The Diagnosis and Treatment of the Cervical Vertigo / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Vertigo is an illusion of environmental movement due to various causes, thus it is hard for medical doctors to determine the exact kind of dizziness in the final diagnosis. Recently, cervical vertigo was reported from several vertigo cases. Cervical vertigo is defined as sensation of rotation, resulting from an alteration of the neck proprioceptive afferents of the upper cervical spine. The aim of our study is to document the clinical features and the treatment outcomes in vertigo patients with myofascial pain syndrome (MPS). SUBJECTS AND METHOD: A total of 488 patients, excluding 18 patients who received other diagnosis, were examined to investigate the reasons for dizziness. We evaluated 34 patients, who were diagnosed with cervical vertigo by questionnaire after MPS treatments. Clinical evaluations for cervical vertigo were performed on all subjects, and vestibular function tests were also performed in patients with vertigo symptoms. All patients received a total of 4 treatments including trigger point injection, physical therapy or medication, and then followed up, respectively. The symptom changes of dizziness, patient satisfaction and cervical pain were checked before and treatment 1, 2, 4 times by Visual Analogue Scale (VAS) score. RESULTS: There were significant improvement in the VAS score of dizziness, patient satisfaction and cervical pain after treatment for MPS. CONCLUSION: Treatment for MPS could improve dizziness in cervical vertigo with MPS patients, but further study is needed to clearly confirm the cervical vertigo with MPS for improving patient's quality of life.

The Efficacy of Posterior Resection of Inferior Turbinate on Patients Who Have Recurred Nasal Obstruction after Inferior Turbinate Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various surgical techniques have been tried to relieve nasal obstruction in patients who have hypertrophic inferior turbinate. Recently, coblators and microdebriders are the favored surgical procedure. This study is aimed at evaluating the long term efficacy of posterior resection of inferior turbinate performed on patients for whom the previous inferior turbinate surgery had not relieved the symptoms of nasal obstruction. SUBJECTS AND METHOD: We selected 27 patients who have had previous inferior turbinate surgery, but were not relieved of the symptom for nasal obstruction. Under local or general anesthesia, hypertrophied posterior part of inferior turbinate was removed. The symptom changes of nasal obstruction and patients satisfaction were checked pre and postoperatively at 1, 2, 3, 6, 12 month by Visual Analogue Scale (VAS) score. The minimal cross-sectional area of second notch and volume of nasal cavity were measured at 1, 2, 3, 6, 12 month after operation. RESULTS: There were significant improvement in the VAS score of nasal obstruction and patient satisfaction after the operation. The minimal cross-sectional area of second notch did not change significantly after surgery, but the nasal cavity volume was significantly improved after surgery. CONCLUSION: This study suggests that posterior resection of inferior turbinate is an effective surgical procedure for patients who have hypertrophic inferior turbinate especially on the posterior part.

The Efficacy of DizzyFIX for Residual Dizziness after Successful Repositioning Maneuvers in Posterior Benign Paroxysmal Positional Vertigo / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.

A Case of Bradycardia due to Vagal Reflex during Laryngeal Microsurgery / 대한이비인후과학회지

Laryngeal microsurgery has been used popularly for phonosurgery. Sometimes, this procedure is complicated by cardiovascular changes due to insertion of laryngosope. Tachycardia and elevation of blood pressure are common but bradycardia induced by vagal reflex is very rare. The authors report the case of severe bradycardia induced by vagal reflex experienced during laryngeal microsurgery with a review of the literature.

A Case of Chondroid Syringoma of the External Auditory Canal / 대한이비인후과학회지

Chondroid syringoma is a benign sweat gland tumor composed of a mixture of epithelial cells and mesenchymal tissue. It is most frequently located on the head and neck. Chondroid syringoma is usually present as a firm intradermal or subcutaneous nodule. Histologically, the epithelial component consists of tubulocystic structures and aggregates of epithelial cells as well as single scattered epithelial cells throughout the stroma. The treatment of choice is complete local excision. We report a case of chondroid syringoma presenting as a external auditory canal mass in 54 year old man with a brief review of literature.

The Efficacy and Safety of Short-term Therapy with Itraconazole Melt-Extrusion Tablet in The Hyperkeratotic Type of Tinea Pedis and/or Tinea Manus / 대한의진균학회지

BACKGROUND: The many antifungal agents have been used in fungal infections. In usual trial agents, itraconazole still remains difficult to absorption in gastrointestinal tract. OBJECTIVE: The purpose of this study is to evaluate the clinical efficacy and adverse reactions of short-term itraconazole melt-extrusion tablet increased in hyperkeratotic type of tinea pedis and/or tinea mauns. METHODS: From November 1998 to February 1999, a total of 60 patients with palmoplantar type of tinea pedis and/or tinea manus at Department of Dermatology of 5 general hospital, were enrolled in a subject group for the study. Itraconazole melt-extrusion tablet was administered, 200mg twice daily, in one week. Clinical symptoms and signs with mycological findings were assessed. RESULTS: Fifty-six patients (male 33, female 23; mean age 36.1+/-10.7; mean duration 6.5+/-4.8) completed the follow-ups. Direct KOH smear examination was positive in all them. Decrease in initial percentages of patients showing symptoms at the last follow-up 2 months after starting therapy: for scale, from 100% to 85.4%; for ertyema, from 91.1% to 10.7%; for hyperkeratosis from 100% to 32.3%; for pruritus, from 82.1% to 10.7%. Mycologic cure rate was 92.9% at the last follow-up. Overall clinical responses evaluated at the last follow-up were 'cured' in 6 pathients(10.7%), 'markedly improved' in 38 patiendts(67.9%), making a clinical response rate of 78.6%. During therapy, transient epigastria pain and indigeastion developed in 5 patients(8.9%). CONCLUSION: With these results, itraconazole melt-extrusion table is considered an effective and safe treatment modality for hyperkeratotic type of tinea pedis and/or tinea manus.

Clinical and Histopathological Study of Calcinosis Cutis / 대한피부과학회지

BACKGROUND: Calcinosis cutis may occur when connective tissue is abnormal (dystrophic), or where calcium or phosphate levels in the blood are high(metastatic); alternatively, there may be no obvious underlying cause(idiopathic). The exact incidence of calcinosis cutis in dermatologic patients is not well-kniown and the pathomechanism of it remains to be elucidated. OBJECTIVE: This study was performed to analyze the incidence, clinical and histopathological features of calcinosis cutis. METHODS: We studied 72 patients with calcinosis cutis who visited our department between January 1985 and December 1996. The patients were classified into 3 types (dystrophic, metastatic, and idiopathic) and were analyzed clinically and histopathologically. Results : The results were summerized as follows; 1. There were 60 cases(83.3%) and 12 cases(16.7%) of the dystrophic and idiopathic types, respectively but the metastatic type was not observed. The frequency of dystrophic calcification in individual disorders was 88.2% in pseudoxanthoma elasticum, 66.7% in trichilemmal cyst and dermatomyositis, and 64.6% in pilomatrichoma. 2. In the idiopathic type, it was common in females aged over 50 years and the mean duration of lesions was 2.8+/-2.0 years. The predilection site was the flank(5 cases) and most of the lesions(7 cases) showed skin-colored nodules 3. Histopathologically, calcified material of the idiopathic type was located predominently in the dermis(10 cases) and was present as large masses surrounded by a foreign body reaction. 4. In the dystrophic type, calcified deposits were noted predominently within the shadow cells of pilomatricoma, in the degenerated elastic fibers of pseudoxanthoma elasticum, and in the keratinized area of basal cell carcinoma, squamous cell carcinoma, trichilemmal cyst, and epidermal cyst. Foreign body reactions with giant cells and mononuclear cell infiltrations were often found around large deposits of calcium. Conclusion : The incidence of calcinosis cutis in dermatologic patients is relatively low, but a variety of disorders can be associated with cutaneous calcification. Therefore, dermatologists should be familiar with the different forms of cutaneous calcification and the dermatoses that manifest them.

A case of acute febrile neutrophilic dermatosis associated with ulcerative colitis / 대한피부과학회지

No abstract available.

A Case of Keratosis Punctata of the Palmar Greses / 대한피부과학회지

Keratosis punctata of palmar creases has been considered an uncommon variant of keratosis punctata, which itself is considered rare condition. Clinically our case, 32-year-old seaman, shows cup-shaped depression of the epidermis of varying size, from 1-3mrn in diameter, limited to the large flexor creases of the palms and digit. The histologic features are hyperkeratotic and slight acanthotic central epidermal depression without parakeratosis and loss of granular layer. A sparse mononuclear infilterate are seen arround the capillaries in the dermal papillas. No relationship to arsenical agents, syphilis, or genetic factors can be ascertained by history.