Acute Embolic Attack on Persistent Sciatic Artery: 1 case

Persistent sciatic artery (PSA) is a continuation of the internal iliac artery into the popliteal-tibial vessels and this structure provides the major blood supply to the lower limb bud during early embyrologic development, Its remnants participate in the formation of the inferior gluteal, deep femoral, popliteal, peroneal and pedal vessels. When the femoral artery develops, the PSA then involutes. In rare circumstances it persists and so provides the only major blood supply to the lower limb. The PSA was first reported by Green in 1832 and until now, only about 100 cases have been reported in the world literatures. This rare vascular anomaly is associated with aneurysmal formation in 15% to 46% of cases and it has a bilateral location in 22% of PSA cases. In more than 40% of cases, PSA is asymptomatic. When present, such non-specific symptoms as gluteal pain and painful buttock mass are presented. However, the most frequent clinical finding is lower limb ischemia because in 25% of such cases, the presented symptoms are limb threatening. We describe here the case of a 54 year-old female affected with PSA occlusion, and she was treated with a combination of thrombolysis and thromboembolectomy.

External Anatomic Localization of Sentinel Lymph Nodes in Breast Cancer: Relationship with Axillary Hair Line and Pectoralis Major Muscle / 한국유방암학회지

PURPOSE: Recent studies have shown that the false negative rate of sentinel lymph node (SLN) biopsy is less than 5% and SLN biopsy is accepted as a highly accurate method for evaluating axillary lymph node metastasis in breast cancer. Purpose of this study was to evaluate the relationship between the location of SLNs and external anatomical structures of axilla in order to help a proper skin incision. METHODS: Between July 2001 and May 2002, SLN biopsies were performed in 25 breast cancer patients. SLNs were detected by hand-held gamma probe after subareolar injections of 99m-Tc antimony sulfur colloid. The location of the SLNs was indicated in terms of distance and direction from the lateral border of pectoralis major muscle and the axillary hair line. Breast conserving surgery or mastectomy was performed with axillary dissection in all cases. RESULTS: The location of tumors was the upper outer quadrant in 11 cases; the central portion in 4 cases; the upper inner quadrant in 4 cases; the lower inner quadrant in 3 cases; and the lower outer quadrant in 3 cases. Lymph nodemetastases were found in 5 cases of which SLNs were only metastatic nodes in 2 cases. The mean number of SLNs was 1.6. The false negative rate of SLN biopsy was 4.0% (1/25), giving a diagnostic accuracy of 96.0% (24/25). All the SLNs were located between the lateral border of pectoralis major muscle and the axillary hair line and the distance from the inferior tip of the hair line was as follows: 2 cases within 0.5 cm; 3 cases between 0.6 cm and 1 cm; 14 cases between 1.1 cm and 1.5 cm; 2 cases between 1.6 cm and 2.0 cm; 3 cases between 2.1 cm and 2.5 cm; 1 case between 2.6 cm and 3.0 cm. All the SLNs were located within a 3 cm diameter circle between the axillary hair line and the lateral border of pectoralis major muscle. CONCLUSION: The SLNs in breast cancer are located in a small area between the lateral border of pectoralis major muscle and the axillary hair line.

A Case of Ossifying Fibroma Arising in the Right Ethmoid Sinus and Nasal Cavity / 대한이비인후과학회지

Ossifying fibroma, a rare tumor entity, is a well-demarcated benign fibrous-osseous tumor composed of bone, fibrous tissue, and cementum. It is commonly found in the mandible, but also found in the maxilla and paranasal sinuses. Simple curettage is enough when the fibrous lesions are located in the mandible; however, complete en bloc excision is required in the maxilla and paransal sinuses to relieve symptoms and to prevent recurrence. With the advent of sinonasal endoscopy in the mid-1980s and subsequent advances in surgical techniques, endoscopic management of the fibrous-osseous lesions has become feasible. We experienced a successful removal of the huge ossifying fibroma which occupied right ethmoid sinus and nasal cavity by endoscopic approach.

