Parathyroid Adenoma Causing Spontaneous Cervical Hematoma: A Case Report and Review of Literature / 대한두경부종양학회지

Parathyroid adenoma can cause extracapsular bleeding. In 1934, Capps first reported a case of massive hemorrhage secondary to rupture of a parathyroid adenoma. Recently, we experienced a 73-year-old female presented with pharyngeal discomfort and extensive ecchymosis over the neck without history of trauma. Endoscopic investigation revealed submucosal hemorrhage in the posterior wall of the hypopharynx. CT scan and ultrasonography demonstrated the presence of a mass below the left thyroid lobe. Serum calcium level was normal and PTH level was elevated. We underwent left thyroidectomy and parathyroidectomy 2 weeks later from first visit. During the operation, hypopharyngeal mucosa was teared and it was treated with pharyngostoma formation and L-tube feeding. We report a rare case of normocalcemic parathyroid adenoma with spontaneous hemorrhage and propose the proper management period with a literature review

A Case of Neurofibroma of the Vocal Cord

Solitary neurofibroma of the glottis is extremely rare and accounts for only 0.1–1.5% of benign laryngeal tumors. Aryepiglottic fold is the most frequent involved site followed by arytenoids and ventricular folds. There have been few reports of neurofibroma of the true vocal cord. We report a case of neurofibroma which was deeply embedded in the vocal cord and misdiagnosed as muscle tension dysphonia with a review of literatures.

Relationship between PTC Genotype and Taste Phenotype in Normal Volunteers / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The ability to taste the bitter compounds phenylthiocarbamide is a classic inherited trait in humans. This trait has also been shown to correlate with a number of dietary preferences and thus may have important implications for human health. Recently, the PTC gene that underlies the phenotype was identified. Three single nucleotide polymorphisms in the PTC gene that result in three aminoacid substitutions (A49P, V262A, I296V) demonstrated a strong association with taster status in several studies. The aim of this study was to investigate the relationship between PTC genotype and taster status in normal volunteers. SUBJECTS AND METHOD: Seventy-three healthy normal volunteers were included. Phenylthiocarbamide detection threshold test was performed with successive solutions, which was comprised of a total of 15 grades. PTC gene haplotypes were defined by havingsingle nucleotide polymorphisms at the base pairs, 145,785 and 886, on the PTC gene. RESULTS: Taste sensitivity to phenylthiocarbamide had a bimodal distribution, which givesrise to the practice of dichotomizing subjects into 'tasters' and 'non-tasters'. The percentages of taster and non-taster were 80.8% and 19.2%, respectively. Haplotype analyses of the three single nucleotide polymorphisms inside the PTC gene allowed to identify only two haplotypes that were associated with the non-taster phenotype (100% AVI homozygous) and the taster phenotype (49% PAV homozygous and 51% PAV/AVI heterozygous). CONCLUSION: There was strong concordance between non-tasters defined by phenylthiocarbamide threshold and AVI homozygous by genotype in normal volunteers.

Effects of Oral Corticosteroids on the Lymphocyte Subsets in Nasal Polyps / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The etiology and pathogenesis of nasal polyps are still not fully understood. In nasal polyps, infiltration of lymphocytes is one of the characteristic findings. The purpose of this study was to determine the lymphoid cell populations in various nasal polyps and the effect of corticosteroid on the lymphocytes of nasal polyps. MATERIALS AND METHODS: We carried out immunohistochemical staining for CD3, CD4, CD8, CD20, and HLA-DR monoclonal antibodies using five allergic polyps, five non-allergic polyps, five antrochoanal polyps and five steroid treated non-allergic polyps, and four normal inferior turbinates tissues. The number of positive cells in three subepithelial and three periglandular areas were counted by light microscopy at x 400 magnification in each section. RESULTS: There were no significant difference among lymphocyte subsets at different levels of nasal polyp. The proportion of CD8+ was significantly higher than that of CD4+ cells in the tissues of every nasal polyp, and CD20+ cells were rare. Corticosteroid significantly influenced the proportion of CD4+ cells. There was no difference among lymphocyte subsets between allergic and non-allergic polyps. The incidence of HLA-DR+ cells were much lower in antrochoanal polyps and inferior turbinates than in nasal polyps. CONCLUSION: The proportion of low CD4+cells, high CD8+ cells, and high HLA-DR+ cells in nasal polyp may be responsible for chronic inflammation, which would be important for the formation of nasal polyps. The difference of lymphocyte subsets and low HLA-DR+ cells may reflect the different pathogenesis of antrochoanal polyp from other nasal polyps.