No abstract available.

Gestational trophoblastic tumors including choriocarcinoma bave become one of the most curable human malignancies with an overall cure rate exceeding 90%. Although systemic chemotherapy is the initial treatment for chorio- carcinoma, some patients with chemotherapy-resistant choriocarcinorna can be treated by integration of cbemotherapy, surgery and radio- therapy. We report two cases of persistent localized choriocarcinoma which was treated by surgical intervention.
Choriocarcinoma* ; Drug Therapy ; Female ; Humans ; Neoplasm Metastasis ; Pregnancy ; Trophoblastic Neoplasms

No abstract available.
Head* ; Neck*

Background: White matter hyperintensity (WMH) is a risk factor for dementia and ischemic stroke. The atherogenic index of plasma (AIP) is a simple and cost-effective marker for the prediction of various vascular diseases. In this study, we evaluated the relationship between AIP and WMH in adults without cerebrovascular accidents. Methods: We analyzed the data of 281 adults, aged ≥26 years, who underwent brain magnetic resonance imaging (MRI) at the health promotion center of an education hospital between January 2014 and December 2018. Participants were divided into three categories according to tertiles of the AIP scores (T1: <0.20; T2: 0.20–0.48; and T3: >0.48). WMH was defined as a modified Fazekas scale score of 1–3 on brain MRI. A cubic spline curve was used to determine the linearity of the relationship between AIP and WMH. Multiple logistic regression analysis was used to evaluate the relationship between the AIP and WMH. Results: The prevalence of WMH was 45.7% in T1, 57.0% in T2, and 66.0% in T3 (T3 vs. T1, P for post-hoc analysis=0.005). The increased odds of WMH were associated with increased AIP. The odds ratio (OR) with a 95% confidence interval (CI) for WMH of T2 and T3 compared with T1 were 1.57 (0.88–2.80) and 2.30 (1.28–4.14), respectively. After adjusting for confounding variables, the OR with a 95% CI for WMH in the T2 and T3 groups vs. the referent T1 were 1.55 (0.76–3.13) and 2.27 (1.06–4.84), respectively. Conclusion AIP is independently and positively associated with WMH in a healthy population.

A 48-year-old woman was admitted to our hospital with a palpable mass in her lower abdomen. A left ovarian, cystic mass containing multiple mobile globules was seen on CT and MR images. The outer portion of the globules showed fat components on CT and fat-saturated T1-weighted MR images. Ultrasonography showed multiple echogenic, mobile globules with some sound attenuation and hyperechoic lines and dots within the cystic mass, which corresponded with the presence of lipid globules and hair shafts of ovarian mature cystic teratoma, respectively.
Abdomen ; Female ; Hair ; Humans ; Middle Aged ; Ovary ; Teratoma* ; Ultrasonography

Purpose: Dipeptidyl peptidase-4 (DPP-4) inhibitors lower blood glucose levels and enhance the function of pancreatic βcells. Yet, it is unknown whether posttransplant administration of DPP4 inhibitors is beneficial for pancreas transplant recipients. Methods: We thus retrospectively analyzed the records of 312 patients who underwent pancreas transplantation between 2000 and 2018 at Asan Medical Center (Seoul, Korea) and compared the metabolic and survival outcomes according to DPP-4 inhibitor treatment. Results: The patients were divided into the no DPP-4 inhibitor group (n = 165; no treatment with DPP-4 inhibitors or treated for <1 month) and the DPP-4 inhibitor group (n = 147; treated with DPP-4 inhibitors for ≥1 month). There were no significant differences in levels of glucose, hemoglobin A1c, and insulin between the 2 groups during 36 months of follow-up. However, the level of C-peptide was significantly higher in the DPP-4 inhibitor group at 1, 6, and 24 months posttransplant (all P < 0.05). Moreover, the DPP-4 inhibitor group had significantly higher rates of overall (log-rank test, P = 0.009) and death-censored (log-rank test, P = 0.036) graft survival during a 15-year follow-up. Conclusion Posttransplant DPP-4 inhibitor administration may help improve the clinical outcomes including β cell function after pancreas transplantation.

Purpose: Dipeptidyl peptidase-4 (DPP-4) inhibitors lower blood glucose levels and enhance the function of pancreatic βcells. Yet, it is unknown whether posttransplant administration of DPP4 inhibitors is beneficial for pancreas transplant recipients. Methods: We thus retrospectively analyzed the records of 312 patients who underwent pancreas transplantation between 2000 and 2018 at Asan Medical Center (Seoul, Korea) and compared the metabolic and survival outcomes according to DPP-4 inhibitor treatment. Results: The patients were divided into the no DPP-4 inhibitor group (n = 165; no treatment with DPP-4 inhibitors or treated for <1 month) and the DPP-4 inhibitor group (n = 147; treated with DPP-4 inhibitors for ≥1 month). There were no significant differences in levels of glucose, hemoglobin A1c, and insulin between the 2 groups during 36 months of follow-up. However, the level of C-peptide was significantly higher in the DPP-4 inhibitor group at 1, 6, and 24 months posttransplant (all P < 0.05). Moreover, the DPP-4 inhibitor group had significantly higher rates of overall (log-rank test, P = 0.009) and death-censored (log-rank test, P = 0.036) graft survival during a 15-year follow-up. Conclusion Posttransplant DPP-4 inhibitor administration may help improve the clinical outcomes including β cell function after pancreas transplantation.

OBJECTIVE: To examine survivin expression in extrapelvic endometriosis. METHODS: The study group consisted of 14 cases with extrapelvic endometriosis which were confirmed histologically. The control group (total, n=47) was divided into 2 groups. Group I included normal endometrium (n=34) obtained from hysterectomy specimens with myoma and without endometriosis. Group II included ovarian endometrioma (n=13) obtained from laparoscopy. Expression of survivin was immunohistochemically confirmed. RESULTS: In extrapelvic endometriosis, the expression of nucleus in glandular epithelium and stromal cells were significantly stronger than normal endometrium. But cytoplasm expression of glandular epithelial cells and stromal cells in extrapelvic endometriosis showed statistically lower in comparison with normal endometrium. In ovarian endometrioma, the expression of nucleus in glandular epithelial cells and stromal cells was significantly stronger than normal endometrium. But the expression of nucleus in glandular epithelial cells with ovarian endometrioma was stronger than during proliferative phase but was not significant. Also cytoplasm expression of ovarian endometrioma was lower than normal endometrium. There was no difference in survivin expression between extrapelvic endometriosis and ovarian endometrioma. CONCLUSIONS: In extrapelvic endometriosis, survivin expression was stronger than normal endometrium except cytoplasm. Our findings suggest that increased survivin expression may contribute to survival of extrapelvic implants.
Cytoplasm ; Endometriosis ; Endometrium ; Epithelial Cells ; Epithelium ; Female ; Hysterectomy ; Laparoscopy ; Myoma ; Stromal Cells

BACKGROUND/AIMS: Caustic ingestion can cause severe injury to upper gastrointestinal tract. There were few studies about clinical characteristics and treatments of caustic injury in Korea. We investigated the changes in clinical features of caustic injury over the past 20 years including pattern of endoscopic mucosal injury and treatment modality. METHODS: This study was a retrospective review of medical records from patients with caustic injury from September 1993 through December 2012. Patients were classified into two groups based on the year when caustic ingestion occurred: patients who visited the hospital from 1993 to 2002 (early group) and patients who visited the hospital from 2003 to 2012 (late group). RESULTS: A total 140 patients were included (early group [n=50] vs. late group [n=90]). Annual number of caustic ingestions did not show decreasing tendency over the past 20 years. Alkali ingestion increased (20.0% vs. 65.6%, p<0.001) and cases with more than grade 2b of esophageal mucosal injury decreased (41.3% vs. 20.7%, p=0.012) in late group. There were no differences between two groups in sex, age, proportion of accidental ingestion, and systemic/gastrointestinal complications. Use of gastric lavage (p<0.01) and broad spectrum antibiotics (p=0.03) decreased in late group. However, there was no difference in use of steroid between two groups. CONCLUSIONS: In this study, overall caustic ingestion did not decrease and ingestion of alkali agents increased over the past 20 years. Tighter legislation on caustic agents is required and we need to be alert to the best management of caustic injury.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Caustics/*toxicity ; Endoscopy, Digestive System ; Esophageal Diseases/chemically induced/complications/*pathology ; Esophageal Stenosis/complications ; Female ; Gastric Lavage ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Severity of Illness Index ; Tertiary Care Centers ; Young Adult

Amyloidosis is a rare disease characterized by deposition and accumulation of insoluble fibrils in various organs and tissues. Variations in the precursor proteins composing each fibril account for the diverse character of amyloidosis. Amyloidosis light chain (AL) and amyloid A amyloidosis (AA) are two clinical entities representative of this diversity. We present a case of a 58-year-old woman presenting with refractory diarrhea and abdominal pain. She was ultimately diagnosed with intestinal amyloidosis diffusely involving the small and large intestines. Even though a definitive therapeutic strategy has not been established for gastrointestinal amyloidosis, this particular patient has been successfully managed with high-dose steroids and azathioprine.
Abdominal Pain ; Amyloid ; Amyloidosis ; Azathioprine ; Diarrhea ; Female ; Humans ; Intestines ; Light ; Middle Aged ; Proteins ; Rare Diseases ; Steroids