Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm that occurs mainly in the soft tissues of head and neck region, with the paranasal sinuses, nasal cavity and nasopharynx being the most common sites. Solitary EMP of the larynx is very rare but increasingly reported recently. Common sites of involvement in larynx in the order of frequency are the epiglottis, ventricles, vocal folds and ventricular folds. We report an extremely rare case of solitary EMP involving in the apex of arytenoids that was successfully treated by only surgical excision. Because solitary EMP of the apex of artytenoids is extremely rare, it should be included in the differential diagnosis for laryngeal mass. Also, solitary, small, pedunculated and localized EMP of the larynx could be completely removed by laryngeal microsurgery.
Diagnosis, Differential ; Epiglottis ; Head ; Larynx ; Microsurgery ; Nasal Cavity ; Nasopharynx ; Neck ; Neoplasms, Plasma Cell ; Paranasal Sinuses ; Plasmacytoma ; Vocal Cords

Objectives: The purpose of this study was to identify whether stress experienced by those working in the local civil service was related to their oral health during the COVID-19 pandemic. Methods: A survey was conducted on 431 civil servants from eight districts, currently working in the Daegu City Hall had COVID-19 related work duties during the pandemic. Results: Several factors associated with oral health related quality of life were explored. Demographic details revealed that men had significantly better oral health related life quality as compared to women; further, being younger, being unmarried, and having a lower position had better outcomes for oral health related quality of life. Regarding the relationship between oral health behavior and oral health related quality of life, it was found that the better the subjective oral health, the higher the rate of not visiting the dentist in the past year. The COVID-19 pandemic has been a particularly important time to explore in order to understand how the stress experienced by local government officials is related to their oral health. It has been especially noted that the higher the work stress, the worse the oral health related quality of life amongst individuals. Conclusions Results of this study emphasize that at a time when fatigue among civil servants is increasing due to the prolonged COVID-19 pandemic, oral conditions caused by stress should be identified and greater awareness should be created about oral health care.

Objective: Regional control is occasionally unsatisfactory in cervical cancer, with the optimal radiation dose for nodal metastases in definitive radiotherapy (RT) with concurrent chemotherapy (CRT) remaining controversial. We investigated dose-response relationship for nodal local control in cervical cancer. Methods: We identified 115 patients with 417 metastatic nodes who received definitive CRT for cervical cancer with nodal metastases. External beam radiation therapy and brachytherapy plans were summated to determine total dose received by each node. Prognostic factors of nodal control and dose-response relationship were investigated using Cox-regression and restricted cubic spline function. Results: The 2-year progression-free survival rate was 69.4%. Among 43 patients with failures, 17 patients (37.5%) had regional failure included in first failure sites of which all except one were in-field only regional failures. Total 30 nodes showed recurrence at initial metastatic site after treatment. Neutrophil-to-lymphocyte ratio (NLR) ≥3.1, total radiation dose (minimum dose received by 98% of the target volume in equivalent dose in 2 Gy per fractions), and initial nodal volume ≥5.29 mL were poor prognostic factors (all p<0.050) of nodal local control. Restricted cubic spline functions revealed strongest dose-response relationship in high NLR (NLR ≥3.1) and initial nodal volume ≥5.29 mL subgroup. Conclusion Initial nodal volume, radiation dose, and NLR were significant factors of nodal local control in cervical cancer; a stronger dose-response relationship was seen in bulky nodes with high NLR. Clinicians may consider these factors when determining the RT dose and the need for boost to nodal metastases in cervical cancer.

Objectives: Children and adolescents have a high prevalence of dental caries, primarily due to negligent oral care, frequent snack intake, and inadequate attention to oral disease prevention.Therefore, ensuring oral care and preventing dental caries during this period is essential. Economic barriers, particularly in low- and middle-income countries like the Philippines, limit access to dental care, highlighting the need for national oral health programs. Methods: This study aimed to investigate the oral health status of children in selected areas of the Philippines and to generate basic data for effective oral health promotion programs. We compared the oral health statuses of enrolled and newly enrolled students in schools with school-based dental clinics. Results: The results indicated that the prevalence of caries and the average number of carious permanent teeth were lower in enrolled students than in new students. Conclusions This finding suggests that school-based oral healthcare programs effectively improve children’s oral health and that introducing school-based dental clinics and establishing efficient systems are essential for improving oral health in low- and middle-income countries.

Objectives: Children and adolescents have a high prevalence of dental caries, primarily due to negligent oral care, frequent snack intake, and inadequate attention to oral disease prevention.Therefore, ensuring oral care and preventing dental caries during this period is essential. Economic barriers, particularly in low- and middle-income countries like the Philippines, limit access to dental care, highlighting the need for national oral health programs. Methods: This study aimed to investigate the oral health status of children in selected areas of the Philippines and to generate basic data for effective oral health promotion programs. We compared the oral health statuses of enrolled and newly enrolled students in schools with school-based dental clinics. Results: The results indicated that the prevalence of caries and the average number of carious permanent teeth were lower in enrolled students than in new students. Conclusions This finding suggests that school-based oral healthcare programs effectively improve children’s oral health and that introducing school-based dental clinics and establishing efficient systems are essential for improving oral health in low- and middle-income countries.

Objectives: Children and adolescents have a high prevalence of dental caries, primarily due to negligent oral care, frequent snack intake, and inadequate attention to oral disease prevention.Therefore, ensuring oral care and preventing dental caries during this period is essential. Economic barriers, particularly in low- and middle-income countries like the Philippines, limit access to dental care, highlighting the need for national oral health programs. Methods: This study aimed to investigate the oral health status of children in selected areas of the Philippines and to generate basic data for effective oral health promotion programs. We compared the oral health statuses of enrolled and newly enrolled students in schools with school-based dental clinics. Results: The results indicated that the prevalence of caries and the average number of carious permanent teeth were lower in enrolled students than in new students. Conclusions This finding suggests that school-based oral healthcare programs effectively improve children’s oral health and that introducing school-based dental clinics and establishing efficient systems are essential for improving oral health in low- and middle-income countries.

Objectives: Children and adolescents have a high prevalence of dental caries, primarily due to negligent oral care, frequent snack intake, and inadequate attention to oral disease prevention.Therefore, ensuring oral care and preventing dental caries during this period is essential. Economic barriers, particularly in low- and middle-income countries like the Philippines, limit access to dental care, highlighting the need for national oral health programs. Methods: This study aimed to investigate the oral health status of children in selected areas of the Philippines and to generate basic data for effective oral health promotion programs. We compared the oral health statuses of enrolled and newly enrolled students in schools with school-based dental clinics. Results: The results indicated that the prevalence of caries and the average number of carious permanent teeth were lower in enrolled students than in new students. Conclusions This finding suggests that school-based oral healthcare programs effectively improve children’s oral health and that introducing school-based dental clinics and establishing efficient systems are essential for improving oral health in low- and middle-income countries.

The aim of the present study is to verify the functional and anatomical neural pathways which innervate the urinary bladder in the central nervous system of the rat. To identify the functional neural pathway, the urinary bladder was stimulated by infusing formalin for 2 h. Then, brain and spinal cord were dissected out and immunohistochemistry was done by using anti-c-fos antibody. Many c-fos immunoreactive (IR) neurons were identified in the telencephalic cortical areas and in several brainstem nuclei, which are known mostly to be related with urinary bladder. In the spinal cord, a number of c-fos IR neurons were found in the lamina I, IIo, dorsal gray commissure, sacral parasympathetic nucleus. To identify the anatomical neural pathway of the urinary bladder, Pseudorabies virus (PRV) was injected into the wall of urinary bladder and was identified with anti-PRV by using immunohistochemistry. Most PRV labeled neurons were found where c-fos IR neurons were identified and few of them were also in the areas where c-fos IR neurons were not found, e.g., prefrontal cortex, agranular insular cortex, and subfornical organ. In the spinal cord, PRV labeled cells were found all over the gray matter. The present study presents morphological evidence demonstrating the supraspinal areas are related with the neural control of the urinary bladder and most functional neural pathway of the urinary bladder is well consistent with the anatomical neural pathway except in some telencephalic cortical areas.
Animal ; Bladder/innervation* ; Central Nervous System/anatomy & histology* ; Female ; Herpesvirus 1, Suid/isolation & purification* ; Immunohistochemistry ; Neural Pathways/anatomy & histology ; Proto-Oncogene Proteins c-fos/analysis* ; Rats ; Rats, Sprague-Dawley

PURPOSE: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. RESULTS: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. CONCLUSION: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.
Brachytherapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Electrons ; Follow-Up Studies ; Glycolysis ; Gynecology ; Humans ; Hysterectomy ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Obstetrics ; Pelvis ; Positron-Emission Tomography and Computed Tomography ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; ROC Curve ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. RESULTS: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. CONCLUSION: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.
Brachytherapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Electrons ; Follow-Up Studies ; Glycolysis ; Gynecology ; Humans ; Hysterectomy ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Obstetrics ; Pelvis ; Positron-Emission Tomography and Computed Tomography ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; ROC Curve ; Uterine Cervical Neoplasms*