Sublingual Gland Excision and Sclerotherapy for Plunging Ranula and Management of Recurrence / 대한이비인후과학회지

Background and Objectives@#For plunging ranula, excision of the sublingual gland has been the major treatment option, with sclerotherapy being widely used as minimal invasive treatment. We compared the outcomes of these two methods as an initial treatment for ranula and investigated the outcomes of salvage procedure in recurred patients.Subjects and Method Patients were classified into the excision group (n=35) and the sclerotherapy group (n=39) according to the type of their initial treatment. The outcomes of the initial and salvage treatment were determined as recurrence or non-recurrence at 3 months after treatment, and statistically compared between the excision and the sclerotherapy groups. @*Results@#Recurrence in the sclerothearpy group (n=20, 51.3%) showed a significantly higher rate (p<0.001) than in the excision group (n=3, 8.6%). Recurring patients who received treatment different from the initial treatment (n=7) were cured, while those who had same procedure as the initial treatment (n=11) showed recurrence of 72.7% (n=8). There was no procedure related complication among the patients. @*Conclusion@#Sublingual gland excision was more effective than ethanol sclerotherapy for the treatment of plunging ranula. In addition, sublingual gland excision was effective even after the failure of ethanol sclerotherapy.

Is Ossiculoplasty Necessary in Canal Wall Down Mastoidectomy? Comparison of Clinical Outcomes Between Type 0 Tympanoplasty and Ossiculoplasty

Background and Objectives@#To assess whether the audiological and clinical outcomes of type 0 tympanoplasty (T0) performed using cartilage were comparable with those of ossiculoplasty in patients who underwent canal wall down mastoidectomy (CWDM). @*Subjects and Methods@#This study included patients who had chronic otitis media with cholesteatoma and underwent CWDM with ossiculoplasty involving partial ossicular replacement prosthesis (PORP), total ossicular replacement prosthesis (TORP), or T0. Anatomical success rates and hearing outcomes were analyzed. @*Results@#Seventy-two patients were included in this study; 29 of them underwent CWDM with T0, 27 underwent CWDM with PORP, while 16 underwent CWDM with TORP. The difference in mean improvement in the air-bone gap (ABG) between the groups was not significant. The differences in the rates of ABG closure to ≤10 dB HL (p=0.030) and ≤20 dB HL (p=0.029) were significant. There were significant differences in improvements in the ABG at 3 kHz among the PORP, TORP, and T0 groups. @*Conclusions@#The audiological outcomes of CWDM with ossiculoplasty seemed to be better than those of CWDM with T0 with no significant difference in the incidence of complications following ossiculoplasty and T0.

Hazardous Alcohol Consumption and the Risk of Hearing Impairment in Adults Based on the Korean National Health and Nutrition Survey: A Retrospective Study

BACKGROUND AND OBJECTIVES: To investigate the relationship between hearing impairment and alcohol drinking patterns in South Korean adults. SUBJECTS AND METHODS: Data collection was performed by Korean National Health and Nutrition Survey from January 1 to December 31, 2012. Data analyses were performed from February 20 to March 3, 2018. Data from 3,860 adults 20 years of age or older without a history of malignancy or chronic otitis media in the Korean National Health and Nutrition Survey 2012 database who participated in the health questionnaires, and who had available results from otologic examinations that included pure tone audiogram, were included. Pure-tone average hearing thresholds were calculated at 500, 1,000, 2,000, and 4,000 Hz. Hearing loss was defined as a pure-tone average >40 dB in one or both ears. The Alcohol Use Disorder Identification Test was used to evaluate drinking statuses of subjects. Data were analyzed using the complex-sample χ²-test of independence and a complex-sample logistic regression analysis. RESULTS: Of the 29,954,319 individuals in the weighted cross-sectional study population, 15,106,040 (50.4%) were men and 14,848,098 (49.6%) were women. A total of 8.1% of men and 7% of women had hearing impairment. The degrees of drinking with appropriate, risky, and hazardous drinking habits were 58.2, 32.1, and 9.7% among men; and 76.4, 12.5, and 11.1% among women, respectively. Among men, the odds ratio of hearing loss increased by 2.506 times when comparing hazardous and appropriate drinking (confidence interval, 1.083 to 5.800, p=0.002). Moderate alcohol consumption (≤2 drinks per day) was not protective for hearing in either group. CONCLUSIONS: As hazardous drinking tends to coexist with hearing impairment in men, appropriate prevention and intervention strategies should be emphasized. A longitudinal study to investigate harmful drinking and the mechanism of hearing loss should be performed.

Luteolin Induces Apoptosis via Mitochondrial Pathway and Inhibits Invasion and Migration of Oral Squamous Cell Carcinoma by Suppressing Epithelial-Mesenchymal Transition Induced Transcription Factors

Oral squamous cell carcinoma (OSCC) is the most common type of oral malignancy. Numerous therapies have been proposed for its cure. Research is continually being conducted to develop new forms of treatment as current therapies are associated with numerous side-effects. Luteolin, a common dietary flavonoid, has been demonstrated to possess strong anti-cancer activity against various human cancer cell lines. Nevertheless, research into luteolin-based anticancer activity against oral cancer remains scarce. Thus, the objective of this study was to assess the effect of luteolin as an anti-cancer agent. After treatment with luteolin, Ca9-22 and CAL-27 oral cancer cells showed condensed nuclei and enhanced apoptotic rate with evidence of mitochondria-mediated apoptosis. Epithelialmesenchymal transition (EMT) is closely related to tumor migration and invasion. Luteolin suppressed cancer cell invasion and migration in the current study. Elevated expression of E-cadherin, an adherens junction protein, was evident in both cell lines after luteolin treatment. Luteolin also significantly inhibited transcription factors (i.e., N-cadherin, Slug, Snail, Twist, and ZEB-1) that regulated expression of tumor suppressors such as E-cadherin based on Western blot analysis and quantitative PCR. Thus, luteolin could induce mitochondrial apoptosis and inhibit cancer cell invasion and migration by suppressing EMT-induced transcription factors.

Neuroprotective Effect of Duloxetine on Chronic Cerebral Hypoperfusion-Induced Hippocampal Neuronal Damage

Chronic cerebral hypoperfusion (CCH), which is associated with onset of vascular dementia, causes cognitive impairment and neuropathological alterations in the brain. In the present study, we examined the neuroprotective effect of duloxetine (DXT), a potent and balanced serotonin/norepinephrine reuptake inhibitor, on CCH-induced neuronal damage in the hippocampal CA1 region using a rat model of permanent bilateral common carotid arteries occlusion. We found that treatment with 20 mg/kg DXT could attenuate the neuronal damage, the reduction of phosphorylations of mTOR and p70S6K as well as the elevations of TNF-α and IL-1β levels in the hippocampal CA1 region at 28 days following CCH. These results indicate that DXT displays the neuroprotective effect against CCH-induced hippocampal neuronal death, and that neuroprotective effect of DXT may be closely related with the attenuations of CCH-induced decrease of mTOR/p70S6K signaling pathway as well as CCH-induced neuroinflammatory process.

Temporal changes in mammalian target of rapamycin (mTOR) and phosphorylated-mTOR expressions in the hippocampal CA1 region of rat with vascular dementia

Mammalian target of rapamycin (mTOR) has an important role in various biological processes in cells. In the present study, we investigated temporal changes in mTOR and phosphorylated-mTOR (p-mTOR) expressions in the rat hippocampal CA1 region following chronic cerebral hypoperfusion (CCH) induced by permanent bilateral common carotid arteries occlusion (2VO). The mTOR immunoreactivity in the pyramidal neurons and mTOR protein level in the hippocampal CA1 region were markedly decreased at 21 and 28 days after 2VO surgery. However, p-mTOR protein expression was significantly increased at 7 days following CCH but then decreased with time. The results indicate that mTOR and p-mTOR expressions change in the hippocampal CA1 region after 2VO surgery and that reduced expressions of mTOR and p-mTOR may be closely related to the CCH-induced neuronal damage in the hippocampal CA1 region.

Measuring Low Density Lipoprotein Cholesterol: Comparison of Direct Measurement by HiSens Reagents and Friedewald Estimation / 가정의학회지

BACKGROUND: Directly measured low density lipoprotein cholesterol (DLDLC) has been reported to be more accurate than calculated low density lipoprotein cholesterol (CLDLC) using the Friedewald equation. However, some limitations of DLDLC have been reported. In this study, we evaluated differences between CLDLC and DLDLC measured using HiSens reagents. METHODS: Data were collected from 582 persons undergoing routine physical examinations at a general hospital. LDLC measurements were made directly or estimated using the Friedewald formula, and were classified according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines. The relationship between these differences and other clinically relevant factors, such as triglyceride (TG) levels, were examined using multiple logistic regression analysis. RESULTS: The DLDLC and CLDLC were strongly correlated according to simple linear regression analysis (r=0.917, P0.5). CONCLUSION: Unlike other studies, DLDLC was significantly lower than CLDLC and the large differences in LDLC concentrations were not dependent on TG concentration. Our work suggests that verification of DLDLC accuracy is needed and differences in LDLC measurements should be accounted for in making clinical decisions.

Effect of 5-FU and MTX on the Expression of Drug-resistance Related Cancer Stem Cell Markers in Non-small Cell Lung Cancer Cells

Cancer stem cells (CSCs) are often characterized by the elevated expression of drug-resistance related stem-cell surface markers, such as CD133 and ABCG2. Recently, we reported that CSCs have a high level of expression of the IL-6 receptor (IL-6R). The purpose of this study was to investigate the effect of anticancer drugs on the expression of the drug resistance-related cancer stem cell markers, ABCG2, IL-6R, and CD133 in non-small cell lung cancer (NSCLC) cell lines. A549, H460, and H23 NSCLC cell lines were treated with the anticancer drugs 5-fluorouracil (5-FU; 25 microg/ml) and methotrexate (MTX; 50 microg/ml), and the expression of putative CSC markers was analyzed by fluorescent activated cell sorter (FACS) and the gene expression level of abcg2, il-6r and cd133 by reverse transcriptasepolymerase chain reaction (RT-PCR). We found that the fraction of ABCG2-positive(+) cells was significantly increased by treatment with both 5-FU and MTX in NSCLC cells, and the elevation of abcg2, il-6r and cd133 expressions in response to these drugs was also confirmed using RT-PCR. Also, the number of IL-6R(+) cells was increased by MTX in the 3 cell lines mentioned and increased by 5-FU in the H460 cell line. The number of CD133(+) cells was also significantly increased by both 5-FU and MTX treatment in all of the cell lines tested. These results indicate that 5-FU and MTX considerably enhance the expression of drug-resistance related CSC markers in NSCLC cell lines. Thus, we suggest that antimetabolite cancer drugs, such as 5-FU and MTX, can lead to the propagation of CSCs through altering the expression of CSC markers.

Determination of Oxyclozanide in Beef and Milk using High-Performance Liquid Chromatography System with UV Detector / 한국실험동물학회지

This study was developed and validated for the determination of oxyclozanide residue concentrations in beef and commercial milk, using high-performance liquid chromatography system. Oxyclozanide was successfully separated on a reverse phase column (Xbridge-C18, 4.6x250 mm, 5 microm) with a mobile phase composed of acetonitrile and 0.1% phosphoric acid (60:40, v/v%). This analytical procedure involved a deproteinization process using acetonitrile for beef and 2% formic acid in acetonitrile for commercial milk, dehydration by adding sodium sulfate to the liquid analytical sample, and a defatting process using n-hexane; after these steps, the extract was exposed to a stream of nitrogen dryness. The final extracted sample was dissolved in the mobile phase and filtered using a 0.45 microm syringe filter. This method had good selectivity and recovery (70.70+/-7.90-110.79+/-14.95%) from the matrices. The LOQs ranged from 9.7 to 9.8 microg/kg for beef and commercial milk. The recoveries met the standards set by the CODEX guideline.

The Treatment of Post Transplant Tuberculosis: Rifampin Sparing Regimen / 대한이식학회지

BACKGROUND: Rifampin reduces the blood levels of cyclosporin (CsA) and steroids by increasing the activity of hepatic cytochrome P450 system and the inclusion of rifampin in the anti-tuberculosis treatment protocol increases the risk of acute allograft rejection and mortality due to its interaction with cyclosporine. We report the successful treatment outcome of post-renal transplant tuberculosis patients who were treated with quinolone substituted for rifampin in anti-tuberculosis regimen. METHODS: This was a retrospective study of 14 patients with tuberculosis diagnosed among 218 transplant recipients from Feb. 1988 through Dec. 2003 at Daejeon St. Mary's hospital of catholic university of Korea and 6 patients with tuberculosis who underwent transplantation in other hospital and followed up in our hospital. RESULTS: The incidence of post-renal transplant tuberculosis was 6.4%. The mean time to diagnosis of tuberculosis after transplantation was 58.6 months (3.3~180.7). 9 were pulmonary and 11 were extrapulmonary tuberculosis. The graft failure was not occurred in quinolone group (0/15) and 2 of 3 in rifampin group. The serum creatinine levels before tuberculosis were not different to that of post-treatment in quinolone group. (P=0.58) The CsA levels before tuberculosis were not also different to that of posttreatment in quinolone group (P=0.68). CONCLUSIONS: The treatment of post-renal transplant tuberculosis with rifampin sparing anti-tuberculosis regimen was successful. Rifampin, although a mainstay drug in the treatment of tuberculosis, can be avoided in patients receiving cyclosporine, thus avoiding the risk of precipitating allograft rejection.

The Effect of Family Member's Attendance on Relief of Patient's Discomfort during Upper Gastrointestinal Endoscopy

BACKGROUND: Upper gastrointestinal endoscopy is a very important and highly sensitive method to detect gastroduodenal lesions. But the investigation and diagnosis of gastrointestinal diseases might be delayed by discomfort, pain and anxiety in patients during endoscopy. This study was performed to evaluate the effect of family member's attendance on relief of discomfort in patients and to identify the predictors for pain and discomfort during upper gastrointestinal endoscopy. METHODS: From July to August 2005, 147 clients who underwent gastrointestinal endoscopy were enrolled in this study. The subjects were randomly grouped into family-attended (n=70) group and non-family-attended group (n=77). The patients recorded their pain and discomfort during endoscopy by Visual-Analogue Scale (VAS) score. And also the client's demographic characteristics and endoscopy related factors (procedure duration, previous endoscopy experience, biopsy, endoscopist etc.) were evaluated. We studied the relationship between the various characteristics and discomfort during endoscopy. RESULTS: There were no significant differences of clients' demographic characteristics and endoscopy related factors between the two groups. There was a significant difference of VAS scores between the family-attended group (3.51+/-1.90) and non-family-attended group (4.35+/-2.10) (P= 0.012). Oxygen saturation and pulse rate during the procedure were lower in the family-attended group than in the non-attended group. Recipients' demographic characteristics and various factors related with the procedure (waiting time, biopsy, and previous experience, etc) were not associated with the degree of discomfort. CONCLUSION: Family member's attendance decreased pain and discomfort during endoscopy. The recipients' demographic characteristics and factors related to the procedure had no influence on the degree of discomfort during endoscopy. In conclusion, attendance of a family member should be considered during endoscopy in order to decrease pain and discomfort during the procedure.

The Association of Non-alcoholic Fatty Liver Disease and Physical Activity

BACKGROUND: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. METHODS: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. RESULTS: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P<0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07~0.77, P<0.05]). CONCLUSION: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease.

Pain and Pain Management in Hospitalized Cancer Patients / 기본간호학회지

PURPOSE: The purpose of this study was to provide basic data for proper pain management. METHOD: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. RESULTS: The level of pain measured by NRS at the three time points was as follows: Time 1 (4.40+/-2.25), Time 2 (0.61+/-1.30), Time 3 (2.47+/-2.75). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 (70.85+/-69.65), Time 2 (91.61+/-89.20), Time 3 (96.71+/-94.25). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2. CONCLUSION: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

Effect of Teenage Physical Activity on Areal Bone Mineral Density in Healthy Premenopausal Women of Korea

BACKGROUND: There have been many studies on osteoporosis, which is one of the most important cause of fracture in adults. However, whether moderate physical activity during youth confers lasting benefits for bone is unclear. Thus, we are here concerned with the relation of teenage physical activity and bone mineral density in Korean premenopausal women. METHODS: From March to June 2007, 75 clients who visited a general hospital for medical check-up were enrolled in this study. The subjects reported physical activity for four age periods (12~18, 19~34, 35~49, current) using self reporting questionnaire. And they completed two 3-day food records, had measurements of height and weight, and aBMD assessed using dual-energy X-ray absorptiometry at the lumbar spine (L2-4) and femoral neck. RESULTS: There was a significant relation of teenage physical activity (especially weight bearing physical activity) and aBMD in both sites (lumbar spine r=0.42, P<0.01; femoral neck r=0.33, P<0.01). But the activity during other age periods was not associated with the current aBMD at both sites. CONCLUSION: Our results suggest that moderate physical activity during the teen years appears to have lasting benefits for lumbar spine and femoral neck aBMD in Korean premenopausal women.

Reversible Pituitary Dysfunction in a Patient with Cushing's Syndrome due to Adrenal Adenoma / 대한내분비학회지

A 45-year-old woman who complained of weight gain and irregular menstruation was diagnosed as having Cushing's syndrome due to a 3 cm sized left adrenal adenoma. She underwent left adrenalectomy, and she also underwent combined anterior pituitary tests before and 9 months after the surgery. The growth hormone and adrenocorticotropic hormone levels failed to respond to hypoglycemia before the surgery, but their responses recovered after the surgery. Cortisol and thyroid stimulating hormone failed to respond to hypoglycemia and thyrotropin releasing hormone (TRH) before the surgery, respectively, but these were improved after the surgery. Luteinizing hormone, follicle stimulating hormone, and prolactin adequately responded to gonadotropin-releasing hormone and TRH, respectively, before and after the surgery. However, the basal levels of these hormones were higher after adrenalectomy, suggesting that hypercortisolemia had a significant influence on all the pituitary hormones.

The Changes of Solute Clearance Following Reprocess by Citric Acid and Heat for High-Flux Dialyzer Reuse / 대한신장학회잡지

BACKGROUND: The reprocess by citric acid and heat is an alternative to chemical reprocess for reusing dialyzers. However, there are little experience and data on the effect of reprocess by citric acid and heat on the solute clearance. METHODS: In the 34 chronic hemodialysis patients using low flux dialyzers, solute clearance was measured after reprocessing high-flux dialyzers by citric acid and heat. Dialyzers were reprocessed using 1.5% citric acid solution heated to 95degrees C for 20 hours. The clearance and reduction rate of urea, beta2-microglobulin, osteocalcin and myoglobin were measured at single use and during reuses for 5,10,15,20 and 25 times. RESULTS: The clearance and reduction rate of urea, beta2-microglobulin, osteocalcin and myoglobin were significantly greater with high-flux dialyzer compared with low flux dialyzer, which were maintained after dialyzer reuse. beta2-microglobulin clearance was increased at 10th and 20th reuse and beta2-microglobulin reduction rate was increased at 10th, 20th and 25th reuse compared with the single use. Myoglobin clearance and reduction rate were increased after the 5th reuse compared with the single use. Albumin loss to dialysate was gradually increased following reuses. Of the 34 dialyzers studied, 14 were discarded before the 25th reuse because of inadequate performance test. CONCLUSION: Reprocessing high flux dialyzers by citric acid and heat increases middle and large molecule clearance and was safe.

The Changes of Solute Clearance Following Reprocess by Citric Acid and Heat for High-Flux Dialyzer Reuse / 대한신장학회잡지

BACKGROUND: The reprocess by citric acid and heat is an alternative to chemical reprocess for reusing dialyzers. However, there are little experience and data on the effect of reprocess by citric acid and heat on the solute clearance. METHODS: In the 34 chronic hemodialysis patients using low flux dialyzers, solute clearance was measured after reprocessing high-flux dialyzers by citric acid and heat. Dialyzers were reprocessed using 1.5% citric acid solution heated to 95degrees C for 20 hours. The clearance and reduction rate of urea, beta2-microglobulin, osteocalcin and myoglobin were measured at single use and during reuses for 5,10,15,20 and 25 times. RESULTS: The clearance and reduction rate of urea, beta2-microglobulin, osteocalcin and myoglobin were significantly greater with high-flux dialyzer compared with low flux dialyzer, which were maintained after dialyzer reuse. beta2-microglobulin clearance was increased at 10th and 20th reuse and beta2-microglobulin reduction rate was increased at 10th, 20th and 25th reuse compared with the single use. Myoglobin clearance and reduction rate were increased after the 5th reuse compared with the single use. Albumin loss to dialysate was gradually increased following reuses. Of the 34 dialyzers studied, 14 were discarded before the 25th reuse because of inadequate performance test. CONCLUSION: Reprocessing high flux dialyzers by citric acid and heat increases middle and large molecule clearance and was safe.

Four Cases of Verapamil Deleterious Effects in Chronic Renal Failure / 대한신장학회잡지

Four hypertensive patients with chronic renal insufficiency who were treated with sustained release verapamil hydrochloride subsequently developed acute toxic effects. All four patients developed marked bradycardia, hypotension, hyperkalemia and metabolic aciodosis and were treated with atropine, fluid therapy, potasium lowing measure, dialysis, and temporary pacemaker, and were restored to the renal function and sinus rhythm after 12-24 hr. Patients with renal impairement who are treated with sustained release verapamil may accumulate verapamil or its metabolites and develop toxic side effects. We conclude that sustained release verapamil should be used with caution in chronic renal failure and that patients should be closely monitored for adverse cardiovascular, metaboic, and hepatic side effects.

Clinical Analysis of 19 Renal Transplant Recipients Back from China to Korea / 대한신장학회잡지

BACKGROUND: Insufficient supply of donated kidneys for the demand of patients willing to transplant kidney, has been predisposed as main limitation to renal transplantation in Korea. Recently, a lot of Korean patients with end stage renal disease have visited China for cadeveric renal transplantation from executed prisoners. Here, we report a clinical investigation about 19 patients of our hospital, who have received kidney transplant in China. METHODS: We selected 19 patients who had received renal transplantation in China from January, 1st, 2003 to september, 30th, 2004. We interviewed them and reviewed their hospital records and laboratory datas. RESULTS: Their mean age was 47.7+/-11.7 (27-66) years, and male to female patients ratio was 13 vs 6. All of them did not have received renal transplantation before and 15 of them had no living related donor in their own family. All of them had been treated with dialysis therapy, and patients with hemodialysis versus patients peritoneal dialysis were 14 vs 5. Their mean dialysis duration was 26.8+/-23.7 (1-90) months. Among the causes of end stage renal disease of them, hypertension was most common and next was chronic glomerulonephritis, and Diabetes mellitus was 3rd place. All of them received kidneys from cadeveric donors as executed prisoners, and mean duration of their Chinese hospital residence was 15.9+/-7.2 (10-32) days. Post-transplantation follow-up duration of them was 12.3+/-4.1 (4-19) months. During the period above, the number of post-transplantation complication was six, and 2 of 19 patients were expired of intra-cranial hemorrhage and Aspergillos infection, each. CONCLUSION: We offer important problems caused by increasing numbers of renal transplantation in China, and suggest more serious discussions and countermeasures among relevant authorities.

A Case of Acromegaly with Gall Bladder Cancer / 대한내분비학회지

Acromegaly is a systemic endocrine disorder due to an excessive release of growth hormone, which increases the serum levels of insulin-like growth factor-1(IGF-1). Elevated levels of these hormones are assumed to increase the incidence of malignant tumors in patients with acromegaly, due to by stimulating the growth and maturation of cells. In particular, IGF-1 is considered to be closely related with the development of colon polyps and colon cancers. Studies suggest that various malignant tumors, including thyroid cancer, brain tumor and renal cell carcinomas, are also more common in patients with acromegaly. Here, a case of gall bladder cancer in a patient with acromegaly, and the possible relationships between these two disorders, is reported.