Chronic idiopathic intestinal pseudo-obstruction syndrome is a clinical condition induced by an impaired function of intestinal motility. Although its clinical symptoms are those of intestinal obstruction, mechanical obstruction of the intestine cannot be found by vigorous studies, even by operative exploration. We have experienced nine cases of chronic idiopathic intestinal pseudo-obstruction syndrome. It will help in diagnosis and treatment of the pseudo-obstruction to present the patients with these syndromes. In all cases severely delayed intestinal transit times were noted in radiological gastrointestinal studies without evidence of mechanical obstruction. The most frequent tentative diagnoses were congenital megacolons. But all of the patients showed the presence of ganglion cells in the intestinal wall. Histological abnormalities of the muscle layer were found in three patients. We could not resolve the symptoms by the surgical decompression of the intestine (such as colostomy, ileostomy etc.). But the symptoms were improved after total colectomy in a patient whose main affected site was confined to the colon. The megacystis was the most frequent combined anomaly. All patients had been improved with NPO and total parenteral nutrition therapies were inevitable. The drugs which facilitate the intestinal activities such as cisapride could not resolve the symptoms of obstruction. Three patients were died with the complications of total parenteral nutrition, and four patients improved clinically. Early diagnosis and proper management will reduce the mortality and morbidity.
Child ; Cisapride ; Colectomy ; Colon ; Colostomy ; Decompression, Surgical ; Diagnosis ; Early Diagnosis ; Ganglion Cysts ; Gastrointestinal Motility ; Hirschsprung Disease ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Intestines ; Mortality ; Parenteral Nutrition, Total

No abstract available.
Lymphangioma*

No abstract available.
Intestinal Pseudo-Obstruction*

No abstract available.
Child* ; Humans

Matrix producing carcinoma of the breast is a variant of heterologous metaplastic carcinoma which is defined as "overt carcinoma with direct transition to a cartilagenous and/or osseous stromal matrix without an intervening spindle cell zone or osteoclastic cells". This tumor is very rare, occuring in less than 0.2% of total breast carcinoma, but the prognosis is better than other metaplastic carcinoma. We experienced a case of fine needle aspiration(FNA) cytologic finding of matrix producing carcinoma of the breast. A 75-year old woman, who presented a right huge breast mass(9x8cm) during 10months, was examined. Mammography reveals right lateral mass with even density without calcification. Breast ultrasonography shows multifocal hypoechogenic cystic change in the huge mass, suggesting resolving hematoma or carcinoma or sarcoma with necrosis. On cytologic finding of FNA, myxoid matrix was the dominant feature and the rest of the material was composed of scanty isolated atypical cells with large irregular nuclei. The histologic finding was moderately differentiated adenocarcinoma with abundant cartilagenous matrix and focal squamous metaplasia.
Adenocarcinoma ; Aged ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Female ; Hematoma ; Humans ; Mammography ; Metaplasia ; Necrosis ; Needles ; Osteoclasts ; Prognosis ; Sarcoma ; Ultrasonography, Mammary

OBJECTIVE: To assess the association between alcohol drinking and hip fracture in the elderly people in Korea. BACKGROUND: Hip fracture is known as one of the major health problems because of its high incidence and serious consequences in the elderly people. The association between alcohol consumption and hip fractures has not been directly evaluated yet in Korea. So we conducted a nested case-control study to investigate the relationship between alcohol consumption and hip fracture in the Korean elderly people. DESIGN: Nested case-control study from the Korea Elderly Pharmacoepidemiology Cohort (KEPEC), in Pusan, Korea. METHODS: Seventy incident cases have been selected since 1993, and 280 controls have been matched with the cases by age and gender among the KEPEC. Average alcohol intake was calculated by multiplying frequency and amount of drinking and unit capacity of each alcohol type. Odds ratios of alcohol intake on the hip fracture and their confidence intervals were computed by using multiple logistic regression with Windows version SAS 6.12. RESULTS: The elderly people's drinking rate is lower than the young people in Korea. In univariate analysis, crude odds ratio was 0.26 in male and adjusted odds ratio after contolling for age, smoking status, medication history, physical activity and body mass index was 0.36 in male. So current drinking reduces the risk of hip fracture. Adjusted odds ratio after controlling for age, smoking status, medication history, physical activity and body mass index odds ratio was 0.24 in female with moderate drinking. CONCLUSION: We found that alcohol consumption reduces the risk of hip fracture in the elderly Korean. However, we could not explain the plausible mechanism with our data yet. So, we suggest the further study for elucidating the possible mechanism of the finding including the possible association between nutritional status, alcohol drinking and bone marrow density in the elderly.
Aged* ; Alcohol Drinking ; Body Mass Index ; Bone Marrow ; Busan ; Case-Control Studies* ; Cohort Studies ; Drinking ; Female ; Hip Fractures ; Hip* ; Humans ; Incidence ; Korea* ; Logistic Models ; Male ; Motor Activity ; Nutritional Status ; Odds Ratio ; Pharmacoepidemiology ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: It is rare to find any studies reporting on the practical measurements of landmarks in the paranasal sinuses that are done intraoperatively as well as comparative analysis on the anatomical and radiological measurements of the paranasal sinuses. The aim of this study was to analyze the anatomical measurements of the paranasal sinuses using nasal endoscope and CT scout films to determine the statistical significance. MATERIALS AND METHODS: In 130 patients the authors used bayonet forceps and seekers to measure the distances from the anterior nares to some of the intranasal structures, such as the uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus. Then, using the CT scout films, we measured the distances between the anterior nasal spine and the basal lamella (B.L.), the anterior wall of sphenoid sinus (A.W.S.), and the posterior wall of sphenoid sinus (P.W.S.). We analyzed the mean values of the basal lamella, the anterior and posterior wall of sphenoid sinus from all the available data in order to compare the endoscopic and radiologic measurements, and carried out a paired t-test. RESULTS: There was a statistically significant discrepancy in the comparative analysis of the CT scout film and the endoscopic measurements of the basal lamella, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus, althought there were no significant discrepancy for basal lamella in female patients (p>0.05). CONCLUSION: The differnces between the CT and operative measurements observed in this study were due to differnt measuring points, differences in the measuring angles, and inaccurate locations of the landmarks on the CT scout films owing to their small sizes. These findings indicate that a more accurate method need to be introduced in using the CT films to measure the anatomical landmarks in the paranasl sinuses.
Endoscopes* ; Ethmoid Sinus ; Female ; Humans ; Paranasal Sinuses* ; Sphenoid Sinus ; Spine ; Surgical Instruments

Background: In a previous study, we carried out whole-exome sequencing to identify genetic variants associated with early onset atopic dermatitis (AD) in Koreans and found that collagen VI α6 chain (COL6A6) gene polymorphisms are associated. COL6A6 is one of the chains that makes up the triple helix of collagen VI, and little is known about its role in AD. Objective: To identify how COL6A6 changes in AD and clarify its role. Methods: Immunohistochemical staining for COL6A6 was performed on tissues of AD, other skin diseases, and healthy controls. Human keratinocytes and fibroblasts were exposed to inflammatory cytokines and cultured to evaluate changes in COL6A6 expression. COL6A6 small interfering RNA (siRNA) was transfected into cells to identify the role of COL6A6. Results: Total COL6A6 mRNA was higher in AD than in controls. In AD tissues, COL6A6 mRNA decreased significantly in the epidermis compared to controls, whereas COL6A6 protein was increased in the dermis. In the cultured cells, COL6A6 mRNA was suppressed in the epidermis by interleukin (IL)-4 and IL-13, whereas COL6A6 protein was induced in the dermis. In the COL6A6 siRNA-transfected keratinocyte, mRNA of FLG, LOR, and CASP14 decreased compared to controls; in contrast, mRNA of MMP1 increased. Conclusion The reduction of epidermal COL6A6 due to the genetic mutation can cause skin barrier damage and it can contributes to the early onset of AD. COL6A6 is induced by IL-4 and IL-13, and it may play a role in fibrotic remodeling and inflammatory processes, which are major features of AD.

We examined the effect of an applied cyclic compressive strain on the growth and differentiation of MC3T3-E1 cultured in a three-dimensional chitosan scaffold. The specially designed testing apparatus for mechanical stimulus was developed for uniaxial cyclic compressive strain. Cyclic compressive strain was applied over a period of 17 days with 150 cycles per day at a frequency of 0.5hz. Strain magnitude was 2.5% of the scaffold length. Control group and mechanically stimulated group were incubated and harvested at the indicated times. (day 3, 7, 10, 14, 17) The total amount of protein and alkaline phosphatase activity were examined. The total amount of protein of the control group was higher than that of the mechanically stimulated group. This was due to cell death for the nodule formation and calcium deposit of the mechanical stimuli group which resulted in cell differentiation. The alkaline phosphatase activity increased slightly in the control group. However, in the mechanical stimuli group, it increased significantly and reached its peak level on day 7 and subsequently its activity dropped to a level that was higher than the level at day 4(p < 0.05). Conclusively, it can be noted that the mechanical stimulus significantly accelerated the differentiation of MC3T3-E1 cells.
Alkaline Phosphatase ; Calcium ; Cell Death ; Cell Differentiation ; Chitosan

To test the hypothesis that the intake of psychotropics may increase the risk of hip fracture, a cohort study was conducted upon elderly Korean women. The Korean Elderly Pharmacoepidemiology Cohort was constructed from members of the Korea Medical Insurance Corporation over 65 yr of age who were living in Busan Metropolitan City in 1993. Study participants (n=6,043) were female respondents to a self-administered question survey. Information on the intake of psychotropics was obtained from the drug prescription database, which contained all psychotropic prescriptions during any hospital admission over the two-year period between January 1, 1993 and December 31, 1994. The cohort follow-up has been conducted with information on hip fracture being collected from the Korea Medical Insurance Corporation medical treatment claims database over the four year period between January 1, 1993 and December 31, 1996. Three hundred and three subjects had received 745 psychotropics prescriptions and 56 cases of hip fracture were found. After adjusting for age, body mass index, and drinking history, it was found that the intake of psychotropics significantly increased the risk of hip fracture (adjusted odds ratio, 4.24; 95% confidence interval, 1.89-9.52). This study suggests that the intake of psychotropics might be an important risk factor for hip fracture in elderly Korean women.
Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Hip Fractures/*chemically induced ; Humans ; Korea ; Psychotropic Drugs/*adverse effects ; Questionnaires ; Risk Factors