We reviewed a total of 36 cases of gastrointestinal carcinoid tumors during a period of ten and a half years at Seoul National University Hospital, looking at their histologic and ultrastructural features, as well as immunohistochemical results, then we correlated these with location. The primary sites of carcinoid tumors were rectum(39%), stomach(25%), appendix(22%), small intestine(8%) and colon(6%), in order of frequency. The predominant histologic types by organ were mixed and solid(A) types in all location, the solid type(type A) in the stomach, and tubular type(type C) in the rectum. Six out of 8 cases of appendiceal carcinoid were type A and the other two cases were mucinous carcinoid. Tubular adenoma or adenocarcinoma was associated with 36% of the rectal carcinoids, with one case of carcinoid in the small intestine, and one(11%) of the gastric carcinoids was found near an adenocarcinoma. Metastasis was found in one case of ileal carcinoid(100%), one case of cecal carcinoid, 3 of gastric carcinoid(33%) and 2 of rectal carcinoid(14%). Primary tumor size ranged from 1 to 7 cm. Tumor necrosis and endolymphatic tumor emboli were found in 57% and 43% of the metastatic carcinoids, respectively. PCNA index showed a borderline significant difference between metastatic and nonmetastatic groups(P value=0.063). The low prevalence of appendiceal carcinoid and the relatively high prevalence of gastric-rectal carcinoid may reflect a low chance of incidental appendectomy and frequent detection of gastrointestinal endoscopy.
Adenocarcinoma ; Adenoma ; Neoplasm Metastasis

No abstract available.
Head and Neck Neoplasms* ; Head* ; Incidence* ; Neck* ; Neoplasm Metastasis*

OBJECTIVES: Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. METHODS: The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. RESULTS: After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. CONCLUSION: Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.
Adolescent* ; Aggression ; Child* ; Drug Therapy ; Executive Function ; Humans ; Methylphenidate ; Parents ; Reaction Time ; Stroop Test

Idiopathic renal hypouricemia (iRHUC) is a rare hereditary disease caused by a defect in urate handling of renal tubules. Type 1 renal hypouricemia (RHUC1) is diagnosed with confirmation of a mutation in SLC22A12 gene which encodes a renal urate-anion exchanger (URAT1). The majority of iRHUC patients are asymptomatic, especially during childhood, and thus many cases go undiagnosed or they are diagnosed late in older age with complications of hematuria, renal stones, or acute kidney injury (AKI). We report a case of a 7-year-old boy with subtle symptoms such as general weakness and dizziness and revealed hypouricemia and incidental nephrolithiasis. Homozygous mutations were detected in the SLC22A12(c.774G>A) by molecular analysis. The present case suggests that fractional excretion of uric acid (FEUA) screening could be better followed by the coincidental discovery of hypouricemia, to prevent conflicting complications of iRHUC, even with normal urine uric acid to creatinine ratio (UUA/UCr), and sequential genetic analysis if needed.

Idiopathic renal hypouricemia (iRHUC) is a rare hereditary disease caused by a defect in urate handling of renal tubules. Type 1 renal hypouricemia (RHUC1) is diagnosed with confirmation of a mutation in SLC22A12 gene which encodes a renal urate-anion exchanger (URAT1). The majority of iRHUC patients are asymptomatic, especially during childhood, and thus many cases go undiagnosed or they are diagnosed late in older age with complications of hematuria, renal stones, or acute kidney injury (AKI). We report a case of a 7-year-old boy with subtle symptoms such as general weakness and dizziness and revealed hypouricemia and incidental nephrolithiasis. Homozygous mutations were detected in the SLC22A12(c.774G>A) by molecular analysis. The present case suggests that fractional excretion of uric acid (FEUA) screening could be better followed by the coincidental discovery of hypouricemia, to prevent conflicting complications of iRHUC, even with normal urine uric acid to creatinine ratio (UUA/UCr), and sequential genetic analysis if needed.

OBJECTIVES: This study aimed to investigate the 3-year mean periods aftermath of child sexual abuse and to compare the sexual violence victims regard to the treatment. METHODS: 682 sexual violence victims were recruited by Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center for children age 13, from 2004 to 2008. Data from 49 victims among 116 consented a follow-up, were analyzed. The victims were assessed by psychological test. Data was analyzed by SPSS ver. 15.0 (SPSS Inc.). RESULTS: The average time elapsed from the last presumed sexual abuse was 39.7 months [standard deviation (SD) 26.02]. Overall, Children's Depression Inventory (CDI) was significantly decreased from 15.8 (SD 9.33) to 10.4 (SD 9.98), and several subscales (depression, anxiety, anger, posttraumatic stress, and dissociation) of Trauma Symptom Checklist for Children (TSCC) were also significantly decreased. CDI and TSCC scores showed no statistical difference between treatment-given and not-given groups, but Revised Children's Manifest Anxiety Scale (RCMAS) was decreased in treatment-given group, whereas it was increased in treatment-not-given group. The difference of RCMAS scores between the two groups was statistically significant [F(1,28)=4.54, p < 0.05]. CONCLUSION: Sexually abused children showed overall symptom decreases over time, but anxiety was not decreased in treatment not-given group.
Anger ; Anxiety ; Checklist ; Child ; Child Abuse, Sexual* ; Child* ; Depression ; Follow-Up Studies ; Helianthus ; Humans ; Korea* ; Manifest Anxiety Scale ; Psychological Tests ; Seoul ; Sex Offenses*

