BACKGROUND: There are several studies about the relationship between serum homocysteine levels and bone mineral density (BMD), but the results are varied, and the studies are limited in Korea. In our study, the relationship between serum homocysteine levels and BMD by part according to age and sex is investigated. METHODS: From March 2012 to July 2015, the 3,337 healthy adults who took a medical examination were recruited. Subjects filled in the self-recording type questionnaire and physical examination, blood test, BMD of lumbar spine and femur were measured. After sorting by aging (≤49 year old, 50-59 year old, ≥60 year old) and sex, the results were adjusted with age and body mass index (BMI) and the relationship between serum homocysteine levels and BMD by lumbar spine and femur was analyzed by multiple regression analysis. RESULTS: As results of analysis, with the adjustment with age and BMI, all age groups of men had no significant relationship between log-converted serum homocysteine levels and BMD. In women aged under 50, there were significantly negative relationships at lumbar spine (β=-0.028, P=0.038), femur neck (β=-0.062, P=0.001), and total hip (β=-0.076, P<0.001), but there was no significant relationship in other age groups (50-59 year old and ≥60 year old). CONCLUSIONS: As the serum homocysteine levels increased in women aged under 50, BMD of the lumbar spine and femur decreased, and correlations between homocysteine and BMD were different by sex and age.
Adult* ; Aging ; Body Mass Index ; Bone Density* ; Female ; Femur ; Femur Neck ; Hematologic Tests ; Hip ; Homocysteine* ; Humans ; Korea ; Male ; Osteoporosis ; Physical Examination ; Spine

Organized hematoma of maxillary sinus is a rare pathologically benign mass in which pressure in the hematoma increases as it undergoes a process of organization, causing the deformation of the surrounding tissue, mimicking malignancies. The midfacial degloving approach can be used when extensive exposure is required in the treatment of lesions or traumas in the midfacial area with intranasal and intraoral incisions. We report a surgical excision case of organized hematoma of maxillary sinus using midfacial degloving approach without major complications and recurrence after one-year follow up.

An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs. It is thought to be a neoplastic or reactive inflammatory condition, controversially. The treatment of choice for myofibroblastic tumor is surgery, and recurrence is known to be rare. The optimal treatment method is not well-known for patients ineligible for surgery. We report a 47-year-old patient with aggressive recurrent IMT of the lungs. The patient had been admitted for an evaluation of back-pain two years after a complete resection of pulmonary IMT. Radiation therapy was performed for multiple bone recurrences, and the symptoms were improved. However the patient presented again with aggravated back-pain six months later. High-dose steroid and non-steroidal anti-inflammatory drugs were administered, but the disease progressed aggressively, resulting in spinal cord compression and metastasis to intra-abdominal organs. This is a very rare case of aggressively recurrent pulmonary IMT with multi-organ metastasis.
Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Myofibroblasts* ; Neoplasm Metastasis* ; Rare Diseases ; Recurrence ; Spinal Cord Compression

Endometriosis is a common gynecologic disease, it occur not only pelvic organ but also anywhere in human body. However inguinal endometriosis is a very rare condition, its incidence is 0.4% of entire endometriosis. Most of inguinal endometriosis are found as inguinal masses in women in 30s and 40s who have history of gynecologic surgery. Majority of the cases are accompanied with pelvic endometriosis. Authors report a case of inguinal endometriosis in patients who has no history of gynecological surgery.
Endometriosis ; Female ; Genital Diseases, Female ; Gynecologic Surgical Procedures ; Human Body ; Humans ; Incidence

