Disseminated peritoneal leiomyomatosis arising after laparoscopic myomectomy / 대한산부인과학회지

Disseminated peritoneal leiomyomatosis is rare condition characterized by multiple subperitoneal nodules of benign smooth muscle proliferations. It is associated with high level of estrogen such as pregnancy, oral contraceptives or estrogen producing ovarian tumor, and occasionally associated with operation history of myomectomy or hysterectomy. Clinical course of disseminated peritoneal leiomyomatosis is usually benign, but malignant changes also rarely have been reported. We experienced a case of disseminated peritoneal leiomyomatosis who has history of laparoscopic myomectomy 10 years ago. The patient was a 35-year-old woman, and her chief complaint was palpable masses in lower abdomen. She underwent laparoscopic surgery which revealed numerous solid masses on the surface of peritoneum, descending colon, rectosigmoid colon, uterus, round ligament, and broad ligament. We present it with a brief review of literature.

A case of sequent occurrence of mature and immature teratomas in same patient / 대한산부인과학회지

Ovarian teratomas are the most common germ cell neoplasm. They include mature cystic teratomas, monodermal teratomas (neural tumors, struma ovarii, carcinoid tumors) and immature teratomas. Malignant transformation of mature teratoma is very rare event and a case of sequence occurance of mature teratoma and immature teratoma in same patient is not reported yet in Korea. A 17-year-old female was found to have a huge mature teratoma of the right ovary 3 years ago. That was treated with surgery. Three years later, Immature teratoma was discovered in left ovary and treated with surgery followed by chemotherapy. We experienced one case of sequent occurrence of mature teratoma and immature teratoma on both ovary in same patient. We present it with a brief of literature.

Diagnosis and Treatment of Extracranial Arteriovenous Malformations in the Head and Neck Region / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Arteriovenous malformation is a vascular malformation with fast-flow shunt from the artery to the vein. Extracranial arteriovenous malformation in the head and neck (HNAVM) is so rare that there have been no systematical reports related to it in Korea. Authors aimed to suggest the treatment protocols for HNAVM through retrospective analysis. SUBJECTS AND METHOD: We reviewed retrospectively the medical records of 19 patients with extracranial HNAVM, who had been diagnosed and treated between 1995 and 2001. Mean follow-up duration was 27.3 months. The mean age at detection was 13.2 years old. The cheek was the most frequently suffered site. We used MRI, angiography, and 99mTechnetium (Tc) RBC scintigraphy for the diagnosis and follow-up of HNAVM. For the treatment, ethanol sclerotherapy, excision, and embolization were adopted alone or in variable combination. RESULTS: Angiography was confirmative of the diagnosis and MRI was excellent in evaluating the extent of the disease. Ethanol sclerotherapy was used as the first line of treatment for 11 cases. For others, surgical excision combined with embolization was used as the first line of treatment for 7 patients and the second choice for 6 patients. 99mTc RBC scintigraphy was useful in quantifying the response after treatment. Fifteen out of 19 patients finally achieved 75% or more reduction in their size of lesions. There were 5 permanent complications from the total of 37 procedures. CONCLUSION: For those cases of HNAVM that had the nidus accessible via the percutaneous route, ethanol sclerotherapy worked as the first-line treatment. For other HNAVM cases, surgical excision with embolization might be the best choice of treatment.

Initial Treatment and Conservation Salvage Surgery of Early Glottic Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Surgery or radiation therapy is most widely employed in the treatment of early glottic cancer with no significant difference in the survival rate. Various treatment modalities including surgery, radiation therapy or combined therapy can also be adopted for recurring early glottic cancer. Nowadays, conservation salvage surgery presents as an excellent alternative to the traditional total laryngectomy with favorable results. The objective of this study is to compare the outcome of each treatment modality for early glottic cancer and evaluate the role of conservation salvage surgery for recurring cases. SUBJECTS AND METHOD: Seventy-three patients with early glottic cancer (stage Tis, T1, T2 N0M0) were treated between January 1995 and December 2001, and followed up for at least over an year. They were divided into two groups with the standards of whether they had surgery or radiation therapy as an initial treatment. Then, both groups were analyzed for local control and recurrence rate after initial treatment and conservation salvage surgery for recurrent case, respectively. RESULTS: Twenty-four patients had conservation surgery and 49 had radiation therapy as an initial treatment. Local control rate was 100% for conservation surgery, 93.9% for radiation therapy and there was no significant difference between groups. Recurrence rate for each group was 8.3% and 15.3%, respectively, but no statistical difference was found. Twelve patients showed recurreence or had remnant cancer. Conservation salvage surgery including laser cordectomy, hemilaryngectomy, frontolateral hemilaryngectomy, and supracricoid partial laryngectomy had been performed in 10 cases. In all cases, laryngeal preservation was possible and there was no recurrence of tumor during follow up periods. CONCLUSION: As an initial treatment modality, conservation surgery and radiation therapy was proven to be equally effective for early glottic cancer with no significant difference in local control and recurrence rate. For the recurrent cases, conservation salvage surgery including supracricoid partial laryngectomy was shown to be a very useful treatment modality with good oncological results and excellent laryngeal preservation.

The Histopathologic Findings as a Prognostic Indicator after Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There have been many studies concerning prognosis after endoscopic sinus surgery showing that the prognosis showing that chronic sinusitis patients with asthma is poorer than those without asthma. But, there are only a few reports about histopathology of chronic sinusitis with asthma and correlation between prognosis. The aim of this study is to investigate histopathology of chronic sinusitis and relevance of prognosis after surgery. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 83 chronic sinusitis patients who had undergone endoscopic sinus surgery from 1995 through 1997 at our institution. We compared 7 parameters of sinus mucosal histophathology, allergy and OMC CT between grups with good and poor outcomes. RESULTS: The study revealed no statistical differences on the presence of allergy, OMC CT. However, the poor outcome group showed significant lymphocytes and eosinophils infiltrations with univariant analysis, whereas asthma was proved to be statistically different with multivariant analysis. CONCLUSION: The more lymphocytes and eosinophils infiltrate the mucosa, the poorer the prognosis after endoscopic sinus surgery in the chronic sinusitis patients get. We assume that there will be a good prognostic factor after surgery, and that adequate management and careful follow-up should be taken of patients showing such histopathologic findings.

The Significance of Serum Eosinophil Count in Chronic Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We previously reported that the more eosinophils infiltrate in the mucosa, the poorer the prognosis gets after an endoscopic sinus surgery for the chronic sinusitis patients. But, there have not been any reports until now about correlation between serum eosinophils and tissue eosinophil infiltrations. The aim of this study is to investigate the relevance of serum and tissue eosinophils, and significance of serum eosinophils in chronic sinusitis. MATERIALS AND METHOD: A retrospective review of medical records was carried out on 158 patients who had undergone endoscopic sinus surgery from January, 1995 through July, 2001 at our institution. We divided them into two groups: good and poor outcome groups, then reviewed serum eosinophil counts and tissue eosinophil infiltrations, and investigated their relationship. RESULTS: There were significant statistical differences of serum eosinophils between the two groups, and significant correlation between serum eosinophil counts and tissue eosinophil infiltrations. CONCLUSION: We assume that the serum eosinophil counts is a one of the prognostic factors after endoscopic sinus surgery.

Outcome of canalith repositioning maneuver in Benign Paroxysmal Positional Vertigo

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of peripheral vestibular disorder and canalith repositioning procedure (CRP) has been popularly used as its treatment. While CRP has been advocated by some as a treatment of choice for BPPV, others have had less uniform results for this disorder. The purpose of this study is to evaluate the effectiveness of the CRP and to define the role of the CRP in BPPV. MATERIALS AND METHODS: From January, 1999 to September, 2001, 123 patients diagnosed as BPPV were included in this study. Each patient was undergone by personal history taking and Dix-Hallpike maneuver and supine head turning test for diagnosis. CRP was applied on all the patients and the patients visited OPD 1week later for evaluation. RESULTS: The mean age was 51.8 year old in males, and 52.7 year old in females. The most common cause of the disorder was idiopathic and the second common cause was post-traumatic. Posterior semicircular canal was the most common involved site and horizontal, anterior semicircular canal in order. After the initial CRP, successful results were obtained in 90 of the 123 patients (75.6%). Recurrence rate was 31 of the 123 patients and among them, 3 patients recurred in different canal. CONCLUSION: Careful observation of the nystagmus is necessary for correct identification of the canal which is involved, and that to perform the appropriate treatment. Although BPPV is known as a self-limited disorder, CRP can help to induce remission of the vertiginous symptoms in short period.