OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.
Aneurysm ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Cardiovascular Diseases ; Death, Sudden ; Education ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Heart Ventricles ; Humans ; Korea ; Male ; Myocardium

PURPOSE: To investigate the neuroprotective effect of Ginexin (Ginkgo biloba extract) on rat retinal ganglion cell in the optic nerve crush injury model. METHODS: From 1 week before the optic nerve injury, Ginexin 100 mg/kg/day (100 mg group), 200 mg/kg/day (200 mg group) or carboxymethylcellulose as a control group (CMC group) was administrated orally 4 weeks in Spraque-Dawley rats. At 3 weeks after the optic nerve injury, the RGCs were counted and the concentration of intravitreal glutamate was measured. RESULTS: The RGC density of CMC group (103+/-22 cells/mm2) was significantly lower than that of 100 mg group (182+/-39 cells/mm2) and 200 mg group (201+/-63 cells/mm2). There was no difference between the 100 mg group and 200 mg group. The concentration of invtravitreal glutamate did not significantly differ among normal, CMC group, 100 mg group and 200 mg group. CONCLUSIONS: Ginexin increased the survival of the retinal ganglion cell in rat optic nerve crush injury model, but, did not influence on the concentration of intravitreal glutamate.
Animals ; Carboxymethylcellulose Sodium ; Glutamic Acid ; Neuroprotective Agents* ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Retinal Ganglion Cells* ; Retinaldehyde*

Lipoma is a common benign neoplasm, but lipoma arising from the pleura is rare. Most pleural lipomas are asymptomatic and are discovered incidentally on chest radiographs. Here we report an unusual case of a pedunculated subpleural lipoma with incomplete torsion in a 29-year-old woman who presented with flank pain. On chest radiography, there was a well-defined, ellipsoidal, homogeneous, radioopaque mass in the left lower lobe. An intrathoracic tumor was suspected, and video-assisted thoracic surgery was performed to establish the final diagnosis. The resected tumor was a 10 X 5 cm sized pedunculated pleural mass. The cut surface showed a yellow, well-circumscribed mass with areas of hemorrhage. Histologically, the tumor was composed of mature adipose tissue with fibrous septae composed of fibroblasts. The outer surface of the tumor was covered by mesothelial cells. Some areas were hypercellular, and occasional mitoses were found, but neither lipoblasts nor atypical mitoses were identified.
Adipose Tissue ; Adult ; Benzeneacetamides ; Female ; Fibroblasts ; Flank Pain ; Hemorrhage ; Humans ; Lipoma ; Mitosis ; Piperidones ; Pleura ; Thoracic Surgery, Video-Assisted ; Thorax

Objectives ; This study was conducted to reveal the health effects of aircraft noise on the residents live near the military airport. METHODS: We sampled systematically 87 residents as the high exposed group, 58 residents as the low exposed group according to the geographical distance from the airport. We also sampled 67 residents as the control group lived far from the airport. Noise levels were measured for conform the exposures. Self-administered questionnaires for symptoms, air conduction hearing threshold level, blood pressure blood cholesterol with health examinations, and SCL-90-R were introduced to get the data from the residents. RESULTS: The Ld/n at the area near the airport was 72.4 dB, however that of control area was 67. 7 dB. The value of pure tone average, high pure tone average, and threshold of 4,000 Hz were decreased with exposure level significantly. Linear regression analysis showed that the noise exposure level of the airport was related to the hearing threshold at pure tone average, threshold of 4,000 Hz, and high pure tone average. The systemic and diastolic blood pressure showed dose-response relationship with noise exposure. The prevalence of hypertension was higher in exposed group, but not statistically significant. In linear regression, noise level was related to systolic and diastolic blood pressure with other variables such as age, sex, BMI (Body Mass Index), and family history of hypertension. SCL-90-R showed that exposed group had higher score significantly in neurotic and psychologic variable and felt the various somatic symptoms. CONCLUSIONS: These results suggest that aircraft noise would influence hearing loss at low frequencies as well as 4,000 Hz and higher frequencies, systolic and diastolic blood pressure, and psychological response.
Aircraft* ; Airports* ; Blood Pressure ; Cholesterol ; Hearing ; Hearing Loss ; Humans ; Hypertension ; Linear Models ; Military Personnel ; Noise* ; Prevalence ; Questionnaires

Adipsic hypernatremia is a rare disorder of hypothalamic osmoreceptor dysfunction for thirst. It is frequently associated with a deficiency in antidiuretic hormone (ADH) release. We report the first case in Korea of adipsic hypernatremia combined with subnormal ADH response to osmotic stimuli without any demonstrable structural lesion. A 69-year-old woman was admitted to the hospital with general weakness. In a hypernatremic hyperosmolar state, she denied thirst and did not drink spontaneously. Her plasma ADH level was markedly subnormal but she had no large volume of dilute urine. Investigation of osmoregulation by infusion of hypertonic saline revealed adipsia and an absolute deficiency in antidiuretic hormone release, despite a serum osmolarity in excess of 321 mOsmol/kg. There was no structural lesion of the hypothalamus and no abnormal finding in hypothalamic-pituitary function. After diagnosis, she was treated successfully with intentional water intake alone.
Aged ; Female ; Humans ; Hypernatremia ; Hypothalamus ; Korea ; Osmolar Concentration ; Plasma ; Thirst ; Water-Electrolyte Balance

Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of skeletal muscle, elevation of muscle enzyme levels, and abnormality of electromyographical change. Its pathogenesis is unclear. Paraneoplastic syndromes are caused by malignant tumors, although not through direct effects of the primary tumor or its metastases. Several paraneoplastic syndromes, including erythrocytosis, hypoglycemia, and hypercholesterolemia, have been reported in patients with hepatocellular carcinoma. A few cases of polymyositis associated with hepatocellular carcinoma and one case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection have been reported. Skeletal muscle injuries without trauma, including metabolic myopathy, effects of certain drugs and toxins, infection, electrolyte imbalances, and endocrine disorders, may cause rhabdomyolysis. We present here a case of primary liver cancer associated with polymyositis and rhabdomyolysis.
Carcinoma, Hepatocellular ; Hepatitis B, Chronic ; Humans ; Hypercholesterolemia ; Hypoglycemia ; Inflammation ; Liver ; Liver Neoplasms ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Muscular Diseases ; Neoplasm Metastasis ; Paraneoplastic Syndromes ; Polycythemia ; Polymyositis ; Rhabdomyolysis ; Viruses

Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of skeletal muscle, elevation of muscle enzyme levels, and abnormality of electromyographical change. Its pathogenesis is unclear. Paraneoplastic syndromes are caused by malignant tumors, although not through direct effects of the primary tumor or its metastases. Several paraneoplastic syndromes, including erythrocytosis, hypoglycemia, and hypercholesterolemia, have been reported in patients with hepatocellular carcinoma. A few cases of polymyositis associated with hepatocellular carcinoma and one case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection have been reported. Skeletal muscle injuries without trauma, including metabolic myopathy, effects of certain drugs and toxins, infection, electrolyte imbalances, and endocrine disorders, may cause rhabdomyolysis. We present here a case of primary liver cancer associated with polymyositis and rhabdomyolysis.
Carcinoma, Hepatocellular ; Hepatitis B, Chronic ; Humans ; Hypercholesterolemia ; Hypoglycemia ; Inflammation ; Liver ; Liver Neoplasms ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Muscular Diseases ; Neoplasm Metastasis ; Paraneoplastic Syndromes ; Polycythemia ; Polymyositis ; Rhabdomyolysis ; Viruses

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the human liver. However, the molecular changes and mechanisms that regulate the development and progression of HCC remain unclear. Beta-catenin is known as a multi-functional protein that acts as a regulator of the cadherin-mediated cell-cell adhesion system and also in the Wingless/Wnt signal transduction pathway. The aim of this study was to investigate the expression of beta-catenin and its possible role in HCC. METHODS: We investigated the expression of beta-catenin, Ki-67, TP53, alpha-smooth muscle actin and CD34 by performing immunohistochemical staining for 61 specimens of HCC and their adjacent non-tumorous tissue. We also examined the relationship between the nuclear expression of beta-catenin and the clinicopathologic parameters. RESULTS: The altered expression of beta-catenin was not detected in the nontumorous liver tissue. The nuclear expression of beta-catenin was observed in approximately 16% (10/61) of the HCC specimens. Double immunohistochemical staining for beta-catenin and E-cadherin showed a close relationship between nuclear translocation of beta-catenin and the loss of the membranous E-cadherin expression. Significant correlation was found between the nuclear translocation of beta-catenin and the tumor size, tumor necrosis and the presence of microvessel invasion and intrahepatic metastasis (p<0.05). CONCLUSIONS: This data indicates that nuclear translocation of beta-catenin could play a role in the growth and progression of HCC.
Humans ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

BACKGROUND/AIMS: P2/MS is known as a simple, accurate, and noninvasive marker for determination of the degree of hepatic fibrosis in patients with viral hepatitis. We aimed to validate P2/MS in patients with HCC. METHODS: Consecutive HCC patients who underwent surgical resection between June 2007 and March 2009 at Seoul National University Hospital were enrolled. Fibrosis stage was reviewed and assessed according to METAVIR scoring. P2/MS values [platelet count (109/L)]2/[monocyte fraction (%)xsegmented neutrophil fraction (%)] and other noninvasive fibrosis scoring systems were calculated. RESULTS: A total of 171 patients were included; seven patients with METAVIR F1, 31 with F2, 41 with F3, and 92 with F4. The area under the receiver-operating characteristic curve of P2/MS was 0.804 [95% confidence interval (CI), 0.681~0.927] for detection of significant fibrosis (F2-F4) and 0.769 (95% CI, 0.698~0.839) for detection of histological cirrhosis (F4). At a value < 62, P2/MS detected significant fibrosis with a specificity of 85.7% (95% CI, 42.0~99.2) and a positive likelihood ratio of 4.268 (95% CI, 0.692~26.309); and at a value > 115, P2/MS ruled out significant fibrosis with a sensitivity of 90.2% (95% CI, 84.4~94.1) and a negative likelihood ratio of 0.34 (95% CI, 0.106~0.095). P2/MS had a superior efficacy for detection of hepatic fibrosis in patients with HCC compared to the other noninvasive panels. CONCLUSIONS: P2/MS can accurately detect fibrosis in patients with HCC. Thus, P2/MS might be utilized as a noninvasive index reflecting the degree of hepatic fibrosis in HCC patients.
Aged ; Area Under Curve ; Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Cohort Studies ; Female ; Health Status Indicators ; Humans ; Liver Cirrhosis/complications/*diagnosis/pathology ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Monocytes/cytology ; Neoplasm Staging ; Neutrophils/cytology ; Platelet Count ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Severity of Illness Index

PURPOSES: To investigate the viral etiology of community-acquired pneumonia in Korean adults, we have detected respiratory viruses (Respiatory syncytial virus, adenovirus, influenza virus and parainfluenza virus) in the way of prospective, multi-center study. METHODS: From July 1997 to April 2000, nasal aspirates or sputum were obtained from adults patients with community pneumonia admitted to the participating hospitals and transferred immediately to the central laboratory in the Seoul National University Children's Hospital. The specimens were divided into three parts. One part was used for indirect immunofluorescent test for respiratory viruses, the other part for the culture of RSV and adenovirus in HEp-2 cell monolayer. Another part was used for the culture of influenza virus and parainfluenza virus in MDCK or LLC- MK2 cell monolayers. RESULTS: Of 317 samples, 32 (10.1%) specimens were positive for viral isolation by indirect IF staining or culture, including one dual-infected specimen (adenovirus and parainfluenza virus). Influenza virus was most commonly detected (16 specimens). Parainfluenza virus, adenovirus and RSV were detected in 10, 4 and 3 patients, respectively. All isolated influenza viruses were type A (H3N2 in 9 patients, H1N1 in 2 and unspecified in 5), and 8 out of 10 parainfluenza virus isolates were type 3. CONCLUSION: Similar to previous foreign reports, a significant portion of community-acquired pneumonia in Korean adult is caused by respiratory viruses. Our data empathized the need of referral system for viral diagnosis and of nationwide investigation on respiratory virus infections.
Adenoviridae ; Adult* ; Diagnosis ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia* ; Prospective Studies ; Referral and Consultation ; Seoul ; Sputum