BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

Sertoli-Leydig cell tumor or Brenner tumor is a relatively rare ovarian tumor. Other associated elements in the form of epithelial, mesenchymal, and tumor components of each tumor have been reported. The Sertoli-Leydig cell tumor with a Brenner tumor element has not been documented in the literature, so we are reporting on a case of Sertoli-Leydig cell tumor coexisting with a Brenner tumor. This 62-year-old woman presented with a 4 year history of lower abdominal mass and vaginal bleeding. Exploratory laparotomy was done. The left ovary showed a multiseptated, cystic, yellow-white solid mass, measuring 17.0x13.0x5.0 cm and weighing 985.0 gm. Microscopic examination revealed a tubular or trabecular arrangement of the Sertoli cells and variable numbers of Leydig cells. There were several tumor nests with cystic spaces composed of ovoid cells showing longitudinal nuclear grooving. Sarcomatoid or heterologous elements were not found.
Female ; Humans

BACKGROUND: TSH receptor blocking antibody (TRBAb) is a pathogenic factor in the vast majority of patients with primary myxedema. It has been reported that TRBAbs are found in some patients with chronic goitrous autoimmune thyroiditis (Hashimoto's thyroiditis), but the significance or the role of TRBAb in Hashimotos thyroiditis is not clear, We recently reported that hTSHR-CHO cells which express the functional human TSH receptors are more sensitive and are better in detecting functional TSH receptor antibodies in Graves patients than FRTL-5 cells. We are to investigate the biological role of TRBAb in Hashimotos thyroiditis by measuring thyroid stimulation blocking antibody (TSBAb) activities of Hashimoto's IgG's using hTSHR-CHO cells. Moreover, we are to see if there is any difference in epitope recognition between Hashimotos TRBAb and myxedema's TRBAb by measuring TSBAb activities with mutant receptor expressing cell lines, Mcl+2 and Mc 2 in those patients. METHOD: We measured TSBAb activities of IgGs from patients with primary myxedema (PM, n= 10) and those with hypothyroid (n 20) or euthyroid (n 17) Hashimoto's thyroiditis (HT) using wild type hTSHR-CHO cells (WT) and two chimeric receptor expressing cell lines, Mcl+2 and Mc2. RESULTS: TSBAb activities measured by WT were higher in hypothyroid HT than in euthyroid HT (30.0+-23.2% vs. 6.1+-28.7, p<0.05), and TSBAb-positive rate tend to be higher in the former (20%, 5/20) than in the latter (0%, 0/17, p=0.07). TRBAbs from PM (n=4) had high TBII activities and had persistent blocking activities despite of the replacement of amino acid residue 8~165 of extracellular domain of TSHR with those of rat LH/CGR (Mcl +2). However, TRBAbs from HT (n=4) had no TBII activity at all and lost blocking activities when measured with Mcl+2. CONCLUSION: TRBAbs are found in 20% of hypothyroid patients with Hashimotos thyroiditis in assay using hTSHR-CHO cells, and they seem to play a role in the development of hypothyroidism in some patients with Hashimotos thyroiditis. TRBAbs of Hashimotos thyroiditis are different in epitope recognition from TRBAbs of primary myxedema.
Animals ; Antibodies* ; Cell Line ; Humans ; Hypothyroidism ; Immunoglobulin G ; Myxedema ; Rats ; Receptors, Thyrotropin* ; Thyroid Gland* ; Thyroiditis* ; Thyroiditis, Autoimmune

No abstract available.
Dust* ; Mastoid*

Background: Cognitive impairment has been reported to be closely associated with poor oral health, and the relationship is bidirectional, as older adults with poor oral health and chewing function are at a higher risk of cognitive decline (CD). This cross-sectional study aimed to determine whether masticatory discomfort in Korean elderly increases the risk of daily living difficulty (DLD) related to CD and whether there is a difference in risk according to gender and age. Methods: The data used were obtained from the Korean Community Health Survey (2019). The final analysis included 22,154 people aged 65 years and older who completed the survey and responded to all items on the variables used in the study. Chi-square test, trend test, and complex sample logistic regression were performed for statistical analysis, to clarify the purpose of this study. Results: As masticatory discomfort increased, the elderly’s DLD tended to increase (p-for trend, p＜0.001). For logistic regression, adjusting for all covariates, participants who reported masticatory discomfort as “discomfort” (adjusted odds ratio [AOR]=2.45, 95% confidence interval [CI]=2.11∼3.50) and “severe discomfort” (AOR=2.95, 95% CI=2.49∼3.50) had a more than a two-fold increased risk of CD-related DLD compared to participants who reported “no discomfort at all.” In age-stratified analyses, elderly men aged 75∼84 years and elderly women aged 65∼74 years had the highest risk of developing CD-related DLD. Conclusion Oral care interventions to improve masticatory function in older adults may slow CD and improve CD-related DLD. We hope that this study will raise awareness among caregivers and clinical professionals regarding the importance of oral care for older adults with CD.

