Chromosome 11q13 deletion syndrome has been previously reported as either otodental syndrome or oculo-oto-dental syndrome. The otodental syndrome is characterized by dental abnormalities and high-frequency sensorineural hearing loss, and by ocular coloboma in some cases. The underlying genetic defect causing otodental syndrome is a hemizygous microdeletion involving the FGF3 gene on chromosome 11q13.3. Recently, a new form of severe deafness, microtia (small ear) and small teeth, without the appearance of eye abnormalities, was also reported. In this report, we describe a 1-year-old girl presenting with ptosis of the left upper eyelid, right auricular deformity, high-arched palate, delayed dentition, simian line on the right hand, microcephaly, and developmental delay. In this patient, we identified a deletion in the chromosome 11q13.2-q13.3 (2.75 Mb) region by using an array-comparative genomic hybridization analysis. The deletion in chromosome 11q13 results in a syndrome characterized by variable clinical manifestations. Some of these manifestations involve craniofacial dysmorphology and require a functional workup for hearing, ophthalmic examinations, and long-term dental care.
Coloboma ; Congenital Abnormalities ; Congenital Microtia ; Deafness ; Dental Care ; Dentition ; Eye Abnormalities ; Eyelids ; Female ; Hand ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Microcephaly ; Nucleic Acid Hybridization ; Palate ; Tooth ; Tooth Abnormalities

PURPOSE: Phyllodes tumors are characterized by a double-layered epithelial component arranged in cleft-like ducts surrounded by a hypercellular spindle-celled stroma. Currently, phyllodes tumors are classified as benign, borderline, or malignant based on microscopic features. The relatively high rate of recurrence is an unsolved management problem. If a malignant phllodes tumor is treated inadequately, it may show a propensity for rapid growth and metastatic spread. However, benign phyllodes tumor are often indistinguishable from fibroadenoma, and can be cured by local surgery. Percutaneous removal of benign breast tumors using the Mammotome system has recently been regarded as a feasible, safe method without serious complications. The Mammotome system has an expanding role in the surgical treatment of benign breast disease, and may further extend its role to the excision of small malignant lesions. The aim of this study was to evaluate the efficacy and the safety of the Mammotome biopsy device in the treatment of benign phyllodes tumor, and to identify whether surgical excision is necessary for benign phyllodes tumors diagnosed and excised by Mammotome. METHODS: From Jan. 2003 to Feb. 2007, a total of 2,751 US- guided mammotome excisions were performed in 2,226 patients at Kangnam Cha hospital. Out of 2,751 lesions, 30 lesions were proved to be benign phyllodes tumors. All lesions were removed using an 8-gauge probe without any residual lesions. Ultrasonographic follow-up was performed at a 3- to 6-month interval to assess recurrence. The mean follow-up period was 33.2 months (max, 51 months; min, 2 months). RESULTS: The mean patient age was 31.4 years. The average size of the lesion was 1.5 cm (SD+0.43 cm). The majority of lesions, 73.3% (22 cases), were palpable, and 26.7% (8 cases) were nonpalpable. Twenty-two lesions (73.8%) were classified as BIRADS category 3, eight lesions (26.7%) were classified as category 4A by ultrasound. During the follow-up period, local recurrence developed in only one patient, making the local recurrence rate 3.3%. No distant metastasis was observed. CONCLUSION: Benign phyllodes tumors found on mammotome excision may not require surgical reexcision if surgeons are sure that the targeted lesions were excised completely and the follow-up ultrasound does not show any residual lesions, especially in small phyllodes tumors, the greatest dimension of which is less than 3 cm.
Biopsy* ; Breast Diseases ; Breast Neoplasms ; Breast* ; Fibroadenoma ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Phyllodes Tumor* ; Recurrence ; Ultrasonography

BACKGROUND AND OBJECTIVES: Although many studies have assessed factors related to adherence of PAP therapy, there were no studies about factors related to doctors or device managers. The purpose of this study was to investigate the relationship between PAP therapy adherence and doctor or device manager. SUBJECTS AND METHODS: Between February 2013 and June 2015, 163 patients newly diagnosed with moderate to severe OSA in one of five hospitals were enrolled in this study. All patients received 4 weeks of PAP treatment with intervention consisting of mechanical support and motivation by doctor and device manager. Data from the PAP device were obtained following a minimum of an initial 30 days, with adherence defined as >4 h/night on 70% of nights. RESULTS: After 30 days, total adherence rate to PAP therapy was 35.6% (n=58). The adherence rate of device manager ① was 26.3% (31/118), and that of device manager ② was 60% (27/45), and there was statistically significant difference between the two device managers. Furthermore, there were statistically significant differences in the adherence to PAP therapy ranging from 85.6% to 0.0% according to doctor. CONCLUSION: Our study demonstrates that the device manager and doctor may be important factors for good adherence to PAP therapy in patients with OSA.
Continuous Positive Airway Pressure ; Humans ; Motivation ; Patient Compliance ; Sleep Apnea, Obstructive*

