The benign mesenchymoma, in which fibrous tissue is accompanied by two or more mesencymal components, occurs very rarely in the head and neck area. The majority appear in patients under 25 years of age, most commonly in the subcutaneous scalp, cheek, or tongue. There is a 20% recurrence rate. Wide surgical excision is the treatment of choice. We report a case of mesenchymoma in the nasopharynx which was removed by transpalatine approach with a brief review of literature.
Cheek ; Head ; Humans ; Mesenchymoma* ; Nasopharynx ; Neck ; Recurrence ; Scalp ; Tongue

OBJECTIVE: To evaluate the usefulness of alendronate for prevention and treatment of postmenopausal osteoporosis this study was taken. METHODS: This prospective randomized clinical trial examined the effects of oral alendronate and HRT(conjugated estrogen plus medroxyprogesterone acetate), in combination and seperately, on BMD, biochemical markers of bone turnover in 79 women with low bone mass. Treatment included alendronate(10mg daily) plus HRT(group I, n=38), or HRT(group II, n=41) for 6 months. Bone density measurements were performed at months 0 and 6 at the lumbar spine. Biochemical markers of bone turnover were also measured every three months. RESULTS: Serum Osteocalcin decreased by 19.2% in group I and by 10.0% in group II at 3 months(p<0.05), and by 30.9% in group I and by 19.8% in group II at 6 months(p<0.05). Urinary deoxypyridinoline showed decrease of 19.75%(I) vs. 10.4%(II) at 3 months, 30.1%(I) vs. 20.7%(II) at 6 months, the difference was significant. Percent change of BMD measurements from baseline at 6 months in group I was 6.2% and in group II 0.6% on the lumbar spine(p<0.05). CONCLUSION: The treatment with alendronate is useful to postmenopausal women with osteoporosis by decreasing bone turnover markers, and by increasing the BMD.
Alendronate* ; Biomarkers ; Bone Density ; Estrogens ; Female ; Humans ; Medroxyprogesterone ; Osteocalcin ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Prospective Studies ; Spine

OBJECTIVE: Cystoscopy has been included as diagnostic procedure for pretreatment evaluation of cervical cancer by FIGO. However, its invasiveness brings up a question regarding the necessity of inclusion in staging work up of cervical cancer. We performed this study to evaluate the clinical implication of cystoscopy in cervical cancer staging. METHODS: 128 patients with invasive cervical cancer patients who were histologically diagnosed from Jan 1995 to Dec 1999 were retrospectively reviewed. Physical examination, computed tomography (CT), cystoscopy were performed in all patients. The distribution of FIGO stage was Ib 48.4%, II 35.2%, III 8.6%, and IV 7.8%. Bladder invasion was evaluated in CT and histopathologic examination was performed on cystoscopy when invasion was suspected. McNemar test was used to compare the finding in CT and cystoscopy for matched patients. P-value of 0.05 was regarded as statistically significant. RESULTS: Among seven patients whose bladder was suspected to be invaded by cervical cancer in CT scan, three patients had actual bladder invasion confirmed by cystoscopy (positive predictive rate = 42.9%). CT was statistically comparable to cystoscopy (P = 0.375, McNemar test; contingency coefficient = 0.481). CONCLUSION: Cystoscopy, which is an invasive procedure, may not be necessary and might be substituted by CT scan for pretreatment evaluation in some subset of cervical cancer patients.
Cystoscopy* ; Humans ; Physical Examination ; Retrospective Studies ; Tomography, X-Ray Computed ; Urinary Bladder ; Uterine Cervical Neoplasms*

