Matrix Metalloproteinases 9 Testing Using Immunoassay Kit in Oculoplastic Outpatient Clinic Patients

Purpose@#We assessed the association between the results of tear film-based matrix metalloproteinases 9 (MMP-9) immunoassay and the diagnosis of patients who visited an oculoplastic outpatient clinic. @*Methods@#We conducted a retrospective analysis of the MMP-9 immunoassay results in 1,703 eyes from 1,703 patients who presented with ocular discomfort at an oculoplastic outpatient clinic. The MMP-9 immunoassay results were analyzed in correlation with the final oculoplastic diagnosis of the patients. @*Results@#In total, 1,126 of 1,533 eyes demonstrated positive expression of MMP-9. No statistically significant differences were observed in MMP-9 expression based on sex (p = 0.107) and age (p = 0.510). Furthermore, 120 of 169 eyes with thyroid eye disease (71.0%, p < 0.001), 145 of 161 eyes with nasolacrimal duct obstruction (90.1%, p < 0.001), 282 of 375 eyes with nasolacrimal duct stenosis (75.2%, p < 0.001), 190 of 238 eyes with entropion (79.8%, p < 0.001), 19 of 23 eyes with ectropion (82.6%, p < 0.001), and 370 of 567 eyes with dry eye syndrome (65.3%, p < 0.001) exhibited positive MMP-9 expression. @*Conclusions@#The MMP-9 immunoassay is a noninvasive, convenient, and rapid test that evaluates ocular surface inflammation. Most patients with oculoplastic diseases exhibit positive MMP-9 expression. These findings provide valuable information for guiding diagnostic and management decisions in patients with oculoplastic conditions.

Vulvar Basal Cell Carcinoma in Postmenopausal Women: Two Case Reports

Basal cell carcinoma (BCC) is a major non-melanoma skin cancer, and its incidence is increasing worldwide. Although the main etiology is sun exposure, BCC may develop in sun-protected areas such as the vulva. The sonic hedgehog signaling pathway mutation may explain the mechanism underlying the occurrence of vulvar BCC. Owing to the rarity of metastases, wide local excision is an appropriate treatment option. Here, we report the cases two postmenopausal women with vulvar BCC who were surgically treated.

Genetic Variants and Clinical Phenotypes in Korean Patients With Hereditary Hemorrhagic Telangiectasia

Objectives@#. Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disorder characterized by recurrent epistaxis, telangiectasia, and visceral arteriovenous malformations (AVMs). Activin A receptor-like type 1 (ACVRL1/ALK1) and endoglin (ENG) are the principal genes whose mutations cause HHT. No multicenter study has yet investigated correlations between genetic variations and clinical outcomes in Korean HHT patients. @*Methods@#. Seventy-two members from 40 families suspected to have HHT based on symptoms were genetically screened for pathogenic variants of ACVRL1 and ENG. Patients with genetically diagnosed HHT were also evaluated. @*Results@#. In the HHT genetic screening, 42 patients from 24 of the 40 families had genetic variants that met the pathogenic criteria (pathogenic very strong, pathogenic strong, pathogenic moderate, or pathogenic supporting) based on the American College of Medical Genetics and Genomics Standards and Guidelines for either ENG or ACVRL1: 26 from 12 families (50%) for ENG, and 16 from 12 families (50%) for ACVRL1. Diagnostic screening of 42 genetically positive HHT patients based on the Curaçao criteria revealed that 24 patients (57%) were classified as having definite HHT, 17 (41%) as having probable HHT, and 1 (2%) as unlikely to have HHT. Epistaxis was the most common clinical presentation (38/42, 90%), followed by visceral AVMs (24/42, 57%) and telangiectasia (21/42, 50%). Five patients (12%) did not have a family history of HHT clinical symptoms. @*Conclusion@#. Only approximately half of patients with ACVRL1 or ENG genetic variants could be clinically diagnosed as having definite HHT, suggesting that genetic screening is important to confirm the diagnosis.

Study for Correlation between Objective and Subjective Voice Parameters in Patients with Dysphonia

BACKGROUND AND OBJECTIVES@#Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease.MATERIALS AND METHOD: The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure.@*RESULTS@#In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases.@*CONCLUSION@#In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.

