No abstract available.
Abscess* ; Reoperation*

BACKGROUND: Recent findings in molecular pathology suggest that genetic translocation and/or overexpression of oncoproteins is important in salivary gland tumorigenesis and diagnosis. We investigated PLAG1, SOX10, and Myb protein expression in various salivary gland neoplasm tissues. METHODS: A total of 113 cases of surgically resected salivary gland neoplasms at the National Cancer Center from January 2007 to March 2017 were identified. Immunohistochemical staining of PLAG1, SOX10, and Myb in tissue samples was performed using tissue microarrays. RESULTS: Among the 113 cases, 82 (72.6%) were benign and 31 (27.4%) were malignant. PLAG1 showed nuclear staining and normal parotid gland was not stained. Among 48 cases of pleomorphic adenoma, 29 (60.4%) were positive for PLAG1. All other benign and malignant salivary gland neoplasms were PLAG1-negative. SOX10 showed nuclear staining. In normal salivary gland tissues SOX10 was expressed in cells of acinus and intercalated ducts. In benign tumors, SOX10 expression was observed in all pleomorphic adenoma (48/48), and basal cell adenoma (3/3), but not in other benign tumors. SOX10 positivity was observed in nine of 31 (29.0%) malignant tumors. Myb showed nuclear staining but was not detected in normal parotid glands. Four of 31 (12.9%) malignant tumors showed Myb positivity: three adenoid cystic carcinomas (AdCC) and one myoepithelial carcinoma with focal AdCC-like histology. CONCLUSIONS: PLAG1 expression is specific to pleomorphic adenoma. SOX10 expression is helpful to rule out excretory duct origin tumor, but its diagnostic value is relatively low. Myb is useful for diagnosing AdCC when histology is unclear in the surgical specimen.
Adenoma ; Adenoma, Pleomorphic ; Antibody-Dependent Cell Cytotoxicity ; Carcinogenesis ; Carcinoma, Adenoid Cystic ; Diagnosis ; Immunohistochemistry ; Oncogene Proteins ; Oncogene Proteins v-myb ; Parotid Gland ; Pathology, Molecular ; Salivary Gland Neoplasms ; Salivary Glands ; SOX Transcription Factors ; Translocation, Genetic

No abstract available.
Biomarkers* ; Propionibacterium acnes* ; Propionibacterium* ; Vitamin D* ; Vitamins*

No abstract available.
Biomarkers* ; Propionibacterium acnes* ; Propionibacterium* ; Vitamin D* ; Vitamins*

BACKGROUND AND OBJECTIVES: The ventricular activation time (VAT) is increased in both ventricular hypertrophy and bundle branch block. It is also known that the VAT is increased in myocardial ischemia due to the development of depolarization abnormality. However, little is known about the changes in the VAT on body surface electrocardiography following coronary stenting in patients with ischemic heart disease. The purpose of this study was to evaluate the clinical significance of VAT following coronary stenting by assessing the changes in the VAT during the 6 months following coronary stenting in patients with ischemic heart disease. SUBJECTS AND METHODS: The VAT was measured in 92 patients who had underdone coronary stenting due to of significant coronary artery stenosis on coronary angiography. The electrocardiography was recorded with a high paper speed at pre-stenting, immediate after and at 1 and 6 months after coronary stenting. RESULTS: The VAT was significantly decreased during the 6 month follow-up following coronary stenting (pre-stenting ; 45.9 +/-5.9 msec, immediate after stenting ; 38.5+/-2.7 msec, after 1 month ; 38.8+/-2.8 msec and after 6 months ; 38.8+/-2.5 msec, p<0.05). The VAT dispersion was significantly decreased during the 6 month follow-up following coronary stenting in the patients with one vessel disease (p<0.05), but not with two vessels disease. CONCLUSION: Coronary stenting significantly decreased the VAT during the 6 month follow-up. We would conclude that coronary stenting relieves depolarization abnormalities caused by myocardial ischemia, and improves the intraventricular conduction velocity. However, further studies are needed to assess the usefulness of VAT in evaluating myocardial ischemia.
Bundle-Branch Block ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Electrocardiography ; Follow-Up Studies ; Humans ; Hypertrophy ; Myocardial Ischemia ; Stents*

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium ; Esophageal Achalasia* ; Follow-Up Studies ; Humans ; Manometry ; Radionuclide Imaging ; Recurrence

BACKGROUND AND OBJECTIVES: The recovery of the normal heart rate immediately after exercise is a function of vagal reactivation. An attenuated heart rate recovery during the first minute after graded exercise is believed to be a marker of reduced parasympathetic activity and has been proven to be an independent predictor of overall mortality. However, the clinical significance of an abnormal heart rate recovery in coronary artery disease and the changes in the exercise parameters after coronary stenting have not been fully evaluated. Subjects and Methods: The study population included 53 patients with a significant coronary artery stenosis and 25 subjects with a normal coronary artery. All underwent a treadmill exercise test prior to coronary angiography. The differences in the heart rate recovery and the Duke treadmill score between two groups were investigated. After coronary stenting, changes in the exercise parameters were evaluated during the follow-up treadmill exercise test in 22 coronary artery disease patients. RESULTS: The frequencies of abnormal heart rate recovery (12% vs 38.3%, p=0.014) and a moderate to high risk Duke treadmill score (4% vs 21.3%, p=0.034) were significantly higher in the coronary artery disease group. The frequencies of these parameters were also significantly higher in the multivessel disease group than the single vessel disease group. After coronary stenting, most of the exercise parameters showed no significant changes but the Duke treadmill score improved significantly (p=0.038). CONCLUSION: The frequency of abnormal heart rate recovery was significantly higher in the coronary artery disease group. The Duke treadmill score was significantly improved and is thought to be a useful follow up parameter after coronary stenting.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Exercise Test ; Follow-Up Studies ; Heart Rate* ; Heart* ; Humans ; Mortality ; Stents*

BACKGROUND: QT dispersion (QTd) represents inhomogeneous ventricular repolarization. Increased QTd has been reported to be associated with ischemic heart disease and sudden cardiac death. Successful percutaneous coronary angioplasty (PTCA) produces a favorable recovery of inhomogenous repolarization and reduces QTd. Although treadmill exercise test is commonly used for follow-up test after PTCA, limited data are available about QTd during treadmill test. The purpose of this study was to evaluate the change in QTd and determine its clinical role in follow-up treadmill exercise test after coronary stenting. METHODS: 41 patients with significant coronary artery disease underwent successful coronary stenting, while 46 patients were medically treated. Treadmill exercise test was performed to compare QTd between two groups as a follow-up test at 6 months after coronary stenting and medical therapy. Treadmill exercise test was recorded in pre-test, peak exercise, and recovery 2 minutes phase. QTd and corrected QT dispersion (QTcd) were measured in these ECGs using a digitizer. RESULTS: Coronary stenting significantly reduced QTd and QTcd at 6 months after coronary stenting. QTd and QTcd did not show significant difference between coronary stenting and medical therapy group at initial EKG before treatment. After coronary stenting, QTd and QTcd were significantly reduced than those of medical therapy group. And the changes in QTd and QTcd were more marked at peak exercise (28.2+/-11.9 and 39.3+/-16.2 msec in coronary stenting group vs 40.4+/-20.5 and 57.8+/-30.0 msec in medical therapy group). Lesion location and diseased vessel number were not associated with changes in QTd and QTcd. CONCLUSION: Coronary stenting reduced QTd and QTcd significantly in follow-up treadmill exercise test. Coronary stenting appears to be more effective to relieve myocardial ischemia and to improve inhomogenous ventricular repolarization than medical therapy. The measurement of QTcd during treadmill exercise test may be a useful index to evaluate myocardial ischemia after coronary stenting. Clinical relevance of these finding will require further study.
Angioplasty ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Electrocardiography ; Exercise Test* ; Follow-Up Studies ; Humans ; Myocardial Ischemia ; Stents*

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.