Metastases to the sinonasal tract are infrequent occurrences from primaries below the clavicles. The total number of reported cases to date is less than 100. There is, however, complete unanimity concerning the histologic type of metastatic neoplasm most often encountered. An interesting phenomenon, generally attributable only to breast and renal cell carcinoma, is the late recurrence of the malignant tumor, even 10 or more years after operation. A 61 year-old-male was admitted to ENT due to frequent epistaxis and right facial swelling. CT scan revealed a huge soft tissue density mass I right maxillary sinus with extension into nasopharynx and deviation of nasal septum. The histologic diagnosis was metastatic renal cell carcinoma. He had left nephrectomy because of renal cell carcinoma, 14 years ago. We report a case of metastatic renal cell carcinoma of maxillary sinus in view of rarity, and a brief review of the literature related to this type of tumor is presented.
Male ; Humans ; Neoplasm Metastasis

Merkel cell carcinoma is a relatively uncommon, cutaneous, neuroendocrine neoplasm that was first recognized by Toker in 1972. Occasionally it is found concurrent with squamous cell carcinoma or basal cell carcinoma and in them cases, the coexistence of them is suggesive of presenting the effect of a common carcinogenic influence on two distinct precursor cells. Now the authors report a case of Merkel cell carcinoma associated with squamous cell carcinoma arising in the overlying epidermis, and a brief review of literatures is introduced. The patient was a 75-year-old female, who had noticed a reddish brown, ulcerated mass on the right buttock. It had progressively enlarged to become lemon-size during last 4 months. The right buttock mass excised measured 10x8x3 cm and was gray white, solid, with an ill-defined marigin. Histologically the tumor was located in the dermis and was lacking in connection with the epidermis in which invasive squamous cell carcinoma developed. The neoplastic cells were arranged in a diffuse, lymphoma-like pattern or trabecular arrangement and their cytologic details were reminiscent of small cell carcinoma of the lung, On electron microscopy the cells displayed many neurosecretory granules averaging about 100nm in diameter, intermediate filaments and desmosomes. Immunohistochemically a ball-like immunostaining for keratin, resembling an inclusion body, was seen, but other markers, including neuron-specific enolase, vimentin, S-100 protein and leukocyte common antigen, were unrewarded.
Female ; Humans

An eccrine squamous syringometaplasia (ESS) is defined as a mature squamous metaplasia of the eccrine ducts. The clinical and pathological features of an ESS are presented. Syringometaplasia is a rare lesion, mostly occuring in the extremities, and as far as we know, no report on the ESS has been published in Korean literature. We experienced a case of an ESS occured in a 15 year-old male, who had a tender erythematous plaque in the right knee. The histologic examination revealed some scattered nests of metaplastic squamous epithelium in the deep dermis, associated with acute nonspecific panniculitis. The importance of the ESS is that it histologically simulates the well differentiated squamous cell carcinoma. The histopathologic findings were discussed and a brief review of the literature was made.
Adolescent ; Carcinoma, Squamous Cell ; Dermis ; Epithelium ; Extremities ; Humans ; Knee ; Male ; Metaplasia ; Panniculitis

PURPOSE: The purpose of this study was to identify family resiliency, ADL in elders with dementia, and symptom for families with an elder with dementia. METHOD: The participants were 102 people who were caregivers to elders with dementia and who visited the out-patient department at S. hospital for follow up care. Data were collected from August to October 2003 using a questionnaire. The collected data were analyzed using descriptive statistics and t-test aided by the SPSS/PC. RESULT: Family resiliency for the whole sample was within normal limits but when the sample was quarter-divided by good and poor family resiliency, based on established cut-off scores, there were differences for some characteristics according to good/poor family resiliency. These differences were for perceived health state of caregivers (t=-2.78, p=.008), economic state of family (t=-3.34, p=.002), and ADL (t=-2.56, p=.014). CONCLUSION: Future research should focus on the way in which family resiliency can be enhanced and on the effects of interventions for those caregivers who report poor family resiliency.
Activities of Daily Living* ; Caregivers ; Dementia* ; Follow-Up Studies ; Humans ; Outpatients ; Surveys and Questionnaires

Purpose: The purpose of this study was to examine the effects of a mobile application on quality of life, wellness, and preventive behaviors against dementia among older adults who use senior citizen centers. Methods: Seventy-two older adults who used senior citizen centers were allocated to an intervention group (n=36) and a control group (n=36). The experimental treatment involved a cognitive enhancement program for preventing dementia using a mobile application for 12 sessions over 6 weeks. Data were analyzed using the t-test, chi-square test, Fisher’s exact test, paired t-test, and independent t-test. Results: The cognitive enhancement program based on a mobile application was effective for wellness (t = -3.87, p < .001) and preventive behaviors against dementia (t = -3.98, p < .001) for older adults who used a senior center. Conclusion The mobile application-based cognitive enhancement program developed in this study is recommended as an effective intervention for dementia prevention in older adults.

PURPOSE: The present study purposed to investigate and analyze domestic websites providing information about dementia and to suggest future directions for the development of dementia-related websites. METHOD: For this purpose, the researcher selected 13 domestic websites that were available in November and December 2004, and evaluated them in terms of construction, operation, accessibility and contents on a scale 4 point (0~3). RESULT: The construction of dementia-related websites got 6~13 out of 18 points, which suggests that management policies for the operation of dementia-related websites are inadequate. The operation of dementia-related websites got 7~15 out of 24 points. In particular, all 13 sites got a low score in the aspect of continuance. With regard to accessibility, the sites were evaluated on how easily users could access the sites and they got 2~8 out of 15 points. In evaluating contents, the sites got 9~18 out of 21 points with regard to the purpose and appropriateness of the contents. CONCLUSION: This shows that most sites did not provide diverse types of dementia-related information. Because it is highly advantageous to perform primary dementia-preventing management through websites, this study proposes to develop a website evaluation system in order to provide high quality dementia-related informatio.
Korea ; *Internet ; Humans ; *Dementia

We evaluated the frequency of genetic alteration of chromosome 3p in lung cancer, and analyzed the patterns of genetic alterations between two distinct histologic types, squamous cell carcinomas (SCC) and adenocarcinomas (AC). PCR-LOH analysis for 40 Korean non-small cell lung cancer including 20 SCC and 20 AC was performed using microsatellite markers, D3S1300, D3S1029 and D3S1038. These markers represented the loci of FHIT gene (3p14), mismatch repair gene hMLH1 (3p21) and VHL gene (3p25), respectively. For SCC, the frequency of LOH at D3S1300, D3S1029 and D3S1038 was 78.6%, 61.5% and 64.3%, and for AC, was 62.5%, 62.5% and 46.7%, and for total 40 cases of SCC and AC, was 70.0%, 62.1% and 55.2%, respectively. Among 27 cases showing heterozygosity at three examined loci, 7 cases (25.9%) revealed LOH at only one locus and 16 cases (59.3%) revealed LOH at two or three loci. The differences of incidence of LOH and the patterns of genetic alterations at chromosome 3p between two distinct histologic types of lung cancer were not significant. The genetic deletion of relatively broad area, including more than two loci, was more frequent than that of small area, including only one locus.
Adenocarcinoma* ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell* ; DNA Mismatch Repair ; Incidence ; Loss of Heterozygosity* ; Lung Neoplasms ; Lung* ; Microsatellite Repeats

PURPOSE: To investigate the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and Ureaplasma urealyticum (UU) in first-voided urine samples and to determine the factors associated with positivity for sexually transmissible microorganisms in healthy, middle-aged Korean men. MATERIALS AND METHODS: Five hundred fifty-one men who came to the hospital for a general prostate health checkup were tested between August 2011 and December 2011. PCR assays for CT, NG, MG, and UU were done with first-voided urine samples and the prevalence of microorganism positivity and association with several clinical parameters were evaluated. RESULTS: The mean age of the men studied was 50.8+/-4.7 years. Among the 551 men, 72 (13.1%) had a positive result for at least one microorganism; one (0.2%) had two different species. The overall prevalence of asymptomatic sexually transmitted infections was 11.1% (61/551). The prevalence rates of CT, NG, MG, and UU infection in the general population were 0.4% (2/551), 0.0% (0/551), 1.0% (6/551), and 11.8% (65/551), respectively. CT-positive patients had a lower mean age than did CT-negative patients. There were no significant differences in symptoms by positivity of each microorganism. CONCLUSIONS: We checked the prevalence rates of four microorganisms, the proportion of symptomatic people, and the association of microbes, age, and symptoms, as the baseline data for Korean middle-aged men. In this population, CT, NG, MG, and UU infections do not seem to be symptomatic. However, the potential role of CT in young men and of UU in middle-aged men with a high rate of detection should be studied continuously as a source of opportunistic infection.
Chlamydia ; Chlamydia trachomatis ; Humans ; Korea ; Male ; Mycoplasma genitalium ; Neisseria gonorrhoeae ; Opportunistic Infections ; Polymerase Chain Reaction ; Porphyrins ; Prevalence ; Prostate ; Ureaplasma ; Ureaplasma urealyticum

OBJECTIVES: The purpose of this study is to find out how the Mental Health Act(MHA) which was enacted in 1995 has been practiced in reality since it was enforced. This study focuses on the following provisions of this law; admission procedures in relation to the protection of patients' rights, discharge procedures in view of the human rights, and the conditions of the restriction of the patients' rights in hospital. METHODS: The questionnaire on "the current state of the application of the MHA" was designed by the authors and was distributed by mail to 213 psychiatric hospitals and general hospitals which operate psychiatric closed wards as of 1999. RESULTS: One hundred ten hospitals responded to the survey(51.6%) and 92.5% of the total admission to the closed ward were by 'admission by agreement of guardian'(article 24 of MHA). It was reported that a written agreement paper of guardian was filed in 98% and the official document(for the article 14 of rule for enforcement of MHA) for legal guardianship was filed in 85 % of these ad-missions respectively. However, the rate of filling the official document is actually below 85% accor-ding to the direct telephone confirmation. Other kind of admissions such as 'admission by the order of head of prefecture(article 25 of MHA) and 'emergency admission'(article 26 of MHA) were not performed except in several psychiatric hospitals. There cases no report regarding the patient's or guardian's appeal for the improvement of patient's right and better treatment and/or disagreement to involuntary admission. Sixty three percent of hospitals reported that the patients were free to use telephone, and 18.1% reported that the official forms to appeal human right violation of the institute were accessible to patients. However, the actual rates are suspected to be lower than the reports by the institutes. Petition for extension of hospital stay requested by the doctor in charge(article 24-3 of MHA) was submitted mostly by psychiatric hospitals, and its rejection rate was 3.7%. CONCLUSION: In case of 'admissions by agreement of guardian', the required qualification for guardianship and the accompanying document to prove the legal guardianship should be amended to make it more realistic. For other kinds of admissions, such as 'emergency admission' and 'admission by order of head of prefecture', admission procedure should be modified to make it more efficient and practical. The rules and regulations for the human rights of psychiatric patients are not observed properly, which needs much improvement. As this study was done by a survey, it has limitation in understanding how the MHA is actually applied and therefore msufficient as data for the use of revising the Act. However, it appears that MHA is not properly observed with problems in applying MHA in practice. The information obtained from this study suggests that extensive study on national level should be done to find out how the MHA is practiced in reality with much discussion on improving the MHA on the basis of its finding.
Academies and Institutes ; Head ; Hospitals, General ; Hospitals, Psychiatric ; Human Rights ; Humans ; Jurisprudence ; Length of Stay ; Mental Health* ; Patient Rights ; Postal Service ; Surveys and Questionnaires ; Social Control, Formal ; Telephone

The kidney and balances of fluid and volume are the basic components of bloocl pressure control, and the kidney is the primary site that initiates the hypertensive process and is affected by hypertensive vascular disease. In the kidney, the dopamine is a potent natriuretic and vasodilating agent, participat- ing in renal sodium excretion and maintenance of cardiovascular homeostasis. And the dopamine receptors in central nervous system and peripheral organs were identified by physiological, biochernical and radioligand binding techniques. Rut previous morphological and biochemical studies have been unable to characterize or determine the tissue distribution of the dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. In the SHR, the ability of exogenous and endogenous renal dopamine to engender a natriuresis is impaired. Since renal dopamine levels in genetic models of hypertension are not lower than their normotensive controls, the impaired intrarenal paracrine effect of dopamine in these animal models of hypertension appears to be receptor or postreceptor mediated. And renal dopamine derives mainly from renal tubular dopamine production and to a lesser extent from dopaminergic nerves. The present study utilizes imrnunohistochemistry with specific antibodies to characterize the renal distribution of dopamine receptor subtypes and recognize the role of dopamine receptor defect in the pathogenesis of hypertension in 14-week-old WKY (mean HP 108+/-5mmHg) and SHR (mean RP 174+/-7 mmHg) kidneys. Also it utilizes antibody of tyrosine hyclroxylase (TH) to recognize the site of the dopamine production mediated by TH using light microscopic immunohistochemistry. In the immunohistochemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proximal tubule, distal tubule, renal vessels, cortical and medullary collecting duct. And in the SHR kidney, dopamine D1 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and juxtaglomerular apparatus (JGA). But there is no demonstrable positive reaction in the proximal tubule and weakly positive reactions in the renal arterioles of SHR compared with WKY kidney. In the immunohisto-chemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proxirnal tubule, distal tubule, renal vessels, cortical and rnedullary collecting duct. And in the SHR kidney, dopamine D2 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and JGA. So, there is no demonstrable positive reaction in the proximal tubule of SHR compared with WKY. In the glomerulus of the WKY and SHR kidneys, both dopamine D1 and D2 receptors are localized. In the in situ hybridization of the WKY and SHR kidneys, dopamine D and D receptors are only demonstrated at the renal vessels. The positive reaction to TH immunohistochemistry of the WKY and SHR kidneys is only observed in the renal medulla compared with negative reaction on the renal cortex. Considering the excretion of sodium up to 65-70% with volume expansion may be mediated by dopamine D1-like receptors in the proximal tubule, our immunohistochemistry findings for the dopamine receptors may support the failure of natriuretic response in the SHR due to an abnormal dopamine receptor. Also our results rnay mean that the glornerular filtration rate is mediated by both dopamine D1 and Dz receptors comparing with the previous studies that the glomerular filtration rate was mediated by dopamine D2 receptor. I'here are some differences in the receptors expressing sites on the previous radioligand binding and pharmacologic studies, but our results suggest that at least some of the renal dopamine DA and DAz receptors correspond structurally to the central dopamine D1 and D2 receptors. Finally the result of TH immunohisto-chemistry suggests that the production of dopamine in the proximal tubule is not mediated by TH.
Animals ; Antibodies ; Arterioles ; Central Nervous System ; Dopamine* ; Filtration ; Glomerular Filtration Rate ; Homeostasis ; Hypertension ; Immunohistochemistry* ; In Situ Hybridization ; Juxtaglomerular Apparatus ; Kidney* ; Ligands ; Models, Animal ; Models, Genetic ; Natriuresis ; Rats* ; Rats, Inbred SHR* ; Receptors, Dopamine ; Receptors, Dopamine D1 ; Receptors, Dopamine D2 ; Sodium ; Tissue Distribution ; Tyrosine ; Vascular Diseases