Bronchogenic cyst is an uncommon congenital lesion which is derived from the primitive foregut. Most bronchogenic cyst may develope at the tracheal bifurcation, both main bronchi, the lung parenchymeand the mediastinum. A 40-year old male was evaluated for dyspnea and chest tightness. Computed tomography revealed a well dermarcated, 7.2 x 7.9 cm sized, homogeneous mass compressing the left atrium. 2D-echo showed grade III mitral regurgitation. We completely removed the cystic mass and then confirmed the bronchogenic cyst in the pathological diagnosis. During the follow up period, the patient progressed well without any symptoms and showed grade I mitral regurgitation on the 2D-Echo. Therefore, we report a case of the bronchogenic cyst causing grade III mitral regurgitation.
Adult ; Bronchi ; Bronchogenic Cyst* ; Diagnosis ; Dyspnea ; Follow-Up Studies ; Heart Atria ; Humans ; Lung ; Male ; Mediastinum ; Mitral Valve Insufficiency* ; Thorax

Atrial fibrillation is the most common of all cardiac arrhythmias. It is associated with significant morbidity and mortality and is frequently resistant to medical therapy. On the experimental and clinical study, the presence of macroreentrant circuits and the absence of either microreentrant circuits or evidence of atrial automaticity suggests that atrial fibrillation should be amenable to surgical ablation. The results of the maze III procedure are associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. We had experienced 4 patients with chronic atrial fibrillation. For the first time, Hioki procedure had been performed in the first patient with ASD and atrial fibrillation, regular sinus rhythm showed on postoperative EKG, but junctional rhythm and bradycardia developed postoperative 3 years. The maze III procedure for the rest with mitral valvular disease and atrial fibrillation had been done, followed by regular sinus rhythm for 2 patients and atrial fibrillation for 1 patient, managed with amiodarone, on immediate postoperative state. Echocardiogram documented good contraction of right atrium and hardly contraction of left atrium for 2 patients with regular sinus rhythm postoperative 3 months.
Amiodarone ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Bradycardia ; Electrocardiography ; Heart Atria ; Humans ; Incidence ; Mortality ; Recurrence ; Sinoatrial Node

A casts of Barrett's esophagus complicated with stricture is reported. A 82 years old male was undergone distal esophagectomy and esophagogastrostomy on suspicion of malignancy. The microscopic examination of specimen taken from the lesion revealed the "tall columnar cells" which were indicative of Barrett's esophagus, hence the diagnosis. Barrett's esophagus is a rare disease in Korea. Because of the malignant potential of the disease, surgery involving esophagectomy is often required.
Aged, 80 and over ; Barrett Esophagus* ; Constriction, Pathologic ; Diagnosis ; Esophageal Stenosis* ; Esophagectomy ; Humans ; Korea ; Male ; Rare Diseases

OBJECTIVE: To determine the usefulness of perfusion MR imaging in assessing the histologic grade of cerebral gliomas. MATERIALS AND METHODS: In order to determine relative cerebral blood volume (rCBV), 22 patients with pathologically proven gliomas (9 glioblastomas, 9 anaplastic gliomas and 4 low-grade gliomas) underwent dynamic contrast-enhanced T2*-weighted and conventional T1- and T2-weighted imaging. rCBV maps were obtained by fitting a gamma-variate function to the contrast material concentration versus time curve. rCBV ratios between tumor and normal white matter (maximum rCBV of tumor / rCBV of contralateral white matter) were calcu-lated and compared between glioblastomas, anaplastic gliomas and low-grade gliomas. RESULTS: Mean rCBV ratios were 4.90'+/-1.01 for glioblastomas, 3.97'+/-0.56 for anaplastic gliomas and 1.75'+/-1.51 for low-grade gliomas, and were thus sig-nificantly different; p < .05 between glioblastomas and anaplastic gliomas, p <.05 between anaplastic gliomas and low-grade gliomas, p < .01 between glioblas-tomas and low-grade gliomas. The rCBV ratio cutoff value which permitted dis-crimination between high-grade (glioblastomas and anaplastic gliomas) and low-grade gliomas was 2.60, and the sensitivity and specificity of this value were 100% and 75%, respectively. CONCLUSION: Perfusion MR imaging is a useful and reliable technique for esti-mating the histologic grade of gliomas.
Adult ; Astrocytoma/*pathology ; Brain/pathology ; Brain Neoplasms/*pathology ; Cerebrovascular Circulation ; Contrast Media ; Female ; Gadolinium DTPA/diagnostic use ; Glioblastoma/*pathology ; Human ; *Magnetic Resonance Imaging ; Male ; Support, Non-U.S. Gov't

The authors regret that there was an important error in the results in Table 1; the ATP7A mutations detected in Patients 2 and 14 were incorrectly noted.

BACKGROUND: Menkes disease (MD) is a rare X-linked hereditary multisystemic disorder that is caused by dysfunction of copper metabolism. Patients with MD typically present with progressive neurodegeneration, some connective tissue abnormalities, and characteristic “kinky” hair. In addition, various types of urological complications are frequent in MD because of underlying connective tissue abnormalities. In this study, we studied the clinical features and outcomes of MD, focusing on urological complications. METHODS: A total of 14 unrelated Korean pediatric patients (13 boys and 1 girl) with MD were recruited, and their phenotypes and genotypes were analyzed by retrospective review of their medical records. RESULTS: All the patients had early-onset neurological deficit, including developmental delay, seizures, and hypotonia. The girl patient showed normal serum copper and ceruloplasmin levels as well as milder symptoms. Mutational analysis of the ATP7A gene revealed 11 different mutations in 12 patients. Bladder diverticula was the most frequent urological complication: 8 (57.1%) in the 14 patients or 8 (72.7%) in the 11 patients who underwent urological evaluation. Urological imaging studies were performed essentially for the evaluation of accompanying urinary tract infections. Four patients had stage II chronic kidney disease at the last follow-up. CONCLUSION: Urologic problems occurred frequently in MD, with bladder diverticula being the most common. Therefore, urological imaging studies and appropriate management of urological complications, which may prevent or reduce the development of urinary tract infections and renal parenchymal damage, are required in all patients with MD.
Ceruloplasmin ; Connective Tissue ; Copper ; Diverticulum ; Female ; Follow-Up Studies ; Genotype ; Hair ; Humans ; Medical Records ; Menkes Kinky Hair Syndrome* ; Metabolism ; Muscle Hypotonia ; Phenotype ; Renal Insufficiency, Chronic ; Retrospective Studies ; Seizures ; Urinary Bladder ; Urinary Tract Infections

Purpose: This study evaluated the diagnostic performance of contrast-enhanced voiding urosonography (ce-VUS) using a second-generation ultrasound contrast agent for the diagnosis of vesicoureteral reflux (VUR) and intrarenal reflux (IRR), and compared it with that of standard fluoroscopic voiding cystourethrography (VCUG). Methods: Thirty-two consecutive children from April to October 2019 were included in this study. ce-VUS and VCUG were performed simultaneously by two operators with intravesical infusion of a mixture of ultrasound contrast medium, iodinated contrast medium and water. Two pediatric radiologists independently reviewed the ce-VUS and VCUG images and reported the presence and degree of VUR (grades I-V), and the presence and type of IRR. Results: Twenty-seven of 63 urinary systems showed VUR. Interobserver agreement for VUR grading was very good for both examinations (κ=0.87; 95% confidence interval [CI], 0.82 to 0.92 for ce-VUS and κ=0.92; 95% CI, 0.87 to 0.96 for VCUG). The detection rate of VUR showed no significant difference between the two examinations (P=0.370). Four cases of VUR were missed on ce-VUS, while one case of VUR was missed on VCUG. All four false-negative cases on ce-VUS were grade 1 VUR. The two examinations showed very good agreement regarding VUR grading (κ =0.89; 95% CI, 0.81 to 0.96). IRR was more frequently detected with ce-VUS than with VCUG (10 cases with ce-VUS vs. 3 cases with VCUG, P=0.016). Conclusion ce-VUS showed very good agreement with VCUG for detecting grade 2 VUR and above, while grade 1 VUR was sometimes missed with ce-VUS. IRR was more frequently detected with ce-VUS than with VCUG.

BACKGROUND: The significance of ER expression and hormone manipulation in gastric cancer is not established. There have been several reports supporting the role of the ER gene as tumor suppressor gene in carcinogenesis. The ER-alpha gene is located on chromosome 6q25.1. Deletions of the long arm of chromosome 6 are common in gastric carcinoma, suggesting the presence of tumor suppressor genes in this region. The proportion of ER-positive gastric cancers ranges between 0% and 67% depending on the method of detection. Epigenetic inactivation might explain the loss of ER-alpha gene expression in gastric cancer. There is no information available regarding the methylation status of the ER-alpha gene promoter region in gastric cancer so far. The aim of this study was to assess the expression of ER-alpha in gastric cancer cell lines and determine whether methylation of the 5' promoter region is associated with loss of ER-alpha expression in gastric cancer. METHODS: We investigated such methylation in 13 gastric cancer cell lines. Western blot analysis, reverse transcription-polymerase chain reaction (PCR), methylation-specific PCR (MS-PCR) and bisulfite sequencing analyses were used. Immunohistochemical staining for the ER-alpha gene was dome for forty-two paraffin embedded tissues from gastric cancer patients. RESULTS: ER-alpha protein was not detected in any cell line, ER-alpha mRNA was expressed in only Kato III cell line. MS-PCR and bisulfite sequencing showed all thirteen gastric cancer cell lines had methylated CpG regions in their ER-alpha gene promoters. Immunohistochemical staining of ER-alpha showed no positivity in any of examined samples. CONCLUSION: Inactivation of ER-alpha gene expression in gastric cancer cell lines appears associated with CpG island methylation near the TGA initiation codon of the ER-alpha gene.
Arm ; Blotting, Western ; Carcinogenesis ; Cell Line ; Chromosomes, Human, Pair 6 ; Codon, Initiator ; CpG Islands ; Epigenomics ; Estrogens* ; Gene Expression ; Genes, Tumor Suppressor ; Humans ; Methylation ; Paraffin ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; RNA, Messenger ; Stomach Neoplasms*

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.