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

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

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

Although mycobacterial culture and the subsequent drug-susceptibility test (DST) for anti-tuberculosis (TB) drugs take several months to complete using solid media, there are no reports on the turnaround times of these tests under clinical conditions. The aim of this study was to determine the interval between initiation of anti-TB treatment and receipt of DST requested at an outpatient clinic. We prospectively enrolled patients with culture-positive pulmonary TB at Seoul National University Hospital from September 2002 to December 2004. Patients were followed up monthly. Mycobacterial cultures were done using Ogawa media at Seoul National University Hospital. DST were performed at the Korean Institute of Tuberculosis. Of the 104 patients enrolled, 54 were male. The median age was 41 yr. The median interval from initiation of anti-TB treatment to receipt of mycobacterial culture results by clinicians was 37 days (range, 0-89 days). The median interval from initiation of treatment to confirmation of DST by requesting clinicians was 80.5 days (range, 28-145 days). Clinicians only received the results of DST more than two months after initiation of treatment when they followed up patients monthly and mycobacterial culture was performed using solid media.
Tuberculosis, Pulmonary/*drug therapy ; Time Factors ; Prospective Studies ; Middle Aged ; *Microbial Sensitivity Tests ; Male ; Humans ; Female ; Antitubercular Agents/pharmacology/*therapeutic use ; Aged ; Adult ; Adolescent

The principle treatment for cervical esophageal cancer and hypopharyngeal cancer with esophageal invasion is radical total pharyngolaryngoesophagectomy (PLE), and it is necessary to totally reconstruct the defect of the resected organ. Stomach, small bowel, colon, a laryngotracheal flap and a pectoralis major musculocutaneous flap can all be used. We commonly use stomach because stomach has a rich blood supply and a low incidence of leakage. But in this present reported case, because previous radical subtotal gastrectomy with gastrojejunostomy had been done, we had to use colon for reconstruction. We use the left colon and left colic artery, and there were no complications. We report here on using the left colon and left colic artery to reconstruct a PLE defect for the first time in Korea.
Arteries ; Colic ; Colon* ; Esophageal Neoplasms ; Gastrectomy* ; Gastric Bypass ; Humans ; Hypopharyngeal Neoplasms ; Incidence ; Korea ; Myocutaneous Flap ; Pharyngeal Neoplasms ; Stomach

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