No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

The purpose of this study was to investigate kinetics of the osteblast cell lineage in the periosteum and endosteum according to different distraction rates in callotasis of rats' Tibiae. 120 rats underwent osteotomy at the proximal metaphysio-diaphyseal junction of the left tibia for callotasis. Lengthening was started with varying distraction rates of 0.25 mm (group I), 0.5 mm (group II), 0.75 mm (group III), 1.0 mm (group IV) until 3.5 mm length gain was achieved. The animals that had osteotomy alone without lengthening served as a control(group V). Immunohistochemical staining of proliferating cell nuclear antigen(PCNA), osteocalcin and transglutaminase C(TGase C) were done on the four animals on each group sacrified at post-distraction 1, 3, 5, 7, 14, 28 days in order to observe the temporal changes among the experimental and control groups. At each examination, radiographic and histological studies were also done in order to correlate the immunohistochemical findings. The results obtained are summarized as follow; 1. The staining rate of PCNA was highest at the early distraction(day 1) phase and subsequently decreased in all groups. The staining rate of the cells in the periosteum was significantly higher than that of the cells in the endosteum (p < 0.01). 2. The expression rates of osteocalcin in the periosteum of all groups were significantly higer than those in the endosteum (p < 0.01). 3. The expression rates of TGase C in the periosteum of all groups were significantly higer than those in the endosteum (p < 0.05). 4. Radiological and histological studies revealed that successful regenerate bone healing was achieved in groups, I, II and III but not complete in group IV. In conclusion, immunohistochemical study on callotasis of rats' tibiae revealed that the osteoblast cell lineage in the periosteum is more activated than that in the endosteum for proliferation and differentiation by distraction, suggesting that the periosteum plays a more important role in neo-osteo-genesis in the distraction gap. Daily distraction rate range of 0.25 mm to 0.75 mm in two increments is the appropriate for successful distraction osteogenisis of rat's tibia, but the rate of 0.25 mm a day is significantly better than that of 0.75 mm upon immunohistochemical observation.
Animals ; Cell Lineage ; Kinetics ; Osteoblasts ; Osteocalcin ; Osteogenesis, Distraction ; Osteotomy ; Periosteum ; Proliferating Cell Nuclear Antigen ; Rats ; Tibia

No abstract available.
Sertoli-Leydig Cell Tumor*

No abstract available.
Methotrexate* ; Pregnancy*

Gastritis cystica polyposa (GCP) is a lesion characterized by all the histological features described for hyperplastic polyps, And there is s marked proliferation of muscular elements and entrapment of numerous epithelial cysts. These lesions have been described at gastroenterostomy stomas, at peptic ulcer edges, and in association with carcinoma. It is rare that GCP presenting as a submucosal tumar-like lesion develops in the absence of above mentioned associated conditions. We had experienced a 69 year-old man with GCP. Barium X-ray and endoacopic findings showed submucosal tumor in antrum, and endoscopic ultrasonograpic findings showed markedly thickened mucosal layer with scattered hypoechoeic areas and the submucosal layer well preserved. GCP was confirmed by histological examination of resected stomach.
Aged ; Barium ; Gastritis* ; Gastroenterostomy ; Humans ; Peptic Ulcer ; Polyps ; Stomach

BACKGROUND: Cultural characteristics of taking care of patients with dementia in Korea are based on the influence of Confucianism on the lifestyle of Koreans. In addition, as the family size has been getting smaller, the number of old persons who live alone has been increasing. The purpose of this study is to examine the proportion of the elderly with dementia who live alone and demographics of caregivers when such patients live with their family. METHODS: From the multiple hospital-based cohort, 973 elderly patients with very mild dementia (Clinical Dementia Rating [CDR]=0.5), 1,056 patients with mild dementia (CDR=1) and 359 patients with moderate dementia (CDR=2) were recruited. We analyzed the proportion of the patients with dementia who live alone and the demographics of the caregivers if such patients live with and are taken care of by such caregivers depending upon the severity of dementia. RESULTS: The proportion of the patients with dementia who live alone accounts for about 40% of all elderly patients with dementia. Major age groups of caregivers are of 40s and 50s. Sons, daughters, and spouses were ranked in the said order in the proportion of caregivers according to their relationship to patients. CONCLUSIONS: Up to now, family members care for about 60% of elderly patients with dementia, which may suggest that from the objective viewpoint, direct burden borne by caregivers for old patients with dementia would be considerably high. On the other hand, about 40% of dementia patients live alone, implying that the social care system is needed for them.
Aged ; Caregivers ; Cohort Studies ; Confucianism ; Cultural Characteristics ; Dementia ; Demography ; Family Characteristics ; Hand ; Humans ; Korea ; Life Style ; Nuclear Family ; Spouses

BACKGROUND: Cultural characteristics of taking care of patients with dementia in Korea are based on the influence of Confucianism on the lifestyle of Koreans. In addition, as the family size has been getting smaller, the number of old persons who live alone has been increasing. The purpose of this study is to examine the proportion of the elderly with dementia who live alone and demographics of caregivers when such patients live with their family. METHODS: From the multiple hospital-based cohort, 973 elderly patients with very mild dementia (Clinical Dementia Rating [CDR]=0.5), 1,056 patients with mild dementia (CDR=1) and 359 patients with moderate dementia (CDR=2) were recruited. We analyzed the proportion of the patients with dementia who live alone and the demographics of the caregivers if such patients live with and are taken care of by such caregivers depending upon the severity of dementia. RESULTS: The proportion of the patients with dementia who live alone accounts for about 40% of all elderly patients with dementia. Major age groups of caregivers are of 40s and 50s. Sons, daughters, and spouses were ranked in the said order in the proportion of caregivers according to their relationship to patients. CONCLUSIONS: Up to now, family members care for about 60% of elderly patients with dementia, which may suggest that from the objective viewpoint, direct burden borne by caregivers for old patients with dementia would be considerably high. On the other hand, about 40% of dementia patients live alone, implying that the social care system is needed for them.
Aged ; Caregivers ; Cohort Studies ; Confucianism ; Cultural Characteristics ; Dementia ; Demography ; Family Characteristics ; Hand ; Humans ; Korea ; Life Style ; Nuclear Family ; Spouses

BACKGROUND: Several studies have revealed a relationship between the cognitive decline and several cardiovascular diseases. The relationship between the metabolic syndrome and cognitive function has not been studied yet in Korea. The objective of our study was to determine the relationship between the metabolic syndrome and cognitive function in elders above 50 years old. METHODS: We examined subjects who visited the health promotion center of one college hospital in Seoul. The metabolic syndrome was defined according to the National Cholesterol Education Program guidelines and we categorized the two groups by the presence of the metabolic syndrome. We used the Korean version of Mini Mental State Examination to check the cognitive functions and compared scores between these two groups. RESULTS: There were a total of 400 subjects (195 men and 205 women). Compared with those without the metabolic syndrome, elders with the metabolic syndrome had lower mean scores in K-MMSE (26.6+/-2.0-28.2+/-1.8, P<0.001). In subcategories of K-MMSE, the average scores of concentration or calculation were lower in the metabolic syndrome group (3.5+/-1.3) than in the control group (4.3+/-1.0) and the average scores of delayed recall were lower in those with the metabolic syndrome (1.7+/-0.9) than the control group (2.2+/-0.8) (P<0.001). After controlling for age, sex, education, smoking, alcohol, and body mass index, multiple regression yielded the metabolic syndrome to be independent associated factor in cognitive function (P<0.001). CONCLUSION: We found a significant relationship between decreased cognitive function and the metabolic syndrome. There are needs for prospective study about the possible development of dementia in the metabolic syndrome and probable prevention of dementia when cardiovascular risk factors in those are modulated.
Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Dementia ; Education ; Health Promotion ; Humans ; Korea ; Male ; Risk Factors ; Seoul ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: Tuberculous (TB) pericarditis is a major cause of constrictive pericarditis requiring pericardiectomy. We sought to determine initial prognostic factors in patients with TB pericarditis. SUBJECTS AND METHODS: We evaluated initial presentation and clinical outcomes (mean follow-up 32+/-27 months) in 60 consecutive patients newly diagnosed with TB pericarditis. RESULTS: Initial presentations were pericardial effusion (PE), effusive-constrictive pericarditis, and constrictive pericarditis in 45 (75%), 9 (15%), and 6 (10%) patients, respectively. Of the 54 patients without initial constrictive pericarditis, 32 (59%) showed echogenic materials in PE, including frond-like exudative coating and fibrinous strands. These patients had a longer disease duration before diagnosis, were initially more symptomatic, in a more advanced state, showed more persistent pericardial constrictions (38% vs. 0%, p<0.001) despite anti-TB medications, and tended to require pericardiectomy more often (19% vs. 0%, p=0.07, p<0.05 by Kaplan-Meier). All patients with effusive-constrictive pericarditis showed echogenic PE. Of the 60 total patients, 10 (17%) underwent pericardiectomies during follow-up. All of these patients showed initial pericardial constrictions, whereas no patient without initial pericardial constriction underwent pericardiectomy (p<0.001). Seven patients showed transient pericardial constrictions that resolved without pericardiectomy. CONCLUSION: Initial pericardial constriction and echogenic PE are poor prognostic signs for persistent pericardial constriction and pericardiectomy in patients with newly diagnosed TB pericarditis. These results suggest that early diagnosis and prompt anti-TB medication may be critical.
Constriction ; Early Diagnosis ; Echocardiography ; Fibrin ; Follow-Up Studies ; Humans ; Pericardial Effusion ; Pericardiectomy ; Pericarditis ; Pericarditis, Constrictive ; Pericarditis, Tuberculous ; Prognosis ; Tuberculosis

We report a case of severe hypothyroidism in a cholangiocarcinoma patient with metastasis to the thyroid gland. A 58-year-old man was admitted for upper abdominal discomfort and multiple palpable neck nodules. Abdominal computed tomography (CT) demonstrated the presence of a 4.7-cm tumor in the right hepatic lobe, and core needle biopsy revealed it to be cholangiocarcinoma. Neck CT showed a diffuse, low attenuation thyroid gland, and fine-needle aspiration (FNA) demonstrated metastatic adenocarcinoma. Thyroid function tests were initially normal, but the size of the thyroid gland decreased and severe hypothyroidism developed after chemotherapy was implemented for cholangiocarcinoma. In a patient with malignant disease and a goiter, the possibility of a metastatic tumor involving the thyroid should be seriously considered. Metastatic thyroid cancer and thyroid dysfunction are probably infrequent, but diagnosis is important in the institution of appropriate therapy.
Adenocarcinoma ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Cholangiocarcinoma ; Goiter ; Humans ; Hypothyroidism ; Middle Aged ; Neck ; Neoplasm Metastasis ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms