Pheochromocytoma is originated from chromaffin cell of sympathetic nervous system and associated with other disease, such as neurofibromatosis, duodenal carcinoid, medullary thyroid cancer and parathyroid adenoma. Especially, pheochromocytoma is developed more than 50% in neurofibromatosis associated with hypertension. In such cases, several clinical features documented as more frequent bilateral phochromocytoma, more associated with other neuroendocrine tumors and thus more poor prognosis. We can observe the sustained hypertension despite of surgical resection of tumors in pheochromocytoma cases. One of the possible reason of post operative sustained hypertension is the pheochromocytoma originated from minor organ of Zukerkandl that was not resected during operation. Untreated or delayed treated cases with pheochromocytoma were often expired by complication of hypertension such as cerebrovascular hemorrhage, myocardial infarction, etc. Thus, in neurofibromatosis with hypertension, screening of pheochromocytorna is very important for the early detection of tumor and more favorable prognosis. Recently, We experienced a case of neurofibromatosis associated with bilateral pheochromocy-toma expired by cerebral hemorrhage during operation, so we report the case with literature review.
Carcinoid Tumor ; Cerebral Hemorrhage ; Chromaffin Cells ; Hemorrhage ; Hypertension ; Mass Screening ; Myocardial Infarction ; Neuroendocrine Tumors ; Neurofibromatoses* ; Parathyroid Neoplasms ; Pheochromocytoma* ; Prognosis ; Sympathetic Nervous System ; Thyroid Neoplasms

The purpose of this study was to examine the comparison of growth development, bone mineral density and nutrient intakes between double income families' preschool children(DIFPC) and full-time housewives' preschool children(FHPC). Subjects were 111 preschool children. Anthropometric characteristics and bone mineral density in right forearm were measured. The questionnaire was composed of health status, life style, dietary behaviors, and dietary intakes and was completed by the children's mothers. The average age of the DIFPC(n=60) was 53.02 months and that of the FHPC(n=51) was 54.80 months. The birth height and weight of the subjects were 50.47cm and 3.27Kg for DIFPC and 50.85cm and 3.36Kg for FHPC, respectively. The average height, weight, % body fat, and obesity index were 108.50cm, 18.35Kg, 15.35%, 96.71% in DIFPC and 111.46cm, 19.64Kg, 16.80%, 97.31% in FHPC, respectively. The bone mineral density in forearm of two groups were 0.24g/cm2 in all. The infant feeding method was significantly different between DIFPC and FHPC; 58.9% of DIFPC was fed formula, while 44.4% of FHPC was fed breast milk(p<0.05). Proportions of children for their regular meal were 59.4%, 89.6%, and 61.0% for breakfast, lunch, and dinner, respectively. The major reasons for irregular meal were lack of time and poor appetite for breakfast and snacks for lunch and dinner. Most of the children answered they have snack over once a day, and 60.0% have unbalanced diet. The intakes of energy, calcium, iron, zinc, vitamin A, vitamin B1, niacin, and vitamin C did not meet the Korean RDAs. The intakes of K and vitamin A for DIFPC were significantly higher than those of FHPC(p<0.05, p<0.05). In conclusion, double income families' preschool children more have a low frequency of breast feeding and low intakes of micro nutrients, such as K and vitamin A than full-time housewives' ones.
Adipose Tissue ; Appetite ; Ascorbic Acid ; Bone Density ; Breakfast ; Breast ; Breast Feeding ; Calcium ; Child ; Child, Preschool* ; Diet ; Feeding Methods ; Forearm ; Humans ; Infant ; Iron ; Life Style ; Lunch ; Meals ; Mothers ; Niacin ; Obesity ; Parturition ; Surveys and Questionnaires ; Snacks ; Thiamine ; Vitamin A ; Zinc

