No abstract available.
HLA Antigens* ; Humans

The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. There tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control (p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results (p<0.01). 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Significantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.
Cerebral Infarction ; Dexamethasone* ; Humans ; Hydrocortisone ; Infarction ; Stroke*

PURPOSE: To report a case of an 82-year-old male with acute myeloid leukemia presenting with bilateral isolated conjunctival and eyelid masses. CASE SUMMARY: An 82-year-old male presented with a bilateral conjunctival mass and right eyelid mass occurring 10 days prior. He was diagnosed with prostate cancer 8 years ago and complete recovery was achieved using selective mass chemotherapy. He experienced a stroke 4 years ago and was treated using a carotid artery stent insertion and medication. In the initial laboratory test, hemoglobin was 13.7 g/dL and leukocyte count 5,530/mm3(neutrophil 74.4%, lymphocyte 10%, monocyte 11.8%). Light reflex, movement of extraocular muscle and fundus examination were all normal. Biopsy was performed 1 week after the first visit. Seven days after biopsy, he complained of sudden dyspnea and febrile sense and was admitted to the intensive care unit via the emergency room (ER). The laboratory tests performed in the ER showed hemoglobin was 9.6 g/dL and leukocyte count was 78,020/mm3(neutrophil 0%, lymphocyte 7%, monocyte 5%, promyelocyte 1%, metamyelocyte 4%, myelocyte 6%, blast 67%). The biopsy revealed diffuse proliferation of atypical plasmacytoid cells, consistent with leukemic infiltration. Under the diagnosis of acute myeloid leukemia, chemotherapy was administered. However, the patient died due to aggravated pneumonia. CONCLUSIONS: Even if non-specific findings appear on the peripheral blood tests, eyelid and conjunctival masses should be considered as possible tumors in acute myeloid leukemia.
Aged, 80 and over ; Biopsy ; Carotid Arteries ; Conjunctiva* ; Diagnosis ; Drug Therapy ; Dyspnea ; Emergency Service, Hospital ; Eyelids* ; Granulocyte Precursor Cells ; Hematologic Tests ; Humans ; Intensive Care Units ; Leukemia, Myeloid, Acute* ; Leukemic Infiltration ; Leukocyte Count ; Lymphocytes ; Male ; Monocytes ; Pneumonia ; Prostatic Neoplasms ; Reflex ; Sarcoma, Myeloid ; Stents ; Stroke

Infectious complications are the biggest problem during bowel surgery, and one of the approaches to minimize them is the bowel cleaning method. It was expected that bowel cleaning could facilitate bowel manipulation as well as prevent infectious complications and further reduce anastomotic leakage. In the past, with the development of antibiotics, bowel cleaning and oral antibiotics (OA) were used together. However, with the success of emergency surgery and Enhanced Recovery After Surgery, bowel cleaning was not routinely performed. Consequently, bowel cleaning using OA was gradually no longer used. Recently, there have been reports that only bowel cleaning is not helpful in reducing infectious complications such as surgical site infection (SSI) compared to OA and bowel cleaning. Accordingly, in order to reduce SSI, guidelines are changing the trend of only intestinal cleaning. However, a consistent regimen has not yet been established, and there is still controversy depending on the location of the lesion and the surgical method. Moreover, complications such as Clostridium difficile infection have not been clearly analyzed. In the present review, we considered the overall bowel preparation trends and identified the areas that require further research.

PURPOSE: To report a case of eccrine spiradenoma that presented as an eyelid nodule. CASE SUMMARY: A 61-year-old female presented with a mass in the right upper lid margin; the onset time was unknown. An ophthalmic examination revealed no abnormalities except the eyelid nodule. The nodule was 3 mm in size with a firm, smooth surface and light pinkish color, and was located near the lid margin. Excision and biopsy of the nodule was performed. The pathological findings of the specimen obtained showed islands of 2 types of lobular cells. Larger, paler cells were grouped around the central area, darker and smaller cells on the periphery. These findings were compatible with eccrine spiradenoma. CONCLUSIONS: Eccrine spiradenoma should be considered a differential diagnosis of a solitary eyelid tumor.
Biopsy ; Diagnosis, Differential ; Eyelids* ; Female ; Humans ; Islands ; Middle Aged

Low-grade nasopharyngeal papillary adenocarcinoma is an unusual nasopharyngeal tumor. This malignant tumor originates in the epithelium and exhibits adenocarcinomatous differentiation and indolent behavior. Macroscopically, these tumors are pedunculated polypoid masses that arise on the roof of the nasopharynx. Microscopically, they are characterized by papillary and glandular epithelial proliferation. We report a case of a 25-year-old woman who presented with a papillary adenocarcinoma on the roof of nasopharynx; in describing the case, we have focused on the histological features and endoscopic management of the tumor. The tumor was completely excised via nasal endoscopic approach. Immunohistochemical analysis of the tumor was performed based on a differential diagnosis of metastatic papillary thyroid carcinoma. The testing involved thyroid transcription factor-1, thyroglobulin, and epithelial membrane antigen analysis. The patient remained disease-free for over 6 months after the surgical excision performed via nasal endoscopic approach.
Adenocarcinoma, Papillary ; Adult ; Carcinoma ; Diagnosis, Differential ; Epithelium ; Female ; Humans ; Mucin-1 ; Nasopharynx ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms

BACKGROUND: The associations of apolipoprotein E (ApoE) genotypes and cholesterol levels with cognitive decline in Alzheimer's disease (AD) are controversial. The aim of this study is to investigate the individual and combined effects of ApoE epsilon 4 allele (Epsilon4) and cholesterol levels on the progression of AD. METHODS: ApoE genotypes and fasting serum total cholesterol levels were measured in 79 patients with AD. The associations were investigated between Epsilon4, cholesterol level and decline in cognitive function (Korean version of Mini-Mental State Examination) over one year. RESULTS: No prospective individual and combined associations were found between Epsilon4, cholesterol level and decline of cognitive function. Adjustment for age, gender, education, and functional activities of daily living made little difference to the associations. CONCLUSIONS: The cognitive decline of AD might be determined by other factors rather than the impact of Epsilon4 or cholesterol levels.
Activities of Daily Living ; Alleles ; Alzheimer Disease* ; Apolipoproteins E ; Apolipoproteins* ; Cholesterol* ; Education ; Fasting ; Genotype ; Humans

BACKGROUND: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. MATERIAL AND METHOD: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS bleb resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mm VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. RESULT: The mean follow-up duration was 20.8+/-16.1 months in 10 mm VATS group, and 13.9+/-8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax (34%) in 10 mm VATS and patient's desire (40%) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, R2 values were lower than 0.1. The postoperative recurrence rate was 2.7% in 10 mm VATS and 2.9% in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. CONCLUSION: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.
Blister ; Chest Tubes ; Drainage ; Follow-Up Studies ; Gyeonggi-do ; Hospitalization ; Korea ; Linear Models ; Pleurodesis ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted* ; Thoracoscopes ; Thoracoscopy*

PURPOSE: The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). METHODS: We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. RESULTS: Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. CONCLUSION: Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.
Adolescent ; Cough ; Fever ; Humans ; Lung ; Lymphatic Diseases ; Male ; Medical Records ; Pleural Effusion ; Pleurisy ; Polymerase Chain Reaction ; Prevalence ; Retrospective Studies ; Sputum ; Sweat ; Sweating ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary