Diabetes is a rapidly increasing heath care problem all over the world due to increased prevalence during past decade. Diabetic nephropathy develops in 25-30% of patients with type 1 diabetes and is the leading cause of end stage renal disease. Diabetic nephropathy is characterized by persistent proteinuria, decline in renal function, hypertension and increased cardiovascular morbidity and mortality. Early detection of diabetic nephropathy risk is an important goal because early diagnosis and treatment prevent advanced renal damage and other diabetic complications. Increased urinary albumin excretion rate is widely accepted as the first clinical sign of diabetic nephropathy. However, reduced glomerular filtration or hypertension could be the first manifestation in some diabetic patients. We need improved markers and predictors of diabetic nephropathy risk. We report a case of diabetic nephropathy and decreased glomerular filtration rate (GFR) without microalbuminuria occcured in type 1 diabetic patient.
Diabetes Complications ; Diabetic Nephropathies* ; Early Diagnosis ; Filtration ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality ; Prevalence ; Proteinuria

PURPOSE: Although the diagnosis of foreign bodies in the airway can be made early, retained and neglected foreign bodies are a common occurrence. The objective of this study was to characterize the clinical features of children diagnosed beyond 14 days following inhalation of a foreign body, long-standing foreign body in airway(LFB). METHODS: We reviewed the records of 180 cases of airway foreign body, noting the age, symptoms and signs, types and location of foreign body, chest radiographs, and lung perfusion scan findings, and compared these findings of children diagnosed within 14 day(short-term foreign body in airway : SFB, n=130) with those of LFB(n=50). RESULTS: Of chief complaints on admission, sputum was more frequent in LFB(24.0%) than in SFB(6.9%). The age distribution was similar, but the proportion of patients aged 3 to 6 years was higher in LFB(16.0%) compared with SFB(3.9%). Of the types of foreign body, plastic was more common in LFB. Abnormal chest radiographic findings were more frequent in LFB(94.0%) than in SFB(80.6%), while the location within the bronchial tree was similar. Hypoperfusion on lung scan was noted in all patients except one in LFB(93.8%). CONCLUSION: There was some difference in age distribution, sputum production, type of foreign body, and abnormal radiographic and perfusion scan findings between SFB and LFB. This suggests that retained foreign bodies may present atypical clinical manifestation and physicians should be alert to the possibility of airway foreign body in children with chronic respiratory symptoms or signs.
Age Distribution ; Child ; Diagnosis ; Foreign Bodies* ; Humans ; Inhalation ; Lung ; Perfusion ; Plastics ; Radiography, Thoracic ; Sputum

Human brain EST data provide important clues for our understanding of the molecular biology associated with the function of the normal brain and the molecular pathophysiology with brain disorders. To systematically and efficiently study the function and disorders of the human brain, 45,773 human brain ESTs were collected from 27 human brain cDNA libraries, which were constructed from normal brains and brain disorders such as brain tumors, Parkinson's disease (PD) and epilepsy. An analysis of 45,773 human brain ESTs using our EST analysis pipeline resulted in 38,396 high-quality ESTs and 35,906 ESTs, which were coalesced into 8,246 unique gene clusters, showing a significant similarity to known genes in the human RefSeq, human mRNAs and UniGene database. In addition, among 8,246 gene clusters, 4,287 genes (52%) were found to contain full-length cDNA clones. To facilitate the extraction of useful information in collected these human brain ESTs, we developed a user-friendly interface system, the Korea Brain Unigene Database (KBUD). The KBUD web interface allows access to our human brain data through three major search modes, the BioCarta pathway, keywords and BLAST searches. Each result when viewed in KBUD offers comprehensive information concerning the analyzed human brain ESTs provided by our data as well as data linked to various other public databases. The user-friendly developed KBUD, the first world-wide web interface for human brain EST data with ESTs of human brain disorders as well as normal brains, will be a helpful system for developing a better understanding of the underlying mechanisms of the normal brain well as brain disorders. The KBUD system is freely accessible at http://kugi.kribb.re.kr/KU/cgi-bin/brain.pl.
Brain Diseases ; Brain Neoplasms ; Brain* ; Clone Cells ; DNA, Complementary ; Epilepsy ; Estrone* ; Expressed Sequence Tags ; Gene Library ; Humans ; Korea* ; Molecular Biology ; Multigene Family ; Parkinson Disease ; RNA, Messenger

Objectives: This study compared the psychological autopsies of suicide victims through interviews of the bereaved family members and investigations of the police death records. Methods: A psychological autopsy was performed using both the Korea Psychological Autopsy Checklist (K-PAC) through an interview of the bereaved family members and the Korea Psychological Autopsy Checklist for Police Record (K-PAC-PR) from the police death records at the same suicide victims. The frequency and percentage of each analysis item were checked, and the information collected was compared. Results: Of 129 victims, information from two methods showed no significant differences in marital status, employment status, cohabitation status and relationship, location of suicide, method of suicide, and main cause. Among the stress information at the time of death, interpersonal and mental health problems were consistent, but the occupational, economy, family-related, physical health problems were estimated to have greater impact according to the interview methods. The estimates of depression, schizophrenia, bipolar disorder, and dementia were consistent, but the investigation method estimated more sleep disorders and anxiety disorders, and the interview methods estimated more drug use disorders. Conclusion Based on the analysis results, the two methods of a psychological autopsy should be properly utilized, and effective suicide prevention using the psychological autopsy information was discussed.

