Patients with acromegaly have a reduced life expectancy rnainly due to cardiovascular, respiratory or cerebrovascular diseas-. Malignancy also seems to occur with greater than the expected incidence. In particular, the published retrospective or prospective studies have suggested a strong association of colonic neoplasia with acromegaly. But, there were a few reports of thyroid cancer in acrornegaly. We report a case of thyroid papillary cancer derived from diffuse goiter in acromegaly, sugge- sting the possible carcinogenic role of growth hormone.
Acromegaly ; Bites and Stings ; Colon ; Goiter ; Growth Hormone ; Humans ; Incidence ; Life Expectancy ; Prospective Studies ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms

Jacobsen syndrome (JS) is a contiguous gene syndrome resulting from a deletion of chromosome 11q, with various clinical manifestations. A post-term small for gestational age infant was born by normal vaginal delivery without trauma or vacuum extraction. On day 5, right parietotemporal scalp swelling developed, with petechiae on the right cheek and thrombocytopenia (platelets: 63,000/µL). A prominent forehead, wide-set eyes, short and upturned nose were noted. Karyotyping and microarray analysis demonstrated del(11)(q24q25), consistent with Jacobsen syndrome. Brain magnetic resonance imaging (MRI) revealed a huge cephalhematoma. The patient is scheduled to receive periodic evaluations for thrombocytopenia and heart, kidney, abdominal malformations, ophthalmologic and auditory problems. There are lots of newborns with cephalhematoma or petechiae after birth. Not all newborns with these symptoms need evaluations, but if they have these symptoms with suspect features or appearances, we need to go through further evaluations.
Brain ; Cheek ; Forehead ; Gestational Age ; Heart ; Humans ; Infant ; Infant, Newborn ; Jacobsen Distal 11q Deletion Syndrome* ; Karyotyping ; Kidney ; Magnetic Resonance Imaging ; Microarray Analysis ; Nose ; Parturition* ; Purpura ; Scalp ; Thrombocytopenia* ; Vacuum

PURPOSE: We investigated the number of test takers of the Korean-Developmental Screening Test (K-DST) in a single children's hospital within a year, according to age, referral rate, and follow-up percentage. METHODS: For this study, 4,062 children who visited and received K-DST at Woorisoa Children's Hospital between January and December 2015 were enrolled. Seven test sets were used according to the Korean National Health Screening Program for infants and children in the following age groups: 4 to 6, 9 to 12, 18 to 24, 30 to 36, 42 to 48, 54 to 60, and 66 to 71 months. The results of the K-DST were categorized into 4 groups as follows: further evaluation (<−2 standard deviation [−2SD]), follow-up test (−2SD to −1SD), peer level (−1SD to 1SD), and high level (>1SD). RESULTS: The test participants' population and follow-up population were concentrated before the age of 24 months (2,532, 62.3%). The children most commonly referred for further evaluation were those in the 30- to 41-month age group. A mismatch was found between the results of the K-DST and the additional questions. Most of the infants and children with suspicious developmental delays showed catch-up development in their follow-up tests (43 of 55, 78.2%). CONCLUSION: The use of K-DST should be encouraged, especially among children aged over 24 months. Multiple-choice question format for the additional questions is recommended to avoid confusion. We suggest a nationwide study to evaluate and revise the K-DST.
Child* ; Follow-Up Studies ; Humans ; Infant* ; Korea ; Mass Screening* ; Referral and Consultation

