Addison's disease is a rare disorder resulted from a chronic deficiency of the adreanl cortical hormone. The clinical manifestations are general weakness, weight loss, hyperpigmentation, hypovolemia with hyponatremia and hyperkalemia. We report a case of Addison's disease in a 60-year-old woman who has experienced slowly progressive weakness, weight loss and generalized cutaneous pigmentation, especially sun exposed area, extensor surface and nail bed for the last, 2 years. On a hormonal assay of the adrenal glands, basal plasma cortisol level was decreased and basal plasma ACTH level was markedly elevated. A chest X-ray showed streaky tuberculous infiltration in left, upper lobe field and adrenal CT scan showed calcific densities of both adrenal glands with nodular enlargement of right adrenal gland. There was a clinical improvement with steroid replacement therapy and anti-tuber- culosis chemotherapy. A nearly normal appearance was obtained after 5 months' treatment.
Addison Disease ; Adrenal Glands ; Adrenocorticotropic Hormone ; Drug Therapy ; Female ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Hypovolemia ; Middle Aged ; Pigmentation ; Plasma ; Solar System ; Thorax ; Tomography, X-Ray Computed ; Weight Loss

Nefazodone, a newer antidepressant is a phenylpiperazine derivative that inhibits the reuptake of both norepinephrine and serotonin, and antagonizes 5-HT2A and alpha1 adrenergic receptors. Compared with SSRIs nefazodone caused the fewer activating symptoms, adverse gastrointestinal effects(nausea, diarrhea, anorexia) and adverse effects of sexual function, but is associated with the more dizziness, dry mouth, constipation, visual disturbances and confusion. We report on 4 cases of visual disturbances and hallucinations in patients taking nefazodone. 1) Nefazodone, as a 5-HT2A antagonist, might induce visual disturbances. 2) mCPP, metabolite of nefazodone might contribute to the hallucination through action on 5-HT receptor. 3) Dopaminergic enhancing activity of nefazodone might cause hallucination. The case report raises the possibility that dose-related perceptual disturbances may exist with nefazodone. The fact emphasizes the need to pay close attention to all possible drug interactions, particularly in patients treated with multiple psychoactive agents, older patients, and patients with decreased hepatic function.
Constipation ; Diarrhea ; Dizziness ; Drug Interactions ; Hallucinations ; Humans ; Mouth ; Norepinephrine ; Psychotropic Drugs ; Receptors, Adrenergic ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists

OBJECTIVE: The aim of this study is to find the most helpful midsagittal reference plane for diagnosis in PA cephalometry compared with 3D CT. METHODS: The subjects consisted of 25 adults who showed no facial asymmetry by gross inspection. 3D CT and posteroanterior cephalogram of the subjects were taken. To find the most helpful midsagittal reference plane in PA cephalometry, we considered five kinds of midsagittal planes from which the distances to five landmarks were measured and compared the result with that of 3D CT. The midsagittal plane for 3D CT was determined by the landmarks Nasion, Sella and Basion. RESULTS: PA measurements using the midsagittal reference plane on a perpendicular plane lying through the midpoint of the right and left latero-orbitales was closest to those of 3D CT. CONCLUSIONS: It was considered that latero-orbitale perpendicular could be used as the helpful midsagittal reference plane to assess facial asymmetry in PA cephalometry.
Adult ; Cephalometry ; Deception ; Facial Asymmetry ; Humans

OBJECTIVE: The purpose of this study was to examine the effect of ipriflavone on periodontal reorganization and prevention of relapse following tooth movement. METHODS: Orthodontic rubber bands were inserted between the first and second maxillary molars of 27 white male rats for 3 weeks for experimental tooth movement. From one day before the removal of orthodontic rubber band, ipriflavone was administered 50 or 400 mg/kg daily in each experimental group whereas carboxymethyl cellulose solution was administered in the control group. They were sacrificed at the 5, 10, and 15th day from the day of removal of orthodontic rubber bands. The amount of relapse was evaluated by measuring the interdental space, and the extent of periodontal reorganization was compared through histological examination. RESULTS: In case of ipriflavone administration, the amount and velocity of relapse was less and slower compared to the control group. In addition, the ipriflavone group showed more rapid periodontal reorganization compared to the control group. CONCLUSIONS: The results of the present study suggest that ipriflavone administration can be used effectively in the prevention of relapse following orthodontic tooth movement through the acceleration of periodontal reorganization.
Acceleration ; Animals ; Carboxymethylcellulose Sodium ; Humans ; Isoflavones ; Male ; Molar ; Rats ; Recurrence ; Rubber ; Tooth ; Tooth Movement

Surgery for pathologic hip fracture poses significant challenges regarding the fixation of fracture and management of the original tumor lesion. An extensive destruction of the femoral neck and intertrochanteric region by benign or malignant lesions complicated by a pathological fracture generally necessitates total hip arthroplasty; however, in adolescents and young adults, preservation of the hip is preferable. We present a 14-year-old female patient, who sustained a pathological intertrochanteric fracture through a pre-existing aneurysmal bone cyst. Several operative interventions with internal fixation and bone graft were unsuccessful, and combined nonunion and progression of osteolysis around the compression hip screw eventually caused femoral head collapse, mimicking osteonecrosis. Hip preservation and resolution of the original tumor were achieved by free vascularized fibular graft.
Adolescent ; Aneurysm ; Arthroplasty, Replacement, Hip ; Bone Cysts ; Female ; Femur Neck ; Fractures, Spontaneous ; Head* ; Hip ; Humans ; Osteolysis ; Osteonecrosis ; Transplants* ; Young Adult

BACKGROUND: The prevalence of metabolic syndrome (MetS) has risen rapidly worldwide, including in South Korea. Factors related to lifestyle are closely associated with the development of MetS. The aim of this study was to investigate the association between MetS and a number of factors positively influencing health, namely non-smoking, low-risk drinking, sufficient sleep, regular exercise, and the habit of reading food labels, among Korean men. METHODS: This cross-sectional study included 3,869 men from the 2007–2009 Korean National Health and Nutrition Examination Survey. Information on five factors positively influencing their health was obtained using a self-reported questionnaire. We categorized subjects into four groups, depending on the number of positive factors reported (group I, 0–1 factor; group II, 2 factors; group III, 3 factors; group IV, 4–5 factors). RESULTS: Men who reported a greater number of positive health factors had better laboratory and anthropometric values than men who reported fewer positive health factors. The prevalence of MetS was 29.1, 27.2, 20.7, and 14.6% in groups I to IV, respectively. Compared to group I, odds ratios (95% confidence intervals) for MetS were 0.96 (0.78–1.19) in group II, 0.67 (0.52–0.87) in group III, and 0.52 (0.35–0.76) in group IV, after adjusting for confounding factors. Odds ratios for abdominal obesity, glucose intolerance, and hypertriglyceridemia were statistically significant. CONCLUSION: A greater number of positive lifestyle factors influencing health were associated with a lower risk of developing MetS, in a nationally representative sample of Korean men.
Alcohol Drinking ; Cross-Sectional Studies ; Drinking ; Glucose Intolerance ; Humans ; Hypertriglyceridemia ; Korea ; Life Style ; Male ; Metabolic Syndrome X ; Nutrition Surveys* ; Obesity, Abdominal ; Odds Ratio ; Prevalence ; Smoking

PURPOSE: The purpose of the study was to describe the parenting experience of parents of children with chronic illness in Korea. METHODS: A conventional contents analysis was used for the study. Twelve mothers of chronically ill children participated in the study. Qualitative data were analyzed using the Morse and Field method. RESULTS: Four categories, 10 subcategories and 42 codes emerged from the data on the parenting experience of parents of children with chronic illness. The four categories were 'Sacrifice and full-engagement within self-mortification', 'Renormalization of collapsed daily life', 'Paving a new way for independence' and 'Growing together of myself and the family'. CONCLUSION: Parents of children with chronic illness experienced not only negative aspects such as a confusion but also re-normalization and growing together. Based on the results, health professionals need to develop effective nursing interventions toward positive parenting for these parents and their children with chronic illnesses.
Child* ; Chronic Disease* ; Health Occupations ; Humans ; Korea ; Mothers ; Nursing ; Parenting* ; Parents* ; Qualitative Research

The most cornmon obstruction of left ventricular outflow in childhood is produced either by a fibrous ring below the aortic valve, or by localized or diffuse muscular hypertrophy of the inter-ventricular septum. Cardiac tumors causing subaortic stenosis in the newborn infant are extremely rare. This report describes two cases of subaortic stenosis caused by a tumor of the left ventricle in newborn infants, both diagnosed by 2-dimensional echocardiography. In one patient, the obstructive portion of the tumor was successfully resected from its attachment to the ventricular septum by aortotomy on day 5. Histologic examination confirmed the diagnosis of rhabdomyoma. This patient developed cutaneous, neurologic and radiologic abnormalities of tuberous sclerosis during the follow-up of 42 months.
Aortic Valve ; Constriction, Pathologic* ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Neoplasms ; Heart Ventricles ; Humans ; Hypertrophy ; Infant, Newborn* ; Rhabdomyoma ; Tuberous Sclerosis ; Ventricular Septum

PURPOSE: The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January 2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation. METHODS: Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in 2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies. Median follow-up time was 44 months (3-63 months). RESULTS: Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig-Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series. On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD, side-by-side positioned great arteries, or associated coronary anomalies. CONCLUSION: The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, as well as ventricular outflow tract obstructions.
Aorta, Thoracic ; Arteries ; Constriction, Pathologic ; Double Outlet Right Ventricle ; Follow-Up Studies ; Hand ; Hospital Mortality ; Humans ; Postoperative Complications ; Pulmonary Artery ; Retrospective Studies ; Risk Factors ; Transposition of Great Vessels ; Ventricular Septum

Trichoblastoma is occasionally observed in association with a pre-existing nevus sebaceous in the Korean literature. However, there has been no report on the pigmented type. Herein, we report the first Korean case of a pigmented trichoblastoma arising from the nevus sebaceous on the forehead. A 28-year-old male presented with a dark nodular lesion within a yellowish plaque on the forehead. The surrounding yellowish plaque on the forehead had existed since birth. The central, dark-pigmented nodule began to appear three years ago and enlarged gradually. Histopathologic findings of central pigmented lesion showed heavy melanin deposits within and around the tumor nests. Complete excision was made as treatment.
Adult ; Forehead ; Humans ; Korea ; Male ; Melanins ; Nevus ; Parturition