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Among a variety of malignant types for parotid gland tumors, intracapsular carcinoma ex pleomorphic adenoma which is classified as a non-invasive tumor has been reported rarely. We report a case of a 69-years old patient, who presented with a left parotid mass that was detected 30 years ago. Fine needle aspiration biopsy result of the mass was “suggestive of pleomorphic adenoma”. Superficial partial parotidectomy was performed for the mass and the permanent pathologic finding was “intracapsular carcinoma ex pleomorphic adenoma” which was a salivary ductal carcinoma with well-preserved myoepithelial cells surrounding the malignant epithelial cell clusters. Surgical resection is the main treatment modality for the treatment of intracapsular carcinoma ex pleomorphic adenoma. Herein, we present the case with a review of literature.
RESUMO
Background and Objectives@#Acute low tone sensorineural hearing loss (ALHL), an acuteonset hearing loss limited to low tone, was thought to be a subtype of sudden sensorineural hearing loss (SSNHL) but also considered as new disease entity because it shows quite different symptoms, progress, and prognosis. More recently, however, it is thought that SSNHL results from chronic inflammation and thrombosis. Some studies have reported that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were high in SSNHL patients, and that they were significant as prognostic factors. The aim of this study was to evaluate the significance of NLR and PLR in ALHL.Subjects and Method From January 2009 to June 2019, we retrospectively studied 58 patients who were diagnosed with ALHL. Characteristics of patients such as sex, age, symptoms and signs, the results of serologic test and pure tone audiometry were evaluated for recovery and for recurrence. Also, we selected 58 people with the same age as control group. @*Results@#A total of 167 patients were identified, of whom a half was diagnosed with ALHL and the other half with were the control group. Among the 58 patients, the mean age was 38.0±14.5 years old, and 10 (17.2%) patients were male and 48 (82.8%) patients were female. Among the patients, 35 (60.3%) were hospitalized and 23 (39.7%) were outpatients. For recovery, 38 (65.5%) patients fully recovered while 11 (19.0%) partially recovered, and 9 (15.5%) did not recover. Additionally, 16 (27.6%) patients recurred later with similar symptoms. Between the patient group and control group, there were significant differences in the total white blood cell count, neutrophil count, NLR and PLR (p=0.015, 0.001, 0.002, and 0.025), but there was no significant differences between the recovery group and non-recovery group in any laboratory findings. Also, NLR and PLR showed no significant differences between the recurred group and non-recurred group. @*Conclusion@#NLR and PLR in ALHL patients were relatively high compared to the control group, but there were no significant differences between the recovery group and non-recovery group. Furthermore, there was no correlation between NLR and PLR with recurrence. High NLR and PLR values in ALHL patients might reflect its inflammatory etiology, but there is lack evidence for them to serve as prognostic factors.
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Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls.