BACKGROUND AND OBJECTIVES: Endoscopic approach to the neck is more widely used since it was first reported by M.Gagner in 1996, because of its low invasiveness and better cosmetic result. In this article, we introduce a surgical technique of video-assisted endoscopic thyroidectomy via cervical approach and assess its efficacy for patients with thyroid nodule. SUBJECTS AND METHOD: Eleven patients hospitalized in our department from May to September 2004, underwent video-assisted thyroidectomy with cervical approach. The subjects were 9 women and 2 men with ages ranging from 23 to 62 year old (mean 40.9 years). Inclusion criteria for the subjects were having benign solitary tumor that is less than 30 mm in longitudinal diameter, low risk micropapillary carcinoma that is less than 1 cm, confined to one lobe, within the thyroid gland, and without lymph node swelling on ultrasonography or computed tomography, and follicular neoplasm that is without evidence of any malignancy or with suspicious and indeterminate cytology among patients with no prior neck surgery or previous radiotherapy. Most patients (82%) had thyroid mass less than 2 cm. Nodular hyperplasia was 7 cases and papillary carcinoma was 4 cases. RESULTS: Hemithyroidectomy with or without isthmusectomy was performed in 10 patients. Video-assisted thyroidectomy was converted into conventional thyroidectomy in only one case because of the uncontrolled intraoperative superior thyroid artery bleeding and large thyroid volume. The operation time was 80+/-12 minutes. Temporary recurrent laryngeal nerve palsy occurred in one case. The average postoperative hospital stay was 5.0+/-1.8 days. Operative scars were small and most patients were satisfied with the cosmetic result. CONCLUSION: We conclude that the video-assisted endoscopic thyroidectomy with cervical approach is feasible, practical, and has safe procedures, and has greater cosmetic benefits than the conventional one. We hope that video-assisted thyroidectomy will become another surgical option for small nodular thyroid diseases.
Arteries ; Carcinoma, Papillary ; Cicatrix ; Endoscopy ; Female ; Hemorrhage ; Hope ; Humans ; Hyperplasia ; Length of Stay ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Radiotherapy ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy* ; Ultrasonography ; Vocal Cord Paralysis

BACKGROUND AND OBJECTIVES: In general, for surgical treatment of septal perforation, a suture repair method is necessary for at least unilateral intranasal mucosal flap with the interposition of a connective tissue graft. However, autologous graft material is sometimes insufficient when septal perforation repair is combined with other surgery such as rhinoplasty. The aims of this study were to introduce a new repair technique of septal perforation using silastic sheet and to assess the usefulness of the new method. SUBJECTS AND METHOD: Between March 2003 and September 2004, 5 patients underwent septal perforation repair using silastic sheet with open rhinoplasty at the same time. Size and causes of septal perforation, symptoms, and complication were evaluated by endoscopic examination and questionnaires pre- and postoperatively. RESULTS: The causes of septal perforation were previous septoplasty (3 cases), syphilis (1 case) and unknown (1 case). Preoperative symptoms including nasal obstruction, rhinorrhea, epistaxis and dryness were all improved postoperatively. The perforations of all patients were 1.0 cm sized or more in diameter. Four of five patients (80%) achieved complete closure and one patient had an incomplete closure after a mean follow up of 16 months. CONCLUSION: The repair of septal perforation using silastic sheets is a very useful technique when the size of septal perforation is more than 1 cm large in diameter or when the autograft material is insufficient.
Autografts ; Connective Tissue ; Epistaxis ; Follow-Up Studies ; Humans ; Nasal Obstruction ; Nasal Septal Perforation* ; Nasal Septum ; Surveys and Questionnaires ; Rhinoplasty ; Sutures ; Syphilis ; Transplants

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the otolithic effects of galvanic vestibular stimulation on the perception of subjective visual vertical in normal subjects. SUBJECTS AND METHOD: Fifteen normal subjects were selected on the basis of medical history and neurological examination. We measured subjective tilt of a central vertical line during galvanic vestibular stimulation (0, 1.0, 2.5, 4.0 mA). Binaural and monaural electric current was applied to each subject's mastoid and forehead for vestibular stimulation. RESULTS: Anodal stimulation of the right mastoid led to clock-wise subjective visual vertical. Anodal stimualtion of the left mastoid led to counter clock-wise subjective visual vertical. There was a correlation between the amount of the measured parameter and the strength of the applied current. More consistent parameters were obtained from the binaural stimulation than the monaural stimualtion. CONCLUSION: Galvanic vestibular stimulation had effects on the vestibular functions, making changes in the subjective visual vertical. Since the galvanic stimulation had consistency with the direction of the stimulation and was proportionate to the intensity, it is thought to be a useful method for assessing otolith functions.
Electric Stimulation ; Forehead ; Mastoid ; Neurologic Examination ; Otolithic Membrane

