Currently transcatheter arterial embolization(TAE) is widely used in Korea as a palliative treatment inpatients with inoperable heptocellular carcinoma. Embolization of cystic artery is frequently unavoidable in TAE but the effect on gallbladder, its significance and sonographic findings have not yet been fully as certained. We analyzed 29 cases of gallbladder in post TAE state by means of sonographic evaluation. The results were as follows. 1. Initial change was observed on the 1st day of TAE. 2. Maximum enlargement of the gallbladder occurred within 3 days. 3. Relief of pain was mostly noted in one week. 4. Ultrasonographic findings are: a) Enlargement ofthe gallbladder: 27 cases b) Sonolucent layer within the wall: 5 cases c) Thickening of the wall: 27 cases d)Sludge formation: 6 cases e) Pericholecystic anechoic area: 3 cases 5. No surgical intervention was necessary for complication of gallbladder, if ever: some medical treatment was sufficient. 6. Non-visualization of gallbladder was experienced, possibly due to atrophic changes. 7. Even in the case of cystic artery salvation, mild gallbladder changes were still observed. 8. No significant difference as sonographic findings was descernable inuse of various embolic materials
Arteries ; Gallbladder* ; Humans ; Inpatients ; Korea ; Palliative Care ; Ultrasonography

The rupture of ventricular septum complicating acute myocardial infarction requires prompt recognition for the correct management of the patient. The diagnosis of this condition had required right heart catheterization. We performed two-dimensional and Doppler echocardiography in patients with systolic murmur after acute myocardioal infarction. Ventricular septal defect was found at lower interventricular septum by mapping technique of pulsed wave Doppler system and obtained high velocity Doppler tracting by continuous wave Doppler echocardiography. Doppler echocardiography could be useful noninvasive method for detection of ventricular septal rupture after acute myocardial infarction.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Heart Septal Defects, Ventricular* ; Humans ; Infarction ; Myocardial Infarction* ; Rupture ; Systolic Murmurs ; Ventricular Septal Rupture ; Ventricular Septum

The diagnosis of primary cutaneous lymphoma is based on a combination of clinical, histological, immunophenotypic and genetic criteria. Nineteen cases of primary cutaneous lymphomas were studied for clinicopathologic, immunophenotypic, and genetic features. Seventeen (89%) cases were T cell origin and two cases (11%) were B cell origin. CD30-positive cutaneous lymphoproliferative disorder was the most frequent subtype, occupying 42% (8 cases) of the cases. CD8 was positive in 5 cases consisting of 3 cutaneous T cell lymphomas and 2 anaplastic large cell lymphomas. CD4 was positive in 2 cases of mycosis fungoides and 3 cases of lymphomatoid papulosis. Six (67%) of 9 cases of cutaneous T cell lymphoma were positive for TIA-1. Ten (83%) out of 12 cases showed clonal rearrangements of TCR gamma genes, however, one T/NK cell lymphoma and one anaplastic large cell lymphoma did not. EBV association was detected only in T/NK cell lymphomas among 10 cases examined. In conclusion, our study showed higher proportion of CD30-positive lymphoproliferative disorders and less frequent mycosis fungoides in Korea compared to the incidences in Western countries. Our immunostaining results suggested that mycosis fungoides and lymphomatoid papulosis are CD4-positive T cell origin, however, the remaining primary cutaneous T cell lymphoma is predominantly CD8-positive cytotoxic T cell origin.
Diagnosis ; Genes, T-Cell Receptor gamma ; Herpesvirus 4, Human ; Incidence ; Korea ; Lymphoma* ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell, Cutaneous ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Mycosis Fungoides

Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.
Accreditation ; Administrative Personnel ; Appointments and Schedules ; Certification ; Counseling ; Delivery of Health Care ; Genetic Counseling ; Genetics, Medical ; Humans ; Precision Medicine ; Korea ; National Health Programs

Richter's syndrome is generally accepted taht lymphoma or leukemia of low grade malignancy, during their course, may alter both their morphologic and clinical appearance and evolve into highly malignant neoplasia. The pathogenesis is not clear, however, dedifferentiation by the emergence of a new clone of cells of higher maligancy similar to the blastic transformation in chronic myelocytic leukemia is suggested as possible mechanism. A case of Richter's syndrome is described. This 45 year old female had been diagnosed as chronic lymphocytic leukemia by absolute peripheral lymphocytosis 5 months before, developed sudden severe abdominal pain and was received segmental resection of ileum under the clinical impression of intestinal perforation with peritonitis. Histologically, the ulcer margin was diffusely infiltrated by polymorphic cells composed of large atypical cells having vesicular nuclei, multinucleated giant cells and Reed-Sternberg like cells admixed with mature lymphocytes. These atypical and multinucleated cells of the paraffin section showed strong monoclonal immunoreactivity for IgG and lambda light chain by PAP method and was interpreted as malignant lymphoma, diffuse, large cell, immunoblastic, polymorphous.
Female ; Humans

