A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledochal Cyst* ; Common Bile Duct* ; Diagnosis ; Gallstones ; Humans ; Pancreatitis ; Prevalence ; Sphincterotomy, Endoscopic ; Ultrasonography

The depressive symptoms are frequent and important ones in the elderly population. We studied the various factors affecting the severity of depressive symptoms in the elderly population. The Korean elderly (more than 65 years old; n=490) in Seoul area (city) were studied on the identifying data and medical and psychiatric history, Mini-Mental State Examination (MMSE) Geriatric Depression Scale (GDS) Korean Depression Scale(KDS: under development)were also administered. In our study, the significant effect of sex, age, education, marital status, and the status of medical security on the severity of depressive symptoms were not found. Significantly higher GDS and KDS scores were found in the elderly who have more than one physical illness, subjective memory complaints, and seven life events. To examine the strength of association of these variables of depression, we conducted logistic regression. Depressive symptoms were associated with 1)the loss of spouse, 2)a current physical illness, and 3)low socioeconomic status. These results showed that depression in the elderly may be correlated with the loss of spouse, a current physical illness, and low socioeconomic status.
Aged* ; Depression* ; Education ; Humans ; Logistic Models ; Marital Status ; Memory ; Seoul ; Social Class ; Spouses

OBJECTIVE: The purpose of this meta-analysis was to determine the applicability of web-based treatment programs for individuals with depression and quality of life impairments. METHODS: We conducted database and manual searches using imprecise search-term strategy and inclusion criteria. Research published from 2005 to December 2015 was included in this study. Upon review, a total of 12 published papers on web-based intervention for individuals with depression were assessed eligible for this meta-analysis. Effect sizes were estimated for depression and quality of life. RESULTS: The mean effect size of web-based treatment on depressive symptoms was 0.72. However, unlike the result showing medium to large effect size, the analysis on the quality of life did not yield adequate effects of web-based interventions. CONCLUSION: Our results suggest robust benefits of employing web-based treatments for depressive symptoms. However, the adequacy of these relatively new intervention tools for individuals who suffer severe impairments of quality of life was found insufficient. The current study demonstrates the need to further develop web-based intervention techniques to improve overall functioning, as well as the clinical symptoms of patients with mental disorders.
Depression* ; Humans ; Mental Disorders ; Quality of Life*

Background: Genome-wide association studies (GWAS) on type 2 diabetes mellitus (T2DM) have identified more than 400 distinct genetic loci associated with diabetes and nearly 120 loci for fasting plasma glucose (FPG) and fasting insulin level to date. However, genetic risk factors for the longitudinal deterioration of FPG have not been thoroughly evaluated. We aimed to identify genetic variants associated with longitudinal change of FPG over time. Methods: We used two prospective cohorts in Korean population, which included a total of 10,528 individuals without T2DM. GWAS of repeated measure of FPG using linear mixed model was performed to investigate the interaction of genetic variants and time, and meta-analysis was conducted. Genome-wide complex trait analysis was used for heritability calculation. In addition, expression quantitative trait loci (eQTL) analysis was performed using the Genotype-Tissue Expression project. Results: A small portion (4%) of the genome-wide single nucleotide polymorphism (SNP) interaction with time explained the total phenotypic variance of longitudinal change in FPG. A total of four known genetic variants of FPG were associated with repeated measure of FPG levels. One SNP (rs11187850) showed a genome-wide significant association for genetic interaction with time. The variant is an eQTL for NOC3 like DNA replication regulator (NOC3L) gene in pancreas and adipose tissue. Furthermore, NOC3L is also differentially expressed in pancreatic β-cells between subjects with or without T2DM. However, this variant was not associated with increased risk of T2DM nor elevated FPG level. Conclusion We identified rs11187850, which is an eQTL of NOC3L, to be associated with longitudinal change of FPG in Korean population.

Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.
Appendix ; Barrett Esophagus ; Biopsy ; Colon ; Endoscopy ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Gastrointestinal Tract ; Hematologic Tests ; Humans ; Inflammation ; Metaplasia ; Middle Aged ; Mucous Membrane* ; Ossification, Heterotopic ; Osteogenesis* ; Physical Examination ; Rectum ; Stomach ; Ulcer

Coprinopsis cinerea was employed to investigate the fungal response to gravity. Mycelium growth revealed a consistent growth pattern, irrespective of the direction of gravity (i.e., horizontal vs. perpendicular). However, the fruiting body grew in the direction opposite to that of gravity once the primordia had formed. For the proteomic analysis, only curved-stem samples were used. Fifty-one proteins were identified and classified into 13 groups according to function. The major functional groups were hydrolases and transferases (16%), signal transduction (15%), oxidoreductases and isomerases (11%), carbohydrate metabolism (9%), and transport (5%). To the best of our knowledge, this is the first report on a proteomic approach to evaluate the molecular response of C. cinerea to gravity.
Carbohydrate Metabolism ; Fruit ; Gravitation* ; Hydrolases ; Isomerases ; Mycelium ; Oxidoreductases ; Proteome ; Signal Transduction ; Transferases

PURPOSE: With the increasing use of antenatal sonography, fetal hydronephrosis has been reported more frequently. But, despite extensive clinical and scientific research much controversy still exists about the assessment and management of hydronephrosis. We performed a retrospective study to determine the frequency of associated malformations and chromosomal defects in prenatally diagnosed hydronephrosis. METHODS: The records of 297 neonates who were diagnosed with hydronephrosis through antenatal ultrasonographic screening, were retrospectively analyzed. They were confirmed at 3 days to 1 month after birth with postnatal ultrasonography in Busan Paik Hospital, between January 2000 and December 2008. We karyotyped 297 neonates after ultrasonographic examination revealed hydronephrosis and malformations. RESULTS: Chromosomal abnormalities were detected in 31 (11%) cases of 297 cases and more common in female than male. The commonest chromosomal abnormality was trisomy 21, followed by Turner syndrome, deletion of autosome, unbalanced translocation. 127 cases in 109 infants had associated malformations such as urogenital and cardiovascular and gastrointestinal anomalies. The associated malformations were more common in moderate to severe hydronephrosis than mild and the number of additional abnormalities increased with the chromosomal defects. CONCLUSION: Particular attention should be paid for the cases in congenital hydronephrosis with any associated malformation such as urogenital and cardiac malformation, to investigate chromosomal abnormalities. This will enable clinicians to establish appropriate management and postnatal care.
Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Hydronephrosis ; Infant ; Infant, Newborn ; Male ; Mass Screening ; Parturition ; Postnatal Care ; Retrospective Studies ; Turner Syndrome

PURPOSE: We report a case of intraocular Thelazia callipaeda infestation in a patient with panuveitis who had a successful recovery after pars plana vitrectomy. METHODS: A 73-year-old female patients complained of a floating sensation and gradually decreasing visual acuity in her right eye. On slit lamp examination, severe intraocular inflammatory reaction was observed. Fundus examination revealed severe vitreous haze with mobile linear structure. Three-port pars plana vitrectomy was performed and then the worm was removed. RESULTS: The worm was confirmed to be Thelazia callipaeda. At postoperative 2 months, the patient's visual acuity was 0.6 and intraocular pressure 14 mmHg. There was no evidence of intraocular inflammatory reaction. CONCLUSIONS: Thelazia callipaeda usually lie in the conjunctival sac or lacrimal apparatus, causing ocular surface disease, but intraocular infestation rarely occurs. If intraocular infestation does occur, early surgical removal should be performed.
Aged ; Female ; Humans ; Intraocular Pressure ; Lacrimal Apparatus ; Panuveitis ; Sensation ; Thelazioidea ; Visual Acuity ; Vitrectomy

Congenital epulis is a rare benign tumor occurring on the anterior maxillary gingiva, also known as granular cell tumor of the newborn or Neumann's tumor, which is seen only in the newborn and is different from other granular cell tumors. Congenital epulis occurs exclusively in female newborns eight to ten fold higher than in males. It can protrude out of the newborn's mouth to prevent normal closure of mouth and interfere with respiration or feeding. The treatment of choice for large symptomatic epulis is simple surgical resection. Wide surgical excision is not required, because no recurrences have been reported. This report describes a case of congenital epulis occurring on the mandibular gingiva, and typical immunohistochemical stain findings.
Female ; Gingiva ; Gingival Diseases ; Gingival Neoplasms ; Granular Cell Tumor ; Humans ; Infant, Newborn ; Male ; Mouth ; Recurrence ; Respiration

The therapeutic efficacy and significance of intraprostatic fosfomycin injection in treating patients with chronic prostatitis were reviewed. During the last 6 years, 350 patients were treated with intraprostatic fosfomycin injection for chronic prostatitis, and among them, 218 patients who could be followed up at least for 3 months were analysed. As for chronic prostatitis, when a patient's WBC count of EPS per high power field remains invariable below 15 for at least 3 months, he is said to be cured. Intraprostatic injection was performed once or twice in all patients and 153 (70.2%) cases were responsive to this treatment. But eleven patients recurred immediately within 3 months after the response. Therefore, final cure rate reached 65.1% (142/218): Adverse effects were rare, if any, they were just trivial symptoms such as mild suprapubic pain or discomfort, transient hematuria and hemospermia. These facts demonstrate that intraprostatic fosfomycin injection has much advantage in patients with chronic prostatitis as treatment modality compared with ordinary method.
Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostatitis*