Impact of the Preoperative Neutrophil to Lymphocyte Ratio on Patients with Head and Neck Cancer / 대한이비인후과학회지

Background and Objectives@#To investigate the prognostic value of the neutrophil to lymphocyte ratio (NLR) in patients with head and neck squamous cell cancer (HNSCC).Subjects and Method Clinical data from 259 patients with HNSCC were collected retrospectively. NLR was adopted as potential prognostic biomarkers. @*Results@#NLR was associated with cancer recurrence (p=0.002 and p＜0.001, respectively). Patients with a NLR ＞2.15 had significantly decreased 5-year disease specific survival (DSS) based on the Kaplan-Meier survival curves (p＜0.001 and p=0.029, respectively). The Multivariate Cox regression analysis confirmed a significant association between 5-year DSS and the NLR (using 2.15 as the cut-off; hazard ratio, 1.852; 95% confidence interval, 1.237-2.771; p= 0.003). @*Conclusion@#A NLR cut-off value ≥2.15 was associated with adverse outcomes in patients with HNSCC.

The Development and Evaluation of a Nutrition Education Program including Sensory and Cooking Activity to Promote Vegetable Intake among School Aged Children

BACKGROUND@#The aim of the study is the development of nutrition education program for promoting vegetable intakes of school aged children.@*METHODS@#After a pilot study and consultations of experts, a program (composed of five lessons) that was emphasized the sensory and cooking activities based on the social cognitive theory was developed. Specially, we focused on enhance expectation, self-efficacy, and behavioral performance through the intervention. For a outcome evaluation survey tool was developed, too. The lessons once-a-week (total five lessons) and survey (pre and pro) were conducted to 20 school aged children.@*RESULTS@#The distribution of children was 11.5 years (mean age), boys (25%), girls (75%). Compared to pre-survey, the result of post-survey was higher scores for self-efficacy and two items out of ten items in food neophobia category. And one items out of six items (unfamiliar vegetables), three items out of ten items (familiar vegetables) showed positive result in food neophilia category significantly (P<0.1).@*CONCLUSIONS@#The education duration was short(5 weeks) but we could observe visible changes on self-efficacy, behavior performances for cooking and intention to intake vegetables non-preferred ones previously. Continuous applying and supplementing this nutrition education program may promote intake of vegetables among children.

The Evaluation of the Short-Term Voice Outcome of Injection Laryngoplasty Using Two Types of Calcium Hydroxylapatite (Radiesse versus Facetem) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Radiesse® is a widely used calcium hydroxyapatite (CaHA) injection material used for vocal fold injection. Recently, a new CaHA injection material (Facetem ®) which complements the structural disadvantages of Radiesse has been developed and released in the market. The aim of this study is to compare the efficacy and short-term voice outcome of these two CaHA materials.SUBJECTS AND METHOD: A retrospective analysis was performed for 70 patients with unilateral vocal fold paralysis who underwent vocal fold injection using CaHA materials. Acoustic voice analysis, maximal phonation time (MPT), voice handicap index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale were evaluated between Radiesse and Facetem injection group.@*RESULTS@#Both groups showed a signifcant improvement of MPT, VHI, and G, B, A scale after injection. The Facetem group showed similar voice improvement as the Radiesse group, where pre- and postoperatively objective and subjective voice evaluation results were compared.@*CONCLUSION@#Our study reveals that there is no significant difference in efficacy and nor any short-term vocal improvement between Radiesse and Facetem. Therefore, the use of Facetem as CaHA injection material could be considered as an alternative material for patients with unilateral vocal cord paralysis.

The Evaluation of the Short-Term Voice Outcome of Injection Laryngoplasty Using Two Types of Calcium Hydroxylapatite (Radiesse versus Facetem) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Radiesse® is a widely used calcium hydroxyapatite (CaHA) injection material used for vocal fold injection. Recently, a new CaHA injection material (Facetem ®) which complements the structural disadvantages of Radiesse has been developed and released in the market. The aim of this study is to compare the efficacy and short-term voice outcome of these two CaHA materials. SUBJECTS AND METHOD: A retrospective analysis was performed for 70 patients with unilateral vocal fold paralysis who underwent vocal fold injection using CaHA materials. Acoustic voice analysis, maximal phonation time (MPT), voice handicap index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale were evaluated between Radiesse and Facetem injection group. RESULTS: Both groups showed a signifcant improvement of MPT, VHI, and G, B, A scale after injection. The Facetem group showed similar voice improvement as the Radiesse group, where pre- and postoperatively objective and subjective voice evaluation results were compared. CONCLUSION: Our study reveals that there is no significant difference in efficacy and nor any short-term vocal improvement between Radiesse and Facetem. Therefore, the use of Facetem as CaHA injection material could be considered as an alternative material for patients with unilateral vocal cord paralysis.

The Development and Evaluation of a Nutrition Education Program including Sensory and Cooking Activity to Promote Vegetable Intake among School Aged Children

BACKGROUND: The aim of the study is the development of nutrition education program for promoting vegetable intakes of school aged children. METHODS: After a pilot study and consultations of experts, a program (composed of five lessons) that was emphasized the sensory and cooking activities based on the social cognitive theory was developed. Specially, we focused on enhance expectation, self-efficacy, and behavioral performance through the intervention. For a outcome evaluation survey tool was developed, too. The lessons once-a-week (total five lessons) and survey (pre and pro) were conducted to 20 school aged children. RESULTS: The distribution of children was 11.5 years (mean age), boys (25%), girls (75%). Compared to pre-survey, the result of post-survey was higher scores for self-efficacy and two items out of ten items in food neophobia category. And one items out of six items (unfamiliar vegetables), three items out of ten items (familiar vegetables) showed positive result in food neophilia category significantly (P<0.1). CONCLUSIONS: The education duration was short(5 weeks) but we could observe visible changes on self-efficacy, behavior performances for cooking and intention to intake vegetables non-preferred ones previously. Continuous applying and supplementing this nutrition education program may promote intake of vegetables among children.

Prevalence of Hepatitis B Virus and HIV Co-infection in Korea

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) have a common route like sexually transmitted infections (STIs), vertical transmission and blood transfusion, etc. Therefore, it was necessary to be an attempt to confirm the relationship of HBV and HIV in Korea. We investigated the prevalence of Hepatitis B surface antigen (HBsAg) and Hepatitis B core antibody (anti-HBc) in HIV positive groups (n=430) and HIV negative groups (n=434) from January 2014 to October 2015. When comparing the prevalence of anti-HBc between the two groups, HIV positive group (36.0%) showed a higher prevalence than HIV negative group (24.7%), the result was statistically significant (p < 0.05). However, there was a little difference on HBsAg and not significant. Therefore, by showing a clear difference in anti-HBc between the two groups of HIV in Korea, it was confirmed to be associated with co-infections between Hepatitis B and HIV.

Time Course and Characteristics of Astrocyte Activation in the Rat Brain after Injury / 대한신경손상학회지

OBJECTIVE: After injury to the central nervous system (CNS), glial scar tissue is formed in the process of wound healing. This can be is a clinical problem because it interferes with axonal regeneration and functional recovery. It is known that intracellular proteins, including the glial fibrillary acidic protein (GFAP), nestin, and vimentin increase in the astrocytes after an injury to the CNS. By studying the time course and co-expression pattern of these intracellular proteins, this study will attempt to prove that these proteins are involved in the processes of glial scar formation. METHODS: Twenty-five male Sprague-Dawley rats were used in this study. Bregma of the cerebral cortex, an area was incised with a sharp blade, and perfusion was performed. The expressions of the intracellular proteins were assayed, while the co-localization of the intermediate filament (GFAP, nestin, and vimentin) and A2B5 were examined. RESULTS: At 12 hours, the GFAP was expressed in the white matter underlying the lesion, and in the cerebral cortex. Nestin was expressed in the astrocytes in the perilesional area after 3 days, while A2B5 was observed in the edge of the wound at 12 hours post-injury, with its expression reaching a peak at 7 days. Vimentin was detected in the white matter at 12 hours, and in the cortex, reaching a peak at 7 days. CONCLUSION: In the processes of glial scar formation, nestin, vimentin, and A2B5 were revealed in the astrocytes, and these factors may be involved in the division, proliferation, and transportation of the astrocytes.

Acute Horseshoe Abscess of the Hand after Local Steroid Injection: A Case Report

The differential diagnosis of hand infections is difficult because hand infections can manifest with variable clinical presentations due to the unique anatomic structures of the hand, and the significance of these infections is often overlooked. A horseshoe abscess is a rare type of deep space infection that can occur due to extension of infection through communications between the deep spaces of the hand. Although horseshoe abscesses are well known due to their anatomic characteristics, there are few clinical reports of such occurrences. Such a case has not been reported in the Korean literature. Here we report a case of horseshoe abscess of the hand after local steroid injection.

Spontaneous Spinal Epidural Hematoma on the Ventral Portion of Whole Spinal Canal: A Case Report

Spontaneous spinal epidural hematoma is an uncommon but disabling disease. This paper reports a case of spontaneous spinal epidural hematoma and treatment by surgical management. A 32-year-old male presented with a 30-minute history of sudden headache, back pain, chest pain, and progressive quadriplegia. Whole-spinal sagittal magnetic resonance imaging (MRI) revealed spinal epidural hematoma on the ventral portion of the spinal canal. Total laminectomy from T5 to T7 was performed, and hematoma located at the ventral portion of the spinal cord was evacuated. Epidural drainages were inserted in the upper and lower epidural spaces. The patient improved sufficiently to ambulate, and paresthesia was fully recovered. Spontaneous spinal epidural hematoma should be considered when patients present symptoms of spinal cord compression after sudden back pain or chest pain. To prevent permanent neurologic deficits, early and correct diagnosis with timely surgical management is necessary.

The Clinical Characteristics and Predictors of Treatment Success of Pulmonary Tuberculosis in Homeless Persons at a Public Hospital in Busan / 가정의학회지

BACKGROUND: Homelessness is associated with an increased risk of exposure to Mycobacterium tuberculosis. Several factors, including alcoholism, malnutrition, lack of stable housing, combine to make tuberculosis more prevalent in the homeless. The aims of this study were to determine the factors associated with increasing success rate of tuberculosis treatment in the homeless. METHODS: A cross-sectional analysis of the clinical features in 142 pulmonary tuberculosis-positive homeless patients admitted to the Busan Medical Center from January 2001 to December 2010 was carried out. These results were compared with a successful treatment group and incomplete treatment group. We also evaluated the risk factors of treatment non-completion. Statistical analysis for the comparisons was performed using a chi2 test, independent samples t-test, and multiple logistic regression. RESULTS: Comparison of clinical characteristics showed significant differences between the two groups in the type of residence (P < 0.001), diseases with risk factors (P = 0.003), and history of tuberculosis treatment (P = 0.009). Multiple regression analysis revealed the residence (odds ratio [OR], 4.77; 95% confidence interval [CI], 2.05 to 11.10; P < 0.001) and comorbidity with risk factor (OR, 2.72; 95% CI, 1.13 to 6.53; P = 0.025) to be independently associated with treatment success. CONCLUSION: To improve the success rate of tuberculosis treatment in the homeless person, anti tuberculosis medication should be taken until the end of treatment and a management system for the homeless person is required. Further social and medical concerns for stable housing and management of comorbidity may lead to an improvement in the successful tuberculosis treatment of homeless person.

