ABSTRACT
BACKGROUND AND OBJECTIVES: Because most patients with Wegener's granulomatosis (WG) visit otolaryngologists complaining of head and neck symptoms, otolaryngologists may play an important role in early diagnosis. In this study, we investigated clinical features, laboratory findings and treatment outcomes of 33 patients with WG, and propose a new algorithm for the diagnosis of WG. SUBJECTS AND METHOD: Thirty-three patients with WG who visited the clinic between January 1980 and December 2007 were included. The medical records of 13 male and 20 female patients were retrospectively reviewed. The mean follow-up duration was 68 months. RESULTS: Most WG patients had ENT symptoms such as nasal obstruction, rhinorrhea, otorrhea, hearing loss, dyspnea and hoarseness. The mean duration from ENT examination to diagnosis was 6.7 months (3 days- 102 months) and tissue biopsy was performed on an average of 2.1 times to confirm the diagnosis. While 16 patients could be diagnosed by the first biopsy, the others were required to repeat the biopsy. ANCA was positive in 17 patients (50%). Twentysix patients (78.7%) had multiple organ involvements such as lung, kidney, joint and skin. Twenty-eight patients received a combination of prednisolone and cyclophosphamide with the remission rate of 87%. CONCLUSION: Based on this study, we propose a better algorithm for the diagnosis of WG to avoid unnecessary delay in the diagnosis and treatment of WG.
Subject(s)
Female , Humans , Male , Antibodies, Antineutrophil Cytoplasmic , Biopsy , Cyclophosphamide , Dyspnea , Early Diagnosis , Follow-Up Studies , Head , Hearing Loss , Hoarseness , Joints , Kidney , Lung , Medical Records , Nasal Obstruction , Neck , Prednisolone , Retrospective Studies , Skin , Granulomatosis with PolyangiitisABSTRACT
BACKGROUND AND OBJECTIVES: The aim of this study is to identify differences in polysomnographic findings according to the upper airway obstruction level in patients with obstructive sleep apnea (OSA). SUBJECTS AND METHOD: Eighty-four patients with OSA were included in this study. Every patient underwent polysomnography (PSG) and upper airway pressure measurement using a four-sensor catheter simultaneously. The catheter was positioned at the posterior nasal cavity, uvula tip, tip of the epiglottis, and mid-esophagus level, which was inserted through the nasal cavity down to the esophagus. The patients were categorized into two groups of single site obstruction and multi-site obstruction. RESULTS: Twenty-one patients showed single site obstruction and sixtythree patients showed multi-site obstruction. Apnea-hypopnea index, apnea index, and minimal oxygen saturation showed statistically significant differences between two groups. There was no difference in bony mass index (BMI). CONCLUSION: Upper airway pressure measurement can be a method to evaluate the upper airway obstruction site. This study shows that OSA patients with multisite obstruction have severer sleep apnea than those with single site obstruction.
Subject(s)
Humans , Airway Obstruction , Apnea , Catheters , Epiglottis , Esophagus , Nasal Cavity , Oxygen , Polysomnography , Sleep Apnea Syndromes , Sleep Apnea, Obstructive , UvulaABSTRACT
Hepatic hemangioma is a benign neoplastic disease of the liver and characterized by high vascularity and accompanied with bleeding episode. We report a case of giant hepatic cavernous hemangioma and review the literature briefly. A 44-year old female patient was admitted because of palpable abdominal mass, which growing for 15 years. She was diagnosed as hepatic hemangioma by abdominal CT scan and selective celiac angiography. She was performed the left lateral segmentectomy of liver and the pathological report was cavernous hemangioma of the liver.