We report a case of non-cirrhotic portal hypertension in a 73 year-old woman, who had 19-year history of idiopathic myelofibrosis. There were esophageal varix, splenomegaly, and ascites. The biopsied liver showed irregular sinusoidal/ perisinusoidal fibrosis and occasional central-to-central fibrous connection. In areas with extensive fibrosis, coarse collagen fibers filled the sinusoidal spaces and compressed hepatocytes. However, nodular regeneration was absent. Double immunohistochemical stain for smooth muscle actin and proliferation cell nuclear antigen (PCNA) revealed diffusely activated stellate cells, some of which showed nuclear PCNA staining. There was also extramedullary hematopoiesis with bizarre megakaryocytes. The portal vein and its branches were patent. Idiopathic myelofibrosis is a rare cause of non-cirrhotic portal hypertension: the portal hypertension was considered to be the result of sinusoidal/perisinusoidal fibrosis in this case.
Actins ; Aged ; Ascites ; Collagen ; Esophageal and Gastric Varices ; Female ; Fibrosis ; Hematopoiesis, Extramedullary ; Hepatocytes ; Humans ; Hypertension, Portal* ; Liver ; Megakaryocytes ; Muscle, Smooth ; Portal Vein ; Primary Myelofibrosis* ; Proliferating Cell Nuclear Antigen ; Regeneration ; Splenomegaly

The hemostatic effect of endoscopic microwave coagulation method for upper gastrointestinal bleeding was evaluated clinically. Hemostasis over 72 hours was achieved in 18 of 20 cases (90%) with upper gastrointestinal bleeding by the endoscopic microwave coagulation method. It is noteworthy that this method was effective in all 4 cases of pulsatile bleeding from exposed vessels. We conclude that this method is useful for emergency endoscopic hemostasis on upper gastrointestinal bleeding, especially bleeding from exposed vessels.
Emergencies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Microwaves*

Neonatal hepatitis(NH) and congenital extrahepatic biliary atresia(BA) are two major causes of neonatal cholestasis. The method of therapeutic trials for each disease is essentially different. Nonetheless it is very difficult to differentiate these diseases histologically, since most of the hepatic changes are mutual in both of them. This study is to aimed to find out major differences between the two by scoring various histological parameters. A total of 63 consecutive liver biopsies taken from 54 patients with suggested NH and BA were examined by applying morphometric scoring system. The detailed clinical histories, laboratory data including serology for HBsAg and TORCH infection and radiologic operative findings were reviewed. Among 54 patients, 27 were diagnosed as NH and 20 as BA. In two cases, features of both diseases were coexistent. The pathological diagnosis was not compatible with the final diagnosis in 5 cases(10.7%). In all of these 5 cases, biopsy had been performed at the age of one to two months. The seropositivity for TORCH was 59.3%(16.27) in NH, but 25.0%(5/20) in BA. Serum AST, ALT and alpha-fetoprotein values were higher in NH, and total bilirubin in BA. Of various histological parameters, scores of portal fibrosis, bile duct and ductular proliferation and bile thrombi were much higher in BA, and at the age of less than 2 months, extramedullary hemopoiesis(EMH) was found much more frequently in NH. Giant cell transformation of hepatocytes(GCT) was more commonly observed in NH. The numbers of GCT and EMH were particulary plentiful when the patients' sera were positive for HBsAg or TORCH. These results indicate that portal fibrosis, biliary proliferation and bile thrombi are the three major histologic features of BA, and therefore erroneous histological diagnosis may ensue when scores of those features are low as in some early BA.
Infant, Newborn ; Humans ; Biopsy

BACKGROUND: The factor structure of the Hamilton Depression Rating Scale (HDRS) is well validated for patients with major depressive disorder (MDD). We examined whether HDRS factors can measure the anxious distress specifier in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, in patients with MDD.METHODS: A retrospective chart review of patients with MDD between March 2012 and June 2015 was conducted. We extracted data on anxious distress symptoms and detailed clinical information and examined how the 5 HDRS factors (anhedonia/retardation, guilt/agitation, bodily symptoms, insomnia, and appetite) were related to the anxious distress specifier using the receiver operating characteristic (ROC) curve analysis and the area under the ROC curve analysis.RESULTS: We observed significant differences in the HDRS and Beck Depression Inventory scores between anxious distress and non-anxious distress groups at the index episode. The score for guilt/agitation factor was significantly higher than that for other factors in the anxious distress group and exhibited good predictive efficiency at baseline.CONCLUSION: Further investigation of the anxious distress specifier as a diagnostic entity would be worthwhile. In addition, the scores for guilt/agitation factor on the HDRS might be a promising marker for distinguishing patients with anxious distress from those with other subtypes of major depression, especially for the index episode.
Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Retrospective Studies ; ROC Curve ; Sleep Initiation and Maintenance Disorders

Hydrops fetalis is diagnosed when abnormal fluid collections are manifest in two or more fetal compartments, including abdominal ascites, pleural effusions, pericardial effusions, skin edema, polyhydroamniosis and placental edema. Although fetal hydrops was hystorically most commonly associated with Rh blood group isoimmunization, the availability of Rh immunoglobulin has increased the proportion of fetuses affected due to nonimmune etiologies. We have experienced a case of nonimmune hydrops fetalis at 32 weeks of gestation in a 27-year-old woman and reported that with brief review of related literatures.
Adult ; Ascites ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Immunoglobulins ; Pericardial Effusion ; Pleural Effusion ; Pregnancy ; Skin

No Abstract Available.
Arthroplasty* ; Knee*

BACKGROUND: It is well known that there is an adverse effect of longterm cigarette smoking on pulmonary function. But there are few reports about the effect of different habits of cigarette smoking on pulmonary function. Some smokers think that different habits of cigarette smoking are more safe than athers and this can be, an obstacle to the education of smoking cessation. Therefore, we have obtained applicable basic information for education of smoking cessation by analysing the effects of different habits of cigarette smoking on pulmonary function. METHODS: We surveyed current smokers on different habits of smoking who had performed puhnonary function test at the pulmonary function laboratory of one tertiary hospital in Seoul and pulmonary function test was done as a part of comprehensive health check-up at health promotion center of one secondary hospital at Ulsan from May 1998 to July 1998. We analysed the effects of different habits of cigarette smoking on pulmonary function in 160 subjects who has no specific respiratory disease. RESULTS: The factors were age, height, weight and amount of total smoking that had effect on pulmonary function. There were six different habits of smoking that we could analyse time of first smoking after sleep, average time of one cigarette smoked, current amount of smoking, length of one cigarette smoked, effort to quit smoking, smoking with drinking and all these six habits of sking had no relationship with the results of the pulmonary function test. CONCLUSIONS: The damage in pulmonary function was not protected by different habits of smoking that were previously known to be more safe or healthy. Therefore, we concluded that smoking cessation is the only way to prevent the damage in pulmonary function from cigarette smoking.
Drinking ; Education ; Health Promotion ; Respiratory Function Tests ; Seoul ; Smoke* ; Smoking Cessation ; Smoking* ; Tertiary Care Centers ; Tobacco Products ; Ulsan

PURPOSE: This study was designed to assess the prognosis of pT3 transitional cell carcinoma of the renal pelvis(renal pelvic tumor) according to the parenchymal invasion pattern and adjuvant chemotherapy. MATERIALS AND METHODS: A total of 48(34 males and 14 females) patients were surgically treated for a renal pelvic tumor. Of these 48 patients, the 27 pT3 renal pelvic tumor patients who had over one year follow-up period were enrolled. The patients were divided into two groups according to the invasion pattern(Group 1: renal parenchymal invasion, Group 2: peripelvic fat invasion). Among these 27 patients, 15 patients received adjuvant chemotherapy following surgery, whereas the other 12 patients did not. The prognostic factors, including age, gender, laterality, tumor grade, size, lympho-vascular invasion, lymph node involvement, the invasion pattern and adjuvant chemotherapy, were analyzed with respect to disease-free survival. RESULTS: There were seventeen patients in Group 1 and 10 patients in Group 2. The mean duration of follow up was 39.4 months. Age, gender, laterality, tumor grade, size, lympho-vascular invasion, invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both the univariate and multivariate analyses. Only lymph node involvement(p=0.028, hazard ratio=20.98) was a prognostic predictor in this study. However, the incidence of renal parenchymal invasion was higher for the high grade tumors than for the low grade tumors. CONCLUSIONS: The renal parenchymal invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both univariate and multivariate analyses for the patients with pT3 renal pelvic tumor. Further studies are necessary to clarify this result.
Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Kidney Pelvis* ; Lymph Nodes ; Male ; Multivariate Analysis ; Prognosis

No abstract available.

OBJECTIVES: This study evaluated the quality of life (QoL) of North Korean defectors in South Korean society in the year 2007 for purposes of comparing it to their QoL in 2004 and identifying demographic variables that influence QoL. METHODS: We used the Korean version of WHOQoL-BREF to evaluate the QoL of 106 North Korean defectors. Other instruments included a questionnaire for discerning demographic data, life experiences, and physical health. RESULTS: For last 3 years, more defectors had higher education, married, and higher income. However, their unemployment numbers did not decrease, while their number of believers in a religion did decrease. QoL scores remained low in the areas of negative feelings, financial resources, dependence on treatment and drugs, recreation and leisure activities, and opportunities for new information and skills, but were high in areas of cognitive mental functions, personal beliefs, work capacity, self-esteem, and transportation. Path analysis suggested that the psychological domain influenced overall QoL while other domains influenced overall QoL indirectly, through the psychological domain. Since 2004, defectors' QoL in the physical domain and in opportunities for education and transportation had improved, while QoL with regard to pain and discomfort, mobility, and negative feelings had worsened. Variables that were negatively correlated with QoL included male sex, higher age, being married, experiencing army service in North Korea, and shorter stays in third countries. In South Korea, QoL was negatively correlated with current physical illness but positively correlated to having a family, a stable job, higher income, and someone to talk with. CONCLUSION: These results suggest that defectors' QoL would be improved by tailored services according to their sex and age, focusing on educational programs to provide new information and skills, support for building families, health services, and community support.
Democratic People's Republic of Korea ; Follow-Up Studies ; Health Services ; Humans ; Leisure Activities ; Life Change Events ; Male ; Mental Health ; Quality of Life ; Surveys and Questionnaires ; Recreation ; Republic of Korea ; Transportation ; Unemployment