BACKGROUND: Fine needle aspiration cytology is an effective and important diagnostic procedure to distinguish benign from malignant thyroid nodule. The purpose of this study is to compare the results of thyroid fine needle aspiration cytology performed by the residents of family medicine and internal medicine. METHODS: Among patients who underwent fine needle aspiration cytology for differential diagnosis of thyroid nodule at the department of family medicine, Pusan National University Hospital from July 1996 to June 1998, we randomly selected 96 patients. We also selected 96 control patients at the department of internal medicine. We assessed the patients age, sex, accompanying symptoms, diagnostic procedures, pathologic results of fine needle aspiration cytology from the medical records and biopsy records. For statistical analysis, we used t-test and Chi-square test. RESULTS: Mean age of 96 patients of family medicine was 44.4 years. Females were 89(92.7%) and males 7(7.3%). Age and sex distributions were not significantly different from that of internal medicine patients(p>0.05). Patients with thyroid nodule had underwent fine needle aspiration cytology(100.0%), thyroid function test(76.0%), thyroid scan(49.0%), and thyroid ultrasond(35.4%). There were more thyroid scans performed in the intemal medicine department, as there were more ultrasonograms done in the family medicine department(p<0.05). Pathology results of 96 cases showed benign in 51 cases(53.1%), malignant in 8(8.3%), indeterminate in 16(16.7%), and insufficient in 21(21.9%). Among the 51 benign cases, there were cystic nodule(27.1%), adenomatous hyperplasia(22.9%), and thyroiditis(3.1%). All 8 malignant cases were papillary carcinoma. The frequency of malignancy thyroid nodules and insufficient specimens were not significantly different between the two departments(p>0.05). Complications of aspiration were rare and not significantly different between the two departments(p>0.05). CONCLUSIONS: Pathology results and complications of fine needle aspiration cytology performed by residents of family medicine and internal medicine were not significantly different.
Biopsy ; Biopsy, Fine-Needle* ; Busan ; Carcinoma, Papillary ; Diagnosis, Differential ; Female ; Humans ; Internal Medicine* ; Male ; Medical Records ; Pathology ; Sex Distribution ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

No abstract available.
Hyperuricemia* ; Kidney Transplantation*

No abstract available.
Hyperuricemia* ; Kidney Transplantation*

BACKGROUND: Since April 2009, novel influenza A (H1N1) infection is spreading throughout the world. This infection might be fatal for immunocompromised patients who are at a potentially high risk of developing infectious complications. We investigated the detection rate and features of H1N1 infection in immunocompromised patients. METHODS: Between August 2009 and February 2010, we examined 8,112 subjects, including 390 immunocompromised patients, for H1N1. Swab samples were taken from the nose and throat of the participants. Real-time PCR was performed to identify H1N1 viral genes. RESULTS: Positive results were obtained in 2,953/8,112 (36.4%) subjects and 46/390 (11.8%) immunocompromised patients. H1N1 was identified in 8.7% patients with solid cancer, 12.9% patients with hematologic malignancy, 16.7% patients with chronic renal disease, and 14.5% patients with kidney transplantation. The mean cycle threshold (Ct) value of PCR was significantly lower (P<0.05) in patients with hematologic malignancy as compared to that in patients with chronic renal disease and control subjects. Four patients died due to respiratory complications. CONCLUSIONS: The detection rate of H1N1 was significantly lower in immunocompromised patients than in other patients. The Ct value of patients with hematologic malignancy was significantly lower than that of other immunocompromised patients and control subjects.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; *Immunocompromised Host ; Infant ; Influenza A Virus, H1N1 Subtype/genetics/*isolation & purification ; Influenza, Human/complications/*diagnosis/epidemiology ; Kidney Failure, Chronic/complications ; Leukemia/complications ; Male ; Middle Aged ; Neoplasms/complications ; Polymerase Chain Reaction

BACKGROUND AND OBJECTIVES: SIRT1, a histone diacetylase, modify transactivation function of various transcription factor including p53 and NF-kappaB. p53 and NF-kappaB is involved in in vitro differentiation of mouse embryonic stem cells (mESC) into mouse embryoid body (mEB). These suggest that SIRT1 might affect in vitro differentiation of mESC into mEB by regulation of p53 and NF-kappaB. METHODS AND RESULTS: In this study we analyzed the effect of SIRT1 in in vitro differentiation of mESC into mEB using wild and SIRT1 knockout mESC. To examine SIRT1-specific gene in mESC, this study conducted microarray-based differential gene expression analysis between wild and SIRT1 knockout mESC. Comparing their gene expression patterns, this study determined a list of genes regulated by SIRT1. cDNA microarray data-set analysis revealed that genes associated with transcription and signal transduction are significantly modified in SIRT1 knockout mESC. cDNA microarray data-set analysis between mESC and EB in wild and SIRT1 showed that SIRT1 inhibits p53 signaling pathway but not affect NF-kappaB signaling pathway. CONCLUSIONS: This study suggests that SIRT1 modify mESC differentiation by regulation of p53 transcriptional activity.
Animals ; Embryoid Bodies ; Embryonic Stem Cells ; Gene Expression ; Histones ; Mice ; NF-kappa B ; Oligonucleotide Array Sequence Analysis ; Signal Transduction ; Transcription Factors ; Transcriptional Activation

