To investigate computed tomography (CT) and magnetic resonance imaging (MRI) features of skull bases involving anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV).
A ...retrospective review was undertaken to identify an institutional historical cohort of 17 patients with confirmed AAV who underwent CT or MRI and had skull base involvement between 2002 and 2021. Two radiologists reviewed the extent and features of the lesions, bone changes, and other MRI findings.
A total of 17 patients (12 men; mean age ± standard deviation, 46.5 ± 17.1 years) were selected. AAV presented as infiltrative lesions with involvement at various sites. Most cases involved the paranasal sinuses (PNS; 88%, 15/17), nasopharynx (88%, 15/17), pterygopalatine fossa (82%, 14/17), and parapharyngeal space (82%, 14/17), frequently accompanied by mucosal irregularity of the PNS and nasopharynx (71%, 12/17). Central skull base and temporal bone involvement were seen in 53% (9/17) and 38% (6/16) of cases, respectively. On T1-weighted imaging (WI) and T2WI MRI, all lesions (15/15) showed predominant signal iso-intensity to grey matter.
Although radiological findings of AAV are non-specific and skull base involvement is less common, AAV may be considered if infiltrative lesions predominantly involving the PNS, nasopharynx, pterygopalatine fossa, and parapharyngeal space with combined bone changes of skull base are seen.
•The skull base involvement of ANCA associated vasculitis (AAV) is rare, but important.•AAV showed infiltrative lesions with various site (PNS, nasopharynx) involvement.•Skull base involvement of AAV could accompany mucosal irregularity and bone change.
Summary
Background
The precise roles of Propionibacterium acnes and other anaerobic bacteria in the pathogenesis of acne are still unclear. Recent studies have shown that P. acnes can be further ...classified into several phylotypes with distinct phenotypes and virulence. Their distribution patterns in acne lesions have rarely been demonstrated.
Objectives
To analyse distribution patterns of P. acnes phylotypes and Peptostreptococcus species on the skin surface of patients with acne and healthy controls, and in comedones, papules and pustules from patients.
Methods
A total of 370 samples from 95 patients with acne and 65 samples from 65 healthy controls were investigated. Three P. acnes phylotypes and three Peptostreptococcus species were identified by polymerase chain reaction primarily using type‐specific primers.
Results
There was no significant difference in the microflora of the skin surface samples between patients with acne and healthy controls. In acne lesions, distribution patterns between skin surface and comedonal lesions were similar, but they were significantly different from those of both papules and pustules. In the inflammatory acne lesions, the proportion of type IA P. acnes was increased, while those of type IB and II were decreased. The proportion of Peptostreptococcus species was also increased significantly in the inflammatory lesions.
Conclusions
At the precision of this qualitative study, our results do not provide any evidence that different phylotypes in the surface microflora might be important in triggering acne. However, type IA P. acnes and Peptostreptococcus species might be more closely associated with inflammatory acne lesions.
What's already known about this topic?
The precise roles of Propionibacterium acnes and other anaerobic bacteria in the pathogenesis of acne are still unclear.
Recent studies have shown that P. acnes can be classified into several phylotypes with distinct phenotypes and virulence; their distribution patterns in acne samples have rarely been demonstrated.
It is suspected that anaerobic organisms other than P. acnes also have a role in the pathogenesis of acne.
What does this study add?
There was no significant difference in the microflora of the skin surface samples from the acne and non‐acne groups.
Type IA P. acnes and Peptostreptococcus species were found in higher proportions in papules and pustules compared with comedones and the skin surface, suggesting their possible association with inflammatory lesions.
Consideration of P. acnes phylotypes or other anaerobic bacteria might add valuable insights for the elucidation of bacterial roles in acne pathogenesis.
We aimed to compare the prevalence and risk factors of chronic rhinosinusitis (CRS) using two different diagnostic criteria with the same statistical data from the Korean National Health and ...Nutrition Examination Survey in 2009.
Symptom-based CRS was defined as CRS diagnosed by questionnaires related to nasal symptoms. Endoscopy-based CRS was defined based on endoscopic findings and nasal symptoms of symptom-based CRS.
The overall prevalence of CRS based on the different diagnostic criteria was as follows: symptom-based CRS was 10.78% (797 of 7,394) and endoscopy-based CRS was 1.20% (88 of 7,343). Comparing symptom-based CRS to endoscopy-based CRS showed slight agreement (kappa = 0.183 (0.150-0.216, 95% confidence interval)). Allergic rhinitis was identified as a common risk factor for CRS based on the two diagnostic criteria.
The prevalence and risk factors of CRS were quite different from each other according to the different criteria, even in the same population. Therefore, it would be important to consider what specific diagnostic criteria have been adopted in the studies comparing the prevalence of CRS.
Background. Multidrug-resistant (MDR) tuberculosis (TB) is more difficult to treat than is drug-susceptible TB. To elucidate the optimal therapy for MDR TB, we assessed the treatment outcomes and ...prognostic factors for patients with MDR TB. Methods. This study included patients who received an individualized treatment regimen for MDR TB at Samsung Medical Center, a tertiary referral hospital in Seoul, Korea, from January 1995 through December 2004. To identify the prognostic factors related to favorable treatment outcomes, univariate comparison and multiple logistic regression were performed. Results. Of 155 patients, 18 (12%) had newly diagnosed MDR TB, 81 (52%) had previously received treatment with first-line drugs, and 56 (36%) had received treatment with second-line drugs. The isolated strains were resistant to a median of 5 drugs. Twenty-seven patients (17%) had extensively drug-resistant (XDR) TB at the start of treatment. Outcome assessment revealed that 102 patients (66%) were cured or completed therapy. The treatment success rates did not differ significantly between patients with non-XDR MDR TB and those with XDR TB (66% vs. 67%). Surgical resection was performed more frequently for patients with XDR TB than for those with non-XDR MDR TB (48% vs. 17%). Combined surgical resection, body mass index ⩾18.5 (calculated as the weight in kilograms divided by the square of the height in meters), use of >4 effective drugs, and a negative sputum smear result were independent predictors of a favorable outcome. Conclusions. Early aggressive treatment comprising at least 4 effective drugs and surgical resection, when indicated, may improve the outcome for patients with MDR TB or XDR TB.
BACKGROUND We investigated the differences in anthropometrical, hormonal and insulin resistance parameters according to the subtype of polycystic ovary syndrome (PCOS) in Korean women. METHODS We ...recruited 166 women with PCOS and retrospectively recruited 277 controls. PCOS was diagnosed by irregular menstruation (IM), polycystic ovary (PCO) and hyperandrogenism (HA). Subjects were divided into four subgroups: the IM/HA/PCO group (n = 87, 52.4%), the IM/PCO group (n = 52, 31.3%), the IM/HA group (n = 23, 13.9%) and the HA/PCO group (n = 4, 2.4%). Clinical and biochemical variables were compared among the PCOS subgroups. RESULTS The IM/HA/PCO and IM/HA groups showed higher body mass index (P < 0.001) and waist-to-hip ratio (P < 0.001) than the IM/PCO group. The IM/HA group had higher triglyceride levels than the other groups (P < 0.001). Higher fasting insulin (P < 0.001) and postprandial 2 h insulin (P < 0.01) were noted in the IM/HA/PCO group and the IM/HA group, compared with the IM/PCO group. Women with PCOS showed lower sex hormone-binding globulin (P < 0.001) and higher systolic blood pressure (BP) (P = 0.004), diastolic BP (P = 0.001), fasting insulin (P < 0.001), postprandial 2 h insulin (P < 0.001), homeostatic model for insulin resistance (P < 0.001) and clinical and biochemical parameters of metabolic syndrome (P < 0.05) compared with subjects without PCOS. CONCLUSIONS Women with PCOS without HA are common in Korea and are less likely to have metabolic dysfunction, insulin resistance and elevated BP. PCOS without HA may be a mild phenotype of PCOS. Therefore, women with PCOS in Korea could have a reduced likelihood of having metabolic syndrome compared with women of other ethnicities.
Summary
Entecavir 0.5 mg (ETV) is widely used among treatment‐naïve chronic hepatitis B (CHB) patients. However, 10%‐30% of patients show partial virologic response (PVR) to the drug. If the ...hepatitis B virus (HBV) continues to replicate, the underlying liver disease may progress. Herein, we compared the efficacy of switching to tenofovir disoproxil fumarate (TDF) with that of continuing ETV in CHB patients with PVR to ETV. This was an open‐label randomized controlled trial including CHB patients who had been receiving 0.5 mg of ETV for >12 months, but who still had detectable HBV DNA levels of >60 IU/mL without known resistance to ETV. Sixty patients were enrolled and 45 qualified for the study: Twenty‐two patients were randomly assigned into the TDF group and 23 into the ETV group. After 12 months of treatment, the virologic response rate (HBV DNA <20 IU/mL) was significantly higher in the TDF group than in the ETV group, as measured using per‐protocol analysis (55% vs 20%; P = .022) and intention‐to‐treat analysis (50% vs 17.4%; P = .020). The reduction in HBV DNA was greater (−1.13 vs −0.67 log10 IU/mL; P = .024), and the mean HBV DNA level was lower (1.54 vs 2.01 log10 IU/mL; P = .011) in the TDF group than in the ETV group. In conclusion, to achieve optimal response in CHB patients with PVR to ETV, switching to TDF would be a better strategy than continuing ETV. Appropriate modification of therapy would further improve the outcome of chronic HBV infection.
Patients with advanced cancer suffer from various physical and psychosocial distresses. With disease progression, anorexia was also a common symptom of distress in cancer patients. Eventually, ...prolonged anorexia and poor nutrition leads the deterioration of patients' performance statuses and quality of life as disease progress.
This study aimed to identify direct correlations between performance status, symptom burden and mid-upper arm circumference (MUAC).
This cross-sectional study was conducted with 200 patients between March 2016 and January 2019 at a tertiary cancer center in Korea.
A total of 65.5% of patients were on chemotherapy at enrollment, and 89.5% of the patients had a Karnofsky Performance Scale (KPS) of 70% or higher. Six items of the Korean Edmonton Symptom Assessment System (K-ESAS) (pain, fatigue, nausea, drowsiness, loss of appetite and feelings of wellbeing) showed a statistically significant negative correlation with MUAC (P<0.01) in the univariate analyses. Conversely, body mass index and KPS had a positive correlation with MUAC (P<0.01) in the univariate analyses. Finally, the KPS was significantly associated with the following three variables in the multivariate analysis: fatigue (P<0.01), feelings of wellbeing (P<0.01) in the K-ESAS and upper MUAC ≥26.5 cm group (P<0.01).
The KPS had a significant relationship with MUAC, fatigue and feelings of wellbeing. Our study suggests that MUAC, as a simple and noninvasive tool played a vital role in functional statuses in patients with advanced cancer.
The intense and complex flavor characteristics of soy sauce makes it very difficult to obtain a comprehensive sensory profiling, and an effective descriptive analysis protocol for soy sauce products ...has not yet been established. The aims of this study were (1) to establish an objective, effective, and powerful descriptive analysis procedure that can be used to understand the sensory characteristics of soy sauce products and (2) to evaluate the sensory characteristics of 6 fermented type soy sauces with high market share in Korea. The test procedures, reference standards, and definitions for the descriptive terms of soy sauces were developed by 8 trained panelists. Panelists developed 11 aroma attributes, 10 flavor attributes, and 1 mouth feel attribute for evaluating the sensory characteristics of soy sauces. The data set were statistically analyzed by analysis of variance and principal component analysis. There were significant differences among the soy sauce samples in the intensity of all the sensory attributes. The 1st and 2nd principal component (PC) explained 53.6% and 23.5% of the total variation, respectively. The basic taste attributes and fermented/chemical attributes were the dominant attributes defining PC1 and PC2 axes, respectively.
Pre-operative planning for total hip replacement (THR) is challenging in hips with severe acetabular deformities, including those with a hypoplastic acetabulum or severe defects and in the presence ...of arthrodesis or ankylosis. We evaluated whether a Rapid Prototype (RP) model, which is a life-sized reproduction based on three-dimensional CT scans, can determine the feasibility of THR and provide information about the size and position of the acetabular component in severe acetabular deformities. THR was planned using an RP model in 21 complex hips in five men (five hips) and 16 women (16 hips) with a mean age of 47.7 years (24 to 70) at operation. An acetabular component was implanted successfully and THR completed in all hips. The acetabular component used was within 2 mm of the predicted size in 17 hips (80.9%). All of the acetabular components and femoral stems had radiological evidence of bone ingrowth and stability at the final follow-up, without any detectable wear or peri-prosthetic osteolysis. The RP model allowed a simulated procedure pre-operatively and was helpful in determining the feasibility of THR pre-operatively, and to decide on implant type, size and position in complex THRs.
The efficacy of inhaled corticosteroids (ICSs)/long-acting beta2-agonist (LABA) treatment in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) compared to ...patients with COPD alone has rarely been examined. This study aimed to evaluate the clinical efficacy for the improvement of lung function after ICS/LABA treatment in patients with ACOS compared to COPD alone patients.
Patients with stable COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. Subjects began a 3-month ICS/LABA treatment after a washout period. ACOS was defined when the patients had 1) a personal history of asthma, irrespective of age, and wheezing in the last 12 months in a self-reported survey and 2) a positive bronchodilator response.
Among 152 eligible COPD patients, 45 (29.6%) fulfilled the criteria for ACOS. After a 3-month treatment with ICS/LABA, the increase in forced expiratory volume in 1 second (FEV
) was significantly greater in ACOS patients than in those with COPD alone (240.2±33.5 vs 124.6±19.8 mL,
=0.002). This increase in FEV
persisted even after adjustment for confounding factors (adjusted
=0.002). According to severity of baseline FEV
, the ACOS group showed a significantly greater increase in FEV
than the COPD-alone group in patients with mild-to-moderate airflow limitation (223.2±42.9 vs 84.6±25.3 mL,
=0.005), whereas there was no statistically significant difference in patients with severe to very severe airflow limitation.
This study provides clinical evidence that ACOS patients with mild-to-moderate airflow limitation showed a greater response in lung function after 3 months of ICS/LABA combination treatment.
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