No abstract available.
Phenytoin* ; Stevens-Johnson Syndrome*

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate

PURPOSE:Urine examination for microalbuminuria during the clinical silent years can help to identify those patients most likely to progress to overt nephropathy. The normalization of the AER(Albumin Excretion Rate) by alteration of glomerular hemodynamics may be the key to preventing or delaying overt nephropathy. The prognostic and therapeutic implications have led to attempts to identify patients with microalbuminuria as early as possible.Because diagnosis of microalbuminuria has required a 12 or 24 hour urine collection,there has been interested in developing tests that might serve as a first-stage screen for microalbuminuria. Most reports have dealt with the usefulness of either the albumin concentration or the albumin/creatinine ratio in a timed or randomly collected urine specimen. Exercise induced albumin excretion is increased compared to resting and could unmask latent glomerular damage. The purpose of this study is to evaluate diagostic significance of urinary albumin measurement after exercise in children with insulin dependent diabetes. METHODS:Fifty-seven patients with IDDM collected their overnight urine from 22:00 to 6:00 in following morning. Exercised method for urine examination was 100M running and collected 2 hour urine after exercise. The AER and Albumin/ creatinine ratio(ACR) were measured in the urine and compared with before and after exercise. RESULTS:Mean ages of diabetic children was 13.7 yrs old and duration of diabetes was 4.1+/-2.7yrs, HbA1c 8.6+/-1.9%,Systolic BP 107+/-10mmHg and Diastolic BP 67+/-8mmHg. The exercise induced AER was increased compared to before exercise(10.3+/-10.5 vs 18.1+/-16.0 mg/24hr). The exercise induced ACR also increased too(1.4+/-1.5 mg/g.Cr vs 4.1+/-3.6mg/g.Cr)(P<0.01). Two(3.5%) children with IDDM was positive for microalbuminuria in terms of AER before exercise and 8 children(14%) after exercise. No one positive for microalbuminuria in terms of Alb/cr before and after exercise. The charateristics of 8 children with microalbuminuria after exercise was no specific difference between positive and negative microalbuminuria. There was specific correlation between microalbuminuria and HbA1c(P<0.05) but sex, ages, duration of diabetes & blood pressure were not correlated with incidence of microalbuminuria. CONCLUSION: The mean timed urinary albumin excretion after exercise was significantly higher than before exercise. Measurement of timed urinary albumin excretion after exercise will be helpful for detecting microalbuminuria earlier.
Blood Pressure ; Child* ; Creatinine ; Diabetes Complications ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies ; Diagnosis ; Hemodynamics ; Humans ; Incidence ; Insulin ; Running

BACKGROUNDS/AIMS: We investigated the clinical application of extended distal pancreatectomy in patients with pancreatic neck cancer accompanied by distal pancreatic atrophy. In this study, we have emphasized on the technical aspects of using the linear stapling device for a bulky target organ. METHODS: From March 2010 to September 2013, 46 patients with pancreatic adenocarcinoma, who underwent pancreatic resection with radical intent at our institute, were reviewed retrospectively. Among them, three patients (6.5%) underwent extended distal pancreatectomy. A linear stapling device and vise-grip locking pliers were used for en bloc resection of the distal pancreas, first duodenal portion, and distal common bile duct. The results were compared with those after standard pancreatectomy. RESULTS: All three patients presented with jaundice, and the ratio of pancreatic duct to parenchymal thickness of the pancreatic body was greater than 0.5. Grade A pancreatic fistula developed in all of the cases, but none of these fistulae were lethal. Pathological staging was T3N1M0 in all of the patients. The postoperative daily serum glucose fluctuations and insulin requirements were comparable to those in patients who received pancreaticoduodenectomy or distal pancreatectomy. At the last follow-up, two patients were alive with liver metastasis at 4 and 10 months postoperatively, respectively, and one patient died of liver metastasis at 5 months postoperatively. CONCLUSIONS: While the prognosis of advanced pancreatic neck adenocarcinoma is still dismal, extended distal pancreatectomy is a valid treatment option, especially when there is atrophy of the distal pancreas. Also, the procedure is technically feasible, and further refinement is necessary to improve patient survival.
Adenocarcinoma ; Atrophy ; Blood Glucose ; Common Bile Duct ; Fistula ; Follow-Up Studies ; Head and Neck Neoplasms* ; Humans ; Insulin ; Jaundice ; Liver ; Neck ; Neoplasm Metastasis ; Pancreas ; Pancreatectomy* ; Pancreatic Ducts ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of: 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.
Disease Management ; House Calls ; Interviews as Topic ; Life Style ; Nursing ; Qualitative Research ; Self Care

