BACKGROUND: Colorectal cancer in Korea has become more prevalent over the few last decades, and calcium is considered a preventive factor for colorectal cancer development. We examined the associations between total and dietary calcium intake and the prevalence of colorectal adenoma in Korean adults. METHODS: This cross-sectional study included 112 colorectal adenoma cases and 252 adenoma-free non-cases, aged 45 to 71 years, who underwent colonoscopies at the Daegu Catholic University Medical Center from August 2011 to September 2012. Participants were asked about their diet using a validated food frequency questionnaire and about supplement use through interviews. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between total and dietary calcium intake and the prevalence of colorectal adenomas using multivariable logistic regression models. RESULTS: Increasing total calcium intake from foods and supplements was significantly associated with a decreased prevalence of colorectal adenoma in women; comparing the highest quartile with the lowest quartile, the OR (95% CI) was 0.35 (0.15-0.85; P for trend = 0.03). Likewise, high dietary calcium intake from foods was associated with a lower prevalence of colorectal adenoma in women; compared with the lowest quartile, the ORs (95% CIs) were 0.32 (0.13-0.82) for the 3rd quartile and 0.44 (0.19-1.03; P for trend = 0.13) for the 4th quartile. However, the association was not clear for either total or dietary calcium intake among men. CONCLUSIONS: A higher intake of calcium was associated with a reduction of colorectal adenoma prevalence in Korean women.
Academic Medical Centers ; Adenoma* ; Adult* ; Calcium ; Calcium, Dietary* ; Colonoscopy ; Colorectal Neoplasms ; Cross-Sectional Studies ; Daegu ; Diet ; Female ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Prevalence

Struma ovarii is a monodermal and highly specialized teratoma which is composed predominantly or entirely of thyroid tissue. It is rare tumor accounting for 2.7% of ovarian mature cystic teratoma. Most of the tumors are benign. Malignant change has been reported in approximately 5% of cases. We have experienced a case of struma ovarii with brief review of the literature.
Struma Ovarii* ; Teratoma ; Thyroid Gland

Heterotopic pregnancy is a condition in which ectopic and intrauterine pregnancies coexist. The reported incidence varies widely from 1 in 1000 to 1 in 30000 pregnancies. Assisted reproductive technologies have led to an increase in the number of heterotopic pregnancies. Because heterotopic pregnancy is difficult to diagnose early and it has high morbidity and mortality rate, careful pelvic examination combined with transvaginal sonogram and serial beta-HCG determinations are important. We experienced a case of heterotopic pregnancy in a natural cycle diagnosed by ultrasonogram who continued intrauterine pregnancy successfully.
Gynecological Examination ; Incidence ; Mortality ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted ; Ultrasonography*

BACKGROUND: Idiopathic membranous nephropathy (IMN) causes variable clinical courses, such as from asymptomatic urinary abnormalities, nephrotic syndrome to end-stage renal failure. We evaluated clinical findings and effects of steroid and steroid with chlorambucil in patients with IMN. METHODS: We reviewed 37 cases of biopsy-proven patents of IMN whose follow-up duration was at least 2 years, retrospectively. The mean follow-up duration of the cases was 74 +/- 49 months. In the cases of steroid therpy, prednisolone 40, 50 or 60 mg/day was given for maximal 16 weeks. Steroid-chlorambucil treatment was done for the cases of no response or relapse after steroid therapy, severe nephrotic syndrome or elevated serum creatinine more than 1.2 mg/dL. We did 3 cycles of treatment. Every cycle was consisted of intravenous 1 gram of methylprednisolone for 3 days followed by prednisolone 0.5 mg/kg/day orally for 27 days then chlorambucil 0.2 mg/kg/day for 28 days. Therapeutic results were evaluated. RESULTS: The mean age was 41 +/- 15 years and 5-6th decade was 48.6%. Male to female ratio was 1.3 : 1. Nephrotic syndrome was in 86.5% in the cases. The results of prednisolone therapy was done in 25 cases were 20% of complete remission (CR), 28% of patial remission (PR) and 52% of no respone (NR). There was no difference between the response rate and dosage of prednisolone. Steroid-chlorambucil therapy was done in 18 cases totally, 5 cases in the first treatment and 13 cases of no response or relapsed cases after prednisolone treatment. The results were 22.2% of CR, 50% of PR and 27.8% of NR. This results were no difference between steroid and chlorambucil combined therapy. Spontaneous remission was observed 35.1% of the total cases, 21.6% of spontaneous CR and 13.5% of spontaneous PR after the final observations. The final results were 16.2% of CR and 10.8% of PR after prednisolone or chlorambucil combined therapy. Progressive renal disease were developed in 6 cases (16.2%) and the mean renal surval time measured by projected reciprocal creatinine from diagnosis to the point of 0.1 was 129 +/- 79 months. CONCLUSION: Nephrotic syndrome was presented in 86.5% of cases and with high remission rates such as 37.8% of complete and 24.3% of partial remission in IMN. Progressive renal failure was occurred in 16.2% of cases and most of the cases progressed very slowly. There was no different results between steroid alone and chlorambucil combined therapy.
Adult* ; Chlorambucil ; Creatinine ; Diagnosis ; Female ; Follow-Up Studies ; Glomerulonephritis, Membranous* ; Humans ; Kidney Failure, Chronic ; Male ; Methylprednisolone ; Nephrotic Syndrome ; Prednisolone ; Recurrence ; Remission, Spontaneous ; Renal Insufficiency ; Retrospective Studies

Primary splenic lymphoma (PSL) is very rare, with a reported incidence of less than 1% of all malignant lymphomas. The differential diagnosis of a solitary splenic mass should include benign entities, such as hemangioma, hamartoma, simple cyst, and metastatic carcinoma, as well as abscess. We report a case of primary splenic lymphoma presenting as a splenic abscess. A 27-year-old man presented with left upper quadrant pain for 3 days. Abdominal computed tomography (CT) revealed a splenic mass, a well-defined hypodense lesion (4.5*4 cm) in the posterosuperomedial aspect of the spleen. The patient improved clinically with percutaneous drainage of the spleen cystic mass and antibiotic therapy. After 8 months, he presented again with left upper quadrant pain and fever. Abdominal CT revealed progression of the splenic mass (5*.5 cm) with some internal hemorrhage. The patient underwent splenectomy for a definitive diagnosis and treatment. At surgery, a splenic tumor was found with no evidence of it involving other sites, and it was confirmed pathologically as a diffuse large B cell lymphoma of the spleen.
Abscess ; Adult ; Diagnosis, Differential ; Drainage ; Fever ; Hamartoma ; Hemangioma ; Hemorrhage ; Humans ; Incidence ; Lymphoma ; Lymphoma, B-Cell ; Spleen ; Splenectomy

To evaluate the role of vascular endothelial growth factor (VEGF) in the pathogenesis of preeclampsia, we measured total VEGF, free VEGF and soluble Flt-1 (sFlt-1) concentrations and determined their relationships. Maternal serum samples were collected from 20 patients with preeclampsia and 20 normotensive women with uncomplicated pregnancies matched with the patients with preeclampsia for gestational age and parity. The serum concentrations of total VEGF (2.39+/-0.75 vs. 0.28+/-0.14) and sFlt-1 (934.5+/-235.5 vs. 298.0+/-161.2) were significantly increased in the patients with preeclampsia compared to the women with uncomplicated pregnancies. However the serum concentration of free VEGF (21.5+/-6.3 vs. 134.0+/-16.3) was lower in patients with preeclampsia. There was a positive correlation between the serum concentrations of total VEGF and sFlt-1 with systolic and diastolic blood pressure, respectively. There was a negative correlation between the serum concentration of free VEGF and systolic and diastolic blood pressure. There was a strong negative correlation between free VEGF and sFlt-1 concentrations. In conclusion, we found VEGF and sFlt-1 were related to the pathogenesis of preeclampsia. Although reduced concentrations of free VEGF might interfere with endothelial cell function and survival, further studies are required to clarify its specific role in the pathogenesis of preeclampsia.
Vascular Endothelial Growth Factor Receptor-1/*blood ; Vascular Endothelial Growth Factor A/*blood/physiology ; Pregnancy ; Pre-Eclampsia/*blood/etiology ; Humans ; Female ; Adult

There are little data on the changes in lymph node (LN) size during the treatment of tuberculous lymphadenopathy (TB LAP). This study aimed to provide data on LN changes during treatment. Between March 2014 and December 2015, 20 patients who were diagnosed with cervical TB LAP were enrolled. LN enlargement within two months (50%, 4/8 vs. 8.3%, 1/12; P = 0.04) was more frequently observed in patients with initial LN size ≥ 7.5 cm². Enlarged LNs were excised in three patients owing to pain and fistula formation. Initial LN size may be associated with LN enlargement during treatment.
Fistula ; Humans ; Lymph Nodes* ; Lymphatic Diseases* ; Tuberculosis

A girl (age, 12 years 11 months) consulted the pediatric endocrinology clinic because of a rapidly growing right breast mass over 13 cm observed during the preceding 3 months. A surgical excision was performed, and the mass was diagnosed as a giant juvenile fibroadenoma. Giant juvenile fibroadenomas are rare, usually occurring between 10 and 18 years of age, and characterized by massive and rapid enlargement of an encapsulated mass. The etiology is believed to be an end-organ hypersensitivity to normal levels of estrogen. We report a case of giant juvenile fibroadenoma and present a review of the diagnostic workup and management of a large breast tumor during adolescence.
Adolescent ; Breast Neoplasms ; Breast* ; Endocrinology ; Estrogens ; Female ; Fibroadenoma* ; Humans ; Hypersensitivity

Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg. However, after a delivery of the second baby by cesarean section in Jul 2016, most of small bowel was herniated through Peterson’s defect, and emergent massive small bowel resection was performed. Thereafter, she visited our hospital for the purpose of intestinal reconstruction. In Sep 2016, she received side–to-side gastrogastrostomy and revision of double barrel enterostomy. The remaining small bowel included whole duodenum, 30 cm of proximal jejunum, and 10 cm of terminal ileum. Pylorus and ileocecal valves were intact. The patient given only PN after surgery was provided rice-based soft fluid diet after 10 day of operation. Through intensive nutritional management care, she could start solid meals, and finally stop the PN and eat only orally at 45 days postoperatively. Three nutritional interventions were conducted over 2 months after the patient was discharged. She did not require PN during this period, and maintained her weight within the normal weight range. Similar interventions could be used for other patients with malabsorption problems similar to SBS.
Bariatric Surgery* ; Cesarean Section ; Diet ; Duodenum ; Enterostomy ; Female ; Gastric Bypass ; Humans ; Ileocecal Valve ; Ileum ; Jejunum ; Meals ; Nutritional Status ; Nutritional Support ; Obesity, Morbid ; Parenteral Nutrition ; Pregnancy ; Pylorus ; Seoul ; Short Bowel Syndrome*

PURPOSE: It has been reported that low-level semiconductor diode lasers could enhance the wound healing process. The periodontal ligament is crucial for maintaining the tooth and surrounding tissues in periodontal wound healing. While low-level semiconductor diode lasers have been used in low-level laser therapy, there have been few reports on their effects on periodontal ligament fibroblasts (PDLFs). We performed this study to investigate the biological effects of semiconductor diode lasers on human PDLFs. METHODS: Human PDLFs were cultured and irradiated with a gallium-aluminum-arsenate (GaAlAs) semiconductor diode laser of which the wavelength was 810 nm. The power output was fixed at 500 mW in the continuous wave mode with various energy fluencies, which were 1.97, 3.94, and 5.91 J/cm2. A culture of PDLFs without laser irradiation was regarded as a control. Then, cells were additionally incubated in 72 hours for MTS assay and an alkaline phosphatase (ALPase) activity test. At 48 hours post-laser irradiation, western blot analysis was performed to determine extracellular signal-regulated kinase (ERK) activity. ANOVA was used to assess the significance level of the differences among groups (P<0.05). RESULTS: At all energy fluencies of laser irradiation, PDLFs proliferation gradually increased for 72 hours without any significant differences compared with the control over the entire period taken together. However, an increment of cell proliferation significantly greater than in the control occurred between 24 and 48 hours at laser irradiation settings of 1.97 and 3.94 J/cm2 (P<0.05). The highest ALPase activity was found at 48 and 72 hours post-laser irradiation with 3.94 J/cm2 energy fluency (P<0.05). The phosphorylated ERK level was more prominent at 3.94 J/cm2 energy fluency than in the control. CONCLUSIONS: The present study demonstrated that the GaAlAs semiconductor diode laser promoted proliferation and differentiation of human PDLFs.
Alkaline Phosphatase ; Blotting, Western ; Cell Proliferation ; Extracellular Signal-Regulated MAP Kinases ; Fibroblasts ; Humans ; Low-Level Light Therapy ; Lasers, Semiconductor ; Periodontal Ligament ; Phosphotransferases ; Semiconductors ; Tooth ; Wound Healing