A Clinical Review of 1,060 Dizziness Cases Who Visited Patients in Emergency Room / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Dizziness is an illusion of environmental movement due to various causes. It is difficult to confirm the diagnosis of dizziness according to history and physical examination in restricted situation such as emergency room. The aim of this study is to find another clue for diagnosis in patients of dizziness who visited emergency room. SUBJECTS AND METHOD: Author retrospectively reviewed the charts of 1,060 patients of dizziness who visited emergency room at Chonnam University Hospital from July 2004 to June 2005 and accumulated the various information such as final diagnosis, clinical feature, physical examination, present illness and past history etc. RESULTS: Average age of patients was 57. The most frequently consulted department for evaluation of dizziness was the department of otolaryngology, head and neck surgery (> 29.8%). Benign paroxysmal positional vertigo (BPPV) was the most frequent final diagnosis (14.4%) in all patients. But, cerebrovascular disease was the more frequent cause for dizziness in male and old age group. Whirling type dizziness was frequent in BPPV (36.8%) and spontaneous nystagmus was detected frequently in peripheral type vertigo such as vestibular neuritis (65.1%). Average age of central vertigo patients was 61.4 and other vertigo patients was 55. Patients of central vertigo visited the emergency room more frequently in the months of Dec, Jan, Feb and patient of other vertigo visited more frequently in June, July, Aug. CONCLUSION: Various specialized departments should be involved in effective and exact diagnosis of dizziness. The organized questionnaire in addition to prevalence, incidence and characteristics of dizziness may be used in finding another clue for diagnosis and managing dizzy patients helpfully.

Neural Differentiation of Mesenchymal Stem Cells from Bone Marrow of Human Mastoid Process / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Reports of neural differentiation of mesenchymal stem cells suggest the possibility that these cells may serve as a source for stem cell-based regenerative medicine to treat neurological disorders. The purpose of this study was to generate neural cells by differentiation of bone marrow-derived mesenchymal stem cells that isolated from human mastoid process. MATERIALS AND METHOD: Human mesenchymal stem cells (hMSCs) isolated from human mastoid process bone marrow during mastoidectomy for chronic otitis media surgery were characterized using fluorescence-activated cell sorter. Induction of neural differentiation from hMSCs was performed using mitogenic factors (basic fibroblast growth factor, epidermal growth factor, forskolin, isobutylmethylxanthine), and the characterization of differentiated hMSCs was performed using immunohistochemistry, RT-PCR and whole cell patch clamp technique. RESULTS: hMSCs from bone marrow of mastoid process were isolated and cultured. Differentiated cells from hMSCs expressed mRNA transcripts for neuron specific markers, TUJ1 and neurofilament proteins (NF-L, NF-M) as determined by RT-PCR, and neuron specific markers, suhc as NeuN, TUJ1, microtubule-associated protein-2 (MAP2) and glial fibrillary acidic protein by immunohistochemistry. These cells showed voltagedependent sodium currents that was blocked by tetrodotoxin. CONCLUSION: hMSCs, which were isolated from human mastoid process bone marrow, were one of the good sources for stem cell-based regenerative medicine to treat neurological disorders.

Rosai-Dorfman Disease in the Neck and Subglottis / 대한이비인후과학회지

Rosai-Dorfman disease is a systemic disease and its etiology is not well understood. It is very rare but established disease. We report a case of Rosai-Dorfman disease occurring in the neck and subglottis. A 18-year-old female had visited with a complaint of bilateral neck mass. Subglottic mass was also detected by flexible laryngoscopy. Lymph node excision and laryngeal microsurgery were performed. The histopathologic findings demonstrated proliferative large histiocytes with clear cytoplasm and rounded nuclei, and lymphagocytosis (emperiopolesis), which were the features of Rosai-Dorfman disease. Rosai-Dorfman disease has various clinical courses. Definitive diagnosis is needed for the appropriate management.

Actinomycosis Presenting as a Nasopharyngeal Mass: A Case Report / 대한이비인후과학회지

Nasopharyngeal actinomycosis is a rare clinical disease. To our knowledge, only a few other cases of nasopharyngeal actinomycosis have been reported previously, following a nasal trauma or surgical manipulation. We report a case of actinomycosis presenting nasopharyngeal mass without prior mucosal trauma. Our patient had endonasal endoscopic excision of the infected tissue and was treated with 4 weeks of oral antibiotics therapy without any evidence of recurrence. We recommend including actinomycosis in the differential diagnosis of a nasopharyngeal mass.