* ; Prenatal Diagnosis* ; Ultrasonography*

Estrogen and progesterone receptors exist in the epithelial and stromal cells of the endometrium. Proliferative disorders of the endometrium may be associated with autocrine and paracrine actions of estrogen and progesterone in epithelial and stromal cells. This study was performed to evaluate the differences estrogen and progesterone receptor(ER/PR) expression in the epithelial and stromal cells of endometrial hyperplasias and adenocarcinomas using immunohistochemical methods. Immunohistochemical analysis of proliferating cell nuclear antigen(PCNA) was done to evaluate a possible correlation between PCNA and hormone receptor expression. Evaluation was based on samples from 31 simple hyperplasias, 30 complex hyperplasias, and 32 adenocarcinomas. The immunohistochemical expression of ER, PR and PCNA in epithelial and stromal cells were examined according to a scoring system based on the percentage of positive cells and the staining intensity. The results were as follows; 1) The expression of ER and PR in epithelial cells showed a graded, significant decreases in simple hyperplasia, complex hyperplasia and endometrial carcinoma, in that order(ER: P=0.008, PR: P= 0.026). 2) PR expression in the stromal cells showed a significant decrease between hyperplasia and adenocarcinoma(P=0.003). The difference in ER expression was not significant. 3) In stromal cells, the decrease in PR expression was more prominent than the decrease in ER expression when complex hyperplasia was compared to simple hyperplasia. 4) The PCNA expression in simple and complex hyperplasia and adenocarcinoma was not higher than the expression of PCNA in nomal proliferative endometrium. There was no significant difference in PCNA expression between simple and complex hyperplasia and adenocarcinoma(P=0.073). 5) A negative correlation between PCNA and ER/PR expression was not demonstrated in simple and complex hyperplasia, or in adenocarcinoma. Endometrial hyperplasia and adenocarcinoma are probably related to a paracrine action of estrogen and progesterone in epithelial and stromal cells. A progressive loss of PR expression in stromal cells may induce abnormal proliferation of endometrium due to a disrupted hormonal balance.
Adenocarcinoma

Potter's syndrome was originally described as combination of bilateral renal agenesis and unique progeric facial characteristics in 1946 by Potter. In cases of severe renal maldevelopment such as bilateral polycystic kidney or marked hypoplasia, similar facial features has been also associated. At 1963, Potter and Osathanondth reported classification of polycystic kidney as Type I-IV by microdissection study. Recently authors experienced an autopsy case of polycystic kidney with characteristic potter face, and other combined malformations such as; absence of both ureters and urinary bladder, pulmonary hypoplasia, undescended testes and oligohydramnios, fetal growth retardation and breech presentation. According to the classification of polycystic kidney of Potter and Osathanondth, this presenting case is compatible with type IIB.

BACKGROUND: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnoimal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management. METHODS: We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultrasound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was derivated from Food Composition Table, and we analyzed several biochemical variables. RESULTS: There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertriglyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8%, in patients, 7.4% in controls(p<0.05). There were no significant statistical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient gr oup or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patients, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0,05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and excercise between patients and controls. CONCLUSIONS: The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.
Adult ; Age Distribution ; Alcohol Drinking ; Chungcheongnam-do ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Hypertriglyceridemia ; Life Style ; Liver Function Tests ; Male ; Middle Aged ; Obesity ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

BACKGROUND: Antibiotics are used prophylactically in surgery to prevent postoperative infection. However, antibiotics administered in large doses can cause a bleeding diathesis as a result of platelet dysfunction. We wondered whether these antibiotics might impair platelet function by interfering with the initial step of platelet activation: the binding of agonists to their specific receptors on the platelet surface. METHODS: In 30 patients (male 18, women 12) undergoing primary elective knee arthroscopic surgery, the whole blood coagulation system was prospectively evaluated before, and 10 and 40 minutes after administration of 1 g of augmentin. All patients who had abnormal preoperative coagulation profiles or who received anticoagulant or antiplatelet, antibiotics therapy within 7 days prior to surgery were precluded. RESULTS: At 10 minutes after augmentin administration 25 of 30 patients had a significant impairment in all phases of whole blood coagulation as monitored by thromboelastography. In contrast, three of 30 patients had a significantly decreased coagulation time. Two of 30 patients had no significant changes of TEG variables. TEG variables were restored toward baseline in fourty minutes after augmentin administration. CONCLUSIONS: Augmentin can cause a significant but transient change in the viscoelastic properties of blood. Coagulation parameters of the TEG should be measured prior to augmentin administration to prevent and prospect a bleeding diathesis as a result of platelet dysfunction.
Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Arthroscopy ; Blood Coagulation ; Blood Platelets ; Disease Susceptibility ; Female ; Hemorrhage ; Humans ; Knee ; Platelet Activation ; Prospective Studies ; Thrombelastography*

No abstract available.
Dwarfism*

OBJECTIVES: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. METHOD: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education-matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools-including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). RESULTS: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression (GDS> or =10) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. CONCLUSIONS: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.
Aged ; Alzheimer Disease ; Anxiety ; Depression ; Humans ; Memory ; Restless Legs Syndrome ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Trail Making Test

Lung cancer is representative of a high frequency and high mortality disease and ranks at the top in incidence and mortality in Korea, when excluding thyroid cancer. In this manuscript, we focused on current targeted therapies for lung cancer used widely in the medical field.Current Concepts: The majority of patients with lung cancer cannot be treated with surgery only and require chemotherapeutics or radiation therapy. Currently, classical chemotherapeutic agents, targeted agents, and immune checkpoint inhibitors are the most widely used. Recently, the Research and Development of antibody-drug conjugates is gaining attention, and this may become a more widely prescribed treatment in the future. Among the available treatment options, targeted therapy is becoming increasingly feasible and widespread for treating inoperable lung cancers, where driver mutations have been identified, and for adjuvant or neoadjuvant therapies. Next-generation sequencing (NGS) improves the ability to identify driver mutations that were previously difficult to detect and can also be performed on blood samples where no cancer tissue is available for testing. This makes it possible to identify therapeutic targets for targeted therapy more rapidly.Discussion and Conclusion: The most common type of lung cancer in Korea is adenocarcinoma, for which a driver mutation has been identified. Newly developed drugs target previously problematic mutations or cancer cell lines that have acquired resistance induced during the treatment process. The survival rate of patients with lung cancer is expected to improve with the development of tailored treatments for targets identified from the NGS data of the patient. This paper will help clinicians understand the current state of targeted therapies for lung cancer treatment.

Lung cancer is the leading cause of cancer-related deaths in developing to advanced countries worldwide. The incidence rate of lung cancer in Korea has been increasing steadily since 1997. Statistics show that in 2017 alone, the incidence and mortality rates for lung cancer were 52.7 and 34.8 per 100,000 people, respectively, accounting for the highest cause of cancer death in Korea. The process of accurately diagnosing lung cancer consists of several steps, starting with the discovery of pulmonary nodule(s) via a cancer screening test or various other methods followed by the collection of cells or tissues and the identification of target molecules. Thereafter, staging and the development of a therapeutic plan lead to improved clinical outcomes. After the completion of a pilot study, a nationwide lung cancer screening program was introduced in Korea; since 2019, this program has targeted population at high risk for lung cancer: men and women aged 54 to 74 years who had a smoking history of 30 pack-years or more. The frequency of detection of pulmonary nodules is increasing in proportion to the public interest in health and economic growth.In this review, we present diagnostic techniques and biomarkers that are widely used in the medical field in the hope that such information would benefit clinical practice.

Although diagnostic esophagogastroduodenoscopy is a reasonably safe procedure, complications may occur and can sometimes cause lift-threatening conditions. Esophageal perforation is one of the most serious complications. We report here a very rare case of esophageal perforation and mediastinitis by routine endoscopic study. A 69-year-old woman complained of edematous and painful neck area just after diagnostic endoscopy was finished. Computed tomography was performed and revealed mediastinitis at the superior mediastinum with deep neck infection by suspicious esophageal perforation. The patient completely recovered with prompt surgical intervention of incision and drainage. Because late diagnosis of the complication can lead to high mortality, endoscopists need to be aware of possible procedure-related complications.
Aged ; Delayed Diagnosis ; Digestive System ; Drainage ; Endoscopy ; Endoscopy, Digestive System ; Esophageal Perforation ; Female ; Humans ; Mediastinitis ; Mediastinum ; Neck