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Assessment of Ovarian Volume and Hormonal Changes after Ovarian Cystectomy in the Different Ovarian Tumor (난소 낭종 제거술후 난소 용적 및 호르몬의 변화)

  • Park, Joon-Cheol;Bae, Jin-Gon;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.155-162
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    • 2008
  • Objectives: The aim of this study was to assess the change of ovarian reserve after removal of ovarian tumor using basal FSH, $E_2$, clomiphene citrate challenge test and ovarian volume. Methods: Twenty two patients with unilateral ovarian tumor, ${\leq}35$ years old, regular menstrual cycle were collected prospectively and divided into endometrioma or non-endometrioma group. We measured the ovarian volume with transvaginal ultrasonography on the day 3 of menstrual cycle within one month before and 3 months after surgery. Basal (cycle day 3) FSH, $E_2$ and CCCT were checked before surgery and repeated at least 2 spontaneous cycles later after surgery. Three patients that had been pregnant within 3 months after surgery were excluded in analysis. Results: The ovarian volume was reduced significantly after surgery in endometrioma and non-endometrioma ${\geq}10\;cm$ group ($4.79{\pm}2.57\;cm^3$ and $5.21{\pm}1.33\;cm^3$, respectively), but not in the non-endometrioma <10 cm group ($6.18{\pm}2.85\;cm^3$). After surgery, basal FSH and cycle day 10 FSH on CCCT in endometrioma and non-endometrioma were $4.25{\pm}0.20\;mIU/ml$ and $3.79{\pm}0.80\;mIU/ml$, $4.24{\pm}0.85\;mIU/ml$ and $4.28{\pm}0.92\;mIU/ml$, respectively. There were neither significant difference in comparison with the preoperative results nor between two groups. Conclusions: Enucleation of ovarian mass was associated with a significant reduction in ovarian volume in endometrioma and non-endometrioma larger than 10cm in diameter. Hormonal markers for evaluation of ovarian reserve, such as basal and cycle day 10 FSH on CCCT, were not changed significantly in each group. In reproductive age women, conservative enucleation or cystectomy rather than oophorectomy should be considered even in a large benign tumor and ovarian function could be reserved by meticulous operative technique.

Long-term Clinical Consequences in Patients with Urea Cycle Disorders in Korea: A Single-center Experience (요소회로대사 질환 환자들의 장기적인 임상 경과에 대한 단일 기관 경험)

  • Lee, Jun;Kim, Min-ji;Yoo, Sukdong;Yoon, Ju Young;Kim, Yoo-Mi;Cheon, Chong Kun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.15-21
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    • 2021
  • Purpose: Urea cycle disorder (UCD) is an inherited inborn error of metabolism, acting on each step of urea cycle that cause various phenotypes. The purpose of the study was to investigate the long-term clinical consequences in different groups of UCD to characterize it. Methods: Twenty-two patients with UCD genetically confirmed were enrolled at Pusan National University Children's hospital and reviewed clinical features, biochemical and genetic features retrospectively. Results: UCD diagnosed in the present study included ornithine transcarbamylase deficiency (OTCD) (n=10, 45.5%), argininosuccinate synthase 1 deficiency (ASSD) (n=6, 27.3%), carbamoyl-phosphate synthetase 1 deficiency (CPS1D) (n=3, 13.6%), hyperornithinemia-hyperammonemia-homocitrullinuria syndrome (HHHS) (n=2, 9.1%), and arginase-1 deficiency (ARG1D) (n=1, 4.5%). The age at the diagnosis was 32.7±66.2 months old (range 0.1 to 228.0 months). Eight (36.4%) patients with UCD displayed short stature. Neurologic sequelae were observed in eleven (50%) patients with UCD. Molecular analysis identified 37 different mutation types (14 missense, 6 nonsense, 6 deletion, 6 splicing, 3 delins, 1 insertion, and 1 duplication) including 14 novel variants. Progressive growth impairment and poor neurological outcomes were associated with plasma isoleucine and leucine concentrations, respectively. Conclusion: Although combinations of treatments such as nutritional restriction of proteins and use of alternative pathways for discarding excessive nitrogen are extensively employed, the prognosis of UCD remains unsatisfactory. Prospective clinical trials are necessary to evaluate whether supplementation with BCAAs might improve growth or neurological outcomes and decrease metabolic crisis episodes in patients with UCD.

Short-Term Result of Endovenous 980-nm Diode Laser Treatment in Varicose Vein of Looter Extremities (하지정맥류에서 정맥내 980-nm 다이오드 레이저 치료의 단기결과)

  • Lee Seock Yeol;Song In Hag;Lee Seung Jin;Park Hyung Joo;Lee Cheol Sae;Lee Kihl Rho
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.557-563
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    • 2005
  • Background: Recently 980-nm diode laser endovenous treatment was introduced and used as a method of treatment for varicose vein in lower extremities. The advantages of endovenous laser treatment are good cosmetic effects without incision and avoidance of complications associated with surgery. Therefore, we performed an endovenous laser treatment using a 980-nm diode laser and observed the effects and the efficiency of treatment. Material and Method: From October, 2003 to March, 2004, 55 patients (84 limbs) underwent endovenous laser treatment with a 980-nm diode laser. The effects of treatment, complications and recurrences were reviewed. Result The mean age of patients was 47.2 years old and the number of men and women were 2f and 35. In a total of 84 limbs, postoperative complications were transient ecchymosis(84 cases), local paresthesia (24 cases), local skin discolorization (6 cases), minimal burn (3 cases), and post operative phlebitis (1 cases). Adjuvant sclerotherapy was performed in 27 limbs and it was performed in varicose veins missed at operation and varicose veins remaining after endovenous laser treatment. In a total of 56 patients, 2 patients $(3.57\%)$ had recurrences after endovenous laser treatment and were treated with phlebectomy. Conclusion: Our findings demonstrated that 980-nm endovenous laser treatment had good cosmetic results with acceptable complications. This study was based on short-term results and long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence. We think that multimodality treatment with endovenous laser treatment including phlebectomy or transilluminated powered phlebectomy can help decreasing of recurrence especially in patients with tortuous varicose cluster.

The Incidences and Characteristics of Malignant Pleural Effusions According to Histologic Types (악성 흉막 삼출증의 조직학적 아형에 따른 빈도와 특성)

  • Yim, Jae-Joon;Kim, U-Jin;Lee, Jae-Ho;Yoo, Chul-Gyu;Chung, Hee-Soon;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.565-573
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    • 1998
  • Malignant pleural effusions are most commonly associated with lung cancers, however, it also can be resulted from breast cancers, ovarian cancers, stomach cancers and so on. According to the their histologic types, adenocarcinoma have been known as the most common cell type of malignant pleural effusions and squamous cell carcinoma is rare. We herein present incidences, clinical characteristics and survivals of malignant pleural effusions according to their cell types and primary diseases. The objects are 84 malignant pleural effusion patients diagnosed by pleural fluid cytologic examination or pleural biopsy from Jan. 1992 to May. 1997 in Seoul National University Hospital. A retrospective chart review on their histologic types, biochemical parameters and survivals is described. Among 84 patients, 52 were males and the other 32 were females with 1.6:1 of male and female ratio and their mean age was 57.6 years old. Common symptoms of them wele dyspnea, cough, sputum and pleuritic chest pain. The proportions of bloody nature of effusion, lymphocyte dominant pleural effusion, exudative effusions were 66%, 39% and 93%, respectively. They consisted of 54 cases of adenocarcinoma(33 cases of them were lung cancers), and 10 cases of squamous cell carcinoma (8 cases of them were lung cancers), 10 cases of malignant lymphoma, 8 cases of small cell lung cancer and a case of mesothelioma and leukemia. There was no differences in characteristics of effusions, clinical features and survivals between each histologic cell types. Analyzing them according to primary diseases, no difference except longer survivals in malignant pleural effusions from breast cancer than from other cancers was observed. In conclusion, considering the incidences of histologic types of lung cancers during same period (squamous cell carcinoma; 47%, adenocarcinoma; 33%, small cell lung cancer; 12% and large cell carcinoma; 2%), malignant pleural effusions more likely occurred in adenocarcinoma than other cell types of lung cancers and there was no significant difference of clinical characteristics between histologic types.

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Operative Treatment of the Displaced Bucket Handle Tear of the Medial Meniscus (내측 반월상 연골의 전위된 양동이 손잡이형 파열의 수술적 치료)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Lee Dong-Ho;Kim Min-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.142-149
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    • 2002
  • Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.

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Homocysteine, insulin, vitamin B12 and folic acid levels in obese children (비만아에서 혈청 호모시스테인, 인슐린, 비타민 B12, 엽산 농도에 대한 연구)

