Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent cessation of breathing due to complete or partial upper airway occlusion during sleep. The incompetent tone of palatal, pharngeal, and glossal muscles which fail to maintain airway patency during sleep causes narrowing of the airway dimension and increased resistance of breathing. The identification of the sites of upper airway obstruction in patients with OSA is important in understanding the pathogenesis and deciding the treatment modality of snoring and/or OSA. Various upper airway imaging modalities have been used to assess upper airway size and precise localization of the sites of upper airway obstruction during sleep. Dynamic imaging modalities enabled assessment of dimensional changes in the upper airway during respiration and sleep. This article focused on reviews of various upper airway imaging modalities, especially dynamic upper airway imaging studies providing important information on the pathogenesis of OSA.
Airway Obstruction ; Diagnostic Imaging ; Humans ; Muscles ; Respiration ; Sleep Apnea, Obstructive* ; Snoring

Teratomas of the fallopian tube are extremely rare, and only about 50 cases have reported in the world literature. Most cases of mature cystic tubal teratoma are asymptomatic and are discovered as an incidental finding on physical or radiologic examination, or at the time of laparatomy. We report a case of mature cystic teratoma of the right fallopian tube which was discovered during pelvic ultrasonogram for antenatal care in a 28 year old woman. Right salpingectomy was performed during cesarean section for cephalo-pelvic distortion at IUP 39 weeks. Gross examination of the right fallopian tube reveals a distended fallopian tube, measuring 8cm in length and 2cm in diameter. On section, it is filled with several small pedunculated nodules and cysts containing sebaceous materials. Microscopically the tumor was seen in continuity with the lining epithelium of mucosal folds. The majority of the tumor was composed of well differentiated mature elements of three germ layers with skin and skin appendages, mature brain tissue, bone, breast tissue, intestinal mucosa and bronchial epithelium.
Female ; Humans ; Cysts

No abstract available.
Humans ; T-Lymphocyte Subsets*

No abstract available.
Ear Cartilage ; Ectropion ; Eyelids ; Transplants

OBJECTIVES: The Diagnosis Related Group (DRG) payment system, which has been implemented in Korea since 1997, is based on voluntary participation. Hence, the positive impact of this system depends on the participation of physicians. This study examined the factors determining participation of Korean obstetrics & gynecology (OBGYN) clinics in the DRG-based payment system. METHODS: The demographic information, practice-related variables of OBGYN clinics and participation information in the DRG-based payment system were acquired from the nationwide data from 2002 to 2007 produced by the National Health Insurance Corporation and the Health Insurance Review & Assessment Service. The subjects were 336 OBGYN clinics consisting of 43 DRG clinics that had maintained their participation in 2003-2007 and 293 no-DRG (fee-for-service) clinics that had never been a DRG clinic during the same period. Logistic regression analysis was carried out to determine the factors associated with the participation of OBGYN clinics in the DRG-based payment system. RESULTS: The factors affecting participation of OBGYN clinics in the DRG-based payment system were as follows (p<0.05): (1) a larger number of caesarian section (c/sec) claims, (2) higher cost of a c/sec, (3) less variation in the price of a c/sec, (4) fewer days of admission for a c/sec, and (5) younger pregnant women undergoing a c/sec. CONCLUSIONS: These results suggest that OBGYN clinics with an economic practice pattern under a fee-for-service system are more likely to participate in the DRG-based payment system. Therefore, to ensure adequate participation of physicians, a payment system with a stronger financial incentive might be more suitable in Korea.
Adult ; Age Factors ; Ambulatory Care Facilities/economics/*statistics & numerical data ; Cesarean Section/statistics & numerical data ; Costs and Cost Analysis/statistics & numerical data ; Demography ; Diagnosis-Related Groups/economics/*statistics & numerical data ; Fee-for-Service Plans/statistics & numerical data ; Female ; Gynecology ; Humans ; Length of Stay/statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Obstetrics ; Pregnancy ; *Prospective Payment System ; Republic of Korea ; State Medicine/economics/*statistics & numerical data