PURPOSE: To determine the appropriate prostate planning target volume (PTV) margins for 3-dimensitional (3D) conformal radiotherapy (CRT) and intensity-modulated radiation therapy (IMRT) patients treated with an endorectal balloon (ERB) under our institutional treatment condition. MATERIALS AND METHODS: Patients were treated in the supine position. An ERB was inserted into the rectum with 70 cc air prior to planning a CT scan and then each treatment fraction. Electronic portal images (EPIs) and digital reconstructed radiographs (DRR) of planning CT images were used to evaluate inter-fractional patient's setup and ERB errors. To register both image sets, we developed an in-house program written in visual C++. A new method to determine prostate PTV margins with an ERB was developed by using the common method. RESULTS: The mean value of patient setup errors was within 1 mm in all directions. The ERB inter-fractional errors in the superior-inferior (SI) and anterior-posterior (AP) directions were larger than in the left-right (LR) direction. The calculated 1D symmetric PTV margins were 3.0 mm, 8.2 mm, and 8.5 mm for 3D CRT and 4.1 mm, 7.9 mm, and 10.3 mm for IMRT in LR, SI, and AP, respectively according to the new method including ERB random errors. CONCLUSION: The ERB random error contributes to the deformation of the prostate, which affects the original treatment planning. Thus, a new PTV margin method includes dose blurring effects of ERB. The correction of ERB systematic error is a prerequisite since the new method only accounts for ERB random error.
Electronics ; Electrons ; Humans ; Prostate ; Radiotherapy, Conformal ; Rectum ; Supine Position

BACKGROUND: The relaxative response of blood vessels to acetylcholine (ACh) is known to be abnormal in diabetic rat due to changes in endothelium-derived relaxing factor (EDRF) and/or endothelium-derived hyperpolarizing factor (EDHF)-mediated action. Oxygen free radical (OFR) interferes with endothelium dependent relaxation to ACh in diabetic rats; this effect rnay be prevented by superoxide dismutase (SOD), OFR scavenger. Then, we determined the effect of SOD on modulation of OFR-induced damage to EDRF and EDHF-mediated relaxations to ACh in diabetic rat aortas. METHODS: After aortas were incubated with free radical generating system for 15 min with or without SOD pretreatment (150 U/mL) and contracted submaximally by norepinephrine (10 (-5) M), relaxative responses to cumulative concentrations (10 (-9) M to 10 (-5) M) of ACh were measured in aortas isolated from the control and 6-8 week streptozotocin-induced diabetic rat. We measured relaxative responses to ACh in these aortas treated with calmidazolium (100uM) or N-nitro-L-arginine methyl ester (luM) after exposure to OFR with/without SOD pretreatment, RESULTS: The ACh-induced relaxation (10 (-9)M to 10 (-5) M) was significantly decreased in diabetic than in control rat aortas (p<0.05). ACh-induced relaxation in diabetic rat aortas was significantly impaired from 79.3% to 71.2% after exposure to OFR (p<0.05), and the degree of ACh-induced relaxation was recovered from 71.2% to 84.0% after pretreatment with SOD (p<0.05). EDRF-mediated relaxation to ACh in diabetic rat aortas was significantly impaired from 71.2% to 61.6% after exposure to OFR (p<0.05), and the degree of impairment of ACh-induced EDRF-mediated relaxation was recovered from 61.6% to 76.0% after pretreatment with SOD. After exposure to OFR, EDHF-mediated relaxation to ACh in diabetic rat aortas was not significanlty impaired. However, the degree of impairment of EDHF-mediated relaxation to ACh was recovered from 46.0% to 59.5% after pretreatment with SOD. CONCLUSION: This study suggests that OFR may impair mainly EDRF-mediated relaxation to ACh and SOD may protect rnainly OFR-induced damage to EDRF-mediated relaxation to ACh in diabetic rat aortas.
Acetylcholine ; Animals ; Aorta* ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Free Radicals* ; Norepinephrine ; Oxygen* ; Rats* ; Relaxation* ; Superoxide Dismutase* ; Superoxides*

