Multiple factors including gastroesophageal reflux disease (GERD) were evaluated for a case-control study in Chonnam area to investigate the causative entity of COPD. Data on the multiple causative factors from hospital records and interview survey were analyzed in three groups of COPD(64 cases as case group), normal lung (83 cases as control group 1) and non-COPD lung disease (45 cases as control group 2). Smoking status, history of adulthood pulmonary infection and frequent history of URI, socioeconomic status, and GERD were significantly different between COPD group and control group 1. Drinking status, physical height of the subjects and GERD were significantly different between COPD group and control group 2. If control group 1 was used, odds ratio of GERD and COPD was 5.68(95%confidence interval, 95% CI:2.59-12.45) and 4.81 (95% CI:1.89-10.53) when adjusted by age and smoking status. If control group 2 was used. Odds ratio of GERD and COPD was 4.22 (95% CI:1.69-10.56) and 4.59 (95% CI:1.64-12.86) when adjusted by alcohol and adulthood respiratory infection status. In summary, there results suggested that GERD might play a causative role in the development of COPD.
Case-Control Studies ; Drinking ; Gastroesophageal Reflux* ; Hospital Records ; Jeollanam-do ; Lung ; Lung Diseases ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking ; Social Class

At first, we review a sample size estimation method for log-rank test in survival analysis. Although it is widely used these days, it has a weakness for practical use. We propose a modification method to avoid the weakness.
Sample Size*

BACKGROUND: During the adolescent growths spurt, iron deficiency becomes more common, particularly with the additional factors of menstrual blood loss in females and the androgen-related rise in hemoglobin concentration in males. This study was conducted to investigate the iron status in the adolescent students. METHODS: Venous peripheral blood was sampled from 178 males(79 of 12-13years, 99 of 15-16years) who were 1st grade students of two boy's middle schools and two high schools and from 186 females(87 of 12-13years, 99 of 15-16years) who were 1st grade students of two girl's middle schools and two high schools. Laboratory procedures included a hemoglobin, hematocrit, serum iron, TIBC and serum ferritin. Transferrln saturation was calculated. RESULTS: 1) Mean values were hemoglobin 13.7+/-0.78 g/dl, hematocrit 40.6+/-2.47%, serum iron 127.6+/-43.02 ug/dl, TIBC 387.9+/-47.73 ug/dl, transferrin saturation 33.3+/-11.38%, and serum ferritin 26.1+/-16.90 ng/ml in 12-13years old males. 2) Mean values were hemoglobin 13.7+/-0.85 g/dl, hematocrit 40.9+/-3.79%, serum iron 99.4+/-34.93 ug/dl, TIBC 387.8+/-45.53 ug/dl, transferrin saturation 26.2+/-9.99%, and serum ferritin in 22.7+/-14.18 ng/ml in 12-13years old females. 3) Mean values were hemoglobin 15.2+/-0.84 g/dl, hematocrit 45.9+/-2.77%, serum iron 144.9+/-51.97 ug/dl, TIBC 419.8+/-52.46 ug/dl, transferrin saturation 34.2+/-10.44%, and serum ferritin 31.2+/-20.91 ng/dl in 15-16years old males. 4) Mean values were hemoglobin 13.2+/-0.89 g/dl, hematocrit 39.9+/-2.78%, serum iron 111.1+/-39.78 ug/dl, TIBC 392.8+/-50.06 ug/dl, transferrin saturation 28.9+/-10.85%, and serum ferritin 21.4+/-17.11 ng/ml in 15-16years old females. 5) The prevalence of iron deficiency was 8.9% and 10.1% in 12-13years and 15-16years old males respectively. In 12-13years and 15-16years old females, the prevalence was 16.1% and 29.3% respectively. The prevalence of iron deficincy anemia was 1.1% and 2.0% in 12-13years and 15-16years old female and absent in male. CONCLUSIONS: Although hemoglobin is normal, we recommend to check other parameters to optimize the identification of individuals with iron deficiency.
Adolescent* ; Anemia ; Female ; Ferritins ; Hematocrit ; Humans ; Iron* ; Male ; Prevalence ; Seoul* ; Transferrin

