We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.
Actinomycosis ; Adult ; Bacteria ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Hepatocellular ; Diverticulum* ; Drainage ; Fibroadenoma ; Flank Pain ; Gallbladder ; Humans ; Infarction ; Liver ; Monocytes ; Neutrophils ; Penicillins ; Physical Examination ; Vesico-Ureteral Reflux* ; Weight Loss

No abstract available.
Blood Transfusion* ; Humans ; Infant, Newborn ; Infant, Premature*

PURPOSE: To report a rare case of orbital malignant lymphoma that occurred in a patient with acquired immunodeficiency syndrome. CASE SUMMARY: A 39-year-old male with acquired immunodeficiency syndrome complained of proptosis and loss of visual acuity. The best corrected visual acuity of his right eye was no light perception, and the BCVA of his left eye was 1.0. Ocular movement was limited, and esotropia of 15 prism diopters was detected. Exophthalmometry measurements showed a significant difference between both eyes (right eye was 18 mm, left eye was 15 mm). Computed tomography scans of the patient's orbit with contrast showed an enhancing mass in the right orbit, so a biopsy was performed. A biopsy specimen of the mass revealed non-Hodgkin's lymphoma (anaplastic variant, diffuse large B cell type). Distant metastasis was not found using abdominal and thoracic computed tomography and positron emission tomography. He underwent radiotherapy (30 Gy, 15 times). CONCLUSIONS: Orbital non-Hodgkin's lymphoma (B cell type) in a patient with AIDS is rare, but our case showed a good response to radiation therapy.
Acquired Immunodeficiency Syndrome ; Adult ; Biopsy ; Esotropia ; Exophthalmos ; Eye ; Humans ; Light ; Lymphoma ; Lymphoma, Non-Hodgkin ; Male ; Neoplasm Metastasis ; Orbit ; Positron-Emission Tomography and Computed Tomography ; Visual Acuity

BACKGROUND: Many methods have been proposed for the correction of sunken upper eyelids. These methods include surgical treatments, such as micro-fat, dermofat, or fascia-fat grafts, or the use of alloplastic materials. Here, we present our experience of sunken upper eyelid correction involving the simple addition of anchoring the central fat pad to the medial fat pad during upper blepharoplasty. METHODS: We performed 74 cases of upper blepharoplasty with sunken upper eyelid correction between October 2013 and September 2014. The lateral portion of the central fat pad was partially dissected to facilitate anchoring. The medial fat pad was gently exposed and then pulled out to facilitate anchoring. After the rotation of the dissected lateral portion of the central fat pad by 180degrees to the medial side, it was anchored spreading to the medial fat pad. Photographs taken at 6 months postoperatively were presented to three physicians for objective assessment. Of the 74 patients, 54 patients followed at 6 months postoperatively were included in this retrospective, objective assessment. RESULTS: Sunken eyelids were effectively corrected in 51 of the 54 patients, but 3 had minimal effect because preaponeurotic fat pads had been removed during previous upper blepharoplasty. In addition to correcting sunken eyelids, lateral bulging was corrected and a better definition of the lateral portion of upper lid creases was obtained. CONCLUSIONS: Anchoring the central fat pad to the medial fat pad provides an effective means of correcting sunken upper eyelids during upper blepharoplasty.
Adipose Tissue* ; Blepharoplasty* ; Esthetics ; Eyelids* ; Humans ; Retrospective Studies ; Transplants

STATEMENT OF PROBLEM: The aim of dental research is to advance scientific knowledge and leads to improvement in the treatment and prevention of dental disease. Utilizing an effective research design and adequate statistical methods are essential procedures ensuring that the results of researches are based on evidences. A research should utilize proper statistical methods without statistical errors; Otherwise, it could adversely affect clinical practice and future research. PURPOSE: This study was made to investigate the statistical methods used in the Journal of Korean Academy of Prosthodontics (JKAP) and then to assess them for the statistical errors. MATERIAL AND METHODS: Among the total of 399 articles in the JKAP published from 2000 to 2006, 292 articles using statistics were reviewed. The validity of the statistical methods used in them were assessed using a checklist based on the guideline for statistical reporting in the uniform requirements for manuscripts submitted to biomedical journals by International Committee of Medical Journal Editors. The checklist consisted of three categories of statistical errors: 1) Unspecified computer statistical packages, 2) Inadequate description of statistical methods, 3) Misuse of statistical terms. Then, the results were compared between the Korean version and the English version in the JKAP. RESULTS: Among the 212 articles using statistics in the Korean version, 115 articles (54%) and among the 80 articles using statistics in the English version, 47 articles (59%) were shown to have unspecified computer statistical packages without statistically significant difference (P = .66). Likewise, 101 articles (48%) in the Korean version and 25 articles (31%) in the English version were shown to have the inadequate description of statistical methods without statistically significant difference (P = .09). However, 114 articles (54%) in the Korean version and 19 articles (24%) in the English version were shown to have the misuse of statistical terms with statistically significant difference (P = .01). CONCLUSION: Some of the articles in the JKAP had inadequate statistical validity, given the statistical errors identified in this assessment. Hence, dental researchers should be more careful when it comes to describing and applying statistical methods.
Checklist ; Dental Research ; Prosthodontics ; Research Design ; Stomatognathic Diseases

