No abstract available.
Heart* ; Thoracic Surgery*

PURPOSE: To determine whether initial corrected anion gap (C(o)AG), base excess caused by unmeasured anions (BEua), and strong ion gap (SIG) can predict the morbidity of critically ill patients admitted to emergency department (ED). METHODS: 138 patients who visited the critical section of the ED and were admitted to intensive care unit (ICU) were enrolled. We calculated the C(o)AG, BEua, and SIG from the initial blood samples of the patients and initial logistic organ dysfunction score (LODS) also. Then we measured the LODS at the last day of ICU stay again. Comparing with the initial LODS, we divided the patients into two groups based on the changes of the values: favorable group and poor group. RESULTS: There was a significant difference in the mean AGcorr (p=0.007), BEua (p=0.008), SIG (p=0.037) between favorable and poor group. The area under the receiver operating characteristic (AUROC) curves for morbidity prediction were relatively small: 0.66 (95% CI, 0.56-0.77) for C(o)AG, 0.65 (95% CI, 0.54-0.76) for BEua, and 0.59 (95% CI, 0.49-0.70) for SIG. CONCLUSION: We found the initial unmeasured anions at the ED of the patients who eventually showed improved LODS during ICU period are significantly different to those of the other patients. But they failed to show enough capability of discriminating the morbidities between two groups.
Acid-Base Equilibrium ; Anions* ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Organization and Administration ; ROC Curve

Pilomatricoma is a benign adnexal tumor, differentiating towards elements of the hair matrix and shaft. The tumor typically presents as a solitary, deep-seated, firm nodule with overlying normal epidermis. Herein, we report three cases of pilomatricomas with the dermal bullae overlying tumors. Histopathological examination of the lesions showed marked lymphatic dilatations, edema, and attenuated collagen and elastic fibers above the pilomatricomas in the upper dermis. We diagnosed them as lymphangiectatic pilomatricomas.
Collagen ; Dermis ; Dilatation ; Edema ; Elastic Tissue ; Epidermis ; Hair ; Pilomatrixoma*

Pilomatricoma is a benign adnexal tumor, differentiating towards elements of the hair matrix and shaft. The tumor typically presents as a solitary, deep-seated, firm nodule with overlying normal epidermis. Herein, we report three cases of pilomatricomas with the dermal bullae overlying tumors. Histopathological examination of the lesions showed marked lymphatic dilatations, edema, and attenuated collagen and elastic fibers above the pilomatricomas in the upper dermis. We diagnosed them as lymphangiectatic pilomatricomas.
Collagen ; Dermis ; Dilatation ; Edema ; Elastic Tissue ; Epidermis ; Hair ; Pilomatrixoma*

Objectives: To investigate brain magnetic resonance imaging (MRI) findings in patients with central precocious puberty (CPP) by age at onset and sex. Methods: We included 130 CPP patients with brain MRI findings of the pituitary gland treated at Ewha Womans University Mokdong Hospital between February 2007 and October 2013 and divided them by age and sex: boys, girls aged ≤6 years, and girls aged >6 years. The control group comprised 224 patients who underwent brain MRIs, and we compared their incidental brain findings with those of the CPP group. Results: In the CPP subgroups who underwent pituitary MRIs, the frequency of incidental brain lesions was 31.6% in boys, 47.1% in girls ≤6 years and 29.8% in girls >6 years. The incidence of pituitary abnormalities was 42.1% in boys, 64.7% in girls ≤6 years and 47.9% in girls >6 years. Among pituitary abnormalities, pituitary hypoplasia had a significantly higher incidence rate in girls ≤6 years (41.2%) than in boys (15.8%) or girls >6 years (13.8%, P=0.027). Hypothalamic hamartomas were detected in one girl aged ≤6 years and in one boy, but not in girls aged 6 years (P=0.075). The incidence of pineal cysts was higher in the CPP groups and significantly higher in girls ≤6 years (47.1%) than in the control group (11.2%, P=0.001). Conclusion There was a higher incidence of brain abnormalities on pituitary MRIs and a higher incidence of pineal cysts, possibly associated with CPP pathogenesis, in younger CPP patients than in other patients.

To improve our understanding of the relationship between soil higher fungi (belonging to Ascomycota and Basidiomycota) and Abies koreana, we surveyed A. koreana soil fungal communities in a forest in Mt. Halla, Jeju Island, Korea by next-generation sequencing (Illumina Miseq). To confirm the soil higher fungal communities, we collected two types of soils from a defined plot: soils with dead (AKDTs) and living A. koreana (AKLTs), respectively. Soil fungi were classified into 2 phyla, 19 classes, 64 orders, 133 families, 195 genera, and 229 OTUs (895,705 sequence reads). Nonmetric multidimensional scaling (NMDS) showed significantly different soil higher fungal communities between AKDTs and AKLTs (p < .05). In addition, the saprophyte composition was significantly affected by A. koreana status (p < .05). The proportion of the mycorrhizal Clavulina spp. was different between soils with AKDTs and AKLTs, suggesting that Clavulina spp. may be a crucial soil fungal species influencing A. koreana. This study will lead to a better understanding of the ecological status of A. koreana in Mt.Halla. In addition, this study could be useful for the conservation and management of A.koreana habitats.