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

CD44 is a hyaluronic acid receptor that exists as a standard 90-kd form (CD44H) as well as several CD44 variants isoforms are produced through alternative splicing. Alternatively spliced variants of the CD44 molecule have been found to be associated with invasive and metastatic potential of cancer cells and poor prognosis in several types of carcinoma. The purpose of the present study is to define the expression of CD44H and CD44v6 in ovarian tumors and to investigate whether the expression of these molecules is associated with adverse prognosis. We evaluated the expression of CD44 isoforms in 58 ovarian tumors by means of immunohistochemistry, and correlated between CD44 expression and the histologic types, tumor grade, peritoneal implants, pseudomyxoma peritonei and FIGO stage. While the CD44H was commonly expressed in ovarian tumors, the CD44v6 was expressed in a minor proportion of serous tumors in comparison with frequent expression of v6 isoform in mucinous tumors. The CD44H expression was significantly higher in stage I/II than in stage III. However, there was no correlation between the expression of CD44 and the presence of peritoneal implants or pseudomyxoma peritonei. These results suggest that CD44H could play an important role in the adhesive function in the lower stage of the ovarian tumor and reduced expression in the higher stage might be related to the metastasis and widespread invasion of ovarian carcinoma cells.
Adhesives ; Alternative Splicing ; Female ; Hyaluronic Acid ; Immunohistochemistry ; Mucins ; Neoplasm Metastasis ; Ovary ; Prognosis ; Protein Isoforms ; Pseudomyxoma Peritonei

The cytologic findings in fine needle aspiration of a case of myxoid liposarcoma of the mediastinum are described. The smear and cell block of the aspirate revealed solid clusters with background of amorphous material and scattered single tumor cells. The clusters were moderately cellular and consisted of atypical lipoblasts in varying stages of differentiation and delicate plexiform capillaries. Good correlation was found between the histologic and cytologic findings in the fine needle aspirates. The differential diagnosis between myxoid liposarcoma and other myxoid soft tissue tumors is discussed.
Biopsy, Fine-Needle* ; Capillaries ; Diagnosis, Differential ; Liposarcoma, Myxoid* ; Mediastinum* ; Needles

Osteosarcoma is one of the most common malignant bone tumors except for multiple myeloma. The current managements of the osteosarcoma patients include preoperative chemotherapy, definitive operation and postoperative chemotherapy with tremendous improved oncologic results by lots of Orthopedic Oncologists. The definitive operations are either limb-salvage operations or amputation. Limb-salvage operations include autograft, allograft, tumor prosthesis, or its combination. However, we have a difficulty to use allograft due to Korean traditonal customs. Authors managed the 6 year-old female patient with the osteosarcoma on the proximal metaphysis of the right humerus by wide-margin resection and reconstruction with a clavicula pro humero procedure with an excellent result, which technique was devised and developed by W. Winkelmann in Germany.
Allografts ; Amputation ; Autografts ; Child ; Drug Therapy ; Female ; Germany ; Humans ; Humerus* ; Multiple Myeloma ; Orthopedics ; Osteosarcoma* ; Prostheses and Implants

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor*

Melanosis coli is the brownish pigmentation of the colon associted with the ingestion of anthraquinone compounds as iaxatives. The brownish discoloration of the colon mucosa is due to accumulation of macrophage containing lipofuscin pigment in the lamina propria. This is the one of the complications of laxative abuse, but the pigments disappear by withdrawing the anthraquinone. We report a case of malanosis coli histologically confirmed by fibersigmoidoscopic biopsy in a 70-year-old female patient consuming anthraquinone compound for twelve months with a review of the literature.
Aged ; Biopsy ; Colon ; Eating ; Female ; Humans ; Lipofuscin ; Macrophages ; Melanosis* ; Mucous Membrane ; Pigmentation

STUDY DESIGN: A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. OBJECTIVES: The purpose of this study is to analyse the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. MATERIALS AND METHODS: In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. RESULTS: The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments(P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05). CONCLUSIONS: The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.
Animals ; Classification ; Follow-Up Studies* ; Humans ; Leg ; Lordosis ; Low Back Pain ; Retrospective Studies ; Sclerosis ; Spinal Fusion* ; Traction ; Vacuum