Pregnancy and the puerperium are associated with an increased risk of stroke, and stroke is considered an important cause of maternal morbidity and mortality during this time. Pregnancy and delivery can lead to substantial alterations in systemic arterial and venous hemodynamics that may predispose to cerebrovascular disorders. We present one case of cerebral hemorrhage in puerperium after a normal pregnancy without any manifestation of preeclampsia or eclampsia and the other case with recurred cerebral hemorrhage in 16 gestational weeks pregnancy with previous cerebral hemorrhage history.
Cerebral Hemorrhage* ; Cerebrovascular Disorders ; Eclampsia ; Female ; Hemodynamics ; Mortality ; Postpartum Period* ; Pre-Eclampsia ; Pregnancy ; Stroke

The aim of this work was to establish the methodology for event positioning by measuring depth of interaction (DOI) information and to evaluate the system sensitivity and spatial resolution of the new detector for I-125 and Tc-99m imaging. For this purpose, a Monte Carlo simulation tool, DETECT2000 and GATE were used to model the energy deposition and light distribution in the detector and to validate this approach. Our proposed detector module consists of a monolithic CsI(Tl) crystal with dimensions of 50.0x50.0x3.0 mm3. The results of simulation demonstrated that the resolution is less than 1.5 mm for both I-125 and Tc-99m. The main advantage of the proposed detector module is that by using 3 mm thick CsI(Tl) with maximum-likelihood position-estimation (MLPE) method, high resolution I-125 imaging and high sensitivity Tc-99m imaging are possible. In this paper, we proved that our new detector to be a reliable design as a detector for a multi-energy SPECT.
Imidazoles ; Light ; Nitro Compounds ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Despite proposing clonal depletion, anergy, and alternation of cytokines in peripheral tolerance, the precise mechanism for the immunosuppressive effect of blood transfusion remains unknown. Here, we evaluated the effect of transfusion on the immune system indirectly via quantitation of leukocyte cytokine mRNA expression before and after allogeneic transfusion. METHODS: Samples were obtained from eight patients, being ordered one to four units of leukocytefree erythrocytes, before, 1, and 7 days after transfusion, from November to December, 2002 at Inha University Hospital. We explored the changes in mRNA expression of interleukin-2 (IL-2), IL-4, IL-10, tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma). RESULTS: In four patients who received blood transfusions among eight, significant changes were observed in the blood mRNA levels of INF-gamma and IL-10. The amounts of IFN-gamma mRNA were significantly decreased a day after transfusion to 78.5% and then recovered to 110.9% 7 days later (P=0.032), whereas, that of IL-10 was increased to 151.5% a day after and recovered to 119.1% 7 days later (P=0.034). mRNA expressions of IL-2, IL-4, and TNF-alpha were not detected in all patients. CONCLUSIONS: We observed a significant decrease in leukocyte IFN-gamma mRNA expression and an increase in IL-10 mRNA after transfusion. These findings indirectly represent that down-regulation of the Th1 cells and the up-regulation of the Th2 cells could be caused by allogeneic transfusion.
Blood Transfusion ; Cytokines ; Down-Regulation ; Erythrocytes ; Humans ; Immune System ; Interferons ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Leukocytes ; Peripheral Tolerance ; RNA, Messenger* ; Th1 Cells ; Th2 Cells ; Tumor Necrosis Factor-alpha ; Up-Regulation

East Asian surgeons generally report lower morbidity and mortality rates for gastrectomy with D2 lymphadenectomy than do surgeons in Western countries; however, the disparity remains unexplained. The aim of this article was to determine the feasibility and safety regarding cases in which East Asian surgeons perform such procedures in Caucasian patients (CPs). Twelve CPs underwent gastrectomy with lymphadenectomy for gastric cancer at Yonsei University Severance Hospital, Seoul, Korea between June 2011 and April 2014. Procedures performed included total gastrectomy (7 of 12, 58%), distal gastrectomy (4 of 12, 33%), and completion total gastrectomy (1 of 12, 8%). Nine patients (75%) underwent D2 lymphadenectomy, and D1+ lymphadenectomy was performed in three others (25%). In four patients (33%), combined resections were carried out. The median values of surgical parameters were as follows: operative time, 266.5 min (range, 120-586 min); estimated blood loss, 90 mL (range, 37-350 mL); retrieved lymph node count, 37.5 (range, 22-63); and postoperative hospital stay, 13.7 days (range, 5-63 days). No mortality was encountered, although two patients (17%) experienced complications (both Clavien-Dindo classification grade IIIa anastomotic leakages), which were successfully managed by conservative treatment. In the hands of East Asian surgeons, mortality and short-term morbidity appears to be acceptably low in CPs subjected to gastrectomy with lymphadenectomy for gastric cancer.
Adult ; Aged ; *European Continental Ancestry Group ; Female ; *Gastrectomy/adverse effects ; Humans ; Length of Stay ; *Lymph Node Excision/adverse effects ; Male ; Middle Aged ; Operative Time ; *Patients ; Pilot Projects ; Republic of Korea ; Safety ; Stomach Neoplasms/pathology/*surgery ; *Surgeons

