BACKGROUND AND PURPOSE: The World Health Organization (WHO) has classified thymic carcinoma and other thymomas (types A, AB, and B) as different neoplasms. Myasthenia gravis (MG) is an early sign of thymoma and theoretically does not accompany thymic carcinoma; however, cases of thymic carcinoma with MG have been reported. Whether thymic carcinoma can accompany MG has yet to be established. METHODS: The medical records of patients who underwent thymectomy for MG between 1990 and 2011 in a single hospital were reviewed. All cases with the diagnostic code of "thymic carcinoma" or "thymoma type C" (old terminology) were selected. A pathologist re-reviewed the pathologic specimens using the new WHO criteria. The rate of thymic carcinoma among these MG patients was then calculated. RESULTS: A total of 81 patients with MG had thymic tumors, 10 of whom had thymic carcinomas or thymoma type C. Seven cases of well-differentiated thymic carcinomas (type B3) were excluded, leaving three (3.7%) cases of thymic carcinoma with MG. All three of these cases were type B3 thymoma with a focal squamous cell carcinoma component that was very small and well demarcated. In addition, two out of the three tumors were found to be at an early clinical stage. All of the cases survived without recurrence over follow-up periods of at least 5 years. CONCLUSIONS: Thymic carcinoma transformation from thymoma can occur during the early stages of thymoma. The association of this condition with MG is not as rare as was previously thought. Thymic carcinomas accompanying MG had a predominant B3 thymoma component with a focal thymic carcinoma area (squamous cell carcinoma).
Carcinoma, Squamous Cell ; Follow-Up Studies ; Humans ; Medical Records ; Myasthenia Gravis* ; Recurrence ; Thymectomy ; Thymoma* ; Thymus Neoplasms ; World Health Organization

No abstract available.
Transplantation* ; Tuberculosis*

No abstract available.
Transplantation* ; Tuberculosis*

Subclavian steal syndrome caused by an acute thrombus is very rare. We present a case of cerebellar infarction with proximal subclavian artery thrombosis. A 56-year-old woman was admitted for sudden vertigo. One day prior to admission, she received a shoulder massage comprised of chiropractic manipulation. On examination, her left hand was pale and radial pulses were absent. Blood pressure was weak in the left arm. Downbeat nystagmus and a right falling tendency were observed. Brain MRI showed multiple acute infarctions in the left cerebellum. The findings of Doppler ultrasonography in the left vertebral artery were compatible with a partial subclavian artery steal phenomenon. Digital subtraction angiography demonstrated a large thrombus in the left subclavian artery. After heparin infusion, thrombus size markedly decreased. Cerebellar infarction caused by acute subclavian thrombosis following minor trauma is rare, but the thrombus can be successfully resolved with anticoagulation.
Brain Infarction/*diagnosis/etiology/pathology ; Cerebellar Diseases/diagnosis/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Thrombosis/*complications

No abstract available.
Kidney* ; Transplants* ; Tuberculosis*

Isolated left brachiocephalic artery with right aortic arch is extremely rare congenital anormaly. This malformation can cause subclavian steal phenomenon. We report the duplex sonographic and conventional angiographic findings of isolated left brachiocephalic artery in a 22-year-old female presented with dizziness.
Aorta, Thoracic ; Arteries ; Dizziness ; Female ; Humans ; Subclavian Steal Syndrome ; Young Adult

As the number of dementia patients increases due to rapid aging, the burden of dementia becomes a big social problem. In response to this, various policies have been introduced in Korea. In particular, as the new policy of national responsibility for dementia care has been implemented in 2017, detailed plans for improving health care and long-term care support for dementia patients and their caregivers have been introduced. The most important thing in carrying out the comprehensive government plan will be securing sufficient the professional health and social care workforce. However, the number of neurologists to play an important role in the management of dementia will be more and more insufficient. Therefore, the need to supply an adequate number of neurologists in Korea should be discussed.
Aging ; Caregivers ; Delivery of Health Care ; Dementia ; Humans ; Korea ; Long-Term Care ; Social Problems

OBJECTIVES: The strategy for the labor flexibility through subcontracted labor have brought a negative effect on the lives of the workers, such as the increase of the unstable employment. This study was conducted to analyze the relationship between the employment of subcontracted firms and the health status of them, and to find out some problems which have been caused in the process of health evaluation and the characteristics of social exclusion. METHODS: We reviewed the periodical health examination and preemployment health examination in order to compare health status of the subcontracted workers with those of the parent firm workers. The SF-36 questionnaire was administered to assess the self-perceived health status. RESULTS: The result shows that compared to the working duration of the parent firm workers, those of the subcontracted workers were shorter, and the job transfer rate was higher. In the periodical health examination, the prevalence of occupational and general disease was higher in the parent firm(10%) than in the subcontracted firms(6%). Preemployment health examination plays an important role in worker's health management. Among 6,260 workers who received preemployment health examination, the prevalence of disease was 37.9%. Mean scores of health status measured by SF-36 were lower in the subcontracted firm than in the parent firm. CONCLUSIONS: Due to social exclusion of the subcontracted workers from the periodical health examination, there is a possibility that the periodical health examination have the healthy worker effect. These results suggests that the preemployment health examination could be a more appropriate indicator which is able to assess the health status of the subcontracted workers than the periodical health examination.
Employment ; Healthy Worker Effect ; Humans ; Parents ; Pliability ; Prevalence ; Questionnaires

OBJECTIVE: The purpose of this study was to evaluate whether the preoperative serum level of CA 125 in patients with endometrial cancer could provide an additional information on determining the extent of surgical staging and which cutoff value might be optimal in this respect. METHODS: CA 125 levels were measured in 42 patients with endometrial carcinoma who underwent surgery at our institution between March 2000 and December 2004. Operative and postoperative pathologic findings were then correlated with preoperative CA 125 values. Statistical analysis was performed using Mann-Whitney U test, Kruskal-Wallis test, chi-square test and logistic regression model to evaluate the association of preoperative CA 125 levels with various factors. Receiver operating characteristic (ROC) curve was used to determine which cutoff value of the preoperative CA 125 was optimal. RESULTS: Univariate analyses showed that elevated CA 125 levels were significantly correlated with an advanced stage, larger tumor size, increasing depth of the myometrial invasion, extrauterine disease, and lymph node metastasis (P<0.05). The ROC curve showed that the best cutoff values to expect extrauterine disease and lymph node metastasis were 30 U/mL and 50 U/mL, respectively. Using the above cutoff value, the sensitivity and specificity for screening extrauterine disease were found to be 80% and 73%, and for lymph node metastasis to be 100% and 87%, respectively. CONCLUSION: Our data provide evidence that extrauterine disease can be strongly predicted at a preoperative CA 125 level of >30 U/mL whereas lymph node metastasis can be predicted at the CA 125 level of >50 U/mL.
Decision Making* ; Endometrial Neoplasms* ; Female ; Humans ; Logistic Models ; Lymph Node Excision* ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; ROC Curve ; Sensitivity and Specificity

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced diffuse trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin (androgenesis). Partial hydatidiform moles appear to be focal trophoblastic hyperplasia, a fetus or indications of previous fetal existence, 69 chromosomes. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies and associated with a risk of persistent gestational trophoblastic tumor. Recently, hydatidiform moles with a fetus have become more common due to use of assisted reproductive technology. Most patients with hydatidiform mole and coexisting normal fetus must cautioned about the potential for risks of malignant change and severe medical complications, such as preeclampsia, hyperthyroidism and antepartum hemorrhage, that may necessitate prompt pregnancy termination. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 15 gestational weeks. A brief reviews of related literature was done.
Classification ; Female ; Fetus* ; Hemorrhage ; Humans ; Hydatidiform Mole* ; Hyperplasia ; Hyperthyroidism ; Incidence ; Pre-Eclampsia ; Pregnancy ; Reproductive Techniques, Assisted ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography