OBJECTIVES: This study was aimed to investigate and compare the life event stress unit, coping strategy and other risk factors in coronary artery disease patients who visited Cardiovascular Division of Dept. of Internal Medicine Chung-Ang University Hospital. METHODS: Review of medical chart, semi-structured interview, Scale of Life Events and Multidemensional Coping Scale were applied to patients group(No.=26) who were diagnosed as cardiovascular disease at Cardiovascular Division Dept. of Internal Medicine, Chung-Ang University Hospital and control group(No.=37) who were screened as normal at Health Screening Center. The data were processed by T test and Chi-square test using SPSS version 7.0. RESULTS: 1) The scores of life event stress of patient group were significantly higher(372.34+/-172.81) than those of normal control group(228.27+/-116.37)(p<0.05). 2) In the aspect of coping strategies, the patients' group was significantly higher than normal control group at the fatalism, accomodation and self-criticism(p<0.05), while in the normal control group, the positive comparison and religious seeking tended to be higher than in the patients group, with no statistical significance. 3) Comparing other risk factors of coronary artery disease, the patients group was higher than the normal control group at the incidence of diabetes, hypo-HDL-cholesterolemia and hypertension(p<0.05). But the incidence of smoking, hypertriglyceridemia and hypercholesterolemia did not differ significantly. CONCLUSIONS: The life event stress was found to be one of the risk factors of coronary artery disease. The passive-negative coping strategies, such as the fatalism, accomodation and selfcriticism, were also another risk factors.
Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Hypercholesterolemia ; Hypertriglyceridemia ; Incidence ; Internal Medicine ; Mass Screening ; Risk Factors ; Smoke ; Smoking

PURPOSE: To evaluate the prevalence of vesicoureteral reflux (VUR) according to the timing of voiding cystourethrography (VCUG) in infantile urinary tract infection (UTI). METHODS: The data of 134 infants (1-12 months) with renal cortical defect in 99mTc-2, 3-dimercaptosuccinic acid (99mTc-DMSA) scan with a diagnosis of UTI in two hospitals from 2000 to 2010 were retrospectively analyzed. The VCUG was performed after 2 weeks from the diagnosis of UTI in Group I (n=68), and the VCUG was performed within 2 weeks from the diagnosis of UTI in Group II (n=66). RESULTS: There were no significant differences between the two groups in the duration of fever, white blood cell count, C-reactive protein levels, and abnormalities in ultrasonography (P>0.05). There was no significant difference between the two groups in the prevelence of VUR, bilateral VUR, and severe VUR. VCUG-induced UTI was detected 16 (23.5%) of patients in whom the procedure was performed 2 weeks after the diagnosis, and none of VCUG-induced UTI occurred in those in whom the procedure was performed 2 weeks within the diagnosis. CONCLUSION: We conclude that the prevalence of VUR according to the timing of VCUG did not differ between the two groups in infantile UTI with renal cortical defect in DMSA scan. We also found that performing VCUG with antibiotics can decrease risk of VCUG-induced UTI.
Anti-Bacterial Agents ; C-Reactive Protein ; Fever ; Humans ; Infant ; Leukocyte Count ; Prevalence ; Retrospective Studies ; Succimer ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: Craniospinal neurenteric (NE) cysts are rare developmental non-neoplastic cysts of the central nervous system with diverse MR imaging findings. The purpose of this study was to evaluate various MR imaging findings of intracranial and intraspinal NE cysts. MATERIALS AND METHODS: We retrospectively reviewed the MR imaging findings of six NE cysts that were confirmed by pathology. We evaluated anatomic location, signal intensity, size and enhancement pattern of NE cysts. RESULTS: Two intracranial lesions were located extra-axially in the cerebellopontine angle and quadrigeminal cisterns. Three spinal lesions were intraduralextramedullary cysts, located ventral to the spinal cord, but one thoracic lesion was an intramedullary cyst. The signal intensity of the cysts was hyperintense on T1-weighted images as compared with the cerebrospinal fluid (CSF) for two intracranial lesions and one cervical lesion. In addition, all intracranial lesions showed diffusion restriction. For the remaining three spinal lesions, the signal intensity was nearly the same as the signal intensity of the CSF as seen on both T1- and T2-weighted images. On contrast-enhanced studies, two intracranial cysts showed a small nodular enhancement and one thoracic spinal lesion showed rim enhancement. CONCLUSION: NE cysts have various locations, signal intensities, and possible focal nodular or rim enhancement. Therefore, NE cysts can be included in the differential diagnosis of various craniospinal cystic or tumorous cystic lesions.
Central Nervous System ; Cerebellopontine Angle ; Diagnosis, Differential ; Diffusion ; Neural Tube Defects ; Retrospective Studies ; Spinal Cord

Intestinal neuronal dysplasia(IND) is a disease characterized clinically by symptoms of intestinal obstruction and pathologically by hyperplasia of the submucosal and myenteric plexuses with formation of giant ganglia. Chronic intestinal pseudo-obstruction is a clinical diagnosis, composed of myopathic form and neuropathic form, and normal intestinal histology. Intestinal neuronal dysplasia is a neuropathic form of chronic intestinal pseudo-obstruction. The clinical presentation and the course of IND is very variable. We experienced a case of intestinal neuronal dysplasia in a 5 year-old boy who had suffered from recurrent abdominal pain and vomiting for 3 years. Small bowel series showed multiple intestinal dilatations and delayed excretion of contrast media. He underwent exploratory laparotomy. However no mechanical causes for markedly dilated intestine were found and he received loop ileostomy. However, he suffered from recurrent vomiting and abdominal pain. So, he received repair-operaton. The pathology of surgical specimen showed hyperplasia of the submucosal and myenteric plexuses with giant ganglia. We report this case with a brief review of the related literatures.
Abdominal Pain ; Child, Preschool ; Contrast Media ; Diagnosis ; Dilatation ; Ganglia ; Humans ; Hyperplasia ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Intestines ; Laparotomy ; Male ; Myenteric Plexus ; Neurons* ; Pathology ; Vomiting

An accelerating effect of methyl-deficient diet (MDD) on hepatocarcinogenesis and methylation pattern of nuclear protein(s) by S-adenosylmethionine: protein arginine N-methyltransferase (protein methylase I, PM-I) have been studied with 3'-methyl-4-dimethyl- aminoazobenzene(MeDAB)-treated rats. The MDD+MeDAB-fed group produced typical cancer cells in the liver almost two weeks earlier than the control synthetic diet (CSD)+MeDAB-fed group. Protein methylase I (PM-I) activity in the livers of MDD alone fed rats began to increase at around 2 weeks after MDD-feeding, reaching a peak at 4 weeks and declining thereafter. When nuclei isolated either from normal livers or from cholangiocarcinoma cells were incubated with PM-I preparation from normal liver, 16 and 23-kDa nuclear proteins were the major methylated proteins, regardless of the source of the nuclei. However, when the above mentioned nuclei were incubated with PM-I preparations either from MDD alone fed livers or MDD+ MeDAB-induced cholangiocarcinoma cells, the methylation of 23-kDa protein was not detected. The result suggests that there is a hitherto-unknown PM-I specific to 23 kDa nuclear protein which was lost during methyl deficient diet feeding and hepatocarcinogenesis. The N-terminal 20 amino acids sequence of the 23-kDa protein was found to be (1)Gly-Val-Pro-Leu-(5)X-Arg-Leu-Phe-Asp-(10)His-Ala-Met-Leu-Gln-(15)Ala -His-Arg-Ala-His-(20)Glu, having 94.7% sequence homology with human chorionic somatomammotropin precursor A and B.
Amino Acids ; Animals ; Arginine ; Carcinogens ; Carcinoma, Hepatocellular ; Cell Differentiation ; Cell Division ; Cell Proliferation* ; Cholangiocarcinoma ; Diet ; Food, Formulated ; Liver ; Methylation* ; Nuclear Proteins ; p-Dimethylaminoazobenzene ; Placental Lactogen ; Protein Methyltransferases ; Protein-Arginine N-Methyltransferases ; Rats ; S-Adenosylmethionine ; Sequence Homology

PURPOSE: The dual-specificity phosphatase PTEN/ MMAC1/TEP1 has recently been identified as the tumor suppressor gene most frequently mutated and/or deleted in human tumors. However, PTEN mutations have rarely been detected in sporadic thyroid cancers. Therefore, this study investigated the PTEN expression of thyroid cancer and the relationship between PTEN, clinical status and other biologic factors such as HER-2/neu and p53. MATERIALS AND METHODS: The study samples consisted of 62 thyroid cancer specimens and 24 benign thyroid tumor specimens from patients who were operated on the Department of Surgery, Uijongbu St. Mary's hospital during the 5 years from January 1995 until January 2000. All tumors were studied by immunohistochemical staining using monoclonal antibodies against PTEN, HER-2/neu and p53. The results were analyzed statistically. RESULTS: PTEN protein was found to be under-expressed more frequently in thyroid cancers (29%) than in benign thyroid tumors (4.2%). The reduction in PTEN expression in thyroid cancers was not significantly related with the recorded clinical factors such as size, age, lymph node metastasis and p53, except for HER-2 which was found to be significantly related (p=0.001). HER-2 over- expression was noted in thyroid cancer (83.8%) more frequently than in benign tumors (16.7%). CONCLUSION: This study has demonstrated that the under-expression of PTEN protein and the over-expression of HER-2 protein may play a role in the carcinogenesis and development of thyroid cancer.
Antibodies, Monoclonal ; Biological Factors ; Carcinogenesis ; Dual-Specificity Phosphatases ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; PTEN Phosphohydrolase ; Thyroid Gland* ; Thyroid Neoplasms

PURPOSE: The detection of occult micrometastasis in breast cancer patients may allow the establishment of prognosis and development of new therapeutic approaches. This study was performed in order to improve on existing methods of detection by evaluating the potential of specific mRNA markers in reverse-transcriptase polymerase chain reaction (RT-PCR) of peripheral blood and bone marrow taken from patients with breast cancer. METHODS: Peripheral blood and bone marrow samples were obtained from thirty-four breast cancer patients who undergone surgery in the Department of Surgery, Uijongbu St. Mary's Hospital between January 2000 and May 2001. In RT-PCR, we tried multiple primers on breast cancer cell lines and patient samples. Using MUC-1 and CK19 mRNA primers, we detected micrometastasis in breast cancer patients. Subsequently, we analysed the correlation with RT- PCR results and other prognostic factors. RESULTS: MUC-1 and CK19 were detected in all breast cancer cell lines. However, CEA was not detected in some cell lines. CK19 showed greater sensitivity than MUC-1 in RT-PCR. Using MUC-1 as primers, the detection rate was 47.1% and 35.3% in bone marrow and peripheral blood, respectively. Seven patients (20.5%) were positive in both sources. In the case of CK19, the detection rate was 50% and 41.2% in bone marrow and peripheral blood, respectively. Twelve patients (35.2%), were noted as being positive for both primers. The concordance rate of both primers mers was 38.2% and 23.5% in bone marrow and peripheral blood, respectively. CK19 positivity in the peripheral blood was correlated with bone marrow positivity and MUC-1 positivity in both sources and inversely correlated with ER. CK19 positivity of bone marrow was correlated with MUC-1 positivity of bone marrow. CONCLUSION: CK19 and MUC-1 may be good candidates for use in RT-PCR for the detection of micrometastasis of breast cancer. CK19 showed greater sensitivity. However, using both primers in RT-PCR, we may detect micrometastasis more sensitively and specifically and more wisely choose a treatment modality.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Cell Line ; Humans ; Keratin-19 ; Neoplasm Micrometastasis* ; Polymerase Chain Reaction ; Prognosis ; RNA, Messenger

OBJECTIVES: It remains unclear as to whether routine central neck dissection (CND) is necessary when performing surgery to treat patients with papillary thyroid microcarcinoma (PTMC). To determine the necessity for routine CND in PTMC patients, we reviewed the clinicopathologic and laboratory data of the patients of PTMC. METHODS: Between September 2001 and July 2005, 101 patients with PTMC and clinical N0 disease were retrospectively reviewed. The study cohort was devided into groups: the total thyroidectomy plus CND group (the CND group, N=48) and the total thyroidectomy without CND group (the no CND group, N=53). The serum stimulated thyroglobulin (Tg) levels were measured after surgery and prior to radioactive iodine ablation therapy (RAI) and at 6-12 months after RAI. Pathology, the Tg levels and recurrence data were compared between the 2 groups. RESULTS: Central nodal metastases were found in 18 of the 48 CND patients (37.5%). The incidence of Tg levels >5 ng/mL at RAI was higher in the no CND patients and in the 18 node-positive CND patients compared with the 30 node-negative CND patients (22-24% vs. 3%, respectively, P=0.020-0.058). The difference when performing a similar comparison using a >2 ng/mL Tg threshold level showed no significance (10-11% vs. 4%, respectively, P>0.1). Two of the no CND patients and one node-positive CND patient had recurrences in the thyroid bed or lateral neck during a mean follow-up of 24 months. CONCLUSION: The data showed that occult metastasis to the central neck is common in PTMC patients. A CND provides pathologic information about the nodal metastases, and it potentially provides guidance for planning the postoperative RAI. However, the long-term benefit of CND on recurrence and survival remains somewhat questionable.
Carcinoma, Papillary ; Cohort Studies ; Follow-Up Studies ; Humans ; Incidence ; Iodine ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Hemorrhagic fever with renal syndrome(HFRS) is characterized clinically by five distinct phases; febrile, hypotensive, oliguric, diuretic and convalescent phases. The oliguric phase usually lasts for three to six days. We here report a case of prolonged oliguric phase over one month in a patient with HFRS. A 36-year-old man developed oliguric acute renal failure due to HFRS. He commenced hemodialysis on the 2nd days of hospitalization. The oliguric phase was prolonged over one month. The endocrinologic study showed nomal range of plasma ACTH, cortisol, thyroid hormone and slight elevation of plasma atrial natriuretic peptide at oliguric phase. Kidney biopsy showed mononuclear cell infiltrate and associated edema in the interstitium. Diuresis appeared at the 43th days of hospitalization, but it was inadequate. To enhance diuresis and recovery of renal function, he was treated with steroid. Five days after steroid treatment, massive diuresis appeared and serum creatinine decreased to 1.2mg/dL at the 5 months after onset of the disease.
Acute Kidney Injury ; Adrenocorticotropic Hormone ; Adult ; Biopsy ; Creatinine ; Diuresis ; Edema ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Hospitalization ; Humans ; Hydrocortisone ; Kidney ; Plasma ; Renal Dialysis ; Thyroid Gland

We report the case of a 14-year-old girl, diagnosed with atypical thrombotic microangiopathy (TMA). The patient presented with persistent fever, nausea, and newly developed peripheral edema. Her laboratory findings indicated chronic anemia with no evidence of hemolysis, thrombocytopenia, or elevated serum creatinine level. A few days after hospitalization, acute renal failure and fever worsened, and proteinuria developed. On day 40 of hospitalization, she experienced a generalized tonic seizure for 5 min, accompanied by renal hypertension. Brain magnetic resonance imaging revealed posterior reversible leukoencephalopathy syndrome. After steroid pulse therapy, a renal biopsy was performed because of delayed recovery from thrombocytopenia. The biopsy findings showed features of thrombotic microangiopathic hemolysis with fibrinoid change restricted. Current diagnostic criteria for TMA have focused on thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, and diagnosis is based on the clinical presentation and etiology, with the consequence that idiopathic and atypical forms of TMA can be overlooked. Developing effective tools to diagnose TMA, such as studying levels of ADAMTS13 or testing for abnormalities in the complement system, will be the first step to improving patient outcomes.
Acute Kidney Injury ; Adolescent ; Anemia ; Biopsy ; Brain ; Complement System Proteins ; Creatinine ; Diagnosis ; Edema ; Female ; Fever ; Hemolysis ; Hemolytic-Uremic Syndrome ; Hospitalization ; Humans ; Hypertension, Renal ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Nausea ; Proteinuria ; Purpura, Thrombotic Thrombocytopenic ; Resin Cements ; Seizures ; Thrombocytopenia ; Thrombotic Microangiopathies*