PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

PURPOSE: Laparoscopic wedge resection of gastric submucosal tumor may be difficult in case of the endophytic mass or the mass located unreachable area such as cardia, and intragastric approach can be useful. We would present the experiences of the intragastric wedge resection. MATERIALS AND METHODS: There were 7 patients diagnosed as gastric submucosal tumor and underwent the intragastric wedge resection at Surgery, Chungnam National University Hospital. We reviewed medical record. RESULTS: There were 3 male and 4 female. Mean age was 65 years-old (57~73). Mean body mass index was 26.28 kg/m2 (21.28~35.30). Location of lesions was 4 cardia, 2 fundus and 1 midbody, respectively. Mean operation time was 83.6 minutes (70~105). All patients were healed without any complication. Mean postoperative hospital stay was 5.4 days (4~6). Mean size was 2.7 cm (2.3~3.8). Pathologic finding was 5 gastrointestinal stromal tumor and 2 leiomyoma. CONCLUSIONS: The single incision intragastric wedge resection of gastric submucosal tumor is feasible and acceptable, especially in mass of gastric upper part.
Body Mass Index ; Cardia ; Female ; Gastrectomy ; Gastrointestinal Stromal Tumors ; Humans ; Laparoscopy ; Length of Stay ; Male ; Stomach Neoplasms ; Surgical Procedures, Minimally Invasive

Breast metastases from extra-mammary malignancies are unusual. In particular, the characteristics of breast metastasis from gastric cancer are rarely reported and there is no common specific finding among the reported cases. Breast metastases from extra-mammary malignancies are often misdiagnosed as benign lesions due to the absence of characteristic finding in imaging studies; however, they also resemble inflammatory breast cancer clinically sometimes. Therefore, differential diagnosis between the primary breast cancer and the metastatic disease is considered difficult. In order to hasten the diagnosis, to avoid unnecessary mastectomy, and to determine appropriate options of treatment, it is important that physicians understand the clinicopathological and radiologic features of breast metastases and consider its possibility in patients with a history of extra-mammary malignancies. Herein, we report a case of breast metastases from gastric cancer.

BACKGROUND: Lung transplantation (LTx) is an effective treatment for end stage lung disease. However, the shortage of donor lungs has been a major limiting factor to increase the number of LTx. Ex vivo lung perfusion (EVLP) is a currently approved method to evaluate lung function and to repair donor lung with poor function. The purpose of this study was to develop EVLP system in pig model and to maintain lung function during 4 hours of EVLP. METHODS: Bilateral lung blocks were harvested from five 40 kg pigs. These blocks were applied in EVLP perfused with 37degrees C Steen solution. We performed arterial blood gas (ABG) analyses before death and also every 1 hour for 4 hours after application of EVLP and calculated oxygen capacities (OC) using the results of ABG. We also calculated pulmonary vascular resistance (PVR) and peak airway pressure (PAP) every 1 hour for 4 hours. After EVLP procedure, we excised specimens for pathologic review. RESULTS: We found that OC gradually decreased during the 4 hour period of EVLP; however, no statistically significant difference was obtained. PVR declined sharply after 1 hour of EVLP (P=0.031) and then remained constant for 3 hours. PAP significantly increased after 3 hours (P<0.0001). Pathologic investigations revealed various findings from normal lung to severe pulmonary edema. CONCLUSIONS: On the results of this study, we could preserve the lung function for 4 hours using EVLP. We conclude that application of EVLP in clinical setting can make more donor lungs available for LTx. However, we also understand that more studies and training are needed in clinical practice.
Humans ; Lung ; Lung Diseases ; Lung Transplantation ; Organ Preservation ; Oxygen ; Perfusion ; Swine ; Tissue Donors ; Unrelated Donors ; Vascular Resistance

BACKGROUND: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. METHODS: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. RESULTS: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P<0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07~0.77, P<0.05]). CONCLUSION: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease.
Cholesterol, HDL ; Exercise ; Fasting ; Fatty Liver ; Fatty Liver, Alcoholic ; Glucose ; Hospitals, General ; Logistic Models ; Motor Activity ; Obesity ; Prevalence ; Triglycerides ; Surveys and Questionnaires

To evaluate the effect of vital tooth bleaching agent and alcohol pretreatment on dentin bonding, flat dentin windows were produced on the buccal side of the crowns of fifty-five extracted, human premolars. A bleaching gel, Opalescence(R) with 10% of carbamide peroxide (Ultradent Product, USA) was daily applied on the teeth of three experimental groups for six hours for 10 consecutive days, while teeth of a control group were not bleached. After 6 hours of bleaching gel application, the specimens were washed and stored in saline until the next day application. After application of One-step(R) dentin bonding agent (Bisco, USA), Z-250(R) resin (3M-ESPE, USA) was bonded to dentin with a mount jig. Shear bond strength was measured with an Instron machine (Type 4202, Instron Corp., USA) after 24 hours. The results were analyzed using one-way ANOVA and Duncan's multiple range test at p < 0.05. Immediate bonding group showed significantly lower bond strength than un-bleached control group (p < 0.05). Ethanol-treated group showed significantly higher bond strength compared to immediate bonding group (p < 0.05). However, the bond strength of the ethanol treatment group was lower than that of the un-bleached control group (p < 0.05). There were no significant difference in shear bond strength between the 2-week delayed bonding group and the ethanol-treated group (p > 0.05) and between delayed bonding group and un-bleached control group (p > 0.05). In the condition of the present study, it seems that alcohol pretreatment after bleaching procedure can reduce the adverse effect of vital bleaching agent on dentin bonding.
Bicuspid ; Crowns ; Dentin* ; Ethanol ; Humans ; Tooth Bleaching* ; Tooth* ; Urea

A 38-year-old man was admitted to the hospital because of abrupt left flank pain. He had no fever and physical examination revealed tenderness of the left costovertebral angle. Laboratory data revealed white blood cell 16,060/microL, C-reactive protein 0.93 mg/dL. Urinalysis showed more than 1/2 red cells per high-power field with severe proteinuria (4+). Enhanced computed tomography (CT) showed the thickened abdominal aorta wall with partial thrombus. The thickened aorta wall compressed the left renal vein and it caused left renal vein thrombosis. Abdominal CT findings suggested aortitis of the abdominal aorta with complication of left renal vein. We could exclude other types of aortitis including autoimmune aortitis, Takayasu's arteritis, giant cell arteritis, and infectious causes based on a serologic test and the history of the patient. Therefore, the patient was diagnosed with idiopathic aortitis and treated with glucocorticoid. After treatment, his symptoms disappeared and a follow-up CT showed decreased mural thickening of the abdominal aorta. Isolated idiopathic aortitis presented with renal vein thrombosis is extremely rare and has not been reported in Korea yet. We present a rare case report on idiopathic aortitis of the abdominal aorta with complication of left renal vein thrombosis.
Adult ; Aorta ; Aorta, Abdominal ; Aortitis* ; C-Reactive Protein ; Fever ; Flank Pain ; Follow-Up Studies ; Giant Cell Arteritis ; Humans ; Inflammation ; Korea ; Leukocytes ; Physical Examination ; Proteinuria ; Renal Veins* ; Serologic Tests ; Takayasu Arteritis ; Thrombosis* ; Tomography, X-Ray Computed ; Urinalysis