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease. The prognosis is poor in most cases with rapid progression despite administering chemotherapy. A 67-year-old man complained of skin rashes on his back and this spread to the trunk, face, arms and thighs, and he was initially diagnosed with cutaneous lupus erythematosus according to the skin biopsy. The skin rashes then became aggravated on a trial of low dose methylprednisolone for 3 months. Repeated skin biopsy revealed a diffuse infiltration of lymphoid cells with medium sized nuclei, positive for CD4 and CD56, negative for Epstein-Barr virus (EBV), indicating a diagnosis of BPDCN. Further workups confirmed stage IVA BPDCN involving the skin, multiple lymph nodes, the peripheral blood and the bone marrow. He was treated with six cycles of combination chemotherapy consisting of ifosphamide, methotrexate, etoposide, prednisolone and L-asparaginase, and he achieved a partial response. Herein we report on a rare case of BPDCN that was initially misinterpreted as cutaneous lupus erythematosus.
Aged ; Arm ; Biopsy ; Bone Marrow ; Dendritic Cells ; Drug Therapy, Combination ; Etoposide ; Exanthema ; Herpesvirus 4, Human ; Humans ; Lupus Erythematosus, Cutaneous ; Lymph Nodes ; Lymphocytes ; Methotrexate ; Methylprednisolone ; Prednisolone ; Prognosis ; Rare Diseases ; Skin ; Thigh

BACKGROUND: Teicoplanin is a glycopeptide antibiotic that is widely used in clinical practice for the treatment of infections caused by drug-resistant Gram-positive bacteria. The aim of this study was to analyze plasma teicoplanin concentrations to determine the percentage of patients in whom therapeutic concentrations of teicoplanin were achieved in clinical practice. MATERIALS AND METHODS: The plasma teicoplanin concentrations of hospitalized patients receiving treatment at a teaching hospital were retrospectively analyzed. The target level was defined as a plasma teicoplanin concentration of 10 mg/L or greater, since this was generally regarded as the lower limit of the optimal concentration range required for the effective treatment of a majority of infections. RESULTS: Patients with sub-optimal (< 10 mg/L) plasma teicoplanin concentrations constituted nearly half of the total study population. The majority of these patients received the recommended loading dose, which were three 400 mg doses administered every 12 hours. Sub-group analysis showed a trend that the group receiving loading dose was more likely to reach the optimal teicoplanin concentration. CONCLUSIONS: The data revealed that a significant proportion of patients in clinical practice achieved only sub-optimal teicoplanin concentrations, which emphasizes the importance of the mandatory use of loading dose and routine therapeutic drug monitoring. Treatment reassessment and simulation of individual dose regimens may also be necessary to achieve optimal drug concentrations.
Drug Monitoring ; Gram-Positive Bacteria ; Hospitals, Teaching ; Humans ; Plasma ; Retrospective Studies ; Teicoplanin*

BACKGROUND: Despite the established benefits of diabetes camps for the continuing education of children with type 1 diabetes mellitus, little is known about the long-term metabolic benefits of diabetes camps for middle-aged and elderly people with type 2 diabetes mellitus (T2DM), especially in terms of glycosylated hemoglobin (HbA1c) variability. METHODS: The 1-year mean and variability of HbA1c before and after the diabetes camp was compared between the participants of the diabetes camp (n=57; median age 65 years [range, 50 to 86 years]; median diabetes duration 14 years [range, 1 to 48 years]). Additional case-control analysis compared the metabolic outcomes of the participants of the diabetes camp and their propensity score-matched controls who underwent conventional diabetes education (n=93). RESULTS: The levels of HbA1c during the first year after the diabetes camp were comparable to those of the matched controls (P=0.341). In an analysis of all participants of the diabetes camp, the 1-year mean±standard deviation (SD) of HbA1c decreased (P=0.010 and P=0.041) after the diabetes camp, whereas the adjusted SD and coefficient of variance (CV) of HbA1c did not decrease. The adjusted SD and CV significantly decreased after the diabetes camp in participants whose 1-year mean HbA1c was ≥6.5% before the diabetes camp (n=40) and those with a duration of diabetes less than 15 years (n=32). CONCLUSION: The 1-year mean and SD of HbA1c decreased after the diabetes camp, with significant reduction in the adjusted SD and CV in those with higher baseline HbA1c and a shorter duration of diabetes.
Adult ; Aged* ; Case-Control Studies ; Child ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2* ; Education ; Education, Continuing* ; Hemoglobin A, Glycosylated ; Humans ; Self Care*

