Objective: : The aim of this study was to verify the equivalence and effectiveness of the tablet-administered Korean Repeatable Battery for the Assessment of Neuropsychological Status (K-RBANS) for the prevention and early detection of dementia. Methods: : Data from 88 psychiatry and neurology patient samples were examined to evaluate the equivalence between tablet and paper administrations of the K-RBANS using a non-randomly equivalent group design. We calculated the prediction scores of the tablet-administered K-RBANS based on demographics and covariate-test scores for focal tests using norm samples and tested format effects. In addition, we compared the receiver operating characteristic curves to confirm the effectiveness of the K-RBANS for preventing and detecting dementia. Results: : In the analysis of raw scores, line orientation showed a significant difference (t=-2.94, p<0.001), and subtests showed small to large effect sizes (0.04–0.86) between paper- and tablet-administered K-RBANS. To investigate the format effect, we compared the predicted scaled scores of the tablet sample to the scaled scores of the norm sample. Consequently, a small effect size (d≤0.20) was observed in most of the subtests, except word list and story recall, which showed a medium effect size (d=0.21), while picture naming and subtests of delayed memory showed significant differences in the one-sample t-test. In addition, the area under the curve of the total scale index (TSI) (0.827; 95% confidence interval, 0.738–0.916) was higher than that of the five indices, ranging from 0.688 to 0.820. The sensitivity and specificity of TSI were 80% and 76%, respectively. Conclusion : The overall results of this study suggest that the tablet-administered K-RBANS showed significant equivalence to the norm sample, although some subtests showed format effects, and it may be used as a valid tool for the brief screening of patients with neuropsychological disorders in Korea.

Objective: : This study aimed to validate the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status Update (K-RBANS). Methods: : We performed a retrospective analysis of 283 psychiatric and neurosurgery patients. To investigate the convergent validity of the K-RBANS, correlation analyses were performed for other intelligence and neuropsychological test results. Confirmatory factor analysis was used to test a series of alternative plausible models of the K-RBANS. To analyze the various capabilities of the K-RBANS, we compared the area under the receiver operating characteristic (ROC) curves (AUC). Results: : Significant correlations were observed, confirming the convergent validity of the K-RBANS among the Total Scale Index (TSI) and indices of the K-RBANS and indices of intelligence (r=0.47–0.81; p<0.001) and other neuropsychological tests at moderate and above significance (r=0.41–0.63; p<0.001). Additionally, the results testing the construct validity of the K-RBANS showed that the second-order factor structure model (model 2, similar to an original factor structure of RBANS), which includes a first-order factor comprising five index scores (immediate memory, visuospatial capacity, language, attention, delayed memory) and one higher-order factor (TSI), was statistically acceptable. The comparative fit index (CFI) (CFI, 0.949) values and the goodness of fit index (GFI) (GFI, 0.942) values higher than 0.90 indicated an excellent fit. The root mean squared error of approximation (RMSEA) (RMSEA, 0.082) was considered an acceptable fit. Additionally, the factor structure of model 2 was found to be better and more valid than the other model in χ2 values (Δχ2=7.69, p<0.05). In the ROC analysis, the AUCs of the TSI and five indices were 0.716–0.837, and the AUC of TSI (AUC, 0.837; 95% confidence interval, 0.760–0.896) was higher than the AUCs of the other indices. The sensitivity and specificity of TSI were 77.66% and 78.12%, respectively. Conclusion : The overall results of this study suggest that the K-RBANS may be used as a valid tool for the brief screening of neuropsychological patients in Korea.

The diagnostic accuracy of the data reported in the Korean tuberculosis surveillance system (KTBS) has not been adequately investigated. We reviewed the clinical data of pulmonary tuberculosis (PTB) cases notified from private medical facilities through KTBS between January and June, 2004. PTB cases were classified into definite (culture-proven), probable (based on smear, polymerase chain reaction, histology, bronchoscopic finding, computed tomography, or both chest radiograph and symptoms) or possible (based only on chest radiograph) tuberculosis. Of the 1126 PTB cases, sputum AFB smear and culture were requested in 79% and 51% of the cases, respectively. Positive results of sputum smear and culture were obtained in 43% and 29% of all the patients, respectively. A total of 73.2% of the notified PTB cases could be classified as definite or probable and 81.7% as definite, probable, or possible. However, where infection was not confirmed bacteriologically or histologically, only 60.1% of the patients were definite, probable, or possible cases. More than 70% of PTB notified from private sectors in Korea can be regarded as real TB. The results may also suggest the possibility of over-estimation of TB burden in the use of the notification-based TB data.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis/isolation & purification ; Private Sector ; Republic of Korea/epidemiology ; Severity of Illness Index ; Sputum/microbiology ; Tuberculosis, Pulmonary/*diagnosis/epidemiology/pathology ; Young Adult

Inflammatory myofibroblastic tumor (IMT) is an uncommon benign fibroinflammatory mass that is composed of myofibroblastic spindle cells with acute and chronic inflammatory cells. IMT may arise within numerous organs such as lung, intestine, orbit and paranasal sinuses. However, IMT of the larynx is extremely rare. IMT can have systemic manifestations including fever of unknown origin, anemia, thrombocytosis and elevated erythrocyte sedimentation rate. The treatment of IMT is complete excision, but in some cases, additional therapy such as chemotherapy or radiotherapy may be required. Recently, we experienced a case of IMT which was originated from the right true vocal cord and mimicking the vocal polyp. So, we report this case with a review of the literature.
Anemia ; Blood Sedimentation ; Fever of Unknown Origin ; Intestines ; Larynx ; Lung ; Myofibroblasts ; Orbit ; Paranasal Sinuses ; Polyps ; Thrombocytosis ; Vocal Cords

Renal cell carcinoma (RCC) has a high incidence of metastasis to any location in the body. This tumor metastasizes to the head and neck region in 15% of cases, whereas metastasis to the sinonasal area or to the mouth floor is rare. None of the cases of the RCC that are metastatic to both sites (sinonasal area and mouth floor) has been previously described. Recently, we experienced a case of metastatic RCC involving the nasal cavity and the mouth floor that were managed by local excision and postoperative radiotherapy. Because of its unpredictable clinical behavior, a long term follow-up is essential for early detection of recurrent or residual lesion of RCC.
Carcinoma, Renal Cell ; Follow-Up Studies ; Head ; Incidence ; Mouth ; Mouth Floor ; Nasal Cavity ; Neck ; Neoplasm Metastasis

OBJECTIVE: Premorbid demographic backgrounds of injured individuals are likely to reflect more accurately the status of patients with traumatic brian injury (TBI) than clinical factors. However, the concrete study about the relationship between the demographic factors and neurocognitive function in TBI patients has not been reported. The object of this study was to evaluate the effect of premorbid demographic factors on the recovery of neurocognitive function following TBI. METHODS: From July 1998 to February 2007, 293 patients (male: 228, female: 65) with a history of head injury, who had recovered from the acute phase, were selected from our hospital to include in this study. We analyzed the effect of premorbid demographic factors including age, sex, educational level and occupation on the recovery of neurocognitive function in each TBI subgroup as defined by Glasgow Coma Scale (GCS) score. Intelligence and memory are components of neurocognitive function, and the Korean Wechsler Intelligence Scale (K-WAIS) and the Korean memory assessment scale (K-MAS) were used in this study. The results were considered significant at p<0.05. RESULTS: The higher level of education was a good prognostic factor for intelligence regardless of GCS score and younger age group showed a better result for memory with an exception of severe TBI group. In the severe TBI group, the meaningful effect of demographic factors was not noted by the cause of influence of severe brain injury. CONCLUSION: The demographic factors used in this study may be helpful for predicting the precise prognosis and developing an appropriate rehabilitation program for TBI patients.
Brain Injuries ; Craniocerebral Trauma ; Demography ; Glasgow Coma Scale ; Humans ; Intelligence ; Memory ; Occupations ; Prognosis

BACKGROUND AND OBJECTIVES: Although the cause of the malignant lymphoma has not been understood entirely, viruses and oncogenes have been implicated as probable causative factors. Particularly, Epstein-Barr virus (EBV), the over-expression of bcl-2 and the mutant p53 seem to be closely related to lymphomatogenesis. The purpose of this study was to investigate the relationship between EBV, bcl-2 and p53 proteins in the development of human extranodal malignant lymphoma in the head and neck. SUBJECTS AND METHOD: Specimens were obtained from 40 patients diagnosed as the extranodal malignant lymphoma in the head and neck region. Paraffin-embedded tumor tissues were analyzed by in situ hybridization for Epstein-Barr virus encoded RNA(EBER) and by immunohistochemical technique for bcl-2 and p53 proteins. RESULTS: In EBER and bcl-2 protein-positive group, there were no significant differences in the pathologic types. However, the angiocentric lymphoma type (85.7%) and the peripheral T cell lymphoma unspecified large cell type (83.3%) were identified significantly in the p53 protein positive group (p<0.05). Expression rate of EBER, bcl-2 and p53 protein were 50%, 42.5% and 53.5%, respectively. In the EBER-positive group (20 cases), bcl-2 protein was detected in 9 cases (45.0%) and p53 protein in 11 cases (55.0%). In bcl-2 protein-positive group (17 case), p53 protein was detected in 9 cases (52.9%). There were no significant difference among these data (p>0.05). CONCLUSION: These results suggest that EBV, bcl-2 and p53 protein play a role in the tumorigenesis of the human extranodal malignant lymphoma, independently.
Carcinogenesis ; Head* ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Lymphoma* ; Lymphoma, T-Cell, Peripheral ; Neck* ; Oncogenes

BACKGROUND AND OBJECTIVES: Endoscopic surgery largely replaced the traditional external approach in the treatment of sinonasal inflammatory diseases and most benign tumors. However, there is much debate about its applicability to resection of sinosal malignancy. In this study, we demonstrate the efficacy of the endonasal endoscopic approach in the treatment of highly selected sinonasal malignant tumors. SUBJECTS AND METHOD: We retrospectively reviewed the medical records and radiologic findings of 11 patients who had underwent transnasal endoscopic excision for sinonasal malignancy from 1998 to 2003. All patients were treated with curative intent. RESULTS: The mean age was 60.6 (31-75 years) years and the mean follow-up period was 69 months (52-112 months). Eight cases consisted of T1 and three cases were T2. The pathologic diagnosis was malignant melanoma (4 cases), plasmacytoma (2 cases), adenoid cystic carcinoma, olfactory neuroblastoma, cylindrical cell carcinoma, squamous cell carcinoma and neuroendocrine carcinoma. In ten cases, the tumor was removed by transnasal endoscopic excision with adequate free margin of normal mucosa. In one case, Caldwell-Luc operation was combined with the endoscopic excision. During the follow-up, only one case of malignant melanoma had recurred at the lateral neck and retropharyngeal lymph node, but the other ten cases have kept up well without recurrence of primary tumor and significant complication. CONCLUSION: Considering oncological results and surgery-related morbidities, transnasal endoscopic resection can be used as a good modality in the highly selected early T stage of sinonasal malignancies.
Carcinoma, Adenoid Cystic ; Carcinoma, Neuroendocrine ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopy ; Esthesioneuroblastoma, Olfactory ; Follow-Up Studies ; Humans ; Lymph Nodes ; Medical Records ; Melanoma ; Mucous Membrane ; Nasal Cavity ; Neck ; Paranasal Sinuses ; Plasmacytoma ; Recurrence ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Mucin gene expression and mucin secretion are highly increased by inflammatory airway diseases such as asthma, chronic bronchitis and rhinosinusitis. Macrolide antibiotics is considered one of the effective drugs inhibiting mucus secretion for chronic bronchitis and rhinosinusitis with nasal polyp. However, the anti-secretory effect of macrolide is not clear. This study was designed to investigate whether macrolide can suppress interleukin-1beta (IL-1beta)-induced MUC4 gene expression and mucin secretion in the cultured human nasal polyp epithelial cells and NCI-H292 epithelial cells. SUBJECTS AND METHOD: Nasal polyps were obtained from 20 patients with chronic rhinosinusitis with nasal polyp during endoscopic sinus surgery. We observed the effect of roxithromycin on the IL-1beta-induced MUC4 gene and mucin secretion by reverse transcriptase-polymerase chain reaction (RT-PCR) with enzyme-linked immunosorbent assay (ELISA) method. RESULTS: Roxithromycin attenuated the IL-1beta-induced MUC4 mRNA expression and mucin secretion with a dose dependent pattern in both of the cultured human nasal polyp epithelial cells and NCI-H292 epithelial cells. CONCLUSION: This result suggests that roxithromycin may be considered as an effective anti-hypersecretory agent for its down-regulation of the MUC4 gene.
Anti-Bacterial Agents ; Asthma ; Bronchitis, Chronic ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression* ; Humans* ; Interleukin-1beta ; Mucins ; Mucus ; Nasal Polyps ; RNA, Messenger ; Roxithromycin

BACKGROUND AND OBJECTIVES: Recent advances in medical management, along with increased life span, have contributed to the increased opportunity for detecting multiple primary malignancy (MPM). The purpose of this study was to evaluate the incidence and clinical characteristics of MPM in the head and neck region. SUBJECTS AND METHOD: We reviewed retrospectively the medical records of 984 patients with malignant tumors of head and neck who had been diagnosed histopathologically and treated between August 1985 to July 2005. RESULTS: Seventy patients (7.11%) were diagnosed as having MPM (double, n=66 ; triple, n=4). This group consisted of 67 men and 3 women (p<0.01). Twenty-five patients (36%) had synchronous double primary malignancy (SDPM) and 45 patients (64%) had metachronous double primary malignancy (MDPM). The hypopharynx was the most frequently involved site of the index tumor. The most common index tumors were squamous cell carcinoma histopathologically. Second primary malignancies were found in esophagus, stomach and lung. Fifty-five patients were found with first primary malignancy in head and neck, and 25 were with second primary malignancy. The patients with first and second primary malignancy in head and neck were 10 cases. The prognosis of SDPM (average of survival 11.1 months) was very poor. Patients with MPM have high cigarettes smoking and alcohol drinking habit. CONCLUSION: Patients with head and neck malignancies will require careful follow up for prevention, early detection, and the treatment of second primary malignancy.
Alcohol Drinking ; Carcinoma, Squamous Cell ; Esophagus ; Female ; Head and Neck Neoplasms ; Head* ; Humans ; Hypopharynx ; Incidence ; Lung ; Male ; Medical Records ; Neck* ; Neoplasms, Multiple Primary ; Prognosis ; Retrospective Studies ; Smoke ; Smoking ; Stomach ; Tobacco Products