We report a very rare case of odontogenic orbital cellulitis causing blindness by severe tension orbit. A 41-yr old male patient had visited the hospital due to severe periorbital swelling and nasal stuffiness while he was treated for a periodontal abscess. He was diagnosed with odontogenic sinusitis and orbital cellulitis, and treated with antibiotics. The symptoms were aggravated and emergency sinus drainage was performed. On the next day, a sudden decrease in vision occurred with findings of ischemic optic neuropathy and central retinal artery occlusion. Deformation of the eyeball posterior pole into a cone shape was found from the orbital CT. A high-dose steroid was administered immediately resulting in improvements of periorbital swelling, but the patient's vision had not recovered. Odontogenic orbital cellulitis is relatively rare, but can cause blindness via rapidly progressing tension orbit. Therefore even the simplest of dental problems requires careful attention.
Adult ; Anti-Bacterial Agents/adverse effects/therapeutic use ; Blindness/*diagnosis/etiology ; Drainage ; Fluorescein Angiography ; Humans ; Male ; Optic Neuropathy, Ischemic/complications ; Orbit/*physiopathology ; Orbital Cellulitis/*diagnosis ; Retinal Artery Occlusion/complications ; Sinusitis/diagnosis/drug therapy ; Tomography, X-Ray Computed ; Tooth Root

A 61-year old man visited to our hospital due to gross hematuria and voiding difficulty. Microscopic examination of the prostatic tissue revealed a tumor composed predominantly of signet ring cells. Signet ring cell adenocarcinoma of the prostate is extremely rare disease. Recently we have experienced a case of signet ring cell adenocarcinoma of the prostate and report it with brief review of literature.
Adenocarcinoma* ; Carcinoma, Signet Ring Cell ; Hematuria ; Humans ; Middle Aged ; Prostate* ; Rare Diseases

Endometriosis, defined as growth of endometrial stroma and glands outside the uterine cavity, is a chronic and recurrent disease that affects patients' quality of life. Ectopic endometrial tissue can proliferate at any location in the body, but the pelvic organs and peritoneum are the most frequent implantation sites. Among extrapelvic endometriosis, inguinal endometriosis is a very rare gynecologic condition usually associated with previous pelvic surgery. Endometriosis should be preoperatively distinguished from other inguinal masses using computed tomography, magnetic resonance imaging, or ultrasonography. Here, we report a case of right inguinal endometriosis in a patient with no previous history of gynecologic surgery; in addition, we have provided a brief review of relevant literature.
Endometriosis* ; Female ; Gynecologic Surgical Procedures* ; Humans ; Magnetic Resonance Imaging ; Peritoneum ; Quality of Life ; Round Ligament of Uterus ; Ultrasonography

PURPOSE: A variety of biodegradable polymers have been utilized to fabricate matrices for engineering genitourinary tissues, Chitosan is a biosynthetic polysaccharide that is the deacetylated derivative of chitin. The aims were to investigate the characteristics of the newly developed porous chitosan-based biodegradable scaffolds and to reconstruct cavernosal smooth muscle structure in vivo. MATERIALS AND METHODS: To study the cytotoxicity of the newly developed scaffolds, cultured L929 murine fibroblasts were stained with PKH-26 and then cultured on culture plate or loaded in chitosan/hyaluronic acid polymers. For in vivo study, human corpus cavernosal smooth muscle cells were seeded on the scaffolds at concentration of 20*106 cells per cm3 .A total of 24 polymer scaffolds were implanted subcutaneously with cells in one side and without cells in the other side, respectively, in 12 athymic mice, Mice were scarificed 7, 14, 28 days after implantation, respectively. H-E stain and monoclonal anti-alpha smooth muscle actin stain were performed. RESULTS: Scanning electron micrographs of chitosan and 0.03% hyaluronic acid based scaffolds showed sheet-like porous structure. The cell division numbers of L929 murine fibroblasts sere significantly increased in scaffolds by chitosan/hyaluronic acid compared with chitosan alone, Histologically the retrieved polymers seeded with cavernosal smooth muscle cells showed organized smooth muscle structure 28 days after implantation. immunohistochemical analysis confirmed the smooth muscle phenotype. CONCLUSION: These results show that porous chitosan-based biodegradable scaffolds are new biomaterials for the reconstruction of cavernosal smooth muscle structure. However, further studies are needed to make cavernosal sinusoidal structure using this new scaffolds.
Actins ; Animals ; Biocompatible Materials ; Cell Division ; Chitin ; Chitosan ; Fibroblasts ; Humans ; Hyaluronic Acid ; Male ; Mice ; Mice, Nude ; Muscle, Smooth* ; Myocytes, Smooth Muscle ; Penis ; Phenotype ; Polymers ; Tissue Engineering

We performed this study to examine lifestyle patterns and dietary behavior based on the level of Internet addiction of Korean adolescents. Data were collected from 853 Korean junior high school students. The level of Internet addiction was determined based on the Korean Internet addiction self-scale short form for youth, and students were classified as high-risk Internet users, potential-risk Internet users, and no risk Internet users. The associations between the students' levels of Internet addiction and lifestyle patterns and dietary behavior were analyzed using a chi-square test. Irregular bedtimes and the use of alcohol and tobacco were higher in high-risk Internet users than no risk Internet users. Moreover, in high-risk Internet users, irregular dietary behavior due to the loss of appetite, a high frequency of skipping meals, and snacking might cause imbalances in nutritional intake. Diet quality in high-risk Internet users was also worse than in potential-risk Internet users and no risk Internet users. We demonstrated in this study that high-risk Internet users have inappropriate dietary behavior and poor diet quality, which could result in stunted growth and development. Therefore, nutrition education targeting high-risk Internet users should be conducted to ensure proper growth and development.
Adolescent ; Appetite ; Diet ; Dietary Sucrose ; Growth and Development ; Humans ; Internet ; Life Style ; Meals ; Snacks ; Tobacco

Juvenile rheumatoid arthritis (JRA), an autoimmune disease, was characterized by chronic synovitis and associated with various extra-articular manifestations. Abnormal hematologic findings have been reported in all form of JRA, especially anemia due to chronic disease or iron deficiency. Dysplastic changes were rarely noted in the peripheral blood and bone marrow. We experienced a 15-year-old female patient with pauciarticular JRA who have pancytopenia in peripheral blood and a number of dysplastic changes in bone marrow, and present the case here with brief review of literatures.
Adolescent ; Anemia ; Arthritis ; Arthritis, Juvenile* ; Autoimmune Diseases ; Bone Marrow ; Chronic Disease ; Female ; Humans ; Iron ; Pancytopenia ; Synovitis

BACKGROUND: Central venous cannulation is one of the important parts of anesthetic management. Because general anesthesia causes external-landmarks (e.g. sternocleidomastoid muscle, carotid artery pulse) indistinct, we developed a new external landmark for internal jugular vein cannulation that can be easily detected under general anesthesia. METHODS: We cannulated the right internal jugular vein of 110 patients under general anesthesia. We used the external jugular vein and cricoid cartilage as a landmark. RESULTS: Cannulation of the right internal jugular vein was successful in 108 out of 110 patients (98.2%). Patients required an average 1.48+/-0.63 attempts. There were 2 carotid punctures (1.8%), 3 discomforts (2.7%) and no brachial plexus irritation. CONCLUSIONS: This new landmark technique has a high success rate and few complications.
Anesthesia, General ; Brachial Plexus ; Carotid Arteries ; Catheterization* ; Central Venous Catheters ; Cricoid Cartilage ; Humans ; Jugular Veins* ; Punctures