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.
Acidosis ; Acidosis, Lactic* ; Amylases ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Humans ; Hypertension ; Insulin ; Lactic Acid ; Lipase ; Metformin* ; Middle Aged ; Nausea ; Pancreatitis* ; Renal Dialysis* ; Sitagliptin Phosphate ; Vomiting

BACKGROUND: Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. METHODS: The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. RESULTS: Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. CONCLUSIONS: The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.
Automation, Laboratory ; Efficiency, Organizational/*standards ; Phlebotomy/*statistics & numerical data ; Republic of Korea ; Time Factors ; Workflow

PURPOSE: Renal graft mass has been known as a determinant of the outcome after kidney transplantation. We evaluated the correlation between the donated kidney weight and the recipient's creatinine clearance (Ccr), the donated kidney weight and serum creatinine (Scr) as well as the correlation between the donor traits and graft function after living-donor transplantation in adults. METHODS: The weight of a donated kidney was measured just after flushing during the operative procedures, and the recipient's Scr was measured on a daily basis postoperatively. When the Scr of the recipient reached the baseline level, we collected the recipient's 24-hour urine for the Ccr calculation. Based on the measured body weight and height, body surface area (BSA) and lean body weight (LBW) were calculated. Pearson correlation analysis was carried out using the SPSS. RESULTS: The weight of donated kidney was significantly correlated with the post-transplant recipient's Ccr (P=0.022). Scr was significantly correlated with the variable of graft weight/ recipient body weight ratio (P=0.047, Pearson correlation=-0.539), graft weight/recipient BSA ratio (P=0.028, Pearson correlation=-0.438), graft weight./recipient LBW ratio (P=0.001, Pearson correlation=-0.603), donor body weight/recipient body weight ratio (P<0.001, Pearson correlation= 0.667), donorBSA/recipient BSA ratio (P<0.001, Pearson correlation=0.743), donor LBW/recipient LBW ratio (p<0.001 Pearson correlation=0.759). CONCLUSIONS: It may be appropriate to select potential living donors based on the predicted size of the kidney, especially for the recipient who will likely to have higher metabolic demands.
Adult ; Body Height ; Body Weight ; Creatinine ; Flushing ; Humans ; Kidney Transplantation* ; Kidney* ; Living Donors* ; Surgical Procedures, Operative ; Tissue Donors ; Transplants*

Carotid sinus nerve blockade (CSNB) has been shown to be effective for management of post-carotid endarterectomy (CEA) hypotension. The underlying hemodynamic changes are unknown. We retrospectively analyzed a recorded arterial blood pressure (ABP) waveform using a Modelflow technique. After declamping, total peripheral resistance (TPR) decreased (-65% of predeclamping value), but cardiac output (CO) and stroke volume (SV) increased (+60 and +57% of predeclamping value, respectively). CSNB abruptly increased blood pressure (BP) and TPR (75 and 95% of nadir, respectively), while CO and SV gradually decreased to -21 and -16% of maximum value, respectively). In conclusion, we found that severe decline of TPR was a cause of severe hypotension after declamping and CSNB increased BP mainly through increase in TPR, with little change in CO and SV.
Arterial Pressure ; Blood Pressure ; Cardiac Output ; Carotid Sinus* ; Endarterectomy ; Endarterectomy, Carotid* ; Hemodynamics* ; Hypotension* ; Nerve Block* ; Retrospective Studies ; Stroke Volume ; Vascular Resistance

Genipin, an aglycone derived from geniposide found in Gardenia jasminoides, is known to be an excellent natural cross-linker, strong apoptosis inducer, and antiviral agent. Although evidence suggests antiviral activity of genipin in several in vitro viral infection systems, there have been few literatures which review antitumor effects of genipin in a variety of in vitro/in vivo models of cancers yet. In this review, we present some of the latest findings in the studies of genipin focusing on antitumor effects and its mechanisms. In brief, genipin inhibits mitochondrial uncoupling protein 2 to increase accumulation of reactive oxygen species, leading to ROS/c-Jun N-terminal kinase-dependent apoptosis of cancer cells. Genipin also increase tissue inhibitors of metalloproteases (MMP), resulting to decrease activities of MMP-2 which plays a key role in metastasis of cancers. Genipin has shown a biphasic effects on cell death and survival in cancer cells as many other plant-derived phytochemicals do. Finally we discuss the potential of genipin as a promosing novel antitumor agent which could be applicable to chemotherapy and/or chemoprevention for cancers.
Apoptosis ; Cell Death ; Chemoprevention ; Drug Therapy ; Gardenia ; In Vitro Techniques ; Metalloproteases ; Neoplasm Metastasis ; Phytochemicals ; Reactive Oxygen Species