Enhancement of Protein Productivity of Recombinant Hepatitis A Virus VP1 in Stably Transfected Drosophila melanogaster S2 Cells

The effect of DMSO and sodium butyrate on the production of recombinant hepatitis A virus (HAV) capsid protein VP1 was evaluated and optimized in the culture of stably transfected Drosophila melanogaster S2 cells using culture plates and spinner flasks. The effect of DMSO and sodium butyrate was also evaluated to improve the recombinant VP1 production in stably transfected Drosophila S2 cells. A production level of 0.88 mg of recombinant VP1/liter was obtained in the culture-plate culture of stably transfected S2 cells at 6 days after induction with 0.5 mM CuSO4. The supplements of 2% DMSO and 10 mM sodium butyrate at 4 days post-inoculation increased recombinant VP1 accumulation by 141 and 104%, respectively, resulting in 2.17 and 1.7 mg/liter of recombinant VP1 production. In spinner flasks, recombinant VP1 production reached maximum level at 9 days after induction with 0.5 mM CuSO4, with approximately 4.96 mg/liter of recombinant VP1 production level. When 2% DMSO or 10 mM sodium butyrate was added at 5 days post-inoculation, the recombinant VP1 production was increased to 8.35 and 5.85 mg/liter, respectively. However, the synergistic effects of DMSO and sodium butyrate were not observed. These results indicate that DMSO and/or sodium butyrate can be successfully used to improve the recombinant HAV VP1 production in culture plates and spinner flasks.

Efficacy of Glycopyrrolate in Primary Hyperhidrosis Patients

BACKGROUND: Primary hyperhidrosis is a disorder of excessive sweating, which shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oral glycopyrrolate is one of the treatments available. There are a few published studies on the use of glycopyrrolate given orally in the treatment of hyperhidrosis. METHODS: Thies is study was a review of case notes in a series of 36 patients with primary hyperhidrosis. We made a comparison between the Keller's scale score of a pre-glycopyrrolate medication group and the Keller's scale score f a post-glycopyrrolate medication group. The Milanez de Campos score, Short Form_36 (SF-36) score, Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the two groups. RESULTS: In the post-glycopyrrolate medication group, there were declines in Keller's scale, and Milanez de Campos scale score and BAI score (P < 0.001). In addition, there were increases in SF_36 score in the post-glycopyrrolate medication group (P = 0.03) However, no changes were seen in, BDI score and ANS score in the post-glycopyrrolate medication group (P < 0.001). CONCLUSIONS: Glycopyrrolate is an effective initial method of treating primary hyperhidrosis that, reduces anxiety and improve patients' quality of life.

Nodular Fasciitis in the Finger: The Sonographic Findings and a Literature Review

A 39-year-old woman presented with a rapidly growing nodule on the right thumb. An ultrasound study demonstrated a mass located in the deep subcutaneous tissue on the ulnar side of the interphalangeal joint. Incisional biopsy yielded the diagnosis of nodular fasciitis. We discuss the ultrasound appearance of nodular fasciitis as reported in the literature and how to make the differential diagnosis of an echogenic finger mass.

Eccrine Spiradenoma Arising in the Breast Misdiagnosed as an Epidermal Inclusion Cyst

Eccrine spiradenomas are rare, benign, cutaneous tumors that originate in the sweat glands. Eccrine spiradenomas in the breast are very rare and only a few cases have been reported. We report here on the case of a 47-year-old woman with superficial masses in the breast and these masses had gradually increased in size during follow-up. They were confirmed to be an eccrine spiradenoma on pathologic examination. There have been a few reports about the radiologic findings of eccrine spiradenomas of the breast. This is the first case of an eccrine spiradenoma in the breast that was characterized by multiple imaging modalities, including mammography, ultrasonography and MRI. The lesion in our patient was first diagnosed as an epidermal inclusion cyst based on the imaging findings and the mass's superficial location. Although the mammographic and ultrasonographic imaging findings of eccrine spiradenomas and epidermal inclusion cysts are similar, the MRI findings are different between epidermal inclusion cysts and eccrine spiradenomas. Eccrine spiradenomas should be considered in the differential diagnosis of cutaneous and subcutaneous lesions of the breast.

Evaluation of Dose Distribution Using a Radiophotoluminescence Glass Dosimeter in Biobeam8000 Gamma Irradiation Device / 의학물리

Gamma irradiator is widely used for cell, animal experiment, irradiation for blood, dose measurement, and education. Biobeam8000 gamma irradiator (STS Steuerungstechnik &. Strahlenschutz GmbH, Braunschweig, Germany, Cs137, 81.4 TBq) that KIRAMS (Korea Institute of Radiological and Medical Science) has is a irradiation device that enables to be used in large-capacity of 7.5 L and extensive area. Cs-137 source moves range of 24 cm back-and-forth in a regular cycle in beaker for uniform irradiation and a beaker that puts a specimen like existing radiation irradiator such as Gammacell3000 rotates 360degrees during irradiation. Precise dose information according to the location of radiation source would be needed because of the movement of radiation source, whereas radiation could be uniformly irradiated in comparison with existing gamma irradiator. In this study, dose distribution of the inside beaker located in Biomeam8000 gamma irradiator was measured using glass dosimeter, and dose evaluation and distribution regarding dose linearity and dose reproducibility were implemented based on measurement results. This aims to show guideline for efficient use of irradiator based on measurement result when doing experiment or radiation exposure.

Lipogranuloma with Osseous Metaplasia in the Breast That Developed after "Bu-Hwang" Oriental Medicine Treatment

A lipogranuloma is an inflammatory reactive process associated with exogenous or endogenous lipids, and it's occurrence in the breast has rarely been reported. Osseous metaplasia, which is used to describe bone formation in abnormal locations, can develop from several conditions such as trauma or a tumor. However, few studies have reported benign breast lesions that have been seen as osseous metaplasia. We present a case of a benign calcified breast lesion that developed after a traumatic treatment process called "Bu-Hwang", and it was confirmed as a lipogranuloma with osseous metaplasia. To the best of our knowledge, this is the first reported case of a lipogranuloma with osseous metaplasia in the breast.

Feasibility Study of the Radiophotoluminescent Glass Dosimeter for High-energy Electron Beams / 의학물리

Our goal is to assess the suitability of a glass dosimeter on detection of high-energy electron beams for clinical use, especially for radiation therapy. We examined the dosimetric characteristics of glass dosimeters including dose linearity, reproducibility, angular dependence, dose rate dependence, and energy dependence of 5 different electron energy qualities. The GD was irradiated with high-energy electron beams from the medical linear accelerator andgamma rays from a cobalt-60 teletherapy unit. All irradiations were performed in a water phantom. The result of the dose linearity for high-energy electron beams showed well fitted regression line with the coefficient of determination; R2 of 0.999 between 6 and 20 MeV. The reproducibility of GDs exposed to the nominal electron energies 6, 9, 12, 16, and 20 MeV was +/-1.2%. In terms of the angular dependence to electron beams,GD response differences to the electron beam were within 1.5% for angles ranging from 0degrees to 90degrees and GD's maximum response differencewas 14% lower at 180degrees. In the dose rate dependence, measured dose values were normalized to the value obtained from 500 MU/min. The uncertainties of dose rate were measured within +/-1.5% except for the value from 100 MU/min. In the evaluation of the energy dependence of the GD at nominal electron energies between 6 and 20 MeV, we obtained lower responses between 1.1% and 4.5% based on cobalt-60 beam. Our results show that GDs have a considerable potentiality for measuring doses delivered by high-energy electron beams.

Forskolin Enhances Synaptic Transmission in Rat Dorsal Striatum through NMDA Receptors and PKA in Different Phases

The effect of forskolin on corticostriatal synaptic transmission was examined by recording excitatory postsynaptic currents (EPSCs) in rat brain slices using the whole-cell voltage-clamp technique. Forskolin produced a dose-dependent increase of corticostriatal EPSCs (1, 3, 10, and 30micrometer) immediately after its treatment, and the increase at 10 and 30micrometer was maintained even after its washout. When the brain slices were pre-treated with (DL)-2-amino-5-phosphonovaleric acid (AP-V, 100micrometer), an NMDA receptor antagonist, the acute effect of forskolin (10micrometer) was blocked. However, after washout of forskolin, an increase of corticostriatal EPSCs was still observed even in the presence of AP-V. When KT 5720 (5micrometer), a protein kinase A (PKA) inhibitor, was applied through the patch pipette, forskolin (10micrometer) increased corticostriatal EPSCs, but this increase was not maintained. When forskolin was applied together with AP-V and KT 5720, both the increase and maintenance of the corticostriatal EPSCs were blocked. These results suggest that forskolin activates both NMDA receptors and PKA, however, in a different manner.

The Impact of Combined Treatments with Aminoguanidine andMethylprednisolone on Neurological Recovery after Spinal Cord Injury / 대한정형외과학회잡지

PURPOSE: To evaluate the effect of a combined treatment with aminoguanidine (AG) and methylprednisolone (MP) on the neurological recovery after a spinal cord injury (SCI). MATERIALS AND METHODS: SCI models (weight-drop) of Sprague Dawley rat were divided into 4 groups after the SCI. Group I was injected with normal saline, Group II with MP, Group III with AG and Group IV with MP and AG. The behavioral and immunohistochemical changes along with RT-PCR of TNFRI, TNFRII, XIAP, IL-6, and IL-6R were analyzed quantitatively and compared. RESULTS: At 7 days, motor recovery was observed in groups II, IV, III, and I with the level of improvement increasing in that order. Neuron cells were observed in groups II, IV=III, and I. TNFRI was not expressed in group I, but was expressed at a similar level in groups II, III and IV. TNFRII was expressed the most in group II but was not expressed in group I. The level of XIAP expression was similar to that of TNFRII. Groups II and IV showed almost no IL-6 expression, while groups I and III showed similar levels of expression. IL-6-R showed an opposite pattern to IL-6. CONCLUSION: Both drugs have a neuroprotective effect but there was no synergistic effect for simultaneous administration.

Fluoxetine Modulates Corticostriatal Synaptic Transmission through Postsynaptic Mechanism

Fluoxetine, widely used for the treatment of depression, is known to be a selective serotonin reuptake inhibitor (SSRI), however, there are also reports that fluoxetine has direct effects on several receptors. Employing whole-cell patch clamp techniques in rat brain slice, we studied the effects of fluoxetine on corticostriatal synaptic transmission by measuring the change in spontaneous excitatory postsynaptic currents (sEPSC). Acute treatment of rat brain slice with fluoxetine (10microM) significantly decreased the amplitude of sEPSC (84.1+/-3.3%, n=7), but did not alter its frequency (99.1+/-4.7%, n=7). Serotonin (10microM) also significantly decreased the amplitude (81.2+/-3.9%, n=4) of sEPSC, but did not affect its frequency (105.8+/-8.0, n=4). The effect of fluoxetine was found to have the same trend as that of serotonin. We also found that the inhibitory effect of fluoxetine on sEPSC amplitude (93.0+/-1.9%, n=8) was significantly blocked, but not serotonin (84.3+/-1.6%, n=4), when the brain slice was incubated with p-chloroamphetamine (10microM), which depletes serotonin from the axon terminals and blocks its reuptake. These results suggest that fluoxetine inhibits corticostriatal synaptic transmission through postsynaptic, and that these effects are exerted through both serotonin dependent and independent mechanism.