Subcutaneous cervicofacial and mediastinal emphysema (SCFME) occur with a variety of disease processes. Most cases involve a passive escape of air from the aerodigestive tract into subcutaneous tissues. Even if the presence of SCFME is not in itself dangerous, prompt recognition of the underlying etiology is essential. Catheterization is a common procedure in the otolaryngologic field, but, clinically, SCFME after catheterization is very rare. Recently, we experienced a case of SCFME after catheterization, so we report this rare case with a review of literatures.
Catheterization* ; Catheters* ; Mediastinal Emphysema* ; Subcutaneous Tissue ; United Nations

The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin, Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p > 0.05). There was also no significant difference between the groups with or without mechanical retention (p > 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.
Adhesives ; Adult ; Bicuspid ; Follow-Up Studies ; Germany ; Gyeonggi-do ; Humans ; Korea ; Prospective Studies* ; Public Health ; Tooth ; United States Public Health Service

Multiple myeloma (MM) is a systemic manifestation of plasma cell tumor. It shows anemia, bone pain and some pathologic fracture. MM is a relatively well known disease, but temporal bone involvement is very rare. In 1979, Lavine first reported the temporal bone involvement in MM. Since then, only a few cases of temporal involvement in MM were reported in literature. In Korea, temporal bone involvement in MM has not been reported yet. It is very difficult to diagnose MM of temporal bone in the early stage, since it presents general, nonspecific otologic symptoms and it is difficult to carry out pathological confirmation in the temporal bone. In most of reported cases, patients are already diagnosed with MM. when they are presented with MM of temporal bone. If MM is found in the temporal area, it is considered to be in the terminal stage of disease, but treatment for it is the same as that for the usual MM. We experienced a case with intractable otalgia and suddenly developed facial palsy, which was later confirmed to be a MM after a pathologic review and a systemic evaluation. We report this rare case with a review of literatures.
Anemia ; Earache ; Facial Paralysis ; Fractures, Spontaneous ; Humans ; Korea ; Multiple Myeloma* ; Plasmacytoma ; Temporal Bone*

Synovial sarcomas are malignant soft tissue neoplasms that develop from tendon and bursa near the large joints and frequently occur in the lower extremities of young male adults. They usually recur within 2 years after surgical treatment. The lung is a common metastatic site and rarely reported as the primary site of synovial sarcoma. The stomach is a very rare primary site of synovial sarcoma and recently only two cases of primary gastric synovial sarcoma were reported. We report a case of metastatic gastric synovial sarcoma in a 53-year-old male 4 years after surgical treatment of primary lung synovial sarcoma. The tumor had histologic, immunohistochemical and ultrastructural features of biphasic synovial sarcoma of the soft tissue.
Adult ; Humans ; Joints ; Lower Extremity ; Lung ; Male ; Middle Aged ; Sarcoma, Synovial* ; Soft Tissue Neoplasms ; Stomach ; Tendons

PURPOSE OF STUDY: Peripheral nerve regeneration depends on neurotrophism of distal nerve stump, recovery potential of neuron, supporting cell like Schwann cell and neurotrophic factors such as BDNF. Peripheral nerve regeneration can be enhanced by the conduit which connects the both sides of transected nerve. The conduit maintains the effects of neurotrophism and BDNF produced by Schwann cells which can be made by gene therapy. In this study, we tried to enhance the peripheral nerve regeneration by using calcium phosphate coated porous conduit and BDNF-Adenovirus infected Schwann cells in sciatic nerve of rats. MATERIALS AND METHODS: Microporous filter which permits the tissue fluid essential for nerve regeneration and does not permit infiltration of fibroblasts, was made into 2mm diameter and 17mm length conduit. Then it was coated with calcium phosphate to improve the Schwann cell adhesion and survival. The coated filter was evaluated by SEM examination and MTT assay. For effective allogenic Schwann cell culture, dorsal root ganglia of 1-day old rat were extracted and treated with enzyme and antimitotic Ara-C. Human BDNF cDNA was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into adenovirus shuttle vector pAACCMVpARS in which E1 was deleted. We infected the BDNF-Ad into 293 human mammary kidney cell-line and obtained the virus plaque 2 days later. RT-PCR was performed to evaluate the secretion of BDNF in infected Schwann cells. To determine the most optimal m.o.i of BDNF-Ad, we infected the Schwann cells with LacZ adenovirus in 1, 20, 50, 75, 100, 250 m.o.i for 2 hours and stained with beta-galactosidase. Rats(n=24) weighing around 300g were used. Total 14mm sciatic nerve defect was made and connected with calcium phosphate coated conduits. Schwann cells(1x10(6)) or BDNF-Ad infected Schwann cells(1x10(6)) were injected in conduit and only media(MEM) was injected in control group. Twelve weeks after surgery, degree of nerve regeneration was evaluated with gait analysis, electrophysiologic measurements and histomorphometric analysis. RESULTS: 1. Microporous Millipore filter was effective conduit which permitted the adhesion of Schwann cells and inhibited the adhesion of fibroblast. We could enhance the Schwann cell adhesion and survival by coating Millipore filter with calcium phosphate. 2. Schwann cell culture technique using repeated treatment of Ara-C and GDNF was established. The mean number of Schwann cells obtained 1 and 2 weeks after the culture were 1.54+/-4.0*10(6) and 9.66+/-9.6*10(6). 3. The mRNA of BDNF in BDNF-Ad infected Schwann cells was detected using RT-PCR. In Schwann cell 0.69 microgram/microliter of DNA was detected and in BDNF-Adenovirus transfected Schwann cell 0.795 microgram/microliter of DNA was detected. The most effective infection concentration was determined by LacZ Adenovirus and 75 m.o.i was found the most optimal. CONCLUSION: BDNF-Ad transfected Schwann cells successfully regenerated the 14mm nerve gap which was connected with calcium phosphate coated Millipore filter. The BDNF-Ad group showed better results compared with Schwann cells only group and control group in aspect to sciatic function index, electrophysiologic measurements and histomorphometric analysis.
Adenoviridae ; Animals ; beta-Galactosidase ; Brain-Derived Neurotrophic Factor* ; Calcium* ; Cell Adhesion ; Cell Culture Techniques ; Cytarabine ; DNA ; DNA, Complementary ; Fibroblasts ; Gait ; Ganglia, Spinal ; Gene Library ; Genetic Therapy ; Genetic Vectors ; Glial Cell Line-Derived Neurotrophic Factor ; Humans ; Kidney ; Micropore Filters ; Nerve Growth Factors ; Nerve Regeneration ; Neurons ; Peripheral Nerves ; Polymerase Chain Reaction ; Rats* ; Regeneration* ; RNA, Messenger ; Schwann Cells ; Sciatic Nerve*

Cicatrical pemphigoid is regarded as a chronic, autoimmune subepithelial blistering disease of mucous membranes in which lesions often heal with scar formation. Cicatrical pemphigoid typically involves the oral and/or ocular mucosa but may affect the nasal, pharyngeal, laryngeal, esophageal, anogenital regions as well. Immunopathologic studies have shown that patients with cicatrical pemphigoid typically have autoantibodies directed against basement membrane antigens and that they demonstrate continuous deposits of immunoglobulins (IgG, A), complement components and fibrin along the basement membrane. A 69-year-old female was admitted with chief complaints of hoarseness, dyspnea, multiple painful oral ulcer and vesiculobullous skin lesion on upper trunk. During admission, dysphagia and epigastric discomfort was developed. Endoscopic examination revealed multiple erosion and ulcerative lesion with scar formation. Immunopathologic studies showed that linear deposit of IgG, A, C3 along the basement membrane zone. We report a case of cicatrical pemphigoid with esophageal involvement with brief review of literature.
Aged ; Autoantibodies ; Basement Membrane ; Blister ; Cicatrix ; Complement System Proteins ; Deglutition Disorders ; Dyspnea ; Esophagus ; Female ; Fibrin ; Hoarseness ; Humans ; Immunoglobulin G ; Immunoglobulins ; Mucous Membrane ; Oral Ulcer ; Pemphigoid, Bullous* ; Skin ; Ulcer

BACKGROUND/AIMS: Antispasmodic agents have been used in the management of irritable bowel syndrome. However, systematic reviews have come to different conclusions about the efficacy in irritable bowel syndrome. Fenoverine acts as a synchronizer of smooth muscle in modulating the intracellular influx of calcium. We compared fenoverine with trimebutine for the treatment of patients with IBS. METHODS: A multicenter, randomized, double-blind, non-inferiority clinical study was conducted to compared fenoverine with trimebutine. Subjects were randomized to receive either fenoverine (100 mg three times a day) or trimebutine (150 mg three times a day) for 8 weeks. A total of 197 patients were analyzed by the intention-to-treat approach. The primary endpoint was the proportion of patients who had 30% reduction in abdominal pain or discomfort measured by bowel symptom scale (BSS) score at week 8 compared to the baseline. The secondary endpoints were changes of abdominal bloating, diarrhea, constipation, overall and total scores of BSS, and overall satisfaction. RESULTS: At week 8, fenoverine was shown to be non-inferior to trimebutine (treatment difference, 1.76%; 90% CI, -10.30-13.82; p=0.81); 69.23% (54 of 78 patients) of patients taking fenoverine and 67.47% (56 of 83 patients) of patients taking trimebutine showed 30% reduction in abdominal pain or discomfort compared to the baseline. There results of the secondary endpoints were also comparable between the fenoverine group and the trimebutine group. CONCLUSIONS: Fenoverine is non-inferior to trimebutine for treating IBS in terms of both efficacy and tolerability.
Abdominal Pain/etiology ; Adult ; Constipation/etiology ; Diarrhea/etiology ; Double-Blind Method ; Drug Administration Schedule ; Female ; Humans ; Irritable Bowel Syndrome/complications/*drug therapy ; Male ; Middle Aged ; Parasympatholytics/*therapeutic use ; Phenothiazines/*therapeutic use ; Severity of Illness Index ; Treatment Outcome ; Trimebutine/*therapeutic use

PURPOSE: Chlormadinone acetate (CMA) therapy for benign prostatic hyperplasia (BPH) may lower the serum prostate specific antigen (PSA) level. However, little is known about the effect of CMA on the total or free serum PSA levels of PSA. Such information would be important since PSA testing is useful for prostate cancer screening. Thus, we prospectively studied the effect of CMA therapy on the total and free serum PSA levels. MATERIALS AND METHODS: The patients with lower urinary tract symptoms (LUTS) and BPH who were aged over 50 years were treated with 50mg CMA for 6 months. Men with a PSA level greater than 10ng/ml were excluded to reduce the likelihood of including cases of occult prostate cancer. Those with suspicious findings on the digital rectal examination and serum PSA testing were biopsied to rule out prostate cancer. alpha- blocking agents were permitted to treat the men with LUTS. Serum levels of the total and free PSA were measured at the study baseline and after approximately 3 and 6 months. The prostate volume (PV) was assessed by transrectal ultrasonography. RESULTS: The analysis included 170 patients with a mean age of 67.9 years, a baseline PV of 47.3ml and a baseline total PSA of 4.1ng/ml. The total PSA levels declined from 4.1ng/ml at baseline to 2.0ng/ml after 6 months of treatment (50.7% decrease, p<0.01). The mean percent free PSA (21% to 22% at baseline) was not significantly altered by CMA treatment. The PSA levels and PV at baseline did not affect the rate of decline of PSA. CONCLUSIONS: The total PSA serum levels decreased by an average of 50% during CMA therapy, but the percent free PSA did not change significantly. This information is potentially useful in the interpretation of the PSA data that's used for early detection of prostate cancer in the men receiving CMA.
Chlormadinone Acetate* ; Digital Rectal Examination ; Humans ; Lower Urinary Tract Symptoms ; Male ; Mass Screening ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Ultrasonography

OBJECTIVE: Atopic dermatitis is a chronically relapsing inflammatory skin disease. However, little is known about the prevalence of atopic dermatitis outside of North America and Europe. We evaluated the nationwide prevalence of atopic dermatitis with the comparison of prevalence between 1995 and 2000, and between Seoul and provincial cities in Korea. We also evaluated the risk factors for atopic dermatitis. METHODS: A cross-sectional ISAAC based questionnaire survey was conducted on random samples of schoolchildren (6 to 15 year olds) in 1995 and 2000. And kindergarten children (5 year olds) were surveyed in 2003, throughout South Korea. RESULTS: The lifetime and last twelve months prevalence of atopic dermatitis in Korean school-aged children was increased from 1995 to 2000. The twelve-month prevalence of atopic dermatitis was higher in Seoul than in other provincial cities in 1995, but the prevalence of atopic dermatitis in Seoul and Provincial Centers became similar in 2000. CONCLUSION: The prevalence of atopic dermatitis in Korean school-aged children was increased from 1995 to 2000. The further evaluations that include objective examination are necessary to confirm these outcomes because the environmental and risk factors may be different among the countries according to their life styles.
Child* ; Dermatitis, Atopic* ; Epidemiology ; Europe ; Humans ; Korea* ; Life Style ; North America ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Seoul ; Skin Diseases