No abstract available.
Congenital Hypothyroidism*

No abstract available.
Breast Neoplasms* ; Breast* ; Estrogens* ; Humans*

Acinar cell carcinoma of the pancreas is an uncommon neoplasm, comprises about 1% of pancreatic non-endocrine malignancies, arising from the pancreatic exocrine acinar cells rather than from ductal or neuroendocrine cells. Only ten cases of pancreatic acinar cell carcinoma has been reported in Korea. We reported a case of pancreatic acinar cell carcinoma in 50-year-old female with an one month history of rapid growing mass on epigastrium. Computed tomography shows a huge mass measured 12x11 cm, appeared cystic, in the body and tail of the pancreas. The patient underwent a distal pancreatectomy with splenectomy and total gastrectomy because of severe adhesion to the posterior gastric wall. After operation, the patient went rather rapidly downhill with progressive enlargement of peripancreatic lymph nodes, progression of pre-existing portal vein thrombosis and liver, bone metastasis inspite of adjuvant chemoradiotherpy and finally expired 17 months after operation.
Acinar Cells* ; Carcinoma, Acinar Cell* ; Female ; Gastrectomy ; Humans ; Korea ; Liver ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Cells ; Pancreas* ; Pancreatectomy ; Splenectomy ; Venous Thrombosis

No abstract available.
Cystectomy* ; Quality of Life* ; Urinary Diversion*

Esophageal actinomycosis is a rare, chronic granulomatous disease caused by Actinomyces species. Endoscopy and biopsy are essential for making a diagnosis. This paper reports a case of esophageal actinomycosis that developed after an endoscopic mucosal resection (EMR) for a subepithelial tumor (SET). A 74-year-old male patient had a 3 cm flat, smooth elevation in the esophagus without symptoms. The SET was partially resected, and histology revealed “nonspecific degenerated mesenchymal tissue”. Three months later, the patient exhibited a persistently large ulceration at the EMR site, and a biopsy revealed actinomycosis. CT of the chest and abdomen revealed no abnormal findings. Ampicillin treatment was administered for six months, and the ulceration on the esophageal SET improved.

Complete remission (CR) following chemotherapy is defined as the disappearance of a previously known-malignancy, with no further development of a new tumor. The treatment of the stage IV gastric cancer, with a distant metastatic or locally advanced-unresectable condition is a surgical dilemma. Many therapeutic modalities including chemoradiation, immunotherapy or intraoperative thermal therapy, have been used for the management of this condition, but their results were still unsatisfactory. Although CR is infrequently reported, pathological confirmation by operation is quite rare. We experienced two cases of CR following FEP (5-FU 500 mg/m2, Epirubicin 50 mg/m2, and Cisplatin 60 mg/m2) chemotherapy; one was a case of locally advanced, unresectable gastric cancer with tumor extension through the adjacent structure, and extensive regional lymph nodes metastasis. We confirmed the pathological CR by a second look operation, a distal gastrectomy with D3 lymph node dissection. The patient is doing well, with no recurrence for 5 years. The other was a case of advanced gastric cancer, with hepatic metastasis, and was treated with the same chemotherapeutic regimens. However, he refused a second operation and recurrence of cancer was detected by a gastrofiberscopic biopsy, with metastatic nodule on liver at 8 and 14 months following CR, respectively. We suggest that although CR is achieved following chemotherapy, subsequent curative resection should be mandatory, as recurrence will develop after a few months.
Biopsy ; Cisplatin ; Drug Therapy* ; Epirubicin ; Gastrectomy ; Humans ; Immunotherapy ; Liver ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Polytetrafluoroethylene ; Recurrence ; Stomach Neoplasms*

Background: Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home. Methods: Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed. Results: In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74–15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08–6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03–4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02–1.88) in females and 0.56 (95% CI, 0.48–0.66) in males. Conclusion In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.

Background: Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home. Methods: Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed. Results: In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74–15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08–6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03–4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02–1.88) in females and 0.56 (95% CI, 0.48–0.66) in males. Conclusion In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.

OBJECTIVE: Elderly Dementia and depression are major neuropsychiatric disorders. Epidemiologic study considered essential part to evaluate and treatment guideline for community mental health. METHOD: The cross-sectional study evaluates the dementia and depression of community- living elderly, over 65 older in a Korean rural community. Mini-Mental State Examination- Korean (MMSE-K) and Geriatric Depression Scale (GDS) was conducted. RESULTS: The prevalence of dementia is 14.0% below the 17 of MMSE-K score. Cognitive function decline is increasing with age. The prevalence of dementia in female elderly is higher than that in male with statistical significance (p<.001). The prevalence of depression is 10% among elderly population. Female elderly have higher frequency than male with statistical significance. CONCLUSION: Elderly dementia and depression is very important neuropsychiatric disorders. MMSE-K and GDS-K is useful instruments for evaluation of elderly dementia and depression. Age and sex are important factors for dementia and depression. More developed instruments for accurate detection and differentiation of dementia and depression are need for mental health program to manage effectively them.
Aged* ; Cross-Sectional Studies ; Dementia ; Depression* ; Epidemiologic Studies* ; Epidemiology ; Female ; Humans ; Male ; Mental Health ; Prevalence ; Rural Population*

PURPOSE: Generalized peritonitis caused by a free perforation of gastric cancer is a rare condition, which occurs in 1~4% of all gastric cancer patients. To assess the characteristics of the patients and investigate the optimal treatment of choice, the data from 51 patients previous recent 10 years were retrospectively analyzed. METHODS: Between 1988 and 1997, 51 patients underwent surgical treatment for perforated gastric cancer. The clinicopathological features and survival rates of the resected group (n=39) and the non-resected group (n=12) were analyzed. RESULTS: The incidence was 0.78% and the mean age was 57 years. The most common tumor location was in the lower 1/3 in the resected group (n=21, 53.8%) and in the upper 1/3 in the non-resected group (n=6, 50%). Borrmann type 3, the poorly differentiated type, and a positive serosa invasion were more common in both groups. Liver and peritoneal metastases were observed in 2 cases (5.2%) and 7 cases (14.3%) in the resected group, and 4 cases (33.4%), and 3 cases (25%) in the non-resected group, respectively. Resectability found in 76.5%: 27 cases of a subtotal gastrectomy and 12 cases of a total gastrectomy. A limited lymph node dissection (D0, D1) was performed in 14 cases (35.9%) and an extended dissection (D2, D3) was performed in 25 cases (64.1%). The 5-year survival rate of stage I was 80%, 40% in stage II, 14% in stage III and 0% in stage IV, and the overall 5 year survival rate was 20.5% in the resected group and 0% in the non-resected group. The depth of invasion, lymph node metastasis and tumor stage significantly influenced the survival rate of the patients. CONCLUSION: Because a perforation of the gastric cancer may develop in every stage, surgeons must take care of these patients by the same way as with non-perforation cases.
Gastrectomy ; Humans ; Incidence ; Liver ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Peritonitis ; Retrospective Studies ; Serous Membrane ; Stomach Neoplasms* ; Survival Rate