Helicobacter pylori, loss of basement membrane, atrophy, type III intestinal metaplasia, adenomatous polyposis coli (APC) gene mutations and altered p53 function were believed as a factor to develop the gastric adenocarcinomas. To investigate the incidence and prevalence of Helicobacter pylori, intestinal metaplasia and atrophy, 120 gastrectomy specimens collected from patients with gastric adenocarcinoma (100 cases) and non-neoplastic conditions (20 cases) were studied. Intestinal metaplasia can be classified as type I (complete), type II (incomplete, sulfomucin-negative) and type III (incomplete, sulfomucin-positive) by Filipe and Jass. The incidence of intestinal metaplasia of gastric adenocarcinoma was 96% compared with the incidence of 75% in non-neoplastic conditions. The type I and type II were more common than type III and were present in both non-neoplastic conditions (75%) and adenocarcinoma (74%). In contrast, type III intestinal metaplasia was seen in only 20% of intestinal metaplasia-positive cases, all of which (22 of 22) were from patients with adenocarcinoma. The high specificity of type III intestinal metaplasia might be acceptable for screening purposes, but its sensitivity of 22% for gastric adenocarcinoma is low. Helicobacter pylori were detected in 96% of adenocarcinoma cases and 100% of non-neoplastic cases. Atrophy was detected in 50% of non-neoplastic cases and in 57% of adenocarcinoma cases. The data thus confirms a significant relation between incomplete sulfomucin-secreting intestinal metaplasia (type III) and gastric carcinoma, especially intestinal type (p<0.01). Thus, the type III intestinal metaplasia should be considered a risk factor and its presence in a biopsy specimen should prompt close surveillance.
Adenocarcinoma ; Adenomatous Polyposis Coli ; Atrophy ; Basement Membrane ; Biopsy ; Gastrectomy ; Helicobacter pylori ; Humans ; Incidence ; Mass Screening ; Metaplasia* ; Prevalence ; Risk Factors ; Sensitivity and Specificity

PURPOSE: Leptin is the product of the of gene secreted by adipocyte. The serum leptin concentration reflects the amount of adipose tissue in the body. We investigated whether leptin concentration was detectable in cord blood of newboms and assessed the effect of gestational age, birth weight, birth length, placental weight, body mass index and ponderal index on cord blood leptin concentration in full-term and preterm newboms. METHODS: Eighty-two newboms were enrolled in this study. Standard growth curves were used to categorize infants as appropriate (AGA), large (LGA), or small for gestational age (SGA). Gestational age, birth weight, length and placental weight were measured. Maternal age, weight and height were measured. Cord blood and maternal venous samples were collected and serum was separated and stored at -70C. Leptin was measured by radioimmunoassay. RESULTS: The mean leptin concentration in full term babies was 8.9+/-9.6 ng/ml compared with 3.5+/-0.6 ng/ml in preterm babies. Leptin concentrations in cord blood of full term babies were significantly increased in cornparison with those in cord blood of preterm babies. Mean serum leptin concentration of SGA infants was significantly lower than in AGA infants and that of LGA was higher than in AGA infants. In full-term and preterm neonates, there was significant positive correlation of leptin concentrations with birth weight, gestational age, birth length, BMI, ponderal index and placental weight. No gender differences were found in cord blood leptin. Maternal age, maternal body mass index, matemal weight at baseline (before pregnancy) and at birth were not significantly correlated with leptin concentration of full-term and preterm neonates. There was no significant correlation between leptin concentration of cord blood and matemal leptin concentration. CONCLUSION: The serum leptin concentration is highly correlated to the size of adipose tissue mass of newborn infant. Leptin may be responsible for regulation of body mass of human neonates and can be used as marker of the nutritional status and growth of fetal and neonatal period.
Adipocytes ; Adipose Tissue ; Birth Weight ; Body Mass Index ; Body Weight ; Fetal Blood* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Leptin* ; Maternal Age ; Nutritional Status ; Parturition ; Radioimmunoassay

BACKGROUND: Congenital hypotrichosis is a non-specific, descriptive term for structural abnormalities of hairs showing variable clinical features. We recently have encountered a group of eleven patients exhibiting abnormal hairs showing similar patterns. OBJECTIVES: Our purpose was to clarify the entity of this structural hair disorder. METHODS: Dermatologic examination with routine histopathology, trichograms along with scanning electron-microscopic examination and laboratory studies were undertaken. RESULTS: All cases except one were female, and hair abnormalities had developed at birth or within a year. Diffuse distribution of thin, sparse, soft and hypopigmented hairs were noticed. On hair mounts, four patients showed tapering of roots. The majority of the patients exhibited cuticular changes, as well as pitting and longitudinal axial twisting by scanning electron-microscopic examination; one case demonstrated trichorrhexis nodosa, and another, trans-verse fracture. CONCLUSION: Although our cases bear some similar points with woolly hair, some differences were noted between this type of congenital hypotrichosis and other previously described syndromes.
Female ; Hair ; Humans ; Hypotrichosis* ; Parturition

BACKGROUND: The classical in vitro method for researching the fibroblast metabolism is a mono layer culture system. But there are a lot of facts that artificial influence of monolayer culture situations do not resemble the in vivo conditions. Recently three-dimensional culture method of fibroblast in collagen gel was developed and in this system fibroblasts seem to behave like in vivo situations. OBJECTIVE: So we examined the effects of ascorbic acid. TGF-beta, and IFN-gamma on fibroblast in collagen gel culture system and then compared these effects with those in monolayer culture system. We also studied the regulatory mechanism of collagen gene by ascorbic acid, TFG-beta, and IFN-gamma by Northern blot analysis in monolayer culture system. METHODS: Using fibroblasts of the neonatal foreskin, we measured the collagen synthesis after treatment of ascorbic acid, TGF-b, and IFN-r in three-dimensional culture and monolayer culture system. We aslo checked the change of mRNA of collagen after treatment in monolayer culture. RESULTS: The relative levels of collagenase-digestible protein synthesis in the three-dimensional culture seemed to be lower than those in the monolayer system. However, difference of fold in crease was not statistically significant. The expression of collagen mRNA was increased after treatment of TGF-beta and decreased after IFN-gamma treatment. CONCLUSION: From these results, fibroblasts in the three-dimensional culture system might resemble the in vivo conditions The molecular level of regulation of collagen synthesis by TGF-beta. and IFN-gamma was thought to be transcriptional. The three-dimensional culture system could be a good model of culture system of fibroblast in studying of aging process or the role of cytokine in wound healing.
Aging ; Ascorbic Acid* ; Blotting, Northern ; Collagen* ; Fibroblasts* ; Foreskin ; Humans* ; Metabolism ; RNA, Messenger ; Skin* ; Transforming Growth Factor beta ; Wound Healing

The purpose of this phenomenological study was to understand the lived experience of mothers of children with muscular dystrophy. The participants were 11 mothers recruited by snowball sampling, who agreed with the objectives of the research and could verbally communicate with the researcher and who lived with their sons who had muscular dystrophy. Data collection was done through in-depth interviews with participants in their own homes. Each interview took 50 to 120 minutes. All of the interviews were audiotaped and then transcribed. Data were analyzed using Colaizzi's (1978) method of phenomenology. From the transcripts 109 significant sentences and phrases were selected and 13 clusters of themes were categorized from 67 significant statements. These results were integrated into the essential structure of the lived experience of mothers of children with muscular dystrophy. 1.Anxious and relying on chance due to indefinite diagnosis. 2. Only able to cry with shock because of son's fatal disease. 3.Seeing the future as dismal and feeling resentment that this disease in transmitted through the mother. 4.Feeling caught between a husband who is distancing himself from his family and the family which is disintegrating. The author would like to thank Dr. Kasil Oh at Yonsei University, College of Nursing for her guidance, 5.Feeling like a sinner for transmission of genetic disease(Feeling guilt for conceiving a son with a genetically transmitted fatal disease). 6. Empathizing with other suffers of muscular dystropy and their parents in their grief and helping to dissipate their heavy feelings. 7. Deciding to sacrifice self as a way of taking responsibility for giving birth to a handicapped son. 8.Losing hope (feeling despair) as son's condition deteriorates in spite of all attempts to help him. 9.Wishing to die with son who becomes progressively immobile. 10. Accumulating Han, because of rising Hwa(anger), and becoming sick both mentally and physically. 11.Seeing events as destiny and finding self-control through faith. 12.Finally, giving up sacrificing self for son and becoming concerned(involved) with other children in the family. 13.Feeling fear at son's impending death. This is the first research on the experience of Korean mothers of children with muscular dystrophy. In applying the phenomenology research method, this study not only helps health professionals understand the experience of these mothers in the Korean patriarchal social system, but the researcher, as a nurse, can share their agony and grief through identification of their inner world through in-depth personal interviews. The results obtained in this study will not only help in the development of family nursing practice for families with genetically transmitted diseases but also prepare basic data for family nursing practice in the Korean sociocultural context.
Child* ; Data Collection ; Diagnosis ; Disabled Persons ; Family Nursing ; Grief ; Guilt ; Health Occupations ; Hope ; Humans ; Mothers* ; Muscular Dystrophies* ; Nursing ; Parents ; Parturition ; Shock ; Spouses ; Child Health

