Neurilemmomas of the trachea are extremely rare. The most common site of them is the distal third of the trachea and the age of the patients at presentation varied from 6 to 78 years old. They usually have a freqeuntly very long natural history, causing symptoms only after they have attained a considerable size. We experienced a case of near-total obstruction of the trachea by an intraluminal sessile neurilemmoma. The patient was a 66-year-old man with 2-year history of progressive exertional dyspnea and had several episodes of pneumonitis associated with productive cough. Grossly, the tumor was a well-circumscribed mass. Microscopically, typical cellular Antoni A and myxoid Antoni B areas were revealed.
Aged ; Cough ; Dyspnea ; Humans ; Natural History ; Neurilemmoma* ; Pneumonia ; Trachea

To evaluate the clinical and histopathological significance of the proliferative activity in neoplastic and non-neoplastic thyroid lesions, we analyzed the mitotic count and the proliferating cell nuclear antigen labeling index (PCNA-LI) by immunohistochemistry as the proliferation- related markers. In this study included were surgically removed normal thyroid tissue (27 cases), adenomatous goiter (15 cases), Hashimoto's thyroiditis (5 cases), follicular adenoma (13 cases), follicular carcinoma (7 cases), papillary carcinoma (44 cases), poorly differentiated carcinoma (2 cases) and undifferentiated carcinoma (3 cases). The median PCNA-LI was 0 in normal thyroid tissue, 0.5 in adenomatous goiter, 6.2 in Hashimoto's thyroiditis, 1.2 in follicular adenoma, 4.8 in follicular carcinoma, 8.5 in papillary carcinoma, 60.8 in poorly differentiated carcinoma, and 55.2 in undifferentiated carcinoma (p=0.0001). Although PCNA-LI was exceptionally high in Hashimoto's thyroiditis, it was suggested that PCNA-LI could be used as a marker differentiating benign lesions from malignant neoplasm. Also, it could differentiate follicular adenoma from follicular carcinoma. Except clinical stage (p=0.0397), PCNA-LI was not related with sex, size, histologic subtype, and lymph node metastasis in papillary carcinoma. The presence of mitosis differentiated the neoplastic thyroid lesions from the non-neoplastic lesions (p<0.05), however, it could not divide benign and malignant neoplasm. These results suggest that an evaluation of the proliferative activity can help to differentiate the thyroid lesions. In addition, there was no significant correlation between the value of PCNA-LI and the presence of mitosis. It can be recommended to evaluate both the mitotic count and the PCNA-LI for determining the proliferative activity of the thyroid lesions.
Adenoma ; Carcinoma ; Carcinoma, Papillary ; Goiter ; Immunohistochemistry ; Lymph Nodes ; Mitosis ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen* ; Thyroid Gland* ; Thyroiditis

No abstract available.
Cell Line* ; Cytokines* ; Humans* ; Neuroblastoma*

BACKGROUND: Demand for emergency medical information is high according to the health information use, utilization and demand survey for on the Internet. In spite of high demand for emergency information service, emergency information service on-line and off-line are very limited. Therefore, it is necessary to develop a website providing emergency medical information and emergency medical resources information by linking emergency medicine where timely information is required with the Internet technology for health promotion of the public. OBJECTIVE: This study is conducted to develop and evaluate a Web site to provide information on emergency medicine and resources for health promotion. METHODS: To identify and specify users' requirements for the emergency medicine related information, online survey was performed for 209 Internet users who visited the Healthguide. Based on this survey results, we developed content for emergency medical information service: cause, risk factors, prevention, treatment, facilities, laws and rules, policy and statistics of emergency medicine. To evaluate the web site developed in this study, twenty health and nursing informatics experts were recruited and asked to rate using an evaluation tool. RESULTS: This content was integrated into the healthy life (http://healthguide.kihasa.re.kr/health_life/emergency/pages/index.html), which is a service component of the Healthguide. This approach was expected to increase accessibility and usability of implemented services. The rating score of the website was fairly high with mean 3.9(SD 0.6) out of 5.0. According to each evaluation criteria, purpose of the site, easiness of use, relevancy, and reliability were scored 4.1-4.2 and authority and accuracy 3.8-3.9 and currency 3.5-3.7. This evaluation results will be fed back to the Healthguide for operation, maintenance, and upgrade in the future.
Emergencies* ; Emergency Medicine ; Health Promotion* ; Information Services* ; Internet ; Jurisprudence ; Nursing Informatics ; Risk Factors

BACKGROUND AND PURPOSE: Although the 15-item Geriatric Depression Scale (GDS15) is a widely used depression screening questionnaire, the implications of the GDS15 in patients with Alzheimer's disease (AD) are questionable. We designed this study to explore the GDS15 factor structure and the relationships between these factors and cognitive-behavioral aspects. METHODS: The GDS15, cognitive function tests, and the Korean-Neuropsychiatry Inventory were administered to 310 patients with probable AD, who were not medicated before visiting the hospital. Three factors were identified by principal components analysis. A bivariate correlation analysis was conducted to determine the relationships between factors and neurocognitive and behavior symptoms. RESULTS: Factor 2 was correlated with the Korean Boston Naming Test, calculating ability, the go-no-go test, the Controlled Oral Word Association Test (COWAT), the Color Word Stroop Test (CWST; words and color), aggression, depression, and apathy. Factor 3 was correlated with calculating ability, the Seoul Verbal Learning Test, immediate recall, copy, and delayed recall on the Rey-Osterieth Complex Figure Test, contrasting on the COWAT, and words and delusion on the CWST. We identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale. CONCLUSIONS: These results suggest that the GDS15 may be comprised of a heterogeneous scale and suggest multi-dimensional properties of the GDS15 in patients with AD.
Aggression ; Alzheimer Disease* ; Apathy ; Delusions ; Depression* ; Factor Analysis, Statistical ; Humans ; Mass Screening ; Memory, Short-Term ; Seoul ; Stroop Test ; Verbal Learning ; Word Association Tests ; Surveys and Questionnaires

Two distinct hantaviruses have been isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. Since our serosurveys conducted in 1994, a genetically distinct hantavirus from Apodemus peninsulae has been investigated. To isolate hantavirus from A. peninsulae captured in Korea, the lung homogenate of seropositive A. peninsulae inoculted Vero E6 cells. Viral antigen was detected in a progressively higher percentage of cells with subsequent passage after 80 days postinoculation. The new isolate from seropositive Apodemus peninsulae was designated Suchong virus after Suchong valley located in northeastern region of South Korea. Comparing with hantaan virus 76-118 strain, Suchong virus-1, 2, 3 and 4 showed the similarity of 71.0~91.8% at nucleotide and 90.9~94.8% at amino acid sequences in 231 nucleotides region of M segment, and the similarity of 75.1~81.0% at nucleotide and 97.5~100% at amino acid sequences in 237 nucleotides of S segment.
Amino Acid Sequence ; Animals ; Hantaan virus ; Hantavirus* ; Korea ; Lung ; Murinae* ; Nucleotides ; Population Characteristics* ; Rats

The aim of this study was to determine if the apoptotic degree could predict the prognosis for breast cancer in mastectomy specimens and to establish if any association existed between the apoptotic degree and clinical variables such as age, size, hormone receptor, lymph node metastasis, stage, result of follow up. The apoptotic degree, defined as the number of morphologically identified apoptotic bodies in the view of a 200X microscope, was calculated for 59 breast cancers. We applied an immunohistochemical procedure for staining the apoptotic cells in parapin sections of 59 breast cancers. The histochemical method used for the analysis of apoptosis was based on the detection of DNA breaks by terminal transferase-mediated in situ end labeling (TUNEL). The results were as follows; 1. An association between apoptotic degree and age was demonstrable (p=0.050). 2. No association between apoptotic degree and tumor size was demonstrable. 3. No association between apoptotic degree and lymph node metastasis was demonstrable. 4. An association between apoptotic degree and stage was demonstrable. 5. No association between apoptotic degree and hormone receptor was demonstrable (p=0.023). 6. No association between apoptotic degree and follow up results was demonstrable, however a low apoptotic degree showed a tendency for a poor clinical outcome, and this result had partiall statistical significance. Thus provisionally its value as an independent prognostic index has yet to be established and demands more study.
Apoptosis* ; Breast Neoplasms* ; Breast* ; DNA Breaks ; Follow-Up Studies ; Lymph Nodes ; Mastectomy ; Neoplasm Metastasis ; Prognosis

OBJECTIVES: The aim of this study was to identify characteristics of children and adolescents who were victims of sexual assault in Korea. METHODS: The subjects were 60 children and adolescents who visited the one-stop center as victims of sexual assault. The medical records of victims of sexual trauma were retrospectively reviewed. We studied the demographic data of the victims, their relationship to their perpetrator, the characteristics of the assault (frequency, duration, place, type), and the process from sexual assault to treatment. We also paid special attention to how the characteristics of the victims or perpetrators affected the characteristics of the assault or follow-up treatment. RESULTS: There were several differences between sexual assaults committed by strangers and those committed by acquaintances. Sexual assaults committed by acquaintances lasted for a longer period of time than those committed by strangers. In addition, it took more time for victims of sexual assaults committed by acquaintances to seek treatment than those who were victims of sexual assaults committed by strangers. The majority (55.0%) of victims were between 10 and 15 years of age. Forty percent of the perpetrators were teenagers, and two of them were under the age of 10. Voluntary discontinuation of treatment was more frequent in adolescents than in children. CONCLUSION: All teenage victims of sexual assault need some sort of urgent intervention. In addition, approachable methods are needed in order to prevent sexual abuse by strangers or acquaintances.
Adolescent ; Child ; Follow-Up Studies ; Friends ; Humans ; Hypogonadism ; Medical Records ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Sex Offenses

PURPOSE: To describe the clinical phenotype of congenital cataract in Korean families and to determine whether the cataract is causally related to other congenital cataract with known gene. METHODS: We examined total 21 patients with congenital cataract and their families. Peripheral blood samples were obtained from congenital cataract patients and their families who visited clinics. The phenotypes were characterized by slit lamp examination and photographs of digital camera. And genetic traits were discriminated by family pedigree analysis. And we performed known mutation specific enzyme digestion, cold - SSCP and sequencing analysis for identification of genetic defects. RESULTS: We found nuclear (42.8%), anterior polar (4.8%), cortical (4.8%), sutural (4.8%) cataract. And the families affected with coexisting cortical and posterior polar opacity, posterior polar and post-subcapsular opacity were two cases (9.4%) respectively. We identified and examined a three-generation family affected with coexisting autosomal dominant zonular cataract and sutural opacity (CCZS, 4.8%: Family Yun). Previously the CCZS had mapped to chromosome 17q11-q12 and reported mutation of the beta A3A1-crystallin (CRYBA1) gene. We had not identified any mutation in CRYAB1 gene. CONCLUSIONS: In conclusion, we reported that nuclear type is very frequent in Korean patients with congenital cataract. And we had not identified any defects in CRYAB1 gene. These results demonstrated another gene caused this congenital cataract with same phenotype. Furthermore it will be necessary to perform the linkage analysis with microsatellite marker.
Cataract* ; Digestion ; Humans ; Microsatellite Repeats ; Pedigree ; Phenotype ; Polymorphism, Single-Stranded Conformational

There have been few articles describing incidences of epileptiform discharges in EEG and epilepsy in subjects with cerebral palsy(CP) and probably no references about lateralizing significance of EEG and brain imaging findings in asymmetrically quadriparetic patients. We reviewed clinical, EEG and brain imaging findings of one hundred and fifty patients with paretic cerebral palsy to assess incidences of epileptiform discharges(Eds), background abnormalities and epilepsy as well as lateralizing significance of those findings in 52 patients who were asymmetrically quadriparetic. The results were as follows. 1) Incidence of Ebs on serial EEG and epilepsy excluding febrile convulsion were 28.0 %(42/150) and 30.0 %(4S/1SO), respectively. 2) Among 42 patients with Eds, 19(45.2 %) did not have any history of epileptic seizure. 3) In 52 patients who were asymmetrically quadriparetic, unilateral background abnormality or focal BDs were observed in 21 and unilateral brain imaging abnormalities in 13 subjects. There was a positive correlation between side of unilateral EEG abnormalities and the more severely affected side of the body in 17/52 (32.3%), while there was a positive correlation between side of brain imaging abnormalities and the more severely affected side of the body in 12/52 (23.1%). Also, there was a positive correlation between unilateral EEG abnormalities and brain imaging laterality in 8 subjects. In conclusion, if any lateralized abnormalities, EEG as well as brain imaging are thought to be useful in determining the side of maximal brain damage in asymmetrically quadriparetic CP.
Brain ; Cerebral Palsy* ; Electroencephalography ; Epilepsy ; Humans ; Incidence ; Neuroimaging ; Seizures, Febrile