Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.

Primary renal lymphoma is a rare tumor of the kidney that typically presents with bilateral nodular enlargement in the absence of extrarenal masses. We describe MR findings of a case of primary renal lymphoma along with ultrasound and CT findings. MR imaging demonstrated globular enlargement of both kidneys with multilobulated contour and multiple masses which had isosignal intensity on T1WI and low signal intensity on T2WI. The masses enhanced slightly on dynamic contrast enhanced scan.
Kidney ; Lymphoma* ; Magnetic Resonance Imaging ; Ultrasonography

Purpose: The current status and rationale of industrial accidents needs to be examined to develop scientific and systemic preventive measures. Methods: The aim of this study is to analyze the current data on industrial accidents provided by the Ministry of Employment and Labor and categorize work-related deaths by types of industries and annual report. Results: First, the highest number of deaths occurred in industries that had less than 50 people. Second, in the manufacturing industry, the highest death rate was found in workers in the age group 50-59 years. In the construction industry, workers aged 50 and above had the highest number of deaths. In other industries, workers aged 60 and above had the highest number of deaths. Third, the highest number of deaths occurred in workers with less than one year of experience in any industry Fourth, in most industries, the highest work-related deaths occurred during weekdays (Monday~Friday). In 2015, the warehouse delivery industry had 33% higher work-related deaths on the weekends (Saturday and Sunday) as compared to other industries. Fifth, in most industries, the highest work-related deaths occurred from 8 AM to 6 PM. The warehouse delivery industry had higher work-related deaths from 10 PM to 8 AM as compared to other industries. Conclusion In order to increase the efficacy of industrial accident prevention, it is necessary to establish an effective health management system and apply strict safety management activities.

Background: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.

PURPOSE: The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. METHODS: Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. RESULTS: Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. CONCLUSION: A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.
Counseling ; Humans ; Informed Consent ; Students, Medical

BACKGROUND: Laminin, the main non-collagenous constituent of vascular basement membranes, can be changed by alteration of metabolism and distribution in diabetic microangiopathy. The serum laminin levels are known to reflect these histological changes. The aim of present study was to investigate whether the serum laminin levels are related to carotid atherosclerosis and diabetic complications, and to assess what clinical variables influence on the serum laminin levels in type 2 diabetes. METHODS: The subjects were 103 type 2 diabetic patients (51 in the no complication group and 52 in the complication group) and 39 controls. We evaluated the intima-media thickness (IMT) and plaques in both carotid arteries by duplex scan. and the serum laminin levels were measured. RESULTS: The serum laminin levels were higher in the group with complications complication group compared to the no complication group (p<0.01), and in the no complication group compared to the control group (plt;0.01). There were no differences in the carotid parameter values between the complication group and the no complication group. The correlations between the serum laminin levels and the measured IMT values were not significant.However, there were significant correlations between the serum laminin levels and the plaque counts and scores (r=0.24, plt;0.05). The presence of diabetic complications, the waist hip ratio, plaque score and apo B affected the elevation of the serum laminin levels (plt;0.05). CONCLUSIONS: The serum laminin levels were related to the presence of diabetic complications. Such levels may be a risk factor for plaque progression rather than the initiation of plaque formation or IMT thickening in the carotid atherosclerosis of type 2 diabetic patients.
Apolipoproteins B ; Basement Membrane ; Carotid Arteries ; Carotid Artery Diseases ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Diabetic Angiopathies ; Humans ; Laminin* ; Metabolism ; Risk Factors ; Waist-Hip Ratio

PURPOSE: Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess the correlation of circulating LBP levels with anthropometric measures and obesity-related biomarkers, including insulin resistance, liver enzyme levels, and lipid profiles. METHODS: The study included 87 adolescents aged 12-13 years; 44 were overweight/obese and 43 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), blood pressure, insulin resistance, liver enzyme levels, and lipid profiles. Plasma LBP levels were measured using an enzyme-linked immunosorbent assay. RESULTS: The mean age of the participants was 12.9±0.3 years. Circulating plasma LBP levels were significantly increased in overweight/obese participants compared with those in normal-weight participants (7.8±1.9 µg/mL vs. 6.0±1.6 µg/mL, P<0.001). LBP levels were significantly and positively associated with BMI, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose and insulin, and insulin resistance as indicated by the homeostatic model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, BMI and HOMA-IR were independently and positively associated with plasma LBP levels. CONCLUSION: LBP is an inflammatory biomarker associated with BMI and obesity-related insulin resistance in adolescents. The positive correlation between these parameters suggests a potentially relevant pathophysiological mechanism linking LBP to obesity-related insulin resistance in adolescents.
Acute-Phase Proteins ; Adolescent* ; Alanine Transaminase ; Aspartate Aminotransferases ; Biomarkers ; Blood Pressure ; Body Mass Index ; Cholesterol ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Linear Models ; Liver ; Obesity ; Plasma*

The passive immunization of pregnant female rats to S-100 protein often leads to ultra-structural abnormalities in the brain glial structures of the offspring of these rats and induces signs of delayed development in the fetal brain. Additionally passive immunization of pregnant animals with certain antigens induces permanent Ag-specific changes in the immune response of their offspring. The purpose of this study was to investigate serum immunoreactiviy (SIR) to S-100 in cerebral-palsied and developmentally-delayed children as well as in their healthy parents and to evaluate its significance related to radiologic findings of brain MRI and single photon emission computed tomography (SPECT). The subjects were children with cerebral palsy and delayed development that had abnormal findings on brain MRI or Brain SPECT. SIR to S-100 protein was measured by ELISA method in the patients, their healthy parents, 20 normal adult controls and 22 normally developed children. The SIR to S-100 protein was significantly higher in the cerebral-palsied and developmentally-delayed children when compared to that of the normal control group children. Increased SIRs were detected in healthy mothers but not in their fathers. There was no difference of SIR between the cerebral-palsied and developmentally-delayed children or any significant difference of SIRs according to the findings of the brain MRI or to developmental quotients. But, the SIRs to S-100 protein were higher in the group of more abnormal findings on brain SPECT.
Adolescence ; Adult ; Cerebral Palsy/immunology* ; Cerebral Palsy/blood ; Child ; Developmental Disabilities/immunology* ; Developmental Disabilities/blood ; Female ; Human ; Male ; Nerve Tissue Protein S 100/blood* ; Parents* ; Reference Values

A low serum level of vitamin D has been associated with an increased incidence of gastrointestinal tract cancers. However, the effects of vitamin D3 have not been investigated in gastric cancer and cholangiocarcinoma. In the present study, we found that vitamin D3 treatment significantly suppressed the viability of gastric cancer and cholangiocarcinoma cells. Moreover, vitamin D3 had a synergistic effect with other anti-cancer drugs, such as paclitaxel, adriamycin, and vinblastine, for suppressing cell viability. To determine the underlying mechanism involved in the regulation of viability by vitamin D3, we examined the effects of vitamin D3 on expression of hedgehog signaling target genes, which has been associated with gastric cancer and cholangiocarcinoma. Vitamin D3 treatment decreased the level of mRNA expression of patched1, Gli1, cyclin D1, and Bcl2, suggesting the possibility that vitamin D3 may act through regulation of hedgehog signaling. From the above results, we conclude that vitamin D3 regulates cell viability in gastric cancer and cholangiocarcinoma.
Cell Survival ; Cholangiocarcinoma ; Cholecalciferol ; Cyclin D1 ; Doxorubicin ; Gastrointestinal Neoplasms ; Hedgehogs ; Incidence ; Paclitaxel ; RNA, Messenger ; Stomach Neoplasms ; Vinblastine ; Vitamin D ; Vitamins