The presence of anti-gastric parietal cell antibodies (AGPAs) has been strongly associated with the pathogenesis of pernicious anemia and atrophic gastritis and has been rarely reported in thyrotoxicosis. In addition, AGPAs more commonly occur in the Western population. No case of AGPA occurring in thyrotoxicosis has been reported in Korea to date. We report a case involving the occurrence of AGPAs in a thyrotoxicosis patient examined at the Hanyang University Hospital. Upon medical consultation, a 55-yr-old woman with no significant medical history was found to have elevated levels of cholesterol, AST, ALT, gamma glutamyl transferase, and mild anemia. Further blood tests revealed elevated levels of T3, free T4, and thyroid-stimulating immunoglobulin (TSI), low level of thyroid-stimulating hormone (TSH), and negative results for the anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (anti-TG), for which the patient was diagnosed with thyrotoxicosis. To rule out autoimmune hepatitis in the explanation of the continuously elevated levels of AST and ALT, the autoimmune target (AIT), anti-smooth muscle antibody (ASMA), anti-liver/kidney/microsomal antibody (LKM), anti-mitochondria antibody (AMA) and anti-neutrophil cytoplasmic antibody (ANCA) tests were done, and the results were all negative. However, during this process, the patient tested positive for AGPA, when stomach tissue was used as the sample. Finally, the patient was diagnosed with thyrotoxicosis without any other autoimmune disease. This is the first report of confirmed presence of AGPA in a thyrotoxicosis-only patient in Korea.
Anemia ; Anemia, Pernicious ; Antibodies* ; Antibodies, Antineutrophil Cytoplasmic ; Autoimmune Diseases ; Cholesterol ; Female ; Gastritis, Atrophic ; Hematologic Tests ; Hepatitis, Autoimmune ; Humans ; Immunoglobulins, Thyroid-Stimulating ; Korea ; Peroxidase ; Rabeprazole* ; Stomach ; Thyrotoxicosis* ; Thyrotropin ; Transferases

BACKGROUND: Diabetes diagnosis can be made using different laboratory tests, including the fasting plasma glucose (FPG) test, 75-g 2-h oral glucose tolerance test (2-h OGTT), and hemoglobin A1c (HbA1c) test; however, these tests have different meanings. This study aimed at comparing patient characteristics based on the diagnosis using each of these 3 tests. METHODS: A total of 750 adults suspected of having diabetes and aged > or =18 years underwent the following tests on the same day: FPG, 2-h OGTT, HbA1c, insulin, general chemistry, and routine urinalysis. The patients were divided into 8 groups based on the combination of positive and negative results of each of the 3 tests, and the characteristics of the patients were compared among groups. RESULTS: In the group that tested positive for all 3 tests, the FPG, 2-h OGTT, HbA1c, homeostasis model assessment for insulin resistance, alanine transaminase, triglyceride, and urine glucose positive values were higher than those of the group that tested positive using the 2-h OGTT and HbA1c test. In the group that tested positive using the 2-h OGTT, blood urea nitrogen was higher than that of the group that tested positive using the HbA1c test. CONCLUSIONS: The characteristics of the patients differed between the tests that yielded positive diagnostic results. This may be related to the fact that the 3 tests indicate different states of glucose metabolism. The results of the 3 tests were significantly different; therefore, it may be more effective to combine the results of the 3 tests to comprehensively describe patient characteristics.
Adult ; Alanine Transaminase ; Blood Glucose ; Blood Urea Nitrogen ; Chemistry ; Diabetes Mellitus ; Diagnosis ; Fasting ; Glucose ; Glucose Tolerance Test ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Metabolism ; Triglycerides ; Urinalysis

Increased anterior teeth mastication following posterior teeth loss leads to greater anterior occlusal force. It may cause greater attrition of anterior teeth, traumatic force occlusion (TFO), also often followed by antagonist extrusion and occlusal disharmony. This clinical report describes the treatment for a 67-year-old female patient diagnosed with loss of both maxillary and left mandibular posterior teeth, severe attrition of maxillary and mandibular anterior teeth and extrusion of multiple teeth. A diagnostic cast was mounted on articular in centric relation (CR) position to evaluate vertical dimension (VD) and interspace. To provide adequate space for the prosthetic reconstructions, VD was increased by 3 mm on the anterior pin. And then diagnostic wax-up was completed upon that VD. Wax-up was converted to provisional restorations and verified in the patient's mouth and the final restorations were delivered. Clinical follow up examination held 3 months after temporary restoration owing to changes in vertical dimension revealed proper function in mastication without evidence of temporo-mandibular joint (TMJ) disorders. This clinical report presents successfully restoring severe attrition case with increasing vertical dimension resulting in satisfaction in esthetics and function.
Aged ; Bite Force ; Centric Relation ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Joints ; Mastication ; Mouth ; Tooth ; Vertical Dimension

BACKGROUND: Hypertrophic scars and keloids are associated with abnormal levels of growth factors. Silicone gel sheets are effective in treating and preventing hypertrophic scars and keloids. There has been no report on the change in growth factors in the scar tissue following the use of silicone gel sheeting for scar prevention. A prospective controlled trial was performed to evaluate whether growth factors are altered by the application of a silicone gel sheet on a fresh surgical scar. METHODS: Four of seven enrolled patients completed the study. Transforming growth factor (TGF)-beta1, platelet-derived growth factor (PDGF), and basic fibroblast growth factor (bFGF) were investigated immunohistochemically in biopsies taken from five scars at 4 months following surgery. RESULTS: In both the epidermis and the dermis, the expression of TGF-beta1 (P=0.042 and P=0.042) and PDGF (P=0.043 and P=0.042) was significantly lower in the case of silicone gel sheet-treated scars than in the case of untreated scars. The expression of bFGF in the dermis was significantly higher in the case of silicone gel sheet-treated scars than in the case of untreated scars (P=0.042), but in the epidermis, the expression of bFGF showed no significant difference between the groups (P=0.655). CONCLUSIONS: The levels of TGF-beta1, PDGF, and bFGF are altered by the silicone gel sheet treatment, which might be one of the mechanisms of action in scar prevention.
Biopsy ; Cicatrix* ; Cicatrix, Hypertrophic ; Cytokines ; Dermis ; Epidermis ; Fibroblast Growth Factor 2* ; Humans ; Intercellular Signaling Peptides and Proteins ; Keloid ; Platelet-Derived Growth Factor* ; Prospective Studies ; Silicone Gels ; Transforming Growth Factor beta1* ; Transforming Growth Factors

Lymphedema is a frequent complication after the treatment of various cancers, particularly breast cancer, gynecological cancers, melanomas, and other skin and urological cancers. Lymphedema patients have chronic swelling of the affected extremity, recurrent infections, limited mobility and decreased quality of life. Once lymphedema develops, it is usually progressive. Over time, lymphedema leads to fat deposition and subsequent fibrosis of the surrounding tissues. However, there is no cure for lymphedema. Recently, the development of microsurgery has led to introduction of new surgical techniques for lymphedema, such as vascularized lymph node transfer. We report here the latest trends in the surgical treatment of lymphedema, as well as diagnosis and conventional treatments of lymphedema.
Anastomosis, Surgical ; Breast Neoplasms ; Diagnosis ; Extremities ; Fibrosis ; Humans ; Lymph Nodes ; Lymphedema* ; Melanoma ; Microsurgery ; Quality of Life ; Skin ; Urologic Neoplasms

Cytomegalovirus (CMV) disease is an important cause of morbidity and mortality in an immunocompromised host. Patients with AIDS, organ transplantion and chemotherapy for malignant disease are susceptible to CMV diseases. CMV disease rarely occurs in an immunocompetent host. The gastrointestinal tract is one of target organs for CMV infection. Immunocompetent patients with gastrointestinal CMV disease frequently recover with supportive therapy. If immunosuppressive therapy is stopped, patients infected with CMV can be spontaneously cured. However, as the prognosis of CMV infection in immunocompromised patients is usually poor, the administration of an antiviral agent is recommended for treatment. We report two cases of gastric CMV in immonocompetent patients who completely recovered with supportive treatment without antiviral therapy.
Cytomegalovirus ; Gastritis ; Gastrointestinal Tract ; Humans ; Immunocompetence ; Immunocompromised Host ; Prognosis ; Transplants