It is well known that HL-60 cell, a human promyelocytic line, is differentiated into eosinophil-like cells in the presence of butyric acid, and thus the differentiated HL-60 cells have been used as a model system to study irnmunological properties of peripheral eosinophils which are thought to be terminally differentiated. To study whether HL-60 cells alter their capability of expressing cytokines during differentiation to eosinophil-like cells, we examined TNF mRNA levels in HL-60 cells treated with butyric acid by Ribonuclease Protection Assay (RPA). HL-60 cells were incubated for 3 days in the presence of butyric acid (0.5 mM), and stimulated with PMA and lipopolysaccharide (LPS). The levels of TNF mRNA decreased by 50 % and 95 % upon one and two days of post-treatment of butyric acid, respectively. The decreased pattern in TNF mRNA levels was also observed in HL-60 cells that have been treated with retinoic acid known as an inducer for differentiation of them. In accordance with these results, prominent azurophilic granules typical in eosinophils appeared in the cytoplasm of the differentiated HL-60 cells. The decreased expression of TNF mRNA was not attributable to the presence of serum, since increasing concentrations of serum had no effect. Furthermore, interleukin-5 (IL-5), which is known to be involved in activation and trafficking of eosinophils in vivo and in vitro, failed to affect TNF mRNA production when it was used in place of butyric acid. These data suggest that the differentiated HL-60 cells may have immunological resemblance to eosinophils in that they weakly produce the cytokine mRNA.
Butyric Acid ; Cytokines ; Cytoplasm ; Eosinophils ; HL-60 Cells* ; Humans ; Interleukin-5 ; Ribonucleases ; RNA, Messenger* ; Tretinoin

No abstract available.
Birth Certificates* ; Parturition*

Tuberous sclerosis is not as rare as once thought and has high psychiatric comorbidities. However, bipolar or psychotic features associated with tuberous sclerosis have been rarely reported. This report first presents a tuberous sclerosis patient, resembling a schizoaffective disorder of bipolar type. A patient with known tuberous sclerosis displayed mood fluctuation and psychotic features. Her symptoms did not remit along with several psychiatric medications. After hospitalization, the patient responded well with lamotrigine and aripiprazole without exacerbation. As demonstrated in this case, tuberous sclerosis may also encompass bipolar affective or psychotic features. We would like to point out the necessity to consider bipolarity in evaluating and treating tuberous sclerosis.
Aripiprazole* ; Comorbidity ; Hospitalization ; Humans ; Psychotic Disorders ; Tuberous Sclerosis*

PURPOSE: To report a case of idiopathic sclerosing inflammatory tumor presenting as painful masses in the medial side of both upper eyelids. CASE SUMMARY: A 26-year-old female presented with pain in both eyes at upward gaze and progressive medial side masses on bilateral upper eyelids 3-4 months prior. Orbit MRI showed an orbital benign tumor and partial excisional biopsy was performed for the larger right upper eyelid mass. The biopsy result was chronic inflammation with fibrosis. There was no change in the masses size after an oral steroid was prescribed for 11 days. At 6 weeks after the first operation, complete excisional biopsy was performed for the bilateral upper eyelid masses and idiopathic sclerosing inflammatory tumor was diagnosed. Intravenous steroid injections were administered twice with a 1-week interval postoperatively. After 6 months of follow-up, no recurrence was evident. CONCLUSIONS: Idiopathic sclerosing inflammatory tumor usually involves the anterior, lateral, or apex of the unilateral orbit and does not invade the inferomedial side of the orbit and typically has a chronic course. We experienced a rare case of idiopathic sclerosing inflammatory tumor that involved the medial side of both upper eyelids which was cured by complete excision.
Adult ; Biopsy ; Eyelids* ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Orbit ; Recurrence

PURPOSE: To evaluate the efficacy of unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia within 25 prism diopters (PD) which occurred after bilateral lateral rectus muscle recession for intermittent exotropia. METHODS: Medical records of 11 patients who underwent unilateral lateral rectus muscle advancement for consecutive esotropia from 2011 to 2014 and who were observed for at least 6 months after surgery were retrospectively reviewed. The change in the angle of deviation before and after consecutive esotropia surgery, success rate, and surgical effect were evaluated. RESULTS: Preoperative esodeviation was -19.6 ± 4.7 PD at distance and -16.5 ± 7.4 PD at near. Unilateral lateral rectus muscle advancement surgeries were performed based on one-fourth of the angle of consecutive esotropia and the mean surgical amount was 4.8 ± 1.1 mm. Of the total 11 patients, 10 patients (91%) recovered to orthotropia or exodeviation within 8 PD. One patient had a recurrence of esotropia at postoperative 3 months, but the patient recovered to orthotropia at postoperative 12 months with alternative patch treatment and a prism glass prescription. The surgical effect of unilateral lateral rectus muscle advancement was 3.3 ± 0.7 PD/mm at postoperative 1 day, 3.7 ± 0.6 PD/mm at postoperative 1 week, and 3.8 ± 0.7 PD/mm at postoperative 6 months. CONCLUSIONS: Unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia within 25 PD was successful in all 11 cases. The surgical effect was significantly greater in unilateral lateral rectus muscle advancement than in primary lateral rectus muscle recession. Thus, reduction in the amount of surgery should be considered carefully in unilateral lateral rectus muscle advancement for consecutive esotropia.
Esotropia* ; Exotropia ; Glass ; Humans ; Medical Records ; Prescriptions ; Recurrence ; Retrospective Studies