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Inverted papillomas are benign but invasive tumors with malignant potential characterized by a high recurrence rate. Although most cases arise from the nasal wall and paranasal sinuses, inverted papillomas originating from the nasolacrimal system have been rarely reported. We describe a rare case of an inverted papilloma in the left nasal cavity, which originated from the lacrimal sac in a 40-year-old female who had a medical history of endoscopic dacryocystorhinostomy at the department of ophthalmology. At first, it was believed to be an inverted papilloma simply occurring in the nasal cavity, but after several recurrences, it was found to originate from the lacrimal sac. All intranasal lesions and the involved lacrimal sac were removed through cooperative surgery between department of otolaryngology and ophthalmology. This case illustrates the importance of including nasolacrimal system in differentiating the origin of inverted papilloma.
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Objective@#The International Cooperative Ataxia Rating Scale (ICARS) is a semiquantitative clinical scale for ataxia that is widely used in numerous countries. The purpose of this study was to investigate the validity and reliability of the Korean-translated version of the ICARS. @*Methods@#Eighty-eight patients who presented with cerebellar ataxia were enrolled. We investigated the construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We also investigated the internal consistency using Cronbach’s α and intrarater and interrater reliability using intraclass correlation coefficients. @*Results@#The Korean-translated ICARS showed satisfactory construct validity using EFA and CFA. It also revealed good interrater and intrarater reliability and showed acceptable internal consistency. However, subscale 4 for assessing oculomotor disorder showed moderate internal consistency. @*Conclusion@#This is the first report to investigate the validity and reliability of the Korean-translated ICARS. Our results showed excellent construct and convergent validity. The reliability is also acceptable.
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Hericium erinaceus, also known as lion’s mane mushroom, is an edible and medicinal mushroom that belongs to the family Hericiaceae. We previously reported hericene A as an anti-diabetic constituent of H. erinaceus and the effect of cultivation substrates on its content was investigated. As the continuation, the contents of five major compounds such as hericenes A-D, which exerted α-glucosidase inhibitory activity, together with ergosterol were investigated depending on cultivation stages. H. erinaceus was cultured for 25 days (5 stages) to induce fruiting bodies, and the contents of the compounds at each stage were quantified. All the five compounds were detected in fruiting body by HPLC analysis. Among the hericene derivatives in the mushroom, the content of hericene A was the highest, followed by hericene C and the content of hericenes B and D was relative low. All four hericene derivatives present in the highest content at stage 4 whereas the content of ergosterol was highest at stage 5. The highest α-glucosidase inhibitory activity of H. erinaceus was measured at stage 4, which correlates with the contents of hericene derivatives. Conclusively, H. erinaceus with better efficacy and high content of active constituents can be secured by the optimization of cultivation conditions.
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Objective@#Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. @*Methods@#Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. @*Results@#Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. @*Conclusion@#This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.
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The Korean Society of Laryngology, Phoniatrics and Logopedics created a task force to establish clinical practice guidelines for the use of botulinum toxin (BT) in otolaryngology. We selected 10 disease categories: spasmodic dysphonia, essential vocal tremor, vocal fold granuloma, bilateral vocal fold paralysis, Frey’s syndrome, sialocele, sialorrhea, cricopharyngeal dysfunction, chronic sialadenitis, and first bite syndrome. To retrieve all relevant papers, we searched the CORE databases with predefined search strategies, including Medline (PubMed), Embase, the Cochrane Library, and KoreaMed. The committee reported 13 final recommendations with detailed evidence profiles. The guidelines are primarily aimed at all clinicians applying BT to the head and neck area. In addition, the guidelines aim to promote an improved understanding of the safe and effective use of BT by policymakers and counselors, as well as in patients scheduled to receive BT injections.
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The Good’s syndrome is a rare immunodeficiency disease characterized by thymoma and hypogammaglobulinemia. The most common cause of infection in patients with Good’s syndrome is the recurrent sinopulmonary infection. One may assume that there could be an unknown immunocompromising condition such as Good’s syndrome in cases of chronic rhinosinusitis refractory to treatment. We experienced a patient with Good’s syndrome, presenting with chronic rhinosinusitis refractory to treatment. We report this case with a brief review of the literature.
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Cognitive behavioral therapy, first introduced by Beck in the 1950s to treat depression by integrating cognitive and behavioral therapies, is now an established psychotherapy technique used to treat insomnia, chronic pain, and anxiety. Currently, cognitive behavioral therapy is widely used to treat tinnitus in European countries, and the efficacy and safety of the treatment have been proven through randomized clinical trials and meta-analyses. Although interest in cognitive behavioral therapy for tinnitus is increasing in Korea, there are limited reports. Because many studies so far have targeted patients in Western countries, it is difficult to apply the same to domestic patients due to cultural and linguistic differences, the absence of standardized guidelines, and limitations in clinic hours. We experienced various cases in which tinnitus was effectively treated simultaneously with pharmacotherapy and cognitive behavioral therapy, so here we report an introduction to the program along with a literature review. Cognitive behavioral therapy was performed as a 4-week program in our hospital, and progress was evaluated through Visual Analogue Scales (VAS) and tinnitus handicap inventory (THI). After each weekly 20-minute individual counseling session, a take-home writing task was given to the patient. The main goal was to guide the patient to discover and correct automatic thoughts related to their tinnitus symptoms. This paper aimed to introduce a specific scheme on how to perform cognitive behavioral therapy for domestic tinnitus patients.
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Masclura tricuspidata, also called as Cudrania tricuspidata, is one of the most common Moraceae family plants in East Asia. Its trivial name follows mulberry due to the similar morphology. Investigation of the bioactive constituents of M. tricuspidata leaves yielded a new xanthone derivative along with twenty known compounds through various chromatographic techniques. A new compound was defined as mascluraxanthone (3), a prenylated xanthone glucoside on the basis of 1D and 2D NMR and MS data. Twenty known compounds were identified as four xanthone derivatives (1-2 and 4-5), two flavans (6-7), six flavanol derivatives (8-13), a flavonone (14) and seven flavonol derivatives (15-21). Among the isolated compounds, flavanol and flavonoid derivatives with 3′,4′-OH groups showed antioxidant and anti-tyrosinase activities. Conclusively, the leaves of M.tricuspidata are rich in aromatic compounds including xanthones and flavonoids. In addition, these constituents showed antioxidant and anti-tyrosinase potentials, which might be useful for oxidative stress related diseases.
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Cordycepin is a characteristic bioactive compound of Cordyceps militaris with various beneficial effects. Cordyceps grows on both grains and insects, and the content of cordycepin varies depending on the cultivation conditions. In this study, the effect of culture conditions on the cordycepin content was analyzed and the extraction conditions were optimized. Analysis of cordycepin content in Pupae-Cordyceps found that it was highly affected by temperature in culture conditions. In the case of mycelium, it grows well at 20 and 25 oC, but not at 30 oC. However, the content of cordycepin was highest at 30oC and less at 20 oC. The fruiting body also showed a similar tendency: growth was 20 oC > 25 oC > 30 oC, but the cordycepin content was 30 oC > 25 oC > 20 oC. The content of cordycepin decreased after the fruiting bodies were produced. Next, extraction conditions such as solvent and time were optimized for maximum cordycepin content using response surface methodology(RSM). There was a large difference in the content of cordycepin according to the content of ethanol and the extraction temperature. Through RSM, it was confirmed that the optimum condition for extraction of cordycepin was 48.9 oC using 49.0% ethanol, and 160.9 mg/g extract could be obtained under this condition. In conclusion, this study suggested the optimized conditions for the cultivation and extraction of Pupae-Cordyceps for maximizing the content of cordycepin, and this may be applied to the discovery of materials using cordycepin.
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Cordycepin is a characteristic bioactive compound of Cordyceps militaris with various beneficial effects. Cordyceps grows on both grains and insects, and the content of cordycepin varies depending on the cultivation conditions. In this study, the effect of culture conditions on the cordycepin content was analyzed and the extraction conditions were optimized. Analysis of cordycepin content in Pupae-Cordyceps found that it was highly affected by temperature in culture conditions. In the case of mycelium, it grows well at 20 and 25 oC, but not at 30 oC. However, the content of cordycepin was highest at 30oC and less at 20 oC. The fruiting body also showed a similar tendency: growth was 20 oC > 25 oC > 30 oC, but the cordycepin content was 30 oC > 25 oC > 20 oC. The content of cordycepin decreased after the fruiting bodies were produced. Next, extraction conditions such as solvent and time were optimized for maximum cordycepin content using response surface methodology(RSM). There was a large difference in the content of cordycepin according to the content of ethanol and the extraction temperature. Through RSM, it was confirmed that the optimum condition for extraction of cordycepin was 48.9 oC using 49.0% ethanol, and 160.9 mg/g extract could be obtained under this condition. In conclusion, this study suggested the optimized conditions for the cultivation and extraction of Pupae-Cordyceps for maximizing the content of cordycepin, and this may be applied to the discovery of materials using cordycepin.
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Purpose@#Post-fracture sleeping disorders can lead to a deterioration of mental and physical health and delay recovery to pre-fracture status. Here, an analysis was conducted to determine if sleep disturbance is a risk factor for delirium in patients older than 60 years of age with surgically treated proximal femoral fractures. @*Materials and Methods@#This retrospective study included 316 patients with surgically treated proximal femoral fractures between January 2014 and December 2016; 33 patients were removed from analysis due to exclusion criteria. Confirmation of delirium was made by a neurologist upon consultation for cognitive impairment and sleeping disorders were confirmed by a doctor or nurse based on the Pittsburgh sleep quality index. Potential risk factors other than a sleep disorder (e.g., history of cognitive impairment, medical illness, preoperational levels of albumin and hemoglobin, transfusion) were also analyzed as variables for the development of delirium. @*Results@#The sensitivity and specificity of a sleeping disorder as a risk factor for the development of delirium were 0.75 and 0.76, respectively; the positive and negative predictive values were 0.64 and 0.93, respectively. A sleeping disorder was significantly related to the development of the delirium (odds ratio adjusted for age, sex and body mass index was 5.78, P<0.01). In those with a history of cognitive impairment, the adjusted odds ratio for the development of delirium was 6.03 (P<0.01). @*Conclusion@#Sleeping disorders occurring after a surgically repaired proximal femoral fracture in patients 60 years of age or older could be an independent predictive factor of delirium.
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The cellular entry of severe respiratory syndrome coronavirus-2 (SARS-CoV-2) is mediated by interaction with the human angiotensin-converting enzyme 2 (ACE2), a receptor that is expressed on both lung and intestinal epithelial cells. We performed a quantitative proteomic analysis to investigate the expression of possible receptors for SARS-CoV-2 in the intestinal mucosa of 23 patients with chronic colitis. ACE2 expression was low and remained unaltered in the gut of patients with ulcerative colitis (UC), Crohn’s disease (CD), intestinal Behćet’s disease (BD), and intestinal tuberculosis (TB), when compared with that of healthy individuals. Additionally, the expression levels of some probable co-receptors, including dipeptidyl peptidase 4 (DPP4), aminopeptidase N (AMPN), and glutamyl aminopeptidase (AMPE), were unchanged in the affected UC, CD, intestinal BD, and intestinal TB colon mucosa samples. In conclusion, gut inflammation associated with chronic colitis does not mediate a further increase in the cellular entry of SARS-CoV-2.
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The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.
