Infestation of tissue by fly larvae is termed myiasis, and it is unusual in humans. Nasal myiasis is common in low socioeconomic status individuals due to poor nasal hygiene. It commonly affects the skin and rarely the nasal and paranasal sinuses. Recently an 82-year-old female was admitted to the emergency department because of discharge of live maggots from the nasal cavity. She had been diagnosed with brain infarction and Alzheimer's disease several years previous. We successfully removed all the maggots from the patient's nasal cavity and sinuses via endoscopic surgery under local anesthesia. Subsequently, the patient's nasal problem resolved completely.
Aged, 80 and over ; Alzheimer Disease ; Anesthesia, Local ; Brain Infarction ; Cerebral Infarction* ; Diptera ; Emergency Service, Hospital ; Female ; Humans ; Hygiene ; Larva ; Myiasis* ; Nasal Cavity ; Paranasal Sinuses ; Skin ; Social Class

BACKGROUND AND OBJECTIVES: The purpose of this study was to share our clinical experience on the use of bioresorbable poly L-/DL-lactide 70/30 implant to repair blow out fracture. SUBJECTS AND METHOD: The medical records of 130 patients with orbital fractures that were treated surgically from June 2006 to February 2011 were reviewed retrospectively. Patients who had diplopia or limited extraocular motion, significant Enophthalmos (>2 mm), or a large orbital wall fracture on a computed tomographic scan were enrolled for the study. We investigated diplopia, limited extraoacular motion, enophthalmos before and after surgery. RESULTS: The mean postoperative follow-up was 28 months. There was no evidence of sinus infection related to the implant. However, six patients showed dislocation of orbital implant in the nasal cavity. After six postoperative months, diplopia was seen in 1 (2%) patient, and significant enophthalmos was seen 2 (2%) patients. We carried out re-operation on six cases and the main cause was incomplete reduction or over reduction. CONCLUSION: Bioresorbable poly L-/DL-lactide 70/30 implants are safe and reliable for the reduction for blowout fracture.
Diplopia ; Dislocations ; Enophthalmos ; Follow-Up Studies ; Humans ; Medical Records ; Nasal Cavity ; Orbit* ; Orbital Fractures ; Orbital Implants ; Retrospective Studies

BACKGROUND: Transforaminal epidural steroid injection is one of the effective treatments in managing radicular pain. There have been some prospective studies on the depth to the epidural space with the transforaminal approach. However, there have been no studies about the depth in Asians, especially Koreans. This study was carried out in order to evaluate the depth to the epidural space and the oblique angle and factors that influence the depth to the epidural space during lumbar transforaminal epidural injection. METHODS: A total of 248 patients undergoing fluoroscopically guided transforaminal epidural steroid injections were evaluated. At the L3-4, L4-5, L5-S1, and S1 levels, we measured the oblique angle and depth to the epidural space. RESULTS: Needle depth was positively associated with body mass index (correlation coefficient 0.52, P = 0.004). The median depths (in centimeters) to the epidural space were 6.13 cm, 6.42 cm, and 7.13 cm for 50-60 kg, 60-70 kg, and 70-80 kg groups, respectively, at L5-S1. Age and height were not significantly associated with the needle depth. CONCLUSIONS: There is a positive association between the BMI (and weight) and transforaminal epidural depth but not with age, sex, and height.
Asian Continental Ancestry Group ; Body Mass Index ; Epidural Space ; Humans ; Needles

BACKGROUND: In previous study, most patients with bronchial anthracofibrosis (BAF) were non-miners, and non-occupational old aged females. However, the clinical significance of BAF in patients with coal workers' pneumoconiosis (CWP) is unknown. METHODS: Among patients with CWP who transferred to our hospital for an evaluation of associated pulmonary diseases, 32 patients who had undergone a bronchofibroscopy (BFS) and chest computed tomography (CT) examination were evaluated for the association of the BAF using a retrospective chart review. RESULTS: Nine of the 32 CWP patients (28%) were complicated with BAF. Four of the 16 simple CWP patients (25%) were complicated with BAF. According to the International Labor Organization (ILO) classification by profusion, 2 out of 3 patients in category 1, 1 out of 8 patients in category 2 and 1 out of 3 patients in category 3 were complicated with BAF. Five out of 16 complicated CWP patients were complicated with BAF. Three out of 7 patients in type A and 2 out of 5 patients in type C were complicated with BAF. CWP patients with BAF had significantly greater multiple bronchial thickening and multiple mediastinal or hilar lymph node enlargement than the CWP patients without BAF. There was no difference in the other clinical features between the CWP patients with BAF and those without BAF. CONCLUSION: Many CWP patients were complicated with BAF. The occurrence of BAF was not associated with the severity of CWP progression. Therefore, a careful evaluation of the airway with a bronchoscopy examination and chest CT is warranted for BAF complicated CWP patients who present with respiratory symptoms and signs, even ILO class category 1 simple CWP patients.
Aged ; Bronchoscopy ; Coal ; Female ; Humans ; Lung Diseases ; Lymph Nodes ; Pneumoconiosis ; Retrospective Studies ; Thorax

OBJECTIVE: The aim of this study was to evaluate the effect of lymph-vascular space invasion (LVSI) on clinicopathologic features and outcomes in patients with endometrial cancer. METHODS: All women who were surgically treated for endometrial cancer at the Cheil General Hospital & Women's Healthcare Center between January 2000 and December 2003 were eligible. One hundred-forty one patients underwent retrospective review of medical record. Pathologic findings of LVSI were reviewed and divided in LVSI-positive group and LVSI-negative. Statistical analysis was performed by dBSTAT-4. RESULTS: Fifty-five patients (39%) were LVSI-positive and eighty-six patients (61%) were LVSI-negative. LVSI-positive patients were statistically older than LVSI-negative. LVSI-positive patients had more abnormal cytology, poorer differentiation, larger tumor size (diameter>2 cm), more myometrial invasion. more pelvic nodal metastasis, more paraaortic nodal metastasis, and more advanced stage. There was no difference between the two groups in the percentage of patients with gravidity, parity, histologic types (endometrioid vs nonendometrioid). CONCLUSION: LVSI-positive patients with endometrial cancer are generally older, consistent with more abnormal cytology, poorer differentiation, larger tumor size, more myometrial invasion, more lymph-node metastasis, and more advanced-stage disease. So, LVSI should be a consideration in appropriate treatment in endometrial cancer.
Delivery of Health Care ; Endometrial Neoplasms ; Female ; Gravidity ; Hospitals, General ; Humans ; Medical Records ; Neoplasm Metastasis ; Parity ; Retrospective Studies

Armeniacae semen has been used in traditional medicine for the treatment of pain and inflammatory diseases. Amygdalin is the major compound of Armeniacae semen, and it is used for treatment of pain and cancers. In the present study, we compared the effects of aqueous extract of Armeniacae semen and a solution of amygdalin extracted from Armeniacae semen on the lipopolysaccharide (LPS)-stimulated cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS) mRNA expressions in mouse BV2 microglial cells. We also compared the effects of these compounds on the prostaglandin E2 synthesis and the nitric oxide production in mouse BV2 microglial cells. In the present results, Armeniacae semen and amygdalin suppressed prostaglandin E2 synthesis and nitric oxide production by inhibiting the LPS-induced enhancement of COX-2 mRNA and iNOS mRNA expressions in mouse BV2 cells. For the COX-1 expression, Armeniacae semen showed more potent suppression effect compared to the amygdalin. However, amygdalin more potently suppressed the LPS-induced COX-2 mRNA expression compared to aqueous extract of Armeniacae semen. In the case of iNOS mRNA expression, Armeniacae semen and amygdalin showed similar suppressing effects. For the LPS-induced PGE2 synthesis, amygdalin showed more potent suppressing effect, meanwhile, Armeniacae semen and amygdalin showed similar suppressing effect on NO production. Based on the present results, amygdalin may exert anti-inflammatory and analgesic effect though mainly the inhibition of COX-2 pathway, in contrast Armeniacae semen may exert such effect though both the inhibition of COX-2 and iNOS pathways.
Amygdalin ; Animals ; Cyclooxygenase 1 ; Cyclooxygenase 2 ; Dinoprostone ; Medicine, Traditional ; Mice ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Prostaglandin-Endoperoxide Synthases ; RNA, Messenger ; Semen

A pheochromocytoma is a neuroectodermal tumor that originates from the chromaffin cells of the sympathetic system. Typical symptoms or signs are periodic attacks of paroxysmal hypertension, spell, palpitation, headache and sweating. However, the clinical presentation is quite variable. Therefore, an atypical clinical presentation sometimes makes a diagnosis difficult. Hemoptysis as a presenting symptom is very rare in pheochromocytoma. We recently experienced a patient with diffuse alveolar hemorrhage due to pheochromocytoma. A chest PA showed diffuse consolidation and ground glass opacities in both lungs. A chest CT showed diffuse consolidation and ground glass opacities in the central, middle and lower portion predominance of the lungs, sparing the costophrenic angles and apices of the lungs. In Korea, a case of pheochromocytoma that presented initially as massive hemoptysis due to diffuse alveolar hemorrhage has not been previously reported. We report the case with a review of the literature.
Chromaffin Cells ; Glass ; Headache ; Hemoptysis ; Hemorrhage ; Humans ; Hypertension ; Korea ; Lung ; Neuroectodermal Tumors ; Pheochromocytoma ; Sweat ; Sweating ; Thorax

OBJECTIVE: The discovery of new biomarkers for ovarian cancer is clearly necessary for the detection and monitoring of the disease. Experion(TM) automated electrophoresis system can be employed in the identification of differentially expressed proteins in cancer cells. The objective of this study was to discover potential diagnostic serological biomarkers for ovarian cancer. METHODS: We performed protein expression difference analyses for 14 healthy women and 28 ovarian cancer patients with stage I, III and IV using Experion(TM) system. And then we checked the protein expression as silver staining after loading at 8~16% gradient gel for comparison with Experion(TM) gel image. The candidate biomarkers were purified and determined using MALDI-TOF mass spectrometer. RESULTS: The distinctive polypeptide peaks were detected at 115.40, 15.96, 14.8, 11.66, and 10.69 kDa and these five peaks were identified as ceruloplasmin, hemoglobin beta chain, hemoglobin sigma chain, serum amyloid A4, and amyloid related serum protein SAA, respectively. These proteins were significantly different between the sera of normal healthy women and ovarian cancer patients. CONCLUSIONS: Five proteins were found to be significantly different between the sera of normal healthy women and ovarian cancer patients. In addition, Experion(TM) assay system can provide high performance for analysis of ovarian cancer-related proteins by increasing the throughput while maintaining a high level of accuracy.
Amyloid ; Biomarkers* ; Ceruloplasmin ; Electrophoresis ; Female ; Humans ; Ovarian Neoplasms* ; Silver Staining

BACKGROUND/AIMS: This study reviewes the clinicopathological features, prognosis, and differences in the expression of p53 and Ki-67 immunochemical staining in squamous cell and adenosquamous carcinoma of the stomach. METHODS: From January 1995 to June 2005, 2,282 cases of gastric carcinoma were resected surgically in our hospital and 191 additional cases were resected by endoscopic mucosal resection. Retrospective pathologic review and immunochemical staining of p53 and Ki-67 were performed. RESULTS: The study consists of eight cases (0.032%) of primary squamous cell carcinoma (one case) and adenosquamous carcinoma (seven cases) without early gastric cancer. Six cases (75.0%) were male and two cases were female. The mean age was 66 year-old. The clinical presentation and physical findings did not differ from those of adenocarcinoma. The mean tumor size was 5.2+/-1.7 cm. Macroscopically, five were Borrmann type 3 (62.5%) and three were type 2. At the initial diagnosis, six (75%) were stage IV based on TNM tumor staging. Six cases (75%) progressed despite the therapy while two cases responded to the treatment. The median survival time was 11.0 months (range 4.3+/-17.7). Overexpression of p53 was seen in five cases (62.5%) and their survival was poor when compared to the p53-negative group (p=0.04). The mean Ki-67 labeling index was 70.0+/-20.8%, and was not associated with p53 staining (p>0.05). CONCLUSIONS: Adenosquamous and squamous cell carcinoma of the stomach are very rare. They tend to be at advanced stages on initial diagnosis, and progress rapidly. They show p53 protein overexpression and high Ki-67 labeling index, which might be related to poor prognosis.
Adult ; Aged ; Carcinoma, Adenosquamous/chemistry/mortality/*pathology ; Carcinoma, Squamous Cell/chemistry/mortality/*pathology ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/*analysis ; Male ; Middle Aged ; Stomach Neoplasms/chemistry/mortality/*pathology ; Survival Rate ; Tumor Suppressor Protein p53/*analysis

BACKGROUND/AIMS: Gastritis cystica profunda (GCP) is a rare disease that is characterized by a hyperplastic and cystic dilatation of the pseudopyloric gland with submucosal invasion. GCP is regarded as a benign lesion. However, there is some controversy regarding its malignant potential. This study reviewed the clinical features and association with malignancy. METHODS: From January 2001 to June 2005, 1,010 cases of resected and 1,228 cases of an endoscopic mucosal resection or polypectomy were examined. RESULTS: Thirty-nine cases (1.7%) were confirmed pathologically and were not associated with prior gastric surgery mostly. The mean age was 60.0+/-11.4 years old and there were 29 male patients. The body was most commonly located on the longitudinal axis (57.1%). Eleven cases (28.2%) were not associated any other gastric lesion, the majority of which were the polypoid type (82.0%). However, two cases were found as a hypertrophic mucosal fold, and a submucosal tumor, respectively. Seventeen cases (43.6%) were associated with early gastric cancer. CONCLUSIONS: Despite its rarity, GCP should be considered when an endoscopically polypoid lesion or submucosal tumor (SMT) is found. Because of its association with early gastric cancer or adenoma, more study will be needed to examine the relationship between GCP and gastric carcinogen
Adenoma ; Axis, Cervical Vertebra ; Dilatation ; Gastritis* ; Humans ; Male ; Rare Diseases ; Stomach Neoplasms