PURPOSE: The use of an autogenous fat graft has become a common procedure in plastic surgery. However, questions remain concerning on the viability of fat cells and preservation method of aspirated fat. The purpose of this study is to examine the viability of fat cells stored at -20degrees C in the freezer for 1 year after harvest from abdominal liposuction. METHODS: Eighteen adults(aged from 24 to 65 years, 16 female and 2 male) were selected for this study. Harvested aspirated fat tissues were obtained by suction-assisted lipectomy and frozen at -20degrees C commercial refrigerator for one year(average 12.5 months). The viability of fat cells in specimens were measured after thawing. The numbers of viable cells were measured on a fluorescence microscope after staining with fluorescein diacetate and propidium iodide. GPDH(Glycerol-3-phosphate dehydrogenase) activity was measured. Cell culture was done for 3 weeks. RESULTS: There were no viable cells under the fluorescence microscope, no detectable GPDH activity, and no cultured cells. CONCLUSION: These findings suggest that aspirated fat after frozen storage for one year at -20degrees C freezer is inadequate to reuse.
Adipocytes ; Cell Culture Techniques ; Cryopreservation ; Female ; Fluorescein ; Fluoresceins ; Fluorescence ; Humans ; Lipectomy ; Propidium ; Surgery, Plastic ; Transplants

During the past decade, many studies using platelet-rich plasma (PRP) or adipose-derived stem cells (ASCs) have been conducted in various medical fields, from cardiovascular research to applications for corneal diseases. Nonetheless, there are several limitations of practical applications of PRP and ASCs. Most reports of PRP are anecdotal and few include controls to determine the specific role of PRP. There is little consensus regarding PRP production and characterization. Some have reported the development of an antibody to bovine thrombin, which was the initiator of platelet activation. In the case of ASCs, good manufacturing practices are needed for the production of clinical-grade human stem cells, and in vitro expansion of ASCs requires approval of the Korea Food and Drug Administration, such that considerable expense and time are required. Additionally, some have reported that ASCs could have a potential risk of transformation to malignant cells. Therefore, the authors tried to investigate the latest research on the efficacy and safety of PRP and ASCs and report on the current state and regulation of these stem cell-based therapies.
Consensus ; Corneal Diseases ; Humans ; Korea ; Mesenchymal Stromal Cells ; Platelet Activation ; Platelet-Rich Plasma ; Stem Cells ; Thrombin ; Treatment Outcome ; United States Food and Drug Administration

BACKGROUND: Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. METHODS: This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension (TcPO2) was evaluated using the Periflux System 5000 with TcPO2/CO2 unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated. RESULTS: Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P < 0.01), day 14 (P < 0.001), and day 28 (P < 0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient. CONCLUSIONS: In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers.
Angiogenesis Modulating Agents ; Blood Gas Monitoring, Transcutaneous ; Debridement ; Diabetic Foot* ; Eosine Yellowish-(YS) ; Foot Ulcer ; Humans ; Inflammation ; Oxygen* ; Polydeoxyribonucleotides ; Prospective Studies ; Skin ; Transplants ; Ulcer* ; Wound Healing

BACKGROUND: Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. METHODS: This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension (TcPO2) was evaluated using the Periflux System 5000 with TcPO2/CO2 unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated. RESULTS: Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P < 0.01), day 14 (P < 0.001), and day 28 (P < 0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient. CONCLUSIONS: In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers.
Angiogenesis Modulating Agents ; Blood Gas Monitoring, Transcutaneous ; Debridement ; Diabetic Foot* ; Eosine Yellowish-(YS) ; Foot Ulcer ; Humans ; Inflammation ; Oxygen* ; Polydeoxyribonucleotides ; Prospective Studies ; Skin ; Transplants ; Ulcer* ; Wound Healing