No abstract available.
Phonation* ; Tooth*

To preserve function of the acoustic nerve and brainstem during posterior fossa surgery, the authors monitored(brainstem auditory evoked potentials) in 42 cases of posterior fossa surgery who were operated at the Department of Neurosurgery of Yonsei University College of Medicine from March, 1983 to February, 1987. The results were summarized as followings : 1) There were 28 cases of hemifacial spasm, 13 cases of trigeminal neuralgia and 1 case of cerebellopontine angle tumor. 2) Among the 41 cases of neurovascular decompression, there were 10 cases(24%) with hearing impairment postoperatively. But there was no postoperative auditory dysfunction in 13 cases of hemifacial spasm in which caudal approach was utilized. 3) There was no postoperative auditory dysfunction in the patients who showed intraoperative BAEPs of Types I, II, and III which were characterized by no loss of waves, but 10 cases(77%) who showed BAEPs of types IV, V and VI which were characterized by loss of the waves showed auditory dysfunction postoperatively.
Brain Stem* ; Cochlear Nerve ; Decompression ; Evoked Potentials, Auditory, Brain Stem* ; Hearing Loss ; Hemifacial Spasm ; Humans ; Monitoring, Intraoperative ; Neuroma, Acoustic ; Neurosurgery ; Trigeminal Neuralgia

BACKGROUND AND OBJECTIVES: Fibroblasts interact with eosinophils and play a key role in the pathogenesis of airway diseases. The aims of this study were to investigate whether Th1 or Th2 type cytokines can induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblast (HNF) and to verify the correlation between the stimulation of different cytokines and chemokines in HNF. Materials and Methods: Cultured HNF were stimulated by IL-13, TNF-alpha, IFN-gamma, IL-13 with TNF-alpha, IL-13 with IFN-gamma, TNF-alpha with IFN-gamma for 6, 24 and 48 hours. In addition, HNF were stimulated by different concentration of IL-13 (0.2, 2, 20, 200 ng/ml). MRNA expression of eotaxin and RANTES were revealed by RT-PCR and protein of eotaxin and RANTES were revealed by ELISA. RESULTS: TNF-alpha and IFN-gammar induced mRNA and protein expression of RANTES in HNF and they synergistically induced protein expression of RANTES. RANTES expression increased in a time dependent manner. IL-13 induced mRNA and protein expression of eotaxin in HNF and it synergistically reacted with TNF-alpha or IFN-gamma. The effects of IL-13 on mRNA and protein expression of eotaxin increased in a concentration dependent manner. CONCLUSION: Th1 or Th2 type cytokines induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblasts. TNF-alpha or IFN-gamma induce more RANTES than eotaxin but IL-13 induces more eotaxin than RANTES. There may be some synergic effects of cytokines for mRNA and protein expression of chemokines.
Chemokine CCL5* ; Chemokines ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Fibroblasts* ; Humans* ; Interleukin-13 ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

Lobular capillary hemangioma (LCH), also known as pyogenic granuloma, is a benign capillary proliferation with a microscopically distinctive lobular architecture that affects the skin and mucous membrane of the oral cavity and nasal region. LCH commonly involves the nasal cavity as a small hypervascular lesion arising from the anterior third of the septum or the lateral wall. Its diagnosis may be difficult in those rare instances of a large LCH that entirely fills the nasal cavity, which can be confused with more aggressive neoplasms such as hemangiopericytoma or angiosarcoma. We report an intriguing case of LCH associated with epidural hematoma presenting as a huge expansile lesion involving the anterior skull base and orbit.
Capillaries ; Epidural Abscess ; Granuloma, Pyogenic ; Hemangiopericytoma ; Hemangiosarcoma ; Hematoma ; Mouth ; Mucous Membrane ; Nasal Cavity ; Orbit ; Skin ; Skull Base

Targeted therapies guided by molecular diagnostics have become a standard treatment of lung cancer. Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements are currently used as the best predictive biomarkers for EGFR tyrosine kinase inhibitors and ALK inhibitors, respectively. Besides EGFR and ALK, the list of druggable genetic alterations has been growing, including ROS1 rearrangements, RET rearrangements, and MET alterations. In this situation, pathologists should carefully manage clinical samples for molecular testing and should do their best to quickly and accurately identify patients who will benefit from precision therapeutics. Here, we grouped molecular biomarkers of lung cancers into three categories—mutations, gene rearrangements, and amplifications—and propose expanded guidelines on molecular testing of lung cancers.
Biomarkers ; Gene Rearrangement ; Humans ; Lung Neoplasms* ; Lung* ; Lymphoma ; Pathology, Molecular ; Phosphotransferases ; Precision Medicine ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

PURPOSE: We were assessed the characteristic findings of defecography and cinedefecography in patients with pelvic outlet obstructive disease, and compared the characteristic physiologic findings between proctography and cinedefecography. METHODS: Physiologic findings of 196 patients who were performed at least two items of physiologic tests were retrospectively evaluated. Patients were categorized as rectocele (Group I: n=119), nonrelaxing puborectalis syndrome (Group II: n=58), rectoanal intussusception (Group III: n=16), significant sigmoidocele (Group IV: n=3). The proctographic and cinedefecographic features were analyzed according to disease categories. The sensitivity, specificity, accuracy, false positive rate, false negative rate, diagnostic rate, and reproducibility were calculated, and we analyzed the difference between proctography and cinedefecography according to the disease groups. RESULTS: On the proctographic examinations; 1) 112 patients were confirmed as a clinically significant rectocele (n=128, sensitivity; 94%, specificity; 79%, accuracy; 88%, false positive rate; 21%, false negative rate; 6%, kappa; 0.749). 2) A clinically significant nonrelaxing puborectalis were 36 patients (n=73, sensitivity; 62%, specificity; 73%, accuracy; 70%, false positive rate; 27%, false negative rate; 38%, kappa; 0.328). 3) 12 patients were confirmed as significant rectoanal intussusception (n=31, sensitivity; 75%, specificity; 89%, accuracy; 88%, false positive rate; 11%, false negative rate; 25%, kappa; 0.425). 4) 3 patients were confirmed as clinically significant sigmoidocele (n=15, sensitivity; 100%, specificity; 94%, accuracy; 94%, false positive rate; 6%, false negative rate; 0%, kappa; 0.316). On the combination of proctography and cinedefecography; 1) 117 patients were confirmed as a clinically significant rectocele (n=122, sensitivity; 98%, specificity; 94%, accuracy; 96%, false positive rate; 6%, false negative rate; 2%, kappa; 0.925). 2) A clinically significant nonrelaxing puborectalis were 50 patients (n=64, sensitivity; 86%, specificity; 90%, accuracy; 88%, false positive rate; 10%, false negative rate; 14%, kappa; 0.738). 3) 16 patients were confirmed as significant rectoanal intussusception (n=22, sensitivity; 100%, specificity; 97%, accuracy; 97%, false positive rate; 3%, false negative rate; 0%, kappa; 0.826). 4) 3 patients were confirmed as clinically significant sigmoidocele (n=9, sensitivity; 100%, specificity; 97%, accuracy; 97%, false positive rate; 3%, false negative rate; 0%, kappa; 0.488). As compared with combined study (proctography plus cinedefecography), the proctography show decreased diagnostic rates in the evaluation of rectocele (P<0.05), nonrelaxing puborectalis (P<0.01), and rectoanal intussusception (P<0.05). And, the proctography also show increased false positive rate in the evaluation of rectocele (P<0.01), nonrelaxing puborectalis (P<0.01), and rectoanal intussusception (P<0.05). CONCLUSIONS: In our study, proctography showed a tendency to overdiagnosis. Therefore, the combined study of proctography and cinedefecography should be taken as a diagnostic tools for pelvic outlet obstructive disease. Adhering to these findings, other anorectal physiologic studies should be added for the clinically significant diagnosis.
Defecography ; Diagnosis ; Humans ; Intussusception ; Rectocele ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: There have been some reports about acoustic analysis of nasality changes after endoscopic sinus surgery (ESS), but no studies on the relationship between acoustic and volumetric changes of rhinosinus. The aims of this study were to measure and follow the postoperative course of nasal formant and spectral changes of nasal consonants and vowels, to evaluate the relationship between these acoustic and volumetric changes of rhinosinus, and to estimate the effect of rhinosinus as a nasal tract on nasal resonance after operation. MATERIAL AND METHODS: The changes of formants and spectral pattern were evaluated in 30 patients before ESS, and one, three and 12 months after ESS. Axial CT planes of 10 patients taken before and one month after the surgery were used for measuring the resonant volume of rhinosinus. RESULTS: The first formant was decreased when ESS was carried out one month after the surgery. However, it almost recovered to the preoperative level within 3 postoperative months. Twelve months after the surgery, the first formant did not show statistically significant differences compared to those of the preoperative state and the postoperative 1 month. The increment of resonant volume in rhinosinus was not correlated with the degree of decrement of the first formant one month after the surgery. CONCLUSION: Having a proper nasal cavity and the sinuses are important for nasality since hypernasality observed in the postoperative 1 month is thought to be caused by significantly increased resonant volume of the nasal tract. Compensatory control of velopharyngeal port as well as the resonant volume of the nasal tract are important factors to changes in nasality.
Acoustics ; Humans ; Nasal Cavity

Academic Medical Centers ; Conscious Sedation ; Deep Sedation ; Dental Care ; Dentistry ; Humans ; Midazolam ; Monitoring, Physiologic ; Outpatients ; Postoperative Complications ; Retrospective Studies

PURPOSE: To compare the variable inflammatory parameters of acute pyelonephritis patients treated with inpatient therapy at 13 hospitals, according to the age and gender distributions. MATERIALS AND MATHODS: A total of 3,544 medical records of patients with confirmed acute pyelonephritis, and admitted to hospital between January 2000 and December 2005, were retrospectively analyzed. RESULTS: The mean age of the patients was 43.2+/-16.2 years old, with a male:female ratio of 1 : 5.1. The average duration of hospital admission was 7.9+/-5.3 days. Underlying diseases were found in 23.0% (749/3,252 patient), largely due to diabetes (35.1%). Radiological abnormal findings were found in 13.7%. The leukocyte count, ratio of segmented form, erythrocyte sedimentation rate (ESR), c-reactive protein, pyuria, positive blood culture, positive urine culture were 11,014+/-5,778/mm(3), 74.8+/-14.5%, 44.0+/-32.0 mm/hr, 12.4+/-9.3mg/dl, 83.9%, 10.5% and 46.7%, respectively. E. coli grow in 79% of the urine culture positive patients. In a comparison of 3 age groups (<40 years, 40-60 years, >61 years), the elderly patients had a greater number of underlying diseases and more pathogens in cultured blood. When divided into males and females, the elderly male patients had more pathogen in cultured urine, but contrary to the male patients, the elderly female patients had elevated leukocyte count and erythrocyte sedimentation rate. Also, the old patient group had more resistance to ampicillin when they had E. coli as the uropathogen (p=0.021). Patients with higher ESR required longer hospital admission periods. CONCLUSIONS: It was found that variable clinical parameters of acute pyelonephritis patients treated with inpatient therapy differed according to both gender and age group in Korea. Therefore, these factors should be taken into account in the treatment plan.
Aged ; Ampicillin ; Blood Sedimentation ; C-Reactive Protein ; Female ; Humans ; Inpatients ; Korea ; Leukocyte Count ; Male ; Medical Records ; Pyelonephritis* ; Pyuria ; Retrospective Studies

Background/Aims: Several prediction models for evaluating the prognosis of nonmetastatic resected pancreatic ductal adenocarcinoma (PDAC) have been developed, and their performances were reported to be superior to that of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. We developed a prediction model to evaluate the prognosis of resected PDAC and externally validated it with data from a nationwide Korean database. Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database were utilized for model development, and data from the Korea Tumor Registry System-Biliary Pancreas (KOTUS-BP) database were used for external validation. Potential candidate variables for model development were age, sex, histologic differentiation, tumor location, adjuvant chemotherapy, and the AJCC 8th staging system T and N stages. For external validation, the concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC) were evaluated. Results: Between 2004 and 2016, data from 9,624 patients were utilized for model development, and data from 3,282 patients were used for external validation. In the multivariate Cox proportional hazard model, age, sex, tumor location, T and N stages, histologic differentiation, and adjuvant chemotherapy were independent prognostic factors for resected PDAC. After an exhaustive search and 10-fold cross validation, the best model was finally developed, which included all prognostic variables. The C-index, 1-year, 2-year, 3-year, and 5-year time-dependent AUCs were 0.628, 0.650, 0.665, 0.675, and 0.686, respectively. Conclusions The survival prediction model for resected PDAC could provide quantitative survival probabilities with reliable performance. External validation studies with other nationwide databases are needed to evaluate the performance of this model.