No abstract available.
Mortality*

An adequate supply of dietary iodine is essential for the synthesis of the thyroid hormons. The measurement of dietary iodine intake is important for the clinical assessment of thyroid disease, especially in areas where iodine intake is excessive or deficient.To evaluate dietary iodine intake in Korean and its effects on thyroid function, we measured urinary iodine excretion with morning urine by electrode method in 184 normal subjects, 96 postpartum women and 181 patients with thyroid disease from October 1994 to February 1995. The results were as follows;1) In normal control, the mean value of urinary iodine excretion was 3.8+-2.7mg/L (range 0.1-15.0mg/L). However, there was no sex and age differences in the urinary iodine excretion.2) In postpartum women, the urinary iodine excretion was 9.0+-10.8mg/L who were not taken high iodine diet(Miyok-Guk), the mean value was statistically higher than normal control(p<0.01) and significant increased the urinary iodine excretion after eating of high iodine diet(p<0.01).3) In volunteer, there were increase of urinary iodine excretion more than 10 folds after high iodine diet and medication.4) The urinary iodine excretion in patients with thyroid diseases was not different from normal control, and there were no significant differences of urinary iodine excretion among the patient groups. The urinary iodine excretion in the acute stage of patients with subactue thyroiditis or painless thyroiditis was significantly increased compared to the recovery stage. However, it was not significantly different from that of normal control.In conclusion, urinary iodine excretion in Korean population is very high comparing to the reported data in Western population but similar with Japanese. The urinary iodine excretion is significant increase( more than 10-folds of basal level) after high iodine diet or high iodine containing medication in postpartum women or healthy persons. As a clue of destruction induced thyrotoxicosis, the urinary iodine excretion measurement is not valid in area where iodine intake is excessive like Korea.
Asian Continental Ancestry Group ; Diet ; Eating ; Electrodes ; Humans ; Iodine ; Korea ; Methods ; Postpartum Period ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis ; Thyrotoxicosis ; Volunteers

A 37-year-old woman was admitted to our hospital with altered mentality. The patient was diagnosed an internal carotid artery (ICA) dorsal wall aneurysm leading to acute subdural hemorrhage (SDH) without occurring subarachnoid hemorrhage and/or internal parenchymal hemorrhage. An aneurysmal neck clipping and hematoma evacuation were performed at once. A pure SDH by ruptured aneurysm is unusual, but it is important to consider it if a SDH patient has no other medical history.
Adult ; Aneurysm* ; Aneurysm, Ruptured ; Carotid Artery, Internal* ; Female ; Hematoma ; Hematoma, Subdural* ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Neck ; Rupture* ; Subarachnoid Hemorrhage

PURPOSE: The pro-inflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha), is a central mediator of the immune response involved in a wide range of immuno-inflammatory and infectious diseases. There is increasing evidence that TNF-alpha may promote the development and spread of the cancer. Polymorphisms in the TNF-alpha promoter have been related to TNF-alpha production. Therefore, we investigated the potential association of TNF-alpha genotypes with gastric cancer in the Korean population. METHODS: The study included 66 patients with gastric adenoma, 75 patients with gastric carcinoma, and 551 healthy controls. The -308 and -238 polymorphisms in the TNF-alpha promoter were analyzed by PCR- restriction fragment length polymorphism (RFLP). Distributions of TNF-alpha promoter polymorphisms were compared between groups by chi2 test. P values smaller than 0.05 were considered to be significant. RESULTS: The proportion of individuals carrying the TNF-alpha -308A allele was higher in the carcinoma group compared to controls and adenomas, but the differences were not significant (P=0.124). However, the TNF-alpha -308A allele was significantly associated with advanced gastric carcinoma (P=0.026), serosa invasion (P=0.004), neural invasion (P= 0.021), and lymph node metastasis (P=0.005). On the other hand, the TNF-alpha -238G/A polymorphism was not associated with the development of gastric adenoma and carcinoma and the severity of gastric carcinoma. CONCLUSION: These results suggest that the TNF-alpha -308A allele is associated with the severity of gastric carcinoma in terms of invasion and metastasis in the Korean population. Therefore, TNF-alpha promoter polymorphism could be used as a predictive marker of the severity of gastric carcinoma.
Adenoma ; Alleles ; Communicable Diseases ; Genotype ; Hand ; Humans ; Lymph Nodes ; Necrosis* ; Neoplasm Metastasis ; Polymorphism, Restriction Fragment Length ; Serous Membrane ; Stomach Neoplasms ; Tumor Necrosis Factor-alpha

Lymphangioleiomyomatosis (LAM) is a rare, progressive cystic lung disease, characterized by a proliferation of immature smooth muscle cell (LAM cell) in the airway, parenchyma, lymph nodes and pulmonary vessels. It mainly affects women in their reproductive years. It is clinically manifested by recurrent pneumothorax, progressive dyspnea on exertion and chylothorax; it can also ultimately lead to respiratory failure. However, no curative treatment for LAM is currently available. We report an anesthetic management for cesarean delivery in a parturient newly diagnosed with LAM.
Anesthesia ; Chylothorax ; Dyspnea ; Female ; Humans ; Lipopolysaccharides ; Lung Diseases ; Lymph Nodes ; Lymphangioleiomyomatosis* ; Myocytes, Smooth Muscle ; Pneumothorax ; Respiratory Insufficiency

Lymphangioleiomyomatosis (LAM) is a rare, progressive cystic lung disease, characterized by a proliferation of immature smooth muscle cell (LAM cell) in the airway, parenchyma, lymph nodes and pulmonary vessels. It mainly affects women in their reproductive years. It is clinically manifested by recurrent pneumothorax, progressive dyspnea on exertion and chylothorax; it can also ultimately lead to respiratory failure. However, no curative treatment for LAM is currently available. We report an anesthetic management for cesarean delivery in a parturient newly diagnosed with LAM.
Anesthesia ; Chylothorax ; Dyspnea ; Female ; Humans ; Lipopolysaccharides ; Lung Diseases ; Lymph Nodes ; Lymphangioleiomyomatosis* ; Myocytes, Smooth Muscle ; Pneumothorax ; Respiratory Insufficiency

No abstract available.
Hodgkin Disease*

BACKGROUND: The role of antidepressants (ADs) in bipolar disorder is long-standing controversial issue in psychiatry. Many clinicians have used ADs as a treatment for bipolar depression, and the selection of therapeutic agents is very diverse and inconsistent. This study aimed to examine recent AD prescription patterns for patients with bipolar disorder in Korea, using the nationwide, population-based data. METHODS: This study utilized the Korean nationwide, whole population-based registry data of the year 2010, 2011, and 2013. All prescription data of the ADs, antipsychotics, and mood stabilizers of the sampled patients diagnosed with bipolar disorder (n = 2,022 [in 2010]; 2,038 [in 2011]; 2,626 [in 2013]) were analyzed for each year. RESULTS: Annual prescription rate of ADs was 27.3%–33.6% in bipolar disorder, which was gradually increasing over the 3-year period. The combination pattern of ADs and antipsychotic drugs tended to increase over 3 years. The proportion of females and the prevalence of comorbid anxiety disorder were significantly higher in AD user group in all three years. Among individual ADs, escitalopram was prescribed most frequently, and fluoxetine and bupropion were prescribed to the next many patients. The mean duration of bipolar depressive episodes was 135.90–152.53 days, of which ADs were prescribed for 115.60–121.98 days. CONCLUSION: Our results show prescription rate of ADs in bipolar disorder was maintained at substantial level and increased in recent 3 years. More empirical data and evidence are needed to establish practical treatment consensuses.
Antidepressive Agents ; Antipsychotic Agents ; Anxiety Disorders ; Bipolar Disorder* ; Bupropion ; Citalopram ; Consensus ; Female ; Fluoxetine ; Humans ; Korea* ; Prescriptions* ; Prevalence

It is well known that obesity central obesity is associated with insulin resistance and some studies reported that sex hormones were associated with insulin resistance. Recently, low levels of sex-hormone binding globulin(SHBG), an indirect index of androgenicity, have been observed to predict the development of non-insulin dependent diabetes mellitus(NIDDM) in women and SHBG has been proposed as a marker for insulin resistance. In contrast to findings in women, decreased SHBG did not predict the occurrence of NIDDM in men, so it is suggested that sex hormones may have a different role for insulin resistance between men and women. To investigate the difference of the associations among the body fat distribution, sex hormone and insulin sensitivity index in men and women, we measured body-mass index(BMI) and waist to hip circumference ratio(WHR) and concentrations serum SHBG, total testosterone, free testosterone, and dehydroepiandrosterone sulfate(DHEA-S) concentrations in 29 healthy adults(men:19, women:10) who showed normal glucose tolerance. Insulin sensitivity index(M/I) was measured by euglycemic hyperinsulinemic clamp. There were no differences in age, BMI, fasting plasma glucose, insulin and free fatty acid levels between men and women. WHR of men is higher than that of women(0.82+-0.01 vs. 0.73+-0.01, p=0.002). Insulin sensitivity index(M/I) is similar in men and women(7.80+-0.71 mg/kg/min/uU/ml X 100 vs. 9.74+-0.89 mg/kg/min/uU/ml X 100, p=0.196).In Pearson's correlation, M/I was significantly correlated with BMI(r=-0.69, p<0.01) and WHR(r=-0.68, p<0.01) in men and DHEA-S(r=-0.68, p<0.05) and SHBG(r=0.61, p=0.056) concentrations in women.In multiple regression analysis, M/I had the most significant association with BMI(R^2=0.484, beta=-0.696, p<0.001) in men and DHEA-S(R^2=0.471, beta=-0.686, p<0.05) concentration in women.Conclusively, we found that sex hormones were significantly associated with insulin resistance and the effects of sex hormones on insulin resistance may be different in men and women.
Adipose Tissue ; Blood Glucose ; Body Fat Distribution ; Body Mass Index ; Dehydroepiandrosterone ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus, Type 2 ; Fasting ; Female ; Glucose ; Gonadal Steroid Hormones ; Hip ; Humans ; Insulin Resistance ; Insulin ; Male ; Multiple Endocrine Neoplasia Type 1 ; Obesity ; Obesity, Abdominal ; Testosterone

BACKGROUNDS/AIMS: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much. This study was conducted to evaluate outcomes with gallbladder carcinoma according to the type of surgery performed, and the prognostic factors for survival. METHODS: One hundred and six patients with gallbladder carcinoma, who underwent surgery for the purpose of curative resection between January 1999 and June 2012 were reviewed retrospectively. RESULTS: Out of 106 patients, curative resection was achieved in 75 (70.8%). The cumulative 1-, 2- and 5-year survival rates of the gallbladder carcinoma patients were 93.4%, 80.9% and 63.0%, respectively. Radical resections, including extended cholecystectomy, were more beneficial for long term survival of patients. The 5-year survival rate in patients who underwent curative resection (56.9%) was significantly higher than in those who underwent palliative resection (0%, p=0.000). Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors. CONCLUSIONS: Curative resection and early detection of patients with gallbladder carcinoma were the most important factors for long term survival. Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.
Cholecystectomy ; Gallbladder* ; Humans ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Survival Rate