Typhlitis is a necrotizing colitis that usually occurs in neutropenic patients and develops most often in patients with hematologic malignancies such as leukemia and lymphoma. Typhlitis may proceed to bowel perforation, peritonitis and sepsis, which requires immediate treatment. Irinotecan is a semisynthetic analogue of the natural alkaloid camptothecin which prevents DNA from unwinding by inhibition of topoisomerase I. It is mainly used in colon cancer and small cell lung carcinoma (SCLC), of which the most common adverse effects are gastrointestinal toxicities. To the best of our knowledge, no case of typhlitis after chemotherapy with a standard dose of irinotecan in a solid tumor has been reported in the literature. We, herein, report the first case of typhlitis developed after chemotherapy combining irinotecan and cisplatin in a patient with SCLC.
Camptothecin ; Cisplatin ; Colitis ; Colonic Neoplasms ; DNA ; DNA Topoisomerases, Type I ; Hematologic Neoplasms ; Humans ; Leukemia ; Lymphoma ; Peritonitis ; Sepsis ; Small Cell Lung Carcinoma ; Typhlitis

A 47-year old man visited our hospital because of purulent sputum for 3 months. Chest X-ray showed destruction of both the upper lungs, and bronchoscopy revealed inflammatory change with whitish plaque on the left main bronchus through upper division of the left upper lobe. Tracheobronchial aspergillosis (TBA) was finally diagnosed as a result of histologic and microbiologic examination. However, he went abroad without medication before the diagnosis was made and visited again 10 months later. Follow-up bronchoscopy showed complete regression of the previously noted endobronchial lesion. We describe this case to consider the role of antifungal treatment in immunocompetent hosts, as well as to discuss a rare condition; TBA resolved spontaneously.
Aspergillosis ; Bronchi ; Bronchial Diseases ; Bronchoscopy ; Follow-Up Studies ; Immunocompetence ; Lung ; Sputum ; Thorax

PURPOSE: Neisseria meningitidis is a leading cause of bacterial meningitis in young adults. University students, especially those living in dormitories, have been known to be at increased risk of meningococcal disease. We performed a longitudinal study to determine the carriage rates of N. meningitidis and the changes thereof. MATERIALS AND METHODS: We recruited Inha University freshmen who were, at that time, admitted to a student dormitory. A pharyngeal swab was taken from all participant who were also asked to complete a questionnaire. This was repeated four weeks later. RESULTS: A total of 136 students were enrolled at the first culture. After four weeks, 128 students were enrolled, including 106 re-participants. The overall carriage rates changed from 11.8% to 14.1%. In analysis of the 106 re-participants, "visiting to pubs" was associated with carriage of N. meningitis for both the first (p=0.047) and second cultures (p=0.026). Serogroup C was found to be the most frequent serogroup (5 isolates), while 3 isolates were found from serogroup B. The most prevalent PorA types were P1.22,14-6 (4 isolates) and P1.19,15 (3 isolates). The DNA sequences of PorA VR2 were changed in 2 students during prolonged carriage. CONCLUSION: The meningococcal carriage rate among first year university students who resided in a dormitory did not significantly increase over 4-week interval between cultures, which is markedly different from those reported in Western studies. Close social contact appeared to be related with carriage. Our data also revealed diversity in PorA types, suggesting the possibility of rapid mutation of the PorA gene during the 4-week interval.
Female ; Genotype ; Humans ; Korea ; Male ; Meningococcal Infections/microbiology ; Neisseria meningitidis/classification/*genetics/pathogenicity ; Serotyping ; Students/statistics & numerical data ; Universities/statistics & numerical data ; Young Adult