BACKGROUND: Although hypochlorhydria, hypergastrinemia and antiparietal cell antibody have been well documented in the patients with hyperthyroidism, a cause of hypochlorhydria or hypergastrinemia is unknown at the present time. Therefore, in order to clarify an inhibitory mechansim of gastric acid secretion in the patients with hyperthyroidism, interrelationship among hypochlorhydria, hypergastrinemia and antiparietal cell antibody was investigated in this study. METHODS: The gastric secretory function, fasting and postprandial plasma concentrations of gastrin and titer of antiparietal cell antibody in the plasma were determined in the patients with hyperthyroidism and normal subjects. Immunoblot analysis was performed to identify the gastric membrane protein, a possible gastric antigen to antiparietal cell antibody. Using a immunocytochemical technique with electron microscopy, intracellular structure of the parietal cell reacted with antiparietal cell antibody was observed. RESULTS: The basal and pentagastrin-stimulated maximal acid output were reduced in the patients with hyperthyroidism. The fasting and postprandial plasma concentrations of gastrin were markedly elevated in the patients. The plasma gastrin concentration in the patients with the antiparietal cell antibody was higher than that of the norrnal subjects as well as the patients without the antibody not only in the fasting state but also in the postprandial state. However, the plasma gastrin concentration of the patients without the antiparietal cell antibody was elevated in the fasting state only. There was no difference in the gastrin content of the antral mucosa between the norrnal subjects and the patients. The antiparietal cell antibody was detected in 5 (38.5 %) out of 13 patients by using the indirect immunofluorescence method. Patient IgG dose-dependently inhibited rabbit gastric H (+),K (+)-ATPase activity. Among proteins of the rabbit gastric mucosa membrane, four high molecular weight proteins (91, 140, 170 and 210 K dalton) were reacted to the patient IgG. The patient IgG positive peroxidase-antiperoxidase (PAP) activity was electron microscopically detected on the intracellular cannalicular membrane of the parietal cell CONCLUSION: We conclude that hypochlorhydria and hypergastrinemia in the patients with hyperthyroidism are partially related to the antiparietal cell antibody and that the antigen to the antiparietal cell antibody may be H (+),K (+)-ATPase in the intracellular canalicular membrane of the parietal cell.
Achlorhydria ; Fasting ; Fluorescent Antibody Technique, Indirect ; Gastric Acid* ; Gastric Mucosa ; Gastrins ; Humans ; Hyperthyroidism* ; Immunoglobulin G ; Membrane Proteins ; Membranes ; Microscopy, Electron ; Molecular Weight ; Mucous Membrane ; Plasma ; Rabeprazole

The proliferating trichilemmal cyst is a rare, usually benign tumor of external root sheath origin. About 90% of the cases gccur on the scalp, with the residual 10% occurring mainly on the back. More than 80% of the patients are women, most of whom are elderly. The cysts are commonly large, measuring up to 6 cm or more in diameter. A 33-year-old woman visited our department with a history of a matchhead- sized erythematous tender papule on her left knee that had been present for two years. A histopathological examination revealed a well-circumscribed, multilobulated cystic tumor with trichilemmal keratinization in the dermis. There were individual cell keratinization and focal calcification in some areas. This case was diagnosed as a proliferating trichilemmal cyst. This case was very unusual not only because the tumor occurred on the knee as a matchhead-sized papule but also because of her young age at presentation.
Adult ; Aged ; Dermis ; Female ; Humans ; Knee ; Scalp

PURPOSE: To report an case regarding phacoemulsification and intraocularlens (IOL) implantation using an iris retractor in a congenital microcoria patient. CASE SUMMARY: A 53-year-old male patient visited the office with a complaint of gradual decrease of visual acuity. The patient's best corrected visual acuity (BCVA) was 0.3, and his refractive index could not be measured, as a very small pupil was observed in both eyes. After applying tropicamide and phenylephrine four times, the refractive index of both eyes remained immeasurable. In addition, on slit-lamp biomicroscopic examination, a nucleosclerotic cataract was observed in both eyes. Any signs of increased intraocular pressure or gonioscopic findings seen in glaucomatous patients was not detected in either eyes. Using an ultrasound biomicroscope and Pentacam, the pupil diameter were 0.31 mm in both eyes, and changed to 0.92 mm in the right eye, and 1.0 mm in the left eye, after applying mydriatics. Phacoemulsification and IOL implantation were performed one month apart from each other, using an iris retractor. On the follow-up examination 2 to 3 months postoperatively, BCVA was 0.7 in the right eye, and 1.0 in the left eye. After the operation, the pupil diameter was not changed before and after mydriasis, and measured 2.53 mm in the right eye, and 2.83 mm in the left eye. CONCLUSIONS: The authors have reported a case regarding visual acuity that improved in a congenital microcoria patient performing a phacoemulsification and IOL implantation operation using an iris retractor.
Cataract ; Eye ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Iris ; Male ; Middle Aged ; Miosis ; Mydriasis ; Mydriatics ; Phacoemulsification ; Phenylephrine ; Pupil ; Pupil Disorders ; Refractometry ; Tropicamide ; Visual Acuity

