Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.
Female ; Humans ; Adenoma

Typhoid fever is an acute systemic febrile disease caused by Salmonella Typhi, characterized by persistent fever, headache, abdominal pain, diarrhea and rose spots. Salmonella infection can lead to diffuse organ involvement including bone, lung, thyroid, kidney, liver, spleen, heart, intestine and skin. While a variety of complications may be seen in typhoid fever, sensorineural hearing loss or pancreatitis has been rarely observed. Recently, we experienced a case of typhoid fever complicated by sensorineural hearing loss, acute pancreatitis and hepatitis in a 21-year-old female patient, who was improved with ceftriaxone and ciprofloxacin administration and supportive care. We report this case with a review of the literature.
Abdominal Pain ; Ceftriaxone ; Ciprofloxacin ; Diarrhea ; Female ; Fever ; Headache ; Hearing Loss, Sensorineural* ; Heart ; Hepatitis* ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Pancreatitis* ; Salmonella Infections ; Salmonella typhi ; Skin ; Spleen ; Thyroid Gland ; Typhoid Fever* ; Young Adult

Backgrounds: Thyroid hormones play a fundamental role in the initiation and maintenance of somatic growth in mammalian species, and the insulin-like growth factors(IGFs) occupy a position of central importance in the growth of all tissues. To evaluate the changes in serum insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding proteins in hyperthyroid and hypothyroid patients, sera was obtained from 19 hyperthyroid patients, 9 hypothyroid patients, and 10 healthy volunteers. Methods: IGF-I concentration was determined by radioimmunoassay, and changes in IGFBPs were assesed by Western Ligand Blotting. To evaluate the binding pattern of IGF-I & IGFBPs, autoradiographs were obtained. Results & Conclusion: IGF-I levels were increased significantly in hyperthyroid patients(mean ±SE, 267.88±9.80 ng/ml, p<0.05) and decreased significantly in hypothyroid patients(154.81±1.43 ng/ml, p<0.01) compaired to healthy control group(209.45±.60 ng/ml). Autoradiograph of serum IGFBPs from patients with hyperthyroidism and hypothyroidism did not show any change in the intensity of IGFBP-3 bands(40-45 KD) and IGFBP-1 bands, but in hyperthyroid patients, it showed increased intensity of IGFBP-2 band compared to healthy control group and hypothyroid patients.
Equidae ; Healthy Volunteers ; Humans ; Hyperthyroidism ; Hypothyroidism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Radioimmunoassay ; Thyroid Hormones

Schizophrenia is a severe mental disorder that significantly impairs the daily functioning of patients that causes substantial societal and economic burden. While drug therapy is crucial for schizophrenia treatment, relying solely on antipsychotic drugs does not yield the most favorable therapeutic outcomes.Current Concepts: Integrating psychosocial interventions could result in maximized therapeutic effects for individuals living with schizophrenia. Evidence-based psychosocial interventions for schizophrenia management include cognitive behavioral therapy, family involvement, psychoeducation, supported employment programs, lifestyle adjustments for physical health, and coordinated and comprehensive early intervention services. Incorporating peer support, allowing both service users and care providers to share knowledge and their illnessrelated personal experiences, facilitates mutual assistance along the path to recovery. Moreover, growing interest follows in using digital interventions, such as wearable technology and smartphone applications, as effective therapeutic tools for illness management.Discussion and Conclusion: The above-mentioned psychosocial interventions empower individuals with schizophrenia, helping them improve their functioning, enhance their life quality, and adapt more effectively to society. Combining early medication with comprehensive psychosocial interventions, including digital technology, is crucial for the best outcomes. This approach should begin as soon as schizophrenia is diagnosed, aiming to promote recovery and overall well-being in affected individuals.

A recombinant adenoviral vector encoding human GDNF gene (Ad -GDNF) was developed to investigate the effect of GDNF gene in 6 -OHDA -induced Parkinson's disease rat. The changes of rotatory behavior and density of TH -immunoreactive axon terminals and number of cell bodies were observed by the GDNF expression. Adult male Sprague -Dawley rats were used. Parkinson's disease (PD) rat models were prepared by the injection of 6 -OHDA into the striatum. After 1 week, the animals showing apomorphine -induced rotatory behavior above 7 turns/ min were defined as PD rat model. Ad -GDNF was injected into the striatum of animal model and tested the apomorphine -induced rotatory behavior at 1 week after injection. These animals were perfused with Zamboni fixative to investigate the morphological changes after rotatory behavior test. Instead of Ad -GDNF, Ad -LacZ injected PD rats were used as a control. The following results are obtained: 1. The apomorphine -induced rotational behavior was significantly reduced by the treatment of PD rat by the injection of Ad -GDNF. The Ad -LacZ injected PD rat showed no change in rotatory behavior. 2. The density of TH -ir axon terminals in the striatum was significantly increased by the Ad -GDNF injection (75% of normal side), but there was no change in the density by the Ad -LacZ injection (37% of normal side) compared to 6 - OHDA lesioned striatum. This means the Ad -GDNF injection prevented the degenerative change of TH -ir axon terminals in the stritum of the PD rat. 3. The number of TH -ir cell body was significantly recovered by the Ad -GDNF (82% of normal side), but there was not recovered by the Ad -LacZ injection (60% of normal side) compared to 6 -OHDA lesion. This means the retrogradely transported Ad -GDNF induced the TH expression in the dopaminergic neurons of the substantia nigra. Gene therapy with Ad -GDNF prevented the degeneration of dopaminergic neurons and axon terminals in the 6 - OHDA -induced PD rat.
Adult ; Animals* ; Apomorphine ; Dopaminergic Neurons ; Genetic Therapy* ; Glial Cell Line-Derived Neurotrophic Factor* ; Humans ; Immunohistochemistry ; Male ; Models, Animal* ; Parkinson Disease* ; Presynaptic Terminals ; Rats ; Substantia Nigra

An appendico-sigmoid fistula is a rare entity that has seldom been reported in the literature. In review articles, there are only several reports of appendiceal fistulas, including two into the ileum, two into the ascending colon, two into the sigmoid colon, and one into the Meckel's diverticulum. Presumably, these cases were caused primarily by antecedent appendicitis and diverticulitis. We experienced a case of an appendico-sigmoid fistula due to appendicitis. A 42-year-old man was admitted with complaints of low abdominal pain, distension, and a chilling sense for 1 month. On physical examination, the patient had right low-quadrant abdominal tenderness and rebound tenderness. However, the patient had no fever, and the WBC count was 8,900/mm3. On colonoscopy and barium study, the patient was diagnosed as having an appendico-sigmoid fistula due to appendicitis. An appendectomy and segmental resection of the sigmoid colon was done.
Abdominal Pain ; Adult ; Appendectomy ; Appendicitis* ; Barium ; Colon, Ascending ; Colon, Sigmoid ; Colonoscopy ; Diverticulitis ; Fever ; Fistula* ; Humans ; Ileum ; Meckel Diverticulum ; Physical Examination

Since maxillofacial injury is frequently accompanied by other diseases, its evaluation and treatment are open delayed. When the evaluation is delayed, the surgical treatment can be difficult or impossible. A 21-yr-old man presented with right facial swelling and deformity after injury. We planned immediate surgical repair for his right tetrapod fracture, but the operation was delayed for two months due to severe hyperthyroidism. During the operation, we reducted and fixed the deviated bone after refracture of the zygomatic arch with an osteotome to achieve mobility. The facial deformity and difficulty in mouth opening were improved after the operation. Even in the presence of accompanying fractures, early evaluation and proper management can prevent complications and achieve acceptable cosmetic outcomes in maxillofacial trauma patients. In patients with malunion of fracture sites, fixation after refracture using an osteotome can be a good treatment option for obtaining good mobility.
Congenital Abnormalities ; Cosmetics ; Facial Injuries ; Fracture Fixation ; Humans ; Hyperthyroidism ; Maxillofacial Injuries ; Mouth ; Zygoma

BACKGROUND: The heat shock proteins (HSPs) play an important role in cellular protection mechanisms against physical or chemical stresses. In this study scFv antibodies specific for human HSP70.1 were isolated from a semi-synthetic human scFv library with the ultimate goal of developing anti-HSP70.1 intracellular antibody (intrabody) that may offer an attractive alternative to gene targeting to study the function of the protein in cells. METHODS: A semi-synthetic human scFv display library (5 X 10(8) size) was constructed using pCANTAB-5E vector and the selection of the library against bacterially expressed recombinant human HSP70.1 was attempted by panning. RESULTS: Three positive clones specific for recombinant HSP70.1 were identified. All three clones used V(H) subgroup III. On the other hand, V(L) of two clones belonged to the kappa light chain subgroup I, but the other utilized V(k) subgroup IV Interestingly, these scFv molecules specifically reacted to the recombinant HSP70.1, yet failed to recognize native HSP70 induced in U937 human monocytic cells by heat treatment. CONCLUSION: Our results indicated that affinity selection of an scFv phage display library using recombinant antigens produced in E. coli might not guarantee the isolation of scFv antibody molecules specific for a native form of the antigen. Therefore, the source of target antigens needs to be chosen carefully in order to isolate biofunctional antibody molecules.
Bacteriophages ; Clone Cells ; Gene Targeting ; Hand ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins ; Humans* ; Single-Chain Antibodies

OBJECTIVE: The impact of beta blockers (BBs) on survival outcomes in ovarian cancer was investigated. METHODS: By using Korean National Health Insurance Service Data, Cox proportional hazards regression was performed to analyze hazard ratios (HRs) with 95% confidence intervals (CIs) adjusting for confounding factors. RESULTS: Among 866 eligible patients, 206 (23.8%) were BB users and 660 (76.2%) were non-users. Among the 206 BB users, 151 (73.3%) were non-selective beta blocker (NSBB) users and 105 (51.0%) were selective beta blocker (SBB) users. BB use in patients aged ≥60 years, longer duration use (≥1 year), in patients with Charlson Comorbidity Index (CCI) ≥3, and in cardiovascular disease including hypertension was associated with better survival outcome. These findings were observed in both NSBB and SBB. When duration of medication was analyzed based on number of days, NSBB (≥180 days) was associated with improved overall survival (OS) with a relatively shorter period of use compared to SBB (≥720 days). In multivariate Cox proportional hazards model, longer duration of BB medication (≥1 year) was an independent favorable prognostic factor for both OS and disease-specific survival in ovarian cancer patients. CONCLUSION: In our nationwide population-based cohort study, BB use was associated with better survival outcomes in ovarian cancer in cases of long term duration of use, in older patients, and in cardiovascular and/or other underlying disease (CCI ≥3).
Adrenergic beta-Antagonists ; Cardiovascular Diseases ; Cohort Studies* ; Comorbidity ; Humans ; Hypertension ; National Health Programs ; Ovarian Neoplasms* ; Proportional Hazards Models ; Treatment Outcome

Objectives: This study evaluates soft tissue changes of the upper lip and nose after maxillary setback with orthognathic surgery such as Le Fort I or anterior segmental osteotomy. Materials and Methods: All 50 patients with bimaxillary protrusion and skeletal Class II malocclusion underwent Le Fort I or anterior segmental osteotomy with backward movement. Soft and hard tissue changes were analyzed using cephalograms collected preoperatively and 6 months postoperatively. Results: Cluster analysis on the ratios shows that 2 lines intersected at 4 mm point. Based on this point, we divided the subjects into 2 groups: Group A (less than 4 mm, 27 subjects) and Group B (more than 4 mm, 23 subjects). Also, each group was divided according to changes of upper incisor angle (≥4°=A1, B1 or <4°=A2, B2). The correlation between A and B groups for Aʼ/ANS and Ls/Is (P<0.001) was significant; Aʼ/A (P=0.002), PRN/A (P=0.043), PRN/ANS (P=0.032), and St/Is (P=0.010). Variation of nasolabial angle between the two groups was not significant. There was no significant correlation of vertical movement and angle variation. Conclusion The ratio of soft tissue to hard tissue movement depends on the amount of posterior movement in the maxilla, showing approximately two times higher rates in most of the midface when posterior movement was greater than 4 mm. The soft tissue changes caused by posterior movement of the maxilla were little affected by angular changes of upper incisors. Interestingly, nasolabial angle showed a different tendency between A and B groups and was more affected by incisal angular changes when horizontal posterior movement was less than 4 mm.