The relationship between thyroid disease and rheumatic disorders has been the subject of considerable debate. Autoimmune thyroid disease (ATD), such as Graves' disease, Hashimoto's thyroiditis are occasionally associated with systemic lupus erythematosus, Sj gren syndrome, and rheumatoid arthritis (RA). Although the exact mechanism of this association is not well documented, genetic factor, immunologic defect, hormonal factor, drugs for treatment might contribute for it. There is a question of whether common factors are involved in the etiology of RA and thyroid disease, and controversy over whether an association between RA and ATD exists. The possibility of coexistent thyroid disease in patients with RA should be carefully considered throughout the course of follow-up. Recently, we experienced a 39-year-old male patient with RA during treatment of Graves' disease, and present the case here with brief review of literatures.
Adult ; Arthritis ; Arthritis, Rheumatoid* ; Autoimmunity ; Follow-Up Studies ; Graves Disease* ; Humans ; Lupus Erythematosus, Systemic ; Male ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

Tumour-induced hypoglycemia is usually caused by insulinoma or non-islet-cell neoplasm, such as hemangiopericytoma, fibrosarcoma, mesotheliomas. Most of the neoplasms in non-islet-cell tumour-induced hypoglycemia are mesenchymal type, and have a common features, including large-sized, slow-growing and metastatic involvement of the liver. The mechanisms of hypoglycemia in metastatic liver disease are not clearly defined, and liver failure secondary to hepatic metastasis or insulin or insulin-like mediated process are considered. Glucagon stimulation test has been used to distinguish between insulin-mediated or insulin-like-mediated hypoglycemia and hypoglycemia induced by liver failure. We experinced a case of hypoglycemia in a patient of hemangiopericytoma with liver metastasis in which glucagon stimulation test was used for proper evaluation. We compare this case with previously reported cases, and present here with brief review of literatures.
Fibrosarcoma ; Glucagon ; Hemangiopericytoma* ; Humans ; Hypoglycemia* ; Insulin ; Insulinoma ; Liver ; Liver Diseases ; Liver Failure ; Mesothelioma ; Neoplasm Metastasis*

The aim of this study was to develop a method for measuring the slumping resistance of flowable resin composites and to evaluate the efficacy using rheological methodology. Five commercial flowable composites (Aelitefil flow:AF, Filtek flow:FF, DenFil flow:DF, Tetric flow:TF and Revolution:RV) were used. Same volume of composites in a syringe was extruded on a glass slide using a custom-made loading device. The resin composites were allowed to slump for 10 seconds at 25degrees C and light cured. The aspect ratio (height/diameter) of cone or dome shaped specimen was measured for estimating the slumping tendency of composites. The complex viscosity of each composite was measured by a dynamic oscillatory shear test as a function of angular frequency using a rheometer. To compare the slumping tendency of composites, one way-ANOVA and Turkey's post hoc test was performed for the aspect ratio at 95% confidence level. Regression analysis was performed to investigate the relationship between the complex viscosity and the aspect ratio. The results were as follows. 1. Slumping tendency based on the aspect ratio varied among the five materials (AF < FF < DF < TF < RV). 2. Flowable composites exhibited pseudoplasticity in which the complex viscosity decreased with increasing frequency (shear rate). AF was the most significant, RV the least. 3. The slumping tendency was strongly related with the complex viscosity. Slumping resistance increased with increasing the complex viscosity. The slumping tendency could be quantified by measuring the aspect ratio of slumped flowable composites. This method may be applicable to evaluate the clinical handling characteristics of flowable composites.
Composite Resins ; Glass ; Handling (Psychology) ; Light ; Syringes ; Viscosity

Backgound/Aims: One of the most important mechanical properties to consider in selecting clinically optimal stents would be expansile pressure. However, there were scanty data about the expansile pressure of stents. Furthermore, the data were improper for the clinical selection of stents. In this study, the authors tried to develop a precise and reproducible expansile pressure measurement method and to measure the expansile pressure of a variety of stent types. METHODS: We developed a new method of expansile force measurement using a cylindrical measurement device under a quasi-static equilibrium state and measured the expansile forces of six different stents made by various manufacturers; covered and uncovered Y2P SR , covered Y3E SR (Stentech, Korea), covered and uncovered Ultraflex and uncovered Wallstent (Boston Scientific, USA) RESULTS: Three important points critical in explaining and predicting the expansion characteristics of stents were found. Firstly, the radial expansion force varies greatly among the types of stents. Secondly, stents could be categorized to "soft stent" and "stiff stent" based upon the slope of expansion force change. Lastly, the initial force needed to compress the fully expanded stents is far greater in stents covered with membrane compared with the stents without membrane. CONCLUSIONS: The newly developed method of measurement helped the authors to get more realistic data of expansion force and pressure, which are thought to be helpful in clinical selection of stent type.
Esophagus ; Membranes ; Stents*

