Effect of Temperature Variation on the Incidence of Acute Myocardial Infarction

Background@#Harsh temperature exposure has been associated with a high risk of cardiovascular events. We sought to investigate the influence of temperature change on longterm incidence of acute myocardial infarction (AMI) in Korean patients. @*Methods@#From the National Health Insurance Service (NHIS) customized health information database (from 2005 to 2014), data from a total of 192,567 AMI patients was assessed according to the International Classification of Disease 10th edition code and matched with temperature reports obtained from the Korea Meteorological Administration database. We analyzed data for a 10-year period on a monthly and seasonal basis. @*Results@#The incidence rate per 100,000 year of AMI exhibited a downward trend from 69.1 to 56.1 over the period 2005 to 2014 (P < 0.005), and the seasonal AMI incidence rate per 100,000 year was highest in spring (63.1), and winter (61.3) followed by autumn (59.5) and summer (57.1). On a monthly basis, the AMI incidence rate per 100,000 year was highest during March (64.4) and December (63.9). The highest incidence of AMI occurred during temperature differences of 8–10° in each season. Moreover, AMI incidence tended to increase as the mean temperature decreased (r = −0.233, P = 0.001), and when the mean daily temperature difference increased (r = 0.353, P < 0.001). @*Conclusion@#The AMI incidence rate per 100,000 year has a decreasing trend over the 10-year period, derived from the Korean NHIS database. Modest daily temperature differences (8–10°) and the spring season are related to higher AMI incidence, indicating that daily temperature variation is more important than the mean daily temperature.

Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction / 고신대학교의과대학학술지

Background@#Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data. @*Methods@#We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset. @*Results@#The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%. @*Conclusions@#Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.

Morning Chronotype Decreases the Risk of Chemotherapy-Induced Peripheral Neuropathy in Women With Breast Cancer

Background@#The purpose of this longitudinal prospective cohort study was to investigate the role of chronotype in the incidence of chemotherapy-induced peripheral neuropathy (CIPN) among women with breast cancer. @*Methods@#We recruited women with breast cancer awaiting adjuvant chemotherapy, including four cycles of docetaxel. Participants reported peripheral neuropathy symptoms of numbness/ tingling at the baseline, and at 4weeks after completion of chemotherapy. Candidate psychiatric factors associated with CIPN were assessed at the baseline, using the Composite Scale of Morningness, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale. To examine the association between chronotype and CIPN, we built logistic regression models, adjusting for demographic, clinical, and other psychiatric variables. @*Results@#Among 48 participants, 29 participants developed CIPN. The morning chronotype was inversely associated with CIPN (odds ratio, 0.06; confidence interval, 0.01–0.74; P = 0.028) after adjusting for age, BMI, education, type of operation, alcohol use, smoking, sleep quality, depression, and anxiety. @*Conclusion@#Our results suggest that the morning chronotype is a protective factor against the development of CIPN in patients with breast cancer who were treated with docetaxel.

Mediation effect of herpes zoster derived by statin use on cardiovascular disease risk

Background/Aims@#Although statins are widely used to reduce the risk of cardiovascular disease (CVD) including stroke and myocardial infarction (MI), it is reported that statin use increases the incidence of herpes zoster (HZ) that is associated with increased risk of CVD. So, we evaluated the mediation effect of HZ caused by statin use on CVD. @*Methods@#We analyzed a prospective cohort from the National Health Insurance Service-database of South Korea. All individuals received a medical check-up and were followed-up from 2002 to 2013. @*Results@#A total of 275,382 individuals > 40 years old were followed up for 11 years from 2003. Of these, 11,415 people (4%) were classified as statin users and 263,967 (96%) as non-statin users. Those who used statins had significantly lower risks of cardiovascular events, stroke, and MI compared with non-statin users; the adjusted hazard ratios in the multivariate analysis were 0.90 (95% confidence interval [CI], 0.82 to 0.98), 0.88 (95% CI, 0.80 to 0.98), and 0.91 (95% CI, 0.79 to 1.07), respectively. When we calculated the mediating effect of cardiovascular events by statin use through HZ, 11.6% of the total beneficial effect of cardiovascular events by statin use was mitigated through the occurrence of HZ caused by statin use. This mediating effect was higher in the younger age group (< 60 years). @*Conclusions@#This study showed that statin use reduced CVD by 10%, but the protective effect of statin use against CVD was mitigated by approximately 10% through the development of HZ caused by statin use.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors / 정신신체의학

Objectives@#：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. @*Methods@#：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. @*Results@#：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). @*Conclusions@#：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors / 정신신체의학

Objectives@#：The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. @*Methods@#：182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-towork support between the patient group and caregiver group (patient’s needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. @*Results@#：34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is “very necessary”. The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-towork support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p= 0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). @*Conclusions@#：The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

Effect of Long-term Comprehensive Rehabilitation on Functional Recovery in Recurrent and Refractory Neuro-Behcet's Disease: a Case Report with 4-year Follow-up

Neuro-Behcet's disease (NBD) is rare, but it is the most serious complication of Behcet's disease, a vasculitis and multisystem inflammatory syndrome. NBD causes a variety of neurological deficits depending on the affected structure in the brain; cognitive impairment, motor weakness, ataxia, and dysphagia significantly affect functioning in independent life. Although steroid therapy usually ameliorates NBD symptoms, its therapeutic effects are limited to the chronic progressive type. In NBD patients with frequent recurrences, comprehensive rehabilitation can help to improve activities of daily living and neurological symptoms.

Cranial Polyneuropathy in Ramsay Hunt Syndrome Manifesting Severe Pharyngeal Dysphagia: a Case Report and Literature Review

Ramsay Hunt syndrome (RHS) is characterized by herpes zoster oticus, facial nerve palsy, and vestibulocochlear symptoms. Dysphagia caused by the involvement of multiple cranial nerves (CNs) in RHS is very rare. We encountered a rare case presented with severe dysphagia due to cranial polyneuropathy involving trigeminal nerve (CN V), facial nerve (CN VII), vestibulocochlear nerve (CN VIII), glossopharyngeal nerve (CN IX), vagus nerve (CN X), and hypoglossal nerve (CN XII) in RHS. This case report suggested that the prognosis for dysphagia in RHS seems favorable, and swallowing rehabilitation therapy could be beneficial in expediting tube removal.

Case of Follicular Bronchiolitis in Rheumatoid Arthritis

Follicular bronchiolitis is an uncommon bronchiolar disorder that is characterized by the presence of hyperplastic lymphoid follicles with reactive germinal centers. The condition is associated with connective tissue diseases such as rheumatoid arthritis, Sjögren’s syndrome, and immunodeficiency disorders. A 56-year-old man with rheumatoid arthritis was admitted to hospital with a progressively enlarging pulmonary nodule in the left upper lobe. A follow-up contrast tomography scan showed that the nodule had increased in size from 4.2 mm to 6.3 mm over a 3 month period. An open lung biopsy was performed to establish a definite pathologic diagnosis of the pulmonary nodule, which was suspected to be a lung malignancy. The nodule was diagnosed as follicular bronchiolitis based on the histopathology findings. We describe a patient with follicular bronchiolitis that was confirmed by an open lung biopsy, and is believed to have had rheumatoid involvement.

Reliability and Validity of the Korean Version of the Child Report of Post-Traumatic Symptoms (CROPS) and the Parent Report of Post-Traumatic Symptoms (PROPS)

OBJECTIVES: The Child Report of Post-traumatic Symptoms (CROPS) and the Parent Report of Post-traumatic Symptoms (PROPS) are screening measures for post-traumatic symptoms in children. The present study aimed to investigate the reliability and validity of the Korean versions of the CROPS and the PROPS. METHODS: The Korean versions of the CROPS and the PROPS were administered to a sample of 304 children aged 6 to 15 years old. The internal reliability, test-retest reliability, factorial validity, predictive validity and concurrent validity were evaluated. RESULTS: The reliability of the CROPS and the PROPS was shown to have excellent internal consistency and test-retest correlation. The single factor structure of the PROPS was good and that of the CROPS was borderline acceptable according to confirmatory factor analysis. Other validity measures such as the predictive validity and concurrent validity were also shown to be satisfactory. CONCLUSION: This study demonstrated that the Korean versions of the CROPS and the PROPS were reliable measures with satisfactory psychometric qualities. Because it takes less than 5 minutes to fill out the CROPS and the PROPS, respectively they can be quick and easy screening scales for assessing post-traumatic symptoms in Korean children.

Sintering behavior and mechanical properties of zirconia compacts fabricated by uniaxial press forming

PURPOSE: The purpose of this study was to compare the linear sintering behavior of presintered zirconia blocks of various densities. The mechanical properties of the resulting sintered zirconia blocks were then analyzed. MATERIAL AND METHODS: Three experimental groups of dental zirconia blocks, with a different presintering density each, were designed in the present study. Kavo Everest(R) ZS blanks (Kavo, Biberach, Germany) were used as a control group. The experimental group blocks were fabricated from commercial yttria-stabilized tetragonal zirconia powder (KZ-3YF (SD) Type A, KCM. Corporation, Nagoya, Japan). The biaxial flexural strengths, microhardnesses, and microstructures of the sintered blocks were then investigated. The linear sintering shrinkages of blocks were calculated and compared. RESULTS: Despite their different presintered densities, the sintered blocks of the control and experimental groups showed similar mechanical properties. However, the sintered block had different linear sintering shrinkage rate depending on the density of the presintered block. As the density of the presintered block increased, the linear sintering shrinkage decreased. In the experimental blocks, the three sectioned pieces of each block showed the different linear shrinkage depending on the area. The tops of the experimental blocks showed the lowest linear sintering shrinkage, whereas the bottoms of the experimental blocks showed the highest linear sintering shrinkage. CONCLUSION: Within the limitations of this study, the density difference of the presintered zirconia block did not affect the mechanical properties of the sintered zirconia block, but affected the linear sintering shrinkage of the zirconia block.

A comparison of fracture strengths of porcelain-fused-to-titanium crown among titanium surface coating treatments / 대한치과보철학회지

STATEMENT OF PROBLEM: Titanium and its alloy, with their excellent bio-compatibility and above average resistance to corrosion, have been widely used in the field of dentistry. However, the excessive oxidization of titanium which occurs during the process of firing on porcelain makes the bonding of titanium and porcelain more difficult than that of the conventional metal-porcelain bonding. To solve this problem related to titanium-porcelain bonding, several methods which modify the surfaces, coat the surfaces of titanium with various pure metals and ceramics, to enable the porcelain adhesive by limiting the diffusion of oxygen and forming the adhesive oxides surfaces, have been investigated. PURPOSE: The purpose of this study was to know whether the titanium-porcelain bonding strength could be enhanced by treating the titanium surface with gold and TiN followed by fabrication of clinically applicable porcelain-fused-to-titanium crown. MATERIAL AND METHOD: The porcelain-fused-to-titanium crown was fabricated after sandblasting the surface of the casting titanium coping with Al2O3 and treating the surface with gold and TiN coating followed by condensation and firing of ultra-low fusing porcelain. To compare with porcelain-fused-to-titanium crowns, porcelain-fused-to-gold crowns were fabricated and used as control groups. The bonding strengths of porcelain-fused-to-gold crowns and porcelain-fused-totitanium crowns were set for comparison when the porcelain was fractured on purpose to get the experimental value of fracture strength. Then, the surface were examined by SEM and each fracturing pattern were compared with each other. RESULT: Those results are as follows. 1. The highest value of fracture strength of porcelain-fused-to-titanium crowns was in the order of group with gold coating, group with TiN coating, group with Al2O3 sandblasting. No statistically significant difference was found among the three (P>.05). 2. The porcelain-fused-to-gold crowns showed the highest value in bonding strength. The bonding strength of crowns porcelain-fused-to-titanium crowns of rest groups showed bonding strength reaching only 85%-94% of that of PFG, though simple comparision seemed unacceptable due to the difference in materials used. 3. The fracturing patterns between metal and porcelain showed mixed type of failure behavior including cohesive failure and adhesive failure as a similar patterns by examination with the naked eye and SEM. But porcelain-fused-to-gold crowns showed high incidence of adhesive failure and porcelain-fused-to-titanium crowns showed high incidence of cohesive failure. CONCLUSION: Above results proved that when fabricating porcelain-fused-to-titanium crowns, treating casting titanium surface with gold or TiN was able to enhance the bonding strength between titanium and porcelain. Mean value of masticatory force was found to showed clinically acceptable values in porcelain bonding strength in all three groups. However, more experimental studies and evaluations should be done in order to get better porcelain bonding strength and various surface coating methods that can be applied on titanium surface with ease.

The bond characteristics of porcelain fused by titanium surface modification / 대한치과보철학회지

STATEMENT OF PROBLEM: Titanium is well known as a proper metal for the dental restorations, because it has an excellent biocompatibility, resistance to corrosion, and mechanical property. However, adhesion between titanium and dental porcelains is related to the diffusion of oxygen to the reaction layers formed on cast-titanium surfaces during porcelain firing and those oxidized layers make the adhesion difficult to be formed. Many studies using mechanical, chemical and physical methods to enhance the titanium-ceramic adhesion have been actively performed. PURPOSE: This study meant to comparatively analyse the adhesion characteristics depending on different titanium surface coatings after coating the casts and wrought titanium surfaces with Au and TiN. MATERIAL AND METHOD: In this study, the titanium specimens (CP-Ti, Grade 2, Kobe still Co. Japan) were categorized into cast and wrought titanium. The wrought titanium was cast by using the MgO-based investment(Selevest CB, Selec). The cast and wrought titanium were treated with Au coating(ParaOne(R), Gold Ion Sputter, Model PS-1200) and TiN coating(ATEC system, Korea) and the ultra low fusing dental porcelain was fused and fired onto the samples. Biaxial flection test was done on the fired samples and the porcelain was separated. The adhesion characteristics of porcelain and titanium after firing and the specimen surfaces before and after the porcelain fracture test were observed with SEM. The atomic percent of Si on all sample surfaces was comparatively analysed by EDS. In addition, the constituents of specimen surface layers after the porcelain fracture and the formed compound were evaluated by X-ray diffraction diagnosis. RESULT: The results of this study were obtained as follows : 1. The surface characteristics of cast and wrought titanium after surface treatment(Au, TiN, Al2O3 sandblasting) were similar and each cast and wrought titanium showed similar bonding characteristics. 2. Before and after the biaxial flection test, the highest atomic weight change of Si component was found in Al2O3 sandblasted wrought titanium(28.6at.% --> 8.3at.%). On the other hand, the least change was seen in Au-Pd-In alloy(24.5at.%--> 19.1at.%). 3. Much amount of Si components was uniformly distributed in Au and TiN coated titanium, but less amount of Si's was unevenly dispersed on Al2O3 sandblasting surfaces. 4. In X-ray diffraction diagnosis after porcelain debonding, we could see Au2Ti compound and TiN coating layers on Au and TiN coated surfaces and TiO2, typical oxide of titanium, on all titanium surfaces. 5. Debonding of porcelain on cast and wrought titanium surface after the biaxial flection is considered as a result of adhesion deterioration between coating layers and titanium surfaces. We found that there are both adhesive failure and cohesive failure at the same time. CONCLUSION: These results showed that the titanium-ceramic adhesion could be improved by coating cast and wrought titanium surfaces with Au and TiN when making porcelain fused to metal crowns. In order to use porcelain fused to titanium clinically, it is considered that coating technique to enhance the bonding strength between coating kKlayers and titanium surfaces should be developed first.

Effects of titanium surface coating on ceramic adhesion / 대한치과보철학회지

STATEMENT OF PROBLEM: The adhesion between titanium and ceramic is less optimal than conventional metal-ceramic bonding, due to reaction layer form on cast titanium surface during porcelain firing. PURPOSE: This study characterized the effect of titanium-ceramic adhesion after gold and TiN coating on cast and wrought titanium substrates. MATERIAL AND METHOD: Six groups of ASTM grade II commercially pure titanium and cast titanium specimens(13mm x 13mm x 1mm) were prepared(n=8). The conventional Au-Pd-In alloy served as the control. All specimens were sandblasted with 110micrometer Al2O3 particles and ultrasonically cleaned for 5min in deionized water, and dried in air before porcelain firing. An ultra-low-fusing dental porcelain(Vita Titankeramik) was fused on titanium surfaces. Porcelain was debonded by a biaxial flexure test at a cross head speed of 0.25mm/min. The excellent titanium-ceramic adherence was exhibited by the presence of a dentin porcelain layer on the specimen surface after the biaxial flexure test. Area fraction of adherent porcelain(AFAP) was determined by SEM/EDS. Numerical results were statistically analyzed by one-way ANOVA and Student- Newman-Keuls test at alpha=0.05. RESULTS: The AFAP value of cast titanium was greatest in the group 2 with TiN coating, followed by group 1 with Au coating and the group 3 with Al2O3 sandblasting. Significant statistical difference was found between the group 1, 2 and the group 3 (p.05). The AFAP values of the cast titanium and the wrought titanium were similar. However the group treated with Al2O3 sandblasting showed significantly lower value (p<.05).

