To evaluate the clinical and histopathological significance of electron dense deposits on capillary in IgA nephropathy, we reviewed and compared the clinical, laboratory, and pathological features of the patients with IgA nephropathy without loop extension of electron dense deposits(Group I, 91 cases) and IgA nephropathy with loop extension(Group II, 17cases) by ultrastructural examination using transmission electron microscope. IgA nephropathy associated with liver disease, Henoch-Schonlein purpura, systemic lupus erythematosus and the other IgA nephropathies associated with systemic diseases were excluded. The results were as follows; 1) There was no significant difference in age distribution. 2) Generalized edema was more common in group II. 3) Nephrotic ranged proteinuria(>3 g/24hr urine) was more prominent in Group II(52.9%) than Group I(8.8%). 4) Among the groups, segmental or mild deposits on the loops were noted in 13 cases, and severe and generalized deposits in 4 cases. Subendothelial deposits were noted in 6 cases, subepithelial deposits in 3 cases, subendothelial with intramembranous deposits in 1 case, subendothelial with subepithelial deposits in 1 case, intramembranous with subepithelial deposits in 2 cases, and subendothelial, subepithelial and intramembranous deposits in 4 cases. 5) The other associated ultrastructural changes of group II were diffuse effacement of foot processes with microvillous transformation, swelling or vacuolar degeneration of podocytes and glomerular endothelium. 6) According to the WHO morphologic criteria, the grade of Group II was significantly higher than Group I. From the above results, it can be concluded that the extension of electron dense deposits along the capillary loops in the cases of IgA nephropathy is highly correlated with proteinuria in the nephrotic ranged. It seems to be a poor prognostic indicator in view of the facts that it correlats with high histopathologic grading.

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.
Education ; Growth and Development ; Hand ; Health Expenditures ; Health Facility Closure ; Hospitals, Community ; Hospitals, General ; Hospitals, Rural* ; Humans ; Inflation, Economic ; Models, Economic

The pinching motion is thought to be one of fundamental hand functions, the power of which has been quantified by measuring it isometrically with variously devised pinch-meters. The present authors describe the investigations on the pinching power of 350 healthy persons, 200 male and 150 female Koreans, by the use of Preston Pinch Gauge. Six kinds of pinch were chosen: (1) thumb index finger tip pinch (1-2TP), (2) thumb-middle finger tip pinch (1-3TP), (3) thumb-index finger pulp pinch (1-2PP), (4) thumb-middle finger pulp pinch (1-3PP), (5) thumb-index-middle finger pulp pinch (3PP), (6) key pinch (KP), which were classified again into 19 kinds according to the shape of thumb, index, middle, or other fingers during each pinch. We describe those as principal type, hyperextension-flexion type, hyperextension type and other type into four. It should be justified to calculate the mean normal value of principal type pinching power in Korean. Principal type of pinch involves 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP, as to Hyperextension type of 1-2PP, 1-3PP, 3PP and KP. Other type of pinch involving 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP is different from Principal type simply because of the shape of nonjoining fingers during pinch. Generally, the pinching power of Principal type was clearly highest among the four types except for pulp pinches.
Asian Continental Ancestry Group ; Female ; Fingers ; Hand ; Humans ; Male ; Reference Values ; Thumb

The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
Female ; Humans

Tatbion is a tripeptide, reduced form of Glutathione(GSH or p-glutamyl-cysteiny1 -glycine). Glutathione(SH compound)is believed to inhibit melanin formation by combining witb the copper in tyrnsinase whicb is essential in the conversion of tyrosine to DOPA (3, 4-dihydroxyphenylalanine) and DOPA to DOPA-quinone or by forming cornplex with the intermediate in the tyrosine-to-melaa.in reaction. The effect of Tathion in the treatment of melasma has not been reported in Korea. We have observed the effect of Tatbion in 150 patients with melasma. After the average duration of Gwks of treatment(50-100mg tree tirnes/daily), we were abIe to grade the results as follow. Excellent(Pigmentation almost disappeared): 17. 4 % Good (Pigmentation markedly improved): 56. 7% Fair (Pigmentation slightly improved: 7. 3% None (No effect) : 18.6% The result showed relatively good effects of Tathion in the treatment of 122pts (81.4%) with melasma in total. The brief review of literature on the treatment of melasma was undertaken.
Copper ; Dihydroxyphenylalanine ; Glutathione* ; Humans ; Korea ; Melanins ; Melanosis* ; Tyrosine

Gestational trophoblastic tumor is one of the curable disease, but metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy. Choriocarcinoma may occur after an any type of human pregnancy. The incidence of choriocarcinoma following term pregnancy is very uncommon, and such tumor appears to follow a more aggressive course with more extensive metastatic spread and is less responsive to chemotherapy resulting in a poorer prognosis. Choriocarcinoma presenting as postpartum hemorrhage, and spontaneous tumor perforation with intra-abdominal hemorrhage is even rarer, requiring emergency laparotomy. We had experienced one case of metastatic choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to uterine perforation and hemorrhage. So, we report this case with brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Laparotomy ; Mortality ; Postpartum Hemorrhage ; Pregnancy ; Pregnancy* ; Prognosis ; Trophoblastic Neoplasms ; Uterine Perforation*

PURPOSE: The purpose of this study was to identify the degree and relationship between self-esteem, depression, and suicidal ideation of youths in the auxiliary police force. METHOD: This descriptive study was conducted using a structured questionnaire from February 1 to March 25, 2007. The participants were 180 youths from 19 to 25 years old (average 20.82 years old) who were auxiliary policemen. The data were analyzed using the SPSS Win 12.0 program. RESULTS: Six of the auxiliary police (3.34%) reported critical scores in suicidal ideation. There was a significant difference in depression according to work area. Self-esteem showed a significant negative correlation with depression (r=-0.38, p<.001) and suicidal ideation (r=-0.39, p<.001). There was a positive correlation between depression and suicidal ideation(r=0.53, p<.001). CONCLUSION: The findings suggest that auxiliary policemen have higher levels of depression and suicidal ideation. Therefore, further study is needed to develop and examine nursing interventions the enhance self-esteem, so that depression and suicidal ideation can be minimized.
Adolescent ; Depression ; Humans ; Police ; Questionnaires ; Suicidal Ideation ; Suicide

PURPOSE: This study was done to identify whether the program, improving adjustment to military life would have an effect on stress, depression, idea of suicide, adjustment to military living, and self-esteem in auxiliary police. METHOD: This quazi experimental study using a non-equivalent control group pretest and posttest design was conducted from February 1 to May 30, 2007. Using convenience sampling, the researcher recruited 120 auxiliary police and randomly assigned each to either the experimental and the control group. The experimental group received an 8-week program to improve adjustment to military life. RESULTS: Anxiety, stress, depression, idea of suicide, self-esteem, and adjustment to military living were significantly different between the experimental and control groups. CONCLUSION: These results suggest that programs to improve adjustment to military life would improve psychological health and adaptation of military living in auxiliary police. Replication studies are needed to confirm the effects of this program and to identify the long-term maintenance effects of the program.
Anxiety ; Depression ; Humans ; Military Personnel ; Police ; Social Adjustment ; Suicide

No abstract available.
Liver* ; Osteosarcoma*

Endometrial adenocarcinoma is the third common malignancy of female genital tract and categorized as estrogen-dependent tumor (type I) or not (type II). Type II endometrial adenocarcinoma more frequently occurs in oriental, which may arise from genetic alterations such as K-ras and p53. To identify whether the K-ras and p53 mutational activation are occurred during endometrial carcinogenesis, we examined point mutations of K-ras codon 12, 13, 61 (PCR-RFLP) and p53 exon 5, 6, 7, 8 (PCR-SSCP) in the 19 samples of endometrial adenocarcinoma. The 9 samples of normal endometrium and 24 samples of endometrial hyperplasia were also examined. K-ras codon 12 mutations were found in one of 3 cases of atypical hyperplasia (33.3%) and three of 19 cases of endometrial adenocarcinoma (15.7%). The correlation with K-ras mutation and endometrial hyperplasia/adenocarcinoma was statistically insignificant(p=0.306). p53 mutation was found in only one case of endometrial adenocarcinoma which concomitantly occurred with K-ras mutation. It could not be determined that K-ras mutation was early or late event during endometrial carcinogenesis due to a few cases of atypical hyperplasia and no K-ras mutation in the benign endometrial hyperplasia. The endometrial adenocarcinoma with K-ras mutation was observed in postmenopausal old age groups, and revealed moderate to severe histologic grade, early clinical stage, and negative lymph node metastasis.
Adenocarcinoma* ; Carcinogenesis ; Codon ; Endometrial Hyperplasia* ; Endometrium ; Exons ; Female ; Genes, p53* ; Humans ; Hyperplasia ; Lymph Nodes ; Neoplasm Metastasis ; Point Mutation