Cystadenomas are benign neoplasm in which the epithelium demonstrates adenomatous proliferation. Several morphologic variants of cystadenomas have bean described, including papillary-oncocytic, mucous, and seromucous subtypes. Cystadenomas arising from salivary glands are very rare and seromucous cystadenoma of parotid gland has not been reported in Korea so far. Cystadenomas of the parotid gland usually Present as asymptomatic slowly growing mass and those of the minor salivary glands produce smooth nodules that may be compressible. We performed a superficial parotidectomy in a patient with a seromucous cystadenoma. This may be the first report of seromucous cystadenoma of carotid gland in Korea.
Cystadenoma* ; Epithelium ; Humans ; Korea ; Parotid Gland* ; Salivary Glands ; Salivary Glands, Minor

No Abstract Available.
Anti-HIV Agents* ; Complement System Proteins* ; HIV-1*

BACKGROUND: Endotoxin stimulates nitric oxide synthase (NOS) and the free radical nitric oxide (NO) is produced by NOS, which vasodilates the smooth muscle of pulmonary vessels. Otherwise, endotoxemia stimulates the release of cyclooxygenase (COX) products, which may modify hypoxic pulmonary vasoconstriction (HPV). We also observed the effect of nonselective NOS inhibition by NG-nitro-L-arginine methyl ester (L-NAME) on receptor-mediated acetylcholine (Ach)/bradykinin (BK) induced vasoconstriction and receptor independent HPV in E.coli lipopolysaccharide (LPS) induced septic isolated rat lungs. METHODS: Four hours before surgical instrumentation for lung isolation, we administered saline (1 ml) to the control group (n = 15), E.coli LPS (20 mg/kg) to the LPS group (n = 14) and LPS (30 mg/kg) the nitric oxide synthase inhibitor, L-NAME (15 mg/kg) to the LPS + L-NAME group (n = 14), intraperitoneally. In 43 isolated rat lungs perfused with physiologic salt-albumin- blood mixture, angiotensin II 0.2 microgram was injected into the perfusion circuit, to confirm pulmonary vascular reactivity in each isolated lung. HPV responses were induced by three hypoxic challenges for 5 minutes separated by 5 minutes of ventilation with a normoxic gas mixture. We observed the pulmonary arterial pressure at each challenge, ten minutes after the last HPV, 0.01, 0.1, 1.0 microgram of Ach and 1, 3, 10 microgram of BK were injected. PAP and static lung compliance were measured. RESULTS: The baseline pulmonary artery pressure in the LPS group higher than in the controls and HPV in the LPS group was changed compared to the controls but in the LPS + L-NAME it was higher than in the controls. The administration of Ach 0.1, 1.0 microgram and BK 3, 10 microgram causedpulmonary vasoconstriction and the vasoconstrictions of BK were dosage-dependent. Lung stiffness in the LPS and LPS + L-NAME groups were higher than those of the controls. CONCLUSIONS: Vascular constriction of pulmonary vessels and increased lung stiffness by Ach and BK might be the result of the endothelial injury. But pulmonary vasoconstriction and stiffness by Ach and BK were similar in the LPS and LPS + L-NAME groups, showing that factors other rather than excessive NO production might be involved in endothelial injury.
Acetylcholine ; Angiotensin II ; Animals ; Arterial Pressure ; Constriction ; Endotoxemia ; Lung Compliance ; Lung* ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Perfusion ; Prostaglandin-Endoperoxide Synthases ; Pulmonary Artery ; Rats* ; Surgical Instruments ; Vasoconstriction* ; Ventilation

No abstract available.
Rheumatic Fever*

No abstract available.
Adult* ; Growth Hormone* ; Humans

Wegener's granulomatosis is characterized by necrotizing granulomatosis lesion of the respiratory tract, glomerulonephritis and frequently vasculitis involving other organs. The basic pathophysiologic mechanism of Wegener's granulomatosis is not defined yet. However, it may be suspected an autoimmune disease. We experienced a case of Wegener's granulomatosis which are associated with acute renal failure and pneumothorax. The patient suffered from hemoptysis, fever and cough. Despite antibiotic therapy, symtoms did not improved and multiple varying sized nodules were aggravated on chest roentogenogram and serum creatinine elevated 3.4mg/dl. After diagnosis using video associated thoracoscopic surgery, the patient was treated with cyclophsphamide, glucocorticoid and sulfamethoxasole-trimethoprime. With the combination therapy, the patient felt completely well and chest roentogenogram showed lungs were improved and serum creatinine was normal. The patient was readmitted because of right pleuritic pain and dyspnea 15 day after discharge. The patient was developed a right pneumothorax. The lung was easily expanded by intercostal tube drainage with a one way valve. The patient has been treated as an out- patient with immunosuppressive agents continously.
Acute Kidney Injury* ; Autoimmune Diseases ; Cough ; Creatinine ; Diagnosis ; Drainage ; Dyspnea ; Fever ; Glomerulonephritis ; Hemoptysis ; Humans ; Immunosuppressive Agents ; Lung ; Pneumothorax* ; Respiratory System ; Thoracoscopy ; Thorax ; Vasculitis ; Wegener Granulomatosis*

A clinieal Observation was done on the 110 cases (male; 52 cases, female; 58 cases) of duodenitis under the gastroduodenoscopic examination among the patients who were performed endoscopic examination because of seeking for the cause of dyspepsia period from Aug. 1981 to Sep. 1981 at Department of lnteral Medicine of BNUH. The results were summerized as follow 1) Normal finding(Grade 0) was highest as 40% in the incidence according to grade of duodenits. Next was moderate (Grade II & II) as 24. 5%, the 3rd was mild(Grade I) as 20% and lowest in severe(Grade IV) duadenitis as 15.5%, 2) Sex distribution of duodenitis showed 37 cases in male and 29 cases in female. And male was slightly higher in incidence than female. 3) Age distribution of duodenitis revealeii 3rd decade and 4th decade were highest in incidence, 30 cases and 28 cases respectively. The order of frequency was 5th decade, 6th decade, 1st decade and 7th decade. 4) Duodenitis was slightly higher in after 4th decade than before 4th decade. 5) The 56 cases of duodenitis except for 1 case were aasociated with gastroduodenal diseases such as gastritis, peptic ulcer or gastric carcinoma. Association of gastritis is highest as 79. 4%. 6) Acurracy of diagnosis in duodenitis on X-ray study was 3 cases in 20 cases. Generally X-ray study was little value in diagnosis of duodenitis.
Age Distribution ; Diagnosis ; Duodenitis* ; Dyspepsia ; Female ; Gastritis ; Humans ; Incidence ; Male ; Peptic Ulcer ; Sex Distribution

Healthcare accreditation, which in the Republic of Korea is based on Article 58 of the Medical Service Act of July 2010, is an evaluation system designed to improve the quality of medical services and secure patient safety. Although ambulatory health organizations such as clinics comprise the majority of all health facilities, because they are not currently evaluated, securing quality and patient safety nationwide is not possible under the existing system. This article reviewed the accreditation programs of ambulatory health organizations in leading countries such as the United States and Australia in order to propose a successful model for Korea. The Accreditation Association for Ambulatory Health Care of the Unites States is a private, non-profit organization established in 1979. Similarly, Australian General Practice Accreditation Limited is a non-profit organization established in 1997 to deliver services to support general practices in Australia. Both are independent professional organizations and perform accreditation programs by a self-regulatory system. As healthcare quality improvement and accreditation have the characteristics of professional service activities, a self-regulatory approach rather than a government-controlled one, and process-oriented evaluation rather than structure-focused evaluation, are known to be effective. We expect an accreditation program for clinics in Korea to be established using a self-regulatory approach by an independent professional organization, not by the government, in the near future.
Accreditation* ; Ambulatory Care Facilities ; Australia ; Benchmarking* ; Delivery of Health Care* ; General Practice ; Health Facilities ; Korea ; Organizations, Nonprofit ; Patient Safety ; Quality Improvement ; Quality of Health Care ; Republic of Korea ; Societies ; United States

BACKGROUND: The purpose of this study was to examine the association of metabolic syndrome (MS) coronary heart disease (CHD) with socioeconomic status (SES). METHODS: The participants were 2,170 (631 men and 1,539 women), aged over 40 years who had visited for health screening from April to December in 2009. We classified them into three SES levels according to their education and income levels. MS was defined using the criteria of modified National Cholesterol Education Program Adult Treatment Panel III and CHD risk was defined using Framingham risk score (FRS) > or = 10%. RESULTS: High, middle, and low SES were 12.0%, 73.7%, and 14.3%, respectively. The prevalence of MS was 18.1%. For high, middle, and low SES, after adjusted covariates (age, drinking, smoking, and exercise), odds ratios for MS in men were 1.0, 1.41 (confidence interval [CI], 0.83 to 2.38; P > 0.05), and 1.50 (CI, 0.69 to 3.27; P > 0.05), respectively and in women were 1.0, 1.74 (CI, 1.05 to 3.18; P < 0.05), and 2.81 (CI, 1.46 to 2.43; P < 0.05), respectively. The prevalence of FRS > or = 10% was 33.5% (adjusted covariates were drinking, smoking, and exercise) and odds ratios for FRS > or = 10% in men were 1.0, 2.86 (CI, 1.35 to 6.08; P < 0.001), and 3.12 (CI, 1.94 to 5.00; P < 0.001), respectively and in women were 1.0, 3.24 (CI, 1.71 to 6.12; P < 0.001), and 8.80 (CI, 4.50 to 17.23; P < 0.001), respectively. CONCLUSION: There was an inverse relationship between SES and FRS > or = 10% risk in men, and an inverse relationship between SES and both risk of MS and FRS > or = 10% in women.
Adult ; Aged ; Cholesterol ; Coronary Disease ; Drinking ; Female ; Humans ; Male ; Mass Screening ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Social Class

Background: The prevalence of depression is much higher in people with chronic disease than in the general population. Depression exacerbates existing physical conditions, resulting in a higher-than-expected death rate from the physical condition itself. In our aging society, the prevalence of multimorbid patients is expected to increase; the resulting mental problems, especially depression, should be considered. Using a large-scale cohort from the Korean Longitudinal Study of Aging (KLoSA), we analyzed the combined effects of depression and chronic disease on all-cause mortality. Methods: We analyzed 10-year (2006–2016) longitudinal data of 9,819 individuals who took part in the KLoSA, a nationwide survey of people aged 45–79 years. We examined the association between multimorbidity and depression using chi-square test and logistic regression. We used the Cox proportional hazard model to determine the combined effects of multimorbidity and depression on the all-cause mortality risk. Results: During the 10-year follow up, 1,574 people (16.0%) died. The hazard ratio associated with mild depression increased from 1.35 (95% confidence interval [CI], 1.05–1.73) for no chronic disease to 1.25 (95% CI, 0.98–1.60) for 1 chronic disease, and to 2.00 (95% CI, 1.58–2.52) for multimorbidity. The hazard ratio associated with severe depression increased from 1.73 (95% CI, 1.33–2.24) for no chronic disease, to 2.03 (95% CI, 1.60–2.57) for 1 chronic disease, and to 2.94 (95% CI, 2.37–3.65) for multimorbidity. Conclusion Patients with coexisting multimorbidity and depression are at an increased risk of all-cause mortality than those with chronic disease or depression alone.