Myofibroblastoma is a rare benign mesenchymal tumor of the breast. It presents as a well circumscribed, solitary nodular mass, and it has been reported to mainly occur in male patients. To our knowledge, few reports have described the radiologic appearance of myofibroblastoma in the female breast and there has been no report from Korea. We describe the mammographic, sonographic and histologic findings of a case of myofibroblastoma that presented as a well defined mass mimicking fibroadenoma in a 44-year-old woman.
Adult ; Breast* ; Female* ; Fibroadenoma ; Humans ; Korea ; Male ; Neoplasms, Muscle Tissue* ; Ultrasonography

Robinsoniella peoriensis has recently been identified as a Gram-positive, spore-forming, anaerobic rod originally recovered from swine manure storage pits. To date, 6 cases of R. peoriensis infection have been reported, including 2 cases of bacteremia, 1 of abdominal fluid collection, and 3 of wound infection. In the present study, we report a 76-yr-old man with R. peoriensis bacteremia who developed aspiration pneumonia. Gram staining of a purified colony revealed Gram-positive, rod-shaped bacteria. Biochemical identification using API 20 A (bioMerieux, France) indicated presence of Clostridium spp. We performed both 500-bp and full-gene sequencing of 16S rRNA of the isolate. The sequence was analyzed with MicroSeq ID 16S rRNA Library v2.0 (Applied Biosystems, USA), GenBank Basic Local Alignment Search Tool (BLAST) (http://www.ncbi.nlm.nih.gov/genbank), and EzTaxon database v2.1 (http://www.eztaxon.org). The 500-bp 16S rRNA sequence of the blood culture isolate showed 99.16-99.79% similarity with R. peoriensis and the full-gene 16S rRNA sequence showed 98.87-99.50% similarity with R. peoriensis. The organism was confirmed as R. peoriensis by using all of the mentioned databases except for MicroSeq, which did not include the RNA sequence of this bacterium. This case suggests that identification of R. peoriensis might be challenging in clinical laboratories with no access to molecular methods, as certain commercial identification systems may not identify, or may misidentify, this organism. To the best of our knowledge, this is the first report of the isolation of R. peoriensis in Korea.
Aged ; Bacteremia/*microbiology ; Clostridium/classification/genetics/*isolation & purification ; Databases, Genetic ; Humans ; Male ; Phylogeny ; Pneumonia, Aspiration/*diagnosis/microbiology ; RNA, Ribosomal, 16S/chemistry/genetics ; Republic of Korea ; Sequence Analysis, DNA

γδ T cells are a rare and unique prototype of T cells that share properties with natural killer cells in secondary lymphoid organs. Although many studies have revealed the function and importance of adult-derived γδ T cells in cancer biology and regenerative medicine, the low numbers of these cells hamper their application as therapeutic cell sources in the clinic. To solve this problem, pluripotent stem cell-derived γδ T cells are considered alternative cell sources; however, few studies have reported the generation of human pluripotent stem cell-derived γδ T cells. In the present study, we investigated whether lymphoid lineage γδ T cells were successfully generated from human pluripotent stem cells via hemogenic endothelium under defined culture conditions. Our results revealed that pluripotent stem cells successfully generated γδ T cells with an overall increase in transcriptional activity of lymphoid lineage genes and cytolytic factors, indicating the importance of the optimization of culture conditions in generating lymphoid lineage γδ T cells. We uncovered an initial step in differentiating γδ T cells that could be applied to basic and translational investigations in the field of cancer biology. Based on our result, we will develop an appropriate method to purify γδ T cells with functionality and it helpful for the study of basic mechanism of γδ T cells in pathophysiologic condition as well as clinic application.

Serotonin syndrome (SS) is a potentially life-threatening drug reaction characterized by mental status change, increased neuromuscular tone, and autonomic instability. Linezolid, an oxazolidinone antibacterial agent, is widely used in general hospitals; however, it interacts with some serotonin agonists and may cause SS. We report a case of SS caused by linezolid, without the concomitant use of serotonin agonist. A 72-year-old patient was admitted due to recurrent wound infection of his left ankle. He developed fever, skin rash, and renal function deterioration, and blood eosinophils and liver enzymes increased after administration of vancomycin. The antibiotic was changed to linezolid against methicillin-resistant Staphylococcus aureus. Four days later, he developed agitation, fever, increased blood pressure, and tachycardia. There were no abnormal findings in laboratory and image tests, including brain and chest computed tomography suggesting the cause of his symptoms. He had not taken any serotonin agonists, including serotonin uptake inhibitors and monoamineoxidase-inhibiting antidepressants. When administration of linezolid was stopped, his symptoms improved within 24 hours and fully recovered within 2 days without additional treatments.
Aged ; Ankle ; Antidepressive Agents ; Blood Pressure ; Brain ; Dihydroergotamine ; Eosinophils ; Exanthema ; Fever ; Hospitals, General ; Humans ; Liver ; Methicillin-Resistant Staphylococcus aureus ; Serotonin Receptor Agonists ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Tachycardia ; Thorax ; Vancomycin ; Wound Infection ; Linezolid