BACKGROUND: Despite improved operator technique and advanced equipment designs, acute closure and restenosis remain as serious limitations to both the short and long-term success of balloon angioplasty. Atherectomy is a new transluminal interventional technique for the treatment of coronary artery obstructive disease. We evaluate preliminary experience of directonal coronary atherectomy (DCA) for complex coronary artery lesions. METHODS: We tried DCA in the 16 lesions of 15 nonrandomized sequential patients(mean age 66 years, M/F : 12/3) with coronary artery lesions that were ostial lesion in 4, ulcerated and/or eccentric in 13, restenosis after PTCA in 2 and after stent implantation in 2. The target vessel was right coronary artery in 7 and left anterior descending artery in 9. RESULTS: Primary success was achieved in 14 of 16 lesions (88%) by atherectomy and in 5(36%) by additional use of balloon angioplasty. Atherectomy retrieved tissue in 15 out of 15 attempts(100%). One patients suffered acute closure due to large dissection during the DCA which was solved successfully after stent implantation. CONCLUSIONS: Atherectomy can predictably treat selected patients with eccentric, ostial bulky coronary lesions with overall safety comparable to that of conventional balloon angioplasty, although the procedure as currently performed does not appear to prevent restenosis.
Angioplasty, Balloon ; Arteries ; Atherectomy ; Atherectomy, Coronary* ; Coronary Vessels ; Equipment Design ; Humans ; Stents ; Ulcer

Laribacter hongkongensis is an emerging pathogen in patients with community-acquired gastroenteritis and traveler's diarrhea. We herein report a case of L. hongkongensis infection in a 24-yr-old male with liver cirrhosis complicated by Wilson's disease. He was admitted to a hospital with only abdominal distension. On day 6 following admission, he complained of abdominal pain and his body temperature reached 38.6degrees C. The results of peritoneal fluid evaluation revealed a leukocyte count of 1,180/microL (polymorphonuclear leukocyte 74%). Growth on blood culture was identified as a gram-negative bacillus. The isolate was initially identified as Acinetobacter lwoffii by conventional identification methods in the clinical microbiology laboratory, but was later identified as L. hongkongensis on the basis of molecular identification. The patient was successfully treated with cefotaxime. To the best of our knowledge, this case is the first report of hospital-acquired L. hongkongensis bacteremia with neutrophilic ascites.
Acinetobacter/isolation & purification ; Acinetobacter Infections/complications/diagnosis/microbiology ; Bacteremia/complications/*microbiology ; Cefotaxime/therapeutic use ; Diagnosis, Differential ; Gastroenteritis/complications/*diagnosis/*microbiology ; Hepatolenticular Degeneration/complications/microbiology ; Humans ; Liver Cirrhosis/complications/microbiology ; Male ; Neisseriaceae/*isolation & purification ; Phylogeny ; Republic of Korea ; Young Adult

PURPOSE: Fingertip amputations are the most common type of upper limb amputations. Composite grafting is a simple and cost-effective technique. Although many factors have investigated the success of composite grafting, the success rate is not high. Therefore, this study was conducted to investigate whether the microscopic procedure process during composite grafts improves the success rate. MATERIALS AND METHODS: Thirteen cases of unreplantable fingertip amputation underwent a microscopic resection procedure for composite graft in the operating room. The principle of the procedure was to remove the least devitalized tissue, maximize the clean tissue preservation and exact trimming of the acral vessel and to remove as many foreign bodies as possible. RESULTS: All fingertips in the thirteen patients survived completely without additional procedures. CONCLUSION: Composite grafting allows for the preservation of length while avoiding the donor site morbidity of locoregional flaps. Most composite grafts are performed as quickly as possible in a gross environment. However, we take noticed the microscopic resection. This process is thought to increase the survival rate for the following reasons. First, the minimal resection will maximize the junction surface area and increase serum imbibition. Second, sophisticated trimming of injured distal vessels will increase the likelihood of inosculation. Third, accurate foreign body removal will reduce the probability of infection and make it possible to increase the concentration and efficiency in a microscopic environment. Although there is a need for more research into the mechanisms, we recommend using a composite graft under the microscopic environment.
Amputation ; Finger Injuries ; Foreign Bodies ; Humans ; Operating Rooms ; Survival Rate ; Tissue Donors ; Tissue Preservation ; Transplants* ; Upper Extremity

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.
Antidepressive Agents ; Depression ; Fluoxetine ; Humans ; Lymphocytes ; Response Elements

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.
Antidepressive Agents ; Depression ; Fluoxetine ; Humans ; Lymphocytes ; Response Elements