Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%). Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal cell carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.
Adenocarcinoma ; Bile Ducts ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carcinoma, Adenoid Cystic ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Carcinoma, Small Cell ; Diagnosis ; Diagnosis, Differential ; Endothelial Cells ; Epithelial Cells ; Epithelium ; Hemolytic-Uremic Syndrome* ; Hepatocytes ; Korea ; Liver ; Necrosis ; Pneumococcal Infections* ; Ulnar Nerve

BACKGROUND: The SF-6D, derived from the SF-36, is a preference-based instrument measuring health-related quality of life (HRQOL). Using this tool, we measured the HRQOL of persons disabled by stroke dwelling in Gyeongju city and identified factors affecting the HRQOL. METHODS: As of March 2008, 991 persons who had had a stroke and were aged 50 and over were identified on the Gyeongju city disabled registry. Interviewers specifically trained for this face-to-face survey gathered pertinent information including general and clinical characteristics from June to October 2008. In addition, the health status was measured using the Modified Rankin Scale, the Barthel ADL index, and the SF-36. The SF-6D index was derived from the SF-36. We analyzed the known-group construct validity and convergent validity. Finally, we performed multiple regression analyses to identify factors affecting the HRQOL. RESULTS: Of the 991 potential subjects, 498 persons participated in the interviews (response rate: 50.3%). The SF-6D indices for females and those aged 70 and over were lower than indices for males and those aged 60 and less. Correlation coefficients between the Modified Rankin Scale, the Barthel index, and the SF-6D index were relatively high (-0.533 and 0.555, respectively) and statistically significant (P<0.001). Multiple regression analyses showed that sex, age, smoking, alcohol use, comorbidity, the Modified Rankin Scale, and the Barthel index had an effect on the SF-6D index of persons with stroke, and the Barthel index was the most important factor. CONCLUSIONS: Our results indicate that the SF-6D can be a valid tool for evaluating health states of persons disabled by stroke, and functional limitation was the main factor affecting the HRQOL.
Activities of Daily Living ; Aged ; Comorbidity ; Disabled Persons ; Female ; Humans ; Male ; Quality of Life ; Smoke ; Smoking ; Stroke ; Value of Life ; Surveys and Questionnaires

Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Curettage ; Cytochrome P-450 CYP1A1 ; Early Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Ligation ; Methotrexate ; Pregnancy* ; Pregnancy, Ectopic ; Uterine Hemorrhage ; Uterus

No abstract available.
Cardiomyopathies* ; Peripartum Period*

Purpose: Although upper eyelid retraction is commonly associated with thyroid eye disease, its etiology remains unclear. This study evaluated the clinical features and treatment outcomes of patients with upper eyelid retraction caused by idiopathic orbital myositis (IOM). Methods: We conducted a retrospective analysis of the medical records of patients who presented with unilateral upper eyelid retraction. IOM was diagnosed based on normal thyroid function tests (TFT), including thyroid-stimulating immunoglobulin (TSI). Orbital imaging demonstrated contrast-enhanced enlargement of the superior rectus-levator palpebrae superioris complex (SR-LC). Pre- and post-systemic steroid treatment, margin-reflex distance 1 (MRD1), MRD1 difference between affected and unaffected eyes, exophthalmos, and diplopia were assessed. Results: In total, five patients (male: 4, female: 1) with a median age of 36.4 years were diagnosed with IOM. Three patients presented with diplopia on upgaze and supraduction limitation. Orbital imaging revealed levator palpebrae superioris muscle enlargement with distinct borders and homogeneous contrast enhancement. All cases with superior rectus enlargement demonstrated tendon involvement. The median duration from symptom onset to treatment initiation was 2.2 months. Four patients received oral prednisolone, whereas one received intravenous methylprednisolone. Although no significant improvements were observed in MRD1, MRD1 difference, or exophthalmos post-treatment, diplopia resolved in all three patients. Conclusions IOM can present with upper eyelid retraction, emphasizing the importance of differentiating it from thyroid eye disease. TFT, including TSIs, and orbital imaging are essential diagnostic tools. These findings indicate that systemic corticosteroids can effectively manage diplopia associated with IOM, emphasizing the potential benefit of early and aggressive treatment.

Purpose: Although upper eyelid retraction is commonly associated with thyroid eye disease, its etiology remains unclear. This study evaluated the clinical features and treatment outcomes of patients with upper eyelid retraction caused by idiopathic orbital myositis (IOM). Methods: We conducted a retrospective analysis of the medical records of patients who presented with unilateral upper eyelid retraction. IOM was diagnosed based on normal thyroid function tests (TFT), including thyroid-stimulating immunoglobulin (TSI). Orbital imaging demonstrated contrast-enhanced enlargement of the superior rectus-levator palpebrae superioris complex (SR-LC). Pre- and post-systemic steroid treatment, margin-reflex distance 1 (MRD1), MRD1 difference between affected and unaffected eyes, exophthalmos, and diplopia were assessed. Results: In total, five patients (male: 4, female: 1) with a median age of 36.4 years were diagnosed with IOM. Three patients presented with diplopia on upgaze and supraduction limitation. Orbital imaging revealed levator palpebrae superioris muscle enlargement with distinct borders and homogeneous contrast enhancement. All cases with superior rectus enlargement demonstrated tendon involvement. The median duration from symptom onset to treatment initiation was 2.2 months. Four patients received oral prednisolone, whereas one received intravenous methylprednisolone. Although no significant improvements were observed in MRD1, MRD1 difference, or exophthalmos post-treatment, diplopia resolved in all three patients. Conclusions IOM can present with upper eyelid retraction, emphasizing the importance of differentiating it from thyroid eye disease. TFT, including TSIs, and orbital imaging are essential diagnostic tools. These findings indicate that systemic corticosteroids can effectively manage diplopia associated with IOM, emphasizing the potential benefit of early and aggressive treatment.

