Primary malignancy of the thymus gland in myasthenia gravis remains rare, especially metastasis of the malignancy to a distant organ. We have presented a case of myasthenia gravis with invasive thymoma and its meatastasis to the diaphragm. The literature concerned with this aspect is reviewed.
Diaphragm ; Humans ; Myasthenia Gravis ; Neoplasm Metastasis* ; Thymoma* ; Thymus Gland

No abstract available.
Asthma* ; Child* ; Eosinophils* ; Humans

No abstract available.
Child* ; Humans ; Hypercalciuria*

Erythropoietic protoporphyria, sometimes also called erythrohepitic protoporphyria or simple protoporphyria, is a heritable detect of heme synthesis in which the last enzyme of the heme synthetic pathway, ferrochelatase(or heme synthetase), is functioning subopt,imally. A 23-year-old male has experi nced erythema and edema on the fae and hands during or immediately after sun exposure, since 3 years of age. The skin lesions have been accompanied by severe itching, a buring sensation and pain. Severe episodes were followed hy head iche and vomiting. We have seen a case of erythropoietic protoporphyria presenting clinically and histo athologically, wit.h a skin lesion on the sun exposured area, and free erthrocyte protoporphyrin serologically.
Edema ; Erythema ; Hand ; Head ; Heme ; Humans ; Male ; Protoporphyria, Erythropoietic* ; Pruritus ; Sensation ; Skin ; Solar System ; Vomiting ; Young Adult

PURPOSE: The purpose of this study was to identify the effects of service orientation on the organizational commitment and management performance of public health center workers. METHODS: A cross-sectional survey design was used. A convenience sample of 280 workers was recruited from six public health centers in J province, South Korea. Data were collected by self-report questionnaires, including general characteristics, service orientation, organizational commitment, and management performance. Data were analyzed with descriptive statistics, Pearson correlation coefficients, independent t-test, one-way ANOVA, and hierarchical regression using the SPSS 22.0 program. RESULTS: The service orientations explained 34.1%of the variance in organizational commitment and explained 31.4% of the variance in management performance. The service orientation was a significant predictor of organizational commitment and management performance. CONCLUSION: The results of this study suggest that better strategies for service orientations will be helpful to enhance organizational commitment and management performance in the public health center.
Cross-Sectional Studies ; Korea ; Public Health*

BACKGROUND: High glucose upregulates MCP-1 expression in rat glomerular mesangial cells and in human peritoneal mesothelial cells. However, the role of high glucose-induced MCP-1 on the development and progression of diabetic renal injury and peritoneal injury during peritoneal dialysis(PD) using high glucose PD solutions are not clear. Since MCP-1 was shown to upregulate transforming growth factor-beta1(TGF-beta1) and collagen expression in lung fibroblasts, the present study investigated the effects of MCP-1 on fibronectin secretion by mouse mesangial cells(MMC), human peritoneal mesothelial cells (HPMC), and human peritoneal fibroblasts(HPFB). METHODS: Synchronized cells were stimulated by different concentrations of MCP-1(0.1-100 ng/mL) or TGF-beta1(0.1-10 ng/mL) for 48 hours. Fibronectin protein secreted into the media was analyzed by Western blot analysis. RESULTS: MCP-1 up to 100 ng/mL did not affect fibronectin secretion by MMC. TGF-beta1 10 ng/mL, however, increased fibronectin secretion by MMC 2.8 fold that of control. MCP-1 up to 100 ng/mL did not affect fibronectin secretion by HPMC. But, TGF-beta1 0.1 ng/mL increased fibronectin secretion by HPMC 1.8 fold compared to control. On the other hand, MCP-1 increased fibronectin secretion by HPFB in a dose-dependent manner. MCP-1 at 1-10 ng/mL significantly increased fibronectin when compared to M199 control. 100 ng/mL MCP-1 further increased fibronectin secretion by HPFB compared to 0.1-10 ng/mL MCP-1. CONCLUSION: These results suggest a possible role for MCP-1 in the development and progression of peritoneal fibrosis and support the view that in addition to recruiting inflammatory cells MCP-1 may play a role in tissue fibrosis in other organs.
Animals ; Blotting, Western ; Chemokine CCL2* ; Collagen ; Fibroblasts* ; Fibronectins* ; Fibrosis ; Glucose ; Hand ; Humans* ; Lung ; Mesangial Cells ; Mice ; Monocytes* ; Peritoneal Fibrosis ; Rats ; Transforming Growth Factor beta1

