Lung cancer is one of the most common types of malignancy in western nations with serious health problem, and it has become the leading cause of cancer death of males, second only to stomach cancer, in Korea. A review of the histopathology of 1363 cases (1231 patients) of lung carcinoma, diagnosed at the Keimyung University Medical center from 1987 to 1996, was performed to reclassify the type of carcinomas and to investigate the change in the distribution of histologic types of lung carcinoma according to age, sex and year. Among the 1363 cases, 132 patients underwent a surgical operation after biopsy. The diagnosis of each case was proven by histopathologic analysis of surgical specimens (13.2%) and biopsy materials (86.8%). The histologic types in our study were basically based on modified WHO classification (1982) and on new WHO classification (1999). The classification of small cell carcinoma was based on International Association for the Small Cell Lung Cancer (IASLC, 1988). Of the 1231 patients with lung carcinoma, 1012 were male and 219 were female (male to female ratio was 3.6:1). According to the analysis of age distribution, the most prevalent age group was 60~69 years in both sex as (n=516, 42.0%). Changing trends in sex distribution of lung carcinoma patients showed that the proportion of men had decreased throughout the years, whereas the proportion of women had significantly increased. Histologically, squamous cell carcinoma was the most common (n=624, 50.7%), followed by small cell carcinoma (21.1%), adenocarcinoma (18.1%), large cell undifferentiated carcinoma (2.1%), adenosquamous carcinoma (0.4%), and large cell neuroendocrine carcinoma (0.4%), in order of frequency. In men, squamous cell carcinoma was the most frequent type (55.1%). In women, adenocarcinoma was the most frequent type (39.7%). In both sexes, adenocarcinoma was the most common type in patients under the age of 40 (n=12, 41.4%), while squamous cell carcinoma proved the most frequent type in patients over the age of 40 (n=617, 51.3%). Changing trends of histologic types of lung cancer showed that the incidences of squamous cell carcinoma had significantly decreased throughout the years, whereas those of adenocarcinoma and small cell carcinoma had increased. In conclusion, the results showing increases in the percentage of female patients and in the number of cases of adenocarcinoma were noteworthy, and well correlated with other related reports.
Academic Medical Centers ; Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Lung* ; Male ; Sex Distribution ; Small Cell Lung Carcinoma ; Stomach Neoplasms

The Pill Questionnaire (PillQ) has been proposed as a simple way to evaluate cognitive deficits and their impact on the daily lives of those with Parkinson’s disease (PD) by asking patients or caregivers about whether patients can independently manage their pills. We used the PillQ to investigate the association of ability to manage medication with cognition and activities of daily living (ADLs) in patients with PD. Patients were divided into two groups based on PillQ scores. The no-impact group was able to take their antiparkinsonian medication independently, and the impact group exhibited problems describing their treatment or taking their drugs independently. A total of 208 participants (93 men) were included. 111 patients (53.4%) were included in the no-impact group, and 97 (46.6%) were included in the impact group. The impact group showed significantly lower cognitive functioning, difficulties with the performance of ADLs, and severe motor dysfunction. PillQ scores were significantly correlated with Mini-Mental State Examination and the Montreal Cognitive Assessment, and Clinical Dementia Rating scores. Management of medication by PD patients is associated with cognitive function, and the PillQ is an easy and useful test for detecting cognitive impairment and its impact on daily life.

No abstract available.
Eczema* ; Scrotum ; Syphilis*

Although most of the known pathogenic mutations in the progranulin gene (PGRN) are null mutations leading to a reduction in the serum PGRN protein levels, missense mutations also have been identifi ed in patients with frontotemporal lobar degeneration and in patients with Alzheimer disease. Among these, p.R564C mutation was identifi ed in a late-onset AD patient with a reduced serum PGRN level. However, recently, we found the p.R564C mutation in a healthy control subject raising doubts whether this is a pathogenic mutation. In this report, we measured the serum PGRN levels in 20 subjects without the p.R564C mutation and in one subject with the p.R564C mutation, to determine whether the p.R564C mutation is associated with reduced serum PGRN levels. We found that the serum PGRN level in the subject with the p.R564C mutation was not reduced compared to the subjects without the p.R564C mutation. Our result reiterates that p.R564C may not be a pathogenic mutation.

Use of the rigid ureteroscope has become widely accepted for the removal of ureteral calculi. We evaluated retrospectively the experience with rigid ureteroscopy from March 1992 to February 1993. We performed 68 ureteroscopies for the removal of stone in 67 patients, overall success rate was 86,8%. 52 stones were treated with sedatives only and l6 stones under the anesthesia. The success rates were 86.5% ( 45/52) and 87.5% (l4/l6) each. We failed to remove ureteral stones in 9 case, the failure of ureteroscope introduction was the most common cause of failure. The most common complication was the ureteral mucosal trauma, that was treated by indwelling of ureteral stent. We conclude that ureteroscopy may be an effective and useful procedure for the treatment of 1ower ureter stone (smaller than 10mm in size) under non-anesthesia.
Anesthesia* ; Humans ; Hypnotics and Sedatives ; Retrospective Studies ; Stents ; Ureter* ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

Drug-induced tubulointerstitial nephritis is one cause of acute kidney injury. Although traditional remedies have been widely used in South Korea, Dioscorea quinqueloba-induced tubulointerstitial nephritis has not been reported in the general population. A 72-year-old male patient was transferred to our hospital with pulmonary edema, oliguria, decreased mentality, severe generalized edema after taking D. quinqueloba 25 days ago. His initial lab findings showed a blood urea nitrogen level of 43.4 mg/dL, a creatinine level of 5.3 mg/dL. Urinalysis revealed SG (1.015), blood (many), protein (++) and WBC (0-3/HPF). Kidney biopsy demonstrated severe mononuclear cell infiltration into the renal interstitium with mild tubular atrophy. Aggressive renal replacement therapy and supportive care resulted in gradual restoration of his renal function. This case implies that D. quinqueloba may be one cause that induces tubulointerstitial nephritis in some patients.
Acute Kidney Injury ; Aged ; Atrophy ; Biopsy ; Blood Urea Nitrogen ; Creatinine ; Dioscorea* ; Edema ; Humans ; Kidney ; Korea ; Male ; Nephritis, Interstitial* ; Oliguria ; Pulmonary Edema ; Renal Replacement Therapy ; Urinalysis

Drug-induced interstitial nephritis is one cause of acute kidney injury. Although traditional remedies have been widely used in South Korea, Corni fructus-induced interstitial nephritis has not been reported in the general population. A 65-year-old female patient was admitted with sudden onset of gross hematuria after ingesting Corni fructus tea for 2 weeks. Her initial lab findings showed a blood urea nitrogen level of 35.1 mg/dL, creatinine level of 1.7 mg/dL, albumin level of 4.5 g/dL, and hemoglobin level of 10.3 g/dL. Urinalysis revealed SG (1.025), blood (many), protein (+), and WBC (0-3/HPF). Her 24-hour total protein level was 1,120 mg/day. No specific abnormalities were found on serum and urine protein electrophoresis. Kidney biopsy demonstrated severe mononuclear cell infiltration into the renal interstitium with mild tubular atrophy and pericapsular fibrosis. Immediate withdrawal of Corni fructus, appropriate education, and conservative management resulted in gradual restoration of her renal function. This case implies that Corni fructus may be a causative allergen that induces acute interstitial nephritis in some patients.
Acute Kidney Injury ; Aged ; Atrophy ; Biopsy ; Blood ; Blood Urea Nitrogen ; Cornus ; Creatinine ; Education ; Electrophoresis ; Female ; Fibrosis ; Hematuria ; Hemoglobins ; Humans ; Kidney ; Nephritis, Interstitial* ; Pyridines ; Republic of Korea ; Tea ; Thiazoles ; Urinalysis ; Urine

Drug-induced interstitial nephritis is one cause of acute kidney injury. Although traditional remedies have been widely used in South Korea, Corni fructus-induced interstitial nephritis has not been reported in the general population. A 65-year-old female patient was admitted with sudden onset of gross hematuria after ingesting Corni fructus tea for 2 weeks. Her initial lab findings showed a blood urea nitrogen level of 35.1 mg/dL, creatinine level of 1.7 mg/dL, albumin level of 4.5 g/dL, and hemoglobin level of 10.3 g/dL. Urinalysis revealed SG (1.025), blood (many), protein (+), and WBC (0-3/HPF). Her 24-hour total protein level was 1,120 mg/day. No specific abnormalities were found on serum and urine protein electrophoresis. Kidney biopsy demonstrated severe mononuclear cell infiltration into the renal interstitium with mild tubular atrophy and pericapsular fibrosis. Immediate withdrawal of Corni fructus, appropriate education, and conservative management resulted in gradual restoration of her renal function. This case implies that Corni fructus may be a causative allergen that induces acute interstitial nephritis in some patients.
Acute Kidney Injury ; Aged ; Atrophy ; Biopsy ; Blood ; Blood Urea Nitrogen ; Cornus ; Creatinine ; Education ; Electrophoresis ; Female ; Fibrosis ; Hematuria ; Hemoglobins ; Humans ; Kidney ; Nephritis, Interstitial* ; Pyridines ; Republic of Korea ; Tea ; Thiazoles ; Urinalysis ; Urine

Several therapeutic methods, expectant management, endourology and ESWL can be used in the treatment of ureteral calculi. In a retrospective analysis during a 3-year period, 96 patients showed spontaneous passage of stones. 164 patients treated with endourologic procedures and 168 who underwent ESWL with a Wolf Piezolith 2300 were analysed as to the success rate in stone removal, complication rate, anesthesia and hospitalization. The mean stone size was 5mm in the expectant management group and 6mm in both endourology and ESWL groups. 11mm was the mean size in the surgical group. Complete removal of all stone fragments was achieved in 52.5% of the expectant managed patients. The overall success rate were comparable with modalities which were 94.5% in endourology and 91.4% in ESWL and 100% in ureterolithotomy. The group treated endourologically had a better success rate but no significant difference to ESWL group. On the other hand, the group treated with ESWL had a shorter hospitalization, lower complication rate, no need for anesthesia. These observations showed that in situ ESWL provides a optimal first line therapy for distal ureteral calculi larger than 5mm, while ureteroscopy is better reserved as a salvage procedure should ESWL fail. Expectant management is more efficient for distal ureteral calculi less than 5mm.
Anesthesia ; Hand ; Hospitalization ; Humans ; Retrospective Studies ; Ureter* ; Ureteral Calculi ; Ureteroscopy ; Wolves

Chronic bronchiolitis is a condition associated with cigarette smoking, and later associated with pulmonary parenchymal alteration and progressive deterioration of lung function. Early respiratory bronchiolitis was produced in Sprague-Dawley rats by indirect inhalation of cigarette smoke daily in a smoke exposure chamber designed by authors for 1 month. Experimental group A (n=5) was sacrificed after having smoked 30 cigarettes, group B (n=5) after 80 cigarette, and group C (n=7) after 140 cigarettes, respectively. Examination of morphologic changes in the lungs was done on light microscope, transmission and scanning electron microscopes. Light microscopically, increase in number of goblet cells in the bronchial mucosa, brown-pigmented macrophages in the alveoli, multifocal alveolar collapse adjacent to the bronchioles, dilatation of alveolar ducts and alveolar spaces were observed. Transmission electron microscopically, irregularly shaped Clara cells, alveolar wall collapse, and focally type I epithelial cell injury were seen. Scanning electron microscopically, scattered alveolar collapse, irregular dilatation of alveolar ducts, alveolar spaces and interalveolar pores (pores of Kohn) were seen. The terminal and respiratory bronchioles showed morphological alteration of Clara cells, but no evidence of cellular bronchiolitis or bronchiolar obstruction. We conclude that sidestream smoke induces an early respiratory bronchiolitis including aggregates of brown pigmented macrophages and varying degrees of structural alteration of adjacent pulmonary parenchyma.
Bronchioles ; Bronchiolitis ; Dilatation ; Epithelial Cells ; Goblet Cells ; Inhalation ; Lung ; Macrophages ; Mucous Membrane ; Rats, Sprague-Dawley ; Smoke* ; Smoking ; Tobacco Products*