No abstract available.
Colonoscopy*

We have experienced a case of 13 ring chromosome in a 40-month-old girl who demonstrated psychomotor retardation with delayed speech, growth retardation, hearing loss(left), microcephaly, trigonocephaly with flat occiput, hypertelorism, epicanthal folds, microophthalmia, broad prominamt nasal bridge, high arched palate, micrognathia, large auricles and other anomalies. Cytogenetic studies of peripheral blood lymphocytes with differential staining of chromosomes revealed 46, XX, r13. Her parents' karyotypes were normal. We reported the case with the review of the associated literatures.
Child, Preschool ; Craniosynostoses ; Cytogenetics ; Female ; Hearing ; Humans ; Hypertelorism ; Karyotype ; Lymphocytes ; Microcephaly ; Palate ; Ring Chromosomes*

PURPOSE: The purpose of this study was to evaluate the spectrum of MR characteristics of cystic acoustic neurinomas and to correlate with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the MR findings of 12 patients with cystic acoustic neurinomas. The signal intensity and enhancement pattern of the cystic components as well as the location relative to the tumors were analyzed. RESULTS: A total of 30 cysts were found in 15 acoustic neurinomas;28 were intratumoral cysts and the remaining two were extratumoral cysts. The signal intensity of all 28 intratumoral cysts was higher than that of CSF on Tl-weighted images, and isointense to CSF on T2-weighted images, while the signal intensity of the two extratumoral cysts was same as CSF on both Tl-weighted and T2-weighted images. Rim enhancement was seen in 27 of 28 intratumoral cysts but in none of the two extratumoral cysts. CONCLUSION: We concluded that intratumoral cyst was due to tumoral necrosis, hemorrhage or degenerative change and extratumoral cyst due to secondary arachnoid cyst formation.
Acoustics* ; Arachnoid ; Hemorrhage ; Humans ; Necrosis ; Neuroma, Acoustic* ; Retrospective Studies

PURPOSE: This study was aimed to identify gender-based health inequality and explore impacting factors on health inequality in one province in Korea. METHODS: This was an explanatory study using the secondary data on Chungnam province from the Fifth Community Health Survey from August 16 to Oct 31, 2012. Variables included in this analysis were education level, poverty, marital status, and residential community for socio-cultural characteristics and subjective health status as an indicator of health inequality. Data were analyzed by chi2-test, t-test, ANOVA, and multiple linear regression. RESULTS: There were gender inequalities and disparities in health, and these inequalities were greater in woman than in man (chi2=161.8, p<.001). The impacting factors were education level, poverty, marital status, and residential community, which was accounted for 22.6% of variances of health inequality. Among these variables, gender showed the largest influence in health inequalities. CONCLUSION: To solve health inequalities, it should be considered gender differences based on social determinants of health. It is necessary to develop long term project based on these results and the social determinants model of World Health Organization.
Chungcheongnam-do ; Education ; Female ; Health Surveys ; Humans ; Korea ; Linear Models ; Marital Status ; Poverty ; Social Determinants of Health ; Socioeconomic Factors* ; World Health Organization

PURPOSE: Differential diagnosis of solitary pulmonary nodule with cavity includes lung abscess, tuberculoma, bronchogenic carcinoma, metastasis and trauma, etc. We analyzed the CT appearance of tubercuioma presenting as a solitary pulmonary nodule with cavity and describe the findings which suggest tuberculoma in the differential dignosis of soliary pulmonary nodule with cavity. MATERIALS AND METHODS: 25 patients with solitary pulmonary nodule(diameter less than 4 cm) without surrounding parenchymal consolidation on chest radiograph, who had a cavity within the nodule on CT, were included in our study. Density of the nodule, maximal wall thickness, the character of inner and outer wall margin, location of cavity within the nodule, location of the nodule, presence or absence of satellite lesions and calcification were analyzed. RESULTS: Solitary tuberculoma with cavity showed maximal wall thickness more than 15 mm in 40%(10/25) and 5-14 mm in 56%(14/25), eccentric cavitation in 84%(21/25) and concentric cavitation in 16%(4/25), spiculated outer wall margin in 56%(14/15) and Iobulated margin in 32%(8/25), smooth inner wall margin in 60%(15/25) and nodular margin in 40%(10/25). CT density of the cavity wall compared with the chest wall muscle was low in 84%(21/25) and isodense in 16%(4/25). Accompanying satellite lesions were seen in 84% (21/25) and calcification was visible in 28%(7/25). CONCLUSION: The CT findings of solitary tuberculoma with cavity are relative peripheral location, eccentric cavitation, finely spiculated outer wall margin, and mean maximal wall thickness of 13.2 mm, which are also the common features of malignant nodule. However, relative low density of the nodule compared to the chest wall muscle and surrounding satellite lesions can be additional clues favoring solitary tuberculoma with cavity on CT.
Carcinoma, Bronchogenic ; Diagnosis, Differential ; Humans ; Lung Abscess ; Neoplasm Metastasis ; Radiography, Thoracic ; Solitary Pulmonary Nodule ; Thoracic Wall ; Tuberculoma*

PURPOSE: The effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on the energy metabolism in girls with central precocious puberty (CPP) are controversial. We focused the changes and related factors of serum levels of leptin and adiponectin in girls with CPP before and during GnRHa treatment. METHODS: Thirty girls with idiopathic CPP were enrolled in the study. Their auxological data and fasting blood were collected at the baseline and after six months of GnRHa treatment. RESULTS: After treatment, height (P<0.001), weight (P<0.001), and serum leptin levels (P=0.033) were significantly increased, whereas body mass index (BMI), homeostasis model of assessment-insulin resistance, serum adiponectin levels, and adiponectin/leptin ratio exhibited no significant changes. A Pearson correlation analysis showed that height, weight, BMI, and their standard deviation scores (SDSs), but not basal LH, FSH, and estradiol, were significantly correlated with serum leptin levels before and after GnRHa treatment. After a multiple linear regression analysis, only BMI was associated with serum leptin levels. Moreover, leptin SDSs adjusted for BMI were not significantly different before and after GnRHa. The Δ leptin levels (r2=0.207, P=0.012), but not with Δ leptin SDS (r2=0.019, P=0.556), during GnRHa treatment were positively correlated with Δ BMI. CONCLUSION: These results suggest that GnRHa treatment in girls with CPP does not affect serum levels of leptin and adiponectin and insulin resistance. Serum leptin levels were depend on the changes in BMI during GnRHa treatment.

PURPOSE: The effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on the energy metabolism in girls with central precocious puberty (CPP) are controversial. We focused the changes and related factors of serum levels of leptin and adiponectin in girls with CPP before and during GnRHa treatment. METHODS: Thirty girls with idiopathic CPP were enrolled in the study. Their auxological data and fasting blood were collected at the baseline and after six months of GnRHa treatment. RESULTS: After treatment, height (P<0.001), weight (P<0.001), and serum leptin levels (P=0.033) were significantly increased, whereas body mass index (BMI), homeostasis model of assessment-insulin resistance, serum adiponectin levels, and adiponectin/leptin ratio exhibited no significant changes. A Pearson correlation analysis showed that height, weight, BMI, and their standard deviation scores (SDSs), but not basal LH, FSH, and estradiol, were significantly correlated with serum leptin levels before and after GnRHa treatment. After a multiple linear regression analysis, only BMI was associated with serum leptin levels. Moreover, leptin SDSs adjusted for BMI were not significantly different before and after GnRHa. The Δ leptin levels (r2=0.207, P=0.012), but not with Δ leptin SDS (r2=0.019, P=0.556), during GnRHa treatment were positively correlated with Δ BMI. CONCLUSION: These results suggest that GnRHa treatment in girls with CPP does not affect serum levels of leptin and adiponectin and insulin resistance. Serum leptin levels were depend on the changes in BMI during GnRHa treatment.