PURPOSE: To identify the symptoms and signs of patients with dry eye disease (DED) after allogenic hematopoietic stem cell transplantation (HSCT) and analyze the correlations between these signs and symptoms. METHODS: We performed a retrospective study in 96 eyes of HSCT recipients with DED. Visual acuity, intraocular pressure, Schirmer test 1 (with anesthesia), tear osmolarity, tear break-up time, Ocular staining score (OSS, Oxford), and Ocular staining disease index (OSDI) were examined before and 1, 2, and 4 months after HSCT. RESULTS: A significant positive correlation was noted between changes in OSS and changes in OSDI. No ocular parameters showed significant correlations with Schirmer test values. Men more frequently described alleviation of symptoms greater than their objective results compared to women. CONCLUSIONS Subjective symptoms alone may be insufficient when diagnosing ocular graft-versus-host disease. We recommend regular ophthalmologic examination after allo-HSCT. In addition, a baseline ocular profile of tear dynamics and ocular surface parameters should be conducted before allo-HSCT.

Wheat is the most widely cultivated grain and an important source of food and dietary protein. Wheat proteins are classified based on extraction in different solvents, which are albumin, globulin, prolamin (gliadin) and glutenin. The term 'gluten' contains approximately equal amounts of gliadin and glutenin and is the major determinant of the properties of wheat flour conferring cohesiveness and viscoelasticity that allows its dough to be processed into many kinds of food. Gluten is known to be responsible for triggering celiac disease and wheat allergy. Wheat allergy is primarily an IgE-mediated response. Clinical manifestations of wheat allergy are similar to those of other food allergies, with symptoms on the skin, gut and respiratory tract. Recent studies have shown that IgE to gliadin can be an indicator for risk of severe immediate reaction-like anaphylaxis and wheat-dependent, exercise-induced anaphylaxis (WDEIA). However, current in vitro test reagents for the diagnosis of wheat allergy mainly contain water-soluble wheat protein and a small amount of gluten, so there are some limitations to diagnose gluten allergy. Furthermore, there is no acceptable method to measure gluten in food products for preparing effective gluten-free diet. To overcome these limitations and to improve quality of life of wheat allergy sufferers, more work is needed. We report a case of a 4-year-old boy with gluten allergy who presented with urticaria after ingestion kneaded wheat flour with a brief review of the literature.
Anaphylaxis ; Celiac Disease ; Edible Grain ; Diet, Gluten-Free ; Dietary Proteins ; Eating ; Flour ; Food Hypersensitivity ; Gliadin ; Glutens ; Hypersensitivity ; Immunoglobulin E ; Indicators and Reagents ; Preschool Child ; Proteins ; Quality of Life ; Respiratory System ; Skin ; Solvents ; Triticum ; Urticaria ; Wheat Hypersensitivity

Purpose: Adenocarcinoma is an extremely rare malignancy in the pediatric population. Research regarding pediatric adenocarcinoma is very rare in Korea. This study aimed to investigate the clinical features of pediatric adenocarcinomas of various primary organ sites in Korea. Materials and Methods: Pediatric patients under 18 years, diagnosed with adenocarcinoma of various sites between January 1995 and December 2016, were included. We retrospectively reviewed patient and tumor characteristics and calculated survival estimates, reported as 5-year survival rate and 95% confidence interval. Results: Of 80 patients (median age, 15 years; range, 10 to 17 years), 37 (46.3%) were men, and 24 (30%) had a family history of cancer or underlying disease relevant to malignancy. The cancer locations were the colon and rectum (n=32), ovaries (n=18), stomach (n=15), lung (n=4), small bowel (n=1), and other sites (n=10). Totally, 54.8% patients (42/77) had stage 3 or 4 disease. The median follow-up period was 2.0 years (range, 0 to 20.4). The 5-year overall survival estimate for all patients, and for those with stomach, colorectal, ovarian, and other cancer sites were 57.9%±11.5%, 58.2%±25.7%, 41.5%±18.2%, 87.5%±16.2%, and 64.0%±34.4%, respectively. The 5-year survival rate differed significantly between categories of adenocarcinomas into gastrointestinal (GI) (44.7%) and non-GI adenocarcinomas (78.8%) (p=0.007). The 5-year survival rate also differed significantly according to carcinoembryonic antigen level (69.3% in < 3 ng/mL, 23.8% in > 3 ng/mL; p < 0.001). Conclusion In pediatric patients, adenocarcinomas arise from various organs and are often diagnosed at advanced stages. Large, prospective studies for their accurate clinical characteristics and prognostic factors are needed.