OBJECTIVE: The measurement of liver size can be used for the diagnosis of the fetal growth abnormality (FGR, macrosomia etc.). The purpose of this study was to evaluate a mathematical relationship between the fetal liver size(liver length or volume) and the gestational age in the normal pregnancies. Brief comparisons were also tried on the base of the degree of the correlation between liver length and its volume. METHODS: We collected 54 singleton pregnancies of 20 to 36weeks of gestation for measuring fetal liver length and 57 singleton pregnancies for measuring fetal liver volume. We used Combison 530 utrasonic machine(Kreztechnik AG, Zipf, Austria). RESULTS: There was significant correlation between liver size( length and volume) and gestation age. And the liver volume better correlated with gestational age than liver length(r=0.93 : r=0.78, p<0.0001, p<0.0001). CONCLUSION: Ultrasonic measurement of fetal liver size is a reliable indicator of fetal growth, especially liver volume. Therefore these data may have a potential value for the prediction of abnormal fetal growth(FGR, macrosomia).
Diagnosis ; Fetal Development ; Gestational Age* ; Liver* ; Pregnancy* ; Ultrasonics

Trauma is frequently not purely penetrating or purely blunt. Such mixed trauma can result from the mechanism of injury. Recently, we encountered a patient who accidentally shot himself with a shotgun. He had a 15 x 8-cm-sized penetrating injury on left flank that did not penetrate into the peritoneal cavity and a blunt splenic injury with hemoperitoneum. Surgical and interventional treatments were performed for each injury. We present this case with a review of the related literature.
Hemoperitoneum ; Humans ; Peritoneal Cavity

BACKGROUND: Rheumatoid arthritis(RA) is a systemic disease not infrequently involing the heart. It has been known that pericardial effusion, most commonly observed cardiac abnormality in patients with RA, and other cardiac manifestations such as conduction disturbances, valve thickenings, and enlargement of left atrium or aorta are associated with RA. We have determined the nature and extent of cardiac manifestations of RA in comparison with those of control group by echocardiographic examination. METHOD: 27 patients with RA(4 males and 23 females, mean age=47 +/-13 years) and 22 control subjects(3 males and 19 females, mean age+43 +/- 11 years) were randomly selected. Standard two-dimensional, M-mode and doppler echocardiographic examination were done on each group of subjects. RESULTS: 1) Pericardial effusions were more commonly detectd in patients with RA than control group(55.6% vs 22.7%, p<0.01). There were no significant differences in the amount of pericardial effusion according to the duration and the stage of RA. 2) Thickness of each cardiac valve was thicker in patients with RA than control group. But, there were no statistical significance between them. 3) The left ventricular mass index(LVMI) and the diameter of aorta showed a trend to increase in patients with RA(109.5 +/-28.0 g/m(2) vs 94.2 +/-24.6 g/m(2), p=0.054). 4) The diameter of left atrium was more lager in patients with RA(35.1 +/- 4.0mm vs 31.6 +/- 4.5mm, p=o.005). 5) The E/A ratio of mitral valve was statistically significantly lower in patients with RA(RA:control=1.2 +/- 0.5 : 1.7 +/- 0.4, p=0.01). CONCLUSION: The asymptomatic patients with RA more frequently show cardiac abnormalities such as pericardial effusion, valve thickening, decrease of E/A ratio than control group. So two-dimensional echocardiography is necessary for early, noninvasive and accurate evaluation of asymptomatic cardiac abnormalities in patients with RA.
Aorta ; Arthritis, Rheumatoid ; Echocardiography ; Female ; Heart ; Heart Atria ; Heart Valves ; Humans ; Male ; Mitral Valve ; Pericardial Effusion

Objective: This study examined whether related experts within the same organ know the standardized viscosity system of fluids and can manufacture solutions consistently. Methods: The subjects of this study were 22 rehabilitation ward nurses, 21 non-rehabilitation ward nurses, and 19 occupational therapists. The additional thickeners, manufacturing time and order, viscosity appropriateness, and solution homogeneity were measured for IDDSI level 4, 3, and 2 solutions manufactured using xanthan gum-based food thickeners. Results: The viscosity appropriateness in the three groups in stages IDDSI levels 4 and 3, but there was a significant difference among the three groups in stage IDDSI level 2. The factors affecting viscosity appropriateness were group and homogeneity of solution. The rehabilitation nurse group produced thicker solutions than the IDDSI standard compared to the other group. The homogeneity of the solution showed significant differences among the three groups in IDDSI levels 4, 3, and 2. The factors affecting homogeneity included the manufacturing order and job group, which often resulted in a clumping phenomenon when water was added first. Compared to the groups of therapists, the clumping phenomenon was significantly higher in the nurse (IDDSI level 3) and non-rehabilitation nurse groups (IDDSI level 4, 3) than the occupational therapists group. Conclusion This study showed that awareness and education about the liquid stage are necessary for medical personnel involved in hydration for patients with dysphagia and that consistent application using a standardized food thickener protocol at an institution is necessary.