Objective: To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patientswith breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventionaldiffusion-weighted imaging (cDWI). Materials and Methods: Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm2 (cDWI800and cDWI1500) and sDWI at b-values of 1000 and 1500 s/mm2 (sDWI1000 and sDWI1500). Qualitative analysis (normal glandulartissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI setsand the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI setin 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test,one-way analysis of variance, and Cochran’s Q test. Results: All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasingb-values, regardless of the type of imaging (synthetic or conventional) (p< 0.001). Additionally, sDWI1500 provided better lesionconspicuity than cDWI1500 (3.52 ± 0.92 vs. 3.39 ± 0.90, p< 0.05). Although cDWI1500 showed better normal glandular tissuesuppression and overall image quality than sDWI1500 (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively;p< 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater insDWI1500 than in cDWI1500 (0.63 ± 0.17 vs. 0.55 ± 0.18, p< 0.001). Conclusion sDWI1500 can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity,better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI1500.

As the interest in health is increasing and the population enjoyed the leisure sports is steadily increasing, the stress fracture, fracture or variant of metatarsal bone of foot has been shown frequently. The mistaken estimation about the length and rank of metatarsal bones during the osteotomy of the metatarsal bones of foot can be complicated. It is essential to have detailed knowledges about the anatomical structure of surgical region. This study aimed to investigate the metatarsal bones of foot and to develop a regression equation that can predict the length of metatarsal bones during the osteotomy. The subject of this study is fifty four feet (30M/224F). We measured the whole length and the article length of metatarsal bone. Also, we measured the whole width and the article width in the head, body, base of the metatarsal bone. The data was analyzed using SPSS win 13.0. The regression equation models of length of the metatarsal bones were developed by multiple regression analysis. The regression equation predicted first metatarsal length was second metatarsal articular length x0.770+7.780, second metatarsal length was third metatarsal length x0.976+6.050, third metatarsal length was fourth metatarsal length x1.000+0.922, fourth metatarsal length was third metatarsal length x0.917+4.167, fifth metatarsal length was fourth metatarsal length x0.901+7.972. The results of this study would be useful to clarify the characteristics of the metatarsal bone of the foot, to develop a regression equation for prediction of the length of the metatarsal bone.
Foot ; Fractures, Stress ; Head ; Leisure Activities ; Metatarsal Bones ; Osteotomy ; Sports

Most intracranial schwannomas originate from the cranial nerve especially CN V, VIII. However, schwannomas from low-cranial nerve are rarely reported. We report a case of large foramen magnum schwannoma in a 26 year-old-man presenting swallowing difficulty, nausea and vomiting. Magnetic resonance image revealed a cystic multilobulated huge mass from midclivus to atlas which compressed brain stem. The mass was removed by far-lateral transcondylar approach and confirmed with schwannoma which originated from hypoglossal nerve.
Brain Stem ; Cranial Nerves ; Deglutition ; Foramen Magnum* ; Hypoglossal Nerve ; Nausea ; Neurilemmoma* ; Vomiting

The use of totally implantable central venous access devices (chemoport) has increased with the development of chemotherapeutic agents in oncologic patients, especially with no venous access site. However, there can be various complications such as port site infection, thromboembolism, injury of central vein, fracture of catheter, and migration of catheter. We report a rare case of migration of catheter to right atrium due to the separation of the catheter from the chemoport.
Catheters ; Heart Atria ; Humans ; Thromboembolism ; Veins

BACKGROUND: Ultrafiltration, used in pediatric cardiac operations to remove excessive body water, can be separated into conventional and modified techniques according to the connection with the bypass circuit and the time of starting ultrafiltration. Ultrafiltration provides more precise hemodynamic and fluid management immediately after CPB (cardiopulmonary bypass), especially in the pediatric patient. The mechanism by which blood pressure improves remains uncertain. The purpose of this study was to compare the efficacy of ultrafiltration for hemodynamics and reduce the blood consumption amounts in paediatric open heart operations. METHODS: Fourty children undergoing surgical correction of VSD (ventricular septal defect) or ASD (atrial septal defect) were randomly assigned to a ultrafiltration or control group. Conventional ultrafiltration was performed with a polysurphone hemofilter during rewarming of CPB. Modified ultrafiltration carried out in the first 10 to 15 minutes immediately after bypass. In all patients, moderate hypothermic CPB, in the range of 20~25 degrees C body temperature, was performed with nonpulsating flow. RESULTS: Demographic data as well as data from CPB did not differ among the groups. In the ultrafiltration group, significant reductions of the amount of blood transfusion significant increases in systolic pressure and hematocrit were noted in the ultrafiltration group. We have been impressed with what appears to be a marked improvement in hemodynamic status in the modified ultrafiltration process during the first few minutes. CONCLUSIONS: Ultrafiltration has been employed successfully in our hospital, and this study demonstrates that ultrafiltration may help to control water balance, concentration of blood, increase systemic arterial pressure and reduces intraoperative blood transfusion.
Arterial Pressure ; Blood Pressure ; Blood Transfusion ; Body Temperature ; Body Water ; Child ; Heart ; Hematocrit ; Hemodynamics* ; Humans ; Rewarming ; Thoracic Surgery* ; Ultrafiltration*

OBJETIVE: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. MATERIALS OF METHODS: The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. RESULTS: The mean ages of the patients with leiomyomas and the control group were 43.1+/-5.6 and 40.6+/-7.2 years, the weights were 63.4+/-7.3 and 59.4+/-8.1 kg, and their heights were 155.4+/-4.8 and 159.3+/-4.8 cm respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. 17beta-estradiol, 5-AT, 11-keto ET, 11beta-hydroxy An, 11beta-hydroxy Et, THS, THA, THE, alpha-cortolone, alpha-cortol, beta-cortol, 11beta-OH Et/11beta-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. 17beta-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. 17beta-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). CONCLUSION: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.
Female ; Gas Chromatography-Mass Spectrometry ; Healthy Volunteers ; Humans ; Leiomyoma* ; Steroids ; Ultrasonography ; Uterus* ; Weights and Measures