Three cases of angiosarcoma of the breast are described. One case in a 66 year old woman was a solid mass and histologically showed poor differentiation leading to a death 14 months after the diagnosis. Another two in 46 and 25 year old females were large vascular masses showing moderate differentiation with endothelial tufting and papillary projections, and abdominal and contralateral mammary, and liver metastasis occurred within postoperative 10 months and 6 months in each case. A radical mastectomy and adjuvant chemotherapy in case 2 were not lifesaving. Although histologic degree of differentiation seems prognosis-related, angiosarcoma is the most malignant tumor of the breast.
Female ; Humans ; Neoplasm Metastasis

The infrapatellar fat pad (IPFP) is one of three fat pads located about the anterior knee. Injury in this region is relatively common. Damage to the IPFP is caused mostly by an iatrogenic injury from a surgical procedure or repeated small collision trauma. The authors experienced a case of an IPFP injury, that has not been reported in the domestic or international literature. In this case, acute IPFP separation followed by a contusion at the anterior aspect of knee in the kneeling position, confirmed using magnetic resonance imaging. The patient was fully recovered with conservative treatment.

BACKGROUND AND OBJECTIVES: Since chronic E-tube dysfunction is believed to play an important role in the development of otitis media, it is necessary to evaluate the function of the E-tube clinically. Recently, the endoscopic techniques have been used more frequently to directly inspect the E-tube orifice. In this study, I evaluated the morphologic and dynamic motion of the E-tube orifice with 4 mm 30 degrees videoendoscope and compared with the other existing tests of the E-tube function. SUBJECTS AND METHOD: 101 E-tubes with chronic otitis media were selected. I performed the transnasal 4 mm 30 degrees videoendoscopic examination of the pharyngeal E-tube orifice when patients were swallowing, and classified morphologic and dynamic findings of the E-tube orifice into three categories as follows: Type A, the E-tube is opened widely on swallowing with normal mucosa (normal); Type B, the E-tube is not opened with normal mucosa (functional blockage) and Type C, the E-tube is not opened with pathologic mucosa (mechanical blockage). Throughout the study, the control group was 60 E-tubes that were free of ear pathologies. RESULTS: There were more type As in the control group than in the otitis media group according to videoendoscopic findings of the E-tube orifice. The videoendoscopic analysis of the E-tube orifice had a close correlations with the results of inflation deflation test and with the classification of otitis media, but had no significant relationship with the degree of mastoid pneumatization. CONCLUSION: The morphologic and dynamic examination of the E-tube orifice with videoendoscopic techniques may be an important and useful method to examine the tubal function as well as its dysfunction.
Classification ; Deglutition ; Ear ; Endoscopy ; Eustachian Tube* ; Humans ; Inflation, Economic ; Mastoid ; Mucous Membrane ; Otitis Media ; Pathology

Glucocorticoids (GCs) are the most effective group of medications available to treat inflammation. Although most patients with inflammation respond to GC, a small group of patients exhibit persistent GC-resistance with prolonged inflammation. Previously, it was proposed that the GC-resistance is caused by low amount of human GC receptor (hGR alpha) and/or excessive presence of a GC receptor isoform, hGR beta that was generated from alternative splicing of the hGR message. We have tested this hypothesis by investigating correlation between the expression pattern of hGR mRNAs in patients with inflammatory nasal polyps and the effectiveness of GC treatment.? We have performed reverse transcription PCR analysis of mRNAs coding each hGR alpha and hGR beta in nasal tissues.? hGR alpha mRNA was more expressed in patients with nasal polyps than in normal subjects. However, the elevated hGR alpha mRNA expression was decreased after GC treatment. Compared with hGR alpha mRNA expression, level of hGR beta mRNA expression was very low in all groups. In patients, hGR beta mRNA was expressed at a similar level regardless of GC efficacy, indicating that there is no correlation between the GC sensitivity and the expression level of hGR beta mRNA. Thus, persistent GC-resistance is not associated with low expression of hGRa or over- expression of hGR beta.
Treatment Failure ; Reverse Transcriptase Polymerase Chain Reaction ; Receptors, Glucocorticoid/*metabolism ; RNA, Messenger/metabolism ; Nasal Polyps/drug therapy/*metabolism/surgery ; Middle Aged ; Male ; Humans ; Glucocorticoids/*pharmacology/therapeutic use ; Gene Expression ; Female ; *Drug Resistance ; Child ; Aged ; Adult ; Adolescent

OBJECTIVES: This study is intended to evaluate the effects of promotion of periodontal health in the elderly, through professional toothbrushing and education on the use of the interdental brush, using the Gingival Bleeding Index and the Patient Hygiene Performance Index (PHP index). METHODS: The study was conducted on 87 participants, who had given the informed consent to participate in the study at a general hospital 'B' in Busan from June to August, 2011. After assessing the general health condition and the medical history of the participants, the Watanabe toothbrushing method was used for professional toothbrushing on four different visits, along with imparting of education on the use of the interdental brush for self-management. The periodontal health of the participants was assessed based on the extent of gingival bleeding, by using the Gingival Bleeding Index, and the degree of plaque accumulation, by using the Patient Hygiene Performance Index. The data thus obtained was analyzed using Statistical Analysis Systems (SAS) (ver 9.13), followed by frequency analysis, analysis of variance (ANOVA), and the mixed effect model. RESULTS: The average gingival bleeding index was 1.65 at the commencement of the study and 1.25, 0.88, and 0.65, after the first, second and third trial, respectively. The PHP index of dental plaque was 2.90 prior to commencement of the study, 2.79, 2.77, and 2.76 after the first, second, and third trials, respectively, thus significantly improving with every successive visit. Gingival bleeding index and PHP index significantly reduced with every visit, regardless of age, smoking habits, or systemic chronic diseases such as diabetes, hypertension, central nervous system or cardiovascular diseases. CONCLUSIONS: Education on the use of the interdental brush and professional tooth brushing promotes periodontal health, regardless of the chronic diseases seen in the elderly. Education on self-management of oral health, along with professional care at regular intervals should be recommended to effectively maintain periodontal health in the elderly.
Aged ; Central Nervous System ; Chronic Disease ; Dental Plaque ; Hemorrhage ; Hospitals, General ; Humans ; Hygiene ; Hypertension ; Informed Consent ; Oral Health ; Self Care ; Smoke ; Smoking ; Tooth ; Toothbrushing

PURPOSE: This study is designed to evaluate the current situation of interhospital transports of critical ill patients requiring emergency care. METHODS: Using a clinical prospective 162 interhospital transports of ill patients by ambulance were evaluated in 2 hospitals. Patients were divided into severe & mild to moderate group by modified-ESI. We evaluated the state of patients, vital sign, monitoring of patient's state, hospitalization or transportation. Data were collected by mean of comprehensive form filled by a physician at the receiving hospital. RESULTS: The receiving hospital were notified prior to the transport in 57.4%. Pretransport information about the patients were adequate in 75% and no data in 9.9%. In 10.4% of the transports, the patients arrived at the receiving hospital in an agonized state. In 80.8% of the transports admitted and 7.4% of the patients were transfer to the other hospital. CONCLUSION: It appears that there are no established guidelines for the emergency transport of critical ill patients in Korea.
Ambulances ; Emergencies ; Emergency Medical Services ; Felodipine ; Hospitalization ; Humans ; Korea ; Patient Transfer ; Prospective Studies ; Transportation ; Vital Signs

The ameloblastic carcinoma is an extremely rare, aggressive odontogenic neoplasm of the jaws. It is described as an ameloblastoma in which there is histologic evidence of malignancy in the primary or recurrent tumors, regardless of whether it has metastasized. We report an aggressive case of ameloblastic carcinoma of the mandible. A 68-year-old man with the complaint of the left facial swelling and intermittent pain was referred to our hospital. Serial images of panoramic radiograph, computed tomograph, and magnetic resonance imaging showed an ill-defined destructive radiolucent lesion of the left mandible. The lesion had typically aggressive behavior with extensive local destruction of bone and extended to the adjacent soft tissues. Bone scan revealed increased uptakes in the left mandibular body and ramus regions. Histological features were generally resembled with those of an ameloblastoma but with cytologic features of epithelial malignancy.
Aged ; Ameloblastoma ; Ameloblasts* ; Humans ; Jaw ; Magnetic Resonance Imaging ; Mandible*

The ameloblastic carcinoma is an extremely rare, aggressive odontogenic neoplasm of the jaws. It is described as an ameloblastoma in which there is histologic evidence of malignancy in the primary or recurrent tumors, regardless of whether it has metastasized. We report an aggressive case of ameloblastic carcinoma of the mandible. A 68-year-old man with the complaint of the left facial swelling and intermittent pain was referred to our hospital. Serial images of panoramic radiograph, computed tomograph, and magnetic resonance imaging showed an ill-defined destructive radiolucent lesion of the left mandible. The lesion had typically aggressive behavior with extensive local destruction of bone and extended to the adjacent soft tissues. Bone scan revealed increased uptakes in the left mandibular body and ramus regions. Histological features were generally resembled with those of an ameloblastoma but with cytologic features of epithelial malignancy.
Aged ; Ameloblastoma ; Ameloblasts* ; Humans ; Jaw ; Magnetic Resonance Imaging ; Mandible*

Knowledge about the mechanism and factors that influence olfaction in laryngectomees remains unclear. The aims of this study were to determine the effect of nasal airflow on olfactory ability, as measured by sniff alone and laryngeal bypass with sniff ; to evaluate varying olfactory abilities according to the status of the speech mechanisms in esophageal speakers (ES) and tracheoesophageal shunt speakers (TES) ; and to assess the relationship between speech acceptability and olfactory ability in laryngectomees. Two laryngectomee groups, consisting of ES and TES, and age-matched controls were analyzed through questionnaires, tests applying a Japanese T&T olfactometer to measure thresholds of odor detection and recognition, intravenous alinamin injection tests, and measures of speech acceptability. The findings that laryngeal bypass with sniff and the TES group demonstrated lower olfactory thresholds and shorter latent times than sniff alone and the ES group was informative about the importance of nasal airflow to the olfactory ability in laryngectomees. Furthermore, the close relationship found between olfactory threshold and speech acceptability showed that the ability to transport airflow through the nasal cavity during speech had a strong influence on olfactory ability in laryngectomees.
Asian Continental Ancestry Group ; Humans ; Nasal Cavity ; Odors ; Smell* ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Noise-induced hearing loss (NIHL) is associated with the damage in outer hair cell (OHC). Otoacoustic emmision (OAE) is sensitive to the detection of damage in OHC. We intended to evaluate the usefulness of transient evoked OAE (TEOAE) and distortion product OAE (DPOAE) on early detection and monitoring of NIHL in guinea pigs. MATERIALS AND METHODS: Ten healthy guinea pigs were exposed to 90+/-3 dBA white noise 8 hours daily for 9 days. Daily measurements of auditory brainstem response (ABR), TEOAE and DPOAE were performed before the noise exposure and daily after the noise exposure. RESULTS: ABR threshold became poorer gradually until the 8th day of post noise exposure, and some recovery on the 9th day. Wave reproducibility on TEOAE demonstrated an abrupt decrement on the 6th post-exposure day, and a tendency of recovery from the 7th day. While the echo amplitudes in f2=2002 Hz and f2=4004 Hz showed similar pattern of change with ABR threshold, the echo amplitude of f2=6348 Hz showed marked decrease on the 5th day compared to two other frequencies (f2=2002 Hz, 4004 Hz). CONCLUSION: The results of this study suggest that wave reproducibility in TEOAE and echo amplitude in high frequency in DPOAE may have applicability for early detection and monitoring of NIHL.
Animals ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs* ; Guinea* ; Hair ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Hearing* ; Noise*