No abstract available.
Maxillary Sinus* ; Maxillary Sinusitis*

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

With the increasing use of the internet and the spread of smartphones, health information seekers obtain considerable information through the internet. As the amount of online health information increases, the need for quality management of health information has been emphasized. The purpose of this study was to investigate the factors affecting the intention of using accredited online health information by applying the extended technology acceptance model (Extended-TAM). An online survey was conducted from September 15, 2016 to October 3, 2016, on 500 men and women aged 19–69 years. The results showed that the greatest factor influencing the acceptance of the accredited health information was perceived usefulness, and the expectation for the quality of the accreditation system was the most important mediator variable. In order to establish the health information accreditation system as a means to provide easy and useful information to the consumers, it is necessary to carry out quality management and promote the system through the continuous monitoring of the accreditation system.
Accreditation ; Female ; Humans ; Intention ; Internet ; Male ; Smartphone

Malignant fibrous histiocytoma is uncommon pleomorphic tumor of the soft tissue possibly arising from the histiocyte. We report on a 43-year-old man with malignant fibrous histocystoma of the right kidney. The chief complaint was nontender mass on the right flank, which recurred locally following radical nephrectomy and postoperative radiation.
Adult ; Histiocytes ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Kidney* ; Nephrectomy

PURPOSE: Restaging after neoadjuvant treatment is done for planning the surgical approach and, increasingly, to determine whether additional therapy or resection can be avoided for selected patients. MATERIALS AND METHODS: Local restaging after neoadjuvant chemoradiation therapy (nCRT) was performed in 270 patients with locally advanced (cT3or4 or N+) rectal cancer. Abdomen and pelvic computed tomography (APCT) was used in all 270 patients, transrectal ultrasound (TRUS) in 121 patients, and rectal magnetic resonance imaging (MRI) in 65 patients. Findings according to imaging modalities were correlated with pathologic stage using Cohen's kappa (κ) to test agreement and intra-class correlation coefficient α to test reliability. RESULTS: Accuracy for prediction of ypT stage according to three imaging modalities was 45.2% (κ=0.136, α=0.380) in APCT, 49.2% (κ=0.259, α=0.514) in rectal MRI, and 57.9% (κ=0.266, α=0.520) in TRUS. Accuracy for prediction of ypN stage was 66.0% (κ=0.274, α=0.441) in APCT, 71.8% (κ=0.401, α=0.549) in rectal MRI, and 66.1% (κ=0.147, α=0.272) in TRUS. Of 270 patients, 37 (13.7%) were diagnosed as pathologic complete responder after nCRT. Rectal MRI for restaging did not predict complete response. On the other hand, TRUS did predict three complete responders (κ=0.238, α=0.401). CONCLUSION: APCT, rectal MRI, and TRUS are unreliable in restaging rectal cancer after nCRT. We think that multimodal assessment with rectal MRI and TRUS may be the best option for local restaging of locally advanced rectal cancer after nCRT.
Abdomen ; Hand ; Humans ; Magnetic Resonance Imaging ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms* ; Ultrasonography

In order to elucidate the pathogenesis of cleft lip and palate, first of all, it is necessary to understand the developmental mechanisms of growth factors and extracellular matrix proteins in the tissues of cleft lip and palate. We have performed immunohistochemical studies on human cleft lip and palate tissues to elucidate the pathogenetic implications of cleft lip and palate. 16 specimens from postnatal human cleft lip and palate subjects and 17 specimens from autopsy of prenatal human cleft lip and palate were fixed in 10% buffered formalin, embedded in paraffin. The sections were routinely stained by hematoxylin and eosin, also stained by PAS, and followed by immunohistochemical stainings using the antiseras of growth factors and extracellular matrix proteins such as PCNA, S-100, c-erb-B2, MMP-3, MMP-10, HSP-70, transglutaninase-C, E-cadherin, VEGF, vWF. Both the prenatal and postnatal specimens of cleft lip and palate showed dysplastic proliferation of the basal cell layer, increased infiltration of melanocytes into mucosal epithelium, sebaceous gland hyperplasia ingrowing into the muscular tissue of lip and palate, and fatty infiltration into the submucosal deep connective tissue. The strong reactions of MMP-3 and HSP-70 were detected in the tissues of cleft lip and palate, especially increased in degenerating muscle bundles, while the immunostainings of PCNA and c-erb-B2 were weakly positive in the tissues of cleft lip and palate. These data suggest that the retrogressive tissue degener-ation around the cleft areas persistently exist during the prenatal and postnatal period after cleft formation, and the sebaceous gland hyperplasia and fatty infiltration with the intense expression of MMP-3 and HSP-70 is closely related to the muscular degeneration around the cleft area.
Autopsy ; Cadherins ; Cleft Lip* ; Connective Tissue ; Eosine Yellowish-(YS) ; Epithelium ; Extracellular Matrix Proteins* ; Extracellular Matrix* ; Formaldehyde ; Hematoxylin ; Humans* ; Hyperplasia ; Immune Sera ; Intercellular Signaling Peptides and Proteins* ; Lip ; Melanocytes ; Palate* ; Paraffin ; Proliferating Cell Nuclear Antigen ; Sebaceous Glands ; Vascular Endothelial Growth Factor A

PURPOSE: Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient's lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme's procedure for the management of the complete rectal prolapse. METHODS: A total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme's procedure in St. Vincent's Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score. RESULTS: All 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation. CONCLUSION: The Delorme's procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.
Constipation ; Fecal Incontinence ; Female ; Flatulence ; Humans ; Incidence ; Korea ; Prolapse ; Rectal Prolapse ; Recurrence ; Retrospective Studies

PURPOSE: In order to evaluate the spectrum of mitochondrial DNA (mtDNA) mutations in the patients with suspected Leber's hereditary optic neuropathy (LHON). METHODS: We investigated 14 primary mtDNA mutations at nucleotide positions (nps 3460A, 4160C, 5244A, 9101C, 9804A, 10663C, 11778A, 13730A, 14459A, 14482G, 14484C, 14495G, 14498T, and 14568T) and one common secondary mutation (np15257A) in 82 Korean patients with suspected LHON. RESULTS: Among them, only three kinds of LHON mutations were identified in 60 (73%) of 82 probands, which were comprised of 46 (56%) cases with the 11778A, 13 (16%) with the 14484C, and 1 (1%) with the 3460A. None of the other mtDNA mutations was detected. Of the 60 probands with LHON positive mutations, 19 (32%) had relevant family histories. Heteroplasmy was determined in 2 (4%) of the 46 probands with the 11778A and 1 (8%) of 13 probands with the 14484C. CONCLUSIONS: In conclusion, the 11778A was the most common cause (56%), and higher prevalence of the 14484C and the lower prevalence of the 3460A were characteristic in Korean patients with LHON. Especially, the 3460A had a remarkable racial difference compared with Caucasians. Except 3460A, 11778A, and 14484C, the other mutations screened may not be involved in pathogenesis and not have a synergistic effect on the clinical expression of LHON in Koreans.
Asian Continental Ancestry Group ; DNA, Mitochondrial* ; Humans ; Molecular Biology* ; Optic Atrophy, Hereditary, Leber* ; Prevalence

The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or disease-free survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.
Disease-Free Survival ; Laparoscopy ; Quality Control ; Rectal Neoplasms ; Recurrence ; Surgeons ; Treatment Outcome

BACKGROUND: Thiopental has a profound impact on the cardiovascular system. The effects of hemody namics after intravenous thiopental on the balance of cerebral metabolism with cerebral blood flow is unknown. The purpose of this study was to monitor hemodynamic change, cerebral arterial-jugular venous oxygen content difference (AVDO2) and jugular venous oxygen saturation (SjVO2) after a thiopental injection for brain protection during cerebral aneurysm surgery. METHODS: Twenty patients received a standard anesthetic consisting of isoflurane, vecuronium and fentanyl with a PaCO2 of 30 35 mmHg. Hemodynamics, arterial and jugular venous blood gases were measured at 3 time points:I; Just before thiopental injection; II; Electroencephalographic (EEG) burst suppression after a 4 5 mg/kg intravenous thiopental injection; and III; EEG recovery. RESULTS: Intravenous thiopental (4 5 mg/kg) induced an EEG burst suppression for 6.5 +/- 1.7 minutes. Hemodynamics and arterial blood gas analysis were not significantly different among the different time points, but mean arterial pressure (68.4 +/- 7.2 mmHg) and systemic vascular resistance (1027.0 +/- 300.9 dynes sec/cm5) in II were significantly (P < 0.05) decreased compared with I (84.3 +/- 9.6, 1169.1 +/- 304.5) and III (89.1 +/- 10.6, 1288.6 +/- 426.1). SjVO2 (71.6 +/- 11.8%) was significantly (p < 0.05) decreased within the normal value compared with I (75.1 +/- 5.6) and III (76.1 +/- 10.1), but AVDO2 was not significantly different among the 3 time points. There was no evidence of cerebral ischemia or infarction in computed tomographic (CT) findings of the 20 patients after surgery. CONCLUSIONS: Hemodynamics after 4 5 mg/kg intravenous thiopental do not modify the balance ofcerebral oxygen metabolism with cerebral blood flow in patients undergoing cerebral aneurysm surgery.
Arterial Pressure ; Blood Gas Analysis ; Brain ; Brain Ischemia ; Cardiovascular System ; Electroencephalography ; Fentanyl ; Gases ; Hemodynamics ; Humans ; Infarction ; Intracranial Aneurysm* ; Isoflurane ; Metabolism ; Oxygen* ; Reference Values ; Thiopental* ; Vascular Resistance ; Vecuronium Bromide