BACKGROUND/AIMS: Serum levels of highly sensitive C-reactive protein (hsCRP), a vascular inflammatory marker, may predict the development of cardiovascular disease (CVD) and type 2 diabetes. Women with polycystic ovary syndrome (PCOS) are at greater risk for type 2 diabetes and CVD. The aim of this study was to compare hsCRP levels between normal weight women with PCOS and controls with a normal menstrual cycle and to determine the factors associated with serum hsCRP levels. METHODS: Thirty-nine lean PCOS patients and 24 healthy, regular cycling women were enrolled in this study. We performed anthropometric measurements, fat computed tomography (CT), and blood sampling to determine blood chemistry and levels of hsCRP, gonadotropins, testosterone, and sex-hormone binding globulin. We also conducted 75-g oral glucose-tolerance test and euglycemic hyperinsulinemic clamp to assess insulin sensitivity. RESULTS: Serum hsCRP concentrations were higher in women with PCOS than in women with regular mensturation. However, this difference was no longer significant after adjusting for body mass index (BMI). hsCRP levels were correlated with waist circumference (r=0.46, p<0.01), BMI (r=0.46, p<0.01), visceral fat area (r=0.45, p<0.01), and systolic (r=0.42, p<0.05) and diastolic blood pressure (r=0.39, p<0.05). hsCRP also tended to be negatively associated with insulin-mediated glucose uptake (IMGU) (r=-0.31, p=0.07). A multiple regression analysis revealed that BMI (beta=0.29, p<0.05), systolic blood pressure (beta=0.39, p<0.01), and IMGU (beta=-0.31, p<0.05) predicted serum hsCRP levels in women with PCOS. CONCLUSIONS: PCOS by itself does not seem to be associated with increased hsCRP levels, whereas known CVD risk factors affect serum hsCRP levels in PCOS.
Adult ; Body Mass Index ; C-Reactive Protein/*analysis ; Cardiovascular Diseases/etiology ; Female ; Humans ; Polycystic Ovary Syndrome/*blood/complications ; Regression Analysis

We describe a case of fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in the lymph node of the neck presenting a predominantly spindle cell pattern. A 36 year-old male patient complained of dysesthesia on the right face and a palpable neck mass. Fine needle aspiration was done on the neck mass. Tumor cells were present in syncytial groups or singly with mainly spindle shaped nuclei, vesicular chromatin, thin and regular nuclear membrane, occasional prominent nucleoli and a few foci of cellular cohesiveness. The cytoplasm was scant and pale with ill-defined borders. Mature lymphocytes were present in the background of aspirates and within the tumor cell clusters. Histologically, the tumor of nasopharynx showed several areas of spindle cell pattern. Because the tumor cells showed a predominantly spindle shape with vesicular nuclear chromatin, the differential diagnosis of spindle cell sarcoma or granuloma of epithelioid cells were considered, but the characteristic morphology of the nuclei with vesicular chromatin and prominent nucleoli, and cellular cohesiveness were important in making the diagnosis of nasopharyngeal carcinoma. The possibility of metastatic carcinoma should always be considered in fine needle aspiration cytology of the lymph node in the neck because the incidence of metastatic carcinoma, particularly of the nasopharyngeal carcinoma in the lymph nodes of the neck is relatively high.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Incidence ; Neoplasm Metastasis

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

Trichoblastic fibroma is a benign trichogenic tumor that has both epithelial and mesenchymal components and exhibits partial follicular induction. We studied 4 cases of trichoblastic fibroma and reviewed their clinical and histologic features. Two tumors were present in the face. The remaining two were in the vulva and perianal area, respectively. The age of the patients ranged from 53 to 68 years, with an average age of 62. All were female. Histologically, the lesions showed a well circumscribed mass, located at dermo-subcutaneous junction in three patients and subcutaneous in one. They demonstrated mesenchymal induction evidenced by hair germ-like structure and perifollicular sheath. There was no connection between the tumor and epidermis. Differentiation toward hair structure led to the formation of the infundibulum through inner root sheath. Trichoblastic fibroma may be confused clinically and/or histologically with basal cell carcinoma. Identification of the mixed epithelial and mesenchymal components, and the absence of epidermal connection and cleft within the stroma are important in differentiating this benign neoplasm from basal cell carcinoma.
Carcinoma, Basal Cell ; Epidermis ; Female ; Fibroma* ; Hair ; Humans ; Vulva

Painful ophthalmoplegia is an unusual presentation of malignant lymphoma. Moreover, spontaneous remission and exacerbation of it has quite rarely been reported. We present a patient who showed spontaneous remission and exacerbation of the painful ophthalmoplegia. Brain MR imagings showed infiltrating, iso-intensity mass a, TlWl and T2WI, and strong enhancement with gadolinium on TIWI in parasellar area. Malignant lymphoma of diffuse large cell type was found in cervical lymph node biopsy.
Biopsy ; Brain ; Gadolinium ; Humans ; Lymph Nodes ; Lymphoma* ; Ophthalmoplegia* ; Remission, Spontaneous*

No abstract available.
Education, Medical* ; Female ; Humans ; Korea

PURPOSE: To investigate the relation of the gastric epithelial cell proliferation, apoptosis and genotypes of H. pylori in children. METHODS: Histologic grading by updated Sydney system, PCNA immunostaining, TUNEL method and the genotypes (cagA, picB and iceA) by PCR were performed in H. pylori positive (N=20) and negative (N=20) gastric biopsy specimens. RESULTS: PCNA index was significantly different between H. pylori positive children (77.4+/-13.12) and H. pylori negative children (52.3+/-12.20) (p=0.000). There were positive correlations between PCNA index and H. pylori density (r=0.624, p=0.000), polymorphonuclear neutrophil activity (r=0.460, p=0.005) and chronic inflammation (r=0.433, p=0.009). Apoptosis index of H. pylori positive children (0.70+/-0.411) was significantly higher than of H. pylori negative children (0.14+/-0.201) (p=0.000). Positive correlations between apoptosis index and H. pylori density (r=0.691, p=0.000), polymorphonuclear neutrophil activity (r=0.585, p=0.000) and chronic inflammation (r=0.535, p=0.001) were noted. As PCNA index increased, apoptosis index significantly increased (r=0.527, p=0.001). The positive rates of genotypes were cagA 90%, picB 75%, iceA1 60% and iceA2 15%, respectively. There were no significant correlations between the status of the genotypes and PCNA index, apoptosis index, the endoscopic findings and the histologic findings. CONCLUSION: PCNA index and apoptosis index in H. pylori positive children were higher than in H. pylori negative children but were not related to H. pylori genotypes. This study suggested that correlatively increased gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.
Apoptosis* ; Biopsy ; Child* ; Epithelial Cells* ; Genotype* ; Helicobacter pylori* ; Helicobacter* ; Humans ; In Situ Nick-End Labeling ; Inflammation ; Neutrophils ; Polymerase Chain Reaction ; Proliferating Cell Nuclear Antigen

Objectives : The purpose of this study was to develop the Korean version of the Social Functioning Scale (KSFS) in the patients with schizophrenia. METHODS : KSFS was administered to 90 schizophrenic patients and 80 their parents and 90 normal controls for examining the reliability and validity. RESULTS : Data analysis showed statistically significant reliabilities and validities of KSFS. The test-retest reliability, rater vs. self-report reliability, and internal consistency for total scores of KSFS were 0.93, 0.44 and 0.94 respectively. Evidence for discriminant validity of KSFS comes from the results that the mean scores of schizophrenic patients were significantly higher than those of normal controls. Construct validity was assessed by calculating the 7 inter-areas correlations of the KSFS, and all areas were statistically significant. Significant correlations between the total scores of KSFS and those of SOFAS lend support for the concurrent validity of this instrument. Factor analyses were performed and two factors were extracted accounting for 63.7% of the variance. Sensitivity was assessed indirectly via the distribution and range of scores on the SFS. The normal control group showed a distribution around a higher mean with a moderate positive skew. CONCLUSION : KSFS was found to be a valid, reliable, and sensitive instrument which can be used to evaluate the degree of social functioning in the patients with schizophrenia.
Accounting ; Humans ; Parents ; Reproducibility of Results ; Schizophrenia ; Statistics as Topic