The nephrotic syndrome that occurs in the absence of renal vein thrombosis, amyloidosis, neoplastic infiltration of the kidneys is an unusual but a well recognized paraneoplastic syndrome. The most frequently reported neoplasms associated with nephrotic syndrome are Hodgkin's disease and various carcinomas. The most common renal lesions are membranous glomerulonephritis(MGN) associated with carcinomas and minimal change lesions associated with Hodgkin's disease. Approximately 40% to 45% of patients clinically manifest the MGN symptoms prior to the diagnosis of the tumor, 40% simultaneously with the tumor and the remaining 15% to 20% following the tumor. Therefore, evaluating the underlying malignancy in patients with MGN is important. Here we report a patient with squamous cell lung cancer, which was detected 12 months after a MGN had been diagnosed, with a review of the relevant literature.
Amyloidosis ; Diagnosis ; Glomerulonephritis, Membranous* ; Hodgkin Disease ; Humans ; Kidney ; Lung Neoplasms* ; Lung* ; Nephrotic Syndrome ; Paraneoplastic Syndromes ; Renal Veins ; Thrombosis

Surgery is the primary treatment for adenocarcinoma arising from Barrett's esophagus. However, in order to avoid the high risk of complications of surgical resection, many physicians try various endoscopic treatments in cases of early adenocarcinoma and high-grade dysplasia of Barrett's esophagus. Endoscopic submucosal dissection (ESD) is a recently highlighted technique because of its high rate of en bloc resection, but there is controversy about ESD because of the uncertain long-term effect. There is a high risk of local recurrence after endoscopic treatments especially in a long-segment Barrett's esophagus, but there are no reports about this in Korea. This case we report on shows that the early adenocarcinoma arising from a long-segment Barrett's esophagus was curatively removed by ESD, but recurred high-grade dysplasia was detected on the remnant Barrett's esophagus after one year. We report here on a case of recurred esophageal malignancy after successful endoscopic resection of adenocarcinoma from a Barrett's esophagus.
Adenocarcinoma ; Barrett Esophagus ; Korea ; Recurrence

BACKGROUND/AIMS: While endoscopic resection could be considered as the best choice for the treatment of small rectal carcinoid, the colonoscopic biopsies performed at the time of detection may lead to scar and ulcer formation and cause unpredicted difficulty in the endoscopic resection. This study was evaluated to analyze the relationship between the post-biopsy scar and the limitation of submucosal elevation for the endoscopic resection of rectal carcinoids. METHODS: Twenty two cases of rectal carcinoid which received prior biopsies before the endoscopic resection were retrospectively compared with 20 non-biopsied cases. All two groups were treated by endoscopic resection from January 2000 to December 2007. There was no difference in the clinical characteristics and endoscopic findings such as size and location between the two groups. RESULTS: The limited submucosal elevation was experienced in 17 cases (77%) in the biopsy group, significantly more frequent than 9 cases (45%) in the non-biopsy group (p=0.03). The colonoscopic findings which contribute to difficult submucosal elevation were the depressive scar formation after biopsy, the size less than 5 mm in the biopsy group, active ulcer formation after biopsy. Regarding the resection method, endoscopic submucosal dissection was frequently adopted (23% vs. 5%) in the biopsy group. The frequency of endoscopic piecemeal resection in biopsy group was higher than non-biopsy group (23% vs 10%), and all cases were subsequently resected by other endoscopic methods. CONCLUSIONS: The post-biopsy scar can interfere with successful submucosal elevation for endoscopic resection of rectal carcinoids. The number of forcep biopsy should be minimized in the diagnostic colonoscopy when endoscopic resection is planned rectal carcinoids.
Adult ; Aged ; Biopsy ; Carcinoid Tumor/*pathology/surgery ; Cicatrix/pathology ; Colonoscopy ; Female ; Humans ; Intestinal Mucosa/surgery ; Male ; Middle Aged ; Rectal Neoplasms/*pathology/surgery ; Risk Factors

BACKGROUND/AIMS: Dominant genotype of hepatitis A virus (HAV) in Korea had been known to be genotype 1A in 1990s. Recently, the epidemiologic change of HAV genotype was reported with an upsurge of acute hepatitis A in Korea. The aim of this study was to investigate the change of HAV genotypes and clinical characteristics in Gwangju and Jeonnam province. METHODS: From November 2008 to October 2009, a total of 82 patients with acute hepatitis A were enrolled prospectively. HAV genotype was determined using reverse transcriptase polymerase chain reaction and sequencing of the PCR products of VP1/2A region of HAV. RESULTS: HAV RNA was detected in 82% (67/82). The genotype IIIA (88%, 59 cases) was significantly more frequent than genotype IA (12%, 8 cases) (p< or =0.01). The subtypes of genotype IIIA were AJ299467 Norway (49%), HA-JNG04-09 Japan (27%), HS-14-12-00 Spain (22%) and H-122 Sweden (2%). The subtypes of IA were FH1 Japan (50%) and HA J04-3 Japan (50%). The substitutions of amino acid were more frequent in genotype IIIA than IA (p< or =0.01). There was no difference in the clinical characteristics between the patients with genotype IIIA and IA. CONCLUSIONS: Genotype IIIA was a dominant genotype of recent HAV infection in Gwangju and Jeonnam province. This study provides valuable epidemiologic information of genetic distributions of HAV in Korea.