PURPOSE: Cyclin D1, which is known as a cell regulatory protein in G1-S phase, is overexpressed in 30-90% of breast cancers. Published data on the relationships between cyclin D1 and the established clinicopathologic factors of breast cancer have been controversial, so we investigated the clinical significance of cyclin D1 and its associations with established clinicopathologic factors in 103 primary breast-cancer patients. METHODS: Cyclin D1 overexpression was measured by using immunohistochemical assays, and the results were compared with clinicopathologic factors. RESULTS: Expression of cyclin D1 was detected in 60.2% (62/103) and cyclin D1 was significantly correlated with the estrogen receptor, the progesterone receptor, lymph-node metastasis, histologic grade, and nuclear grade. But there were no associations between cyclin D1 and tumor size, tumor stage, vascular invasion of tumor, DNA ploidy and S phase. CONCLUSION: We found that breast cancer with cyclin D1 overexpression was associated with predictive factors such as the estrogen receptor and the progesterone receptor. Thus, we suggest that aggressive treatment is needed in breast cancer with cyclin D1 overexpression. For cyclin D1 to become a more informative clinical prognostic factor, more prospective studies with large sample sizes are needed.
Breast Neoplasms* ; Breast* ; Cyclin D1* ; Cyclins* ; DNA ; Estrogens ; Humans ; Neoplasm Metastasis ; Ploidies ; Receptors, Progesterone ; S Phase ; Sample Size

The expression of two intermediate filaments, nestin and vimentin, was studied in spinal cord injury (SCI) to elucidate their roles in the formation of glial scars. Rats were sacrificed 1, 4, and 7 days after induction of compression injury of the spinal cord using an aneurysm clip. The affected spinal cords were studied using antibodies against nestin and vimentin intermediate filaments. One day after spinal cord injury, some clusters of nestin-positive vessels were detected in the center of the injury, but few were seen in other cell types. Vimentin immunostaining was detected in some glial cells in the center and its level of immunoreactivity was enhanced in the ependymal cells of the central canal. On days 4 and 7 after spinal cord injury, astrocytes and some ependymal cells in the central canal were stained positively for nestin and increased expression of nestin was observed in vessels. Vimentin was detected in some macrophages and astrocytes in the lesions. Nestin was co-localized with glial fibrillary acidic protein in some glial cells in SCI. These findings imply that spinal cord cells in adult animals have embryonic capacity, and these cells are activated after injury, which in turn contributes to repair of spinal cord injury through formation of a glial scar.
Animals ; Cicatrix/pathology ; Glial Fibrillary Acidic Protein/analysis ; Immunohistochemistry ; Intermediate Filament Proteins/analysis ; Intermediate Filaments/*physiology ; *Nerve Tissue Proteins ; Neuroglia/*pathology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries/*pathology ; Vimentin/analysis

This is a case report of a 61 years old man with suprasellar and pituitary metastasis from bronchogenic adenocarcinoma who developed polyuria and polydipsia. The clinical diagnosis has been made by bronchoscopy with washing cytology, biopsy of cervical lymph node, and brain MRI scan. Brain MRI scan showed metastatic tumor in the suprasellar area and pituitary gland with invasion of pituitary stalk. Light microscopic findings revealed adenocarcinoma in bronchoscopic washing cytology, and metastatic adenocarcinoma in the cervical lymph node. The combined pituitary stimulation test showed decreased reserve capacity of anterior pituitary hormones. And the water deprivation test also showed complete central diabetes inspidus. We report a case of suprasellar and pituitary metastasis from bronchogenic adenocarcinoma with a review of the literature.
Adenocarcinoma ; Biopsy ; Brain ; Bronchoscopy ; Diabetes Insipidus* ; Diagnosis ; Humans ; Hypopituitarism ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Pituitary Gland ; Pituitary Hormones, Anterior ; Polydipsia ; Polyuria ; Water Deprivation