BACKGROUND: Urticaria pigmentosa(UP) is primarily a disease of children. There have been no clinical studies of UP in Korea. OBJECTIVE: This study was performed to find the clinical characteristics of UP in Korean child-hood patients. METHOD: Twenty-nine cases of urticaria pigmentosa confirmed clinically and histopathologically were analyzed. RESULTS: The maculopapular type was the most common with the usual age of onset before the age of 6 months, and the lesions tended to be distributed in the central portion of the body. Darier sign was positive in 92% of the patients(24/26). No systemic involvements were detected in any of the patients with minimal associated symptoms. Seven patients of the maculopapular type and one patient of the multiple nodular type followed up for more than 2 years showed a tendency to improve or clear by the age of 6 years. CONCLUSION: Neonatal or infantile-onset patients of UP in Korean pediatric population were considered to have a benign clinical course and to require no aggressive therapy.
Age of Onset ; Child* ; Clinical Study* ; Humans ; Korea ; Methods ; Urticaria Pigmentosa* ; Urticaria*

BACKGROUND: With the rapid growth of the elderly population, osteoporosis has become a major health problem worldwide. Although health knowledge and self-efficacy are important assets to facilitate healthy behaviors and disease prevention, such information as it relates to individuals and their bone health is limited. The purpose of this study was to assess the levels of knowledge, self-efficacy, and health behaviors on promoting bone health in middle-aged Korean women. METHODS: This is a cross-sectional survey study. A convenience sampling of middle-aged women (> or =40 years) was done at a community health center in Korea. Bone mineral density was measured by dual energy X-ray absorptiometry with the DEXXUM T. The level of knowledge was measured with the Knowledge of Osteoporosis Scale, and self-efficacy with the Osteoporosis Self-efficacy Scale. A questionnaire for bone health behaviors was developed for this study. Collected data were analyzed through descriptive methods, independent t-test, analysis of variance, and Pearson's correlation analysis. RESULTS: A total of 150 middle-aged women whose mean age was 59.8+/-11.5 years participated in the study. Most (74%) were menopausal. Less than one-quarter of participants (22.7%) had osteoporosis and less than half (42%) had osteopenia based on the T-score at the left femur neck site. Level of knowledge (mean score, 10.35) and self-efficacy (mean score, 47.67) ranged from low to moderate. Intake of calcium and vitamin D-rich foods was insufficient in our subjects. Bone health behaviors had significant positive relationships with knowledge (r=0.22, P=0.008) and self-efficacy (r=0.29, P<0.001) on promoting bone health. CONCLUSIONS: These results indicate that educational interventions are needed to enhance knowledge and confidence and to encourage middle-aged women to engage in bone health behaviors.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Community Health Centers ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Behavior ; Humans ; Korea ; Middle Aged ; Osteoporosis ; Self Efficacy ; Vitamins

Explosive burns following inhalation of butane gas rarely occurred in the past, but recently it has brought about a social problem among groups of teenagers. This constitutes 1.6% of admissions due to flame burn in the burn unit of Hallym Medical Center. A retrospective review during a five-year period identified 48 patients. The male to female ratio was 3:1. The mean age was 16 years and 8 months. The place of accidents were commonly bedrooms or motel rooms. There were nine group settings of 27 patients at the time of the accident. The pneumothorax(n=3) and respiratory difficulty(n=12) were noted on admission. The average burn area was 28.5% of the total body surface area. All patients sustained burn injury on the face, arms and hands, and 24 patients among them had extended burn areas on the trunk and/or lower extremity. Twenty-two patients(mean hospital stay; 51.6%) required skin grafting, and 12 patients (mean hospital stay; 22.3 days) were treated with conservative management. The mortality rate was 10.4 percent. Explosive burns following inhalation of butane gas can result in mortality as well as major burn injuries.
Adolescent ; Arm ; Body Surface Area ; Burn Units ; Burns* ; Female ; Hand ; Humans ; Inhalation* ; Length of Stay ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Skin Transplantation ; Social Problems

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

PURPOSE: The objective of augmentation mammoplasty includes reconstruction and cosmesis after breast surgery Increasing frequency of the procedure has been related with increased complications. Authors evaluated the value of breast MRI in the diagnosis of complications after augmentation mammoplasty. MATERIALS AND METHODS: Authors studied 42 breasts of 24 patients, who had undertaken augmentation mammoplasty. We evaluated findings of mammography, ultrasonography, and breast MRI in all patients. We used variable MRI sequences for better evaluation of implant status. The results were compared with the findings in surgical field. RESULTS: In all imaging studies, nodule or mass was indentifiable in the cases of interstitial paraffine injection(8 breasts), interstitial silicon injection(7 breasts), and herb medication(2 breasts). However, the differentitation between malignant and benign nodule was only possible at dynamic breast MRI. Mammogram was not helpful in the evaluation of extracapsular rupture in the cases of silastic bag insertion. In sonogram, identification of echogenic material was possible, although, false negative and false positive rate were high. MRI was able to visualize contour of entire implant and it was able to easily recognize low signal internal structure. CONCLUSION: MRI was the most accurate diagnostic tool in the evaluation of the character of the palpable mass after augmentation mammoplasty and early detection of breast implant rupture.
Breast ; Breast Implants ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging* ; Mammaplasty* ; Mammography ; Paraffin ; Rupture ; Silicones ; Ultrasonography