BACKGROUND AND OBJECTIVES: Amyotropic lateral sclerosis (ALS) is a progressive neuromuscular disease that involves degeneration of upper motor neurons in the cortex and lower motor neurons in the brain stem and spinal cord. Although there is a decline in the articulatory dysfunction, respiratory, and phonatory dysfunctions are known to occur in ALS. However, the pattern of disease progression and early identification of phonatory changes are not well documented. The purpose of this study was to compare selected acoustic parameters of voice in the normal control group to the ALS group who were perceptually free of vocal symptoms. Significant differences between the two groups could indicate that signs of bulbar degeneration in ALS may be present even when the voice is clinically perceived as normal. MATERIALS AND METHODS: The authors used a computerized acoustic analysis program (CSL-MDVP) to measure mean fundamental frequency (Fo), jitter, shimmer, and noise to harmonics ratio (NHR) from voice samples of ALS patients and compared this results with the acoustic parameters of 60 control subjects (men: 30, women: 30) who have no history of neurologic disease and were over 60 years old. RESULTS: There were significant group differences for jitter, shimmer, and NHR in male ALS. There was significant group difference for jitter in female ALS. CONCLUSION: Certain acoustic measures of voice may be sensitive indicators of early laryngeal deterioration in ALS. Acoustic analysis of voice may be one way of detecting aberrant vocal features before the human ear detects dysphonia, and jitter may be the most sensitive acoustic variable.
Acoustics* ; Amyotrophic Lateral Sclerosis* ; Brain Stem ; Disease Progression ; Dysphonia ; Ear ; Female ; Humans ; Male ; Middle Aged ; Motor Neuron Disease ; Motor Neurons ; Neuromuscular Diseases ; Noise ; Spinal Cord ; Voice*

Tuberculosis of the nose and paranasal sinuses is so rare that only 43 cases of primary tuberculosis of paranasal sinuses had been reported in literature worldwide. Recently, the authors have experienced 4 cases of tuberculosis developed in the nose and/or paranasal sinuses. We reviewed medical records, radiological and histopathological findings of these cases to find out the clinical features and treatment outcome. Chief complaints of patients were cheek swelling or nasal obstruction. One case had inactive pulmonary tuberculosis on the chest X-ray film, whereas the others had no evidence of previous tuberculosis infection. All cases revealed abnormalities in the maxillary sinuses. One case was diagnosed with tuberculosis after a tissue biopsy from the inferior turbinate, and the others were diagnosed with tissue biopsies from the maxillary sinus mucosa taken during endoscopic sinus surgery or Caldwell-Luc's operation. Histopathologic examinations revealed granulommatous inflammation and caseation necrosis. All cases showed positive reactions in acid fast bacteria (AFB) staining or culture for AFB. Patients were managed with periodic nasal dressing and antituberculous chemotherapy over 9 months and they became free of symptoms.
Bacteria ; Bandages ; Biopsy ; Cheek ; Drug Therapy ; Humans ; Inflammation ; Maxillary Sinus ; Medical Records ; Mucous Membrane ; Nasal Obstruction ; Necrosis ; Nose ; Paranasal Sinuses ; Thorax ; Treatment Outcome ; Tuberculosis* ; Tuberculosis, Pulmonary ; Turbinates ; X-Ray Film

OBJECTIVES: To investigate the number of leiomyoma patients-exposed to bisphenol A (BPA) and to observe whether the serum concentration of BPA is related to leiomyoma growth. METHODS: A total of 158 patients were recruited for this study. Leiomyoma patients were divided into three groups, mild (n = 48), moderate (n = 32) and severe (n = 28), according to the size of leiomyomas. The control (n = 30) group was defined as having no leiomyomas. Transvaginal ultrasonography was used to identify and measure the leiomyomas. Serum BPA concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: BPA was detected in 87.0% out of a total of 158 samples, and in 86.0% out of 108 leiomyoma patients. In detail, the detection rates of serum BPA were 88.0% in the control group, 77.2% in the mild group, 90.0% in the moderate group and 96.0% in the severe group. The mean BPA concentration in the control group was 0.558 +/- 0.097 ng/mL, the leiomyoma groups, the mean BPA concentrations were 0.274 +/- 0.063 ng/mL (mild), 0.346 +/- 0.064 ng/mL (moderate) and 0.647 +/- 0.039 ng/mL (severe) (P = 0.0003). Values represent the mean +/- standard error. CONCLUSION: The detection rates of serum BPA in the control and leiomyoma groups were 88.0% and 86.0%, respectively. However, there was no significant difference in the serum BPA concentrations between the control and leiomyoma groups. To verify the effect of BPA on leiomyoma growth, a close and sequential monitoring is recommended for people who are at risk for uterine leiomyoma.
Endocrine Disruptors ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Leiomyoma* ; Ultrasonography ; Uterus

PURPOSE: Several studies have reported that laparoscopic cholecystectomy with percutaneous transhepatic gallbladder drainage (PTGBD) is associated with a reduced duration of surgery and a lower rate of conversion to open laparotomy compared with laparoscopic cholecystectomy without PTGBD and delayed laparoscopic cholecystectomy after conservative therapy. However, these results are contradictory. This retrospective study investigated the safety and usefulness of laparoscopic cholecystectomy combined with pre-operative PTGBD in patients with acute cholecystitis. METHODS: The clinicopathologic data and surgical outcomes of 101 patients who underwent laparoscopic cholecystectomy between January 2010 and September 2015 were reviewed retrospectively. RESULTS: Patients in the PTGBD group vs. the non-PTGBD group were significantly older (mean age: 65.47±12.2 vs. 56.32±13.7; p=0.001). Underlying diseases were also significantly more common in the PTGBD group (75.4% vs. 45.5%; p=0.002). There were no significant differences between the two groups in terms of operative time, blood loss, rate of open conversion, postoperative oral intake, and postoperative hospital stay. Total hospital day was significantly longer in the PTGBD group (11.14±7.22 vs. 6.23±5.17; p=0.049). There was no significant difference in the postoperative complications between the two groups, and all patients in this study lived. CONCLUSION: This study suggested that satisfactory results can be achieved with selective preoperative PTGBD in older and sicker patients with acute cholecystitis.
Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute* ; Drainage* ; Gallbladder* ; Humans ; Laparotomy ; Length of Stay ; Operative Time ; Postoperative Complications ; Retrospective Studies

Endometriosis is an estrogen dependent disease in reproductive age. Endometriosis is a chronic inflammatory gynecologic disease. Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. Postmenopausal endometriosis is rare; however, postmenopausal endometriosis is infrequently associated with cancer, thus management is most important for gynecologists. We present two cases of endometriosis associated with postmenopausal women who were not receiving menopausal hormone therapy with a retrospective review of the medical records and a brief review of the literature.
Dysmenorrhea ; Dyspareunia ; Endometriosis ; Estrogens ; Female ; Genital Diseases, Female ; Humans ; Infertility ; Medical Records ; Postmenopause ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Benign vocal cord lesions that are not responsive to medical and/or speech therapy are often treated by microlaryngeal surgery. The purpose of this study is to measure selected acoustic parameters to document quantitative changes in vocal quality before and after microlaryngeal surgery and to analyze differences of prognosis for various benign vocal cord lesions, such as vocal cord polyp, vocal cord nodule, and Reinke's edema. MATERIALS AND METHODS: The authors used a computerized acoustic analysis program (CSL-MDVP) to measure mean fundamental frequency (Fo), jitter, shimmer, and noise to harmonics ratio (NHR) from voice samples of selected patients who had benign vocal cord lesions before and after at least 10 weeks of surgery. RESULTS: The values of Fo and NHR showed no significant difference in all three groups. There was significant improvement in nodule regarding jitter. Also, there was significant improvement in the vocal cord polyp regarding jitter and shimmer. CONCLUSION: Jitter and shimmer will be effective acoustic parameters in documenting the quantitative changes in vocal quality before and after microlaryngeal surgery.
Acoustics* ; Edema ; Humans ; Noise ; Polyps ; Prognosis ; Speech Therapy ; Vocal Cords* ; Voice

BACKGROUND AND OBJECTIVES: The accurate diagnosis of nasal bone fracture by means of simple radiographs and physical examination is difficult in cases of severe soft tissue swelling or minimally displaced fracture. The purpose of this study is to evaluate the practical effectiveness of nasal bone CT for the diagnosis of nasal bone fracture. MATERIALS AND METHODS: The authors reviewed nasal bone CT and simple radiographs of 11 patients with nasal bone injury who were suspected to have nasal bone fracture after history taking and physical examinations. The nasal bone fracture was classified as one of three types on nasal bone CT : type I (simple fracture), type II (simple fracture with displacement) and type III (comminuted fracture). Associated facial bone injuries were also evaluated and simple radiographs of nasal bone were reviewed for comparison. RESULTS: Nine out of eleven patients showed followingfracture lines on nasal bone CT: 3 cases of type I, 4 cases of type II, and 2 cases of type III. Seven out of eleven patients showed fracture lines on simple radiographs, but one patient out of those seven showed no fracture lines on CT. Four patients showed no fracture lines on simple radiographs, but three of them showed fracture lines on CT. Out of three cases of type I fracture, only two cases were detected on plain radiographs. Four patients showed complicated nasal septal fracture on CT, which could not be detected on simple radiographs. One other patient had fracture of the frontal process of maxilla. Conclusion: Nasal bone CT is a useful tool for diagnosis of nasal bone fracture since it provides accurate identification and evaluation of associated injuries such as nasal septal fracture.
Diagnosis* ; Facial Bones ; Humans ; Maxilla ; Nasal Bone* ; Physical Examination

BACKGROUND: In the life cycle, bone mineral density (BMD) is the most optimal condition in the 20s. In Korea, vitamin D deficiency status is very serious in Korean women due to recent lack of activity, weight polarization, and inadequate nutritional intake. The purpose of this study was to compare serum vitamin D and BMD according to obesity status in Korean young adult women. METHODS: A total of 143 female college students participated in the research. Body fat and lean body status were analyzed using a body composition analyzer. Nutrient intakes of the subjects were assessed by 3-days food record method. The BMDs was measured by dual energy X-ray absorptiometry. The subjects were divided into normal weight group and obesity group on their body mass index. RESULTS: Obesity group showed significantly higher weight, body fat (%), and body fat (kg) than normal weight group and T-scores of lumbar-2 spines were significantly lower. Obesity group showed high triglyceride and low-density lipoprotein cholesterol levels and vitamin D levels were significantly lower. Physical fitness and activity status showed that sit and reach and sit up were significantly lower in obesity group. The intake of carbohydrates was higher in the obesity group than in the normal weight group, and the intake of vitamin C and vitamin D was significantly lower. Factors affecting serum vitamin D were analyzed as body fat (%), lumbar-2 T-score, triglyceride, and carbohydrate intake. CONCLUSIONS: Obese women need more effort to manage their serum vitamin D status and balanced nutrition to prevent bone loss.
Absorptiometry, Photon ; Adipose Tissue ; Ascorbic Acid ; Body Composition ; Body Mass Index ; Body Weight ; Bone Density ; Carbohydrates ; Cholesterol ; Female ; Humans ; Korea ; Life Cycle Stages ; Lipoproteins ; Methods ; Nutritional Status ; Obesity ; Physical Fitness ; Spine ; Triglycerides ; Vitamin D Deficiency ; Vitamin D ; Vitamins ; Young Adult

Sclerosing stromal tumor (SST) of the ovary is a rare tumor derived from the sex cord stroma. This tumor was first described by Chalvaridjian and Scully in 1973. SST of the ovary is prevalence of 1.5% to 6% of ovarian stromal tumors. Patients are most commonly diagnosed in their 20s and 30s. There have been reports of SST postmenopausal women aged 65-, 67-, and 71 in the Republic of Korea; however, no report of this disease has been reported in women older than 80. In this study, we would like to report an 80-year-old postmenopausal woman who did not previously complain of any symptoms, and was finally diagnosed with SST. She was involved in a traffic accident, and huge pelvic mass was found during the evaluation of intra-abdominal hemorrhage. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed ; a final pathologic diagnosis reported SST.
Accidents, Traffic ; Aged* ; Aged, 80 and over ; Diagnosis ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Ovary ; Postmenopause ; Prevalence ; Republic of Korea ; Sex Cord-Gonadal Stromal Tumors

Early esophageal cancer is defined as a tumor invading the mucosa with or without lymph node or distant organ metastasis. In the current guidelines for early esophageal cancer, absolute indication for endoscopic resection include lesions limited to the epithelium or lamina propria mucosa not exceeding two-thirds of the circumference, and relative indications include lesions limited to the muscularis mucosa or the upper third of the submucosal layer and not accompanied by clinical evidence of lymph node metastasis. After endoscopic submucosal dissection for early esophageal cancer, locally recurrent cancer can occur, especially in the case of incomplete resection. Here, we report a rare case of a submucosal tumor-like recurrence after endoscopic resection of early esophageal cancer.
Endosonography ; Epithelium ; Esophageal Neoplasms ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence