Surgical Treatment of Sucidal Laceration in the Wrist

PURPOSE: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. MATERIALS AND METHODS: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. RESULTS: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. CONCLUSIONS: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.

Intermittent Bleeding Method after Replantation o the Distal Phalanx

PURPOSE: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. MATERIALS AND METHODS: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. RESULTS: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. CONCLUSIONS: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.

Long-Surviving Patients with Recurrent GIST after Receiving Cytoreductive Surgery with Imatinib Therapy

In the treatment of recurrent or metastatic gastrointestinal stromal tumors (GIST), good prognoses may not be expected by surgery alone. Recently, imatinib has been applied for the treatment of GISTs, resulting in improved patient survival. However, long-term success is limited due to the development of resistance. Herein, we report two cases of long-surviving patients with recurrent GIST after receiving cytoreductive surgery with imatinib therapy. A 49 year-old man was diagnosed to a duodenal GIST with single hepatic metastasis, and an antrectomy including the duodenal lesion with intraoperative radiofrequency ablation were performed in April, 2002. After four months, a new metastatic hepatic lesion was identified. Percutaneous radiofrequency ablation was done, and imatinib therapy was started. A 56 year-old man underwent laparoscopic segmental resection of the distal ileum and partial excision of parietal peritoneum in March, 2001 to treat a malignant GIST of the distal ileum that was attached to parietal peritoneum. After six months, recurrence of GIST with peritoneal seeding and hepatic metastasis was found, and he underwent cytoreductive surgery including right hemicolectomy and wedge resection of liver. After surgery, there was no residual tumor grossly and imatinib therapy was started. In both cases, they were doing well with no evidence of recurrence for 5 years with imatinib therapy. Therefore, in patients with a recurrent GIST, improved survival can be expected with imatinib therapy after cytoreductive surgery.

Hematochezia with Colonic Polypoid Angiodysplasia in a Young Female Patient

A 18-year-old girl visited the hospital due to hematochezia. Colonoscopy revealed a 6-mm Yamada type II polyp with stigmata of bleeding, and a shallow ulcer on top was found at the cecum base. The polyp was removed by snare polypectomy, and hematochezia stopped thereafter. Angiodysplasia was diagnosed histopathologically. Generally, angiodysplasia appears as a flat or elevated, bright-red lesion on endoscopy, with a polypoid shape being extremely rare. This case is significant because the lesion occurred at the youngest reported age and was the smallest that has been reported, and is the only polypoid arteriovenous malformation to be discovered in the cecum.

Spontaneous Pharyngeal Perforation After Forceful Vomiting: The Difference from Classic Boerhaave's Syndrome

Boerhaave's syndrome is spontaneous transmural perforation of the esophagus, which occurs most often after forceful vomiting or retching. This commonly occurs in the lower third of the esophagus but spontaneous perforation of the pharynx or cervical esophagus is extremely rare. This case presented a 20-yr-old healthy man with spontaneous pharyngeal perforation after forceful vomiting who had no history of instrumentation, cervical trauma, or having eaten anything sharp. Cervical pain and crepitus were the early symptom and sign of pharyngeal perforation and the rupture was detected on gastrografin swallow and CT examinations. The rupture site was higher than the upper esophageal sphincter, differing from Boerhaave's syndrome. The patient was conservatively managed without significant morbidity and mortality. Although this may resolve without surgical intervention, the pharyngeal rupture should receive early detection and clinical attention for preventing potential morbidity by late diagnosis.

Association of Epstein-Barr Virus and Head and Neck Cancer in an Endemic Area / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A number of reports have suggested that Epstein-Barr virus (EBV) is associated with different forms of head and neck cancers (HNC) such as nasopharyngeal carcinoma, NK/T cell lymphoma and Burkitt's lymphoma. We evaluated the association of EBV with HNC as a causative factor in an endemic area of the virus. SUBJECTS AND METHOD: Fresh specimens of HNC were obtained from 72 new patients between August 2003 and January 2005. In situ hybridization for EBER was performed with immunohistochemical staining of p53, Bcl-2 and LMP-1 and serologic tests on anti-viral capsid antigen(VCA) and anti-early antigen (EA)-D. The results of EBV positivity were analyzed according to tumor TNM stages, sites, pathology and smoking status. A correlation between EBV positivity and p53, Bcl-2, LMP-1 positive staining was investigated. RESULTS: Nine (12%) of the total 72 patients showed EBV positivity of tumor, depending mainly on pathology and sites, but not tumor staging, age, sex or smoking status : NPC (3), NK/T cell lymphoma (5), lymphoephithelial carcinoma of the parotid gland (1). All patients had sero-positivity of anti-VCA IgG but not anti-VCA IgM and anti-EA-D. There was a relationship between the presence of EBV, its oncoprotein (LMP-1) and oncogene (Bcl-2). CONCLUSION: Overall, the incidence of EBV positivity of HNC in an endemic area is not significantly different from the prior reports about non-endemic area. The association between EBV and LMP-1 or Bcl-2 may be helpful for understanding the role of viral oncogenes in the HNC.

Distortion of the Dose Profile in a Three-dimensional Moving Phantom to Simulate Tumor Motion during Image-guided Radiosurgery / 대한방사선종양학회지

PURPOSE: Respiratory motion is a considerable inhibiting factor for precise treatment with stereotactic radiosurgery using the CyberKnife (CK). In this study, we developed a moving phantom to simulate three-dimensional breathing movement and investigated the distortion of dose profiles between the use of a moving phantom and a static phantom. MATERIALS AND METHODS: The phantom consisted of four pieces of polyethylene; two sheets of Gafchromic film were inserted for dosimetry. Treatment was planned to deliver 30 Gy to virtual tumors of 20, 30, 40, and 50 mm diameters using 104 beams and a single center mode. A specially designed robot produced three-dimensional motion in the right-left, anterior-posterior, and craniocaudal directions of 5, 10 and 20 mm, respectively. Using the optical density of the films as a function of dose, the dose profiles of both static and moving phantoms were measured. RESULTS: The prescribed isodose to cover the virtual tumors on the static phantom were 80% for 20 mm, 84% for 30 mm, 83% for 40 mm and 80% for 50 mm tumors. However, to compensate for the respiratory motion, the minimum isodose levels to cover the moving target were 70% for the 30~50 mm diameter tumors and 60% for a 20 mm tumor. For the 20 mm tumor, the gaps between the isodose curves for the static and moving phantoms were 3.2, 3.3, 3.5 and 1.1 mm for the cranial, caudal, right, and left direction, respectively. In the case of the 30 mm tumor, the gaps were 3.9, 4.2, 2.8, 0 mm, respectively. In the case of the 40 mm tumor, the gaps were 4.0, 4.8, 1.1, and 0 mm, respectively. In the case of the 50 mm diameter tumor, the gaps were 3.9, 3.9, 0 and 0 mm, respectively. CONCLUSION: For a tumor of a 20 mm diameter, the 80% isodose curve can be planned to cover the tumor; a 60% isodose curve will have to be chosen due to the tumor motion. The gap between these 80% and 60% curves is 5 mm. In tumors with diameters of 30, 40 and 50 mm, the whole tumor will be covered if an isodose curve of about 70% is selected, equivalent of placing a respiratory margin of below 5 mm. It was confirmed that during CK treatment for a moving tumor, the range of distortion produced by motion was less than the range of motion itself.

Family Function and Children of Alcoholics Screening Test Score in High School Students

BACKGROUND: Parent's alcohol drinking not only influences their health but also their children. This research was designed to assess the family function of children who were affected by parent's alcohol drinking. METHODS: Questionnaire survey was performed on 208 high school students (129 males and 79 females) in Daejeon from March to April, 2005. We defined the students whose CAST (Children of Alcoholics Screening Test) score was 6 or more as children of alcoholics (COA) group. Then, we evaluated the family function by family APGAR score between the COA group and the control group. RESULTS: Among the total, 36 (27.9%) male and 27 (34.1%) female students were in COA group. There was a significant (P<0.01) negative correlation between the CAST score and the family APGAR score in all students. In boys, there was no significant correlation between the CAST score and the family APGAR score, but in girls, there was significant negative correlation (P<0.01). Mean family APGAR score of the COA group was significantly (P<0.05) lower than that of the control group in all students. In boys, there was no significant difference, but in girls, the COA group's family APGAR score was significantly lower than the control group's score (P<0.05). CONCLUSION: The high school students, especially girl students, who were affected by parent's alcohol drinking showed a lower family APGAR score. Therefore, family physicians need to evaluate the family function when encountering students similar to COA group.

A Case of Gastritis Cystica Profunda with a Long Stalk Presenting with Upper Gastrointestinal Bleeding / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a rare disease in which hyperplastic and cystic dilatation of the gastric mucous glands extend into the tissues beneath the submucosa. GCP is mainly observed at the site of a gastroenterostomy; however, it may occur in the stomach without a previous history of surgery. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps but also rarely as a giant gastric mucosal fold. In a patient without a previous history of surgery, GCP presents mainly as a sessile polypoid protrusion or as a submucosal tumor. In addition, GCP presents with non-specific symptoms and is most commonly found incidentally. We present a case of GCP that developed upper gastrointestinal bleeding and showed a long stalk and a focal ulcerative lesion on the surface of a polyp that developed in the stomach without a history of previous surgery. This lesion was removed by the use of an endoscopic polypectomy and was histologically diagnosed as GCP.

Alcohol and the Metabolic Syndrome in Korean Women

BACKGROUND: Moderate drinking has been known to be associated with a risk of reduced cardiovascular disease morbidity and mortality. The metabolic syndrome has been associated with a risk of increased cardiovascular diseases. Because drinking is considered as a risk factor of the metabolic syndrome, this study was performed to examine the association between alcohol drinking and the metabolic syndrome in Korean women. METHODS: The subjects were 262 women who visited the health promotion center of Chungnam National University Hospital for general health check-up. The metabolic syndrome was diagnosed according to the definition by the National Cholesterol Education Program Adult Treatment Panel III. The abdominal obesity guidelines for waist circumference applied the WHO Asian Pacific Guideline. The subjects were classified into nondrinking, moderate drinking (1 drink) according to their drinking amount per day. The relationship between the components of the metabolic syndrome and drinking state were investigated. The prevalence of the metabolic syndrome was compared according to the drinking state. RESULTS: The women with moderate drinking showed significantly lower levels of triglyceride than nondrinkers (P<0.05). The women with drinking showed significantly higher levels of HDL cholesterol than nondrinkers (moderate drinkers P<0.05, heavy drinkers P<0.05). Considering nondrinkers as standard, the risk of the metabolic syndrome was significantly low in women with moderate drinking (odds ratio=0.43, 95% confidence interval: 0.22~0.84, P=0.013). CONCLUSION: The results of the present study suggest that moderate drinking is related to a lower rate of the metabolic syndrome in Korean women.

Effective Management of Head and Neck Cancer Patients with an Improved Registration Program / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Registration programs of head and neck cancer (HNC) have been developed for better patient care and data acquisition. However, there is a lack of unified registration programs of HNC in Korea. We evaluated our new HNC registration program to help effective and systemic management of HNC patients in Chungnam National University Hospital. METHOD: A HNC registration program was developed by using a computer program of 'Delphi', based on patient's demographics, diagnosis, treatment, and follow-up status. This partly cited prior HNC or other cancer registration programs and focused on the specification of the HNC. RESULTS: The program composed of registration, search, and printing forms. The registration form consists of basic epidemiologic data, previous treatment history, cancer status including primary sites, clinical and pathologic stages, treatment modality and follow-up results. The search form used a multiple selection format to enable the data interchangeable to the Excel program for effective use. The program helped to update patient's current status, promptly select data for clinical studies of clinical cancers and better patient care. This program was simple, easy, convenient, time-saving for users and it included important HNC items. CONCLUSION: Although this program is still in its primitive stage, this will be an useful tool for the registration and management of HNC patients. We suggest this program to be used nationwide to unify the registration of HNC patients and annual HNC reports, and increase cooperation among different centers.

Expression of MT-1 MMP, MMP2, MMP9 and TIMP2 mRNAs in Ductal Carcinoma in Situ and Invasive Ductal Carcinoma of the Breast

We investigated the expression of membrane type-1 (MT1)-MMP, MMP2, MMP9 and TIMP2 mRNAs and their roles in ductal carcinoma in situ (DCIS) and T1 and T2 invasive ductal carcinoma of the breast. We further compared these two types of carcinomas for differences in microvessel density, and expression of angiogenic factors and CD44std. MT1-MMP, MMP2, MMP9 and TIMP2 mRNA were expressed in both DCIS and invasive ductal carcinomas. Expression rates of MT1-MMP, MMP2, MMP9 and TIMP2 mRNAs were not statistically different between DCIS and invasive ductal carcinomas, nor did they differ statistically when grouped by tumor size, histologic grade or nuclear grade of invasive ductal carcinoma. Microvessel density and expression of VEGF and TGF-beta were not statistically different between DCIS and invasive ductal carcinoma. CD44std expression was significantly increased in DCIS compared to invasive ductal carcinoma (p < 0.05) and it was also significantly increased in lower clinical stage, histologic grade and nuclear grade of invasive ductal carcinoma (p < 0.05). Axillary node metastasis was significantly correlated with MT1-MMP mRNA, VEGF and TGF-beta expression (p < 0.05) and MT1-MMP mRNA was positively correlated with VEGF expression and TIMP2 mRNA (p < 0.05). In summary, patterns of MMP mRNA expression in DCIS and invasive ductal carcinoma suggest that the invasive potential of breast carcinoma is already achieved before morphologically overt invasive growth is observed. As MT1-MMP mRNA expression is significantly correlated with axillary nodal metastasis, it may be useful as a prognostic indicator of invasive ductal carcinoma. Considering the positive correlation of MT1-MMP mRNA and TIMP2mRNA expression, our finding supports a role for TIMP2 in tumor growth, as well as the utility of CD44std as a prognostic indicator of breast cancer.

Expression of MT-1 MMP, MMP2, MMP9 and TIMP2 mRNAs in Ductal Carcinoma in Situ and Invasive Ductal Carcinoma of the Breast

We investigated the expression of membrane type-1 (MT1)-MMP, MMP2, MMP9 and TIMP2 mRNAs and their roles in ductal carcinoma in situ (DCIS) and T1 and T2 invasive ductal carcinoma of the breast. We further compared these two types of carcinomas for differences in microvessel density, and expression of angiogenic factors and CD44std. MT1-MMP, MMP2, MMP9 and TIMP2 mRNA were expressed in both DCIS and invasive ductal carcinomas. Expression rates of MT1-MMP, MMP2, MMP9 and TIMP2 mRNAs were not statistically different between DCIS and invasive ductal carcinomas, nor did they differ statistically when grouped by tumor size, histologic grade or nuclear grade of invasive ductal carcinoma. Microvessel density and expression of VEGF and TGF-beta were not statistically different between DCIS and invasive ductal carcinoma. CD44std expression was significantly increased in DCIS compared to invasive ductal carcinoma (p < 0.05) and it was also significantly increased in lower clinical stage, histologic grade and nuclear grade of invasive ductal carcinoma (p < 0.05). Axillary node metastasis was significantly correlated with MT1-MMP mRNA, VEGF and TGF-beta expression (p < 0.05) and MT1-MMP mRNA was positively correlated with VEGF expression and TIMP2 mRNA (p < 0.05). In summary, patterns of MMP mRNA expression in DCIS and invasive ductal carcinoma suggest that the invasive potential of breast carcinoma is already achieved before morphologically overt invasive growth is observed. As MT1-MMP mRNA expression is significantly correlated with axillary nodal metastasis, it may be useful as a prognostic indicator of invasive ductal carcinoma. Considering the positive correlation of MT1-MMP mRNA and TIMP2mRNA expression, our finding supports a role for TIMP2 in tumor growth, as well as the utility of CD44std as a prognostic indicator of breast cancer.

Necessity of Prophylactic Central Lymphadenectomy in the Treatment of Thyroid Papillary Carcinoma: A Preliminary Report / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Papillary thyroid carcinoma (PTC) tends to have highly metastatic property, especially in the central compartment, and central lymphadenectomy (CL) in patients with PTC is still controversial. This study determines the necessity of prophylactic central lymphadenectomy with total thyroidectomy in patients with PTC based on metastatic probability of tumors and lymph nodes, and surgical morbidity following CL. SUBJECTS AND METHOD: Extracapsular spread, endolymphatic tumor emboli, and the location of metastatic lymph nodes in the central compartment were analyzed according to pertinent pathological methods. The complications following CL were compared between CL and control groups. RESULTS: A total of 43 patients with PTC underwent CL. Forty of them (95%) presented extracapsular spread of the primary tumor and 42 patients (98%) presented tumor emboli in lymphovascular space of tumors. Twenty-nine patients (67%) had lymph node metastasis in the central compartment. No statistical correlation between tumor size or location of primary tumor and subsites of the metastatic lymph nodes was found. The complication rates of vocal cord paralysis or hypocalcemia showed no statistical difference between groups. Seven patients with previous history of total thyroidectomy underwent central lymphadenectomy for recurred PTC and one hypocalcemia and two vocal cord paralysis were encountered, respectively. CONCLUSION: Our results suggest that high nodal metastases rates of PTC into the central compartment and no significant increase of postoperative morbidity can justify CL combined with total thyroidectomy in patients with PTC.

Effect of Ebselen on Noise Induced Cochlear Damage / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: With the advancement of modern civilization and mechanical development of society, the prevalence of noiseinduced hearing loss is increasing. There were some suggestions that noise-induced hearing loss may be reduced or prevented with antioxidant treatment. The purpose of this study is to evaluate the effect of ebselen as a free radical scavenger or antioxidant in noise-induced cochlear damage. MATERIALS AND METHOD: Thirty male Sprague Dawley rats (250-300 g) with normal auditory brainstem response (ABR) thresholds were exposed for 6 h to 115 dB SPL broad band noise. 10 mg/kg ebselen were injected intraperitoneally at 12 h before and 1h before noise exposure. After noise exposure, auditory brainstem response threshold shifts were evaluated. A study for iNOS and nitrotyrosine expressions in the cochlea was examined by immunohistochemical staining. RESULTS: After the noise exposure, auditory brainstem responses indicated that ebselen treatment reduced threshold shifts significantly. The expression of iNOS and nitrotyrosine were observed in hair cells, supporting cells of the organ of Corti, stria vascularis and spiral ganglion. The expression of iNOS and nitrotyrosine were lower in the ebselen treated group than in the non-treated group. CONCLUSION: Ebselen protects cochlea from noise by playing a role as a scavenger of reactive free radicals.

Effects of Ebselen on Ozone-Induced Nasal Mucosal Inflammation in Mice / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although the mechanism of ozone-induced airway inflammation and hyperresponsiveness is largely unknown, NO and peroxynitrite has been suggested to be associated with it. Ebselen, a seleno-organic compound, is known to inhibit the production of superoxide, iNOS-related NO, and their combined product, peroxynitrite. The purpose of this study is to investigate whether ebselen suppress ozone-induced nasal inflammation and whether ebselen inhibit the production of NO and peroxynitrite in nasal mucosa. SUBJECTS AND METHOD: Thirty-six BALB/c mice were divided into three groups: control group, ozone exposure group, and ozone+ebselen treated group. In the ozone exposure group, mice were exposed to 1 ppm ozone for 8 hours a day for 3 consecutive days. In the ebselen treated group, the ebselen (32.5 mg/kg) solution was injected intraperitoneally 1 hour before and 3 hours after the ozone exposure. At 18 hours of the last ozone exposure, Evans blue was infused via tail vein in 6 animals of each group. Mice were sacrificed five minutes later and nasal mucosa was obtained to measure the amount of extravasated Evans blue dye. From the remaining 6 animals in each group, nasal lavage fluid (NLF) was obtained to measure the concentration of albumin and the number of neutrophils. After lavage fluid was obtained, nasal mucosa was taken for immunohistochemical staining against iNOS and nitrotyrosine usng the ABC method. RESULTS: Extravasation of Evans blue was significantly increased in the ozone exposure group, but it was significantly decreased in the ebselen treated group. Albumin concentration in NLF showed a tendency to increase in the ozone exposure group and a tendency to decrease in the ebselen treated group when compared with the ozone exposure group. The number of neutrophils was significantly increased in the ozone exposure group and was decreased more in the ebselen treated group than in the ozone exposure group. Immunoreactivity to iNOS and nitrotyrosine was strongly expressed in nasal mucosa of the ozone exposure group. However, it was nearly abolished by the treatment with ebselen. CONCLUSIONS: These results may suggest that ebselen can be applied as a useful therapeutic agent for airway diseases by modulating the oxidant-related inflammatory process.

Prevention of Posterior Glottic Stenosis by Mitomycin-C in a Rabbit Model / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Posterior glottic stenosis (PGS) is a disabling disease and most commonly induced by trauma from endotracheal intubation. We performed a randomized, controlled study with three animal groups to investigate the preventive effect of mitomycin-C on the posterior glottis undergone laser injury. MATERIALS AND METHOD: Twenty rabbits were available for evaluation. Group 1 (n=7) and 2 (n=6) were treated with topical mitomycin-C of 0.4 and 1.0 mg/ml, respectively, with the group 3 (n=7) used as the control. All animals underwent laser injury of 6 W, continuous mode on the posterior glottis. Group 1 and 2 were treated by a single topical use of cottonoid soaked in mitomycin-C solution on the injured posterior glottis for 5 minutes and the group 3 by saline. The posterior glottis of all groups was evaluated by telescopic examinations under direct laryngoscopy 2 months after the injury and was harvested for histological staining with hematoxylin-eosin and Masson trichrome. RESULTS: The scar, granulation tissue and synechia formation of the posterior glottis was clearly induced by laser injury. Microscopic examinations showed increased collagen content and fibroblast proliferation in the region. Topical use of mitomycin-C significantly decreased the incidence of such gross and microscopic changes of the posterior glottis (p<.05). CONCLUSION: Mitomycin-C prevents PGS via its anti-proliferative effect on fibroblasts. The use of Mitomycin-C is warranted for patients with a history of prolonged intubation or for those who have undergone surgery of the posterior glottis.

Osteoma: Presenting as a Retroauricular Mass / 대한이비인후과학회지

Osteomas in the head and neck regions are uncommon benign lesions and usually found in the front ethmoid area. Temporal bone osteoma is an extremely rare entity. When it is located in the temporal bone, it may cause various symptoms such as hearing loss, tinnitus, vertigo, facial palsy and cosmetic deformities such as auricular protrusion and external mass. We report, with a short review of the relative literature, a case of large osteoma that originated from a squamomastoid portion of the temporal bone in a female patient of 20 years old.

A case of secondary amyloidosis due to bronchiectasis / 대한내과학회지

The Amyloidosis represent a heterogeneous group of disorders characterized by abnormal extracellular and endothelial accumulation of insoluble proteins. This disorder displays variable clinical symptoms depending upon the involved organ and a diagnosis is rendered through a biopsy of the affected organ, follwed by staining using Congo-red which reveals an apple-green birefringence. We report a case of secondary amyloidosis diagnosed incidentally by endoscopic gastric and sigmoid colon mucosal biopsy in a patient who had history of bronchiectasis and recurrent pneumonia, pseudomembranous colitis and paralytic ileus.

Repeated Ozone Exposure Induces Th2 Immune Responses in Mice

BACKGROUND AND OBJECTIVES: It has been reported that ozone exposure exacerbate allergic rhinitis symptoms and may contribute to increase allergic rhinitis prevalence. However, a causal relationship still remained unsolved. The purpose of this study is to investigate whether prolonged exposure to ozone induce Th2 immune response without allergen. MATERIALS AND METHODS: Fourteen BALB/c mice were divided into two groups: control group and ozone exposure group. Mice were exposed to 0.3 ppm of ozone for 4 hours a day, 3 times per week, for 4 weeks. At 24 hour after the last ozone exposure, nasal lavage fluid (NLF) was obtained to measure the levels of cytokine IL-4, IL-5, and IFN-gamma. After lavage fluid was obtained, blood was obtained via inferior vena cava to measure the amount of total IgE and IgG1. The concentration of cytokines and immunoglobulins was measured using the ELISA method. In addition, Luna staining was performed to identify eosinophils infiltrated in nasal mucosa. RESULTS: The levels of IL-4 and IL-5 in NLF were significantly increased in ozone exposure group compared with control group. But the level of IFN-gamma in NLF shows no significant difference between two groups. Serum total IgE and IgG1 were significantly increased in ozone exposure group compared with control group. On histologic examination, number of eosinophils infiltrating nasal mucosa was significantly increased in ozone exposure group. CONCLUSION: These results suggest that repeated ozone exposure induces Th2 response in the nasal mucosa of mice.