Erectile dysfunction (ED) is a highly prevalent disorder that affects millions of men worldwide. ED is now considered an early manifestation of atherosclerosis, and consequently, a precursor of systemic vascular disease. This study was designed to investigate the effects of male silkworm pupa powder (SWP) on the levels of nitric oxide synthase (NOS) expression, nitrite, and glutathione (GSH); lipid peroxidation; libido; and erectile response of the corpus cavernosum of the rat penis. We induced ED in the study animals by oral administration of 20% ethanol over 8 weeks. The SWP-treated male rats were divided into 3 groups that were orally administered 200, 400, and 800 mg/kg. The libido of the SWP-administered male rats was higher than that of the ethanol control group. In addition, the erectile response of the corpus cavernosum was restored in males on SWP administration, to a level similar to that of the normal group without ED. The testosterone concentration did not increase significantly. The lipid peroxidation in the corpus cavernosum of the male rats administered SWP decreased significantly. In contrast, compared to the ethanol group, SWP-administered male rats showed increased GSH levels in the corpus cavernosum. The level of nitrite and NOS expression in the corpus cavernosum of SWP-administered male rats increased significantly. These results indicated that SWP effectively restored ethanol-induced ED in male rats.
Administration, Oral ; Animals ; Atherosclerosis ; Bombyx ; Erectile Dysfunction ; Ethanol ; Glutathione ; Humans ; Libido ; Lipid Peroxidation ; Male ; Nitric Oxide Synthase ; Penis ; Pupa ; Rats ; Testosterone ; Vascular Diseases

A 60-year-old woman with end stage liver cirrhosis caused by genotype 2 hepatitis C virus (HCV) infection received an orthotopic liver transplantation (OLT). The patient was negative for the hepatitis B surface antigen (HBsAg) and positive for the anti-hepatitis B surface antibody (anti-HBs) prior to and one and a half months following the OLT. Due to reactivation of hepatitis C, treatment with interferon-alpha and Ribavirin started two months following the OLT and resulted in a sustained virological response. We performed a liver biopsy because a biochemical response was not achieved. Surprisingly, liver pathology showed HBsAg-positive hepatocytes with a lobular hepatitis feature, which had been negative in the liver biopsy specimen obtained one and a half months post-OLT. High titers of both HBsAg and HBeAg were detected, while anti-HBs antibodies were not found. Tests for IgM anti-hepatitis B core antibody and anti-delta virus antibodies were negative. The serum HBV DNA titer was over 1x10(7) copies/mL. A sequencing analysis showed no mutation in the "a" determinant region, but revealed a mixture of wild and mutant strains at an overlapping region of the S and P genes (S codon 213 (Leu/Ile); P codons 221 (Phe/Tyr) and 222 (Ala/Thr)). These findings suggest that de novo hepatitis B can develop in patients with HCV infection during the post-OLT period despite the presence of protective anti-HBs.
Antibodies ; Biopsy ; Codon ; DNA ; Female ; Genotype ; Hepacivirus ; Hepatitis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis C ; Hepatocytes ; Humans ; Immunoglobulin M ; Interferon-alpha ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Middle Aged ; Ribavirin ; Superinfection ; Viruses

Hepatocellular carcinoma (HCC) is the 2nd most common cause of cancer related death in Korea and well-known malignancy with poor prognosis. Sorafenib is the first-line molecular targeted agent in patients with extra-hepatic spread of HCC. However, complete response is extremely rare in patients treated with sorafenib and the disease control rate is only 43%. We report a 53-year-old man with advanced HCC with pulmonary metastasis who showed complete response by cytotoxic chemotherapy with doxorubicin and cisplatin with relatively tolerable adverse effects after failure of treatment with sorafenib.
Carcinoma, Hepatocellular* ; Cisplatin ; Doxorubicin ; Drug Therapy* ; Humans ; Korea ; Middle Aged ; Neoplasm Metastasis* ; Prognosis