Pancreatic tissue is maintained by a simple proliferation of the preexisting cells in adulthood, whereas, they are dynamically derived from precursor/ stem cells from ductal epithelia during prenatal life. It has been known that tissue regeneration rarely occurs in the normal adult pancreas, particularly in the human pancreas. However, regeneration can be experimentally induced in the adult pancreas in response to various tissue injuries such as partial resection, pancreatitis by obstruction of the duct, and chemical insults. Regenerating pancreatic tissue shares a common morphogenic feature of "neogenic regeneration" in all regenerating animal models. Neogenic regeneration occurs at the site of tissue injury by forming small tubular structures with elongated epithelial cells (ductules) which grow to form pancreatic ducts and acini. The endocrine cells, including insulin secreting beta cells, are also derived from these ductules. As a sequential process of neogenesis, the regenerating tissue becomes heterogeneous in composition. Some areas were composed by tubules and ductules in surrounding loose connective tissue while others were denser with differentiating acini derived from tubules or ductules. Such neogenic regeneration mimics tissue development during fetal pancreatic organogenesis. In the process of pancreatic neogenesis, we found unique expressions of bioactive proteins such as nestin and clusterin as morphogenic factors. It is likely that the stem/precursor cells could be recapitulated and regenerated to functional cells, including endocrine and exocrine pancreatic cells with acinar and ductal cells during neogenic regeneration of the pancreas.
Adult ; Candidiasis, Cutaneous ; Clusterin ; Connective Tissue ; Endocrine Cells* ; Epithelial Cells ; Humans ; Insulin ; Models, Animal ; Nestin ; Organogenesis ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Regeneration* ; Social Change ; Stem Cells ; Tinea

Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.
Anxiety ; Child ; Cognitive Therapy ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychiatry ; Symptom Assessment ; Tic Disorders ; Tics ; Tourette Syndrome ; Ventilation ; Weights and Measures

BACKGROUND: Long term patency of arterial graft has been better than venous graft and redo coronary artery bypass grafting has been increasing, therefore, there has been an increasing need for alternative arterial grafts except internal thoracic artery(ITA). MATERIAL AND METHOD: Right gastroepiploic arteries(RGEA) were harvested from 100 patients who had received gastrectomy for gastric cancer or ulcer. ITAs were obtained from 10 patients undergoing coronary artery bypass grafting. The length of RGEA was measured from the pyloric ring. Items of the morphometric and histologic study at the pyloric ring and sites of the 10cm and 20cm RGEA from the pyloric ring were luminal diameter, intimal thickness, medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness, medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness index, medial thickness index, and the number of discontinuities of the internal elastic lamina. Similar items were applied to the proximal site of ITAs. RESULT: The length of RGEA was 23+/-2.7cm(range 17~31cm). Comparing the 20cm RGEA with ITA, intimal thickness, medial thickness, wall thickness, and degree of intimal hyperplasia did not show any difference(p>0.05). However, 20cm RGEA was greater than ITA at the luminal diameter, intimal thickness index, and the number thickness and wall thickness in each site of the RGEA(pyloric ring, 10cm, 20cm) decreased from the pyloric ring to the distal sites(p<0.05). The degree of intimal hyperplasia and the number of discontinuities of the internal elastic lamina did not show any difference between the pyloric ring and 10cm, however, those of 20cm were smaller than these sites(p<0.05). RGEA had more number of discontinuities of the internal elastic lamina and rich smooth muscle cells in the media than ITA. CONCLUSION: The length and diameter of RGEA is good enough to reach most of the coronary arteries. Moreover, long term patency of RGEA may be improved, if anastomosed in the distal site.
Coronary Artery Bypass* ; Coronary Vessels* ; Gastrectomy ; Gastroepiploic Artery* ; Humans ; Hyperplasia ; Myocytes, Smooth Muscle ; Phenobarbital ; Stomach Neoplasms ; Transplants ; Ulcer