Meningiomas are common intracranial tumors; however, reports on extracranial cutaneous meningiomas are exceedingly rare. A 77-year-old woman visited our hospital with an asymptomatic child fist-sized mass on the scalp.Biopsy results indicated nuclear atypia and mitoses of sarcomatous cells. Brain magnetic resonance imaging revealed a subgaleal mass with strong enhancement. Suspecting sarcoma, wide excision was performed jointly by the departments of plastic surgery and neurosurgery, during which no evidence of cranial invasion was noted. In the surgical specimen, numerous mitoses of sarcomatous cells and poorly formed nests of epithelioid cells were observed. This led to the diagnosis of anaplastic meningioma without intracranial origin. Subsequently, the patient received adjuvant radiotherapy and is currently under close follow-up. Anaplastic meningioma is rare, but early diagnosis is important as it enables timely and appropriate treatment, thus, improving survival rates. Dermatologists should remain vigilant as meningiomas can manifest as cutaneous scalp nodules, and their accurate diagnosis can profoundly impact prognosis.

Purpose: To investigate the characteristics and treatment results of patients aged ≥ 85 years who were diagnosed with treatment-naïve neovascular age-related macular degeneration (nAMD). Methods: The medical records of patients diagnosed with treatment-naïve nAMD who were ≥ 85 years old at the time of diagnosis with at least 12 months follow-up were retrospectively reviewed. The number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) and agents used during the entire period were investigated. Best-corrected visual acuity and optical coherence tomography results before and after treatment were analyzed. Visual acuity of the fellow eye was also collected. Results: A total of 40 eyes of 40 patients with mean age of 87.5 ± 2.4 were included in the study. The mean logarithm of the minimal angle of resolution visual acuity was 0.85 ± 0.57, and the mean of the fellow eye was 0.93 ± 0.99. Compared to before the treatment, there was no significant difference after intravitreal injection in terms of visual acuity. Central retinal thickness showed significant reduction at all time points after treatment. Conclusions In patients aged ≥ 85 years at the time of diagnosis, intravitreal injections of anti-VEGF prevented deterioration of visual acuity and showed successful anatomical outcomes. Especially, many had poor visual acuity in the fellow eye, suggesting the importance of maintaining visual acuity. Therefore, active treatment is necessary in the elderly.

BACKGROUND: As the number of big-cohort studies increases, validation becomes increasingly more important. We aimed to validate administrative database categorized as colorectal cancer (CRC) by the International Classification of Disease (ICD) 10th code. METHODS: Big-cohort was collected from Clinical Data Warehouse using ICD 10th codes from May 1, 2003 to November 30, 2016 at Seoul National University Bundang Hospital. The patients in the study group had been diagnosed with cancer and were recorded in the ICD 10th code of CRC by the National Health Insurance Service. Subjects with codes of inflammatory bowel disease or tuberculosis colitis were selected for the control group. For the accuracy of registered CRC codes (C18–21), the chart, imaging results, and pathologic findings were examined by two reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated. RESULTS: A total of 6,780 subjects with CRC and 1,899 control subjects were enrolled. Of these patients, 22 subjects did not have evidence of CRC by colonoscopy, computed tomography, magnetic resonance imaging, or positron emission tomography. The sensitivity and specificity of hospitalization data for identifying CRC were 100.00% and 98.86%, respectively. PPV and NPV were 99.68% and 100.00%, respectively. CONCLUSIONS: The big-cohort database using the ICD 10th code for CRC appears to be accurate.
Classification ; Colitis ; Colonoscopy ; Colorectal Neoplasms ; Hospitalization ; Humans ; Inflammatory Bowel Diseases ; Magnetic Resonance Imaging ; National Health Programs ; Positron-Emission Tomography ; Retrospective Studies ; Sensitivity and Specificity ; Seoul ; Tuberculosis

BACKGROUND: Lead (Pb), mercury (Hg), and cadmium (Cd) are well-known environmental pollutants. They are unnecessary in the biological processes of humans. This study was performed to estimate the representative background exposure levels to the metals by measuring concentrations in whole blood of the Korean general population. METHODS: This population-based cross-sectional study included 4,000 subjects (1,886 males and 2,114 females) 0–83 years of age in 2010 and 2011. Adult subjects (≥ 19 years of age) were collected by sex- and age-stratified probability method, and preschool- and school-aged subjects were recruited by a cluster sampling method. Written consent was provided prior to blood sampling. Pb and Cd blood concentrations were determined by a flameless atomic absorption spectrophotometry, and blood Hg was analyzed by a direct Hg analyzer. RESULTS: The geometric mean, median and 95th percentile of blood Pb was 1.82 µg/dL, 1.83 µg/dL, and 3.78 µg/dL, respectively. The respective values were 2.92 µg/L, 2.87 µg/L, 9.12 µg/L for Hg, and 0.56 µg/L, 0.59 µg/L, 2.20 µg/L for Cd. Blood Pb and Hg were higher in males than in females, but no sex difference was observed, respectively, in subjects 0–4 years of age for Pb and in subjects less than 20 years for Hg. However, blood Cd was higher in females than in males and no sex difference was observed in subjects < 30 years of age. CONCLUSION: This study provides representative data of human exposure to Pb, Hg, and Cd covering whole age groups of the general population in Korea.
Adult ; Biological Processes ; Cadmium ; Cross-Sectional Studies ; Environmental Pollutants ; Female ; Humans ; Korea ; Male ; Metals ; Methods ; Sex Characteristics ; Spectrophotometry, Atomic

PURPOSE: Proper management of nutrition or health care for pregnant women is known to have better perinatal outcomes for maternal and neonatal health. In this study, we investigated the effect of regular medical and nutritional counseling provided to pregnant women for improved-results for mother and neonates. METHODS: Thirty-five pregnant women participated in the study and received information on nutrition management via telephone or e-mail every four weeks until childbirth. The nutrition management program comprised proper diet, low-salt diet, low-sugar diet, breast-feeding preparation, and provision of a healthy menu according to their pregnancy trimesters. We categorized them by their degree of participation into a “low participation group” that formed the control group, and a “high participation group” as the study group. RESULTS: No significant differences were found in maternal age, and body mass index between the two groups at the time of enrollment in the study. Post-natal exclusive breast feeding rate was significantly higher in the high participation group (62%) than in the low participation group (32%) (p<0.05). In the neonatal results, gestational age at birth and neonatal birth weight were significantly higher in the high participation group than in the low participation group (p<0.05). Neonatal complication rate, neonatal admission rate to intensive care unit, rate of low birth weight, Apgar score at 1 and 5 minutes, as well as the rate of transient tachypnea were higher in the low participation group, but lacked any statistically significant difference. CONCLUSION: Collaborative nutrition management with obstetricians and nutritionists is helpful in achieving better perinatal outcomes.
Apgar Score ; Birth Weight ; Body Mass Index ; Breast Feeding ; Counseling ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Electronic Mail ; Female ; Gestational Age ; Gyeonggi-do* ; Humans ; Infant Health ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units ; Maternal Age ; Mothers ; Nutritionists ; Parturition ; Pregnancy Outcome ; Pregnancy Trimesters ; Pregnancy* ; Pregnant Women ; Tachypnea ; Telephone

Periodontal disease is one of the most prevalent chronic disorders worldwide. It is accompanied by inflammation of the gingiva and destruction of periodontal tissues, leading to alveolar bone loss. Here, we focused on the role of adipokines, which are locally expressed by periodontal tissues, in the regulation of catabolic gene expression leading to periodontal inflammation. The expression of the nicotinamide phosphoribosyltransferase (NAMPT) adipokine was dramatically increased in inflamed human and mouse gingival tissues. NAMPT expression was also increased in lipopolysaccharide- and proinflammatory cytokine-stimulated primary cultured human gingival fibroblasts (GF). Adenovirus-mediated NAMPT (Ad-Nampt) overexpression upregulated the expression and activity of COX-2, MMP1 and MMP3 in human GF. The upregulation of IL-1β- or Ad-Nampt-induced catabolic factors was significantly abrogated by the intracellular NAMPT (iNAMPT) inhibitor, FK866 or by the sirtuin (SIRT) inhibitor, nicotinamide (NIC). Recombinant NAMPT protein or extracellular NAMPT (eNAMPT) inhibition using a blocking antibody did not alter NAMPT target gene expression levels. Moreover, intragingival Ad-Nampt injection mediated periodontitis-like phenotypes including alveolar bone loss in mice. SIRT2, a part of the SIRT family, was positively associated with NAMPT actions in human GF. Furthermore, in vivo inhibition of the NAMPT-NAD⁺-SIRT axis by NIC injection in mice ameliorated the periodontal inflammation and alveolar bone erosion caused by intragingival injection of Ad-Nampt. Our findings indicate that NAMPT is highly upregulated in human GF, while its enzymatic activity acts as a crucial mediator of periodontal inflammation and alveolar bone destruction via regulation of COX-2, MMP1, and MMP3 levels.
Adipokines ; Alveolar Bone Loss ; Animals ; Fibroblasts* ; Gene Expression* ; Gingiva ; Humans ; Inflammation ; Mice ; Niacinamide ; Nicotinamide Phosphoribosyltransferase ; Periodontal Diseases ; Periodontitis* ; Phenotype ; Up-Regulation

BACKGROUND: Arthroscopic iliopsoas tendon release was introduced in 2000. The purpose of this study was to evaluate clinical outcomes of arthroscopic iliopsoas tendon release for painful internal snapping hip with concomitant hip pathologies. METHODS: Between January 2009 and December 2011, we performed arthroscopic iliopsoas tendon release and related surgeries in 25 patients (20 men and 5 women; mean age, 32 years; range, 17 to 53 years) with combined intraarticular hip pathologies. The patients were followed for a minimum of 2 years postoperatively. Clinical and radiological evaluations were performed. RESULTS: Snapping sounds had disappeared by the 2-year follow-up in 24 of the 25 patients. All patients who had presented with loss of flexion strength postoperatively showed recovery at postoperative week 6 to 10. Harris hip score improved from 65 points (range, 46 to 86 points) preoperatively to 84 points (range, 67 to 98 points) postoperatively (p < 0.001). Seven hips (28%) had an excellent score, 15 hips (60%) a good score, 2 hips (8%) a fair score, and one hip (4%) a poor score (p < 0.001). The Tonnis grade of osteoarthritis did not change in any of the patients at the last follow-up. CONCLUSIONS: Patients with painful internal snapping hip have combined hip pathologies. Therefore, the surgeon should keep in mind that painful internal snapping hips are frequently combined with concomitant intraarticular pathologies.
Adult ; *Arthroscopy ; Female ; *Hip Joint ; Humans ; Joint Diseases/*surgery ; Male ; Middle Aged ; Retrospective Studies ; Tenotomy/*methods ; Young Adult

OBJECTIVE: Perinatal hemorrhagic stroke (PHS) is common cause of cerebral palsy, congenital hemiparesis, and subsequent behavioral, cognitive, and language problems. Despite of this importance, risk factors for this condition have not been studied. This study was undertaken to survey the clinical features and risk factors of PHS. METHODS: A retrospective study was carried out on 24 newborns with PHS who were admitted to the neonatal intensive care unit (NICU) of Daegu Fatima hospital from January 2004 to July 2009. Cases of PHS in neonates (28 weeks' gestational age through 28 days of life) were identified through neuroimaging studies, clinical findings and chart review. Two controls per case were randomly selected. Risk factors of PHS were assessed and clinical features of PHS were reviewed. RESULTS: We identified 24 cases of PHS (19 intracerebral hemorrhage, 4 intracerebral hemorrhage with subarachnoid hemorrhage, 1 subarachnoid hemorrhage). PHS was more common in male (15 males and 9 females). Case presented with encephalopathy (100%), seizures (20.8%) and cyanosis (4.2%). The neuroimaging findings of PHS were more commonly unilateral (78.3%), and right-hemisphere (73.9%). PHS was most often seen in temporal lobe (38.2%). There were no statistical and significant risk factors of PHS. CONCLUSIONS: Newborns with PHS typically present with encephalopathy (lethargy, hypotonia, apnea, feeding disability) and seizures. The neuroimaging findings were more commonly unifocal, unilateral and seen in temporal lobe. Additional prospective studies are needed to determine the prevalence and risk factors of PHS.
Apnea ; Cerebral Hemorrhage ; Cerebral Palsy ; Cyanosis ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care, Neonatal ; Male ; Muscle Hypotonia ; Neuroimaging ; Paresis ; Prevalence ; Retrospective Studies ; Risk Factors ; Seizures ; Stroke ; Subarachnoid Hemorrhage ; Temporal Lobe

BACKGROUND: We introduce a new, simple portable inhalational induction device (PD) that provides co-operative inhalational induction of anaesthesia using N2O and subsequent sevoflurane in the preanaesthetic induction area in children. METHODS: Forty-five children (30 to 94 months old age, <35 kg) who were scheduled to undergo simple operations were assigned randomly to one of three regimens. Patients were encouraged by their parents to inhale N2O followed by sevoflurane (PD N2O-sevo group) or sevoflurane (PD sevo group) using a portable inhalational induction device in the preanaesthetic induction area until they were unable to respond to their names. They were then transferred to the operating room while maintaining inhalation of sevoflurane via the device. The control group underwent conventional inhalational induction in the operating room with the parents in attendance. RESULTS: Patients in the PD N2O-sevo group had a higher co-operative inhalation frequency than the patients in the PD sevo or the control group. Anaesthesia induction in the PD N2O-sevo and the PD sevo groups were faster than in the control group. Parent satisfaction score (0-100) was higher for the PD N2O-sevo group than for the control group. CONCLUSIONS: A new portable inhalational induction device allows faster induction in co-operation with parents present in the preanaesthetic induction area compared to conventional inhalational induction in the unfamiliar operating room with the parents in attendance.
Child ; Humans ; Inhalation ; Methyl Ethers ; Nitrous Oxide ; Operating Rooms ; Parents

Serotonin (5-hydroxytroptamine, 5-HT) has been shown to affect the induction of long-term potentiation (LTP) in the cortex such as the hippocampus, the visual cortex and the prefrontal cortex. Fluoxetine, as a selective serotonin reuptake inhibitor, is used in the management of a wide variety of psychological diseases. To study the effect of fluoxetine on the induction of LTP, we recorded the field potential in layer II/III of the frontal cortex from 3-wk-old. LTP was induced in horizontal input by theta burst stimulation (TBS). TBS with two-folds intensity of the test stimulation induced LTP, which was blocked by application of D-AP5 (50microM), an NMDA receptor antagonist. Whereas bath application of 5-HT (10microM) inhibited the induction of LTP, treatment with the 5-HT depleting agent, para-chloroamphetamine (PCA, 10microM), for 2hr did not affect the induction of LTP. Bath application of fluoxetine (1, 3, and 10microM) suppressed the induction of LTP in concentration-dependent manner, however, fluoxetine did not inhibit the induction of LTP in 5-HT-depleted slices. These results indicate that fluoxetine may inhibit the induction of LTP by modulating serotonergic mechanism in the rat frontal cortex.
Animals ; Baths ; Fluoxetine* ; Hippocampus ; Long-Term Potentiation* ; N-Methylaspartate ; p-Chloroamphetamine ; Prefrontal Cortex ; Rats* ; Serotonin ; Visual Cortex