Skull Base Dermoid Cyst in the Right Infratemporal Fossa Diagnosed Using the Dixon Technique: a Case Report and Review of Literature

Dermoid cysts are benign congenital tumors composed of keratinizing squamous epithelium and dermal derivatives. They account for less than 1% of all intracranial tumors and are rarely exhibited at the base of the skull. To the best of our knowledge, only one case report has presented computed tomography and conventional T1-weighted magnetic resonance (MR) findings that revealed an infratemporal dermoid cyst. In the present study, we report an unusual case of a dermoid cyst in the right infratemporal fossa, which was incidentally detected by MR imaging with the Dixon technique. This article also highlights the importance of meticulous radiological review and the usefulness of the Dixon technique in everyday clinical practice.

Skull Base Dermoid Cyst in the Right Infratemporal Fossa Diagnosed Using the Dixon Technique: a Case Report and Review of Literature

Dermoid cysts are benign congenital tumors composed of keratinizing squamous epithelium and dermal derivatives. They account for less than 1% of all intracranial tumors and are rarely exhibited at the base of the skull. To the best of our knowledge, only one case report has presented computed tomography and conventional T1-weighted magnetic resonance (MR) findings that revealed an infratemporal dermoid cyst. In the present study, we report an unusual case of a dermoid cyst in the right infratemporal fossa, which was incidentally detected by MR imaging with the Dixon technique. This article also highlights the importance of meticulous radiological review and the usefulness of the Dixon technique in everyday clinical practice.

Nontraumatic Intracystic Hemorrhage of Arachnoid Cyst: CT and MR Findings

Arachnoid cysts (AC) are intraarachnoidal cerebrospinal fluid collections, and account for 1% of all intracranial space-occupying lesions. Intracystic hemorrhage of the AC can occur spontaneously, but this is an extremely rare event. Herein, we present a case of hemorrhagic AC in a nontraumatic patient in the left middle cranial fossa. We also performed relevant literature review on this disease.

Experiences with Endoscopic Interventions for Variceal Bleeding in Children with Portal Hypertension: A Single Center Study / 대한소아소화기영양학회지

PURPOSE: The aim of this study was to compare the efficacy and safety of band ligation and injection sclerotherapy in the endoscopic treatment of children with variceal bleeding. METHODS: The study population included 55 children, all of whom were treated at the time of endoscopic diagnosis of esophageal varices at Asan Medical Center, Seoul, Korea, between January 1994 and January 2011. The primary outcomes included initial success rates and duration of hemostasis after endoscopic management (band ligation vs. injectionsclerotherapy). RESULTS: The mean age was 6.7+/-5.2 years and the mean follow-up time was 5.4+/-3.7 years. The most common cause of esophageal varices was biliary atresia. Of 55 children with acute variceal bleeding, 39 had band ligation and 16 had injection sclerotherapy. No differences between groups were observed in terms of the size, location, and presence of red color sign. The success rates of band ligation and sclerotherapy in the control of acute bleeding episodes were 89.7% and 87.5%. The mean duration of hemostasis after endoscopic intervention was 13.2+/-25.1 months. After one year, 19 of 39 patients (48.7%) treated with band ligation and 7 of 16 patients (43.8%) with injection sclerotherapy had experienced rebleeding episodes. Complications after the procedures were observed in 10.3% and 18.8% of children treated with band ligation and injection sclerotherapy. CONCLUSION: The results of our current study suggest that band ligation and injection sclerotherapy are equally efficient treatments for the control of acute variceal bleeding and prevention of rebleeding.

Recent Trends in the Endoscopic Management of Variceal Bleeding in Children / 대한소아소화기영양학회지

Variceal bleeding results in significant morbidity and mortality in both children and adults. The guidelines for the management of variceal bleeding are well established in adults but not in children as there have been insufficient pediatric studies of this disorder. In addition, the adult guidelines for treatment of variceal bleeding cannot be applied directly to children as the etiology and natural course of this disease differs between children and adults. Examples of recommended treatments in children include endoscopic variceal ligation as secondary prophylaxis for biliary atresia whereas a meso-Rex shunt operation for extrahepatic portal vein obstruction. In this review, we discuss prophylaxis options and some technical aspects of endoscopic management for variceal bleeding in children.

Granulocytic Sarcoma in Breast after Bone Marrow Transplantation / 한국유방암학회지

Granulocytic sarcoma is a localized extramedullary solid tumor composed of immature myeloid cell and is usually associated with acute myeloid leukemia or myelodysplastic syndrome. Although it can involve any site, commonly in lymph nodes, skin, bone and soft tissue, the involvement of breast is unusual. Especially, the involvement of the breast as a pattern of relapse after bone marrow transplantation is extremely rare. We have experienced 2 cases of granulocytic sarcoma after bone marrow transplantation. One case was a 39-year-old woman with right breast mass diagnosed with granulocytic sarcoma. She had received an unrelated bone marrow transplantation due to biphenotype acute leukemia 3 years before our presentation. Another case was a 48-year-old woman with acute myeloid leukemia, who was diagnosed with granulocytic sarcoma on both breasts 8 months after allogenic bone marrow transplantation. We also discuss the clinicopathologic features of granulocytic sarcoma in breast after bone marrow transplantation.

The Strategies to Address Regional Health Inequalities in Gyeongsangnam-Do: Health Plus Happiness Plus Projects / 農村醫學 地域保健

OBJECTIVES: This study was conducted to implement Health Plus Happiness Plus projects in Gyeongsangnam-Do and assess the policy implications of initiatives to address regional health inequalities. METHODS: Health Plus Happiness Plus projects were started as strategies to address regional health inequalities in Gyeongsangnam-Do. The principles of these projects are taken from the Health Action Zones initiatives in England: participation, partnership, resource concentration in project areas. The time period for these projects is from 2010 to 2017, and the total budget is 5.6 billion won. In 2010, a 6.8 hundred million won total budget was invested in 17 project areas. Such investments fell into four broad categories: establishment of the means and local framework; survey development to analyze the health determinants; development of an education and training center; and establishment of a technical support center. RESULTS: Education and training programs for practitioners and coordinators were provided, and project teams and project promotion committees were established in project areas. Health survey result briefing meetings were held, and 17 health committees were established in project areas. CONCLUSIONS: Health Plus Happiness Plus projects have some problems in relation to participation and partnerships, however, if these principled projects are performed continuously, they will contribute to a reduction of standardized mortality rate and regional health inequalities in Gyeongsangnam-Do and the improvement of residents' well-being in project areas.

Problem awareness of old age among dentists in Seoul and the metropolitan area / 대한구강보건학회지

OBJECTIVES: The aim of this study was to examine and analyze the awareness of dentists of the problems of elderly life, and to provide direction for a desirable retirement plan, according to individual awareness. METHODS: A stratified sampling method was used in proportion to the number of dental clinic and dental hospitals practicing in the Seoul metropolitan area, Incheon city, and Gyeonggi province. The data was verified by the Korea Dental Association's 2010 list of dentists, and for stratified random sampling, was stratified according to the number of regional dental clinics. Dentists from 855 dental clinics and dental hospitals were selected between May and Sept. 2010 for a self-administered survey questionnaire, by mail, fax or interview. 484 valid questionnaires (56.7%) were collected from respondents for data analysis. The study used SPSS (ver. 18.0) to analyze Chi-square tests, one-way ANOVA, and independent t-tests on the collected survey data. RESULTS: The responders pointed out that 'health related problems', 'financial problems', and 'isolation from society', were, in order, the main problems of the elderly stage of life. Dentists showed the highest response to their own suitable retirement age of '60- under 70'. The more that responders recognized his or her own good personal health status, the lower the subjective degree of anxiety for financing after retirement (P<0.001). Responders who had monthly net income of 'under 1,500 ten thousand won' showed the highest degree of anxiety, and those who had 'over 2,500 ten thousand won' showed the lowest degree of anxiety, which showed statistical significance (P<0.001). CONCLUSIONS: In conclusion, 'health related problems' was the highest predicted problem for elderly dentists. Therefore, dentists should actively engage in a healthy living style to prepare for a healthy old age. Furthermore, early preparation and establishment of countermeasures to actively manage predictable problems in elderly living is needed.

A Correlation between Neurocognitive Function and Serum Lipid Levels among the Korean Elderly / 신경정신의학

OBJECTIVES: In this study, we evaluated the correlation between neurocognitive function and serum lipids levels among Koreans over 60 years old. Also, we investigated the sociodemographic risk factors and vascular risk factors in Alzheimer's disease. METHODS: Six hundred fifty elderly persons participated in this study. We screened for cognitive impairment via the Mini-Mental Status Examination-Korean version (MMSE-KC) and evaluated 181 participants using the Consortium to Establish a Registry for Alzheimer's disease, Korean version (CERAD-K). For further classification, we employed the Clinical Dementia Rating Scale (CDRS) and DSM-IV diagnostic criteria. Participants having a CDRS score of 1 or more were diagnosed as having Alzheimer's disease. RESULTS: We diagnosed 38 participants as having Alzheimer's disease, 67 participants as having mild cognitive impairment, and 76 participants as having no cognitive impairment. There were significant differences among the groups with regard to age, education, history of diabetes mellitus medication, history of head trauma, history of CVA, and Hachinski ischemic score (p<0.05). The mild cognitive impairment group showed inverse correlations between triglyceride serum level and both total MMSE-KC score and Orientation in MMSE-KC (rs=-0.267, p=0.029 ; rs=-0.324, p=0.007). This group also showed inverse correlations between total cholesterol serum level and both total MMSE-KC score and Orientation in MMSE-KC (rs=-0.259, p=0.034 ; rs=-0.417, p=0.000) and an inverse correlation between low density lipoprotein serum level and Orientation in MMSE-KC (rs=-0.320, p=0.008). CONCLUSION: There were inverse correlations between some lipids' serum levels and cognitive functions in the mild cognitive impairment group.

Correlation of the Immunohistochemical Coexpression of p53 and HER-2/neu and the Prognosis of Breast Cancer / 한국유방암학회지

PURPOSE: Among the many biological parameters of breast cancer, the p53 and HER-2/neu genes, which are located on the chromosome 17, and their gene products have been studied extensively by many researchers in regard their relation to the prognosis. The aim of this study was to evaluate the prognostic significance of the coexpression of p53 and HER-2/neu in breast cancer. METHODS: Formalin-fixed, paraffin-embedded tissues from 126 patients with invasive breast cancer were immunostained for p53 and HER-2/neu. Other prognostic parameters such as the patients' age, tumor size, lymph node metastasis, histologic grade, the presence of estrogen receptor (ER), and progesterone receptor (PgR) were evaluated. The patients' outcome was analyzed according to the expression of p53 and HER-2/neu as well as to the other prognostic factors. RESULTS: Among the 126 patients, p53 and HER-2/neu were positive in 46 (36.5%) and 33 (26.2%) patients. According to the expression of p53 and HER-2/neu, the patients were classified into three groups; group 1: negative expression for both factors (n = 63), and group 2: positive expression for either one of the factors (n = 47), and group 3: positive expression for both factors (n = 16). The median follow-up period was 50+/-11.1 months. On the Kaplan-Meier analysis, p53 and HER-2/neu were both related to the 5-year disease free survival rate (DFSR). Group 3 showed a significantly lower 5-year DFSR than did group 2 (66.2% vs. 85.2%, respectively, p = 0.05) and the group 1 (66.2% vs. 94.0%, respectively, p = 0.01). The multivariate analysis indicated that lymph node metastasis, ER, PgR, p53 and HER-2/neu expressions were significantly related to the patients'5-year DFSR. CONCLUSION: The expression of p53 and HER-2/neu was related to the 5-year DFSR of breast cancer, and the coexpression of p53 and HER-2/neu was found to have a more significant prognostic value than either one of these two parameters alone.

Two Cases of New Operative Technique in Treatment of Stress Urinary Incontinence / 대한비뇨기과학회지

Most stress urinary incontinence require a surgical correction for stabilizing the urethrovesical junction Many procedures had been applied for the treatment of stress urinary incontinence. Recently we experienced two cases of stress urinary incontinence, corrected by endoscopic suspension of bladder neck with percutaneous nephrostomy needles, ang good results were obtained. Herein we reported a more simple and safe modified procedure with some literatures.