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis

PURPOSE: The purpose of this study is to examine the impact of type D personality on health status and health promoting behaviors in middle-aged women. METHODS: A cross-sectional study design was used with 220 middle aged women. All participants completed 3 measuring tools: a 14-item Type D Personality Scale, a 12-item Short Form Health Survey Questionnaire version 2, and Health Promoting Lifestyle Profile-version II. All were completed in November 2010. RESULTS: The prevalence of type D personality was 34.5%. Type D women had significantly lower physical (p=.020) and mental health status (p<.001) compared with non-type D women. In addition Type D women reported significantly poorer performance of health responsibility (p=.015), physical activity (p=.001), nutrition (p=.027), spiritual growth (p<.001), interpersonal relations (p<.001) and stress management (p<.001) techniques in health behaviors than non-type D women. CONCLUSION: Type D personality is a vulnerability factor that affects health status and is associated with poor health promoting behaviors in middle aged women. Therefore, screening for Type D personality is important to detect women at risk for health status and quality of life in community settings in Korea.
Cross-Sectional Studies ; Female ; Health Behavior ; Health Surveys ; Humans ; Interpersonal Relations ; Korea ; Life Style ; Mass Screening ; Mental Health ; Middle Aged ; Motor Activity ; Prevalence ; Quality of Life ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD). METHODS: A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events. RESULTS: Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events. CONCLUSION: Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.
Aged ; Aged, 80 and over ; Anger ; Anxiety ; Cohort Studies ; Coronary Artery Disease/*psychology ; Databases, Factual ; Depression ; Female ; Hostility ; Humans ; Male ; Prospective Studies ; Recurrence ; Risk Factors ; *Stress, Psychological

No abstract available.
Aneurysm ; Aneurysm, Ruptured* ; Cerebral Veins* ; Veins*

PURPOSE: This study was done to identify self-directed learning readiness, achievement goal orientations, learning satisfaction and learning achievement, and to evaluate the factors affecting learning achievement for nursing students using a web-based Health Assessment e-Book. METHODS: The research design was a cross-sectional study with a structured questionnaire and data were collected before using the web-based Health Assessment e-Book and 1 week after finishing. The participants were 80 nursing students who were taking the Health Assessment class from March to June 2009. RESULTS: Mean score for subjective learning achievement was 31.26 and for objective learning achievement, 69.25. Subjective and objective learning achievement were positively correlated with self-directed learning readiness, mastery goal, attitude toward distance education, and learning satisfaction. In subjective learning achievement, learning satisfaction and mastery goal were significant predictive factors and explained 64% of the variance. Objective learning achievement was significantly predicted by learning satisfaction and self-directed learning readiness, which explained 24% of the variance. CONCLUSION: Learning satisfaction, mastery goal and self-directed learning readiness were found to be very important factors associated with learning achievement for nursing students using a web-based Health Assessment e-Book. To provide high quality and effective web-based courses and to improve nursing students' learning achievement and learning satisfaction, educators should consider the learner's characteristics from the initial stages of lecture planning.
Adult ; *Computer-Assisted Instruction ; Cross-Sectional Studies ; *Education, Nursing, Baccalaureate ; Educational Status ; Female ; Humans ; Internet ; *Learning ; Male ; Personal Satisfaction ; Questionnaires ; Students, Nursing/*psychology

The E-cadherin, alpha-catenin, and beta-catenin expressions were immunohistochemically investigated in paraffin-embedded materials of 80 cases of colorectal adenocarcinomas. The staining similar to normal colorectal mucosa with preserved strong membranous staining pattern was considered normal or preserved expression. The X2 test was used to analyse the statistical correlation of cadherin/catenin expression with clinicopathologic parameters and the Breslow test for the correlation with survival length. Normal colorectal mucosa showed strong membranous expression of cadherin/catenin complex. The reduced E-cadherin, alpha-catenin, and beta-catenin expression were found in 53/80 (66.3%), 46/80 (57.5%), and 44/80 (55.5%) cases of colorectal cancers examined, respectively. There were significant correlations between E- cadherin and alpha -catenin (p=0.035), and between alpha-catenin and beta-catenin (p=0.013). The reduced E-cadherin expression was associated with histologic dedifferentiation, tumor depth, lymph node metastasis, clinical stage (p<0.05), poor clinical outcome in stage II (p=0.016) and the reduced alpha-catenin expression with lymph node metastasis and clinical stage (p<0.05). Reduced expression of two or more proteins was correlated with lymph node matastasis, histologic dedifferentiation, clinical stage, and survival (p<0.05). The present study demonstrates a significant down-regulation of E-cadherin and alpha-catenin expression in colorectal cancer is associated with tumor invasiveness, histologic dedifferentiation, lymph node metastasis, and clinical stage. These results suggest that E-cadherin and alpha-catenin may be useful markers of invasiveness, lymph node metastatic potential, and clinical stage and of value as prognostic markers in the earlier stage. Further studies are needed to confirm the prognostic value of these cadherin/catenin complex.
Adenocarcinoma* ; alpha Catenin* ; beta Catenin* ; Cadherins* ; Colorectal Neoplasms ; Down-Regulation ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis

One hundred eighty infants with oxygen therapy who were under 2,500gm birth weight or under 37 weeks of gestational age, were examined between January 1990 and November 1992. We performed clnical analysis and results were as follows. 1) Fifty six infants (31.1%) were diagnosed as retinopathy of prematurity. 2) The first examination was performed at 2.5 weeks of life on average, and the retinopathy of prematurity was diagnosed at 3.8 weeks on average. 3) The incidence of retinopathy of prematurity was highly associated with low birth weight (< or =1,890 gm), low gestational age ( < or =33.1 weeks), and high oxygen concentration with long duration (FiO2> or =0.4 over 1 week)(P<0.005). 4) Other associated risk factors were idiopathic respiratory distress syndrome, anemia, neonatal hypoxia and sepsis.
Anemia, Neonatal ; Anoxia ; Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Oxygen ; Retinopathy of Prematurity* ; Risk Factors ; Sepsis