Heorrhage and infarct-like necrosis of anterior lobe of the pituitary gland is one of the characteristic pathologic findings of the autopsied cases of Korean Hemorrhagic Fever (KHF) patients, but there has been rare reports of hypopituitarism in patients with KHF. Recently we have experienced a patient with hyponatremia who had recovered from KHF. He was admitted to our hospital due to nausea, vomiting, and epigastric discornfort. To determine the function of the anterior pituitary gland, hormonal levels of target galnds and pituitary gland were measured, and combined pituitary stimulation test was performed. ACTH, GH, and prolactin deficiency were confirmed by combined pituitary stimulation test in this patient. There was no evidence of hypothalamic or other pituitary diseases by brain MRI. Our experience shows that KHF can be a cause of hypopituitarism and these findings should alert physicians the possibility of hypopituitarisrn in patients who had recovered from KHF.
Adrenocorticotropic Hormone ; Brain ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hyponatremia ; Hypopituitarism* ; Magnetic Resonance Imaging ; Nausea ; Necrosis ; Pituitary Diseases ; Pituitary Gland ; Pituitary Gland, Anterior ; Prolactin ; Vomiting

OBJECTIVE: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine lefels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-alpha) in infertile women with endometriosis and normal women without endometriosis. Design : Prospective and case-control study in university hospital. MATERIALS AND METHODS: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzymelinked immunosorbent assay. RESULTS: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were 72.7+/-23.7 pg/ml and 18.5+/-9.7 pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls (445.0+/-89.6, vs 45.1+/-48.4, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls (1.09+/-0.04 vs 2.19+/-0.03, p=0.03). The level of tumor necrosis factor-alpha was not significantly different between the two study groups. CONCLUSIONS: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Cytokines ; Endometriosis* ; Female ; Humans ; Infertility ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Laparoscopy ; Laparotomy ; Macrophages, Peritoneal ; Prospective Studies ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

We performed spherical LASIK operations using manual microkeratome and assessed the axis and magnitude of surgically induced astigmatism by vector analysis[Jaffe's rectangular coordinates]. Six month follow-up of 124eyes of 98 patients who were followed for 6 months or longer were included. Myopia ranged from -4.00 to -9.75 diopter. We divided eyes depending on the degree of myopia;group 1, 31 eyes between -4.00 and -5.75 diopter, group 2, 46 eyes between -6.00 and -7 .75 diopter, and group 3, 47 eyes between -8.00 and -9.75 diopter. Also, we compared the axis of surgically induced astigmatism between right eyes[73 eyes]and left eyes[48 eyes]. Preoperative astigmatic refraction was -0.63 +/-0.30 diopter in group 1, -0.67 +/-0.35 diopter in group 2, -0.67 +/-0.41 diopter in group 3.After 2 months, magnitude of surgically induced astigmatism was 0.84 +/-0.57 diopter in group 1, 1.08 +/-0.72 diopter in group 2, 1.19 +/-0.84 diopter in group 3[P=0.15], after 6 months, 1.01 +/-0.59 diopter in group 1, 1.16 +/-0.98 diopter in group 2, and 0.99 +/-0.59 diopter in group 3[P=0.52]. Change in the axis of vectorial-induced astigmatism was not statistically significant between right eyes and left eyes after 2 months[P=0.16], but significant after 6 months[p<0.05 ]. In conclusion, spherical LASIK using manual microkeratome may induce a significant change in magnitude of the astigmatism regardless the degree of myopia. The difference of astigmatic axis was statistically significant between right eyes and left eyes after 6 months. These changes and differences may require long-term follow-up and further investigation.
Astigmatism ; Axis, Cervical Vertebra ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Myopia

Telemedicine is a health care system that contains new-media techniques and medical special knowledge, using information techniques such as audio, moving picture, and communication provided to patients in distant areas with medical service such as diagnosis, consultation, education. Especially during medical transportation, it is possible that transferred patient can be rapidly taken care of by telemedicine. Our study reports 65 cases between a doctor in a hospital on ground and a patient during medical evacuation by telephone, e-mail and facsimile. Sixteen of 65 cases (25%) were immediately transferred to a hospital by sailing or helicopter. Other 49 cases were successfully taken care of by telemedicine.Telemedicine is economic and reasonable solving medical problems that may occur during medical evacuation where access to medical facilities is impossible.
Aircraft ; Delivery of Health Care ; Diagnosis ; Education ; Electronic Mail ; Humans ; Telemedicine* ; Telephone ; Transportation

Crushing injury is a common in work place and require early judgment and assessment. However during shipping, it is impossible that patient is rapidly taken care in hospital. But in this case, crushed handed patient during shipping was early assessment and sutured by telemedicine. A healthy 28-year-old man had crushed hand during working. But this patient was on the sea, so could not use medical facilities. Using e-mailing and telephone by satellite, report-ed to the doctor that patient status. In order to doctor 's pre-scription, patient hand was sutured and prescribed medicines. So patient preserved good hand function and rapidly recovered. In the future, telemedicine will be useful and economic medical field in isolated areas to medical facilities or shipping.
Adult ; Electronic Mail ; Hand* ; Humans ; Judgment ; Ships ; Telemedicine* ; Telephone ; Workplace

PURPOSE: This study was conducted to determine how a manual therapy (joint mobilization and flexion-distraction technique) would affect pain and function with the chronic low back pain. METHODS: Thirty patients were assigned to either the experimental group (n=15) or the control group (n=15). Patients in the experimental group performed joint mobilization and flexion-distraction technique. Patients in the control group performed spinal decompression therapy. Both exercises were performed for three days per week, for a period of six weeks. Pain was measured by the visual analogue scale (VAS) and functional disability was measured using the Oswestry disability index (ODI). A paired t-test was used for identify differences before and after treatment, and an independent t-test was used to identify differences between treatment groups. RESULTS: In the within group comparison, the experimental group and control group differed significantly for all variables (p<0.05). However, no significant differences were observed in any variables between groups (p>0.05). CONCLUSION: The above results confirmed that it is necessary to confirm the various benefits of therapy with the joint mobilization and the flexion-distraction technique. The findings of the concerned study will be useful to doctors applying therapy to treat patients with the chronic low back pain.
Decompression ; Exercise ; Humans ; Joints ; Low Back Pain* ; Musculoskeletal Manipulations*

PURPOSE: To determine whether triple-phase multi-detector-row helical CT images of the liver improves the detection rate of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Forty-one patients with 103 HCCs underwent triple-phase multi-detector-row helical CT imaging of the entire liver after contrast administration. Early and late arterial phase images were obtained serially during a single breath-hold, and portal venous-phase images were then obtained. Each image set was independently assessed for the presence of HCC by two radiologists unaware of the possible presence of tumors, and for each phase the detection rate was determined. For each arterial-phase image, lesion conspicuity (attenuation of a tumor compared with that of its parenchyma) was calculated. RESULTS: For reader 1, the detection rates for the early arterial, late arterial, and portal venous phase were 81%, 77%, and 55%, respectively, and for reader 2 were 83%, 81%, and 68%, respectively (p>0.05). When triplephase imaging findings were combined, the detection rate was significantly higher than when only those of the early or late arterial, and portal venous, phase were used (p<0.05). Mean lesion conspicuity for the late arterial phase was higher than for the early arterial phase, but the difference was statistically insignificant (p>0.05). CONCLUSION: Triple-phase imaging of the liver, involving the early arterial, late arterial, and portal venous phase, and using multi-detector-row helical CT, increases the detection rate of HCC.
Carcinoma, Hepatocellular ; Humans ; Liver* ; Tomography, Spiral Computed*

