Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses in both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.
Adult ; Biopsy, Fine-Needle ; Chromatin ; Curettage ; Cytoplasm ; Epiphyses ; Female ; Femur ; Forearm ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Glomerulonephritis* ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Mitosis ; Osteoclasts ; Radius ; Stromal Cells ; Thigh ; Young Adult

BACKGROUND: Antihypertensive effect and safety of the newer, long acting, nonsulfhydryl angiotensin converting enzyme inhibitor, lisinopril, were studied. METHODS: Twenty eight patients of mild to moderate essential hypertension were administered 10-20mg of lisinopril once daily for ten weeks. Patients were evaluated every two weeks concerning the changes of blood pressure and pulse rate in the sitting position and also any untoward sumptoms and signs attributable to the side effect. Chest X-rey, ECG and laboratory examination were performed in principle two times before and after the completion of medication. RESULTS: The blood pressure declined from 165.4/107.6mmHg to 141.3/92.4mmHg at the end of ten weeks of medication, thus the reduction of 24.1mmHg of systolic pressure and 15.2mmHg of diastolic pressure were observed and the overall effective rate was 85.7%. The pulse rate and laboratory findings were not sigificantly changed before and after the administration of lisinopril. The side effects were observed in 2 cases(7.1%) of mild dry cough and in 2 cases(7.1%) of transitory mild headache and in 1 case(3.6%) of dizziness but no one discontinued medication due to adverse effects. CONCLUSION: Lisinopril proved effective and safe in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Cough ; Dizziness ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension* ; Lisinopril* ; Peptidyl-Dipeptidase A ; Thorax

Recently, the Korean Neuropsychiatric Association expelled one of its members on grounds of multiple ethical violations, which included a sexual boundary violation between doctor-patient relationships. However, the lack of understanding of why this is an ethical issue was found among the general population as well as psychiatric professionals. In this review article, we introduce the basic concepts of psychotherapy and psychiatrist-patient relationships, including therapeutic structure and transference/countertransference, and elaborate the reasons why boundary violations, and especially sexual boundary violations, are unethical and potentially harmful to the patient and to the psychiatric community.
Ethics ; Humans ; Psychiatry* ; Psychotherapy

Child abuse is a serious public health problem that can lead to compromised development, various psychopathologies, and subsequent health morbidities. In 2014, mandatory reporting of child abuse by physicians was enacted, but the rate of child abuse reporting by physicians remains low. Abuse victims exhibit several psychopathologies, including post-traumatic stress disorder, but there are claims that the existing diagnostic criteria do not cover all of the symptoms these victims may present. Complex post-traumatic stress disorder is a newly proposed diagnosis for those who have experienced long-term repeated interpersonal trauma in their childhood or adolescence. There are several evidence-based treatment options for children and adolescents who have experienced abuse. Psychiatrists are encouraged to increase their knowledge of the nature and characteristics of child abuse, its psychological consequences, the associated legal considerations, and the related social resources.

BACKGROUND: Newly developed alpha-, beta-receptor blocker, Amosulalol HCI(YM-09538) was evaluated for its hypotensive efficacy, safety and usefulness in patients with mild to moderate essential hypertension. METHODS: Thirty patients of essential hypertension(male 8, female 22), mean age 55 years were included for the study. Amosulalol HCI was administered 20-60mg daily for 10 weeks and initial starting dose was 10mg twice daily and dose was increased 40mg and 60mg daily in cases of insatisfactory hypotensive effect ever 2 weeks interval. Patients were evaluated every two weeks on blood pressure, pulse rate, improvement of subjective symptoms and side effects. Laboratory examinations were carried out routinely in principle two times before trial and after completion of study. RESULTS: Blood pressure began to fall significantly after tow weeks of administration and changed from initial 172.4mmHg of systolic pressure to final 149.3mmHg and from 104.7mmHg of diastolic pressure to final 92.5mmHg. The response rates were marked fall in 30%, satisfactory fall in 40%, thus overall hypotensive effect was observed in 70%. Pulse rate decreased slightiy but significantly from 4 weeks of administration. Improvement of subjective symptoms were observed in 7 cases out of 12 cases and no significant side effects were observedd except of two mild transitory cases of polyuria and indigestion. Laboratory examination also did not show any significant changes before and after medication. CONCLUSION: The daily administration fo 20-60mg of Amosulalol HCI to moderate essectial hypertension seems to be effective and safe with clinical usefulness.
Blood Pressure ; Dyspepsia ; Female ; Heart Rate ; Humans ; Hypertension* ; Nifedipine ; Perindopril ; Polyuria

