OBJECTIVES: Stress is considered a causal factor in many diseases, allergic disease being one of them. The prevalence of allergic disease is increasing in Korea, but the relationship between allergic symptoms and stress is not empirically well known. We aimed to evaluate the relationship between allergy-related symptoms and stress in children and adolescents. METHODS: We investigated 698 children and adolescents living in Gwangyang Bay, Korea, using a multi-stage cluster sampling method. Using the International Study of Asthma and Allergies in Childhood and the Psychosocial Well-being Index, these subjects were surveyed on allergy-related symptoms and psychosocial stressors in their lives, respectively. We used a multivariate logistic analysis for odds ratios for the complaint rate of allergic symptoms, after adjusting for age, gender, household income, body mass index, and residence. RESULTS: After adjustments, lifetime rhinitis (odds ratio [OR], 1.024), rhinoconjunctivitis (OR, 1.090), diagnosis of itchy eczema (OR, 1.040), treatment of itchy eczema (OR, 1.049), 12-month allergic conjunctivitis (OR, 1.026), diagnosis of allergic conjunctivitis (OR, 1.031), and treatment of allergic conjunctivitis (OR, 1.034) were found to be significantly associated with stress. CONCLUSIONS: Our results support the notion that there is a relationship between stress and allergic symptoms in children and adolescents. Further research into any causal relationship between stress and allergies, as well as preventative public health plans for decreasing stress in children and adolescents are needed.
Adolescent ; Child ; Cluster Analysis ; Conjunctivitis, Allergic/diagnosis/psychology/therapy ; Cross-Sectional Studies ; Eczema/diagnosis/psychology/therapy ; Female ; Humans ; Hypersensitivity/diagnosis/epidemiology/*psychology ; Interviews as Topic ; Logistic Models ; Male ; Questionnaires ; Republic of Korea ; Rhinitis/diagnosis/psychology ; *Stress, Psychological

PURPOSE: To assess the influence of body position on intraocular pressure (IOP) in patients who underwent vitrectomy and intraocular gas tamponade. METHODS: Patients who did not undergo any surgery were defined as Group 1. The remaining patients were divided into 3 groups according to the surgery performed (Group 2; cataract surgery, Group 3; vitrectomy and cataract surgery, Group 4; vitrectomy with intraocular gas tamponade and cataract surgery). IOP was measured by a non-contact tonometer, Goldmann applanation tonometer, and Tono-Pen in the sitting, supine, and prone positions. RESULTS: The difference of IOP measured in the sitting position among the 4 groups was not significant. IOP was significantly elevated by 2.04 mm Hg on average when the posture was changed from sitting to supine or prone in all 4 groups. The IOP discrepancy between supine and sitting positions was significantly greater in group 4 by 3.61 mm Hg than the other groups (p = 0.003, ANOVA test). The IOP difference between the prone and sitting position was also significantly higher in group 4 by 3.82 mm Hg than the other groups (p = 0.001, ANOVA test). CONCLUSIONS: The patients with vitrectomized gas tamponade eyes had a mean IOP increase of 3.82 mm Hg when the position was changed from sitting to prone. When performing vitrectomy and intraocular gas tamponade on patients in the prone position, an IOP elevation should be monitored thoroughly.
Cataract ; Humans ; Intraocular Pressure* ; Posture ; Prone Position ; Vitrectomy*

Listeria monocytogenes has been recognized as a pathogen in elderly and immunecompromised hosts with malignancies, alcohol abuse, diabetes mellitus, transplanted organs, liver cirrhosis, renal failure, or acquired immunodeficiency syndrome (AIDS). In adults, it usually presents as neuromeningeal infection, such as meningitis, meningoencephalitis, or encephalitis, or as primary bacteremia. Involvement of the liver with L. monocytogenes is uncommon. We report on a case of multiple liver abscesses and bacteremia associated with L. monocytogenes in a 67-year-old diabetic female with concomitant active multidrug-resistant pulmonary tuberculosis. Blood cultures were positive for L. monocytogenes. In patients with liver abscess with advanced age or who are immune-compromised, including those with diabetes, clinicians should consider Listeria infection as a differential diagnosis.
Acquired Immunodeficiency Syndrome ; Adult ; Aged ; Alcoholism ; Bacteremia ; Diabetes Mellitus ; Diagnosis, Differential ; Encephalitis ; Female ; Humans ; Listeria ; Listeria monocytogenes ; Listeriosis ; Liver ; Liver Abscess ; Liver Cirrhosis ; Meningitis ; Meningoencephalitis ; Renal Insufficiency ; Transplants ; Tuberculosis, Pulmonary

Organized hematoma of maxillary sinus is a rare pathologically benign mass in which pressure in the hematoma increases as it undergoes a process of organization, causing the deformation of the surrounding tissue, mimicking malignancies. The midfacial degloving approach can be used when extensive exposure is required in the treatment of lesions or traumas in the midfacial area with intranasal and intraoral incisions. We report a surgical excision case of organized hematoma of maxillary sinus using midfacial degloving approach without major complications and recurrence after one-year follow up.

PURPOSE: The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. METHODS: This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. RESULTS: The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the "number of suspicious findings" between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. CONCLUSION: Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of "two or more suspicious findings" can be used as the cutoff for distinguishing benign and malignant nodules.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Follow-Up Studies* ; Logistic Models ; Retrospective Studies ; ROC Curve ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography

We report an anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia (elevated free thyroxine, fT4 and normal 3, 5, 3'-L-triiodothyronine, T3) and suspected impairment of conversion from T4 to T3. Despite marked hyperthyroxinemia, this patient's perioperative hemodynamic profile was suspected to be the result of hypothyroidism, in reference to the presence of T4 to T3 conversion disorder. We suspected that pretreatment with antithyroid medication before surgery, surgical stress and anesthesia may have contributed to the decreased T3 level after surgery. She was treated with liothyronine sodium (T3) after surgery which restored her hemodynamic profile to normal. Anesthesiologists may be aware of potential risk and caveats of inducing hypothyroidism in patients with euthyroid hyperthyroxinemia and T4 to T3 conversion impairment.
Anesthesia ; Conversion Disorder ; Hemodynamics ; Humans ; Hyperthyroxinemia* ; Hypothyroidism ; Sodium ; Thyroxine ; Triiodothyronine

The purpose of this study is to monitor the secretion of matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) produced by human osteosarcoma cell line (MG63) stimulated with Prevotella nigrescens lipopolysaccharides (LPS), and to compare the level of secretion before and after the treatment of calcium hydroxide on P. nigrescens LPS. LPS was extracted and purified from anaerobically cultured P. nigrescens. MG63 cells were stimulated by the LPS (0, 1, 10 microg/ml) or LPS (10 microg/ml) pretreated with 12.5 mg/ml of Ca(OH)2 for 3 days. Total RNA was isolated from the cell, and real-time quantitative polymerase chain reaction (PCR) was performed for quantification of MMP-1 and TIMP-1. The results were as follows. 1. MMP-1 mRNA expression at 48 hr was highly increased by stimulation with P. nigrescens LPS. The increase was dose-dependent. 2. When stimulated with 1 microg/ml of LPS, TIMP-1 mRNA expression was highly increased at 24 hr and 48 hr. However, TIMP-1 expression was suppressed at higher concentration (10 microg/ml). 3. When P. nigrescens LPS was pretreated with Ca(OH)2, MMP-1 and TIMP-1 gene expression was downregulated. The results of this study suggest that transcriptional regulation of MMP-1 and TIMP-1 by P. nigrescens LPS could be one of the important mechanisms in bone resorption of periapical inflammation. The result of calcium hydroxide on MMP-1 and TIMP-1 gene expression suppression shows that calcium hydroxide detoxified bacterial LPS and thus should be used the medication of choice for intracanal dressings in root canal infected with black-pigmented bacteria.
Bacteria ; Bandages ; Bone Resorption ; Calcium Hydroxide ; Cell Line ; Dental Pulp Cavity ; Gene Expression ; Humans ; Inflammation ; Lipopolysaccharides ; Matrix Metalloproteinase 1 ; Osteosarcoma ; Polymerase Chain Reaction ; Prevotella nigrescens* ; Prevotella* ; RNA ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1*

PURPOSE: The aim of this study was to investigate whether the observed changes over time in the survival rates vary according to the intrinsic subtypes of breast cancer diagnosed. METHODS: Data from 46,320 breast cancer patients in the Korean Breast Cancer Registry who underwent surgery between 1999 and 2006 were reviewed. Among them, results from 25,887 patients with available data about the status of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) were analyzed. Patients were classified into two cohorts according to the year in which they underwent surgery: 1999-2002 and 2003-2006. RESULTS: The patients treated in the latter time period showed significantly better overall survival (OS) compared with those in the former period when adjusted for follow-up duration. The proportion of hormone receptor+/HER2-subtype and stage I breast cancer were significantly higher in the latter period (47.4% vs. 54.6%, p<0.001; 31.0% vs. 39.6%, p<0.001, respectively). Improvement in OS between the former and latter periods was seen in all subtypes of breast cancer, including triple-negative cancers (all p-values <0.001 in univariate and multivariate analyses). CONCLUSION: Improvement in survival in Korean breast cancer patients over the study years is being observed in all subtypes of breast cancer, implying that increases in both early-stage detection and the proportion of less aggressive cancers contribute to this improvement.
Breast Neoplasms* ; Cohort Studies ; Estrogens ; Follow-Up Studies ; Humans ; Korea ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Registries ; Survival Rate

OBJECTIVES: This study was performed to consider the clinical experience of surgical outcome of single port access (SPA) laparoscopic myomectomy according to suturing methods. METHODS: The authors operated with 2 suturing method in SPA laparoscopic myomectomy for 246 patients and compared the surgical outcomes. RESULTS: The some significant difference of surgical outcome according to two suturing methods was demonstrated. Operating time was 100.50 minutes (+/- 42.09 minutes) in interrupted suture method group than 121.04 minutes (+/- 61.56 minutes) in continuous interlocking suture method group (P = 0.021). Estimated blood loss was less 222.59 mL (+/- 144.94 mL) in interrupted suture group than 340.11 mL (+/- 380.62 mL) in continuous interlocking suture method group (P = 0.042). CONCLUSION: This experience suggests that interrupted suture method was effective for operating time and estimated blood loss than continuous interlocking method in SPA laparoscopic myomectomy.
Humans ; Laparoscopy ; Leiomyoma ; Suture Techniques ; Sutures ; Treatment Outcome

PURPOSE: To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity. MATERIALS AND METHODS: Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis. RESULTS: Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor. CONCLUSION RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.