Background: There are incoherent studies about the effect of night shift work on circadian diurnal rhythms of cardiovascular parameters. Our study aimed to assess the alteration of circadian diurnal rhythms of cardiovascular parameters by night shift work. Methods: We studied 26 healthy nurse volunteers engaged in 3 shift work. From March 16 to April 30, 2006, ABPM (ambulatory blood pressure monitoring) was performed to each nurse two times during the day and night shift. Three nurses were excluded due to pain omdiced by ABPM. Blood pressure and heart rate was monitored every 30 minutes. Paired T-test was used for statistical analysis. Results: The mean arterial pressure, the mean systolic pressure, the mean heart rate and the mean pulse pressure during the overall period were significantly higher in the night shift than the day shift (P-value: <0.05, <0.001, <0.05, and <0.001, respectively). The mean arterial pressure, the mean diastolic pressure and the mean heart rate during in-hospital working period were significantly higher in the day shift (P-value: <0.05, <0.001, and <0.05, respectively). All parameters during the daytime sleep period after the night shift were significantly higher than during the nighttime sleep period after the day shift (P-values: <0.001). Proportional percentile falls of 3 parameters (systolic pressure, diastolic pressure, and heart rate) during the daytime sleep period after the night shift were significantly less than during the nighttime sleep period after the day shift (P-values: <0.001). Conclusion: The night shift work caused significant alteration in homeostasis of autonomic nervous system associated with circadian diurnal rhythms of cardiovascular parameters.
Arterial Pressure ; Autonomic Nervous System ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Circadian Rhythm* ; Heart ; Heart Rate ; Homeostasis ; Volunteers

OBJECTIVE: To evaluate the degree to which the paralysis of a dominant hand affects quality of life (QOL) in patients with subacute stroke. METHODS: We recruited 75 patients with subacute hemiplegic stroke. Patients were divided into two groups according to the location of the lesion and the side of the dominant hand. Group 1 consisted of patients whose strokes affected the dominant hand (i.e., right hemiplegia and right dominant hand or left hemiplegia and left dominant hand). Group 2 consisted of patients whose strokes affected the non-dominant hand (i.e., left hemiplegia and right dominant hand or right hemiplegia and left dominant hand). The primary outcome measure was the Short-Form 36-Item Health Survey (SF-36), which was used to evaluate health-related QOL. Secondary outcomes were scores on the Modified Barthel Index (MBI) and Beck Depression Inventory (BDI). RESULTS: We did not find any statistically significant differences between the groups in any SF-36 domain including the summaries of physical and mental component. Similarly, the MBI and BDI scores were not significantly different between the groups. CONCLUSION: The effect of paralysis on the dominant hand and QOL in patients with subacute stroke was not significantly different from the effect of paralysis on the non-dominant hand.
Depression ; Hand* ; Health Surveys ; Hemiplegia ; Humans ; Outcome Assessment (Health Care) ; Paralysis* ; Quality of Life* ; Stroke*

BACKGROUND/AIMS: Spontaneous HBeAg seroconversion occurs frequently in the immune reactive phase in HBeAg-positive chronic hepatitis B (CHB). Therefore, observation for 3-6 months before commencing antiviral therapy is recommended in patients with alanine aminotransferase (ALT) levels that exceed twice the upper limit of normal (ULN). However, HBeAg seroconversion occurs infrequently in patients infected with hepatitis B virus (HBV) genotype C. The aim of the present study was to determine whether the waiting policy is necessary in endemic areas of HBV genotype C infection. METHODS: Ninety patients with HBeAg-positive CHB were followed prospectively without administering antiviral therapy for 6 months. Antiviral therapy was initiated promptly at any time if there was any evidence of biochemical (i.e., acute exacerbation of HBV infection or aggravation of jaundice) or symptomatic deterioration. After 6 months of observation, antiviral therapy was initiated according to the patient's ALT and HBV DNA levels. RESULTS: Only one patient (1.1%) achieved spontaneous HBeAg seroconversion. Biochemical and symptomatic deterioration occurred before 6 months in 17 patients (18.9%) and 5 patients, respectively. High ALT and HBV DNA levels were both independent risk factors for biochemical deterioration. Of 15 patients with HBV DNA > or =5.1x107 IU/mL and ALT > or =5xULN, biochemical deterioration occurred in 7 (46.7%), including 1 patient receiving liver transplantation due to liver failure. CONCLUSIONS: Spontaneous HBeAg seroconversion in patients with HBeAg-positive CHB is rare within 6 months. Biochemical deterioration was common and may lead to liver failure. Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas of genotype C infection.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Follow-Up Studies ; Genotype ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/*blood ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors