No abstract available.
Nephrotic Syndrome*

The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
Female ; Humans

In this article, on page 205, Fig. 4C and D should be corrected.

BACKGROUND AND OBJECTIVES: An understanding of cardiovascular diseases (CVD) mortality is important for the development of strategies aimed at reducing the burden of CVD. Thus, we examined the changing pattern of CVD mortality in Korea over 30 years (1983-2012) by analyzing the Cause of Death Statistics. MATERIALS AND METHODS: Deaths from diseases of the circulatory system and those of five CVD categories were analyzed: total heart diseases, acute rheumatic fever/chronic rheumatic heart disease, hypertensive heart disease, ischemic heart disease (IHD) and atherosclerosis. To assess the effects of population ageing on CVD mortality, crude and age-adjusted mortality rates were calculated. Age-adjusted mortality rates were calculated by using the direct standardization method. RESULTS: Over the 30-year period analyzed in this study, circulatory system disease mortality markedly declined. The age-adjusted mortality rate decreased by 78.5% in men and by 76.3% in women. Consistent decreasing trends were observed for mortalities from rheumatic heart disease, hypertensive heart disease, and atherosclerosis. However, IHD mortality rapidly increased during the 30 years. Crude IHD mortality showed a steady increase until 2007, after which there were fluctuations. But the penalized regression splines showed that crude IHD mortality continued to increase. Age-adjusted IHD mortality peaked in the early 2000s, and started to decrease during the last few years. CONCLUSION: In summary, total CVD mortality rate has significantly decreased over the 30-year period analyzed in this study but the IHD mortality rate has continuously increased until recently. The prevention and management of cardiovascular diseases amongst the Korean population, especially IHD, still represents a great challenge.
Atherosclerosis ; Cardiovascular Diseases* ; Cause of Death ; Female ; Heart Diseases ; Humans ; Korea ; Male ; Mortality* ; Myocardial Ischemia ; Rheumatic Heart Disease

BACKGROUND AND OBJECTIVES: Cerebrovascular disease is a leading cause of mortality and morbidity in Korea. Understanding of cerebrovascular disease mortality trends is important to reduce the health burden from cerebrovascular diseases. We examined the changing pattern of mortality related to cerebrovascular disease in Korea over 30 years from 1983 to 2012. SUBJECTS AND METHODS: Numbers of deaths from cerebrovascular disease, hemorrhagic stroke, and cerebral infarction were obtained from the national Cause of Death Statistics. Crude and age-adjusted mortality rates were calculated for men and women for each year. Penalized B-spline methods, which reduce bias and variability in curve fitting, were used to identify the trends of 30-year mortality and identify the year of highest mortality. RESULTS: During the 30 years, cerebrovascular disease mortality has markedly declined. The age-adjusted cerebrovascular disease mortality rate has decreased by 78% in men and by 68% in women. In the case of hemorrhagic stroke, crude mortality peaked in 2001 but age-adjusted mortality peaked in 1994. Between 1994 and 2012, age-adjusted mortality from hemorrhagic stroke has decreased by 68% in men and 59% in women. In the case of cerebral infarction, crude and age-adjusted mortality rates steeply increased until 2004 and 2003, respectively, and both rates decreased rapidly thereafter. CONCLUSION: Cerebrovascular disease mortality rate has significantly decreased over the last 30 years in Korea, but remains a health burden. The prevalence of major cardiovascular risk factors are still highly prevalent in Korea.
Bias (Epidemiology) ; Cause of Death ; Cerebral Infarction ; Cerebrovascular Disorders* ; Female ; Humans ; Korea* ; Male ; Mortality* ; Prevalence ; Risk Factors ; Stroke

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial lung biopsy confirmed primary lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother's brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with lung cancer.
Adenocarcinoma ; Adult ; Anoxia ; Biopsy ; Brain ; Chemoradiotherapy ; Child ; Cough ; Emergencies ; Fetal Distress ; Humans ; Lung ; Lung Neoplasms ; Mothers ; Neoplasm Metastasis ; Parturition ; Pregnancy ; Pulmonary Atelectasis ; Rare Diseases ; Smoke ; Smoking ; Thorax

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial lung biopsy confirmed primary lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother's brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with lung cancer.
Adenocarcinoma ; Adult ; Anoxia ; Biopsy ; Brain ; Chemoradiotherapy ; Child ; Cough ; Emergencies ; Fetal Distress ; Humans ; Lung ; Lung Neoplasms ; Mothers ; Neoplasm Metastasis ; Parturition ; Pregnancy ; Pulmonary Atelectasis ; Rare Diseases ; Smoke ; Smoking ; Thorax

Lung cancer frequently metastasizes to distant organs. However, solitary metastasis to the pancreas, with lung cancer as the source, is very rare. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastases are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. We described the case of a 63-year-old man who presented with abdominal pain and a pancreatic nodule. The patient underwent resection of primary lung cancer followed by pylorus preserving pancreatoduodenectomy. The pancreatic nodule was confirmed as a solitary metastasis from lung cancer.
Abdominal Pain ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Pancreaticoduodenectomy ; Pylorus

BACKGROUND: Pain is one of the most troublesome problems caused by malignancy. We evaluated the change in pain status according to observance of NCCN guidelines in lung cancer patients. METHODS: Lung cancer patients complaining of pain at admission were examined. The pain was assessed with visual analogue scale (VAS) for 20 days and moderate-to-severe pain was defined as more than VAS level 3. The guideline observance was classified as high (more than 80%), medium (50~79%) and low (less than 50%). RESULTS: Among the total 91 lung cancer patients with pain, 34 patients (37%) had moderate-to-severe pain. Their average VAS score at admission was 5.6. It decreased to 2.9 after a 20-day period of pain management. The time to reach a VAS less than 3 was 3 days in a high guideline observance group, while it took 6 days in a low observance group. In addition, the pain in the high observance group was controlled to less than 3 VAS level in 86% of patients, whereas only 25% of patients in the low observance group succeeded. CONCLUSION: Pain was more effectively controlled when the dose of drugs was modified according to NCCN guidelines in lung cancer patients indicating the importance of guideline observance in pain management.
Humans ; Lung ; Lung Neoplasms ; Pain Management

PURPOSE: Although inconsistent, reports have shown fibrinogen levels to be associated with atherosclerosis. Accordingly, since cigarette smoking is associated with increased levels of fibrinogen and atherosclerosis, it may also affect the association between fibrinogen and atherosclerosis. We investigated the associations between fibrinogen and carotid intima-media thickness (IMT) according to smoking status in a Korean male population. MATERIALS AND METHODS: Plasma fibrinogen levels were measured in 277 men aged 40-87 years without a history of myocardial infarction or stroke. High-resolution B-mode ultrasonography was used to examine the common carotid arteries. IMT level was analyzed both as a continuous (IMT-max, maximum value; IMT-tpm, 3-point mean value) and categorical variable (higher IMT; presence of plaque). Serial linear and logistic regression models were employed to examine the association between fibrinogen and IMT according to smoking status. RESULTS: Fibrinogen levels were positively associated with IMT-max (standardized beta=0.25, p=0.021) and IMT-tpm (standardized beta=0.21, p=0.038), even after adjusting for age, body mass index, systolic blood pressure, fasting glucose, and total cholesterol to high-density lipoprotein cholesterol ratio in current smokers (n=75). No significant association between fibrinogen and IMT, however, was noted in former smokers (n=80) or nonsmokers (n=122). Adjusted odds ratios (95% confidence interval) for having plaque per one standard deviation higher fibrinogen level were 2.06 (1.09-3.89) for current smokers, 0.68 (0.43-1.10) for former smokers, and 1.06 (0.60-1.87) for nonsmokers. CONCLUSION: Our findings suggest that cigarette smoking may modify the association between fibrinogen and carotid atherosclerosis. Further studies are required to confirm this finding in different populations.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/*statistics & numerical data ; Atherosclerosis/*ultrasonography ; Blood Pressure ; Body Mass Index ; Carotid Artery Diseases/*blood/epidemiology/ultrasonography ; Carotid Artery, Common ; *Carotid Intima-Media Thickness ; Cholesterol/blood ; Cholesterol, HDL ; Cross-Sectional Studies ; Fibrinogen/*analysis ; Humans ; Lipoproteins, HDL/blood ; Logistic Models ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Smoking/*adverse effects/blood/epidemiology ; Surveys and Questionnaires