PURPOSE: To evaluate the clinical findings, prognosis and treatment strategy of patients with neuroendocrine carcinoma of cervix. MATERIALS AND MEHTODS: Thirteen patients with neuroendocrine carcinoma of cervix were included in this study, as confirmed histologically and immunohistochemically at the Dongsan Medical Center, Keimyung University, between May 1944 and October 2001. The mean age of patients was 56 years with a range of 32 to 78 years of age. According to the FIGO staging system, there were 5 patients with stage IB carcinoma, 5 patients with IIA, and 3 patients with stage IIB. Four patients underwent radical hysterectomy with pelvic lymphadenectomy, 3 of these patients also received postoperative radiotherapy, and one patient underwent extrafascial hysterectomy after radiotherapy. Primary radiotherapy was done in 9 patients, and 3 were irradiated postoperatively. Nine patients received chemotherapy, 7 received neoadjuvant and 2 received concurrent chemoradiotherapy. The radical purpose of radiotherapy consisted of external irradiation to the whole pelvis (4,500~5,400 cGy) and intracavitary irradiation (3,000~3,500 cGy). RESULTS: The mean follow up duration was 36 months with a range of 3 to 104 months. The overall 5-year survival rate was 61.5% and the 5-year survival rates for stage IB, IIA, IIB were 60.0%, 60.0%, and 66.7% respectively (p=0.99). Eight patients are still alive without disease, and all of the 5 patients with recurrence are dead due to distant metastasis. CONCLUSION: Neuroendocrine carcinoma of cervix is highly aggressive, with early lymphatic dissemination and a high rate of distant recurrence. Therefore, an aggressive therapeutic strategy is required to obtain pelvic and distant disease control. Multimodal therapy should be considered at the time of initial diagnosis.
Carcinoma, Neuroendocrine* ; Cervix Uteri* ; Chemoradiotherapy ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Neoplasm Metastasis ; Pelvis ; Prognosis ; Radiotherapy ; Recurrence ; Survival Rate

OBJECTIVE: Apoptosis or programmed cell death is a normally physiological cell suicide program that is highly conserved among all animals. We previously evaluated overexpression of c-IAP1(Inhibitor of Apoptosis Protein) in ovarian carcinomas compared with normal ovaries. In this study, we demonstrate evidence for the involvement of c-IAP2 in ovarian carcinomas. METHODS: Fresh 9 normal ovaries, 5 benign ovarian cysts and 13 ovarian carcinomas were obtained from routine gynecologic surgeries carried out for benign and malignant ovarian tumors. They were examined for the presence of c-IAP2 by RT-PCR(Reverse Transcriptase Polymerase Chain Reaction), Western blot analysis and immunohistochemical stains. RESULTS: Nine of 14 normal and benign ovarian tumors were negative and 11 of 13 ova rian carcinomas were positive for c-IAP2 by RT-PCR. Positive RT-PCR for c-IAP2 was seen in 11/13 of ovarian carcinomas, a significantly higher percentage than in normal and benign ovarian tumors(5/14). All of these tumors showed strong positive for c-IAP2 by western blot and immunohistochemical staining. Whereas negative RT-PCR for c-IAP2 was seen in 9/14 of normal and benign ovarian tumors, a significantly higher percentage than ovarian carcinomas(2/13). Of these 9 negative samples, 6 had positive Western blot and immunohistochemical stains. There was weak concordance of the result. But expression of c-IAP2 in normal ovarian tissue was localized exclusively in the corpus luteum. Therefore, c-IAP2 may play important role in determining the fate of the follicular destiny. There was no expression in normal ovarian stroma cells for c-IAP2. CONCLUSIONS: These findings suggest that c-IAP2 is expressed in ovarian carcinomas and emerging role in cancer. The c-IAP2 expression has been investigated in the normal ovary, where apoptosis is thought to play an important role in ovulation.
Animals ; Apoptosis ; Blotting, Western ; Cell Death ; Coloring Agents ; Corpus Luteum ; DNA-Directed RNA Polymerases ; Female ; Gynecologic Surgical Procedures ; Ovarian Cysts ; Ovary ; Ovulation ; Ovum ; Suicide

Xanthogranulomatous cholecystitis is an extremely rare benign inflammatory disease of the gall bladder characterized by yellowish focal nodular appearance with tissue necrosis and lipid-containing histiocyte (xanthomacell). Recently, we experienced a case of xanthogranulomatous cholecystitis. A 71-year old woman was admitted with the complaints of RUQ pain for 1 month. On abdominal ultrasound examination, there were diffuse gallbladder wall thickening, echogenic nodule with acoustic shadow, the calculous cholecystiti and the gall badder cancer were strongly suspected and the operation was performed. At operation the gall bladder was marked enlarged and wall thickening with two brownish, oval shaped, smooth surfaced stones. The specimen was revealed a xanthogranulomatous cholecystitis by the pathology.
Acoustics ; Aged ; Cholecystitis* ; Female ; Gallbladder ; Histiocytes ; Humans ; Necrosis ; Pathology ; Ultrasonography ; Urinary Bladder

BACKGROUND: Graves' disease and primary myxedema are thought to be caused by the action of TSH receptor autoantibodies(thyroid stimulating antibody; TSAb & thyroid stimulation blocking antibody; TSBAb). Thus, detection of these antibodies is crucial in diagnosis and in follow up of those patients. Recently, a sensitive method using human TSH receptor transfected Chinese Hamster Ovary(CHO) cells has been developed. However, the complexity of IgG purification procedure is considered as a limitation for its clinical application as a routine test. The aim of this study is to determine whether polyethylene glycol(PEG)-precipitated immunogiobuIin fraction could substitute for purified IgG. METHODS: We developed optimal conditions for TSAb and TSBAb assays using crude, PEG precipitated immunoglobulin fraction; and evaluated the correlation of TSAb and TSBAb activities between thase measured using crude immunoglobulin fraction and purified IgG to clarify the usefulness of PEG-precipitated immunoglobulin fraction. TSH receptor expressing wild type CHO cells were used in TSAb and CHO cells expressing chimeric TSH receptor(Mc2; 90-165 amino acid residues were substituted by those of rat LH/CG receptar) were used in TSBAb assay to minimize the possible disturbing effects of TSAb in serum. RESULTS: The optimal serum amount for TSAb and TSBAb assay using PEG-precipitated immunoglobulin fraction were 250mL serum equivalent/well and 50mL serum equivalent/well, respectively. The optimal incubation time for both assays were 2 homs, and aptimal ccrncentration of bTSH for TSBAb assay was 0.1U/L. TSAb activities measured with PEG-precipitated immunoglobulin were significantly correlated with those measured with purified IgG in 26 patients with Graves diseases(r=0.93, p<0.001). Although TSBAb activities measured using PEG-precipitated imrnunoglobulin were conelated with those measured using purified IgG in 20 patients with primary myxedema(r=0.86, p<0.001), the positive rate in TSBAb assay using PEG-precipitated immunoglobulin was lower than that of usmg purified IgG(20% v.s. 65%) because of negative conversion of TSBAb activities in samples with weakly positive TSBAb activities measured using purified IgG. CONCLUSION: PEG-precipitated immunoglobulin fraction could be used instead of purified IgG in TSAb assay using hTSHR-tranasfected wild type CHO cells with equal sensitivity and specificity. This simple and practical TSAb assay using PEG-precipitated immunoglobulin in hTSHR-transfected CHO cells would be useful in clinica1 practiee.
Animals ; Antibodies* ; Asian Continental Ancestry Group* ; CHO Cells ; Cricetinae ; Cricetulus* ; Diagnosis ; Graves Disease ; Humans ; Humans* ; Immunoglobulin G ; Immunoglobulins* ; Myxedema ; Polyethylene Glycols* ; Polyethylene* ; Rats ; Receptors, Thyrotropin* ; Sensitivity and Specificity ; Thyroid Gland

Blow-out fracture is frequently encountered in facial bone trauma. And the frequency of medial orbital wall fracture in Asia is high. Various approaches have been reported for medial orbital wall fractures. The field of medial orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital wall, susceptibility of injury of orbital structures. Recently, endoscopic reduction of orbital wall was provided good fuctional and cosmetic results. In order to address this shortcoming we have explored the use of endoscopic external short scar approach in medial orbital wall dissection to allow direct visualization of orbital content and nearly whole fracture components. In this study a direct local approach through a 2cm, modified Z-shaped incision on superior medial orbital area was used as a consistent method to reconstruct medial blow-out fractures. The incision line consist 3 limbs. The angle of the limbs is to 110 degrees. First, 1cm sized line exsists frontonasal line. Second, 5mm sized 2 limbs of the incision line were placed parallel or oblique to the relaxed skin tension line. During the follow-up period of 6 to 12 months, excellent functional and cosmetic results were observed with an inconspicuous scar. Therefore, a direct external short scar incision approach with endoscope on the superior medial orbit may be a consistent method to gain the surgical goal in treatment of blow-out fractures of the medial orbital wall.
Asia ; Cicatrix* ; Endoscopes ; Extremities ; Facial Bones ; Follow-Up Studies ; Orbit* ; Orbital Fractures* ; Skin