Experimental Immune-Mediated Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In 1979, MaCabe described the autoimmune sensorineural hearing loss generally characterized by bilateral progressive sensorineural hearing loss over weeks to months. He also described steroid responsiveness of heaing loss. Since then, numerous attempts have been tried to investigate autoimmune inner ear disease. But, there is insufficient information concerning pathophysiology and no reliable laboratory tests are available for diagnosis. In this study, we immunized healthy rats with bovine brain antigen, and monitored auditory brainstem response threshold shifts and serum antibody titer especially antibody to 68 kD protein, and observed histologic changes to develop animal model and to investigate pathophysiology of inner ear autoimmunity. MATERIALS & METHODS:We used 15 female Wistar rats weighing 200 g to 250 g. Three of them (as control group) were immunized with bovine serum albumin and the rest were weekly immunized with bovine brain antigen 3 times. After the antigen challenges, animals were sacrificed at 1st, 2nd, 4th or 8th week after collection of serum and ABR test. Hearing was evaluated by ABR prior to each immunization and at 1st, 2nd, 3rd, 4th, 6th or 8th week following immunization. Collected sera were analyzed by Western blotting immunoassay against fresh bovine brain antigen preparation. RESULTS: On ABR, hearing threshold shifts of 10 to 40 dB were recorded and shifts of greater than 20 dB were recorded in 8 ears (33.3%) of 24 ears. On Western blot assay, a band at 68 kD M.W. was observed with high binding activity at 1st week through 4th week following immunization. Cellular infiltration was observed in the are as adjacent to the spiral modiolar venules in the cochlear modiolus and in the spiral ganglion cells in a scattered pattern. CONCLUSION: These results suggest that bovine brain antigen can induce autoimmune inner ear disease in experimental animals and that inner ear autoimmunity may play an important role in the development of inner ear disorders and hearing loss.

Effect of PDGF-AA on the Healing Process of Tympanic Membrane Perforation and Expression of PDGF-Receptor and Fibronectin / 대한이비인후과학회지

BACKGROUND: In recent years, repair of tympanic membrane(TM) perforation has been investigated using growth promoting factors. Platelet derived growth factor(PDGF), basic 30kD cytokine, promotes wound healing by its mitogenicity for fibroblast and stimulation of the production of fibronectin and hyaluronic acid. OBJECTIVES: The purpose of this study is to investigate the effect of PDGF-AA on the healing process of TM perforation. MATERIALS AND METHODS: The effects of PDGF on the healing process of TM perforation was investigated in rats using the endoscope and light microscope after topical application of 2ug of PDGF-AA or placebo on the edge of TM perforation. The rats were sacrificed at 3, 5, 7, 9, 11, 13 and 15 days following the surgery of TM. The tympanic membranes were also immunohistochemically examined for PDGF-Ralpha and fibronectin to evaluate the mechanism of healing process in the PDGF-treated-TM. RESULTS: 1) Application of PDGF-AA accelerated the healing process of TM perforation and the wound was completely closed at 5 days following surgery. 2) PDGF-AA induced prominent proliferation of the connective tissue layer of TM after surgery, however the connective tissue growth has reduced at 2 weeks following surgery. 3) PDGF-Ralpha was intensely expressed in the epithelial layer of the PDGF-AA-treated TM. 4) Intense expression of fibronectin was observed in the fibroblasts of the connective tissue layer of the PDGF-AA-treated TM. CONCLUSION: From this study, we concluded that PDGF may play a role in the imm-unoregulation of the healing process of TM perforation and it may be an alternative to the surgical management of TM perforation.

Morphological Changes of Cochlear Hair Cells in the Streptozotocin-Induced Diabetic Rat / 대한이비인후과학회지

BACKGROUND: Diabetes Mellitus has been known as a multisystemic disorder for a long time. An association between diabetes and hearing loss was first postulated in the one case report published by Jordao in 1857. The typical hearing loss from diabetes is a progressive and bilateral sensorineural deficit that predominantly occurs in the high frequency and in the elderly patients. OBJECTIVES: The purpose of this study was to investigate the morphological changes of cochlear hair cells in the insulin-dependent diabetes mellitus induced by Streptozotocin. MATERIALS AND METHODS: Thirty two rats were used for this study and divided into control and diabetic group. Furthermore each group was subdivided into 4 weeks, 8 weeks, 12 weeks and 16 weeks group. All experimental animal were put in the same environmental condition. Insulin-dependent diabetes mellitus was induced by intravenous injection of Streptozotocin (65 mg/kg of body weight). Hair cell loss and their ultrastructural changes were observed with phase contrast light microscope and transmission electron microscope. CONCLUSION: The results of this study suggest that metabolic change of diabetes mellitus may affect the cochlear hair cells.

Skeletal muscle metastasis from lung cancer: A case report / 대한정형외과학회잡지

No abstract available.

Relationship between traumatic spinal canal stenosis and neurologic deficits in thoracic and lumbar burst fractures / 대한정형외과학회잡지

No abstract available.