OBJECTIVE: Indoleamine 2, 3-dioxygenase (IDO), an immuno suppression enzyme, is one of the initial and rate-limiting enzymes involved in the catabolism of the essential amino acid tryptophan. IDO inhibits T cell proliferation, induces T cell apoptosis, and plays a fundamental role in autoimmunity and allergy. We investigated which subtype of dendritic cells (DCs) is involved in IDO expression and the generation of regulatory T cells during the induction of oral tolerance in type II collagen-induced arthritis (CIA). METHODS: Type II Collagen was fed to DBA/1J mice before immunization. Changes in DC subtypes and induction of regulatory T cell in orally tolerized CIA mice were analyzed. Whether the effect of DC subtype was modulated by the IDO expression, was determined by flow cytometry (FACs) and confocal microscopy. RESULTS: IDO expression of CD11c+ DCs was higher in orally tolerized CIA mice than in non-tolerized CIA mice. CD11b+ DCs of the CD11c +DCs, subtype was higher in the induction of in IDO expression. Our data suggest that these IDO expressing DCs of oral tolerized mice suppressed type II collagen-specific T cell proliferation and favored the differentiation of naive CD4+ T cells into regulatory T cells. Especially, CD11c+CD11b+ DCs expressed IDO, which is known to be associated with regulatory T cell induction. CONCLUSION: We observed that oral tolerance induced the increase in IDO-expressing CD11c+CD11b+ DCs, which appeared to induce regulatory T cells. IDO-expressing CD11c+CD11b+ DCs are involved in oral tolerance, which may provide a new therapeutic approach for the treatment of rheumatoid arthritis.
Mice ; Animals

OBJECTIVE: The aim of the present study was to evaluate the impact of previous abdominal surgery on surgical outcomes of single-port access (SPA) total laparoscopic hysterectomy (TLH). METHODS: We reviewed the medical records of 111 women who underwent SPA-TLH at the Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University between January 2010 and December 2010. Women were classified according to their history of previous abdominal surgery. RESULTS: Of 111 women undergoing SPA-TLH, 74 women (66.7%) without history of previous abdominal surgery and 37 women (33.3%) with history of previous abdominal surgery were classified. There was no significant difference in surgical outcomes including operative time, estimated blood loss, change in hemoglobin, uterine weight, perioperative complications, transfusion, and additional port insertion between two groups. CONCLUSION: In our experience, previous abdominal surgery has no significant impact on SPA-TLH.
Female ; Gynecology ; Hemoglobins ; Humans ; Hysterectomy ; Laparoscopy ; Medical Records ; Obstetrics ; Operative Time

BACKGROUND: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are considered the first line treatment for a subset of EGFR-mutated non-small cell lung cancer (NSCLC) patients. Although transformation to small cell lung cancer (SCLC) is one of the known mechanisms of resistance to EGFR TKIs, it is not certain whether transformation to SCLC is exclusively found as a mechanism of TKI resistance in EGFR-mutant tumors. METHODS: We identified six patients with primary lung adenocarcinoma that showed transformation to SCLC on second biopsy (n = 401) during a 6-year period. Clinicopathologic information was analyzed and EGFR mutation results were compared between initial and second biopsy samples. RESULTS: Six patients showed transformation from adenocarcinoma to SCLC, of which four were pure SCLCs and two were combined adenocarcinoma and SCLCs. Clinically, four cases were EGFR-mutant tumors from non-smoking females who underwent TKI treatment, and the EGFR mutation was retained in the transformed SCLC tumors. The remaining two adenocarcinomas were EGFR wild-type, and one of these patients received EGFR TKI treatment. CONCLUSIONS: NSCLC can acquire a neuroendocrine phenotype with or without EGFR TKI treatment.
Adenocarcinoma* ; Biopsy ; Carcinoma, Non-Small-Cell Lung ; Female ; Humans ; Lung ; Lung Neoplasms ; Phenotype ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Small Cell Lung Carcinoma*