No abstract available.

Bloating is one of the most common and troublesome problems in a large proportion of patients with gastrointestinal disorders but the mechanism is not completely understood. Several factors, including gas-producing intestinal microbiota, disturbed handling of intestinal gas, visceral hypersensitivity, abnormal viscero-somatic responses, fermentable diet, and psychological factors, have been suggested as mechanisms. For an assessment, thorough medical history-taking and physical examination are the first steps. On the other hand, organic disorders should always be considered first for a differential diagnosis. The therapeutic options available are considered challenging and still limited in clinical practice. The treatment strategy may include diet modification, pharmacologic approach, psychiatric approach, biofeedback, etc. Further studies will be needed to explore the variable mechanism of bloating and develop an efficient treatment.
Biofeedback, Psychology ; Diagnosis, Differential ; Diet ; Food Habits ; Gastrointestinal Microbiome ; Gastrointestinal Tract ; Hand ; Humans ; Hypersensitivity ; Physical Examination ; Psychology

Constipation is one of the most common gastrointestinal disorders with a prevalence up to 16.5% in the general population. It is frequently multifactorial and the pathophysiologic mechanism of constipation is not fully understood. Many preclinical studies of constipation have used animal models. Translational research using these animal models is essential to the investigation of neurogenic and myogenic mechanisms of colon, and to the estimation of the clinical efficacy of new drugs. In this review, we discuss some of the current translational research projects on constipation using animal models.
Colon ; Constipation* ; Gastrointestinal Motility ; Models, Animal ; Prevalence ; Translational Medical Research* ; Treatment Outcome

Fine-needle aspiration cytology(FNAC) has been used extensively in the diagnosis of metastatic malignancies. However, metastatic soft tissue sarcomas are often overlooked, primarily due to the low frequency with which they occur. Here, we report a rare case of metastatic rhabdomyosarcoma in both cervical lymph nodes, which was detected by FNAC. A 45-year-old woman presented with anosmia, postnasal drip, and sneezing, symptoms which had persisted for 1 month. The patient was found to have a tumorous lesion at the upper portion of the mid-turbinate, with multiple enlarged cervical lymph nodes, and this lesion was examined closely at our facility. FNA cytology smears obtained from both cervical lymph nodes revealed a high degree of cellularity, and displayed cohesive clusters with gland-like spaces, as well as single isolated cells with abundant karyorrhectic debris. The tumor cells exhibited round to oval nuclei containing fine chromatin, occasional small nucleoli, and scanty cytoplasm, or a total lack of cytoplasm. Some of the tumor cells were arranged in multinucleated forms and abundant dense eosinophilic cytoplasms, reminiscent of a rhabdomyoblast. The histological findings of the lymph nodes revealed an outstanding sinusoidal infiltration and a prominent alveolar growth pattern, interspersed with occasional typical rhabdomyoblasts. The immunohistochemical results [desmin(+), myoglobin(+), myogenin (+), pan CK(-), synaptophysin(-), neuron specific enolase(-)] supported a confirmative diagnosis of alveolar rhabdomyosarcoma. Alveolar rhabdomyosarcoma is a representative sarcoma, which typically manifests with nodal metastasis and carcinoma-like clustering. The cytopathologist should remain alert upon encountering unusual morphology, so that the possibility of this condition, although somewhat remote, should not be dismissed or overlooked.
Biopsy, Fine-Needle* ; Chromatin ; Cytoplasm ; Diagnosis ; Eosinophils ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Middle Aged ; Myogenin ; Neoplasm Metastasis ; Neurons ; Olfaction Disorders ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Alveolar* ; Sarcoma ; Sneezing

Epithelial myoepithelial carcinoma is a rare tumor with slightly less than one percent of salivary gland neoplasm. Histologically, the carcinomas are characterized by a mixture of trabecular structure with outer myoepithelial cells and inner ductal cells, which are confirmed by electron microscopy and immunohistochemistry. Although this neoplasm exhibits high degree of cellular differentiation histologically, it is classified into low grade carcinoma because of its locally infiltrative, destructive growth pattern, and tendency to metastasize. We report a 45-year-old woman with epithelial-myoepithelial carcinoma arising from a submandubular gland, one of the most unusual locations.
Female ; Humans ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Salivary Gland Neoplasms ; Submandibular Gland

BACKGROUND AND OBJECTIVES: Surgical treatment is considered as a secondary treatment option for obstructive sleep apnea (OSA). This study was performed to determine whether surgical treatment can be considered in patients with moderate-severe OSA as a treatment modality. MATERIALS AND METHODS: A total of 127 patients with moderate-severe OSA were retrospectively enrolled. The anatomic narrowing sites were mainly evaluated using cephalometry and drug induced sleep endoscopy (DISE), and then multi-level surgeries were performed. RESULTS: Both uvula and soft palate were the most frequent narrowing sites and a total of 110 patients showed upper airway narrowing more than two anatomic structures. A total of 79 patients (62.1%) were categorized as responders and 48 patients (39.1%) were non-responders. After multi-level sleep surgeries, patients' subjective symptoms and sleep parameters were significantly improved. However, AHI was not considerably decreased. Non-responders to sleep surgeries showed relatively higher rates of severe OSA and body mass index. Tongue base narrowing, incomplete corrections of nasal pathologies and soft palate were significant factors for lower success rates. CONCLUSION: We estimate that sleep surgery might be a therapeutic option for moderate to severe patients with OSA. A delicate pre-operative evaluation for upper airway narrowing is necessary to adapt sleep surgery to these patients.
Body Mass Index ; Cephalometry ; Endoscopy ; Humans ; Palate, Soft ; Pathology ; Retrospective Studies ; Sleep Apnea, Obstructive* ; Tongue ; Treatment Outcome* ; Uvula

