Osteoma is a slow-growing benign tumor composed of mature bone. Osteoma of the nose and paranasal sinuses is usually asymptomatic and most commonly occurs in the frontal sinus, followed by the ethmoidal and maxillary sinus. The occurrence in the sphenoidal sinus and nasal cavity is very rare. We present a case report of a patient with an isolated osteoma in the right nasal cavity presenting with nasal obstruction.
Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity* ; Nasal Obstruction ; Nose ; Osteoma* ; Paranasal Sinuses

BACKGROUND: Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women. METHODS: Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (beta) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM. RESULTS: Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17+/-3.7 and 50.58+/-3.5 years, respectively), with a statistically significant correlation (P<0.05). This correlation was still observed after adjusting for age, body mass index, menstrual regularity, and personal income (P<0.05 for variables). CONCLUSION: In Korean women between 40 and 70 years of age who are in natural menopause, there is a statistically significant correlation between stress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
Body Mass Index ; Female ; Humans ; Menopause* ; Mental Health ; Nutrition Surveys* ; Risk Factors

Cardiac myxoma is the most common benign cardiac tumor and it presents various clinical symptoms and signs. Although two-thirds of patients have abnormal electrocardiographic findings, atrial flutter or conduction abnormalities are known to be rare. We report on a case of a large left atrial myxoma which was diagnosed by trans-thoracic, trans-esophageal echocardiography, chest computerized tomography, and histological examination. The myxoma was presented as atrial flutter in a 41-year old man who was complaining palpitation and dyspnea on exertion. After surgical excision of the mass, atrial flutter converted to normal sinus rhythm. We report this case with review of literatures on left atrial myxoma associated with arrhythmia.
Arrhythmias, Cardiac ; Atrial Flutter ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart Neoplasms ; Humans ; Myxoma ; Thorax

Ventricular tachycardias(VTs) usually complicate iscemic heart disease. Cardiomyopathy or other organic heart disease and are aften associated with sudden cardiac death. Ventricular tachycardias with no apparent cardiac abnormalities, however, have been known to have different clinical features comprising a unique clinical entity among other tachycardias. Eleven patients(7men, 4 women) were investigated on their clinical features, electrophysiologic studies and late potentials. 1) The mean age at diagnosis was 23.4+/-6.5 years and the predominating clincal features were palpitation, syncope or congestive heart failure. No death occured over a mean follow up period of 29.2+/-26.5 months. 2) The resting ECGs were within normal limits in 8 patients and showed nonspecific ST-T changes in 3 patients. 3) Ventricular pacing induced sustained ventricular tachycardias in 7 patients and nonsustained VT in 1 aptient. Atrial pacing could provoke sustained VTs in 3 patients. 4) His bundle electrograms(HBE) were obtained in 7 patients during tachycardial. The HV intervals of the induced VTs distributed between 0 to -25msec in 5 patients and there was no definite His potentials in two patients. 5) The coupling interval of premature stimuli and the echo interval(the interval from the stimulus to the initiation of resulting VT) showed inverse relationship in 5 cases. No direct relationship was observed. 6) The termination mode, observed in 7 patients, showed delayed ternmination in 2 patients. 7) Late potentials(LPs) were pisitive in three patients but there was no significant statistical difference between LPs in normal control and those with idiopathic sustained left VTs. 8) Verapamil terminated VTs in 8 patients and slowed the rate of tachycardial in 1 patient. In conclusion, idiopathic sustained left ventricular tachycardias occur in younger age group and have more favorable prognosis. The findings of EPS and LPs suggest microreentry or triggered activity as their basic mechanism and verapamil can be used effectively for their termination.
Bundle of His ; Cardiomyopathies ; Death, Sudden, Cardiac ; Diagnosis ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Humans ; Prognosis ; Syncope ; Tachycardia ; Tachycardia, Ventricular* ; Verapamil

Papillary thyroid carcinomas comprise approximately 80 percent of all thyroid cancers, but haves a good prognosis, with overall survival rates at 10 years of about 80 to 95 percent. They spreads through the lymphatic system, and the lung is the most frequent metastasis site. If distant metastasis is present, the overall survival rate is about 40 percent. Although malignant pleural effusion, with pleural metastasis is a rare complication in patients with papillary thyroid carcinoma, the development of malignant pleural effusion is an extremely adverse prognostic indicator. We recently experienced a case of malignant pleural effusion with papillary thyroid carcinoma. A 54-year-old woman was admitted to the hospital because of dyspnea. A chest X-ray showed massive pleural effusion in the right hemithorax. Previously total thyroidectomy, and iodine-131 therapy had been performed, but a local recurrence and pulmonary metastasis developed 5 years later, accompanied by malignant pleural effusion with pleural metastasis. We performed diagnostic thoracentesis, which confirmed a metastatic papillary thyroid carcinoma. This patient was a rare case of paplillary thyroid carcinoma, in which the disease was represented by a rapid deterioration with malignant pleural effusion. So we report this case with a review of the literature.
Dyspnea ; Female ; Humans ; Lung ; Lymphatic System ; Middle Aged ; Neoplasm Metastasis* ; Pleural Effusion ; Pleural Effusion, Malignant* ; Prognosis ; Recurrence ; Survival Rate ; Thorax ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND: LB20304(gemifloxacin) is a new fluoroquinolone antibacterial agent with excellent activity against both Gram-negative and Gram-positive organisms. In vitro studies using clinical isolates have shown gemifloxacin to be highly active against penicillin-resistant strains of S. pneumoniae and in contrast to other reference quinolones, gemifloxacin retained good activity against clinical isolates of S. pneumoniae that were resistant to other members of the quinolone class. Therefore, gemifloxacin is thought to be effective in treating acute bacterial exacerbation of chronic bronchitis(AECB). The objective of this study was to evaluate the efficacy and safety of oral gemifloxacin at doses of 160mg or 320mg once daily for 7 days for the treatment of AECB in Korean adult population. METHODS: This was a randomized, multicenter, double-blind, parallel group Phase II study to assess the clinical and antibacterial efficacy and safety of oral gemifloxacin for the treatment of AECB. Treatment Group A (67 patients) took oral gemifloxacin 160mg once daily for seven days and treatment Group B (70 patients) took oral gemifloxacin 320mg once daily for seven days. RESULTS: The demographic profiles of the two treatment groups were similar. The clinical response at follow-up was 84.2% in the gemifloxacin 160-mg group, and 88.7% in the gemifloxacin-320 mg group, showing no statistically significant difference between two treatment groups(p=0.49). The clinical response at the end of therapy was 96.5% in the 160-mg group, and 96.4% in the 320-mg group. The bacteriological response at the end of therapy and follow-up were 81.8% and 78.9%, respectively, in the 160-mg group, and 86.4% and 84.2%, respectively, in the 320-mg group, showing no statistically significant difference between two treatment groups(p=0.68 and 0.68, respectively). S. pneumoniae(12 isolates) and H. influenzae(10 isolates) were the most prevalent pathogens. The MICs were lower for gemifloxacin than other quinolones against these key pathogens, and for S. pneumoniae, the MICs for gemifloxacin were considerably lower(< or = 0.03 ug/mL) than those for other quinolones, beta-lactams and acrolides. In the period on-therapy plus 30 days post-therapy, a total of 18 patients(26.9%) in the gemifloxacin 160mg group and 22 patients(31.4%) in the 320mg group reported at least one adverse event(AE). The most frequently reported AE was abdominal pain(3/67 patients, 4.5%) in the gemifloxacin 160mg group and increased level of hepatic enzyme(5/70 patients, 7.1%) in the 320mg group. The overall AE profiles for the two treatment groups were similar. Two out of 67 patients(3.0%) in the gemifloxacin 160mg group and 1/70 patients(1.4%) in the 320mg group reported at least one serious AE, however, none of which was considered by the investigator to be of suspected or probable relationship to study medication. CONCLUSION: The results of this study showed that gemifloxacin at doses of 160mg or 320mg once daily for 7 days in the treatment of acute exacerbations of chronic bronchitis(AECB) in adult Koreans was a very effective and safe treatment both clinically and bacteriologically.
Adult* ; beta-Lactams ; Bronchitis, Chronic* ; Double-Blind Method* ; Follow-Up Studies ; Humans ; Mesylates* ; Pneumonia ; Quinolones ; Research Personnel

OBJECTIVE: In this retrospective study, we analyzed the clinicopathologic characteristics of advanced serous epithelial ovarian cancer and evaluated the prognostic factors which have an impact on survival of patients with epithelial ovarian cancer. We also compared several analyzing methods of CA 125 for predicting prognosis of advanced serous epithelial ovarian cancer. METHODS: A total of 57 patients with advanced serous epithelial ovarian cancer who were treated at Samsung Medical Center between Aug. 1995 and Jul. 2000 were included. Medical records including pathologic reports were reviewed to identify clinicopathologic characteristics and serum levels of CA 125. Five different methods of analyzing serum CA 125 were compared for predicting the prognosis of advanced serous epithelial ovarian cancer. Survival curves were analyzed by Kaplan-Meier method and Cox proportional hazards model. RESULTS: The median age of all patients was 54.2 years. In univariate analysis, age, FIGO stage, grade, residual tumor and ascites showed no significant correlation with prognosis. Among five different analyzing methods of serum CA 125 levels, normalization after 3rd chemotherapy was correlated with improved 5-year survival rate (p=0.026). CONCLUSION: This study showed that normalization of serum levels of CA 125 after 3rd chemotherapy is useful for predicting prognosis of advanced serous epithelial ovarian cancer patients.
Ascites ; Drug Therapy ; Humans ; Medical Records ; Neoplasm, Residual ; Ovarian Neoplasms* ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

BACKGROUND: This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules (18microgram once daily) with a ipratropium metered dose inhaler (2 puffs of 20microgram q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). METHOD: After the initial screening assessment and a two-week run-in period, patients received either tiotropium 18microgram once daily or ipratropium 40microgram four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. RESULT: In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted FEV1 of 42 (12)% were analyzed. The trough FEV1 response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. CONCLUSION: This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.
Adult* ; Albuterol ; Bronchodilator Agents ; Capsules ; Forced Expiratory Volume ; Humans ; Inhalation ; Ipratropium* ; Lung ; Mass Screening ; Metered Dose Inhalers ; Outcome Assessment (Health Care) ; Peak Expiratory Flow Rate ; Pulmonary Disease, Chronic Obstructive* ; Surveys and Questionnaires ; Vital Capacity ; Tiotropium Bromide