Pheochromocytoma is derived from the chromaffin cells and patients with pheochromocytoma present with several signs and symptoms by producing, storing and secreting catecholamine. Spontaneous rupture or necrosis of pheochromocytoma is extremely rare, but it can be lethal because of the dramatic change in the circulation such as an acute abdominal emergency or shock. Spontaneous remission of the clinical symptoms due to necrosis of the pheochromocytoma is rare. We describe such a case that presented with cardiogenic shock due to extensive necrosis of the pheochromocytoma and this was followed by spontaneous remission of the clinical symptoms without removal of the pheochromocytoma.
Chromaffin Cells ; Emergencies ; Humans ; Necrosis ; Pheochromocytoma ; Remission, Spontaneous ; Rupture, Spontaneous ; Shock ; Shock, Cardiogenic

No abstract available.
Knee Joint* ; Knee*

BACKGROUND: We evaluated the clinical and radiological results of one-stage correction for cerebral palsy patients. METHODS: We reviewed clinical outcomes and radiologic indices of 32 dysplastic hips in 23 children with cerebral palsy (13 males, 10 females; mean age, 8.6 years). Ten hips had dislocation, while 22 had subluxation. Preoperative Gross Motor Function Classification System (GMFCS) scores of the patients were as follows; level V (13 patients), level IV (9), and level III (1). Acetabular deficiency was anterior in 5 hips, superolateral in 7, posterior in 11 and mixed in 9, according to 3 dimensional computed tomography. The combined surgery included open reduction of the femoral head, release of contracted muscles, femoral shortening varus derotation osteotomy and the modified Dega osteotomy. Hip range of motion, GMFCS level, acetabular index, center-edge angle and migration percentage were measured before and after surgery. The mean follow-up period was 28.1 months. RESULTS: Hip abduction (median, 40degrees), sitting comfort and GMFCS level were improved after surgery, and pain was decreased. There were two cases of femoral head avascular necrosis, but no infection, nonunion, resubluxation or redislocation. All radiologic indices showed improvement after surgery. CONCLUSIONS: A single event multilevel surgery including soft tissue, pelvic and femoral side correction is effective in treating spastic dislocation of the hip in cerebral palsy.
Adolescent ; Arthroplasty/*methods ; Cerebral Palsy/*complications ; Child ; Child, Preschool ; Female ; Hip Dislocation/*etiology/*surgery ; Hip Joint/pathology/radiography/*surgery ; Humans ; Male ; Osteotomy ; Pain/etiology ; Range of Motion, Articular ; Tomography, X-Ray Computed

PURPOSE: To investigate the correlation between Glutathione-S-transferase (GST) genes and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (DM). METHODS: In this case-control study, 131 patients who were diagnosed with DR, 105 diabetic patients who did not have DR, and 45 nondiabetic controls were examined from January 2013 to November 2015. To analyze deletion of the GSTT1 and GSTM1 genes, polymerase chain reactions of DNA in a buffy coat from peripheral blood were performed via electrophoresis. RESULTS: There were no statistically significant differences in age, sex, or spherical equivalent between the 236 type 2 diabetic patients and the 45 normal controls (p > 0.05). In both univariate and multivariate analyses, the duration of type 2 DR was longer (p = 0.004, p = 0.013), and HbA1c was higher (p = 0.004, p = 0.007) in the DR group than in the non-DR group. Presence of a GSTM1 deletion is associated with a lower frequency of DR (p = 0.017, p = 0.012). CONCLUSIONS: Deletion of the GSTT1 gene is not associated with an increased risk of DR, whereas GSTM1 deletion is associated with a lower risk of DR in patients with type 2 DM in the Korean population. Additional studies with larger sample sizes and different types of GST genes are needed to confirm this study.
Case-Control Studies ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diabetic Retinopathy* ; DNA ; Electrophoresis ; Humans ; Multivariate Analysis ; Polymerase Chain Reaction ; Sample Size

Primary small intestinal lymphoma is relatively uncommon. Small bowel tumors are difficult to diagnose, because they are usually asymptomatic in the initial phase, and they are not easily detected by traditional methods of investigating the small intestine. This case shows a successfully detected and treated gastrointestinal bleeding from rare ileal mucosa-associated lymphoid tissue lymphoma, using double balloon endoscopy.
Aged ; Arteries ; Capsule Endoscopy ; Constriction, Pathologic ; Gastrointestinal Hemorrhage ; Humans ; Ileal Neoplasms/*diagnosis/pathology ; Intestinal Mucosa/pathology ; Lymphoid Tissue/*pathology ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology ; Male