BACKGROUND: It is well known that hypertension attenuate endothelium-dependent vasodilator response. And this finding is closely related to the development of atherosclerosis. Recently it is reported that the expression of NADPH-dependent oxidase is increased in angiotensin-induced hypertension model and superoxide (O2) produced from that might contribute to the development of vascular diseases. The possible mechanism is the degradation of endothelium-derived NO by O2. We hypothesized that SOD prevents endothelial dysfunction via prevention of the degradation of endothelium-derived NO. METHODS AND MATERIALS: We made renovascular hypertension model by constricting abdominal aorta just above the left renal artery of Sprague-Dawley female rats. The descending thoracic aorta was stuied in the organ chambers using acetylcholine as an endothelium-dependent vasodilator with or without pretreatment of SOD. RESULTS: Blood pressures of all 14 rats were significantly increased (174/123 mmHg, mean 146 mmHg). The residual tensions of the vessels precontracted by phenylephrine were similar in both groups (15.04+/-19.53 % in SOD group vs 11.84+/-18.57% in non-SOD group, p=.66). CONCLUSIONS: The endothelial dysfunctions in the rat aorta with renovascular hypertension were not improved by SOD. There is no acute effect of SOD on endothelial function in high renin/angiotensin state.
Acetylcholine ; Animals ; Aorta* ; Aorta, Abdominal ; Aorta, Thoracic ; Atherosclerosis ; Endothelium ; Female ; Humans ; Hypertension ; Hypertension, Renovascular* ; Oxidoreductases ; Phenylephrine ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Superoxides ; Vascular Diseases

PURPOSE: This study aimed to evaluate whether prophylactic extended-field pelvic radiotherapy (EF-PRT) yields better results than standard whole pelvic radiotherapy (WPRT) in patients with pelvic lymph node-positive cervical cancer treated with concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS: A total of 126 cases of stage IB-IVA cervical cancer that had pelvic lymph node involvement in magnetic resonance imaging and were treated with CCRT between 2000 and 2016 were reviewed. None of the patients had paraaortic lymph node (PALN) metastases. The patients were classified to two groups, namely, those treated with EF-PRT, including prophylactic para-aortic radiotherapy, and those treated only with WPRT. The median dose to the PALN area in patients treated with EF-PRT was 45 Gy. All patients received concurrent cisplatin-based chemotherapy. RESULTS: Overall, 52 and 74 patients underwent EF-PRT and WPRT, respectively. Patient characteristics and irradiated dose were not significantly different, except the dose to the para-aortic area, between the two groups. The median follow-up period was 75.5 months (range, 5 to 195 months). The 10-year cumulative recurrence rate of PALN for EF-PRT vs. WPRT was 6.9% and 10.1% (p = 0.421), respectively. The 10-year disease-free survival and overall survival for EF-PRT vs. WPRT were 69.7% vs. 66.1% (p = 0.748) and 71.7% vs. 72.3% (p = 0.845), respectively. Acute gastrointestinal complications were significantly higher in EF-PRT (n = 21; 40.4%) than WPRT (n = 26; 35.1%) (p = 0.046). Late toxicities were not significantly different in both groups. CONCLUSION: In this study, prophylactic radiotherapy for PALN does not have an additional benefit in patients with pelvic lymph node-positive cervical cancer treated with CCRT.
Chemoradiotherapy ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Survival Rate ; Uterine Cervical Neoplasms*

As the Immunoserology Subcommittee of the Korean Association of External Quality Assessment, we organized two trials on the external quality assessment of viral markers and serological tests for syphilis (STS) in 2015. For this purpose, we delivered three kinds of pooled sera specimens for external proficiency testing to 1,071 and 1,074 institutions for the first and second trials, respectively. Pooled sera were checked for their homogeneity and stability using multiple methods between the day of their manufacture and three days after dispatching. The number of participating laboratories was 1,055 (98.5%) and 1,055 (98.2%) in the first and second trial, respectively. The most commonly tested items were hepatitis B surface antigen, followed by the antibodies to hepatitis B surface antigen, antihuman immunodeficiency virus, anti-hepatitis C virus, STS, and anti-hepatitis B core. The most frequently used methods for detecting viral markers were the chemiluminescence immunoassay (CLIA) and the electrochemiluminescence immunoassay, which were found to generate few false positive results. In contrast, false negative results were frequently found when the immunochromatographic assay (ICA) was used; the use of ICA for detecting viral markers has been steadily increasing in recent years. Furthermore, the use of turbidoimmunoassay and CLIA, tests recently introduced for the measurement of nontreponemal and treponemal antibodies, is also increasing.
Antibodies ; Biomarkers* ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C ; HIV ; Immunoassay ; Immunochromatography ; Korea* ; Laboratory Proficiency Testing ; Luminescence ; Serologic Tests* ; Syphilis*