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Purpose@#Minor foot amputations are performed for recurrent or infected ulcers or osteomyelitis of the diabetic feet. Patients may require a large amount of bone resection for wound closure. On the other hand, this results in more foot dysfunction and a longer time to heal. The authors describe fillet flap coverage to avoid more massive resection in selected cases. This study shows the results of fillet flap coverage for the closure of diabetic foot minor amputation. @*Materials and Methods@#This was a retrospective case series of patients who underwent forefoot and midfoot amputation and fillet flap for osteomyelitis or nonhealing ulcers between March 2013 to November 2017. In addition, the patient comorbidities, hospital days, complications, and duration to complete healing were evaluated. @*Results@#Fourteen fillet flap procedures were performed on 12 patients. Of those, two had toe necrosis, nine had forefoot necrosis, and three had midfoot necrosis. Eleven forefoot amputations and three midfoot amputations were performed. Among forefoot necrosis after a fillet flap, three patients had revision surgery for partial necrosis of the flap, and two patients had an additional amputation. Two patients had additional amputations among those with midfoot necrosis. By the fillet flap, the amputation size was reduced as much as possible. The mean initial healing days, complete healing days, and hospital stay was 70.6 days, 129.0 days, and 60.0 days, respectively. @*Conclusion@#The fillet flap facilitates restoration of the normal foot contour and allows salvage of the metatarsal or toe.
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Purpose@#Minor foot amputations are performed for recurrent or infected ulcers or osteomyelitis of the diabetic feet. Patients may require a large amount of bone resection for wound closure. On the other hand, this results in more foot dysfunction and a longer time to heal. The authors describe fillet flap coverage to avoid more massive resection in selected cases. This study shows the results of fillet flap coverage for the closure of diabetic foot minor amputation. @*Materials and Methods@#This was a retrospective case series of patients who underwent forefoot and midfoot amputation and fillet flap for osteomyelitis or nonhealing ulcers between March 2013 to November 2017. In addition, the patient comorbidities, hospital days, complications, and duration to complete healing were evaluated. @*Results@#Fourteen fillet flap procedures were performed on 12 patients. Of those, two had toe necrosis, nine had forefoot necrosis, and three had midfoot necrosis. Eleven forefoot amputations and three midfoot amputations were performed. Among forefoot necrosis after a fillet flap, three patients had revision surgery for partial necrosis of the flap, and two patients had an additional amputation. Two patients had additional amputations among those with midfoot necrosis. By the fillet flap, the amputation size was reduced as much as possible. The mean initial healing days, complete healing days, and hospital stay was 70.6 days, 129.0 days, and 60.0 days, respectively. @*Conclusion@#The fillet flap facilitates restoration of the normal foot contour and allows salvage of the metatarsal or toe.
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Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Subject(s)
Humans , Advisory Committees , Bias , Carcinoma, Squamous Cell , Counseling , Expert Testimony , Mouth Neoplasms , Neck , Republic of KoreaABSTRACT
OBJECTIVE: To compare the treatment effects, satisfaction with the treatment, and performance improvement following bandage treatment using the spiral method and spica method for breast cancer-related lymphedema (BCRL).METHODS: A prospective study with 46 patients with BCRL was conducted. All patients were divided into either the spiral or spica group for non-elastic bandage therapy and received the same treatment for 2 weeks, apart from the group-specific bandaging method used. For both groups, the Quality of Life Instrument score before treatment, changes in the volume of lymphedema limb and the Disability of the Arm, Shoulder, and Hand (DASH) score before and after treatment, and treatment satisfaction after treatment were compared. The Student t-test was used to compare the parameters between the two different bandage methods.RESULTS: With respect to the treatment outcomes, total volume reduction and proximal part volume reduction after treatment were 98.0±158.3 mL and 56.0±65.4 mL in the spiral method group and 199.0±125.1 mL and 106.1±82.2 mL in the spica method group, respectively. Therefore, the spica method group showed a significantly better improvement (p < 0.05). The DASH score changes after treatment showed that the spiral group score increased by 3.8±5.4 and the spica group score increased by 7.7±6.1; thus, a significantly better improvement was noted in the spica group (p < 0.05).CONCLUSION: The spica method indicated better volume reduction and DASH score improvement than the spiral method. Therefore, the spica method may be more effective for treating patients with BCRL.
Subject(s)
Humans , Arm , Bandages , Breast , Extremities , Hand , Lymphedema , Methods , Prospective Studies , Quality of Life , ShoulderABSTRACT
@#Objective: To analyze and compare the performance of the language sectors in the Denver Developmental Screening Test II (DDST II) and the Bayley Scales of Infant Development III (Bayley III) test with that of the Sequenced Language Scale for Infants (SELSI). Methods: Retrospective medical chart reviews including the Bayley III, DDST II and SELSI were conducted for 35 infants suspected to have delayed language development. More than 1 caution or fail in the DDST II-language sector (DLS) and Bayley III-language sector (BLS) score below 7were regarded as delayed language development. The sensitivity, specificity, positive predictive value, and negative predictive value of the DLS and BLS were analyzed. The degree of agreement between the Bayley III-receptive language sector (BRLS) or Bayley III-expressive language sector (BELS), DLS and SELSI was assessed by Cohen’s kappa. Pearson’s correlation between the Bayley III and SELSI was performed. Results: The DLS and BELS showed high sensitivity, while the BRLS showed low sensitivity. The BRLS showed very high specificity and the BELS showed high specificity; in contrast, the DLS showed low specificity. Cohen’s kappa for the BRLS and DLS with the SELSI indicated moderate, while the value for the BELS indicated good agreement. The equivalent age as assessed by the BRLS or BELS was significantly associated with that assessed by the SELSI. Conclusion: We propose that the DDST II is a useful screening test to identify infants with delayed language development. But the BLS cannot replace the SELSI in the evaluation of language development.
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BACKGROUND: The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups. METHODS: This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis. RESULTS: Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014). CONCLUSION: The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.
Subject(s)
Humans , Biopsy, Fine-Needle , Biopsy, Large-Core Needle , Cohort Studies , Follow-Up Studies , Neoplasm Metastasis , Prognosis , Prospective Studies , Quality of Life , Risk Factors , Thyroid Gland , Thyroid Neoplasms , UltrasonographyABSTRACT
PURPOSE: The purpose of this study was to develop a Korean version of the self-reported thyroid-specific quality of life (QoL) questionnaire for thyroid cancer patients (KT-QoL), and to evaluate its reliability and validity. MATERIALS AND METHODS: Two hundred seventy-two patients who underwent thyroidectomy from January to December 2010 were recruited in this study. The original version of the thyroid QoL was translated into Korean and evaluated for its reliability and validity. Using the developed KT-QoL, the postoperative QoL was evaluated until postoperative 1 year. RESULTS: At the preoperative baseline, the item internal consistency (IIC) ranged from −0.19 to 0.76, with low IIC values for items 2, 17, and 27. Item discriminant validity ranged from 86% to 97%. These values were similar at the postoperative periods. The internal consistency reliability (Cronbach's α) was high for all dimensions, ranging from 0.90 to 0.95. The test-retest reliability (intraclass correlation coefficient) was acceptable (0.74-0.82). The external validity examined by the correlation between the item 1j (voice changes) of KT-QoL and the voice handicap index-30 ranged from 0.51 to 0.75. Patients' QoL scores decreased after surgery, which demonstrated the sensitivity of the questionnaire. The QoL scores in patients with lobectomy showed best QoL scores postoperatively and those with receiving radioactive iodine still showed decreased QoL scores along the postoperative periods. CONCLUSION: These results demonstrate that KT-QoL is a valid instrument for evaluating QoL of Korean patients with thyroid cancer.