We report a patient with traumatic atlanto-occipital dislocation who presented with dysphagia as the chief complaint. A 59-year-old man complained of swallowing difficulty for 2 months after trauma to the neck. On physical examination, there was atrophy of the right sternocleidomastoid and upper trapezius muscles, and the tongue was deviated to the right. In a videofluoroscopic swallowing study, penetration and aspiration were not seen, food residue remained in the right vallecula and pyriform sinus, and there was decreased motion of the soft palate, pharynx and larynx. Electromyography confirmed a right spinal accessory nerve lesion. Magnetic resonance imaging confirmed atlanto-occipital dislocation. Dysphagia in atlanto-occipital dislocation is induced by medullary compression and lower cranial nerve injury. Therefore, in survivors who are diagnosed with atlanto-occipital dislocation, any neurological symptoms should be carefully evaluated.
Accessory Nerve ; Atlanto-Occipital Joint ; Atrophy ; Cranial Nerve Injuries ; Cranial Nerves ; Deglutition ; Deglutition Disorders ; Dislocations ; Electromyography ; Humans ; Larynx ; Magnetic Resonance Imaging ; Muscles ; Neck ; Palate, Soft ; Pharynx ; Physical Examination ; Pyriform Sinus ; Survivors ; Tongue

We report a case of catheter-related bacteremia due to Tsukamurella pulmonis. T. pulmonis is a rare cause of opportunistic infection in immunosuppressed patients and in cases of indwelling foreign materials. This infection was nearly impossible to identify using conventional phenotyping methods because of its similarities to the related genera Nocardia, Rhodococcus, Gordonia, Streptomyces, Corynebacterium, and Mycobacterium. This organism was initially misidentified as Mycobacterium aubagnense through PCR-RFLP analysis. We correctly identified this organism using 16S rRNA sequencing combined with phenotyping tests.
Bacteremia ; Catheters ; Corynebacterium ; Humans ; Korea ; Mycobacterium ; Nocardia ; Nontuberculous Mycobacteria ; Opportunistic Infections ; Rhodococcus ; Streptomyces

BACKGROUND AND OBJECTIVES: There are several evidences of reduced cochlea blood flow after noise exposure in the cochlea. However, the pathophysiology of blood flow change is still obscure, and endothelins, proteins that constrict blood vessels and play a key role in vascular homeostasis using its receptors may have importance in this respect. In this study, we investigated the expression changes of endothelin-1 (ET-1), endothelin receptor A (ETAR) and B (ETBR) according to auditory threshold change after noise exposure. MATERIALS AND METHOD: Mice were exposed to different noise to generate transient (group 2) and permanent threshold shift (group 3), respectively. Auditory threshold shifts were evaluated with auditory brainstem response and expression changes of ET-1, ETAR and ETBR after noise exposure were evaluated by immunohistochemistry and real time RT-PCR. RESULTS: After noise exposure, the increased ET-1, ETAR and ETBR immunoreactivities were observe in stria vascularis, spiral ligament and spiral ganglion neuron. ET-1 mRNA expressions increased after noise exposure in both group 2 and group 3 compared to those of the control group. At 2 weeks after noise exposure, however, the ET-1 mRNA expressions in group 3 increased compared to that of the control but decreased compared to that of group 2. On the other hand, ETAR mRNA expression increased at 2 weeks after noise exposure in both groups, just after noise exposure in group 2 and at 2 weeks after noise exposure in group 3. CONCLUSION: These results suggest that expression changes of ET-1, ETAR and ETBR might be associated with hearing threshold shift and recovery after noise exposure in the cochlea.
Animals ; Auditory Threshold ; Blood Vessels ; Cochlea ; Endothelin-1 ; Endothelins ; Evoked Potentials, Auditory, Brain Stem ; Hand ; Hearing ; Homeostasis ; Immunohistochemistry ; Mice ; Neurons ; Noise ; Proteins ; Receptors, Endothelin ; RNA, Messenger ; Spiral Ganglion ; Spiral Ligament of Cochlea ; Stria Vascularis

OBJECTIVES: To estimate the prevalence of edentulism according to the socio-demographic variables of Korean adults between 2007 and 2018 and to analyze the trends. METHODS: This study was conducted using raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2018. Edentulism was defined as the absence of upper and lower teeth or the retained root of the missing teeth. To obtain the prevalence of edentulism, complex sample frequency analysis and regression analysis were performed according to the socio-demographic variables to represent the national population. The Korean population structure in 2005 was exploited as a standard population to calculate age-standardized edentulism. RESULTS: The prevalence of edentulism in 2016-2018 was 9.7% in the Korean elderly, and the change of age-standardized edentulism steadily declined over time from 2007, 12.8%. In particular, it decreased by approximately 20% in the period between 2016 and 2018 compared to that in 2007 for those in their 80s. The trend of the prevalence according to gender decreased significantly in women. According to the level of education, the greatest decrease was seen in the group with the lowest education, although the prevalence itself was higher than that seen in those who were more educated. CONCLUSIONS The prevalence of edentulism among the older Korean population has decreased over time. However, the concern is on those with lower education and men as these groups are still at higher risk for edentulism.

Objective: Using microRNA (miR) as a biomarker has been a new way for diagnosing many diseases. Although many studies on miR-biomarker have been published, researches on miR-biomarker in ankylosing spondylitis (AS) are limited. Therefore, the objective of this study was to valiate a candidate serum miR as a novel disease-specific novel miR for AS. Methods: Total RNAs were extracted from sera samples of patients with AS (n=57), patients with rheumatoid arthritis (RA) (n=37), or healthy controls (HC) (n=19). Through serum miR screening by microarray, differential levels of miR were subsequently validated by real time PCR. At the time of serum sampling, clinical values such as sex, age, disease duration, AS-disease activity score, uveitis, peripheral arthritis, enthesitis, human leukocyte antigen-B27 presence, and recent medication were evaluated. Results: We found that the expression level of serum miR-3620-3p in AS was notably lower than that in RA or HC. The receiver–operator characteristics curve for determining the diagnostic accuracy showed an area under the curve of 0.919 (p＜0.001) with a sensitivity of 87.1% and a specificity of 86.0%. Correlation studies showed that the expression level of miR-3620-3p was only associated with the development of uveitis (p＜0.05). Conclusion Serum miR-3620-3p can be as a new biomarker for diagnosing AS.

OBJECTIVES: To estimate the prevalence of edentulism according to the socio-demographic variables of Korean adults between 2007 and 2018 and to analyze the trends. METHODS: This study was conducted using raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2018. Edentulism was defined as the absence of upper and lower teeth or the retained root of the missing teeth. To obtain the prevalence of edentulism, complex sample frequency analysis and regression analysis were performed according to the socio-demographic variables to represent the national population. The Korean population structure in 2005 was exploited as a standard population to calculate age-standardized edentulism. RESULTS: The prevalence of edentulism in 2016-2018 was 9.7% in the Korean elderly, and the change of age-standardized edentulism steadily declined over time from 2007, 12.8%. In particular, it decreased by approximately 20% in the period between 2016 and 2018 compared to that in 2007 for those in their 80s. The trend of the prevalence according to gender decreased significantly in women. According to the level of education, the greatest decrease was seen in the group with the lowest education, although the prevalence itself was higher than that seen in those who were more educated. CONCLUSIONS The prevalence of edentulism among the older Korean population has decreased over time. However, the concern is on those with lower education and men as these groups are still at higher risk for edentulism.

Objective: The objective of this study was to evaluate the safety and efficacy of light-emitting diode therapy (LEDT) in the management of pain and stiffness in patients with refractory hand tenosynovitis to non-steroidal anti-inflammatory drugs. Methods: A total of 12 patients were enrolled in the study and received LEDT twice a week for four weeks. Sociodemographic, clinical, and laboratory data were collected, and the visual analog scale (VAS) pain and stiffness scores of each hand were assessed every two weeks. The thickness of the flexor tendon in the patients’ hand was evaluated using ultrasonography. To investigate the molecular effects of LEDT, we measured the expression levels of type III collagen in tendon cells, with and without LEDT treatment. Results: After undergoing LEDT, participants showed clinically significant improvements in VAS pain scores at weeks 2, 4, and 8 compared to their baseline, and in VAS stiffness scores at weeks 4 and 8. According to the ultrasonography results, there was a decreasing tendency in tendon thickness for each finger in week 8 compared to the baseline, but the difference was not statistically significant. No adverse events were reported. Additionally, our results indicated a significant increase in type III collagen levels in the LEDT group compared to the control group (1.48±0.18 vs. 0.99±0.02, p=0.031), indicating a potential molecular mechanism for the observed clinical improvements. Conclusion LEDT may provide a viable alternative to pharmacological treatments in the future, due to its simple and easy method of administration.

PURPOSE: To assess the MR imaging features in differentiating a chondroblastoma (CB) from a giant cell tumor (GCT), with an emphasis on the accompanying peritumoral bone marrow edema. MATERIALS AND METHODS: MR imaging findings in 20 patients with CB were compared with the imaging features of 22 patients with GCT. The location of the lesion, signal intensity, adjacent cortical change, degree of accompanying bone marrow edema, synovitis in the adjacent joint and cystic change were analyzed. The findings of CB and GCT were examined statistically with use of Fisher's exact test. RESULTS: The incidence ratios of MR imaging findings were as follows (CB:GCT). Metaphyseal dominant involvement (2:21), partial cortical disruption (2:14), extensive bone marrow edema surrounding the tumor (14:0) and synovitis in the adjacent joint (11:2) were statistically different in incidence between CB and GCT (p < 0.01). The inhomogeneous signal intensity (17:17) and cystic change (10:15) were not different in incidence between a CB and a GCT. CONCLUSION: The presence of metaphyseal dominant involvement and cortical disruption favors a diagnosis of a GCT rather than a CB. In contrast, extensive bone marrow edema surrounding the tumor and synovitis in the adjacent joint are highly indicative of a CB.
Bone Marrow ; Chondroblastoma* ; Diagnosis ; Edema ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Incidence ; Joints ; Magnetic Resonance Imaging* ; Synovitis

OBJECTIVE: This study was designed to determine the optimal mixture ratio of gadolinium and iodinated contrast agent for simultaneous direct MR arthrography and CT arthrography. MATERIALS AND METHODS: An in vitro study was performed utilizing mixtures of gadolinium at six different concentrations (0.625, 1.25, 2.5, 5.0, 10 and 20 mmol/L) and iodinated contrast agent at seven different concentrations (0, 12.5, 25, 37.5, 50, 75 and 92-99.9%). These mixtures were placed in tissue culture plates, and were then imaged with CT and MR (with T1-weighted sequences, proton-density sequences and T2-weighted sequences). CT numbers and signal intensities were measured. Pearson's correlation coefficients were used to assess the correlations between the gadolinium/iodinated contrast agent mixtures and the CT numbers/MR signal intensities. Scatter diagrams were plotted for all gadolinium/iodinated contrast agent combinations and two radiologists in consensus identified the mixtures that yielded the optimal CT numbers and MR signal intensities. RESULTS: The CT numbers showed significant correlation with iodinated contrast concentrations (r = 0.976, p < 0.001), whereas the signal intensities as measured on MR images showed a significant correlation with both gadolinium and iodinated contrast agent concentrations (r = -484 to -0.719, p < 0.001). A review of the CT and MR images, graphs, and scatter diagram of 42 combinations of the contrast agent showed that a concentration of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was the best combination for simultaneous CT and MR imaging. CONCLUSION: A mixture of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was found to be optimal for simultaneous direct MR arthrography and CT arthrography.
*Arthrography ; Contrast Media/*administration & dosage ; Gadolinium/administration & dosage/*diagnostic use ; Iohexol/administration & dosage/*analogs & derivatives/diagnostic use ; *Magnetic Resonance Imaging ; Meglumine/administration & dosage/*diagnostic use ; Organometallic Compounds/administration & dosage/*diagnostic use ; Phantoms, Imaging ; *Tomography, X-Ray Computed

Nucleotide-binding domain 1 (Nod1) is a cytosolic receptor that is responsible for the recognition of a bacterial peptidoglycan motif containing meso-diaminophimelic acid. In this study, we sought to identify the role of Nod1 in host defense in vivo against pulmonary infection by multidrug resistant Acinetobacter baumannii. Wildtype (WT) and Nod1-deficient mice were intranasally infected with 3×107 CFU of A. baumannii and sacrificed at 1 and 3 days post-infection (dpi). Bacterial CFUs, cytokines production, histopathology, and mouse β-defensins (mBD) in the lungs of infected mice were evaluated. The production of cytokines in response to A. baumannii was also measured in WT and Nod1-deficient macrophages. The bacterial clearance in the lungs was not affected by Nod1 deficiency. Levels of IL-6, TNF-α, and IL-1β in the lung homogenates were comparable at days 1 and 3 between WT and Nod1-deficient mice, except the TNF-α level at day 3, which was higher in Nod1-deficient mice. There was no significant difference in lung pathology and expression of mBDs (mBD1, 2, 3, and 4) between WT and Nod1-deficient mice infected with A. baumannii. The production of IL-6, TNF-α, and NO by macrophages in response to A. baumannii was also comparable in WT and Nod1-deficient mice. Our results indicated that Nod1 does not play an important role in host immune responses against A. baumannii infection.
Acinetobacter baumannii* ; Acinetobacter* ; Animals ; Cytokines ; Cytosol ; Interleukin-6 ; Lung ; Macrophages ; Mice* ; Pathology ; Peptidoglycan