Schwannoma of the Tongue Base with Imaging Features and Differential Diagnosis: a Rare Case Report and Literature Review

Schwannoma or neurilemmoma is a benign peripheral nerve sheath tumor that arises from Schwann cells. Approximately 25–45% of all schwannomas occur in the head and neck regions, and the intraoral presentation of these is only 1%. We report a rare case of a patient presenting tongue base schwannoma with characteristic imaging features on computed tomography and magnetic resonance imaging.

Prevention of Lateral Synechia Formation with Silastic Sheet in the Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Lateral synechia formation between the middle turbinate and the lateral nasal wall is one of the most common complications in endoscopic sinus surgery. Unstable and floppy middle turbinate occurs not infrequently and it may make meticulous postoperative dressing difficult during healing period, and consequently increases the risk of synechia and recurrence of sinusitis. The aim of this study was to investigate whether insertion of the silastic sheet in the middle meatus can effectively prevent the synechia formation. SUBJECTS AND METHOD: Twenty eight patients (31 sides including 3 bilateral cases) with unstable and floppy middle turbinate occurred during endoscopic sinus surgery were enrolled in this study. The silastic sheet was designed in fan-shape and inserted between the middle turbinate and the lateral nasal wall. The silastic sheet was secured to the caudal septum and removed 2 to 3 weeks after the operation. We performed a follow-up study for 5 months and investigated the occurrence rate of synechia. RESULTS: The success rate of our method was 90.3% and synechia in the middle meatus developed in 3 of 31 sides (9.7%). Although synechia between the middle turbinate and nasal septum occurred in 4 sides, the patients did not complain of olfactory disturbance. CONCLUSION: The results of this study suggest that insertion of the silastic sheet in the middle meatus can be a useful method in the prevention of lateral synechia formation when unstable and floppy middle turbinate has developed during endoscopic sinus surgery.

The Expression of Vascular Endothelial Growth Factor(VEGF) and Survivin in Squamous Cell Carcinoma of Larynx / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Angiogenesis and alteration of apoptosis are hypothesized to be the mechanisms of the growth of tumor. Vascular endothelial growth factor (VEGF) is considered to be the most primary factor prompting the angiogenesis in tumor tissue, which also holds the central position in the course of formation and metastasis of tumor and regulates expression of survivin. The survivin protein is the member of inhibitor of apoptosis protein (IAP) family which inhibits apoptosis. Recently, several authors reported survivin and VEGF expression was found in various cancer tissue and they are suggest to play on the important role in cancer development. The purpose of this study is to evaluate the expression of VEGF and survivin and to investigate their correlation with the clinical stage, nodal involvement, and histologic grade in the squamous cell carcinoma of larynx. SUBJECTS AND METHOD: Immunohistochemical staining for the paraffin sections by using a polyclonal antibody for VEGF and survivin by the standard avidin-biotin-peroxidase technique was performed in 19 cases with the squamouse cell carcinoma of larynx. The relationships between the expression of VEGF and survivin and clinicopathological characteristics were analyzed. RESULTS: Immunohistochemical analysis showed the expression of VEGF in 15 of 19 cases (78.9%) and survivin in 19 of 19 cases (100%). There was no correlation between the expression of VEGF and survivin and the clinical stage, nodal involvement, and histologic grade in the squamous cell carcinoma of larynx (p>0.05). But VEGF results in an increased expression of survivin (p<0.05). CONCLUSION: Further study will be needed to understand the relationships between the VEGF and survivin and squamous cell carcinoma of larynx.

Species Identification of Coagulase Negative Staphylococci by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism of Heat Shock Protein 60 Gene / 대한임상미생물학회지

BACKGROUND: An accurate and rapid method for specise identification of coagulase negative staphylococci(CNS) has been increasingly necessary for the clinical significance and planning the management of patients with staphylococcal infections. Recently, it has been reported that there is a highly conserved area on their 60KDa heat shock protein(HSP60) gene sequences between the interspecies of CNS and it can be amplified by a set of universal degenerate primer. This led us our attention to focus on whether the PCR-based RFLP method using Mse / restriction enzyme could be a useful tool for the species identification of CNS. METHODS: In the present study, we performed PCR-based RFLP analysis using a set of degenerate primers covering HSP60 and Mse / restriction enzyme on the reference strains and 25 clinical isolates(10 of S. epidermidis, 10 of S. haemolyticus, 4 of S. lugdunensis and 1 of S. warneri) which were previously identified by the API-STAPH, Vitek GPI card and/or with conventional biochemical test. RESULT: All the seven reference strains revealed that each strain has a distinct electrophoresed band patterns with combination of different number (up to 8) and size of fragments. And these distinct band patterns showed remarkable concordance with the seven reference strains and 25 clinical isolates. CONCLUSION: These result strongly suggest that the PCR-RFLP method using degenerate primers covering the HSP60 gene and Mse / digestion enzyme offer a convenient and accurate tool for species-specific identification of CNS.

Measurement of thoracic spinal canal by computed tomography in Korean adults

The size of spinal canal is valuable ot detect the body encroachment of spinal canal and expansion due totumors by computed tomography. This study was desinged for taking accurate measurement of the normal thoracicspinal canal in korean adults. The anteroposterior diameter, interpediculate distance and cross-sectional area ofthoracic spinal canal were measured in 80 normal adults. The results were as follows. 1. In A-P diameter, middleparts of the canal were smaller values than those of upper and lower parts from T1 to T6, and upper parts of thecanal were larger than those of middle and lower parts from T7 to T10. 2. In interpediculate distance, middleparts of the canal revealed larger value than those of upper parts. 3. All measurements of male were larger thanthose of female at all levels of the spinal canals and 65 measurement(93%) were statistically significant.

A case of primary obstructive megaureter with CT demonstration

Megaureter is a relatively rare disease and its first description was done by Caulk in 1923. It is characterized by marked ureteral dilatation without obvious cause, and occurs in lower ureter especially. Authers report a case of primary obstructive megarureter with CT demonstration in 19 year-old female. To our knowledage,this is the first case report of primary obstructive megaureter in Korea.

Measurement of lumbar spinal canal by computed tomography in Korean adults

The size of spinal canal is mesured to detect the lumbar spinal stenosis syndrome and expanding intraspinaltumors by CT. This study was desinged for taking accurate measurement of the normal lumbar spinal canal in Koreanadults. The anteroposterior diameter, interpediculate distance and cross-sectional area of lumbar spinal canalwere measured in 110 normal adults. The results were as follows; 1. The window center that showed identical valueconsistent with actual measurement of phantom was between + 160HU and + 240HU and the window width was below +300HU. 2. In anteroposterio diameter, upper part of the canal was larger value than that of middle and lowerparts, but in interpediculate distance, lower part of the canal revealed larger value than that of upper andmiddle parts. There was no significant difference in cross-sectional area. 3. All measurements male were largerthan those of female at all levels of the spinal canal and 42 measurements(58%) were significant statisstically.4. Compared with Americans, Korean showed lower value in anteriopsterior diameter and cross-sectional area buthigher value in interpediculate distance. 5. Above results should contribute to making an another criteria fordiagnosing the lumbar spinal stenosis in Koreans.

Clinical values of CT and dynamic CT in brain infarction

With the advent of faster scan time and new computer program, a scanning technique called “dynamic computedtomography” has become possible. Dynamic CT consists of performing multiple rappid sequence scans after injectionof contrast material. The authors have evaluated the clinical usefulness of CT and dynamic CT of 93 patients withbrain infarction and/or ischemia during the period of 17 months from April 1983 to Aug. 1983 to Aug. 1984 inDepartment of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The agedistribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59years(40.9%). 2. The sites of brain infarction were cerebral lobes(63 cases,68), basal ganglia(15 cases, 16.1%)and mlultiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. Thecontrast enhancement of acute infarction was noted in 14 cases(17.5%) which occured commonly between 3 days and 2weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a .Depression of slow wash-in phase was 20 cases(59%). b. Lower peak concentration was 17 cases(50%), c. Lower anddelayed peak concentration was 7 cases(21%), d. No definite peak concentration was 6 cases(18%). First threepatterns of time-density curve were thought as relatively characteristic curve of brain infarction and/orischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings ashypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entityof dynamic CT scan were as follows: a. large artery thrombotic infarction were 23 cases (58%). b. lacunarinfarction were 6 cases (15%). c. ischemia were 5 cases (13%), d. normal were 5 cases(13%), In six cases oflacunar infarction which was doubtful hypodensity on pre-and postcontrast CT scan had a marked difference in CT#(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. Theclinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evaluation ofeffectiveness of medical or surgical treatment.