OBJECTIVES: The purpose of this study was to compare and analyze the results of salty taste assessment, dietary attitudes, and dietary behaviors among adult and senior women by region and by age. The results generated from this was expected to provide fundamental data for implementing a nationwide salt reduction education program. METHODS: The salty taste assessment tool was applied to 4,064 subjects from 15 areas in Korea. Also, a survey of dietary attitude and dietary behavior related to salt intake was conducted for all subjects participated in this study. RESULTS: The salty taste assessment scores by region and by age were the lowest in capital (p < 0.01) and was highest among the 70+ year age group (p < 0.01). The dietary attitude scores and dietary behavior scores showed that Gyeongsang was the highest (p < 0.001) and the capital was the lowest. The dietary attitude scores were highest at 20&30's followed by 40's and 70's group (p < 0.001). Dietary behavior scores showed that 20's~30's and 40's groups were higher than the other age groups (p < 0.001). The score of 'I like kimchi' was 3.46 +/- 0.88, which was the highest among 10 dietary behavior questions. The score of 'I eat a lot of kimchi' was 3.30 +/- 0.90, which was the highest among 10 dietary behavior questions related to salt intake. The scores of salty taste assessment had significant positive correlations between the scores of dietary attitude (p < 0.001), dietary behavior (p < 0.001) and self-awareness (p < 0.001). CONCLUSIONS: Based on the results of salty taste assessment, we observed a tendency that older people and regions except the capital had higher preference for salty taste. Our results suggested the necessity for a nationwide salty reduction education program tailored for regions and for different age groups.
Adult* ; Education ; Female ; Humans ; Korea

Apocrine carcinoma is a rare breast cancer and its frequency is about 0.4% of all breast cancers. Little is known about its clinical behavior and prognosis. To our knowledge, few studies have reported the radiologic appearances of apocrine carcinoma in the breast and there has been no such report from Korea. We describe the sonographic findings of a case of apocrine carcinoma in the breast. The sonographic findings are microlobulated heterogeneous hypoechoic lesion that has a central markedly hypoechoic portion and a peripheral mixture of iso and hypoechgenecity.
Apocrine Glands ; Breast Neoplasms ; Breast* ; Korea ; Prognosis ; Ultrasonography

PURPOSE: Occult papillary thyroid carcinomas (OPC) are defined as tumors measuring <15 mm. These tumors are believed to be a less aggressive subset of papillary cancers. They generally behave more like benign lesions and are often more conservatively treated. However, it is unclear if a cancer 1.0 to 1.5 cm in diameter will have a similar favorable clinical behavior as tumors <1.0 cm (micropapillary thyroid carcinoma). Therefore, a retrospective chart review study of patients with OPC in order was carried out in order to answer this question and characterize the biology and optimal treatment for OPCs. METHODS: From October 2001 to January 2007, Among the impalpable thyroid nodules detected incidentally during screening examinations, 260 patients underwent surgery for occult papillary thyroid cancer (OPC) at Kangnam Cha University hospital. The data from these patients was analyzed retrospectively. The mean follow up period was 25.6 +/- 14.5 (max: 63, min: 1) months. RESULTS: The mean age of these patients was 42.8 years, and 233 (89.5%) were female. 46.2% of patients underwent a total or neartotal thyroidectomy, and 54.6% underwent a central lymph node dissection. Of the 260 patients, 55 (21.2%) had lymph node metastases. The OPC presented with signs of aggressiveness including multifocality (34.2%), bilaterality (17.7%), capsular invasion (52.7%), and lymph node metastases (21.2%). A progressively increasing frequency of the signs of tumor aggressiveness was observed with increasing tumor size at presentation. LN metastases were associated with the tumor size (P=0.0063), extracapsular invasion (P=0.0015) and multfocallity (P=0.0020). However, there was no association with age and gender. With a follow-up of up to 63 months, 3 patients had a local recurrence (0.014%). No patients currently have active disease and no patients with OPC died during this period. CONCLUSION: In OPC patients, there is a progressively increasing frequency of the signs of tumor aggressiveness with increasing tumor size. Moreover, a small size itself cannot guarantee low risk and low recurrence rate. The prevalence of LN metastases and extracapsular invasion were higher in those with a tumor size >0.5 cm. A near-total or total thyroidectomy with a central lymph node dissection is the preferred treatment. The early detection and treatment of OPC might be warranted through the routine use of thyroid USG and USG-guided FNA.
Biology ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Prevalence ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy

PURPOSE: To review the retrospective imaging findings of thyroid cancer initially assessed as no suspicious malignancy. MATERIALS AND METHODS: Of 338 nodules confirmed to be thyroid cancer, this study included 38 patients with 39 nodules assessed as no suspicious malignancy on initial sonography. (mean age: 39 years, 36 females and 2 males). We evaluated sonographic findings by shape, margin, echogenecity, calcification, cystic degeneration and peripheral hypoechoic rim retrospecively. We analyzed whether sonographic findings were different according to the size (standard: 1 cm). RESULTS: The most frequent sonographic findings were ovoid to round shape 90%, well-defined smooth margin 64%, hypoechogenecity 54%, no calcification 92%, no cystic degeneration 77% and peripheral hypoechoic rim 56%. Suspicious malignancy findings were taller than wide shape 10%, well-defined spiculated margin 36%, markedly hypoechogenecity 10% and microcalcifications 8%. Isoechogenecity, cystic degenetaion and peripheral hypoechoic rim were common in 1 cm more than nodules. Well-defined spiculated margin was common in 1 cm less than nodules. In retrospective, 56% showed no suspicious malignancy finding. CONCLUSION: Although nodules assessed as no suspicious malignancy on initial US had many retrospectively suspicious malignancy findings, still many nodules showed no suspicious malignancy finding. Suspicious findings were ignored due to equivocal finding in small size, isoechogenecity, cystic degeneration or peripheral hypoechioic rim. We need careful observation.
Female ; Humans ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

BACKGROUND AND OBJECTIVES: The cause of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unclear, but recently, chronic inflammation and thrombosis have received attention. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are some of the markers that show the state of inflammation and ischemia, which are measured routinely in the complete blood cell count (CBC) test. The aim of this study were to investigate the relevance of NLR and PLR with ISSNHL. SUBJECTS AND METHOD: Enrolled in our retrospective analysis were 103 patients diagnosed with ISSNHL. Blood samples were taken from the patients and hearing assessments were performed. NLR and PLR were calculated using the CBC results. Then the patients were divided into 4 groups using Sigel's criteria according to their response to the treatment, which were again classified two groups, the “recovered” and “unrecovered” group. RESULTS: NLR, PLR, and neutrophil values of the unrecovered group were significantly higher than the recovered group (p=0.002, p=0.009, and p=0.038, respectively). On the other hand, lymphocyte values were significantly higher in the recovered group (p=0.007). After adjustment in a multivariate logistic regression analysis, NLR was associated with the recovery of ISSNHL (Odds ratio=1.290, p=0.042). In addition, NLR and PLR values were also significantly different between the groups classified by the Sigel's criteria (p=0.009 and p=0.029, respectively). CONCLUSION: PLR values may be useful in predicting hearing recovery after treatment in patients with ISSNH. It is also expected to be a potential marker for predicting the prognosis and determining further treatment options.
Biomarkers ; Blood Cell Count ; Hand ; Hearing ; Hearing Loss, Sensorineural* ; Humans ; Inflammation ; Ischemia ; Logistic Models ; Lymphocytes ; Methods ; Neutrophils ; Prognosis* ; Retrospective Studies ; Thrombosis

PURPOSE: To evaluate the sonographic and mammographic features of apocrine metaplasia of the breast. MATERIALS AND METHODS: We retrospectively evaluated the sonographic and mammographic findings of 16 lesions that were diagnosed with only apocrine metaplasia after mammotome excision. The age ranged from 27 years old to 57 years old (mean age; 40 years old). The sonographic features were interpreted by the ACR BI-RADS (American College of Radiology Breast Imaging Reporting and Data System) for shape, orientation, margin, boundary, echo pattern, posterior acoustic feature, calcification and special cases. The mammographic features were interpreted by the ACR BI-RADS (American College of Radiology Breast Imaging Reporting and Data System) for breast composition, shape, margin, density and calcification. RESULTS: Sonographic features were that the shapes were oval (n = 16) in 100%. The orientation was parallel (n = 15) in 94%. The margins were circumscribed (n = 8) in 50% and microlobulated (n = 8) in 50%. The echo patterns were hypoechoic (n = 8) in 50%, complex (n = 5) in 31% and anechoic (n = 3) in 19%. Posterior acoustic enhancement was seen in 69% (n = 11). There was internal microcyst (n = 4) in 25%. There was no calcification. Mammography performed for 12 cases demonstrated negative findings (n = 10) for 83%, obscured hypodense mass (n = 1) for 8% in 11 cases of breast composition 3 and 4, and circumscribed isodense mass (n = 1) for 8% in one case of breast composition 2. There was no calcification. The final assessment was category 4a (n = 7) in 44%, category 3 (n = 6) in 38% and category 2 (n = 3) in 19%. CONCLUSION: Although sonographic and mammographic features of apocrine metaplasia are occasionally suspicious malignancy such as microlobulation and complex echo. We consider the possibility of apocrine metaplasia if masses show internal microcyst and abrupt boundary.
Acoustics ; Breast ; Breast Neoplasms ; Mammography ; Metaplasia ; Orientation ; Retrospective Studies

Bicuspid ; Chronic Pain ; Congenital Abnormalities ; Dental Caries ; Female ; Head ; Hemangiosarcoma ; Humans ; Hyperbaric Oxygenation ; Incidence ; Molar ; Mucositis ; Neck ; Necrosis ; Osteoradionecrosis ; Porphyrins ; Prostheses and Implants ; Sutures ; Tongue ; Xerostomia