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

OBJECTIVE: To evaluate the reliability of virtual non-contrast (VNC) images reconstructed from contrast-enhanced, dual-energy scans compared with true non-contrast (TNC) images in the assessment of high CT attenuation or calcification of mediastinal lymph nodes. MATERIALS AND METHODS: A total of 112 mediastinal nodes from 45 patients who underwent non-contrast and dual-energy contrast-enhanced scans were analyzed. Node attenuation in TNC and VNC images was compared both objectively, using computed tomography (CT) attenuation, and subjectively, via visual scoring (0, attenuation < or = the aorta; 1, > the aorta; 2, calcification). The relationship among attenuation difference between TNC and VNC images, CT attenuation in TNC images, and net contrast enhancement (NCE) was analyzed. RESULTS: CT attenuation in TNC and VNC images showed moderate agreement (intraclass correlation coefficient, 0.612). The mean absolute difference was 7.8 +/- 7.6 Hounsfield unit (HU) (range, 0-36 HU), and the absolute difference was equal to or less than 10 HU in 65.2% of cases (73/112). Visual scores in TNC and VNC images showed fair agreement (kappa value, 0.335). Five of 16 nodes (31.3%) which showed score 1 (n = 15) or 2 (n = 1) in TNC images demonstrated score 1 in VNC images. The TNC-VNC attenuation difference showed a moderate positive correlation with CT attenuation in TNC images (partial correlation coefficient [PCC] adjusted by NCE: 0.455) and a weak negative correlation with NCE (PCC adjusted by CT attenuation in TNC: -0.245). CONCLUSION: VNC images may be useful in the evaluation of mediastinal lymph nodes by providing additional information of high CT attenuation of nodes, although it is underestimated compared with TNC images.
Adult ; Aged ; Aged, 80 and over ; Calcinosis/*radiography ; Contrast Media/diagnostic use ; Female ; Humans ; Image Processing, Computer-Assisted ; Lymph Nodes/*radiography ; Male ; Mediastinum/*radiography ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods

Few studies have reported on the long-term prognosis of anti-neutrophil cytoplasmic antibody (ANCA)-negative renal vasculitis. Between April 2003 and December 2013, 48 patients were diagnosed with renal vasculitis. Their ANCA status was tested using indirect immunofluorescence and enzyme-linked immunosorbent assays. During a median (interquartile range) follow-up duration of 933.5 (257.5-2,079.0) days, 41.7% of patients progressed to end stage renal disease (ESRD) and 43.8% died from any cause. Of 48 patients, 6 and 42 were ANCA-negative and positive, respectively. The rate of ESRD within 3 months was higher in ANCA-negative patients than in ANCA-positive patients (P = 0.038). In Kaplan-Meier survival analysis, ANCA-negative patients showed shorter renal survival than did ANCA-positive patients (log-rank P = 0.033). In univariate Cox-proportional hazard regression analysis, ANCA-negative patients showed increased risk of ESRD, with a hazard ratio 3.190 (95% confidence interval, 1.028-9.895, P = 0.045). However, the effect of ANCA status on renal survival was not statistically significant in multivariate analysis. Finally, ANCA status did not significantly affect patient survival. In conclusion, long-term patient and renal survival of ANCA-negative renal vasculitis patients did not differ from those of ANCA-positive renal vasculitis patients. Therefore, different treatment strategy depending on ANCA status might be unnecessary.
Age Factors ; Aged ; Antibodies, Antineutrophil Cytoplasmic/*analysis ; Cohort Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Kidney Diseases/*diagnosis/mortality ; Kidney Failure, Chronic/etiology ; Male ; Microscopy, Fluorescence ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Sex Factors ; Vasculitis/complications/*diagnosis/mortality