  • Park, Jee Yoon;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.475-481
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    • 2006
  • Purpose : As the prevalence of childhood obesity is increasing, hypertension, hyperlipidemia, insulin resistance and diabetes mellitus have become problems. High homocysteine levels and low vitamin $B_{12}$ supplementation are acknowledged to have a role in coronary artery disease, but there are few studies on homocysteine, insulin and vitamin $B_{12}$ levels in obese children. We aimed to study whether homocysteine, insulin, vitamin $B_{12}$, folic acid levels could have any difference and relation in obese children. Methods : The disease group consisted of 27 children from 8 to 11 years old, whose obesity index was over 130. The control group consisted of 30 healthy children of the same age group. Obesity index and body mass index were calculated by height and body weight of the children, and their systolic and diastolic blood pressures at resting state were checked. Total cholesterol, triglyceride, homocysteine, insulin, vitamin $B_{12}$, folic acid levels were studied after 10 hours of fasting. Intracellular fluid, extracellular fluid, protein, mineral, muscle mass, lean body fat, fat mass and fat percentages were checked by bioelectrical impedance. Results : Homocysteine levels were higher in obese children($8.1{\pm}2.1{\mu}mol/mL$ vs. $4.9{\pm}1.0{\mu}mol/mL$). Insulin levels were also higher in obese children($26.8{\pm}11.2{\mu}IU/mL$ vs. $12.5{\pm}5.24{\mu}IUl/mL$). Vitamin $B_{12}$ was lower in obese children($798.6{\pm}174.3pg/mL$ vs. $967.8{\pm}405.0pg/mL$). But there was not a difference in the folic acid levels between the two groups. In obese children, systolic blood pressure (r=0.535), triglyceride(r=0.517), total cholesterol(r=0.408), folic acid(r=0.408), vitamin $B_{12}$(r=0.338) and abdomoanl fat %(r=0.306) had a positive correlation. Conclusion : We found definite differences of insulin, homocysteine, and vitamin $B_{12}$ plasma levels in obese children, but we need more study to use those parameters as risk factors of metabolic syndrome in pediatric obese patients.

Effects of Light Sources in Poultry House on Growth Performance, Carcass Yield, Meat Quality and Blood Components of Finishing Broilers (계사 내 광원이 육계 후기의 생산성, 도체수율, 육질 특성 및 혈액성분에 미치는 영향)

  • Hong, Eui-Chul;Kang, Bo-Seok;Kang, Hwan-Ku;Jeon, Jin-Joo;You, Are-Sun;Kim, Hyun-Soo;Son, Jiseon;Kim, Chan-Ho;Kim, Hee-Jin
    • Korean Journal of Poultry Science
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    • v.47 no.3
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    • pp.159-167
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    • 2020
  • This study investigated the effect of different light sources in the poultry house on performance, meat quality, and blood composition of finishing broilers. Two hundred and forty male broilers (1-day-old, 42.2±0.1 g) were divided into three groups and subjected to different light source treatments (incandescent, LED, and fluorescent lamps) from 3 weeks of age (four replications/treatment, 20 birds/replication). After breeding for 6 weeks, the carcass yield and meat quality of broilers with similar body weight (BW; 3.4±0.07 kg) were investigated, and blood components were analyzed. Corn-soybean meal-based feed was provided as starter (CP 22.5%, ME 3,020 kcal/kg), early (CP 18.5%, ME 3,050 kcal/kg), and finishing (CP 18%, ME 3,100 kcal/kg). Performance, carcass yield, meat quality, and blood components were evaluated. BW, BW gain, feed intake, and feed conversion ratio did not show any significant differences among treatments. There was no significant difference on live weight and carcass yield among treatments. There was no significant difference on meat color, shear force, and water holding capacity; however, cooking loss at 17.2% was the highest in the LED treatment (P<0.05). There was no significant difference on blood components except for glucose (blood biochemistry component) among treatments. Glucose was 234.5 mg/dL, 256.9 mg/dL, and 250.1 mg/dL in the three treatments, respectively, with a significant difference between incandescent and LED treatments (P<0.05). These results are used useful as basic data for investigating the effect of lighting in broilers production.

Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.55-62
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    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

Usefulness of $^{18}F$-Fluoride PET/CT in Bone Metastasis of Prostate Cancer (전립선암 환자의 뼈 전이에 대한 $^{18}F$-Fluoride PET/CT의 유용성)

  • Park, Min-Soo;Kim, Jung-Yul;Park, Hoon-Hee;Kang, Chun-Goo;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.24-30
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    • 2009
  • Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

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The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005~2009 (일개 부산지역 3차 병원에서 관찰한 다제내성 결핵의 실태, 2005~2009)

  • Yoon, Neul-Bom;Lee, Sung-Woo;Park, Su-Min;Jeong, Il-Hwan;Park, So-Young;Han, Song-Yee;Lee, Yu-Rim;Jung, Jin-Kyu;Kim, Joon-Mo;Kim, Su-Young;Um, Soo-Jung;Lee, Soo-Keol;Son, Choon-Hee;Hong, Young-Hee;Lee, Ki-Nam;Roh, Mee-Sook;Kim, Kyeong-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.2
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    • pp.120-125
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    • 2011
  • Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.