The importance of tick-borne diseases is increasing because of climate change, with a lack of long-term studies on tick-borne pathogens in South Korea. To understand the epidemiological characteristics of tick-borne diseases, the monthly distribution of field ticks throughout the year was studied in South Korea between May 2014 and April 2018 in a cross sectional study.

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has increased after wider use of assisted reproductive technology. The rising incidence presents a serious problem as the diagnosis of this potentially fatal condition is often missed. Careful pelvic examination combined with serial beta-hCG determinations, and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in vitro fertilization and embryo transfer(IVF-ET) with a brief review of literature.
Diagnosis ; Early Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gynecological Examination ; Incidence ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted

Gastric neurofibroma is rare and its exact incidence is unknown. We experienced a case of solitary gastric neurofibroma. A 49-year-old woman was admitted because of hematemesis and melena. Neither cafe-au-lait spots in skin nor superficial tumor were found. Gastrofibroscopic examination and UGI series showed a 3 * 4 cm sized luminal protruding mass with adjacent bridging mucosal fold and cental ulceration on the anterior wall of lower body. Mass excision was performed. Grossly, the mass was 4.5 * 3.0 * 2.0 cm sized, well circumscribed submucosal tumor with homogenous cut surface, Microscopically, each of the tumor cells had oval shaped nucleus and spindle shaped cytoplasm. Nuclear atypism and frequent mitosis were not observed. We report a rare case of solitary gastric neurofibroma with review of the literatures.
Cafe-au-Lait Spots ; Cytoplasm ; Female ; Hematemesis* ; Humans ; Incidence ; Melena* ; Middle Aged ; Mitosis ; Neurofibroma* ; Phenobarbital ; Skin ; Stomach ; Ulcer

We report a rare case of severe hypoglycemia after sunitinib treatment for pancreatic neuroendocrine carcinoma. We describe the initial clinical presentation, laboratory results, pathologic findings, and managment in a patient with a nonfunctioning pancreatic neuroendocrine carcinoma with liver metastases who developed life threatening hypoglycemia after 2 months of sunitinib therapy. A 46-year-old woman presented to the emergency department with loss of consciousness from hypoglycemia. Serum C-peptide and insulin levels at fasting state revealed that the hypoglycemia resulted from endogenous hyperinsulinemia. She had been diagnosed with nonfunctioning pancreatic neuroendocrine carcinoma based on a biopsy of metastatic cervical lymph node and was being treated with sunitinib, a small molecule tyrosine kinase inhibitor. Immunohistochemical stain of the metastatic liver mass demonstrated that the initially nonfunctioning neuroendocrine carcinoma cells had changed into insulin-producing cells after sunitinib therapy. Transarterial chemoembolization of the liver masses and systemic chemotherapy with streptozotocin/adriamycin relieved the hypoglycemia. A nonfunctioning pancreatic neuroendocrine carcinoma was transformed into an insulin-producing tumor after treatment with sunitinib, causing endogenous hyperinsulinemia and severe hypoglycemia.
Biopsy ; C-Peptide ; Carcinoma, Neuroendocrine ; Emergencies ; Fasting ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia ; Indoles ; Insulin ; Insulinoma ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Pyrroles ; Unconsciousness

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea. MATERIALS AND METHOD: A series of eight surveys were sent to the board members of the Korean Rhinologic Society via e-mail between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously. RESULTS: The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was preferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS. CONCLUSION: The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.
Anesthesia, General ; Anonyms and Pseudonyms ; Anti-Bacterial Agents ; Clinical Protocols ; Surveys and Questionnaires ; Electronic Mail ; Foot ; Hospitalization ; Hypersensitivity ; Korea ; Paranasal Sinuses ; Postoperative Care ; Preoperative Care ; Sinusitis

Systemic sclerosis (SSc) is a generalized connective tissue disorder of unknown etiology. Clinically, there is a broad spectrum of disease ranging from widespread severe skin thickening to skin thickening limited to the distal extremities. In rare cases of systemic sclerosis, no cutaneous change only with internal organ involvement has been reported, which is called ?ystemic sclerosis sine scleroderma (ssSSc)?. We describe a patient with Raynaud? phenomenon, who showed intestinal pseudoobstruction as a presenting symptom but did not show any skin change. She had also an esophageal motility disorder, but other organ involvement was not evident. Antinuclear antibody was positive. Her obstruction symptoms were improved by decompression by nasogastric tube and pharmaceutical treatment with erythromycin and octreotide.
Antibodies, Antinuclear ; Connective Tissue ; Decompression ; Erythromycin ; Esophageal Motility Disorders ; Extremities ; Humans ; Intestinal Pseudo-Obstruction ; Octreotide ; Scleroderma, Systemic* ; Sclerosis ; Skin

No abstract available.
Mediastinum*

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

PURPOSE: To find out the proper compression ratios without degrading image quality and affecting lesion detectability on diagnostic images used in dentistry compressed with JPEG 2000 algorithm. MATERIALS AND METHODS: Sixty Digora periapical images, sixty panoramic computed radiographic (CR) images, sixty computed tomographic (CT) images, and sixty magnetic resonance (MR) images were compressed into JPEG 2000 with ratios of 10 levels from 5 : 1 to 50 : 1. To evaluate the lesion detectability, the images were graded with 5 levels (1: definitely absent; 2: probably absent; 3: equivocal; 4: probably present; 5: definitely present), and then receiver operating characteristic analysis was performed using the original image as a gold standard. Also to evaluate subjectively the image quality, the images were graded with 5 levels (1: definitely unacceptable; 2: probably unacceptable; 3: equivocal; 4: probably acceptable; 5: definitely acceptable), and then paired t-test was performed. RESULTS: In Digora, CR panoramic and CT images, compressed images up to ratios of 15 : 1 showed nearly the same lesion detectability as original images, and in MR images, compressed images did up to ratios of 25 : 1. In Digora and CR panoramic images, compressed images up to ratios of 5 : 1 showed little difference between the original and reconstructed images in subjective assessment of image quality. In CT images, compressed images did up to ratios of 10 : 1 and in MR images up to ratios of 15 : 1. CONCLUSION: We considered compression ratios up to 5 : 1 in Digora and CR panoramic images, up to 10 : 1 in CT images, up to 15 : 1 in MR images as clinically applicable compression ratios.
Data Compression ; Dentistry* ; Radiography, Dental, Digital ; ROC Curve ; Tomography, X-Ray Computed

A low grade endometrial stromal sarcoma is a rare malignant tumor in woman. We experienced this infrequent malignant tumor in a 36 years old woman showing metas- tasis to both ovaries, omentum, rectum and mesenteric lymph nodes, and she was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by VAC(vincristi n, actinomycin, cyclophoshamide) chemotherapy. The authors report this case with the clinicopathologic findings and brief review of literature.
Adult ; Dactinomycin ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Omentum ; Ovary ; Rectum ; Sarcoma, Endometrial Stromal*