Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

No abstract available.
HIV-1* ; Humans* ; Tumor Necrosis Factor-alpha*

PURPOSE: The purpose of this study was to investigate the feasibility of shear wave ultrasound elastography for differentiating superficial benign soft tissue masses through a comparison of their shear moduli. METHODS: We retrospectively analyzed 48 masses from 46 patients from February 2014 to May 2016. Surgical excision, fine-needle aspiration, and clinical findings were used for the differential diagnosis. The ultrasonographic examinations were conducted by a single musculoskeletal radiologist, and the ultrasonographic findings were reviewed by two other radiologists who were blinded to the final diagnosis. Conventional ultrasonographic features and the median shear modulus were evaluated. We compared the median shear moduli of epidermoid cysts, ganglion cysts, and lipomatous tumors using the Kruskal-Wallis test. Additionally, the Mann-Whitney U test was used to compare two distinct groups. RESULTS: Significant differences were found in the median shear moduli of epidermoid cysts, ganglion cysts, and lipomatous tumors (23.7, 5.8, and 9.2 kPa, respectively; P=0.019). Epidermoid cysts showed a greater median shear modulus than ganglion cysts (P=0.014) and lipomatous tumors (P=0.049). CONCLUSION: Shear wave elastography may contribute to the differential diagnosis of superficial benign soft tissue masses through a direct quantitative analysis.
Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential ; Elastic Modulus ; Elasticity Imaging Techniques* ; Epidermal Cyst ; Ganglion Cysts ; Humans ; Lipoma ; Retrospective Studies ; Shear Strength ; Ultrasonography

OBJECTIVE: The physiological and pathogenetic role of microRNAs (miRNAs) in the maintenance of joint homeostasis and in the development of arthritis is recently being elucidated. In this study, we attempted to identify differentially expressed miRNAs in human osteoarthritis (OA) chondrocytes in response to interleukin (IL)-1beta. In addition, simultaneous profiling of miRNA and mRNA expression was performed to get an integrated analysis of miRNA and mRNA expression. METHODS: Monolayer cultured chondrocytes obtained from knee cartilages of OA patients were stimulated with IL-1beta for 4 hours and RNA was isolated. One microgram of total RNA was polyadenylated and converted to cDNA and miRNA microarray was performed. Seven hundred thirty five oligos were used, corresponding to 470 well-annotated human miRNA sequences and 265 potential miRNAs that were identified recently. mRNA microarray was performed simultaneously using the RNA samples that were used for miRNA array. Both sequence and expression information was used to identify regulatory relationship between miRNA and mRNA pairs. RESULTS: Expression profiling of miRNA extracted from IL-1beta treated chondrocytes identified 25 miRNA which showed differential expression. We also identified 7190 mRNAs differentially regulated by IL-1beta treatment. Among the 25 miRNAs differentially regulated, 13 miRNAs had targets searched by MiRANDA scheme. By combining target search and miRNA-mRNA pairing, we could identify 1043 miRNA-mRNA target pairs. MiR-200a was found to be expressed in human OA and normal cartilages, with downregulation in OA lesion cartilages. CONCLUSION: It is suggested that miRNA may play a role in the regulation of cartilage degradation in OA.
Arthritis ; Cartilage ; Chondrocytes ; DNA, Complementary ; Down-Regulation ; Homeostasis ; Humans ; Interleukin-1 ; Interleukins ; Joints ; Knee ; MicroRNAs ; Osteoarthritis ; RNA ; RNA, Messenger

Interleukin-6(IL-6) stimulate osteoclast differentiation. 17beta-estradiol, 1,25-dihydroxyvitamin D3(1,25-(OH)2D3) and interleukin-1beta inhibit or stimulate osteoclast differentiation by decreasing or increasing the synthesis of interleukin-6(IL-6) from stromal/osteoblastic cells, respectively. Periodontal ligament(PDL) cells reside between the alveolar bone and the cementum and have osteoblastic characteristics. To estimate the effect of 17beta-estradiol and 1,25(OH)2D3 on IL-6 production of PDL cells, PDL cells were treated with 17beta-estradiol or 1,25-(OH)2D3 in the absence or the presence of IL-1beta. The concentration of IL-6 produced form PDL cells was determined by enzym linked immunosorbent assay(ELISA). In unstimulated PDL cells, we detected constitutive production of IL-6 at 1st and 2nd day. IL-1beta increased IL-6 synthesis at 1st day and 2nd day. 17beta-estradiol had no significant effect on the secretion of this cytokine, either constitutively or after stimulation with IL-1beta(0.05 ng/ml). 1,25-(OH)2D3(10(-8)M) decreased not only constitutive IL-6 production but also IL-1beta-induced IL-6 production at 2nd day. These results suggest that 1,25-(OH)2D3 may control IL-1beta-induced osteoclast differentiation by decreasing IL-1beta-induced IL-6 secretion of PDL cells.
Calcitriol* ; Dental Cementum ; Interleukin-1beta ; Interleukin-6* ; Osteoblasts ; Osteoclasts ; Periodontal Ligament*

The purpose of this study was to investigate the variations of the skeletal and dentoalveolar dimensions in relation to vertical facial patterns. Lateral cephalogram of 200 cases (100 cases of male and 100 cases of female, average age of which was 23.2 years) were traced and some measurements of skeletal and dentoalveolar dimensions were measured. The ratio of UAFH/LAFH was employed to classify the samples into groups of excess and short lower anterior facial height. And the comparison between two groups were taken statistacally. The following results were obtained. 1. The dentoalveolar height, lower anterior facial height, lower gonial angle, and FMA in the excess-lower-anterior-facial-height group were significantly larger than those in short-lower-anterior-facial-height group. 2. The dentoalveolar height, ramus height, and Jarabak ratio in the male subjects were significantly larger than those in the female subjects. 3. The UAFH/LAFH ratio showed a significant correlation to upper, lower facial height, AUDH, PUDH, ALDH, PLDH, Lower gonial angle, FMA, and Bjok`s Sum.
Female ; Humans ; Male

This study examined the hygiene practices of contract foodservice employees and investigated the influence of education and work environment on these hygienes practices. A questionnaire was distributed to 250 contract foodservice employees and a total of 232 responses were received and analyzed. The overall score for hygiene practices of contract foodservice employees was 3.89 based on a 5-point scale. Cross-contamination was prominent (highest score at 4.46) and the heating temperature was less prominent (lowest score at 3.49). The factors most affecting contract foodservice employees were their work period, the size of the contract foodservice management company, the number of meals served daily, the frequency of meal service per day and the frequency of hygiene education. Compared to small and medium-sized contract foodservice management companies, the major contract foodservice management companies showed higher scores for refrigerator/freezer control (P<0.001), vegetable/fruit disinfection (P<0.001), thawing (P<0.001), heating temperature (P<0.001), cleaning/disinfection (P<0.01), and personal hygiene (P<0.05). The frequency of hygiene education had a significant effect on the performance levels for refrigerator/freezer control (P<0.001), vegetable/fruit disinfection (P<0.001), thawing (P<0.001), heating temperature (P<0.001), cleaning/disinfection control (P<0.001), food supply control (P<0.05), and personal hygiene (P<0.05). From these results, to increase the sanitation quality of contract foodservice operations, hygiene practice levels need to increase and hygiene education systematically should be enforced for foodservice employees.
Contracts ; Disinfection ; Food Supply ; Heating ; Hot Temperature ; Humans ; Hygiene ; Meals ; Surveys and Questionnaires ; Sanitation

OBJETIVE: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. MATERIALS OF METHODS: The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. RESULTS: The mean ages of the patients with leiomyomas and the control group were 43.1+/-5.6 and 40.6+/-7.2 years, the weights were 63.4+/-7.3 and 59.4+/-8.1 kg, and their heights were 155.4+/-4.8 and 159.3+/-4.8 cm respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. 17beta-estradiol, 5-AT, 11-keto ET, 11beta-hydroxy An, 11beta-hydroxy Et, THS, THA, THE, alpha-cortolone, alpha-cortol, beta-cortol, 11beta-OH Et/11beta-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. 17beta-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. 17beta-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). CONCLUSION: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.
Female ; Gas Chromatography-Mass Spectrometry ; Healthy Volunteers ; Humans ; Leiomyoma* ; Steroids ; Ultrasonography ; Uterus* ; Weights and Measures

Rheumatoid arthritis (RA) is a progressive inflammatory disease with severe symptoms of pain and stiffness. Chronic persistent inflammation of RA often leads to joint destruction, deformity and limitation of function, which ultimately results in significant deterioration of quality of life (QoL). RA is characterized pathogenetically by immunologically driven, chronic synovitis, and production of autoantibodies, such as rheumatoid factor and anti-cyclic citrullinated peptide antibodies. Although the cause of RA is yet unknown, advances in the molecular biology led to in-depth understanding of its pathogenesis, and have fostered the recent development of novel treatments. The last decade has seen the dramatic change in the landscape of RA treatment with more aggressive therapy early in the disease course and with treatment guided by a structured assessment of disease activity, with the ultimate goal of reaching remission. In addition, prevention and control of joint damage and improvement in QoL are important goals. To achieve these goals, a multidisciplinary approach to reduce disease activity with disease modifying antirheumatic drugs and biological therapy is needed. We also need to find ways to identify those patients who are at risk for more rapid disease progression who would benefit from intensive therapy early in the course of disease.
Antibodies, Monoclonal/therapeutic use ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/*diagnosis/etiology/*therapy ; Biological Products/therapeutic use ; Humans ; Tumor Necrosis Factor-alpha/antagonists & inhibitors

OBJECTIVE: To compare clinical features of minilaparoscopic radiofrequency myolysis (MLRFM) with laparoscopic-assisted vaginal hysterectomy (LAVH) in the treatment of uterine myoma. METHODS: Between 1st January 2006 and 31th March 2009, 125 patients underwent LAVH and 125 patients underwent MLRFM by same surgeon at the University of Chosun Hospital, Department of Gynecology. We compared the age of patients, indication for treatment, myoma size, major symptom, duration of procedure, amounts of blood loss and postoperative transfusion, length of hospital day, postoperative complication and satisfaction between the two groups. RESULTS: There were significant differences in duration of procedure between the LAVH group and the MLRFM group (69.0+/-31.6 minutes vs 43.5+/-19.8 minutes) and in the amounts of blood loss during procedure (215.2+/-215.0 mL vs 0.8+/-8.9 mL). The amounts of postoperative transfusion was 0.3+/-0.7 pints, 16 of the 125 (12.8%) for the LAVH group and no one underwent postoperative transfusion for the MLRFM group. There was significant difference in length of postoperative hospital day between the LAVH group and the MLRFM group (5.0+/-1.2 days vs 2.3+/-1.2 days). In the comparison of postoperative complications, there was no significant complication for the LAVH group, but there was major complications requiring readmission and reoperation for the MLRFM group. In MLRFM group, postoperative myoma size decreased compared to preoperative size. CONCLUSION: We conclude that there was no treatment of choice in uterine myoma. When considering treatment of uterine myoma, we should choose appropriate method after analyzing patient characteristics, general condition, uterine myoma characteristics case by case.
Female ; Gynecology ; Humans ; Hysterectomy, Vaginal ; Myoma ; Postoperative Complications ; Reoperation