Insulin-like growth factor-I(IGF-I) is a peptide hormone of approximately 7.5 kilodaltons which has been shown to be involved in cellular growth and differentiation. Because the IGF-I is synthesized in a variety of tissues, it is thought to act both locally in a paracrine/autocrine manner, as well as a true endocrine hormone after entering the circulation. It may be considered that IGF-I is very important for differentiation of bone, cartilage, and muscle. The eustachian tube has the function of ventilation, clearance, and protection of the middle ear, contributing to the maintenance of normal hearing. After the opening of eustachian tube, it may return to its original position by elasticity resulting from the recoil of elastic fiber, muscle itself, and other deformed soft tissues surrounding the tube. Previously we have studied the distribution of elastic fibers in the rat eustachian tube and ascertained enormous elastin in the cartilage of the eustachian tube. The maintenance of elasticity in the tubal cartilage, related to closing of the eustachian tube, has been suspected as one of important factors in the pathogenesis of otitis media. Rich13) previously described that IGF-I acts as a modulator of the elastogenesis, essential for stretch and recoil actions. However, the examination of the presence of IGF-I in the eustachian tube, especially cartilage may very important as one of factors for well functioning of the eustachian tube. This immunohistochemical study, the tubal cartilage has a considerable content of IGF-I in the capsule around the chondrocytes. The submucosal connective tissue layer of the eustachian tube contained some immunostained cells, considered to be fibroblasts. These findings suggest that IGF-I may be important for normal chondrocyte growth of rat eustachian tube.
Animals ; Cartilage ; Chondrocytes ; Connective Tissue ; Ear, Middle ; Elastic Tissue ; Elasticity ; Elastin ; Eustachian Tube* ; Fibroblasts ; Hearing ; Insulin-Like Growth Factor I ; Otitis Media ; Rats* ; Ventilation

The intradermal nevus is composed of nevus cells which are usually referred to as the melanocytic nevi and is a form of benign cutaneous tumor. Although the intradermal nevi are common benign pigmented skin tumors, their occurrence within the external auditory canal is uncommon. The clinical and pathologic features of the intradermal nevus arising within the external auditory canal are presented, with a review of literature.
Ear Canal* ; Nevus ; Nevus, Intradermal* ; Nevus, Pigmented ; Skin

We have experienced a case of mucinous ductal ectasia of the pancreas. The patient visited hospital with the symptoms of acute pancreatitis. The plasma levels of amylase and lipase checked at hospital were elevated. Abdominal ultrasonography and CT scan showed cystlike, intrapancreatic defects localized in the uncinate process of pancreatic head, On duodenoscopy, bulging ampulla of Vater and patulous papillary orifice were seen. Mucin leaked out of the patulous opening. Endoscopic retrograde pancreatography was performed and the localized, grape-like cyatic dilatation of the side branch of a main pancreatic duct on the uncinate process was shown. The main pancreatic duct was also dilated and had multiple filling defects in it. Whipple' s operation was performed and the histologic diagnosis was a benign intraductal papillary mucinous neoplasm of the pancreas.
Ampulla of Vater ; Amylases ; Diagnosis ; Dilatation ; Dilatation, Pathologic* ; Duodenoscopy ; Head ; Humans ; Lipase ; Mucins* ; Pancreas* ; Pancreatic Ducts ; Pancreatitis* ; Plasma ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND AND OBJECTIVES: Professional singers have a particular "ringing" sound quality during singing, so called singer's formant. Two types of professional singers in Korea that sound very different are classical (pansori) and western style performers. The purpose of this research was to systematically analyze and compare the acoustic sound structure of both the speaking and singing voices of Korean classical singers (pansori). We also investigated the morphologic and vibratory characteristics of vocal folds using videostroboscopy. MATERIALS AND METHODS: 24 classical singers and 29 western style singers were subjects. The formant frequencies, intensities and singing power ratio was evaluated for clarifying the existence of singing formant. Using laryngeal stroboscopy, the vibratory characteristics were evaluated. RESULTS: The all formant intensities were incraesed in the classical singers, but typical increase of third and fourth formant in the western style singers. The singing power ratio was smaller in the western style singers. Most of classical singers showed abnormal vibratory patterns. CONCLUSION: The western style singers have typical singing formant during singing, but not in the classical singers. Most of classical singers showed abnormal vibratory patterns of vocal folds during phonation, but usually normal vibration in the western style singers.
Acoustics ; Korea ; Music* ; Phonation ; Singing* ; Stroboscopy ; Vibration* ; Vocal Cords* ; Voice

BACKGROUND: Inverted papilloma is a benign neoplastic lesion which shows high recurrence rate and possibility of association with malignancy. Medial maxillectomy has been preferred as a treatment of choice, for conservative treatments resulted in higher recurrence rate. However, introduction of nasal endoscope made more precise evaluation of intranasal lesion under brighter illumination. OBJECTIVES: Aim of this study was to compare the recurence rate between medial maxillectomy and conservative surgery using nasal endoscope. MATERIAL AND METHODS: Thirty one patients who underwent operation between 1980 and 1995 were retrospectively studied. RESULTS: Fifteen patients were treated via external approach and sixteen patients endoscopically. Inverted papilloma was recurred in two cases of endoscopic surgery group and one case of external surgery group. CONCLUSION: Endoscopic conservative surgery can be an alternative surgical modality in the selected cases.
Endoscopes* ; Humans ; Lighting ; Papilloma, Inverted* ; Recurrence ; Retrospective Studies

PURPOSE: This study aimed to establish a large-scale database of patients with gastric cancer to facilitate the development of a national-cancer management system and a comprehensive cancer control policy. MATERIALS AND METHODS: An observational prospective cohort study on gastric cancer was initiated in 2010. A total of 14 cancer centers throughout the country and 152 researchers were involved in this study. Patient enrollment began in January 2011, and data regarding clinicopathological characteristics, life style-related factors, quality of life, as well as diet diaries were collected. RESULTS: In total, 4,963 patients were enrolled until December 2014, and approximately 5% of all Korean patients with gastric cancer annually were included. The mean age was 58.2±11.5 years, and 68.2% were men. The number of patients in each stage was as follows: 3,394 patients (68.4%) were in stage IA/B; 514 patients (10.4%), in stage IIA/B; 469 patients (9.5%), in stage IIIA/B/C; and 127 patients (2.6%), in stage IV. Surgical treatment was performed in 3,958 patients (79.8%), endoscopic resection was performed in 700 patients (14.1%), and 167 patients (3.4%) received palliative chemotherapy. The response rate for the questionnaire on the quality of life was 95%; however, diet diaries were only collected for 27% of patients. CONCLUSIONS: To provide comprehensive information on gastric cancer for patients, physicians, and government officials, a large-scale database of Korean patients with gastric cancer was established. Based on the findings of this cohort study, an effective cancer management system and national cancer control policy could be developed.
Cohort Studies* ; Diet ; Drug Therapy ; Humans ; Korea ; Male ; Occupational Groups ; Prospective Studies* ; Quality of Life ; Stomach Neoplasms*

BACKGROUND/AIMS: The effectiveness of combination therapy with conventional or pegylated interferon alpha and ribavirin in patients with chronic hepatitis C is well understood. However, the profound investigation about complications of the treatment has been rarely reported in Korea, where patients have broader spectrum of disease manifestations. The aim of this study was to evaluate the effectiveness and complications of the combination therapy of interferon alpha and ribavirin in patients with chronic hepatitis C. METHODS: Two hundred and forty patients with chronic hepatitis C were included. All patients were treated with interferon alpha (3 million units thrice a week) in combination with ribavirin (800-1,200 mg, depending on body weight). Patients were treated for 6 or 12 months according to the genotypes (genotype 1; 12 months, non-1; 6 months). We retrospectively evaluated ETR (end of treatment response) and SVR (sustained virologic response) on the basis of intent-to-treat in patients completing the therapy. RESULTS: In 154 patients who had completed the therapy, ETR was 79.2% and SVR was 61.0%. Multivariate analysis showed that genotype and early virologic response at 3 months of treatment were indepedent predictive factors of SVR. Due to insufficient response, 11.3% of the patients discontinued the therapy. In addition, 24.5% of the patients prematurely discontinued the therapy due to adverse events including aggravated liver function (15.4%), failure to return (7.9%), and others (1.2%). Dose modifications of interferon alpha or ribavirin were required due to anemia (15.4%), neutropenia (8.8%), or thrombocytopenia (4.6%). CONCLUSIONS: The overall SVR of patients who had completed the combination therapy with interferon alpha and ribavirin was 61.0%. However, about one third of the patients discontinued the therapy prematurely due to insufficient response, adverse events and/or noncompliance.
Adult ; Aged ; Antiviral Agents/*adverse effects/therapeutic use ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/*drug effects/genetics ; Hepatitis C, Chronic/*drug therapy/virology ; Humans ; Interferon-alpha/administration & dosage/*adverse effects ; Male ; Middle Aged ; Ribavirin/administration & dosage/*adverse effects

The objective of the study was to document practice pattern of gastroenterologists for the management of gastroesophageal reflux disease (GERD) under the minimal influence of the insurance reimbursement guideline. Data on management for 1,197 consecutive patients with typical GERD symptoms were prospectively collected during 16 weeks. In order to minimize the influence of reimbursement guideline on the use of proton pump inhibitors (PPIs), rabeprazole was used for the PPI treatment. A total of 861 patients (72%) underwent endoscopy before the start of treatment. PPIs were most commonly prescribed (87%). At the start of treatment, rabeprazole 20 mg daily was prescribed to 94% of the patients who received PPI treatment and 10 mg daily to the remaining 6%. At the third visits, rabeprazole 20 mg daily was prescribed to 70% of those who were followed and 10 mg daily for the remaining 30%. Continuous PPI treatment during the 16-week period was performed in 63% of the study patients. In conclusion, a full-dose PPI is preferred for the initial and maintenance treatment of GERD under the minimal influence of the insurance reimbursement guideline, which may reflect a high proportion of GERD patients requiring a long-term treatment of a full-dose PPI.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Enzyme Inhibitors ; Female ; Gastroenterology ; Gastroesophageal Reflux/*diagnosis/*drug therapy ; *Guideline Adherence ; Humans ; Insurance, Health, Reimbursement ; Male ; Middle Aged ; *Physician's Practice Patterns ; Proton Pump Inhibitors/therapeutic use ; Republic of Korea ; Treatment Outcome

Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort Study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35;95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection.

BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus ; Biopsy ; Chest Pain ; Cough ; Esophagus ; Gastroesophageal Reflux ; Heartburn ; Hoarseness ; Light ; Metaplasia ; Microscopy ; Prospective Studies ; Proton Pumps ; Sensation