Constipation is one of the most common functional digestive complaints worldwide. We investigated the laxative effects of figs (Ficus carica L) in a beagle model of constipation induced by high protein diet and movement restriction. The experiments were consecutively conducted over 9 weeks divided into 3 periods of 3 weeks each. All 15 beagles were subjected to a non-treatment (control) period, a constipation induction period, and a fig paste treatment period. We administered fig paste (12 g/kg daily, by gavage) for 3 weeks following a 3-week period of constipation induction in dogs. Segmental colonic transit time (CTT) was measured by counting radiopaque markers (Kolomark) using a radiograph performed every 6 h after feeding Kolomark capsules, until capsules were no longer observed. Fig paste significantly increased fecal quantity in constipated dogs, and segmental CTT was also reduced following fig paste administration. There were no significant differences in feed intake, water intake, body weight, or blood test results, between the constipation and fig paste administration periods. Our results demonstrate that fig is an effective treatment for constipation in beagles. Specifically, stool weight increased and segmental CTT decreased. Fig pastes may be useful as a complementary medicine in humans suffering from chronic constipation.
Animals ; Body Weight ; Capsules ; Carica ; Colon ; Complementary Therapies ; Constipation ; Diet ; Dogs ; Drinking ; Ficus ; Hematologic Tests ; Humans ; Ointments ; Stress, Psychological

BACKGROUND: Diamond Blackfan anemia (DBA), characterized by impaired red cell production, is a rare condition that is usually symptomatic in early infancy. The purpose of this study was to assess nationwide experiences of DBA encountered over a period of 20 years. METHODS: The medical records of 56 patients diagnosed with DBA were retrospectively reviewed from November 1984 to July 2010. Fifteen institutions, including 13 university hospitals, participated in this study. RESULTS: The male-to-female ratio of patients with DBA was 1.67:1. The median age of diagnosis was 4 months, and 74.1% were diagnosed before 1 year of age. From 2000 to 2009, annual incidence was 6.6 cases per million. Excluding growth retardation, 38.2% showed congenital defects: thumb deformities, ptosis, coarctation of aorta, ventricular septal defect, strabismus, etc. The mean hemoglobin concentration was 5.1+/-1.9 g/dL, mean corpuscular volume was 93.4+/-11.6 fL, and mean number of reticulocytes was 19,700/mm3. The mean cellularity of bone marrow was 75%, with myeloid:erythroid ratio of 20.4:1. After remission, 48.9% of patients did not need further steroids. Five patients with DBA who received hematopoietic transplantation have survived. Cancer developed in 2 cases (3.6%). CONCLUSION: The incidence of DBA is similar to data already published, but our study had a male predilection. Although all patients responded to initial treatment with steroids, about half needed further steroids after remission. It is necessary to collect further data, including information regarding management pathways, from nationwide DBA registries, along with data on molecular analyses.
Anemia ; Anemia, Diamond-Blackfan ; Aortic Coarctation ; Bone Marrow ; Congenital Abnormalities ; Diamond ; Erythrocyte Indices ; Heart Septal Defects, Ventricular ; Hemoglobins ; Hospitals, University ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Registries ; Reticulocytes ; Retrospective Studies ; Steroids ; Strabismus ; Thumb ; Transplants

Pediatric differentiated thyroid cancers (DTCs), mostly papillary thyroid cancer (PTC, 80-90%), are diagnosed at more advanced stages with larger tumor sizes and higher rates of locoregional and/or lung metastasis. Despite the higher recurrence rates of pediatric cancers than of adult thyroid cancers, pediatric patients demonstrate a lower mortality rate and more favorable prognosis. Considering the more advanced stage at diagnosis in pediatric patients, preoperative evaluation is crucial to determine the extent of surgery required. Furthermore, if hereditary tumor syndrome is suspected, genetic testing is required. Recommendations for pediatric DTCs focus on the surgical principles, radioiodine therapy according to the postoperative risk level, treatment and follow-up of recurrent or persistent diseases, and treatment of patients with radioiodine-refractory PTCs on the basis of genetic drivers that are unique to pediatric patients.