Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.
Female ; Humans ; Adenoma

Grip strength is used in the various field to assess the disorder of upper limb. Normative data on the grip strength of population is needed to assess decreased grip strength. In this study, we tried to make a estimating model considering age and anthropometry investigation data, by analyzing 2014-2015 Korean National Health and Nutrition Examination Survey data. The subjects of this study were 10,430 participants who measured grip strength of both hands, have no missing data on anthropometry data and survey. Analysis showed that the grip strength had a curve-shaped correlation which could best be explained by the cubic expression of age, and linear correlation between height, weight and waist circumference. After the stratification of the gender, a prediction formula with age, height, and body weight as independent variables for dominant hand and non-dominant hand grip strength was presented. In addition, the distribution of estimated value to measured value ratio among subjects was suggested, which can be used to assess the abnormal value of grip strength. The distribution of non-dominant hand grip strength to dominant hand grip strength was also suggested, which can be used to determine decreased unilateral grip strength. Several studies have suggested normative value for grip strength by gender and age of Koreans, but there are no consideration for adjusting heightand weight. In this study, the model was developed to calculate the predicted grip force considering age, height, and weight. With the distribution data of measured value to predicted value ratio and non-dominant hand grip strength to dominant hand grip strength ratio, the model can be helpful to assess a reduction in grip strength.
Anthropometry ; Body Weight ; Hand ; Hand Strength* ; Korea* ; Nutrition Surveys* ; Regression Analysis ; Upper Extremity ; Waist Circumference

PURPOSE: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. METHOD: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, chi-square-test, and Mann-whitney U test were used to analyze the data. RESULTS: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. CONCLUSION: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.
Colostomy* ; Education ; Humans ; Persuasive Communication ; Self Care* ; Self Efficacy* ; Telephone

Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy.Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy.Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

OBJECTIVE: To evaluate the efficacy and safety of radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC) in a large population.MATERIALS AND METHODS: Cases of 152 biopsy-proven PTMCs from 133 patients who had undergone RFA for PTMC between May 2008 and January 2017 were included in this study. All patients were either of high surgical risk or refused to undergo surgery. They were followed up for at least 6 months after initial RFA. Ultrasonography (US) and computed tomography were performed to evaluate the PTMC and the presence of neck metastasis before treatment. RFA was conducted using an internally cooled thyroid-dedicated electrode system. Follow-up US was performed at 1 week, and 2, 6, and 12 months, after the initial RFA, and then at every 6–12 months. We evaluated serial changes of ablated tumors, newly developed cancers, lymph node (LN) or distant metastasis and complications.RESULTS: Complete disappearance was found in 91.4% (139/152) of ablated tumors. Among the 13 tumors in patients who did not show complete disappearance, no tumor displayed any regrowth of the residual ablated lesion during the follow-up period. The mean follow-up period was 39 months. During the follow-up period, there were no local recurrence, no LN or distant metastasis, and no newly developed thyroid cancers. No patients were referred to surgery. The overall complication rate was 3% (4/133) of patients, including one voice change. There were no life-threatening complications or procedure-related deaths.CONCLUSION: Our results suggest that RFA is an effective and safe option for treating low-risk PTMC patients who are of high surgical risk or refuse surgery.
Catheter Ablation ; Electrodes ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Recurrence ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonography ; Voice

BACKGROUND: Proteinase-activated receptor 2 (PAR2) is cleaved, and it is activated by trypsin or mast cell tryptase. PAR2 plays an important role in inflammation. The aim of this study is to examine the potential of PAR2 agonists to modulate TNF-alpha secretion from the human astrocytoma cell line CCF-STTG1. METHODS: PAR2 expression in CCF-STTG1 was examined using reverse transcriptase polymerase chain reaction and immunocytochemistry. The potential of PAR2 agonists to modulate TNF-alpha secretion from CCF-STTG1 was examined by enzyme-linked immunosorbent assays. RESULTS: CCF-STTG1 expresses PAR2. PAR2 agonists such as trypsin, mast cell tryptase, and activating peptide SLIGKV-NH2 (corresponding to the PAR2 tethered ligand) directly signal CCF-STTG1 to induce the secretion of TNF-alpha but not in the case of the soybean trypsin inhibitor (SBTI) or VKGILS-NH2 (control peptide). Furthermore, the secretion of TNF-alpha was significantly reduced in CCF-STTG1 cells pre-treated with either 50 microM PD98059 (mitogen-activated protein/extracellular signal-regulated kinase kinase (MEK) inhibitor) or 1 microM SB203580 (p38 MAPK inhibitor) 30 min before trypsin stimulation. CONCLUSIONS: These results show that trypsin may induce TNF-alpha secretion through the activation of MEK and p38 MAPK via PAR2 in astrocytoma cell line CCF-STTG1.
Astrocytes* ; Astrocytoma ; Cell Line* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunohistochemistry ; Inflammation ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Reverse Transcriptase Polymerase Chain Reaction ; Soybeans ; Trypsin ; Tryptases ; Tumor Necrosis Factor-alpha*

Core needle biopsy is a complementary diagnostic method of fine needle aspiration for patients with thyroid nodules. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for diagnosis of thyroid nodules and recurrent thyroid cancers using core needle biopsy. These recommendations are based on evidence from the current literature and expert consensus.
Advisory Committees ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Consensus ; Humans ; Thyroid Gland ; Thyroid Nodule

PURPOSE: Fractional exhaled nitric oxide (FeNO) is a maker of airway inflammation, and impedance of low frequency in the impulse oscillometry system (IOS) reflects small-airway obstruction. We investigated the association of the FeNO level with IOS parameters and spirometry results in asthma patients. METHODS: Fifty-eight children with asthma (60.3%, male), mean age 8.3 years (range, 4.5-16.0 years), were enrolled in the study. Reactance and resistance at 5 Hz with IOS, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and forced expiratory flow 25%-75% of the vital capacity (FEF25%-75%) with spirometry and FeNO were measured in all patients. The Z-score of spirometry and IOS parameters and the mean level of FeNO were used for correlation and regression analysis. RESULTS: FeNO was not significantly associated with height, age, or other demographic parameters. There was a statistically significant correlation between spirometry results and IOS measurements. The FeNO level was not significantly correlated with IOS variables. After adjusting for height, sex, atopic status, and the use of inhaled corticosteroid, the FeNO level showed significant correlations with Z-score of FEV1/FVC (P=0.037, adjusted R 2=0.234). CONCLUSION: FeNO was significantly correlated with Z-scores of FEV1/FVC, but not with IOS variables. Therefore, FeNO may be used to detect whole airway obstruction, but not small-airway obstruction.
Airway Obstruction ; Asthma* ; Child* ; Electric Impedance ; Forced Expiratory Volume ; Humans ; Inflammation ; Nitric Oxide* ; Oscillometry* ; Regression Analysis ; Respiratory Function Tests ; Spirometry* ; Vital Capacity

PURPOSE: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. MATERIALS AND METHODS: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. RESULTS: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. CONCLUSION: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.
Angiography ; Angiography, Digital Subtraction ; Cerebrovascular Disorders ; Female ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Male ; Middle Cerebral Artery ; Sensitivity and Specificity ; Stroke ; Thrombosis ; Veins