PURPOSE: HIF-1alpha (Hypoxia inducible factor-1alpha) and VEGF (vascular endothelial growth factor) have been reported to be involved in tumor growth and metastasis, but only a little data on the roles of HIF-1alpha and VEGF in renal cell carcinomas are available, and few studies have yet evaluated their prognostic values. The aim of the present study was to assess the HIF-1alpha and VEGF expression and evaluate the relationships between HIF-1alpha/VEGF and the histopathological characteristics in renal cell carcinomas. MATERIALS AND METHODS: HIF-1alpha and VEGF immunohistochemical stainings were performed on formalin-fixed, paraffin-embedded archival tissues from 22 renal cell carcinoma tissues and 13 normal kidney tissues, used as a control group. The interpretation of the immunohistochemical stainings were semi-quantitatively performed by one pathologist. RESULTS: The expressions of HIF-1alpha and VEGF were significantly higher in the patient than the control group. The HIF-1alpha and VEGF expressions were correlated to each other, and inclined to be positively correlated with the pathological stage and grade of the renal cell carcinoma. CONCLUSIONS: The HIF-1alpha and VEGF expressions might be independent predictors of the outcome, as well as the stage and grade of renal cell carcinomas. This study suggests that HIF-1alpha and VEGF may be potential prognostic factors in renal cell carcinomas.
Angiogenesis Inducing Agents ; Anoxia* ; Carcinoma, Renal Cell* ; Humans* ; Kidney ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

OBJECTIVE: It has been known that mind-body training (MBT) can affect personality and behavior system as well as emotional well-being, but different effects of MBT on them has not been reported according to BDNF genetic polymorphism. METHODS: Healthy subjects consisted of 64 subjects and the MBT group who practiced meditation regularly consisted of 72 practitioners. Participants completed neuroticism-extraversion-openness (NEO) Five-Factor Inventory and Behavioral Activation System/Behavioral Inhibition System (BAS/BIS) scales. All subjects were genotyped for the BDNF Val66Met polymorphism. RESULTS: In the same genotypes of the BDNF Val/Val+Val/Met group, MBT group showed the increased Extraversion (p=0.033) and the increased Openness to Experience (p=0.004) compared to the control group. Also, in the same Met/Met carriers, MBT group exhibited the increase of Extraversion (p=0.008), the reduction of Neuroticism (p=0.002), and the increase of Openness to Experience (p=0.008) compared to the control group. In the same genotypes of the BDNF Val/Val+Val/Met group, MBT group showed the decreased BAS-Reward Responsiveness (p=0.016) and the decrease of BIS (p=0.004) compared to the control group. In the BDNF Met/Met group, MBT group increased BAS-Fun Seeking (p=0.045) and decreased BIS (p=0.013) compared to the control group. CONCLUSION: MBT would differently contribute to NEO personality and BAS/BIS according to BDNF genetic polymorphism, compensating for different vulnerable traits based on each genotype.
Brain-Derived Neurotrophic Factor* ; Extraversion (Psychology) ; Genotype ; Meditation ; Polymorphism, Genetic ; Weights and Measures

Diagnosis ; Diagnosis, Differential ; Humans ; Leukemia ; Mouth Mucosa ; Mucositis ; Necrosis ; Opportunistic Infections ; Prognosis ; Reference Values

OBJECTIVES: We analyzed whether gender role stereotypes (GRS) and patriarchal attitudes are associated with cognitive function in an elderly community. METHODS: We analyzed data from 580 people enrolled in the Korean Social Life, Health, and Aging Project. The degrees to which respondents held stereotypical beliefs about gender roles and had patriarchal mindsets were measured using a questionnaire. Based on participants’ responses, we divided respondents into 2 groups—those with conservative mindsets and those with open mindsets—according to the median score for each of the 2 variables. Cognitive function was assessed using the Mini-Mental State Examination, Korean version (MMSE-K). Cognitive impairment was defined as an MMSE-K score ≤21 points. Multivariable logistic regression was performed, adjusting for gender, age, socio-demographic and lifestyle factors, and social network size. Age and lifestyle factors were stratified. RESULTS: Compared to those with open mindsets, those with conservative mindsets regarding gender roles and patriarchal norms had adjusted odds ratios of 1.88 (95% confidence interval [CI], 1.11 to 3.19) and 1.67 (95% CI, 1.00 to 2.79) for cognitive impairment, respectively. In the stratified analysis, subgroups with younger age and a good lifestyle maintained a protective association with cognitive impairment. CONCLUSIONS GRS and a patriarchal mindset were marginally significantly associated with cognitive impairment among women later in life.