PURPOSE: This study evaluated the usefulness of a new scoring system in diagnosing acute appendicitis which expresses the patient's symptoms, physical examination, and laboratory findings more clearly and objectively. METHODS: A prospective study was conducted with 314 patients who were hospitalized with suspicion of acute appendicitis. After analyzing the symptoms, physical examination, and laboratory findings, 10 meaningful variables were selected, each of which were scored separately. The diagnostic value of the new scoring system was evaluated, and analyzed in comparison to the preexisting Alvarado score. RESULTS: Ten variables including vomiting, migration pain, fever, Dunphy's sign, Rovsing's sign, tenderness, rebound tenderness, increased white blood cell counts, increased neutrophil proportion, and increased CRP levels were associated with acute appendicitis. The new scoring system is developed by applying 1 point for each variable, with a total score of 10 points. In the new scoring system, a score above 5 points had sensitivity of 0.75, specificity of 0.73, positive predictive value of 0.92, and diagnostic accuracy of 0.71. The area under the receiver operating characteristic curve was 0.80, which is larger than 0.72 of the preexisting Alvarado score, and thus has a higher diagnostic accuracy. As acute appendicitis progresses, the average score tends to become significantly higher (P=0.001). CONCLUSION: The new scoring system, which objectively reflects the clinical variables of the patient's symptoms, physical examination and laboratory findings, will be useful in accurately diagnosing acute appendicitis and in quickly deciding a therapeutic policy in patients with right lower abdominal pain.
Abdominal Pain ; Appendicitis ; Fever ; Humans ; Leukocyte Count ; Neutrophils ; Physical Examination ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Vomiting

BACKGROUND: Stenosis of the left pulmonary artery (LPA) after repair of tetralogy of Fallot (TOF) is troublesome. A new technique of LPA angioplasty using an autologous MPA flap was performed in patients with TOF. MATERIALAND METHOD: From October 1998 to January 2001, 24 patients (median age; 10 months, range; 4 to 145 months)underwent total correction of TOF with LPA angioplasty using the autologous MPA flap. Five patients underwent pulmonary angioplasty without any patch over the MPA and LPA. The patches were required to enlarge only the MPA in 4 patients, and transannular RVOT widening was performed in 15. RESULT: There were no operative or late deaths. During follow-up (range: 6~42 months), reoperation for LPA stenosis was not required in any patients, but balloon angioplasty for branch pulmonary artery stenosis was performed in 3 patients. Echocardiography and CT angiography at the recent follow-up showed an obtuse angle between the MPA and LPA. CONCLUSION: Although further follow-up is needed, the angioplasty using the autologous MPA flap can be easily performed, avoiding patch-related complications, and allowing growth of the MPA flap. This angioplasty technique creates a more natural and obtuse angle between the MPA and LPA, which can minimize kinking of the LPA, especially in the patients who underwent transannular patch widening.
Angiography ; Angioplasty* ; Angioplasty, Balloon ; Constriction, Pathologic ; Echocardiography ; Follow-Up Studies ; Humans ; Pulmonary Artery* ; Reoperation ; Tetralogy of Fallot

Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.
Adult ; Choriocarcinoma* ; Chorionic Gonadotropin ; Consolidation Chemotherapy ; Diagnosis, Differential ; Drug Therapy ; Early Diagnosis ; Female ; Fertility ; Follow-Up Studies ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Lung ; Neoplasm Metastasis* ; Pneumothorax* ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts ; Uterus

The purpose of the study was to examine the adolescents' awareness and practice of Dietary Action Guide for Adolescence, which was developed by the Ministry of Health & Welfare. Subjects were middle and high school students, selected one class each from all of the 16 provinces in Korea, which were 32 schools and 998 students all together. The subjects were asked to self-evaluate the degree of awareness and practice of Dietary Action Guide using the 5 point-Likert scale from July to September, 2010. On average, 55.1% of the students responded that they were aware of the Dietary Action Guide and 49.4% answered that they put Guidelines into practice. The average score of awareness and practice were 3.54 +/- 0.24 and 3.42 +/- 0.33, respectively. The awareness score was higher than those of practice score in all the questions in the 6 categories. Awareness score of female students was higher than those of male students but there was no difference by residence area. Awareness and practice of the nutrition education-experienced were higher than those of the inexperienced. Practice score was higher among middle school-students compared to high school students, which reflected the opportunity of taking nutrition related classes. This finding shows that nutrition education for adolescents is important to change their dietary behaviors regardless of gender, residence area and school level.
Adolescent ; Female ; Humans ; Korea ; Male

OBJECTIVE: To compare the effect of radio frequency ablation (RFA) on the dimensions of radio frequency coagulation necrosis in a rabbit lung using a wet electrode in monopolar mode with that in dual electrode bipolar mode at different infusion rates (15 mm/hr versus 30 ml/hr) and saline concentrations (0.9% normal versus 5.8% hypertonic saline) . MATERIALS AND METHODS: Fifty ablation zones (one ablation zone in each rabbit) were produced in 50 rabbits using one or two 16-guage wet electrodes with a 1-cm active tip. The RFA system used in the monopolar and dual electrode wet bipolar RFA consisted of a 375-kHz generator (Elektrotom HiTT 106, Berchtold, Medizinelektronik, Germany). The power used was 30 watts and the exposure time was 5 minutes. The rabbits were assigned to one of five groups. Group A (n = 10) was infused with 0.9% NaCl used at a rate of 30 ml/hr in a monopolar mode. Groups B (n = 10) and C (n = 10) were infused with 0.9% NaCl at a rate of 15 and 30 ml/hr, respectively in dual electrode bipolar mode; groups D (n = 10) and E (n = 10) were infused with 5.8% NaCl at a rate of 15 and 30 ml/hr, respectively in a dual electrode bipolar mode. The dimensions of the ablation zones in the gross specimens from the groups were compared using one-way analysis of variance by means of the Scheffe test (post-hoc testing). RESULTS: The mean largest diameter of the ablation zones was larger in dual electrode bipolar mode (30.9+/-4.4 mm) than in monopolar mode (22.5+/-3.5 mm). The mean smallest diameter of the ablation zones was larger in dual electrode bipolar mode (22.3+/-2.5 mm) than in monopolar mode (19.5+/-3.5 mm). There were significant differences in the largest and smallest dimension between the monopolar (group A) and dual electrode wet bipolar mode (groups B-E). In dual electrode bipolar mode, the mean largest diameter of the ablation zones was larger at an infusion rate of 15 ml/hr (34.2+/-4.0 mm) than at 30 ml/hr (27.6+/-0.1 mm), and the mean smallest diameter of the ablation zones was larger at an infusion rate of 15 ml/hr (27.2+/-7.5 mm) than at an infusion rate of 30 ml/hr (24+/-2.9 mm). CONCLUSION: Using a wet electrode, dual electrode bipolar RFA can create a larger ablation zone more efficiently than monopolar RFA.
Sodium Chloride/administration & dosage ; Rabbits ; Pulmonary Alveoli/pathology ; Necrosis ; Lung Neoplasms/surgery ; Equipment Design ; *Electrodes ; Catheter Ablation/*instrumentation/methods ; Animals

OBJECTIVE: With the burgeoning elderly population, mental health among the elderly has surfaced as an important medical, social, and economic issue. This study was a pilot study testing the assessment module that was developed to survey mental health among the elderly living in the city of Busan. METHODS: Basic demographic data and mental health problems were investigated using the General Health Questionnaire-12 (GHQ-12), suicide risk screening tool, subjective memory deterioration scale, sleep disorder and sleep pattern scale, health-related quality of life scale (EuroQoL-5 dimension), and alcohol abuse screening tool (Cut down, Annoyed, Guilty, Eye-opener Questionnaire). RESULTS: Four-hundred adults aged 65 years or older living in either of two districts in the Busan metropolitan city participated in the study, of whom 219 (54.8%) were female. About 26.8% of the participants were obese, while 2.3% were underweight. One hundred and twenty-five (31.3%) participants were in need of attention to or improvement of nutrition management, and 19.1% perceived themselves to be in poor health. In the GHQ-12, 68.8% were in psychological distress (≥2). About 49.8% of the participants had insomnia, 61.8% had subjective memory disturbance, and 6% were at risk of suicide. The GHQ-12 score, proportion of participants with sleep disturbance, and subjective memory deterioration was significantly higher among women than in men, while health-related quality of life was higher in men. CONCLUSION: A considerable number of older adults living in the Busan region were suffering from psychological stress, were in need of nutrition management, had low quality of life, and had poor mental health, and women were particularly more vulnerable.
Adult ; Aged* ; Alcoholism ; Busan ; Female ; Humans ; Male ; Mass Screening ; Memory ; Mental Health* ; Pilot Projects* ; Quality of Life ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders ; Stress, Psychological ; Suicide ; Thinness