Purpose: Although upper eyelid retraction is commonly associated with thyroid eye disease, its etiology remains unclear. This study evaluated the clinical features and treatment outcomes of patients with upper eyelid retraction caused by idiopathic orbital myositis (IOM). Methods: We conducted a retrospective analysis of the medical records of patients who presented with unilateral upper eyelid retraction. IOM was diagnosed based on normal thyroid function tests (TFT), including thyroid-stimulating immunoglobulin (TSI). Orbital imaging demonstrated contrast-enhanced enlargement of the superior rectus-levator palpebrae superioris complex (SR-LC). Pre- and post-systemic steroid treatment, margin-reflex distance 1 (MRD1), MRD1 difference between affected and unaffected eyes, exophthalmos, and diplopia were assessed. Results: In total, five patients (male: 4, female: 1) with a median age of 36.4 years were diagnosed with IOM. Three patients presented with diplopia on upgaze and supraduction limitation. Orbital imaging revealed levator palpebrae superioris muscle enlargement with distinct borders and homogeneous contrast enhancement. All cases with superior rectus enlargement demonstrated tendon involvement. The median duration from symptom onset to treatment initiation was 2.2 months. Four patients received oral prednisolone, whereas one received intravenous methylprednisolone. Although no significant improvements were observed in MRD1, MRD1 difference, or exophthalmos post-treatment, diplopia resolved in all three patients. Conclusions IOM can present with upper eyelid retraction, emphasizing the importance of differentiating it from thyroid eye disease. TFT, including TSIs, and orbital imaging are essential diagnostic tools. These findings indicate that systemic corticosteroids can effectively manage diplopia associated with IOM, emphasizing the potential benefit of early and aggressive treatment.

OBJECTIVES: The purpose of this study was firstly to introduce a Participatory Action-Oriented Training (PAOT) program for the prevention of work-related musculoskeletal diseases (WRMSDs) in Small and Medium sized Enterprises in the Gumi Industrial Zone, and secondly to assess its effect. METHODS: Two PAOT workshops to prevent WRMSDs were conducted with 39 volunteer participants from 10 companies selected (on a first-come, first-served basis) among 200 small- or medium-sized enterprises in Gumi. These companies had been provided with mandatory occupational health management agency services for Small and Medium sized Enterprises by an occupational medicine clinic. Each workshop consisted of 6 technical sessions and one closing ceremony. At the 1st session, the principles of each action checklist item were explained and an on-site checklist exercise was carried out. The 2nd to 5th sessions presented good example pictures on 4 subjects: material storage and handling, working environment, work organization and work-related welfare. Group discussions were carried out by the participants. In the final 6th session on the implementation of improvement, each participant was asked to present 6 action plans, 3 short-term and 3 long-term, for their own workplace improvement. RESULTS: Overall, the participants worked out 47 real action plans, 27 short-term and 20 long-term, for improvement of their own workplaces. Three to 6 months after the workshops, through in-person visits to each company, it was confirmed that more than half of these 47 plans had been completed; 25 plans (53.2%) had been completed as planned, 8 (17.0%) were in processing, and 14 (29.8%) had not yet been put into practice. CONCLUSIONS: The study findings confirmed that the PAOT program holds strong potential as an intervention method to prevent WRMSDs in Small and Medium sized Enterprises, although the final results have not been fully assessed yet.
Checklist ; Education ; Gyeongsangbuk-do ; Musculoskeletal Diseases ; Occupational Health ; Occupational Medicine ; Volunteers

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

Maternal and child health is an important issue throughout the world. Given their impact on maternal and child health, nutritional issues need to be carefully addressed. Accordingly, the effect of maternal, child, and nutritional disorders on disability-adjusted life years (DALYs) should be calculated. The present study used DALYs to estimate the burden of disease of maternal, neonatal, and nutritional disorders in the Korean population in 2012. For this purpose, we used claim data of the Korean National Health Insurance Service, DisMod II, and death data of the Statistics Korea and adhered to incidence-based DALY estimation methodology. The total DALYs per 100,000 population were 376 in maternal disorders, 64 in neonatal disorders, and 58 in nutritional deficiencies. The leading causes of DALYs were abortion in maternal disorders, preterm birth complications in neonatal disorders, and iron-deficiency anemia in nutritional deficiencies. Our findings shed light on the considerable burden of maternal, neonatal, and nutritional conditions, emphasizing the need for health care policies that can reduce morbidity and mortality.
Anemia, Iron-Deficiency ; Child ; Child Health ; Delivery of Health Care ; Humans ; Korea* ; Malnutrition ; Mortality ; National Health Programs ; Nutrition Disorders* ; Premature Birth