PURPOSE: We conducted this study to evaluate the clinical efficacy of simplified single suture aponeurotic tuck technique and examine its long-term results in ptosis patients with levator function of over 7 mm. METHODS: For twenty patients (22 eyes) were noted to have ptosis from September 2000 to December 2001, we performed simplified single suture levator tuck technique to repair ptosis using a single 5-0 prolene suture. We performed tucking 1-2 mm higher than the contralateral side in patients with unilateral ptosis and same height in those with bilateral ptosis. Mean post-operative follow-up observation period was 6.8 months. 7 patients (7 eyes) had congenital ptosis and 13 patients (15 eyes) had acquired ptosis. Pre-operative and post-operative marginal reflex distance [MRD1] at week 1, month 1 and month 3 were measured to evaluate surgical outcome and post-operative complications. RESULTS: All the cases with congenital ptosis showed satisfactory surgical outcomes. On the contrary, 3 eyes with acquired ptosis who had shown unsatisfactory surgical outcomes received re-operation and showed satisfactory outcomes. 1 case with acquired ptosis had eyelid peaking, but was resolved with no further complications. The postoperative MRD1 was stabilized after the 1-month follow-up. CONCLUSIONS: It was possible to predict post-operative outcome by performing simplified single stitch levator tuck for ptosis patients under local infiltrative anesthesia if the patients are cooperative. Simplified single stitch levator tuck had such advantages as short surgical time, convenient technique, minimal postoperative anatomical change in upper eyelid, and easiness to perform to re-operation.
Anesthesia ; Eyelids ; Follow-Up Studies ; Humans ; Operative Time ; Polypropylenes ; Reflex ; Sutures*

Several different methods of posterior wiring and fusion have been advocated for treatment of the odontoid process fractures, regardless of direction of displacement. Between 1983 and 190, 8 cases of type II odontoid process fracture underwent posterior wiring and fusion at Kyungpook National University Hospital. Among them, three cases were posteriorly displaced fractures. For these three cases, the authors modified wiring method and applied acrylic resin. The authors thought this procedure is not complex and a good method for posteriorly displaced type II fractures in which conventional posterior wiring may actually create a tration effect that further displaces the fractured odontoid into the spinal canal.
Gyeongsangbuk-do ; Odontoid Process* ; Spinal Canal

Of the 68 cervical spondyltic patients showing symptoms of radiculomyelopathy, assessments were made on 29 patients who underwent neural decompressive surgery with cervical laminectomy through posterior approach for the results of surgery. Analyses were also made on the anterior-posterior diameters of cervical canal on the plain film of cervical spine. The mean values of anterior-posterior diameters measured on the levels of cervical C3-7 were 16.5+/-1.83 mm in the normal adult and 7.3+/-1.08 mm in the cervical spondylotic patients with radiculomyelopathy, which is far narrower than that of the normal. In cervical spondylotic patients, the anterior-posterior diameters of directly upper and lower parts of the lesions were 11.9+/-1.20 mm and 12.1+/-1.61 mm respectively, also much narrower mean values than those of the normal control group. The results of the 29 patients who received cervical laminectomy by posterior approach were much improved for 51.7% and improved for 44.8%.
Adult ; Humans ; Laminectomy ; Spine ; Spondylosis*

PURPOSE: Although differentiated normal human nasal epithelial (NHNE) cells can be used to study the role of human nasal epithelium, there is a need for effective culture models of nasal epithelium in sinonasal disease status, including allergic rhinitis (AR). We aimed to examine the feasibility of intranasal brushing for culture of nasal epithelial cells in AR patients and to verify the hypothesis that allergic nasal epithelial (ARNE) cells differ in histologic and physiologic characteristics. METHODS: We established a system for isolating (via intranasal brushing) and culturing (with air-liquid interface, ALI) nasal epithelial cells from healthy volunteers (n=8) and AR patients (n=8). We used this system to compare the histologic findings and physiologic characteristics of NHNE and ARNE. RESULTS: The histology results showed that fully differentiated ALI culture was obtained at least 14 days after confluence and that both ciliated and secretory cells were well differentiated in ALI culture using nasal brushing. The histology results of ARNE culture were significantly different from NHNE. The number of ciliated cells was lower, and secretory cells were more dominant in ARNE cell culture compared to NHNE cells. We also observed, by electron microscopy, loose tight junctions and short cilia in cultured ARNE cells. In addition, the mRNA level of TSLP which was one of the epithelial-derived allergic cytokines was significantly higher, and the expressions of genes involved in ciliogenesis were lower in cultured ARNE cells without allergen stimulation. CONCLUSIONS: Our findings suggest that ALI culture of ARNE cells using intranasal brushing may be an alternative method for epithelial cell culture in AR patients and that cultured ARNE cells will be useful for in vitro studies of the mechanisms at play during AR because they maintain unique allergic characteristics.
Cell Culture Techniques ; Cilia ; Cytokines ; Epithelial Cells* ; Healthy Volunteers ; Humans ; Microscopy, Electron ; Nasal Mucosa ; Primary Cell Culture ; Rhinitis* ; RNA, Messenger ; Tight Junctions