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Trachea

We have reported a case of granular cell myoblastoma of the larynx which is considered to the first reported case in the Orient. A review of the literature is given with special emphasis on the pathology, various theories of histogenesis, diagnosis, treatment and prognosis.
Asian Continental Ancestry Group ; Human ; Korea ; *Laryngeal Neoplasms ; Male ; Middle Aged ; *Neoplasms, Muscle Tissue

BACKGROUND: There are conflicting reports on the attenuationof the frontal N30 component of the median nerve derived somatosensory evoked potentials(MN SSEP) and the P37-N45 component of the posterior tibial nerve derived somatosensory evoked potentials(PT SSEP) in Parkinson's disease(PD). The central motor conduction time(CMCT) and the threshold of the magnetic motor evoked potentials(MEP) in PD also demonstrate inconsistent results. METHODS: We studied MN SSEP, PT SSEP and MEP in 10 patients with PD and compared them with 10 normal controls. RESULTS: The latency and amplitude of MN SSEP was normal in the patients with PD and, in particular, the frontal N30 compo-nent was not significantly depressed. There was no difference between the PD patients and the normal controls in the CMCT and the amplitude of arm and leg MEP. But compared with the normal controls, the latency of P37 cortical evoked potentials was prolonged and transmagnetic stimulation(TMS) threshold for evoking responses in relaxed or active tibialis anterior muscle decreased in the patients with PD. CONCLUSIONS: Recording of MEP threshold in tibialis anterior muscle and P37 latency of PT SSEP may be useful for the evaluation of patients with PD.
Arm ; Evoked Potentials ; Evoked Potentials, Motor* ; Humans ; Leg ; Median Nerve ; Parkinson Disease* ; Tibial Nerve

The FK506 binding protein 5 (FKBP5) is a co-chaperone that regulates the activity of the glucocorticoid receptor (GR) and has been reported to mediate stress resilience. This study aimed to determine the effects of Fkbp5 deletion on acute stress-induced recognition memory impairment and hippocampal GR signaling. Wild-type and Fkbp5-knockout mice were subjected to acute uncontrollable stress induced by restraint and electrical tail shock. First, we assessed the cognitive status of mice using a novel object recognition task. Next, we measured plasma corticosterone, GR levels, and the levels of GR phosphorylation at serine 211 in the hippocampus. Wild-type mice exhibited stress-induced memory impairments, whereas Fkbp5-knockout mice did not. Plasma corticosterone and GR levels did not differ between the non-stressed wild-type and Fkbp5-knockout mice, but the levels of phosphorylated GR were lower in Fkbp5-knockout mice than in wild-type mice. Wild-type and Fkbp5-knockout mice showed increased nuclear GR levels following stress, indicating GR translocation. However, cytosolic phosphorylated GR levels were lower in the hippocampi of Fkbp5-knockout mice following stress than in those of wild-type mice. These results suggest that FKBP5 deficiency increases resilience to acute stress by altering GR signaling.

The use of neuroaxial blocks in patients with multiple sclerosis has been controversial, because the effect of local anesthetic drugs on the course of the disease is unclear. We report an obstetric patient with multiple sclerosis whose caesarian section was performed successfully under combined spinal-epidural anesthesia and postoperative pain control was managed using patient-controlled epidural analgesia. There were no exacerbation of neurologic symptoms and no relapse of disease at two month follow-up. We suggest that the choice of anesthetic technique for patients with multiple sclerosis should be determined after evaluation of the course of the disease and informed consent. The obstetric patients with multiple sclerosis should not be denied the neuroaxial block for labor and caesarian section.
Analgesia, Epidural ; Anesthesia ; Anesthetics ; Follow-Up Studies ; Humans ; Informed Consent ; Multiple Sclerosis ; Neurologic Manifestations ; Pain, Postoperative ; Recurrence

The purpose of this study was to assess the physical activity level of Korean farmers to establish estimated energy requirements during the off-season. Subjects were 90 healthy males (n = 25) and females (n = 65). Body weight, height and body fat and muscles of subjects were measured. The prevalence of obesity among farmers was 56.7% according to the BMI. The farmers spent about 18 hours 7 minutes (75.5%) in sleeping and resting. The farmers spent about 19 hours 56 minutes (83.1%) out of 24 hours (one day) in "sedentary activities" and spent about 3 hours 56 minutes (16.4%) in "light activities". Physical activity level (PAL, activity coefficient) of female farmers was 1.42 which was not significantly higher than that (1.37) of male farmers. Estimated energy requirements (EER) for farmers who were different in age groups and gender were calculated. For example, the EERs for male and female farmers were 2190 kcal/day and 1712 kcal/day, respectively. The daily energy intakes of male and female farmers were 1803 kcal/day and 1610 kcal/day, respectively. The EER of male farmers was 2190 kcal/day which was significantly higher than that (1803 kcal/day) of the recommended daily energy intake of male farmers. The results of this study suggest that estimated EER of farmers should be modified according to seasonal workload and energy balance of farmers should be evaluated to prevent obesity.
Adipose Tissue ; Body Weight ; Energy Intake ; Energy Metabolism ; Female ; Humans ; Male ; Motor Activity ; Muscles ; Obesity ; Prevalence ; Seasons

PURPOSE: Live Mycobacterium bovis Bacille Calmette-Guerin (BCG) has a suppressive effect on asthma, but its use in clinical practice may be limited due to adverse reactions. To develop a product that is effective for suppressing asthma with minimal adverse reactions, we investigated whether the heat-killed body or culture supernatants of mycobacteria could also prevent asthma development. METHODS: Female BALB/c mice were treated with live BCG, the heat-killed body, or culture supernatants of BCG or Mycobacterium tuberculosis intraperitoneally, while sensitizing and provoking with ovalbumin. Then they underwent a methacholine bronchoprovocation test, and the peribronchial inflammatory cell numbers and cytokine levels in splenocyte culture supernatants were assessed. RESULTS: The airway sensitivity to methacholine decreased significantly after treatment with not only live BCG (30.8 versus 10.0 mg/mL, P<0.001) but also with the culture supernatant (BCG, 23.0 mg/mL, P<0.05; M. tuberculosis, 20.5 mg/mL, P<0.05). In contrast, heat-killed mycobacteria did not effectively decrease airway sensitivity. The peribronchial eosinophil counts and the goblet cell proportions in total epithelial cells decreased significantly in most of the groups. The interferon-gamma/interleukin-5 ratios increased significantly in most of the treatment groups except for the heat-killed groups, and were significantly related to airway sensitivity (r=0.312, P<0.01) and peribronchial eosinophil counts (r=-0.416, P<0.001). Interleukin-17A level was inversely related to airway sensitivity (r=-0.212, P<0.05) and was significantly lower in the live BCG group than in the control (137+/-20 versus 308+/-57 pg/mL, P<0.05). CONCLUSIONS: BCG and mycobacteria culture supernatants may effectively prevent the development of asthma associated with altered Th1/Th2 cytokines and interleukin-17A levels.
Animals ; Asthma ; BCG Vaccine ; Cell Count ; Cytokines ; Eosinophils ; Epithelial Cells ; Female ; Goblet Cells ; Humans ; Interferons ; Interleukin-17 ; Interleukins ; Methacholine Chloride ; Mice ; Mycobacterium ; Mycobacterium bovis ; Mycobacterium tuberculosis ; Ovalbumin ; Tuberculosis

PURPOSE: Patients with chronic kidney disease frequently show cognitive dysfunction. The association of depression and cognitive function is not well known in maintenance dialysis patients. We evaluated cognitive impairment and depression, as well as their relationship in regards to methods of dialysis, maintenance hemodialysis (MHD) and chronic peritoneal dialysis (CPD). MATERIALS AND METHODS: Fifty-six maintenance dialysis patients were recruited and their clinical and laboratory data were collected. The Korean version of the mini-mental state exam (K-MMSE) was applied to screen the patient's cognitive function, while the Korean version of the Beck Depression Inventory (K-BDI) was used for depression screening. RESULTS: The average age of the participants was 54.2+/-10.2 years; 29 (51.8%) were female. The average dialysis vintage was 4.2+/-3.8 years. The CPD group showed significantly higher K-MMSE score (27.8+/-2.9 vs. 26.1+/-3.1, p=0.010) and lower K-BDI score (12.0+/-8.4 vs. 20.2+/-10.4, p=0.003) compared with the MHD group. The percentage of patients with depression symptoms was higher in the MHD group (51.7% vs. 18.5%). There was a negative correlation between cognitive function and prevalence of depressive symptoms. Depression and education level were shown to be independent predictors for cognitive impairment in multivariate analysis. CONCLUSION: Cognitive impairment was closely correlated with depression. It is important to detect cognitive impairment and depression early in maintenance dialysis patients with simple bedside screening tools.
Adult ; Cognition Disorders/etiology/*physiopathology ; Depression/etiology/*physiopathology ; Female ; Humans ; Kidney Failure, Chronic/physiopathology/psychology/therapy ; Male ; Middle Aged ; Renal Dialysis/*adverse effects/*psychology

BACKGROUND/AIMS: Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBV-MN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs. METHODS: Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN. RESULTS: The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e., development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug. CONCLUSIONS: New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains.
Adenine/analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; Arabinofuranosyluracil/analogs & derivatives/therapeutic use ; Drug Resistance, Viral ; Female ; Glomerulonephritis, Membranous/*drug therapy/*etiology ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B, Chronic/*complications/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Organophosphonates/therapeutic use ; Young Adult

Background/Aims: The gut microbiome has emerged as a key player that mechanistically links various risk factors to colorectal cancer (CRC) etiology. However, the role of the gut microbiome in CRC pathogenesis remains unclear. This study aimed to characterize the gut microbiota in healthy controls (HCs) and patients with colorectal adenoma (AD) and CRC in subgroups based on sex and age. Methods: Study participants who visited the hospital for surveillance of CRC or gastrointestinal symptoms were prospectively enrolled, and the gut microbiome was analyzed based on fecal samples. Results: In terms of HC-AD-CRC sequence, commensal bacteria, including lactate-producing (Streptococcus salivarius) and butyrate-producing (Faecalibacterium prausnitzii, Anaerostipes hadrus, and Eubacterium hallii) bacteria, were more abundant in the HC group than in the AD and CRC groups. In the sex comparison, the female HC group had more lactate-producing bacteria (Bifidobacterium adolescentis, Bifidobacterium catenulatum, and Lactobacillus ruminis) than the male HC group. In age comparison, younger subjects had more butyrate-producing bacteria (Agathobaculum butyriciproducens and Blautia faecis) than the older subjects in the HC group.Interestingly, lactate-producing bacteria (B. catenulatum) were more abundant in females than males among younger HC group subjects. However, these sex- and age-dependent differences were not observed in the AD and CRC groups. Conclusions The gut microbiome, specifically lactate- and butyrate-producing bacteria, which were found to be abundant in the HC group, may play a role in preventing the progression of CRC. In particular, lactate-producing bacteria, which were found to be less abundant in healthy male controls may contribute to the higher incidence of CRC in males.