BACKGROUND AND OBJECTIVES: Excretion of bile acid and free cholesterol of bile was important to maintain cholesterol homeostasis. ATP-binding cassette transporter G5 (ABCG5) and G8 (ABCG8) promoted biliary cholesterol excretion. In previous study, hepatic secretion of cholesterol and ABCG5/G8 expression are strongly stimulated in hypophysectomized rats during treatment with thyroid hormone. In this study, we aimed to evaluate the effect of thyroid hormone to expression of ABCG5 and G8 in mouse liver. MATERIALS AND METHODS: We administered thyroid hormone (T3) to C57BL/6 mice and then RNA and protein was isolated from liver. We isolated primary hepatocyte and administered T3 to evaluate in vitro effect. HepG2 cells were cotransfected with either a control plasmid or expression plasmids for human thyroid hormone receptor (hTR)beta/human retinoid X receptor (hRXR)alpha or human liver X receptor (hLXR)alpha in combination with reporter plasmids TK-LXRE3-LUC with or without T3. RESULTS: Serum total cholesterol was decreased after 5 days of T3 treatment. Expression of ABCG5/8 mRNA and ABCG5 protein was increased after T3 treatment. In primary hepatocytes, T3 also increased ABCG5/8 mRNA expression. LXRalpha mRNA was not increased by T3. However, when we cotransfected liver X receptor response element (LXRE) construct and TRbeta/RXRalpha with T3, the activity of LXRE containing construct was markedly increased. CONCLUSION: We confirmed that thyroid hormone increased expression of ABCG5/8. This result suggested that thyroid hormone played an important role in decreasing serum cholesterol through bile excretion.
Animals ; Bile ; Cholesterol ; Hep G2 Cells ; Hepatocytes ; Homeostasis ; Humans ; Liver ; Mice ; Orphan Nuclear Receptors ; Plasmids ; Rats ; Receptors, Thyroid Hormone ; Response Elements ; Retinoid X Receptors ; RNA ; RNA, Messenger ; Thyroid Gland ; Thyroid Hormones

PURPOSE: In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy. MATERIALS AND METHODS: A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method. RESULTS: The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001). CONCLUSIONS: The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.
Gastrectomy* ; Hospitalization ; Humans ; Insurance Coverage* ; Insurance* ; Insurance, Health ; Korea ; Methods ; Mortality ; National Health Programs ; Seoul ; Social Class ; Stomach Neoplasms* ; Survival Rate

Purpose: Traumatic kidney injury can be treated surgically or nonsurgically. Nonsurgical treatment options include angiography, embolization, and conservative treatment. We aimed to identify factors that help in making clinical decisions on treatment plans for patients with traumatic kidney injury caused by blunt trauma. Methods: The study included 377 patients aged ≥18 years with traumatic kidney injury caused by blunt abdominal trauma admitted to the emergency room of Wonju Severance Christian Hospital between January 2008 and July 2020. Medical records, laboratory test results, and computed tomography results were retrospectively reviewed. Results: Multivariable logistic analysis showed diastolic blood pressure at admission and disruption of Gerota's fascia were significantly associated with surgical treatment, and that perinephric hematoma rim distance was the only significant indicator favoring embolization. Receiver operating characteristic curve analysis showed that angiography and embolization should be considered when hematoma size exceeds 2.97 cm. Conclusion When a patient with traumatic kidney injury due to blunt trauma visits an emergency room, even when vital signs are stable, Gerota’s fascia should be checked by computed tomography prior to deciding on surgical treatment, and angiographic embolization should be considered if perinephric hematoma rim distance exceeds 2.97 cm.

Purpose: Traumatic kidney injury can be treated surgically or nonsurgically. Nonsurgical treatment options include angiography, embolization, and conservative treatment. We aimed to identify factors that help in making clinical decisions on treatment plans for patients with traumatic kidney injury caused by blunt trauma. Methods: The study included 377 patients aged ≥18 years with traumatic kidney injury caused by blunt abdominal trauma admitted to the emergency room of Wonju Severance Christian Hospital between January 2008 and July 2020. Medical records, laboratory test results, and computed tomography results were retrospectively reviewed. Results: Multivariable logistic analysis showed diastolic blood pressure at admission and disruption of Gerota's fascia were significantly associated with surgical treatment, and that perinephric hematoma rim distance was the only significant indicator favoring embolization. Receiver operating characteristic curve analysis showed that angiography and embolization should be considered when hematoma size exceeds 2.97 cm. Conclusion When a patient with traumatic kidney injury due to blunt trauma visits an emergency room, even when vital signs are stable, Gerota’s fascia should be checked by computed tomography prior to deciding on surgical treatment, and angiographic embolization should be considered if perinephric hematoma rim distance exceeds 2.97 cm.

PURPOSE: The objective of this study was to ascertain the incidence of congenital heart disease in the western part of Gyeongnam Province in Korea. METHODS: We enrolled 849 children (M:F=390:459) who were diagnosed with congenital heart disease (CHD) and received echocardiography during January 1997 to December 2005 in Gyeongsang National University Hospital. The subjects were limited to patients born from 1997 to 2004. The CHDs were classified into acyanotic types and cyanotic type. Further, acyanotic type CHDs were divided into shunt type and valvular types. RESULTS: Numbers of initially diagnosed patients from 1997 to 2004 were as follows: 113, 128, 116, 104, 129, 97, 84, and 78. The median age of initially diagnosed CHD patients was 1 month in the acyanotic type and 0.5 months in cyanotic type. Also, an annual frequency among CHD types and gender ratio were no significant difference in every year. Incidences of CHD from 2000 to 2004 in the western part of Gyeongnam Province were 8.9, 12.7, 10.9, 10.0, and 9.7 per 1,000 live births, respectively. CONCLUSION: From 1997 to 2001, 100-130, and from 2002 to 2004, less than 100 patients were diagnosed with CHD. This showed a decrease in the numbers of CHD patients in the last three years. However, the Incidence of CHD was 0.89-1.24% during the last five years. Therefore, the decrease in the annual frequency of CHD was due to the recent decline in birth rate in Korea.
Birth Rate ; Child ; Echocardiography ; Heart ; Heart Diseases ; Humans ; Incidence ; Korea ; Live Birth