BACKGROUND: Left ventricular hypertrophy (LVH) offers prognostic information beyond that provided by the evaluation of traditional cardiovascular risk factors. However, the validation of electrocardiogram (ECG) criteria for the diagnosis of LVH is limited in Korea general population. The purpose of this study is to investigate the diagnostic accuracy of ECG criteria for the detection of LVH in general population. METHODS: In the present study, we investigated a total of 1,946 adults from the community-based cohort. The left ventricular mass index (LVMI) was estimated with echocardiographic measurement and adjusted with body surface area. LVH was defined as a value greater than or equal to the sex-specific 90th percentile value of LVMI. ECG criteria for the diagnosis of LVH were Sokolow-Lyon criteria and Cornell criteria. RESULTS: The LVMI was significantly higher in male subjects (91.1 +/- 23.9 g/m2 vs. 83.9 +/- 21.7 g/m2, p < 0.001). The cutoff values were 120.8 g/m2 in male subjects and 112.2 g/m2 in female subjects. The sensitivity and specificity of Sokolow-Lyon criteria were 5.6% and 93.6% in male, 4.1% and 97.8% in female. Those of Cornell criteria were 2.8% and 98.7% in male, 14.3% and 95.8% in female. In male, the area under the receiver operating characteristic curves of Sokolow-Lyon voltage and Cornell voltage were 0.55 and 0.52. And those in female were 0.59 and 0.60. CONCLUSIONS: In our community-based sample, ECG criteria showed low sensitivity and high specificity. The performance of ECG criteria for detection of LVH was suboptimal, suggesting limited usefulness of ECG as mass screening tools.
Adult ; Body Surface Area ; Cohort Studies* ; Diagnosis ; Echocardiography ; Electrocardiography* ; Female ; Humans ; Hypertrophy, Left Ventricular* ; Korea ; Male ; Mass Screening ; Risk Factors ; ROC Curve ; Sensitivity and Specificity

Objective: Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls. Methods: A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory–Borderline Features Scale. Results: BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients. Conclusion The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.

PURPOSE: We investigated the prevalence and risk factors of allergic rhinitis (AR), nationwide in random children and adolescents of Korea. METHODS: A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire survey was done in 1,820 children from elementary, middle, and high school nationwide in Korea. The subjects were selected by the stratifying sampling method by school grade and five regions. Current AR was defined as having AR symptoms during the last 12 months with a history of physician-diagnosed AR. Skin prick tests for 18 common allergens were performed. RESULTS: The number of males was 945, and that of females was 875. The mean age of the patients was 12.61+/-3.40 years. The prevalence of current AR and atopic current AR were 29.0% and 18.7%, respectively. Risk factors for current AR were male (adjusted odds ratio [aOR], 1.486; 95% confidence interval [CI], 1.189-1.856), family history of paternal AR (aOR, 3.208; 95% CI, 2.460-4.182), family history of maternal AR (aOR, 3.138; 95% CI, 2.446-4.025), antibiotic use in infancy (aOR, 1.547; 95% CI, 1.228-1.949), mold exposure during infancy (aOR, 1.416; 95% CI, 1.103-1.819), mold exposure during the last 12 months (aOR, 1.285; 95% CI, 1.012-1.630), and sensitization on skin prick tests (aOR, 2.596; 95% CI, 2.055-3.279). Risk factors for atopic current AR were the same as those of current AR, whereas breast-milk feeding (aOR, 0.720; 95% CI, 0.530-0.976) was a protective factor. Sensitized allergens as risk factors for current AR were Dermatophagoides pteronyssinus, Dermatophagoides farina, ragweed, mugwort, oak, alder, birch, Japanese hop, cat, and dog. CONCLUSION: The prevalences of current AR and atopic current AR were 29.0% and 18.7%, respectively. Male, sex parental AR, antibiotic use in infancy, mold exposure during the last 12 months, mold exposure during infancy, and atopic sensitization were risk factors for current AR. Breast-milk feeding was a protective factor for atopic current AR. Aeroallergen sensitization was an important risk factor for AR.
Adolescent ; Allergens ; Alnus ; Ambrosia ; Animals ; Artemisia ; Asian Continental Ancestry Group ; Asthma ; Betula ; Cats ; Child ; Dermatophagoides pteronyssinus ; Dogs ; Female ; Fungi ; Humans ; Humulus ; Hypersensitivity ; Korea ; Male ; Odds Ratio ; Parents ; Prevalence* ; Pyroglyphidae ; Rhinitis* ; Risk Factors* ; Skin