Black adenoma is known to be a rare variant of adrenal cortical adenoma containing characteristic abundant lipofuscin pigments in the cytoplasm. Almost all of them are nonfunctioning and only occasionally they are associated with Cushing's syndrome or primary hyperaldosteronism. We present two cases of black cortical adenoma of the adrenal gland associated with Cushing's syndrome in a 24-year-old woman and a 64-year-old man. This report dealt with clinical and pathologic presentation including ultrastructural identification of lipofuscin pigment.
Female ; Male ; Humans ; Adenoma

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

BACKGROUND: Recently, the incidence of nonalcoholic fatty liver disease (NAFLD) has been growing rapidly. Corrected QT (QTc) interval prolongation is known to be associated with the risk of coronary heart disease. In this study, our aim was to establish whether NAFLD diagnosed using ultrasonography is associated with QTc intervals in Korean adult men.METHODS: We recruited 1,155 Korean adult men who visited the Gangnam Severance Hospital health promotion center between October 2007 and July 2010. The participants underwent liver ultrasonography according to a standardized protocol, which confirmed the diagnosis of NAFLD. Standard electrocardiography was performed for analysis of the QTc interval.RESULTS: The 1,155 participants had a mean QTc interval of 430.7±21.2 ms. Of them, 366 had a QTc interval ≥440 ms. The values of the QTc interval increased in relation to the severity of NAFLD. After adjustment for confounders, QT interval prolongation was significantly associated with NAFLD in the severe NAFLD group. The odds ratios were 2.102 (95% confidence interval [CI] 1.536–2.877) (model 1), 1.986 (95% CI 1.399–2.819) (model 2), and 1.960 (95% CI 1.347–2.851) (model 3).CONCLUSION: QTc interval prolongation was significantly associated with NAFLD severity in Korean adult men. Depending on the severity of NAFLD, QTc intervals were prolonged. QTc interval length is easily determined and may contribute to cardiovascular risk stratification in male patients with NAFLD.
Adult ; Coronary Disease ; Diagnosis ; Electrocardiography ; Fatty Liver ; Health Promotion ; Humans ; Incidence ; Liver ; Male ; Non-alcoholic Fatty Liver Disease ; Odds Ratio ; Ultrasonography

Objectives: ：The turnover rate of mental health workers in community mental health institutes is remarkably high.We explored the mediating effects of perceived work value on the relationship between burnout and turnover intention among mental health professionals working for community mental health centers and addiction centers. Methods: ：A total of 161 mental health workers completed this survey. We administered the Maslach Burnout Inventory-General Survey (MBI-GS) and the Michigan Organizational Assessment Questionnaire (MOAQ) (which explores turnover intention). Perceived work value was assessed using two items of the Scale of Resilience to Burnout.Associations were sought using the t-test, analysis of variance, correlation analyses, and hierarchical regression analyses. Results: ：The burnout level was significantly negatively correlated with perceived work value. Burnout was significantly positively correlated with turnover intention, and perceived work value significantly negatively correlated. Bootstrapping showed that perceived work value partially mediated the relationship between burnout and turnover intention. Conclusion ：Perceived work value may buffer turnover intention caused by burnout. Creation of an environment in which mental health workers feel that their work is valuable is important to prevent resignations.

Emphysematous pyelitis is uniquely characterized by gas-forming infection restricted to the renal collecting system. This disease entity is uncommon, and shows preferred occurrence in patients with diabetes mellitus or urinary tract obstruction. We report a case of bilateral emphysematous pyelitis in a diabetic end-stage renal disease patient undergoing peritoneal dialysis therapy. The patient was treated by medical treatment only and then recovered from infection, and she has maintained peritoneal dialysis until today. The authors report this case as a successful medical treatment for emphysematous pyelitis accompanying multiple risk factors, such as diabetes mellitus, amorphous medullary kidney stones, and even underlying maintaining peritoneal dialysis.
Diabetes Mellitus ; Humans ; Kidney Calculi ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Pyelitis ; Risk Factors ; Urinary Tract

In Korea, Plasmodium vivax (P. vivax) is the most common agent of malaria infection. However, as travel to regions where malaria is endemic increases, so do the numbers of Plasmodium falciparum and mixed infections. P. falciparum predominates, while P. vivax is rare in west-central Africa. We report on a case of mixed malaria infection with severe hemolytic anemia caused by P. falciparum and P. vivax in a 38-year-old man after traveling to Angola. A diagnosis of P. falciparum malaria was made by microscopic examination. However, both P. vivax and P. falciparum were detected by the polymerase chain reaction (PCR). As a radical cure P. vivax, the patient was treated with mefloquine, artemether, and primaquine. Both P. falciparum and P. vivax had disappeared from peripheral blood by admission day 4, however, low grade fever and headache persisted, and his hemoglobin and hematocrit levels were depleted. A peripheral blood smear was negative for both P. vivax and P. falciparum; however, a direct anti-globulin test and anti-nuclear antibody test were positive, suggesting immune hemolytic anemia. After conservative treatment, which included a transfusion with packed red blood cells (RBC), his symptoms and signs showed improvement and laboratory findings were normalized.
Adult ; Africa ; Anemia, Hemolytic ; Angola ; Artemisinins ; Coinfection ; Erythrocytes ; Fever ; Headache ; Hematocrit ; Hemoglobins ; Humans ; Korea ; Malaria ; Mefloquine ; Plasmodium falciparum ; Plasmodium vivax ; Polymerase Chain Reaction ; Primaquine

We describe two cases of multiple lymphomatous polyposis in the gastrointestinal tract from the esophagus to the rectum. Clinical findings, histopathologic and immunohistochemical findings in paraffin embedded tissue are discussed. It is important to recognize this rare form of gastrointestinal lymphoma because of the prognostic and therapeutic implications.
Antigens, CD/analysis ; Gastrointestinal Neoplasms/immunology/*pathology ; Humans ; Immunohistochemistry ; Intestinal Polyps/immunology/*pathology ; Lymphoma/immunology/*pathology ; Male ; Middle Aged ; Polyps/immunology/*pathology

OBJECTIVES: Vitamin D deficiency has been shown to influence the development of some cardiovascular disease. In this study, the association between the existence of coronary artery plaque and vitamin D was examined among participants who were not previously diagnosed with coronary artery disease. METHODS: A total of 339 participants (246 men and 93 women) who visited a health examination center for check-up including blood test for serum vitamin D level and coronary computed tomography angiography (CCTA) were selected for this study. RESULTS: Among the total 339 participants, 106 displayed coronary artery plaques. The serum 25-hydroxy vitamin D (25(OH)D) level of the group with plaque was lower than that of the group without (17.7 ± 7.72 ng/mL vs. 19.6 ± 7.12 ng/mL, P = 0.0316). The group with plaque had higher incidence rates of diabetes mellitus, hypertension, and dyslipidemia than that without (P = 0.0078, P = 0.0065, and P = 0.0174, respectively). The former displayed higher serum glucose and glycated hemoglobin levels than the latter (P = 0.0055 and P = 0.0137, respectively). The group with plaque showed higher systolic and diastolic blood pressure than that without (P < 0.0001 and P = 0.0012, respectively). Stepwise multivariate logistic regression analysis revealed that 25(OH)D (coefficient, −0.06; odd ratio, 0.9433; 95% confidence interval, 0.8967–0.9924), age, and sex were independently related with presence of coronary artery plaque. CONCLUSIONS: Relatively low vitamin D level was observed among participants with plaque, which was determined through CCTA during a health examination. Plaque formation and serum 25(OH)D level showed inverse relationship.
Angiography* ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels ; Diabetes Mellitus ; Dyslipidemias ; Hematologic Tests ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Incidence ; Logistic Models ; Male ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

BACKGROUND/AIMS: Gastric stasis in migraineurs remains controversial. The aim of this study is to investigate gastric emptying (GE) time, and any associations between GE parameters and dyspeptic symptoms among patients with functional dyspepsia (FD) and migraine without any gastrointestinal symptoms during the interictal period. METHODS: We enrolled 27 migraine patients, 32 FD patients and 12 healthy people as controls, and performed GE scintigraphy as gastric function test. Gastrointestinal symptoms were evaluated in the FD and migraine. RESULTS: The age-adjusted mean gastric half-emptying time in FD (125.51 +/- 52.55 minutes) patients was longer than in migraineurs (100.82 +/- 23.94 minutes, P = 0.035) and controls (95.25 +/- 23.29 minutes, P = 0.021). The percentage of gastric retention was higher in FD than in migraine. However, migraineurs did not show an obvious delayed gastric emptying or an increase of gastric retention when compared to the normal controls. The association between each dyspeptic symptom and GE parameters was not significant, but postprandial fullness and early satiety showed a tendency of delayed GE. In migraineurs, GE time did not show significant association with nausea and vomiting during interictal periods. CONCLUSIONS: Delayed GE does not appear to be a mechanism that patients with FD and migraine have in common. Migraineurs without dyspepsia during interictal period had normal GE, and further study for association with FD should be investigated.
Dyspepsia ; Gastric Emptying ; Gastroparesis ; Humans ; Migraine Disorders ; Nausea ; Retention (Psychology) ; Vomiting

99mTc-MAG3 Scintigraphic Scan is sensitive at depicting focal parenchymal abnormalities and can be used for the measurement of overall renal function. We experienced a 12-year-old girl presenting with fever and flank pain. On the ultrasonogram and post-voiding delayed image of 99mTc-MAG3 scintigraphic scan, severe right cortical atrophy and hydronephrosis with vesicoureteral reflux were detected. We could demonstrate the reflux nephropathy by these two diagnostic work-up without conventional voiding cystourethrography.
Atrophy ; Child ; Female ; Fever ; Flank Pain ; Humans ; Hydronephrosis ; Technetium Tc 99m Mertiatide ; Ultrasonography ; Vesico-Ureteral Reflux