BACKGROUND AND OBJECTIVES: The main treatment modality of sinonasal benign tumor is surgical resection, and the endoscopic intranasal approach has been commonly performed since the 1990s. The objective of this study was to evaluate the recurrence rates of different sinonasal benign tumors and to analyze the diverse approaches used in their surgical treatment. SUBJECTS AND METHOD: In 270 patients who were histopathologically diagnosed with sinonasal benign tumor during a period of 20 years, histopathologic type, treatment approach, interval between first treatment and recurrence, and recurrence rate according to treatment approach were analyzed. RESULTS: Recurrence rate was higher with the intranasal approach than with the extranasal approach in inverted papilloma and angiofibroma, but the differences were not statistically significant. The proportion of the intranasal approach during the latter 10 years was higher than that during the former 10 years. There was no significant differences between the recurrence rate during the former 10 years and that during the latter 10 years for both intranasal and extranasal approaches. CONCLUSION: Based on tumor location and stage and skill of the surgeon, the intranasal approach can replace the extranasal approach with no major changes in treatment outcome.
Angiofibroma ; Humans ; Methods ; Nasal Cavity ; Nose Neoplasms ; Papilloma, Inverted ; Paranasal Sinus Neoplasms ; Paranasal Sinuses ; Recurrence ; Treatment Outcome

For the surgical treatment of osmidrosis with subdermal excision in adolescent patients, immobilization of the axilla after the surgery is very important to prevent hematoma. Skin necrosis may occur when hematoma develops in the axilla after subdermal shaving. However, in case of young patients, they cannot maintain immobilization of the axilla after surgery for a long time, so they are relatively vulnerable to skin necrosis of the axilla due to hematoma after surgery. We used Yogips(R) splint for the dressing in 21 patients from January, 2002 to December, 2002 in our institute to prevent hematoma. The control group was composed of 46 patients only with tie-over dressing after subdermal excision for the dressing. We compared the incidence of hematoma 5 days after the surgery with that of the control group. There was no evident hematoma observed in the patients with Yogips(R)splint, but in case of the control group, hematoma developed in 16 patients of total 46 patients(33%). In this 16 patients with hematoma, 12 patients(75%) were adolescents. In conclusion, the dressing with a Yogips(R)splint seems to be a good method for immobilization of axilla and preventing hematoma after subdermal excision in young patients with osmidrosis.
Adolescent ; Axilla ; Bandages* ; Hematoma ; Humans ; Immobilization ; Incidence ; Necrosis ; Skin ; Splints*

BACKGROUND AND OBJECTIVES: Three-dimensional (3D) imaging is gaining popularity and has been partially used in robotic surgery but not in sinonasal surgery owing to technical problems. This is not only the first pilot study to evaluate the usefulness of newly-developed ‘twin lens’ HD-3D endoscope (Machida), but also the first clinical study to compare this instrument with the pre-existing ‘insect eye’ 3D endoscope (Visionsense). MATERIALS AND METHOD: A total of 45 surgeries for cerebrospinal fluid leakage, angiofibroma, or sinonasal malignancy were performed using a 3D endoscope between November 2011 and October 2013 (‘insect eye’ Visionsense VSII 3D: 29 cases, ‘twin lens’ Machida HD-3D: 16 cases). RESULTS: Depth perception and recognition of anatomical structures were all excellent in the two 3D methods. The ‘twin lens’ HD-3D endoscope provided better image resolution and naturalness of color and showed less unfavorable phenomena such as image blurring and blackout than the ‘insect eye’ 3D endoscope. CONCLUSION: If the technical limitations are solved, the 3D endoscope will be used as a substitute and a standard tool in endoscopic sinonasal surgery rather than as supplement to the two-dimensional (2D) endoscope in the near future.
Angiofibroma ; Cerebrospinal Fluid Leak ; Clinical Study ; Depth Perception ; Endoscopes* ; Imaging, Three-Dimensional ; Methods ; Paranasal Sinus Neoplasms ; Pilot Projects ; Sinusitis

The technetium (Tc)-99m pyrophosphate scans have been used to diagnose acute myocardial infarctions and to confirm the equivocal cases. Many articles have been reported about its diagnostic performance and pitfalls. But there has been no evaluation of its predictability according to the grades of the radioactivity land statistical evaluation of the trade-off point, i.e., grade 2 and the area under the receiver operating characteristic curve. To achieve the goals, we reviewed 252 cases of Tc-99m pyrophosphate scans (acute transmural infarction [n=99], acute subendocardial infarction [n=7], unstable angina[n=16], old myocardial infarction [n=19] others [n=111]). The predictabilities of the scan are 98% in grade 4, 84% in grade 3, 83% in grade 2, 53% in grade 1 and 18% in non-uptake. The usual trade-off point, grade 2 is not statistically significant(Z=1.945, P=0.0259>0.01). The area under the receiver operating characteristic curve(Az) is 0.885. Our study shows that the probable main cause of the false negative cases is the time interval between the onset of symptoms and the test.
Infarction ; Myocardial Infarction ; Radioactivity ; ROC Curve ; Technetium

Nevus unius lateris (NUL) is a variant of an epidermal nevus that involves a widespread body surface, especially half of the body, and its onset usually occurs at birth or early life. An increased risk of basal cell carcinoma (BCC) in epidermal nevus has also been reported. However, the exact incidence remains unknown. A 67-year-old female patient visited our dermatology clinic with black nodules protruding over multiple verrucous brownish patches and plaques on the right side of the trunk. The patient had congenital NUL. Black nodules were observed to develop several months previously and gradually enlarged. The skin biopsy of one black nodule was consistent with BCC. Subsequently, Mohs micrographic surgery was performed for the BCC. To date, there have been few reports of BCC arising within the nevus unius lateri. Herein, we report a rare case of BCC considered to originate from a congenital NUL.

The rapid response system (RRS) is an innovative system designed for in-hospital, at-risk patients but underutilization of the RRS generally results in unexpected cardiopulmonary arrests. We implemented an extended RRS (E-RRS) that was triggered by actively screening at-risk patients prior to calls from primary medical attendants. These patients were identified from laboratory data, emergency consults, and step-down units. A four-member rapid response team was assembled that included an ICU staff, and the team visited the patients more than twice per day for evaluation, triage, and treatment of the patients with evidence of acute physiological decline. The goal was to provide this treatment before the team received a call from the patient's primary physician. We sought to describe the effectiveness of the E-RRS at preventing sudden and unexpected arrests and in-hospital mortality. Over the 1-yr intervention period, 2,722 patients were screened by the E-RRS program from 28,661 admissions. There were a total of 1,996 E-RRS activations of simple consultations for invasive procedures. After E-RRS implementation, the mean hospital code rate decreased by 31.1% and the mean in-hospital mortality rate was reduced by 15.3%. In conclusion, the implementation of E-RRS is associated with a reduction in the in-hospital code and mortality rates.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Education, Professional ; Female ; Heart Arrest/mortality ; *Hospital Mortality ; *Hospital Rapid Response Team ; Hospitals, University ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Young Adult

BACKGROUND: Celecoxib, a COX-2 specific inhibitor, has recently been used for the treatment of rheumatoid arthritis. However, the molecular and cellular mechanisms of celecoxib against RA inflammation remain to be defined. To elucidate the action mechanism of celecoxib on inflammatory cells, we investigated the effect of celecoxib on the production of two important mediators of inflammation, nitric oxide and PGE2 METHODS: RAW 264.7 cells stimulated with LPS were preincubated with various concentrations of celecoxib (from 10(-8) to 10(-5) M) and 10muM hydrocortisone, respectively. The production of NO and PGE2, the end products of iNOS and COX-2 genes, were estimated in culture supernatants by Greiss method and EIA, respectively. The expression of iNOS gene, COX-2 gene, NF-kappaB, and I-kappaB were determined by RT-PCR and western blot analysis. RESULTS: Celecoxib and hydrocortisone inhibited the production of NO and PGE2 in dose dependent manner, when RAW 264.7 cells were stimulated with LPS. The expression of iNOS was also down-regulated by celecoxib and hydrocortisone. Interestingly, COX-2 gene differentially expressed according to the dose of celecoxib, a decrease with lower dose (10(-8) M) but an increase with higher dose (10(-5) M). NF-kappaB binding activity was decreased by lower dose of celecoxib, whereas was not affected by higher dose of it. The expression of I-kappaB was suppressed by higher dose of celecoxib. CONCLUSION: The celecoxib strongly suppressed the production of NO and PGE2 in LPS-stimulated RAW264.7 cells. The decrease of NO seems to be linked to the inhibition of iNOS by celecoxib. The lower and higher dose of celecoxib differentially regulated the COX-2 expression and NF-kappaB activity
Arthritis, Rheumatoid ; Blotting, Western ; Celecoxib ; Cyclooxygenase 2* ; Dinoprostone* ; Hydrocortisone ; Inflammation ; Inflammation Mediators ; Macrophages* ; NF-kappa B ; Nitric Oxide*

PURPOSE: This study was performed to investigate the interaction of genetic polymorphisms of glutathione S-transferases and L-myc proto-oncogene with smoking, drinking, and dietary factors in the carcinogenesis of gastric cancer. MATERIALS AND METHODS: Two hundred and four gastric cancer patients and 1:1 matched hospital controls were the study subjects. They were interviewed with a questionnaire including alcohol consumption, smoking and dietary habit. We investigated genetic polymorphisms of GSTM1, GSTT1 and L-myc genes using PCR-RFLP techniques. RESULTS: Smoking and soybean paste stew were risk factors and doughnut, fried potato, welsh onion, rice cake, seaweed, slices of raw fish, melon, tomato, garlic and onion were protective factors of gastric cancer. The odds ratios of some food items changed significantly according to the genotypes; green vegetables and pork according to the GSTM1 genotype; pork, soybean curd, steamed or hard-boiled soybean and welsh onion according to the GSTT1 genotype; rice cake and garlic according to the L-myc proto-oncogene genotype. CONCLUSION: These results suggest that the genetic polymorphisms of GSTM1, GSTT1 and L-myc genes might modify the effects of environmental factors on gastric cancer possibly by engaging in the metabolism of food, alcohol and cigarette smoke.
Alcohol Drinking ; Carcinogenesis ; Cucurbitaceae ; Diet* ; Drinking* ; Food Habits ; Garlic ; Genes, myc ; Genotype ; Glutathione* ; Humans ; Lycopersicon esculentum ; Metabolism ; Odds Ratio ; Onions ; Polymorphism, Genetic* ; Surveys and Questionnaires ; Risk Factors ; Seaweed ; Smoke* ; Smoking* ; Solanum tuberosum ; Soybeans ; Steam ; Stomach Neoplasms* ; Tobacco Products ; Vegetables

A stable cohort (n = 369,725) was reconstructed to test the association of hepatitis B virus (HBV) infection with subsequent occurrence of liver cancer in a healthy Korean population. The cohort consisted of male beneficiaries of the Korea Medical Insurance Corporation over 30 years of age, living nationwide. The HBV infection was tested by the reversed passive hemagglutination method for the HBsAg and by the passive hemagglutination method for the anti-HBs at the time of recruitment in 1984. Admissions due to liver diseases were identified through a computerized system for reimbursements on medical insurance claims from January 1, 1985 to December 31, 1987. For a more valid estimate of incidence, a sample survey was carried out, obtaining correction coefficients against misclassification of the diagnosis, as well as those for duplicate claims in a year. The incidence rate of liver cancer steadily increased with age (kappa 2 TREND = 51.1, df = 1, p = 0.00).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult ; Age Factors ; Aged ; Cohort Studies ; Hepatitis B/*complications ; Humans ; Incidence ; Income ; Korea/epidemiology ; Liver Neoplasms/epidemiology/*microbiology ; Male ; Middle Aged ; Risk Factors

PURPOSE: The aim of this study was to investigate urinary nerve growth factor (NGF) as a biomarker of treatment efficacy and recurrence in overactive bladder (OAB) patients. METHODS: We enrolled 189 OAB subjects who visited our outpatient clinic from February 2010 to February 2015. All subjects with OAB received antimuscarinic treatment. A 3-day voiding diary and questionnaire were collected from each patient. Urinary levels of NGF were evaluated at baseline, the beginning of antimuscarinic treatment, and the end of antimuscarinic treatment. Urinary NGF was normalized to urine creatinine (Cr). Between-group comparisons of baseline characteristics were made using the Mann-Whitney U-test. Multivariate logistic regression analyses were used to predict responses to anticholinergic treatment and recurrence. The Wilcoxon signed-rank test with the Bonferroni correction was used for intragroup comparisons. A receiver operating characteristic curve was used to analyze the utility of this biomarker. RESULTS: Urinary levels of NGF/Cr tended to decrease in patients who responded to treatment (n=62), but this was not significant (P=0.260). Urinary NGF levels were higher at baseline in patients who did not experience recurrence than in those who did (P=0.047). In those who did not experience recurrence (n=29), urinary NGF/Cr decreased at the end of treatment compared to baseline, and this reduction was maintained at 12 weeks after the end of treatment (P < 0.05). CONCLUSIONS: Urinary NGF is a potential biomarker for predicting the outcome of antimuscarinic treatment in OAB patients. This may provide useful information when deciding to stop antimuscarinic treatment in responders.
Ambulatory Care Facilities ; Biomarkers ; Creatinine ; Humans ; Logistic Models ; Nerve Growth Factor* ; Recurrence ; ROC Curve ; Treatment Outcome ; Urinary Bladder, Overactive*