A cross-sectional study on the pulmonary function of residents in two urban areas with different PM10 concentrations: data from the fourth Korea national health and nutrition examination survey (KNHANES) 2007–2009

BACKGROUND: The present study aims to compare the pulmonary function of residents of Seoul special city (Seoul) and Jeju special self-governing province including Jeju city and Seogwipo city (Jeju), characterized by vastly different annual average airborne particulate matter with an aerodynamic diameter less ≤10 μm (PM10) concentrations, with the annual average PM10 concentration in Seoul being significantly higher than that in Jeju. METHODS: This cross-sectional study analyzed the pulmonary function test results and sociodemographic data of Korean adults ≥19 years of age derived from the 4th KNHANES, 2007–2009. A total of 830 individuals residing in Seoul or Jeju were included in this study. T-tests were used to analyze predicted values of forced expiratory volume in 1 sec (FEV1p), predicted values of forced vital capacity (FVCp) and FEV1/FVC ratio (FEV1/FVC), as dependent variables, to examine the differences in the subjects’ pulmonary function according to the city of residence. Stratified analysis was then performed to adjust for variables potentially affecting pulmonary function. The analysis was performed on subjects as a group and also following stratification according to sex and other variables. RESULTS: Seoul residents had a significantly lower FVCp than that of the Jeju residents (difference: 3.48%, p = 0.002). FEV1p, FVCp and FEV1/FVC of male Seoul residents were significantly lower than those of male Jeju residents (difference: 6.99, 5.11% and 0.03, respectively; p < 0.001, p = 0.001, p = 0.001). In male subjects, statistically significant results were obtained even after adjusting the influence of other variables through stratified analysis. CONCLUSION: The present analysis was based on cross-sectional data collected at one point in time. Therefore, unlike longitudinal studies, it does not establish a clear causal association between the variables. Nevertheless, this study found that pulmonary function among subjects residing in Seoul was significantly decreased compared to that of subjects residing in Jeju.

Administration of Goji (Lycium chinense Mill.) Extracts Improves Erectile Function in Old Aged Rat Model

PURPOSE: This study investigated the effect of goji (Lycium chinense Mill.) on erectile dysfunction in old-aged rats. MATERIALS AND METHODS: Twenty-four 18-month-old male Sprague-Dawley rats (defined as old-aged rats) were used. Treatment groups contained eight rats each: a control group, goji extract of 150 mg/kg/day group, and goji extract of 300 mg/kg/day group. Treatment was by orogastric tube once daily for 6 weeks. After 6 weeks of treatment, testes weight, serum testosterone, superoxide dismutase, nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-related parameters, intracavernous pressure/mean arterial pressure, and histological changes were examined. RESULTS: Treatments with goji extracts increased serum testosterone level, increased the expression of endothelial NO synthase, neuronal NO synthase, and cGMP, improved the oxidative stress marker, and decreased corporal fibrosis. CONCLUSIONS: Our results indicate that goji extract may have a positive effect on erectile dysfunction via its antioxidant effects.

BRCA1-mutated ovarian cancer with skin metastasis: a case report

The major risk factor for ovarian cancer (OC) is mutation of the BRCA1 or BRCA2 DNA mismatch repair genes, which occurs in approximately 10% of OC cases. Most previous studies have demonstrated that BRCA1- and BRCA2-mutated OCs are associated with better prognosis than sporadic OCs. However, information about the patterns and clinical course of the metastatic spread of BRCA-mutated OCs is limited. Herein, we describe a case of OC with a BRCA1 mutation and skin metastases in a 49-year-old patient, which to the best of our knowledge has not been reported previously.

A Comparison Study of e-health Literacy and Self-care Agency between Nursing Students and Non-health Department Women College Students / 간호행정학회지

PURPOSE: The aim of this study was to investigate e-health literacy and self-care agency of nursing students and non-health department women college students. METHODS: A descriptive comparative design was used. Participants were 67 nursing students and 67 non-health department women college students between 18 and 25 years old from a university located in Seoul. Data collection was done from September 2 to October 5, 2016 using structured questionnaires. Data were analyzed using independent t-test, χ² test, ANCOVA, ANOVA, Scheffé test, and Pearson's correlation coefficients with SPSS 23.0. RESULTS: e-Health literacy had significant difference (F=1.95, p<.018) between nursing students and non-health department women college students. However, self-care agency was not significantly different (F=1.05, p=.426). There were significant positive correlation (r=.63, p<.001) in e-health literacy and self-care agency of nursing students. CONCLUSION: The results of this study suggest that education programs should be provided to improve the e-health literacy and self-care agency for women college students.

Evaluation of Anti-Subsidence Effect of Abductor Pollicis Longus Suspensionplasty in Carpometacarpal Arthritis of the Thumb

PURPOSE: To evaluate the anti-subsidence effect of suspensionplasty using abductor pollicis longus (APL) tendon in carpometacarpal (CMC) arthritis of the thumb. METHODS: From June 2009 to May 2016, hematoma distraction arthroplasty (HDA; group A, 10 cases) and HDA with suspensionplasty using APL tendon (group B, 7 cases) were performed in total 17 patients with CMC arthritis. The K-wire was fixed from 1st metacarpal to 2nd metacarpal in both group to maintain the empty space for 6 weeks until the fibrous tissue fill the space. We measured the preoperative trapezium space height with picture archiving and communication (PACS) system and compare the height with that was measured postoperatively. Additionally the subsidence rate checked sequentially with follow-up plain radiography. RESULTS: The subsidence ratios (subsidence/trapezium height) were average 33.2% in group A and 31.4% in group B. There is no statistical difference between two groups. Six weeks after pin removal almost of subsidence occurred, and then from 3 months after surgery to 6 months after surgery, few subsidence was occurred and it is average only 8% of total subsidence. The trial of distraction the empty space when perform the Kirschner wire (K-wire) fixation, it does not influence the prevention of subsidence. Between distraction height and subsidence, there was no statistical relevance. CONCLUSION: Although suspensionplasty was known as one of methods to prevent the subsidence, it is thought to be not very helpful method to prevent subsidence of thumb in CMC arthritis.

Diagnostic dilemma in cervical endocervicosis

Müllerianosis is an embryonic Müllerian disease, resulting in the formation of the benign diseases adenomyosis, endometriosis, endosalpingiosis, and endocervicosis. Endocervicosis primarily affects the bladder, and rarely the cervix. Cervical endocervicosis, which is also a pseudoneoplastic glandular lesion, could be misinterpreted as a premalignant or even a malignant lesion. Because the treatment of these diseases is very different, early clinical diagnosis is important. Unfortunately, however, this lesion is difficult to diagnose preoperatively using clinical and radiological information, and pathological confirmation is needed. Herein, we report a rare case of cervical endocervicosis that was difficult to diagnosis preoperatively.

Uterine Clear Cell Carcinoma of Postmenopausal Woman: A Case Report

Endometrial cancer is the most common gynecologic malignancy in developed countries. Clear cell carcinoma typically occurs in the ovaries, and very rarely occurs in the endometrium; it accounts for less than 3% of all endometrial cancers. It is presumed that clear cell carcinomas are of Müllerian duct origin, and an association with exposure to diethylstilbestrol (DES) or other nonsteroidal follicle stimulating hormones has been described. We report a case of a postmenopausal woman who presented with vaginal bleeding without a specific medical history. Under the impression of an endometrial mass, we performed a laparoscopic operation. Pathologic results showed clear cell carcinoma of the endometrium. Depth of invasion was 0.2 cm out of a 0.5 cm total thickness, and the rectal shelf mass was clear cell carcinoma. We report the case with a brief review of the relevant literature.

Anti-Inflammatory and Antimicrobial Effects of a Novel Herbal Formulation (WSY-1075) in a Chronic Bacterial Prostatitis Rat Model

PURPOSE: The aim of this study was to investigate the anti-inflammatory and anti-oxidative effects of a multi-herbal formula known as WSY-1075 in the treatment of chronic bacterial prostatitis in a rat model. MATERIALS AND METHODS: Experimental chronic bacterial prostatitis was induced in 32 Wistar rats by instillation of a bacterial suspension (Escherichia coli, 10⁸ colony-forming units [CFU]/mL) into the prostatic urethra. After the induction of prostatitis, the rats were randomly divided into one of 4 treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (400 mg/kg) (n=8), and WSY-1075 (400 mg/kg)+ciprofloxacin (n=8). After 4 weeks of treatment, microbiological data from prostate tissue cultures, level of prostatic pro-inflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin [IL]-6, and IL-8), anti-oxidant effects (superoxide dismutase [SOD]), and histological findings were noted. RESULTS: The WSY-1075, ciprofloxacin, and WSY-1075+ciprofloxacin groups showed fewer CFUs in prostate tissue cultures than the control group. The WSY-1075, ciprofloxacin and WSY-1075+ciprofloxacin groups showed statistically significantly lower levels of the pro-inflammatory cytokines TNF-α, IL-6, and IL-8 than the control group. SOD levels in the WSY-1075, ciprofloxacin and WSY-1075+ciprofloxacin groups were significantly higher than in the control group. CONCLUSIONS: This study found that WSY-1075 had anti-microbial effects, anti-inflammatory effects, and anti-oxidative effects in a chronic bacterial prostatitis rat model. We expect the WSY-1075 may be useful for the clinical treatment of chronic bacterial prostatitis.

Development of an Improved Animal Model of Overactive Bladder: Transperineal Ligation versus Transperitoneal Ligation in Male Rats

PURPOSE: We compared a transperineal ligation model and a transperitoneal ligation model in male rats to determine which animal model of overactive bladder (OAB) was more useful based on cystometrography, estimations of oxidative stress, and measurements of pro-inflammatory cytokine levels. MATERIALS AND METHODS: Male rats were randomly divided into three groups (n=15 in each): the control group, the transperineal ligation group, and the transperitoneal ligation group. Four weeks after the ligation procedure, cystometrography was performed and oxidative stress, pro-inflammatory cytokine levels, and histologic changes were evaluated. Oxidative stress was assessed by measuring 8-hydroxy-20-deoxyguanosine and superoxide dismutase, and pro-inflammatory cytokine activity was investigated by measuring levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α. RESULTS: The transperineal model led to results similar to those observed for the transperitoneal model, namely (1) increased voiding frequency and reductions in the non-voiding contraction interval and the maximal vesical pressure, (2) increased levels of oxidative stress markers, (3) increased pro-inflammatory cytokine levels, and (4) fibrotic changes in the bladder tissue. CONCLUSIONS: We suggest that the transperineal procedure can be used as an alternative OAB model in male rats.

The relationship between night work and involuntary weight change: data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012)

BACKGROUND: Previous studies on the association between shift or night work and weight change have been focused on finding the risk of weight gain caused by shift or night work. In this study, we aimed to reveal the risk of weight gain and weight loss associated with night work by using a nationwide representative data. METHODS: This study was performed on 1605 full-time wage workers between the age of 20 and 69 based on the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012). The association between night work and involuntary weight change in the previous year was divided into the categories of weight gain and weight loss and studied with modifications in socio-demographic variables, health behavior-related variables, and occupational characteristic variables. RESULTS: The participants working in night work accounted for 10.6 % of total study participants (male; 11.9 %, female 7.4 %). Workers who worked more than 48 hours per week on average accounted for 41.6 % of the total study participants (male; 46.3 %, female 29.1 %). Odds ratio (OR) of weight loss associated with night work in male workers was 0.34 (95 % confidence interval (CI) 0.16–0.76) after controlling for several related factors. OR of weight loss associated with night work in female workers with long working hours was 1.95 (95 % CI 0.47–80.86) and that of weight gain was 2.83 (95 % CI 0.12–69.83) after adjusting associated factors. CONCLUSIONS: In this cross-sectional study with national representative sample, night work may lower the risk of weight loss in male workers and induce weight change (weight loss or weight gain) in female workers with long working hours. Therefore, future studies with cohort study design for night workers are needed to reveal the mechanisms and health effects of weight change associated with night work and establish proper management solutions with health and labor policies for Korean night workers.

The association between long working hours and hearing impairment in noise unexposed workers: data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012)

BACKGROUND: This study is aimed at finding out the relationship between long working hours, one of major job stress elements, and hearing impairment in unexposed workers to occupational and environmental noise. METHODS: This study was performed on 1628 regular, full-time wage workers between the age of 25-64 who indicated in the survey of having no experience of exposure to noise, normal otoscopic findings, and not suffering from diabetes based on the data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012). The average working hours per week was categorized into 40 h and lower group, more than 40 to 48 h group, more than 48 to 60 h group, and more than 60 h group. The groups were defined as suffering from low or high frequencies hearing impairment if the average hearing threshold for 0.5, 1, 2 kHz or 3, 4, 6 kHz in both ears exceeds 25 dB based on the pure tone audiometry. The association between average weekly working hours and hearing impairment was analyzed using logistic regression after gender stratification. RESULTS: The prevalences of low and high frequencies hearing impairment in male workers were 4.3 and 28.6 %, respectively, which were much higher than female’s prevalence of 2.7 and 11.1 %. For male workers, no significant association was found between average weekly working hours and low and high frequencies hearing impairment. For female workers, odds ratios (OR) of low and high frequencies hearing impairment were 4.22 (95 % confidence interval (CI) 1.09–16.27) and 4.49 (95 % CI 1.73–11.67), respectively, after controlling for several related factors, such as, age, Body Mass Index (BMI), socio-economic status, health-related behavioral, and occupational characteristics variables, in the final model in the group working more than 60 h compared to the group working 40 h and lower. In addition, a dose-response relationship was observed that ORs of low and high frequencies hearing impairment were increased according to increasing average weekly working hours. CONCLUSIONS: The association between long working hours and hearing impairment in both low and high frequencies was significant in Korean female workers with a dose-response relationship. Therefore, the law to change the culture of long working hours should be enacted in order to protect the workers’ health and improve the quality of life in Korean workers.

Superficial Angiomyxoma of the Vulva in a Postmenopausal Woman: A Case Report and Review of Literature

Superficial angiomyxomas (SAMs) are rare benign cutaneous tumors that involve the subcutaneous layer. They are commonly located in the trunk, lower limbs and head or neck of women of reproductive age. SAMs in the vulva of postmenopausal women are especially rare case. Herein, we report a vulvar SAM in a postmenopausal 60-year-old woman. The patient presented with a palpable cutaneous mass in the right labium majora that had appeared 3 months earlier. The mass was slow growing and approximately 5 cm in size and resembled a soft tissue malignancy. It appeared as a well-defined multilocular cystic mass in magnetic resonance images. The preoperative diagnosis was a benign cystic lesion such as an epidermoid cyst. Grossly, the completely excised mass was 6 × 5 cm in size and well circumscribed with a multilocular outer surface, a yellowish-gray gelatinous cut surface, and a smooth rubbery inner surface. Histologic review revealed that the mass contained small to moderate amount of cellular angiomyxoid nodules and bland-looking spindle-shaped to ovoid cells without atypia. Neutrophil infiltration, which is a diagnostic feature of SAMs, was observed. Immunohistochemistry showed expression of CD34, but not of estrogen receptors, progesterone receptors, or desmin in the SAM. The patient has been followed up for 12 months without recurrence.

Epithelioid Trophoblastic Tumor in a Postmenopausal Woman: A Case Report

Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic neoplasm composed of intermediate trophoblasts. Most cases of ETT are reported in women of reproductive age following a prior gestation within 2 weeks to 30 years. ETT is extremely rare in postmenopausal women. It is commonly misdiagnosed as a poorly differentiated carcinoma or another type of gestational trophoblastic tumor. We report a case of ETT in a 56-year-old woman that developed 23 years after the patient's last pregnancy.

Postmenopausal Meigs' Syndrome in Elevated CA-125: A Case Report

Meigs' syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated cancer antigen 125 (CA-125) in Meigs' syndrome is an unusual clinical condition reported in few cases. We report here on a 61-year-old woman who presented with dyspnea; in imaging assessment, a heterogeneous pelvic mass measuring 12 x 11 cm with ascitic fluid was reported. Pleural effusion was detected on Chest X-ray. Aspiration of pleural fluid showed no evidence of malignancy. CA-125 level was 347 IU/mL. The patient underwent laparotomy during which a mass measuring 12 x 11 cm was detected in her left adnexa. Histology showed ovarian thecoma. The mass was resected, and, after that, the symptoms disappeared and CA-125 level reached 19 IU/mL. The patient had experienced no problem after 12 months of follow up. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA-125 levels probably have malignant ovarian tumors, Meigs' syndrome must be considered in the differential diagnosis.

Uterine Lipoleiomyoma in Peri or Postmenopausal Women

Lipoleiomyoma is an uncommon neoplasm of the uterus, composed of smooth muscles intermixed with mature adipocytes. These tumors are considered a benign variant of uterine leiomyomas. Herein, we report six cases of lipoleiomyoma experienced in our institution from January 2005 to March 2015. The patients ranged in age from 45 to 70 years; the etiology may be related to estrogen deficiency occurring after menopausal transition. Except for one lipoleiomyoma in the broad ligament, all others were found in the uterine corpus. The presenting symptoms were nonspecific, and most cases were incidentally diagnosed during surgery for other reasons. We performed preoperative imaging studies, including abdominal and pelvic computed tomography and magnetic resonance imaging. Preoperatively, four patients were diagnosed as having a pelvic mass and one patient was diagnosed as having a right ovarian mature teratoma. In one case, we found a gynecologic malignancy (cervical cancer 1A1). Histologically, there was no gross or microscopic contiguity between the lipoleiomyoma and the malignancy. Lipoleiomyomas seem to have a benign clinical course. In our study, there were no recurrences of or deaths attributed to the lipoleiomyomas during a mean follow-up period of 16.17 +/- 23.80 months.

Abdominal Wall Metastasis of Uterine Papillary Serous Carcinoma in a Post-Menopausal Woman: A Case Report

Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy.