A Case of Primary Tuberculosis of the Paranasal Sinuses

Tuberculosis of the paranasal sinus is a rare disease caused by infection with Mycobacterium tuberculosis, the causative agent of pulmonary tuberculosis. Although the worldwide incidence of tuberculosis is declining, the diagnosis of primary paranasal tuberculosis remains challenging and cannot be ruled out in patients presenting with refractory chronic rhinosinusitis after adequate surgical and medical treatment. We experienced a case of paranasal tuberculosis with no evidence of previous tuberculosis infection. It was diagnosed after a surgical biopsy revealed granulomatous inflammation and caseous necrosis. The patient responded well to antituberculosis drug therapy and became free of symptoms after 7 months of treatment. We report our findings in this case with a review of the recent literature.

Do Anatomical Variations Affect the Location of Solitary Sphenoid Sinus Fungal Balls? A 10-Year Retrospective Study

Background and Objectives@#Sinonasal fungal balls (FBs) most commonly occur in the maxillary sinus, followed by the sphenoid sinus (SS). Relatively little is known about the predisposing factors and pathogenesis of unilateral sphenoid sinus fungal balls (SSFBs) compared to maxillary sinus FBs. We investigated whether anatomical variations have clinical implications for the location of unilateral SSFBs. @*Methods@#This study included 33 patients who underwent endoscopic sinus surgery for unilateral SSFBs between 2010 and 2021. Preoperative computed tomography scans were used to analyze the presence of anatomical variations, including sphenoid lateral recess, complete accessory septum of the SS, types of SS pneumatization, anterior and posterior nasal septal deviation (NSD), cephalocaudal NSD, concha bullosa (CB), Haller cell (HC), paradoxical middle turbinate (MT), everted uncinated process (UP), and Onodi cell. @*Results@#The presence of HC (33.3% vs. 12.1%, p=0.04), complete accessory septum of the SS (51.6% vs. 25.8%, p=0.04), and the sellar type of the SS (90.9% vs. 50%, p=0.003) differed significantly according to the presence or absence of FBs in the SS. However, other anatomical variations, including NSD, CB, paradoxical MT, everted UP, Onodi cell, and sphenoid lateral recess, were not significantly associated with the presence of unilateral SSFBs (all p>0.05). In the multivariable analysis, only sellar-type pneumatization of the SS showed a statistically significant relationship with SSFB, not the combined conchal and presellar type (adjusted odds ratio, 8.96; 95% confidence interval, 1.27–63.19; p=0.03). @*Conclusion@#We demonstrated that unilateral SSFBs were most strongly associated with the ipsilateral type of SS pneumatization, followed by the presence of HC and a complete accessory septum of the SS. Intranasal anatomical variations may play a significant role in the location of unilateral SSFBs.

Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study / 예방의학회지

Objectives@#Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity. @*Methods@#This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7). @*Results@#The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise. @*Conclusions@#These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.

Risk Model Establishment of Endoscopic Sinus Surgery for Patients with Chronic Rhinosinusitis:a Multicenter Study in Korea

Background@#Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes. @*Methods@#Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and LundMackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes. @*Results@#In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis (P 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [−0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) − 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed. @*Conclusion@#Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS.

Risk Model Establishment of Endoscopic Sinus Surgery for Patients with Chronic Rhinosinusitis:a Multicenter Study in Korea

Background@#Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes. @*Methods@#Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and LundMackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes. @*Results@#In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis (P 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [−0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) − 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed. @*Conclusion@#Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS.

Association Between Cadmium Exposure and Liver Function in Adults in the United States: A Cross-sectional Study / 예방의학회지

Objectives@#Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population. @*Methods@#In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index. @*Results@#The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively. @*Conclusions@#Chronic exposure to cadmium showed positive associations with liver damage.

Development of Korean Version Burnout Syndrome Scale (KBOSS) Using WHO’s Definition of Burnout Syndrome

Background@#Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO’s definition of BOS and present the cut-off points for screening. @*Methods@#We developed the KBOSS based on WHO’s definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson’s correlation. The KBOSS reliability was assessed using Cronbach’s alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. @*Results@#The validity and reliability of the KBOSS were good. Regarding reliability, the scale’s overall Cronbach’s alpha was 0.813. Cronbach’s alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. @*Conclusion@#The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.

Nasal Septal Deviation and Incidental Paranasal Sinus Opacification: A Role of Computed Tomography

Background and Objectives@#The purpose of this study was to investigate the prevalence of incidental paranasal sinus (PNS) opacification in nasal septal deviation (NSD) using computed tomography (CT) and to identify contributing factors.Subjects and Method: We analyzed 216 patients who underwent septoplasty for the correction of NSD and who underwent preoperative PNS CT. We assessed the prevalence of incidental PNS opacification in these patients and determined the type of NSD according to Mladina classification. We also evaluated whether the direction of NSD affected the presence of PNS opacification on CT, and whether the presence of PNS opacification was associated with other rhinologic symptoms. @*Results@#Of 216 patients with NSD, 86 showed opacified PNS on CT. According to Mladina classification, NSD patients were classified as type I (24.1%), type II (36.1%), type III (20.8%), type IV (5.6%), type V (9.7%), type VI (2.3%), or type VII (1.4%). Patients with type II NSD showed a significantly higher incidence of PNS opacification compared with other types of NSD (p=0.001). However, the direction of NSD did not significantly influence the presence of incidental PNS opacification. Furthermore, regardless of the presence of PNS opacification, there was no significant difference in rhinologic symptoms such as olfactory dysfunction, among others. @*Conclusion@#We found that incidental PNS opacification on CT was common in NSD patients, especially in patients with type II NSD. Thus, we suggest that CT evaluation of patients with NSD may be helpful for assessing comorbid PNS pathologies as well as objectively identifying nasal septal deformities.

Risk Factors Related to Poor Threshold, Discrimination, and Identification Scores in Patients with Chronic Rhinosinusitis with Olfactory Dysfunction / 대한이비인후과학회지

Background and Objectives@#Although patients with chronic rhinosinusitis (CRS) present a similar degree of olfactory dysfunction, their impairments in threshold, discrimination, and identification test results may vary. We investigated factors related to each of these components using the Korean version of the Sniffin’ Sticks test II in CRS patients.Subjects and Method A total of 120 CRS patients with olfactory dysfunction were enrolled and assigned to hyposmia and anosmia groups. Correlation between the three components were examined in both groups. We also subdivided patients into higher- and lower-score groups according to the threshold, discrimination, and identification scores within the hyposmia and anosmia groups to determine associated factors among the demographic factors, CRS severity on computed tomography (CT) and endoscopic findings. @*Results@#Threshold, discrimination, and identification scores were significantly correlated in hyposmia patients. Age [odds ratio (OR), 0.94] was associated with the threshold score, and the anterior olfactory cleft opacification score (OR, 1.31) on CT was associated with identification difficulties in hyposmia patients. The posterior olfactory cleft opacification score was associated with threshold (OR, 2.76) and identification difficulties (OR, 1.68) in anosmia patients. However, we could not identify significant risk factors for discrimination in both groups. @*Conclusion@#We demonstrated that the three components of the olfactory function test for CRS are significantly correlated in patients with hyposmia. Age was associated with threshold score in hyposmia patients and CRS severity, and with discrimination scores in both hyposmia and anosmia patients. These findings will help the understanding of pathophysiology of CRSrelated olfactory dysfunction.Korean J Otorhinolaryngol-Head Neck Surg 2020;63(8):358-68

Association between green areas and allergic disease in Korean adults: a cross-sectional study

Association Between the Frequency of Eating Non-home-prepared Meals and Women Infertility in the United States / 예방의학회지

The purpose of this study was to determine whether eating non-home-prepared meals (NHPM), including fast food, ready-to-eat foods, and frozen foods, was associated with self-reported infertility in the United States women. Methods: Data on diet and infertility from women aged 20-49 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n=2143). Dietary information, including the number and types of NHPM consumed, was obtained from a self-reported questionnaire, and infertility status was analyzed using the following question, “Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant?” Results: The frequency of NHPM consumption was positively associated with self-reported infertility after adjusting for confounding effects (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.48 to 5.38 of >1 vs. 0 NHPM/d). The odds of infertility were 2-3 times higher in women who consumed fast food than in those who did not consume fast food (OR, 2.73; 95% CI, 1.15 to 6.48 of >1 vs. 0 times/d). Conclusions: The frequency and types of NHPM may be a factor contributing to infertility. Although our findings require confirmation, they suggest that eating out may be deleterious to women fecundity.

Association between green areas and allergic disease in Korean adults: a cross-sectional study

BACKGROUND@#Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults.@*METHODS@#In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service.@*RESULTS@#The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively.@*CONCLUSIONS@#We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.

Association between green areas and allergic disease in Korean adults: a cross-sectional study

BACKGROUND@#Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults.@*METHODS@#In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service.@*RESULTS@#The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively.@*CONCLUSIONS@#We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.

Two Cases of Actinomycosis with Aspergillosis in Unilateral Paranasal Sinuses

The Association of Patient-Reported Local Allergic Symptoms with Postoperative Outcomes of Chronic Rhinosinusitis

Association between exposure to ambient air pollution and renal function in Korean adults

BACKGROUND: Ambient air pollution has a negative effect on many diseases, such as cardiovascular and respiratory diseases. Recent studies have reported a relationship between air pollution and renal function, but the results were limited to exposure to particulate matter (PM). This study was to identify associations between various air pollutants and renal function among Korean adults. METHODS: Nationwide survey data for a total of 24,407 adults were analyzed. We calculated the estimated glomerular filtration rate (eGFR) for each individual to assess their renal function and used this to categorize those with chronic kidney disease (CKD). To evaluate exposure to ambient air pollution, we used the annual mean concentrations of four ambient air pollutants: PM with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO). RESULTS: We identified significant inverse relationships between the air pollutants PM10 and NO2 and eGFR in all statistical adjustment models (all p  0.05). CONCLUSIONS: Exposures to PM10 and NO2 were significantly associated with decreases in eGFR levels, but not CKD, in Korean adults.

Psychological Characteristics and Aesthetic Concerns of Male Patients Seeking Primary Rhinoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The demand for rhinoplasty has been high for both men and women over the years; recently, however, it is rapidly increasing for men as their interest in aesthetics has heightened. This study investigated the psychological characteristics of male patients who underwent rhinoplasty through questionnaire-guided consultation. In addition, we investigated the difference between patients and surgeons regarding their aesthetic concerns for rhinoplasty. SUBJECTS AND METHOD: Of the male patients who underwent rhinoplasty from January 2006 to December 2012, 124 patients who had completed the questionnaires were included. The questionnaire for rhinoplasty asked about the basic personality traits of patients, patients' complaints about their nose, reasons for receiving the operation and expectation for postoperative change. RESULTS: Patients responded most to the item, “I have high expectations for the surgery” for the question regarding personality characteristics, followed by the response, “I am concerned about my health.” Regarding questions about reasons for rhinoplasty, complaints about their dorsum were high; among these patients, they were most concerned about the appearance of the ‘crooked nose’ when viewed from the front. On the other hand, the concern for the ‘poorly defined nasal tip’ was not high, whereas it was defined as one of the problems mentioned by the surgeons. CONCLUSION: These results show differences regarding aesthetic concerns between the patients and the surgeon, especially regarding the nasal tip. It would be helpful for both patient and surgen to plan the surgery after careful consultation based on the questionnaire, accurate understanding of the patients' complaints and expectations to obtain satisfactory results for both.

Inhibition of protein tyrosine phosphatase (PTP1B) and α-glucosidase by geranylated flavonoids from Paulownia tomentosa.

Protein tyrosine phosphatase 1B (PTP1B) and α-glucosidase are important targets to treat obesity and diabetes, due to their deep correlation with insulin and leptin signalling, and glucose regulation. The methanol extract of Paulownia tomentosa fruits showed potent inhibition against both enzymes. Purification of this extract led to eight geranylated flavonoids (1-8) displaying dual inhibition of PTP1B and α-glucosidase. The isolated compounds were identified as flavanones (1-5) and dihydroflavonols (6-8). Inhibitory potencies of these compounds varied accordingly, but most of the compounds were highly effective against PTP1B (IC50 = 1.9-8.2 µM) than α-glucosidase (IC50 = 2.2-78.9 µM). Mimulone (1) was the most effective against PTP1B with IC50 = 1.9 µM, whereas 6-geranyl-3,3',5,5',7-pentahydroxy-4'-methoxyflavane (8) displayed potent inhibition against α-glucosidase (IC50 = 2.2 µM). All inhibitors showed mixed type Ι inhibition toward PTP1B, and were noncompetitive inhibitors of α-glucosidase. This mixed type behavior against PTP1B was fully demonstrated by showing a decrease in Vmax, an increase of Km, and Kik/Kiv ratio ranging between 2.66 and 3.69.

Difference according to Interpretation Methods in Allergic Skin Test

BACKGROUND AND OBJECTIVES: The skin prick test is a widely used test that uses three methods (allergen/histamine ratio method, erythema size method, and wheal size method) to interpret the results. However, there has been no comparison of these methods. The aim of this study is to compare the three different interpretation methods and define the relationship among them. SUBJECTS AND METHOD: A total of 139 patients who visited our allergy clinic complaining of nasal symptoms were enrolled. Three interpretation methods were used for defining positivity in the skin prick test, and their results were compared. The validity of each interpretation method was evaluated by total nasal symptom score. RESULTS: Positivity in the skin prick test was reported in 48.2% of patients according to the allergen/histamine ratio method and in 64.0% of patients according to the wheal size method and erythema size method. The proportion of subjects who showed a negative result with the allergen/histamine ratio method but positive results with the wheal size method or erythema size method was 15.8%. This group had a significantly higher total nasal symptom score, especially rhinorrhea and nasal obstruction, than subjects who showed negative results on all three methods. CONCLUSION: When diagnosing allergic rhinitis patients using the skin prick test, the wheal size method and erythema size method should be considered rather than the allergen/histamine ratio method.

Decreased Progesterone Receptor B/A Ratio in Endometrial Cells by Tumor Necrosis Factor-Alpha and Peritoneal Fluid from Patients with Endometriosis

PURPOSE: Progesterone resistance is thought to be a major factor that contributes to progression of endometriosis. However, it is not clear what causes progesterone resistance in endometriosis. This study aimed to assess whether cytokines or peritoneal fluid can affect progesterone receptor (PR) expression in endometrial cells and to verify whether PR expression is reduced in endometriosis. MATERIALS AND METHODS: The PR-B/A ratio was measured via real-time polymerase chain reaction after in vitro culture, in which endometrial cells were treated with either tumor necrosis factor-alpha (TNF-α), interleukin-1 beta, or peritoneal fluid obtained from women with advanced-stage endometriosis. Immunohistochemistry was performed to compare PR-B expression between eutopic and ectopic endometrial tissues from women with and without advanced-stage endometriosis. RESULTS: The PR-B/A ratio was significantly decreased by treatment with either TNF-α (p=0.011) or peritoneal fluid from women with advanced-stage endometriosis (p=0.027). Immunoreactivity of PR-B expression was significantly lower during the secretory phase than during the proliferative phase in endometrial tissues from control subjects (p<0.001). PR-B expression was significantly reduced in the eutopic endometrium (p=0.031) and ovarian endometrioma (p=0.036) from women with advanced-stage endometriosis compared with eutopic endometrium tissues from control subjects. CONCLUSION: Progesterone resistance in endometriosis may be caused by proinflammatory conditions in the pelvic peritoneal microenvironment.