No abstract available.
Gestational Sac* ; Ultrasonography*

BACKGROUND: Suction auto epidermal graft for the treatment of stable vitiligo has become popular clinically. In general, depigmented epidermis is removed by liquid nitrogen freezing for preparation of the recipient site. There have been some problems with the nitrogen freezing method, uneven repigmentation, appearance of Koebner's phenomenon on normal colored skin around the graft site, scar formation on recipients sites. In our view these resulted in unwanted damage to the dermis and epidermal and skin appendageal melanocytes of normal skin by freezing. OBJECTIVE: To introduce a method to remove the depigmented epidermis of recipient site with minimal unwanted damage to melanocytes and dermal tissue. METHODS: Using Ellman surgitron, irradiation equipment of 3.8MHz frequency the depigmented epidermis was removed with a blade electrode under rated electric power around 10 watts depending on the thickness of the epidermis. Operating mode was fully filtered current for minimal charring and destruction of tissue through pure micro-smooth cutting. RESULTS: In the case of removal of the epidermis with Ellman surgitron, oozing and inflammation decreased markedly compared with those applied with liquid nitrogen. And it was confirmed histopathologically that there was no significant unwanted destruction of healthy tissue. Moreover, the electrode of Ellman surgitron is designed to be apt to trace the margin of depigmented lesion. And Ellman surgitron features a continuously linear intensity setting for precise, predictable control to minimize tissue destruction and charring. So we were able to remove the epidermis of the shallow lesion looking like a pseudopod and of the thinnest part of the body like eyelid also. And we grafted normal epidermis successfully on the depigmented lesion. CONCLUSION: The removal of depigmented epidermis by radio-frequency gave satisfactory results in the suction auto epidermal graft by overcoming the defects shown as depigmented epidermis which were removed by liquid nitrogen freezing. And this method made patients comfortable because of less pain, a one day operation procedure and good results.
Cicatrix ; Dermis ; Electrodes ; Epidermis* ; Eyelids ; Freezing ; Humans ; Inflammation ; Melanocytes ; Nitrogen ; Skin ; Suction* ; Transplants* ; Trout ; Vitiligo

Intensive insulin therapy effectively delays the onset and slows the progression of nephropathy in patients with IDDM. TGF- 0 has recently been implicated in the pathogenesis of diabetic nephropathy. We evaluated the effects of different level of glucose control with insulin therapy on the progression of diabetic nephropathy in age-matched control rats(C) and 3 groups of streptozotocininduced diabetic rats', high blood glucose diabetic rats without insulin therapy(HG), rnoderate glucose diabetic rats with insulin therapy(MG), and normal glucose diabetic rats with intensive insulin treatment (NG). Glomerular volume(VG) was measured using Image-Pro morphometric software, glomerular TGF- Bl mRNA expression by in situ hybridization, and glomerular expression of TGF-8 and type IV collagen proteins by immunohistochemical staining. VG was significantly higher in HG than in other groups in 12 weeks. Kidney weight(KW) was the highest while the body weight the lowest in HG of all groups in 12 weeks. Daily urine albumin excretion (UAE) increased with time in all groups but was significantly larger in HG than in all other groups in 12 weeks. MG also had significantly larger UAE than C in 12 weeks. There was no difference in VG, KW, and UAE between NG and C. Glomerular TGF-Bl mRNA expression was significantly higher in HG than in all the rest of the groups in 4 and 12 weeks. Glomerular expression of TGF-B and type IV collagen proteins was proportional to the levels of blood glucose, being the highest in HG in 12 weeks. There was little or no expression of TGF-0 1 mRNA and protein or type IV collagen protein in NG. Thus these results support the view that high blood glucose is the prerequisite for glomerular injury in diabetes mellitus and that the glomerular injury in diabetes mellitus is mediated, in part, by TGF-01 and suppressed by glucose control.
Animals ; Blood Glucose* ; Body Weight ; Collagen Type IV ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies* ; Glucose ; Humans ; In Situ Hybridization ; Insulin* ; Kidney ; Rats ; RNA, Messenger

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginally administered misoprostol(PGE1) versus dinoprostone(PGE2) for labor induction in a prospective controlled trial. METHOD: One hundred eleven patients for labor induction (including preterm rupture of membranes) were randomly assigned to receive either misoprostol 50microgram or dinoprostone 3mg intravaginally. The interval of doses was 8 hours after first dose, with a potential maximum of six dose until active labor pain was achieved. RESULTS: Among 111 patients enrolled, 55 were randomized to receive misoprostol 50microgram and 56 to receive dinoprostone 3mg with every 8 hours interval intravaginally. There were no significant differences in demographic characteristics except in Bishop score(3.81+/-1.52 vs 4.38+/-1.29, P<0.05). There were no significant differences in indications for labor induction. The interval of induction to delivery was shorter in the misoprostol group(750.8+/-518.8min) than in the dinoprostone group(1264.1+/-730.7min). Delivery within 24 hours after administration occurred more often in the misoprostol group than in the dinoprostone group (86.3% vs 65.2%, P<0.05). More than two doses for completion of delivery were frequent in dinoprostone group(36.96% vs 9.8% in misoprostol group, P<0.05). Additional Oxytocin augmentation was needed more commonly in the misoprostol group(3.64%) than in the dinoprostone group(14.29%)(P<0.05), but no significant differences were noted between two groups in total oxytocin doses and indications. Tachysystole occurred more often in the misoprostol group (12.73% vs 1.79% in the dinoprostone, P<0.05) Precipitating delivery occurred more commonly in the misoprostol group(21.82% vs 7.14% in the dinoprostone group, P<0.05). No differences in the cesarean section rate, fetal heart rate abnormalities, hyperstimulation syndrome, meconium staining, fetal outcome (Apgar score at 1 and 5 minutes, birth weight), and marternal outcome (nausea and vomitting, postpartum bleeding) were noted. The cost of misoprosl is one hundredth cheaper than dinoprostone. There was no significant differences in the fetal outcome and maternal outcome. CONCLUSION: These results suggest that intravaginal misoprostol(PGE1) is a safe drug for labor induction which is more effective and cheaper compare to intravaginal dinoprostone(PGE2).
Alprostadil* ; Cesarean Section ; Dinoprostone* ; Female ; Heart Rate, Fetal ; Humans ; Labor Pain ; Meconium ; Misoprostol* ; Oxytocin ; Parturition ; Postpartum Period ; Pregnancy ; Prospective Studies ; Rupture