PURPOSE: The purpose of this study was to investigate the occurrence of first onset of constipation during the rehabilitation stage and risk factors for constipation in patients with cerebral vascular disease (CVD). METHODS: Participants for this retrospective study were 214 CVD patients admitted to rehabilitation units. First onset of constipation and factors influencing constipation such as dependency level were recorded for 14 days during the rehabilitation stage. Survival analysis with Cox proportional hazard model and descriptive statistics were conducted. RESULTS: Age, patients'severity, types of diet, and dependency level were different between constipation and non-constipation groups. In survival analysis, 99% of participants developed constipation within 14 days after admission to rehabilitation units. Median constipation occurrence time was 7.4 days. Patients who were immobile and had tube feedings were more likely to develop constipation 4.07 times (95% CI: 1.018~16.301, p=.047) and 2.09 times (95% CI: 1.001~4.377, p=.050) respectively compared to patients who were independent and had a regular diet, respectively. CONCLUSION: Most CVD patients experienced constipation within 2 weeks after entering the rehabilitation stage. Constipation was linked to types of diet and dependency level. These factors associated with constipation should be considered when caring for patients in rehabilitation.
Constipation* ; Diet ; Humans ; Proportional Hazards Models ; Rehabilitation* ; Retrospective Studies ; Risk Factors ; Stroke ; Survival Analysis ; Vascular Diseases*

BACKGROUND AND OBJECTIVES: The nasal septum, centrally located in the nasal cavity, has dynamic relations with other craniofacial structures and is also influenced by them during development. Moreover, the mosaic structure of the septum is constituted through ossification. The purpose of this study was to evaluate the anatomical characteristics of the deviated nasal septum with preoperative computed tomography (CT) and calculations during surgery. SUBJECTS AND METHOD: We studied 62 patients with nasal septal deviation on one side, who underwent septoplasty between July 2008 and February 2009. The area of the septal cartilage, vomer, and perpendicular plate of the ethmoid bone was calculated with sagittal imaging using preoperative CT. The angle of deviation was also measured with coronal imaging. The length between the anterior nasal spine and sphenoidal sinus and that of the sphenoidal process was measured during surgery. RESULTS: The deviation angle increased significantly with the length of the sphenoidal process (p<0.01). The area of the septal cartilage decreased with age due to the progression of ossification. CONCLUSION: Nasal septal deviation without a history of trauma is influenced by the progression of nasal septal ossification.
Bone Development ; Cartilage ; Ethmoid Bone ; Humans ; Nasal Cartilages ; Nasal Cavity ; Nasal Septum ; Spine ; Vomer

PURPOSE: To investigate the relationship between early treatment response to definitive chemoradiotherapy (CRT) and survival outcome in patients with limited stage small cell lung cancer (LS-SCLC). MATERIALS AND METHODS: We retrospectively reviewed 47 patients with LS-SCLC who received definitive CRT between January 2009 and December 2012. Patients were treated with systemic chemotherapy regimen of etoposide/carboplatin (n = 15) or etoposide/cisplatin (n = 32) and concurrent thoracic radiotherapy at a median dose of 54 Gy (range, 46 to 64 Gy). Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response. The median dose at adaptive RT planning was 36 Gy (range, 30 to 43 Gy), and adaptive CT was performed in 30 patients (63.8%). RESULTS: With a median follow-up of 27.7 months (range, 5.9 to 75.8 months), the 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 74.2% and 56.5%, respectively. The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively. The median ETVRR was 71.4% (range, 30 to 97.6%) and the ETVRR >45% group showed significantly better OS (p < 0.0001) and LRPFS (p = 0.009) than the other group. CONCLUSION: ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.
Chemoradiotherapy* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Treatment Outcome ; Tumor Burden

PURPOSE: To investigate the relationship between early treatment response to definitive chemoradiotherapy (CRT) and survival outcome in patients with limited stage small cell lung cancer (LS-SCLC). MATERIALS AND METHODS: We retrospectively reviewed 47 patients with LS-SCLC who received definitive CRT between January 2009 and December 2012. Patients were treated with systemic chemotherapy regimen of etoposide/carboplatin (n = 15) or etoposide/cisplatin (n = 32) and concurrent thoracic radiotherapy at a median dose of 54 Gy (range, 46 to 64 Gy). Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response. The median dose at adaptive RT planning was 36 Gy (range, 30 to 43 Gy), and adaptive CT was performed in 30 patients (63.8%). RESULTS: With a median follow-up of 27.7 months (range, 5.9 to 75.8 months), the 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 74.2% and 56.5%, respectively. The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively. The median ETVRR was 71.4% (range, 30 to 97.6%) and the ETVRR >45% group showed significantly better OS (p < 0.0001) and LRPFS (p = 0.009) than the other group. CONCLUSION: ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.
Chemoradiotherapy* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Treatment Outcome ; Tumor Burden

Extramedullary leukemic infiltration rarely occurs in patients with acute lymphoblastic leukemia. An eight-year-old boy presented with a mass lesion of the left parotid gland with several palpable lymph nodes in the ipsilateral neck. The patient did not have any previous medical history. Given the suspicion of a lymphoma, an excisional biopsy of the parotid mass was performed. The preliminary pathologic result indicated myeloid sarcoma. The patient subsequently underwent bone marrow biopsy, and was finally diagnosed as acute lymphoblastic leukemia. Here we report a case of leukemic infiltration of the parotid gland as an extramedullary manifestation preceding the clinical onset of acute lymphoblastic leukemia.
Biopsy ; Bone Marrow ; Humans ; Leukemic Infiltration ; Lymph Nodes ; Lymphoma ; Neck ; Parotid Gland ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sarcoma, Myeloid

BACKGROUND AND OBJECTIVE : Sinusitis of odontogenic source is common disease accounts for about one tenth of cases of all maxillary sinusitis. Odontogenic sinusitis differs in its pathophysiology, clinical manifestation and the management from sinusitis of other causes. As the advance of dental procedure, the characteristics of odontogenic sinusitis are changing. The purpose of this study was to define the characteristics of odontogenic sinusitis with respect to the pathophysiology and management. SUBJECTS AND METHOD: Sixty two patients who were diagnosed to odontogenic sinusitis between May 2000 and May 2008 were included. All the diagnosis was supported by both dentist and otolaryngologist with objective data such as endoscopic exam and radiologic finding. All the medical records were reviewed retrospectively. RESULTS: Dental caries was most common cause of odontogenic sinusitis. Iatrogenic injuries during invasive procedure such as tooth extraction and implants were considerable. Most commonly presented symptom is facial discomfort. The surgical managements including local treatment were needed over 80% of cases. Average follow up period was 15.7 months, no complication was observed. CONCLUSION: The half of cases of odontogenic sinusitis was resulted from iatrogenic problem. The combination of a medical and surgical approach is generally required for the treatment.
Dental Caries ; Dentists ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Medical Records ; Oroantral Fistula ; Retrospective Studies ; Sinusitis ; Tooth Extraction

PURPOSE: For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer. MATERIALS AND METHODS: We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy). RESULTS: The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1). CONCLUSION: Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.
Deglutition Disorders ; Esophageal Neoplasms ; Follow-Up Studies ; Humans ; Tracheoesophageal Fistula

Classical Hodgkin lymphoma (cHL) is a highly curable disease, but the prognosis for relapsed/refractory cHL is grave. Pembrolizumab has recently shown impressive effects in patients with relapsed/refractory cHL in a phase Ib study (KEYNOTE-013). This report presents a case of a 17-year-old male with refractory cHL who received multiple chemotherapy regimens and radiotherapies, including brentuximab vedotin. Following both the second and fourth cycles of intravenous pembrolizumab 100 mg (2 mg/kg), positron emission tomography/computed tomography (PET/CT) scan showed progression. However, because performance status and fever improved, treatment was continued, and complete remission was confirmed by PET/CT after eight cycles of pembrolizumab. This case suggests that clinicians need to be aware of the potential for pseudoprogression in patients treated with pembrolizumab.
Adolescent ; Drug Therapy ; Electrons ; Fever ; Hodgkin Disease* ; Humans ; Male ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Radiotherapy

Splenosis refers to the heterotropic autotransplantation of splenic tissue. Sometimes splenosis after surgical resection is difficult to differentiate from recurrence or metastasis of cancer. A 49-year-old male patient was diagnosed with clear cell renal cell carcinoma of left kidney. As there was no evidence of metastasis, he underwent radical nephrectomy with splenectomy. On surveillance computed tomography, masses at nephrectomy site and pleura were found and both were initially considered to be recurrence. After several cycle of pazopanib administration, pleural mass decreased in size while mass at nephrectomy site did not respond at all. Spleen scan showed increased uptake of the mass and therefore the mass was revealed to be splenosis. To avoid unnecessary treatment and planning optimal treatment, considering the possibility of splenosis is important and spleen scan can be helpful.
Autografts ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Male ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy* ; Pleura ; Radionuclide Imaging ; Recurrence* ; Spleen ; Splenectomy ; Splenosis* ; Transplantation, Autologous

Objective: To evaluate the accuracy and quality of Korean videos associated with restless legs syndrome (RLS) on YouTube. Methods: A YouTube search was performed on April 1, 2020 using the term “restless legs syndrome” in the Korean language. Two reviewers coded the source, content, and demographics of the included videos. Video quality was assessed using the modified DISCERN (mDISCERN) instrument. Results: Among the 80 videos analyzed, 44 (55.0%) were reliable, and 36 (45.0%) were misleading. There was a trend toward a higher number of mean daily views in the misleading videos than in the reliable videos. Most of the misleading videos (72.2%) advocated complementary and alternative medicine as a primary treatment for RLS. Although the reliable videos had higher mDISCERN scores than the misleading videos, the overall quality of the reliable videos was low. Conclusion Many Korean videos regarding RLS on YouTube involve a risk of exposure to misinformation and are of unsatisfactory quality.