OBJECTIVE: To investigate the musculoskeletal symptoms of migrant workers. We focused on the relationship between job stress and musculoskeletal symptoms. METHOD: A questionnaire was administered to 502 migrant workers who visited NGO migrant worker centers located in Gyung-gi province. A structured, self-reported questionnaire was administered to participants in order to capture the following information: sociodemographics, health factors including past medical history, work related characteristics, job stress, and musculoskeletal symptoms. The job stress questionnaires were used according to KOSS-26 and musculoskeletal symptoms were measured using KOSHA Code H-30-2003. We used multiple logistic regression analysis to assess the relationship between risk factors which included job stress, and musculoskeletal symptoms. RESULTS: The prevalence rate of musculoskeletal symptoms in survey subjects was 35.1%. Other than job stress factors, past medical history was the only factor that had a statistical relationship to musculoskeletal symptoms (P<0.01). In the domains of job stress, physical environment (OR 1.62, 95% CI: 1.03~2.54), job demand (OR 2.43, 95% CI: 1.46~4.03), job insecurity (OR 1.59, 95% CI: 1.03~2.47), occupational climate (OR 2.30, 95% CI: 1.27~4.19) were most likely experience musculoskeletal symptoms. CONCLUSION: The job stress factor appeared to correlate more with musculoskeletal symptoms than with sociodemographics or other factors. Hence, in order to prevent migrant worker's musculoskeletal symptoms, we believe that intervention in job stress (physical environment, job demand, job insecurity, occupational climate) is necessary.
Climate ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Risk Factors ; Transients and Migrants

Background: Currently, there is no consensus on the treatment of psoriasis in Korean patients. Objective: This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. Methods: Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evaluation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. Results: The panel participants strongly agreed that the ideal treatment goals for Korean patients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. Conclusion This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treatment outcomes for psoriasis in Korea.

Background and Objectives: Ginsenoside Rb1 is the main metabolite of Panax ginseng. It is known to have many beneficial properties including anti-inflammatory, antitumoral and antioxidant effects. However, the therapeutic effects of ginenoside Rb1 on inflammatory airway diseases have not been elucidated. Therefore, we investigated the effects of ginsenoside Rb1 on the TGF-β1-induced mucin gene expression and epithelial-mesenchymal transition (EMT) in human airway epithelial cells.Materials and Method We evaluated the effects of ginsenoside Rb1 on the changes of MUC4, MUC5AC, occludin, claudin 4, claudin 18, neural (N)-cadherin, and epithelial (E)-cadherin expression by TGF-β1 in NCI-H292 cells using reverse, real-time polymerase chain reaction, enzyme-linked immunosorbent assay, and western blot. Results: TGF-β1 significantly increased MUC4/5AC expression. Rb1 inhibited TGF-β1- induced MUC4/5AC expression. In addition, TGF-β1 significantly attenuated occludin, claudin 18, and E-cadherin expressions but induced claudin 4 and N-cadherin expressions. On the other hand, Rb1 reversed changes in the TGF-β1- mediated expressions of cell junction molecules. Conclusion These results suggest that ginsenoside Rb1 attenuates TGF-β1-induced MUC4/5AC expressions and EMT in the human airway epithelial cells. These findings are important data demonstrating the potential of ginsenoside Rb1 as a therapeutic agent for inflammatory airway diseases.

Background and Objectives: Peroxiredoxin (Prx) is an antioxidant enzyme involved in signaling pathway. Prx2 is the most abundant in mammalian gray matter neurons and has protective role under oxidative stress. MUC5AC and MUC5B are typical mucin genes in human airway epithelial cells. Even if free radicals play a key role in chronic respiratory inflammatory diseases, the effects of the Prx2 on mucin expression and oxidative stress are not clearly known. The purpose of this study is to investigate the effect of Prx2 on lipopolysaccharide (LPS)-induced MUC5AC/5B expression and reactive oxygen species (ROS) in human airway epithelial cells.Subjects and Method In NCI-H292 cells and human nasal epithelial cells, the effects of Prx2 on LPS-induced MUC5AC/5B expression and ROS production were investigated using reverse transcriptase-polymerase chain reaction, real-time polymerase chain reaction, enzyme linked immunosorbent assay (ELISA) and flow cytometry analysis. Results: MUC5AC, MUC5B mRNA expression and protein production were increased by LPS. ROS production was also increased by LPS. Prx2 suppressed the LPS-induced MUC5AC mRNA expression and protein production as well as ROS production. However, Prx2 did not inhibit MUC5B mRNA expression and protein production. N-acetylcysteine, diphenyleneiodonium, and apocynin also inhibited LPS-induced ROS production. Conclusion These results may show that Prx2 suppresses LPS-induced MUC5AC expression via ROS in human airway epithelial cells.

Solid organ transplant recipients are at increased risk for various opportunistic infections because of their immunocompromised state. Pneumocystis jirovecii (carinii) infection has posed serious problems in these patients which can be life threatening. It has been reported that incidences of Pneumocystis infection have dramatically decreased with the use of prophylactic antibiotics. However, there have been reports that say the risks of Pneumocystis infection are increasing with the use of new immunosuppressive drugs and in presence of preceding immunomodulating infections such as CMV infection which is another common opportunistic infection in transplant patients. There were only a few case reports abroad on Pneumocystis infection following CMV infection in patients who underwent kidney transplantation. In Korea, however, there hasnt been any report of such cases. Herein we report a case of a kidney transplant patient who experienced a serious episode of Pneumocystis jirovecii pneumonia following CMV duodenitis. After adequate mechanical ventilation and use of antibiotics the patient completely recovered without any complications.
Anti-Bacterial Agents ; Cytomegalovirus ; Duodenitis ; Humans ; Incidence ; Kidney ; Kidney Transplantation ; Korea ; Opportunistic Infections ; Pneumocystis ; Pneumocystis Infections ; Pneumocystis jirovecii ; Pneumonia ; Respiration, Artificial ; Transplants

Page kidney refers to the phenomenon of hypertension secondary to long-standing compression of renal parenchyma caused by renal subcapsular collection. The most common cause of renal subcapsular collection is a hematoma which usually occurs after a history of blunt trauma. A 42-year-old female patient who received botulinum toxin injection in her back during chiropractic care was admitted to the emergency room with sudden bilateral flank pain and hypertension. The computed tomography (CT) images demonstrated the presence of bilateral subcapsular renal hematoma. The patient was treated conservatively and recovered well. The follow up CT images showed markedly resolved bilateral hematoma.
Adult ; Botulinum Toxins* ; Chiropractic* ; Emergency Service, Hospital ; Female ; Flank Pain ; Follow-Up Studies ; Hematoma ; Humans ; Hypertension ; Kidney*

BACKGROUND/AIMS: Treatment with flumazenil results in rapid reversal from sedation. In addition, the use of flumazenil can prevent accidents or memory loss after endoscopy. This study was conducted to evaluate the role of flumazenil according to dose. METHODS: A total of 150 consecutive outpatients were randomly allocated into three groups: patients given normal saline (control group), patients given 0.25 mg flumazenil (0.25 mg flumazenil group) and patients given 0.5 mg flumazenil (0.5 mg flumazenil group). Flumazenil or normal saline was injected 10 minutes after the completion of endoscopy. We evaluated the recovery time, time to discharge, patient satisfaction, and memory loss after discharge. RESULTS: The control group consisted of 44 subjects, the 0.25 mg flumazenil group consisted of 46 subjects and the 0.5 mg flumazenil group consisted of 45 subjects. The recovery time was significantly shorter in the two flumazenil groups as compared to the control group (28.5+/-15.0 min, 13.8+/-3.7 min, 12.4+/-1.7 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively)(p<0.001). The time to discharge after an examination was shorter in the flumazenil groups and showed dose-dependency (41.2+/-20.5 min, 22.1+/-10.9 min, 16.4+/-2.2 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively) (p<0.001). There was no significant difference in patient satisfaction among the three groups. The degree of memory recall was better in the 0.5 mg flumazenil group than in the other two groups (p<0.001). CONCLUSIONS: Flumazenil reversal of midazolam sedative endoscopy results in fast recovery and is helpful to minimize memory loss after an examination without interference of satisfaction.
Endoscopy ; Flumazenil ; Humans ; Memory ; Memory Disorders ; Midazolam ; Outpatients ; Patient Discharge ; Patient Satisfaction