Mechanical properties of laser-welded cast titanium and titanium alloy / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the effect of the output energy(voltage) of laser welding on the strength and properties of joint of cast titanium(CP Gr II) and titanium alloy(Ti-6Al-4V). MATERIAL AND METHOD: Cast titanium and its alloy rods(ISO6871) were prepared and perpendicularly cut at the center of the rod. After the cut halves were fixed in a jig, and the joints welded with a laser-welding machine at several levels of output voltage of 200V.280V. Uncut specimens served as the non-welded control specimens. The pulse duration and pulse spot size employed in this study were 10ms and 1.0mm respectively. Tensile testing was conducted at a crosshead speed of 0.5mm/min. The ultimate tensile strength(MPa) was recorded, and the data(n=6) were statistically analyzed by one-way analysis of variance(ANOVA) and Scheffe's test at alpha=0.05. The fracture surface of specimens investigated by scanning electron microscope(SEM). Vickers microhardness was measured under 500g load of 15seconds with the optimal condition of output voltage 280V. RESULTS: The results of this study were obtained as follows, 1. When the pulse duration and spot size were fixed at 10ms and 1.0mm respectively, increasing the output energy(voltage) increased UTS values and penetration depth of laser welded to titanium and titanium alloy. 2. For the commercial titanium grade II, ultimate tensile strength(665.3MPa) of the specimens laser-welded at voltage of 280V were not statistically(p>0.05) different from the non-welded control specimens(680.2MPa). 3. For the titanium alloy(Ti-6Al-4V), ultimate tensile strength(988.3MPa) of the specimens laser-welded at voltage of 280V were statistically(p<0.05) different from the nonwelded control specimens(665.0MPa). 4. The commercial titanium grade II and titanium alloy(Ti-6Al-4V) were Vickers microhardness values were increased in the fusion zone and there were no significant differences in base metal, heat-affected zone.

Synchronous Double Primary Carcinoma of the Intrahepatic Bile Duct and the Gallbladder

A 66-year-old male was admitted to the department of surgery, at the Presbyterian Medical Center due to right upper quadrant pain. Tumor marker studies reported CEA and CA19-9 elevation. Liver function test was normal. Ultrasonography and computed tomography showed a single infiltrative tumor in the left lobe of liver, multiple lymphadenopathies around the common hepatic duct and intrahepatic bile duct dilatation of the left lobe. The gallbladder was nonspecific. During laparotomy, we found an ill-marginated and infiltrative tumor in the left lobe of liver, multiple enlarged lymph nodes around the common hepatic duct and cystic duct, and mild thickening of the gallbladder fundus wall. Left hepatic lobectomy and cholecystectomy were performed. Pathologic findings revealed that the liver tumor was a moderated differentiated adenocarcinoma with extension to the pericystic and pericommon hepatic lymph nodes and focal adenocarcinoma in situ of gallbladder mucosal wall with clear cystic duct resection margin. We therefore report a rare case of synchronous double primary cancer of the intrahepatic bile duct and gallbladder.

A Case of Primary Extranodal NK/T Cell Lung Lymphoma Presenting as Multiple Patchy Pulmonary Infiltrations / 결핵

Primary lung lymphoma is an uncommon tumor, which constitutes 0.5% of primary lung cancer, and 3% of extranodal lymphoma. The most frequent radiologic presentation of pulmonary parenchymal lymphoma is single mass or nodule. But we have experienced a case which was radiologically presented as patchy lung infiltration at first, and then progressive multiple reticulonodular infiltrations in lung. A 48-year-old woman was admitted to the hospital because of fever and cough. Chest PA obtained on admission revealed multiple patchy infiltration. Eventually, open lung biopsy was performed and the specimen disclosed extranodal NK/T cell lymphoma, and in bone marrow aspiration, hemophagocytosis was present. We report a case of primary extranodal NK/T cell lung lymphoma presented as patchy lung infiltrations, which was treated with chemotherapy.

Thyroid MALT Lymphoma Associated with Thyroid Papillary Cancer / 대한내분비외과학회지

There are thyroid lymphoma and thyroid papillary cancer in thyroid disease which can happen being associated with Hashimoto's thyroiditis. Thyroid lymphoma is a rare disease consisting of less than 1% of lymphoma and of 5% of thyroid cancer. It occurs with Hashimoto's thyroiditis in 75%, and the cause is the immune reaction in which autoantibodies originated from thyroid are exposed B-cell continually. Also, the incidence of thyroid cancer, especially thyroid papillary cancer, increases in Hashimoto's thyroiditis. The reason is that the genetic change-RET/PTC mutation- of Hashimoto's thyroiditis is specific to thyroid papillary cancer than to other cancer. Patients usually complain neck nodule or sudden neck mass growing, hoarseness and respiratory difficulty. FNA, USG, Neck CT, MRI, and RI scan can be used for diagnosis. We can choose radiation, operation, and chemotherapy in single form or combined form according to the stage and the location of disease. If a patient who has neck mass, the pathologic finding of it is similar to that of Hashimoto's thyroiditis, and it is resistant to thyroid hormonal therapy, we should consider that it can be thyroid lymphoma or thyroid papillary cancer associated with Hashimoto's thyroiditis. We report a case of thyroid MALT lymphoma combined with occult papillary cancer which was resistant to thyroid hormonal therapy and which was successfully treated by operation and radiation therapy.

Two Cases of Adult Intussusception

Intussusception can develop at any age but about 95% of patients are children under 2 years-old. Adult intussusception is a rare condition. Unlike children, nearly all adults with intussusception have a lead point such as benign or malignant small bowel tumors, intestinal tuberculosis, or Meckel's diverticulum. First case is a 48-year-old male who was admitted with 2 days of diffuse abdominal cramping pain and no other associated gastrointestinal symptoms. Barium enema revealed ileocolic intussusception with a round cecal mass after barium reduction. An ileocecectomy was performed electively. The pathologic report was cecal cyst, which was an intraluminal structure with an epithelial lining of colonic mucosa. The second case, a 53-year-old male, was admitted with 1 week of diffuse abdominal cramping pain and watery diarrhea. Barium enema revealed ileocecal intussusception. Emergency surgery (ileocecectomy), revealed a polypoid small bowel mass. The pathologic report was lipoma. Recently, we experienced two cases of adult intussusception and report these cases with a brief review of the literature.

Analysis of Induced Sputum to Examine the Effects of Inhaled Corticosteroid on the IL-8 and Myeloperoxidase in Asthmatic Subjects / 소아알레르기및호흡기학회지

PURPOSE: The of this study was to describe the changes of airway inflammation in children with stable, steriod naive asthma after inhaling fluticasone by using serial induced sputum. We sought to investigate the role of neutrophils, interleukin-8(IL-8), and myeloperoxidase(MPO) in asthma. METHOD: To examine the change of neutrophil and their products in childhood asthma after inhaling fluticasone, we assessed the cell counts, IL-8, and MPO in the sputum at each visit. Also, the daily symptom scores, FEV1, peak expiratory flow variability, and methacholin airway responsiveness were checked and their relationships were analyzed. RESULT: There was a significant improvement in asthma severity, as measured by symptom score, and FEV1. There were significant reductions in IL-8 and MPO after 3 weeks treatment, and significant increase in the total sputum cell counts. Significant increase in total lymphocyte and alvelor macrophage cell counts with no increase in neutrophil and eosinophil counts were found. Airway responsiveness was significantely correlated with total eosinophil counts before inhaling fluticasone and it was correlated with IL-8 after the treatment. CONCLUSION: This study highlight, the probable importance of IL-8 and myeloper-oxidase within the asthmatic airways and the beneficial modulatory effect of inhaled fluticasone treatment upon them.