PURPOSE: To evaluate the effectiveness of optical coherence tomography angiography (OCTA) in investigating changes in the area of the foveal avascular zone (FAZ) in patients with diabetic retinopathy (DR) and normal subjects. METHODS: Eighty-five eyes of 50 DR patients and 50 eyes of 25 normal subjects were included. OCTA images of the FAZ were acquired using the split-spectrum amplitude decorrelation angiography algorithm of Optovue Avanti RTVue XR OCT. Patients were divided into three groups according to DR severity: mild-to-moderate non-proliferative diabetic retinopathy (NPDR) group, severe NPDR group, and proliferative DR group. The area of the FAZ was measured using built-in software and was compared between the patients and normal subjects and among the three groups. RESULTS: The area of the FAZ in patients with diabetic retinopathy (0.46 mm²) was significantly larger than that in normal subjects (0.30 mm², p = 0.001). A significant difference was observed depending on DR severity: 0.40 mm² in the mild-to-moderate NPDR group, 0.45 mm² in the severe NPDR group, and 0.53 mm² in the PDR group (p = 0.03). Correlation between area of the foveal avascular zone and visual acuity showed a tendency toward reduction in visual acuity (p = 0.002). CONCLUSIONS: OCTA effectively detected changes in the FAZ area in DR patients. OCTA has the potential to be used for noninvasive quantification and monitoring of the FAZ.
Angiography ; Diabetic Retinopathy* ; Humans ; Tomography, Optical Coherence ; Visual Acuity

Antioxidants oppose the toxic actions of lipid peroxides and oxygen radicals, and they limit the amount of lipid peroxides formed. Women with normal pregnancies have an increase in oxidative stress and lipid peroxidation when compared with nonpregnant women. The antioxidants also increase progressively with advancing gestation, and the antioxidants in the fetus also increase with advancing gestation, especially during late gestation. The purpose of this study is to investigate the diefference of antioxidant status in maternal and neonatal plasma according to the delivery type. So, we investigated the status of antioxidant in the maternal and neonatal plasma when compared normal vaginal delivery with Cesarian section without labor. This study was done under the hypothesis that labor pain is originated from the hypoxic state of myometrium during uterine contraction. The number of women who were studied was total 56, 24 women were delivered by normal vaginal delivery and 32 women were done by Cesarean section without labor. The blood was sampled during active labor and postpartum 24 hour in the case of normal vaginal delivery, the women who were done Cesarean section being sampled before operation and 24 hours after operation. The neonatal blood was sampled from cord, birth 1 day and 3 day. The antioxidant levels were measured by Total Antioxidant Status (Randox Laboratory Ltd., UK) kit. The results were as follows. 1. The mean maternal plasma antioxidant status was not significantly different according to delivery types and not significantly different when compared antepartum with postpartum (vaginal delivery; antepartum: 1.54+/-0.31 mM/L, postpartum: 1.58+/-0.32 mM/L, Cesarean section; antepartum: 1.55+/-0.29 mM/L, postpartum: 1.56+/-0.33 mM/L). 2. The neonatal antioxidant status was not significantly different between the neonates who were born by vaginal delivery and the neonates who were born by Cesarean section. The neonatal plasma antioxidant status was increased progressively after birth (cord: birth 1 day: birth 3 day=1.46+/-0.25 mM/L: 1.59+/-0.25 mM/L: 1.79+/-0.37 mM/L). Therefore, labor pain was not seems to be significantly affect the maternal and neonatal plasma antioxidant status. And the neonatal antioxidant status was increased for adaptation to the external environment after birth.
Animals ; Antioxidants ; Cesarean Section ; Female ; Fetus ; Humans ; Infant, Newborn ; Labor Pain ; Lipid Peroxidation ; Lipid Peroxides ; Mice ; Myometrium ; Oxidative Stress ; Parturition ; Plasma* ; Postpartum Period ; Pregnancy ; Reactive Oxygen Species ; Toxic Actions ; Uterine Contraction

We report a case of a 41-year-old female with acrogeria. She was in good health except for the prominent atrophy over the hands and feet. On microscopic examination of a biopsy specimen from the atropl6c skin, elastic fibers were clumped and fragmented. Electronmicroscopy revealed amorphous and granulous pseudoelastin, which is presumed to be consistent with acrogeria. Our patient had acro-osteolysis and an extra chromosome in addition to the normal 23 pairs of chromosomes in one of 20 cells examined, which have been very rarely reported in the literature. Further studies are needed to find out whether this chromosomal aberration might contribute to the pathogenesis.
Acro-Osteolysis ; Adult ; Atrophy ; Biopsy ; Chromosome Aberrations ; Elastic Tissue ; Female ; Foot ; Hand ; Humans ; Skin

No abstract available.
Anus Neoplasms* ; DNA* ; Ploidies*

No abstract available.
Alopecia* ; Minoxidil*