Lipomas are benign soft-tissue tumors that typically progress gradually. In this case report, we describe a 77-year-old woman who presented with a mass on the left upper eyelid. An ophthalmologic examination was normal, and ultrasonography revealed a 1-cm ill-defined mass in the subcutaneous fat layer of the left upper eyelid. The tumor was completely excised surgically, and a histopathological examination showed mature fibro-adipose tissue consistent with a lipoma. The patient had an excellent postoperative prognosis. Even though eyelid lipomas are extremely rare, it is important to carefully examine the integrity of the orbital muscle, orbital septum, and levator aponeurosis. Lipoma should be distinguished from herniated orbital fat or the lacrimal glands in the differential diagnosis of an upper eyelid mass.

Polymyositis is an inflammatory connective tissue disease involving, predominantly, skeletal muscle. Occasionally, it is complicated by serious interstitial pneumonia. The presence of interstitial pneumonia affects the prognosis and contributes substantially to the morbidity and mortality. Although the treatment recommendations for interstitial pneumonia in polymyositis are still not optimal, high-dose steroid or immunosuppressive agents such as methotrexate, azathioprine, cyclosporine A, or cyclophosphamide alone or in combination are effective in myositis-associated interstitial pneumonia in many cases. Nevertheless, the relative frequency of complications, such as opportunistic infection, steroid-induced myopathy, and steroid psychosis, limits the use of high-dose steroid or immunosuppressive regimens. Here, we describe our experience of combination treatment with a steroid inhaler and low-dose cyclophosphamide in a patient with bronchiolitis obliterans organizing pneumonia associated with polymyositis who developed steroid-induced myopathy during initial high-dose steroid and cyclosporine A treatment.
Azathioprine ; Bronchiolitis ; Bronchiolitis Obliterans ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia ; Cyclophosphamide ; Cyclosporine ; Humans ; Immunosuppressive Agents ; Lung Diseases, Interstitial ; Methotrexate ; Muscle, Skeletal ; Muscular Diseases ; Nebulizers and Vaporizers ; Opportunistic Infections ; Polymyositis ; Prognosis ; Psychotic Disorders

PURPOSE: This study was aimed to investigate the relationship between the mandibular asymmetry and the internal derangement of temporomandibular joint. MATERIALS AND METHODS: One hundred and sixty eight patients had been assessed through clinical examinations, panoramic radi-ographs and magnetic resonance imagings (MRIs), were selected. The samples were classified into three subgroups according to the severity of the mandibular asymmetries in the panoramic radiographs and the status of TMJ discs on the MRI were compared among each groups. RESULTS: In an apparent asymmetry group, there was a significant difference in the number of temporomandibular disk displacement without reduction between the long and short side (66.7%, 18/27 joints on the short side) when the ratio of condylar process and coro-noid process was used (P<0.05), but there was no statistically significant difference when the ratio of condyle and ramus was used. CONCLUSION: The probability of the disc displacement without reduction was higher at the side with relatively shorter condylar process on the panoramic radiograph, and also it might be more effective to use ratio of condylar process and coronoid process in the assessment of mandibular asymmetry. Therefore, a careful assessment on the temporomandibular disorders is necessary to diagnose and establish the treatment plans for the patients with a mandibular asymmetry and the panoramic radiograph can be used effectively on that way.
Humans ; Joints ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disc* ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

Sialolithiasis is caused by the obstruction of a salivary gland or its excretory duct by the formation of calcareous concretions or sialoliths; this results in salivary ectasia and provokes subsequent dilation of the salivary gland. Sialolithiasis is relatively common, accounting for 30% of salivary diseases; however, it is rarely observed in childhood. This case report describes a 2-year-old male patient who complained of a painful swelling over the right cheek, and presented with palpable stones and pus discharge from the orifice of the right Stensen's duct. Computerized tomography of the neck confirmed the diagnosis, and the patient received intravenous empiric antibiotics combined with intraoral sialolithotomy. We also provide a review of the spectrum of concepts regarding the pathogenesis, diagnosis, and treatment of sialolithiasis.
Anti-Bacterial Agents ; Cheek ; Child ; Dilatation, Pathologic ; Humans ; Male ; Neck ; Parotid Gland* ; Parotitis ; Preschool Child ; Salivary Duct Calculi* ; Salivary Ducts ; Salivary Gland Calculi* ; Salivary Glands ; Suppuration ; Tomography, X-Ray Computed

BACKGROUND/OBJECTIVES: Turmeric (Curcuma longa L.) has been reported to have many biological functions including anti-obesity. Leptin, peptide hormone produced by adipocytes and its concentration is increased in proportion to the amount of the adipocytes. In the present study, we examined the effects of Korean turmeric on the regulation of adiposity and leptin levels in 3T3-L1 adipocytes and rats fed a high-fat and high-cholesterol diet. MATERIALS/METHODS: Leptin secretion, free fatty acid and glycerol contents in 3T3-L1 adipocytes were measured after incubation of cells with turmeric for 24 hours. Rats were divided into four experimental groups: a normal diet group (N), a high-fat and high-cholesterol diet group (HF), a high-fat and high-cholesterol diet group supplemented with 2.5% turmeric extracts (TPA group) and a high-fat and high-cholesterol diet group supplemented with 5% turmeric extracts (TPB group). Serum samples were used for the measurement of leptin concentration. RESULTS: Contents of free fatty acid and glycerol showed concentration dependent increase in response to turmeric extracts. Effects of turmeric extracts on reduction of lipid accumulation in 3T3-L1 cells were examined by Oil Red O staining. Treatment with turmeric extracts resulted in increased expression levels of adipose triglyceride lipase and hormone-sensitive lipase mRNA. The concentration of leptin from 3T3-L1 adipocytes was significantly decreased by turmeric. Proportional abdominal and epididymal fats weights of the turmeric 5% supplemented group, TPB has significantly decreased compared to the HF group. The serum levels of leptin in the TPA and TPB groups were significantly lower than those of the HF group. CONCLUSIONS: Based on these results, we suggested that Korean turmeric may contribute to the decreasing of body fat and regulating leptin secretion.
3T3-L1 Cells ; Adipocytes* ; Adipose Tissue ; Adiposity ; Animals ; Curcuma* ; Curcumin ; Diet ; Fats ; Glycerol ; Leptin* ; Lipase ; Lipolysis* ; Rats* ; RNA, Messenger ; Sterol Esterase ; Weights and Measures

OBJECTIVE: There are currently limited treatment options for rheumatoid arthritis (RA) patients with chronic hepatitis B (CHB). In the process of pursuing further treatment strategies for this subgroup of patients, it is prudent to study what medications have been commonly prescribed, particularly for disease modifying anti-rheumatic agents (DMARDs) in Korea. METHODS: We analyzed the Korean National Health Insurance claims database (2007~2009) of RA patients through co-working with the Clinical Research Center for RA (CRCRA). Patients with CHB were defined by an algorithm including prescription information, blood tests, and the ICD-10 code. RESULTS: There were 8,677 CHB patients (3.8%) among 226,592 RA patients in the database. The age distribution or gender difference in CHB patients was comparable to the general RA population. Hydroxychloroquine was the most frequently (66.2%) prescribed DMARD. Thirty four percent of CHB patients had been prescribed with methotrexate (MTX) during the study period; most of them without concomitant anti-viral treatment. About 3% of RA patients with CHB were prescribed with TNF inhibitors. CONCLUSION: Apart from the published expert recommendations, MTX still seems to be one of the main DMARDs prescribed to Korean RA patients with CHB. This is most likely due to the lack of evidence-based, effective treatment strategies for this subgroup of patients.
Age Distribution ; Antirheumatic Agents ; Arthritis, Rheumatoid ; Hematologic Tests ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hydroxychloroquine ; International Classification of Diseases ; Methotrexate ; National Health Programs ; Prescriptions

OBJECTIVE: There are currently limited treatment options for rheumatoid arthritis (RA) patients with chronic hepatitis B (CHB). In the process of pursuing further treatment strategies for this subgroup of patients, it is prudent to study what medications have been commonly prescribed, particularly for disease modifying anti-rheumatic agents (DMARDs) in Korea. METHODS: We analyzed the Korean National Health Insurance claims database (2007~2009) of RA patients through co-working with the Clinical Research Center for RA (CRCRA). Patients with CHB were defined by an algorithm including prescription information, blood tests, and the ICD-10 code. RESULTS: There were 8,677 CHB patients (3.8%) among 226,592 RA patients in the database. The age distribution or gender difference in CHB patients was comparable to the general RA population. Hydroxychloroquine was the most frequently (66.2%) prescribed DMARD. Thirty four percent of CHB patients had been prescribed with methotrexate (MTX) during the study period; most of them without concomitant anti-viral treatment. About 3% of RA patients with CHB were prescribed with TNF inhibitors. CONCLUSION: Apart from the published expert recommendations, MTX still seems to be one of the main DMARDs prescribed to Korean RA patients with CHB. This is most likely due to the lack of evidence-based, effective treatment strategies for this subgroup of patients.
Age Distribution ; Antirheumatic Agents ; Arthritis, Rheumatoid ; Hematologic Tests ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hydroxychloroquine ; International Classification of Diseases ; Methotrexate ; National Health Programs ; Prescriptions

BACKGROUND: Some types of ventricular tachycardia(VT), so called verapamil-sensitive ventricular tachycardia, occur in healthy young people without organic heart disease. The mechanism of the above VT is not established yet. The most possible mechanism is a triggered activity but reentry is also possible mechanism. We studied the possible mechanism and the eletrophysiologic properties of the verapamil-sensitive VT in 6 patients. METHODS: The patients included in this study were patients with documented ventricular tachycardia response to intravenous verapamil and complete RBBB morpholgy. As noninvasive tests, treadmill test, echocardiography and MUGA scan were performed and endomyocardial biopsy was perfomed in all patients in all patients and in patients with inducible VT, the electrophysiologic study was repeated on next day. The response to various antiarrhythmic agents was also studied. RESULTS: Total studied patients were 6(M : F=5 : 1, mean age=22). The noninvasive tests were normal in all patients and the VT was not induecd during treadmill test. The average cycle length of VT was 370msec and the 12-lead ECG during VT showed complete RBBB. The endomyocardial biopsy showed a mild focal infiltration of inflammatory cell in one patient and moderate small vessel vasculosclerosis in one patient. The clinical VT was induced in 5 patients by programmed electrical stimulation(PES). VT was induced in 5 by ventricular stimulation and in 1 by atrial stimulation. The induction and termination modes changed in 4 of 5 on next day. The cycle length dependency of PVC could be measured in 3 patients and the relationship was same direction in 2 patients and inverse direction in another patient. Intravenous procainamide was effective in 2 of 4 patients and IV adenosine was effective in 1 of 5 patients and IV propranolol was not effective in all 3 patients. CONCLUSION: The verapamil-sensitive ventricular tachycardia is a unique VT showing characteristics of both reentry and triggered activity but in one patient of our study, the most possible mechanism is triggered activity. A further cellular electrophysiologic study is needed for the genesis of verapamil-sensitive ventricular tachycardia.
Adenosine ; Biopsy ; Echocardiography ; Electrocardiography ; Exercise Test ; Heart Diseases ; Humans ; Procainamide ; Propranolol ; Tachycardia, Ventricular* ; Verapamil

Neural stem cells (NSCs) have been suggested as a groundbreaking solution for stroke patients because they have the potential for self-renewal and differentiation into neurons. The differentiation of NSCs into neurons is integral for increasing the therapeutic efficiency of NSCs during inflammation. Apoptosis signal-regulating kinase 1 (ASK1) is preferentially activated by oxidative stress and inflammation, which is the fundamental pathology of brain damage in stroke. ASK1 may be involved in the early inflammation response after stroke and may be related to the differentiation of NSCs because of the relationship between ASK1 and the p38 mitogen-activated protein kinase pathway. Therefore, we investigated whether ASK1 is linked to the differentiation of NSCs under the context of inflammation. On the basis of the results of a microarray analysis, we performed the following experiments: western blot analysis to confirm ASK1, DCX, MAP2, phospho-p38 expression; fluorescence-activated cell sorting assay to estimate cell death; and immunocytochemistry to visualize and confirm the differentiation of cells in brain tissue. Neurosphere size and cell survival were highly maintained in ASK1-suppressed, lipopolysaccharide (LPS)-treated brains compared with only LPS-treated brains. The number of positive cells for MAP2, a neuronal marker, was lower in the ASK1-suppressed group than in the control group. According to our microarray data, phospho-p38 expression was inversely linked to ASK1 suppression, and our immunohistochemistry data showed that slight upregulation of ASK1 by LPS promoted the differentiation of endogenous, neuronal stem cells into neurons, but highly increased ASK1 levels after cerebral ischemic damage led to high levels of cell death. We conclude that ASK1 is regulated in response to the early inflammation phase and regulates the differentiation of NSCs after inflammatory-inducing events, such as ischemic stroke.
Animals ; Cell Death ; Infarction, Middle Cerebral Artery/*metabolism ; Lipopolysaccharides/pharmacology ; MAP Kinase Kinase Kinase 5/genetics/*metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Microtubule-Associated Proteins/genetics/metabolism ; Neural Stem Cells/cytology/drug effects/*metabolism ; *Neurogenesis ; Neuropeptides/genetics/metabolism ; p38 Mitogen-Activated Protein Kinases/genetics/metabolism

PURPOSE: Rib fractures are the most common injuries resulting from blunt chest trauma. The sensitivity of conventional chest radiography (chest PA, rib series) in showing a rib fracture is limited, particularly in those involving the cartilage part of the rib. We investigated the possible rib fractures. We used ultrasonography (US) to investigate possible rib fractures in patients with minor blunt chest trauma who showed no evidence of a rib fracture on the conventional chest radiography. METHODS: A total of 96 patients with minor blunt chest trauma and showing no evidence of a rib fracture on the conventional chest radiography were examined with US performed with a 7.5-MHz linear transducer. RESULTS: A total of 44(45.8%) patients showed a rib fracture whereas 52(54.2%) patients had no evidence of a rib fracture. Fracture of the rib with displacement 24 patients was the most common finding. CONCLUSIONS: Rib US is a useful imaging method in showing rib fractures overlooked on chest X-rays in cases of minor blunt chest trauma. Compared with conventional chest radiography, rib US takes a shorter time and is not difficult. Additionally, lesions combined with rib fractures and costal cartilage fractures are diagnosed more easily when using rib US.
Cartilage ; Fractures, Cartilage ; Humans ; Radiography ; Rib Fractures* ; Ribs* ; Thoracic Injuries ; Thorax ; Transducers ; Ultrasonography*