This study examined three women, AHN Soo-kyung, KIM Youngheung and KIM Hae-ji, who were officially licensed as doctors for the first time in Joseon. I wanted to find a new “starting point” of women’s medicine history by scrutinizing their home environment, medical classes, graduation and medical license, and life after becoming doctors. The parents of KIM Young-heung and KIM Hae-ji might have been enlightened and Christians. AHN Soo-kyung did not have a Christian family. Her father, AHN Wang-geo, who was both an educator and a poet, was aware of the need for women’s education or modern education. Female medical missionaries such as Rosetta S. Hall and Mary Cutler also worked hard to get them admitted to the medical class.
They went to school with a female guardian and a brother and adapted to school life safely. After graduating from Kyongsung Medical College they obtained doctors’ licenses and continued their medical activities at the hospital.
KIM Young-heung actively engaged in social activities as a female intellectual by giving public lectures. She worked as a doctor in Kyongsung, Pyongyang, and Incheon. KIM Hae-ji did medical work and got married in Pyongyang. However, she had a hard time due to her husband’s death and a medical accident. In the end, she seems to have left the medical field by returning her medical license.
AHN Soo-kyung had been working at Dongdaemun (East Gate) Women’s Hospital for more than 20 years and was willing to participate in what she could do as a woman, doctor and intellectual. Therefore, she established a free maternity clinic in the hospital. She defended Joseon’s students and hospitals in protest of the controversy of nursing school and the move to abolish Dongdaemun Women’s Hospital. She quietly participated in the Dong-Ah Women’s Association and 6.10 the Independence Movement by doing anything she could do to help. She had a shy personality, but she faithfully fulfilled her duty as a doctor with a strong professional sense that saving people was her calling.

This study examined three women, AHN Soo-kyung, KIM Youngheung and KIM Hae-ji, who were officially licensed as doctors for the first time in Joseon. I wanted to find a new “starting point” of women’s medicine history by scrutinizing their home environment, medical classes, graduation and medical license, and life after becoming doctors. The parents of KIM Young-heung and KIM Hae-ji might have been enlightened and Christians. AHN Soo-kyung did not have a Christian family. Her father, AHN Wang-geo, who was both an educator and a poet, was aware of the need for women’s education or modern education. Female medical missionaries such as Rosetta S. Hall and Mary Cutler also worked hard to get them admitted to the medical class.
They went to school with a female guardian and a brother and adapted to school life safely. After graduating from Kyongsung Medical College they obtained doctors’ licenses and continued their medical activities at the hospital.
KIM Young-heung actively engaged in social activities as a female intellectual by giving public lectures. She worked as a doctor in Kyongsung, Pyongyang, and Incheon. KIM Hae-ji did medical work and got married in Pyongyang. However, she had a hard time due to her husband’s death and a medical accident. In the end, she seems to have left the medical field by returning her medical license.
AHN Soo-kyung had been working at Dongdaemun (East Gate) Women’s Hospital for more than 20 years and was willing to participate in what she could do as a woman, doctor and intellectual. Therefore, she established a free maternity clinic in the hospital. She defended Joseon’s students and hospitals in protest of the controversy of nursing school and the move to abolish Dongdaemun Women’s Hospital. She quietly participated in the Dong-Ah Women’s Association and 6.10 the Independence Movement by doing anything she could do to help. She had a shy personality, but she faithfully fulfilled her duty as a doctor with a strong professional sense that saving people was her calling.