No abstract available.
Thyroid Dysgenesis*

BACKGROUND: Microalbuminuria in type 2 diabetes is a predictor of development of clinical nephropathy and cardiovascular disease. But, it has been reported that reduced glomerular filtration rate (GFR) may occur in some normoalbuminuric diabetic patients. The aim of this study was to identify whether decreased GFR without microalbuminuria is to predict diabetic vascular complications. METHODS: Between January 1998 and February 2001, 73 patients with type 2 diabetes who visited Yeungnam university medical center were divided into 5 groups according to initial GFR ranges: group 1 (GFR < 30 mL/min), group 2 (30 < or = GFR < 60 mL/min), group 3 (60 < or = GFR < 90 mL/min), group 4 (90 < or = GFR < 125 mL/min), group 5 (125 mL/min < or = GFR). They were examined for microvascular and macrovascular complications initially and after 4 years. RESULTS: Decreased GFR had a negative correlation with age (r = -0.472, P = 0.001). Decreased GFR without microalbuminuria had a significant correlation with development of diabetic nephropathy (P = 0.016) after 4 years. There were no significant correlation with the prevalence of diabetic retinopathy, peripheral neuropathy, and macrovacular disease. But, our study showed that coronary artery disease had an increasing tendency with decreased GFR without statistical significance (P = 0.085). CONCLUSIONS: Our data suggest that reduced GFR, independent of albuminuria, may be an important predictor of diabetic nephropathy and coronary artery disease to some extent. So we recommend that not only the microalbuminuria, but also the decrease in GFR should be evaluated at the follow-up of patients with type 2 diabetes.
Academic Medical Centers ; Albuminuria ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetic Nephropathies ; Diabetic Retinopathy ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Peripheral Nervous System Diseases ; Prevalence

Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of (99m)Tc-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using (99m)Tc-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GRF calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of (99m)Tc-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GRF. In conclusion, the determination of GFR according to Gates' formula shows good and reproducible of GRF with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.
Creatinine ; Filtration* ; Glomerular Filtration Rate ; Injections, Intravenous ; Kidney ; Methods ; Nuclear Medicine

Many features of the developing nervous system are visible from external observations of intact human embryos. In this study, a photographic atlas from the 4th to the 7th week after ovulation (Carnegie stages 10-18) is provided. The neural folds began to fuse at stage 10, and the rostral and caudal neuropore were closed during stages 11 and 12, respectively. The three primary divisions of the brain were distinguishable before closing of the neural tube. The five secondary brain vesicles were formed during stages 14-15. The development of the cerebellum and cerebrum were first observed at stages 14 and 15, respectively. The mesencephalic flexure was seen at stage 12, and the cervical flexure and pontine flexure at stage 14. After stages 18-19, it became increasingly difficult to identify detailed features of the brain from the surface. Results from this study will help to correlate the characteristic findings of the developing central nervous system of human embryos from stereomicroscopical and light microscopical observations and to locate the exact parts of the developing human brain for other purposes.
Brain/embryology* ; Embryo/anatomy & histology ; Fetal Development ; Human

Background: Information about the factors involved in the progress of both high distressed and low distressed victims in the early days after a sexual assault are needed to provide effective intervention for victims of sexual assault. In this study, we examined the relationship among posttraumatic stress disorder (PTSD) symptoms, assault-related factors and trauma-related cognitions in Korean female victims of sexual assault. Methods: For this study, we retrospectively investigated the records of 94 female victims from the Sunflower Center for Women and Children Victims of Violence at the Ajou University Hospital in Korea. Demographic characteristics and the features of the sexual assault, post-traumatic stress symptoms, and trauma-related cognition were obtained from data recorded at the initial assessment. One month after the initial assessment, victims were contacted by telephone and their PTSD symptom severity was re-evaluated. The sample of 94 participants were divided into two groups depending on the PTSD symptom scale scores at initial assessment: High-distress group and Low-distress group. Results: Repeated-measured analyses of variance revealed that the high-distress group showed a decrease in PTSD symptom severity over the month, while the low-distress group did not show significant change of PTSD symptom severity. In correlation analysis, negative thoughts and beliefs about the assault were strongly correlated with PTSD symptom severity one month later in both the low-distress and high-distress groups. Conclusion Our results suggest that trauma-related cognitions seem to play an important role in the maintenance of PTSD both of high-distress and low-distress groups, and that effective intervention will need to address these cognitive factors.