For the purpose of prenatal diagnosis of CAH, genetic linkage analysis by HLA genotyping with lymphocytes and cultured amniotic cells were performed in a family at risk in which two consecutive children had been affected with SW CAH. In addition, the response of serum 17-OHP to intravenous ACTH was determined in obligate carrier parents, and 17-OHP concentration of amniotic fluid was also measured at 16 weeks of gestation. As might be expected, the baseline levels of 17-OHP in obligate parents were significantly higher than that of normal control. Although the post stimulation response of 17-OHP to ACTH in the mother (I-2) was significantly higher than that of normal control, the post stimulation levels of 17-OHP were in normal range in the father (I-1). The 17-OHP level (5.7 ng/ml) in the amniotic fluid showed intermediate value compared to Pang's report (normal less than 30 ng/ml, CAH greater than 12.0 ng/ml) suggesting heterozygote of the fetus. Genetic linkage analysis by HLA genotyping with cultured amniotic cells revealed heterozygote in their fetus (II-3) who has received one chromosome No,6 containing HLA haplotype A24, B40, Cw3 (normal allele for 21-OH) from the father and the other chromosome No,6 containing HLA haplotype A2, Bw62, Cw4 (mutant allele for 21-OH D) from the mother. In conclusion, attempts to detect heterozygote for 21-OH deficiency by ACTH stimulation test were partially successful and prenatal diagnosis of CAH by the hormone studies in ammiotic fluid requires reliable values in normal, heterozygotes and patients group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
*Adrenal Hyperplasia, Congenital/*diagnosis/enzymology/genetics ; Adult ; Amniocentesis ; Cells, Cultured ; Female ; Fetal Diseases/*diagnosis/enzymology ; HLA Antigens/analysis ; Heterozygote Detection ; Humans ; Pedigree ; Pregnancy ; *Prenatal Diagnosis ; Steroid Hydroxylases

No abstract available.
Carcinoma, Hepatocellular ; Colon ; Neoplasm Metastasis

BACKGROUND AND OBJECTIVES: We assessed olfactory function change in patients with chronic sinusitis who received endoscopic sinus surgery. By comparing the olfactory test results of two different age groups, we determined whether age affected postoperative olfactory function. SUBJECTS AND METHOD: Twenty patients with chronic sinusitis (2 age groups, with 10 patients in the forties and 10 patients in the seventies), who underwent endoscopic sinus surgery were selected. We used preoperative OMU CT and nasal endoscopy examination to evaluate the severity of sinusitis and polyp. Preoperative and postoperative nasal symptoms were assessed by questionnaires. The improvement of olfactory function after endoscopic sinus surgery was evaluated by olfactory function tests (T & T olfactometer and CCCRC test) preoperatively and postoperatively. RESULTS: There was no significant difference in the severity of chronic sinusitis in both groups. Significant improvement of olfactory function was seen in both groups. There was no significant differences in the improvement of olfactory function between younger and older groups. CONCLUSION: Though old aged patients with chronic sinusitis have olfactory dysfunction, active surgical treatment is effective in the improvement of olfactory function.
Aged ; Endoscopy ; Humans ; Olfaction Disorders ; Polyps ; Surveys and Questionnaires ; Sinusitis

delta12-Prostaglandin J2 (delta12-PGJ2) is one of cyclopentenone prostaglandins. The delta12-PGJ2 is known to induce apoptosis of tumor cells, however, it's action mechanism is not clear. It has recently been reported that STAT3 is involved in tumorigenesis. In the present study, we investigated the role of STAT3-interacting protein (STIP1) in the cytotoxicity of delta12-PGJ2, since STIP1 was recently reported as a modulator of STAT3 activation by specifically binding to inactive (unphosphorylated) STAT3. The effect of delta12-PGJ2 was observed in stably overexpressing Neuro-2A cells transfected with full cDNA of STIP1, and cytotoxicity of delta12-PGJ2 in the transfected cells was increased, compared with the vector control cells. The cytotoxicity of delta12-PGJ2 treatment was significantly accentuated by pretreatment of the STIP1-transfected cells with protein kinase inhibitor, genistein, and less activation of STAT3 in STIP1-transfected cells was shown, compared with the vector control cells. Expression of bax was also increased in the STIP1-transfected cells. These data suggest that STIP1 inhibits cell growth via inhibition of STAT3 activation in delta12-PGJ2 treatment.
Apoptosis ; Carcinogenesis ; Cell Death* ; DNA, Complementary ; Genistein ; Prostaglandins ; Protein Kinases

BACKGROUND AND OBJECTIVES: Ductal calculi and stenosis are well known causes of salivary ductal obstructive lesions. As a direct view of the ductal systems was not possible for the surgeons, sialendoscopy has been a convenient tool for finding out these obstructive lesions. This study contains some unusual endoscopic findings that we have found during diagnostic and interventional sialendoscopy. SUBJECTS AND METHOD: Retrospective chart reviews were done, and endoscopic findings were reviewed for patients who received sialendoscopy from September 2003 to January 2007. Sixtyfour patients received sialendoscopy for either diagnostic or interventional method. RESULTS: We found unusual findings in 7 cases (10.9%). Three cases of basin malformation were observed. Two cases had spontaneous ductal perforation, and we also observed 2 cases of occult stone. CONCLUSION: The sialendoscopy is an excellent method in evaluating and treating salivary ductal diseases. We found out that the sialendoscopy made it possible to explore ductal systems completely, as well as to detect unusual findings, and to help in the management of some salivary ductal diseases.
Calculi ; Constriction, Pathologic ; Humans ; Retrospective Studies ; Salivary Ducts ; Salivary Gland Calculi ; Salivary Glands

BACKGROUND AND OBJECTIVES: To predict postoperative pulmonary complication in patients with conservative laryngectomy, variable factors such as pulmonary function test (PFT) have been reported. Therefore, we reviewed the relationships between postoperative pulmonary complications and preoperative risk factors including the parameters of PFT. PATIENTS AND METHOD: From 1997 Jun. to 2005 July., conservative laryngectomy was performed under diagnosis of laryngeal cancer in 36 patients. The factors related to age, history of lung diseases, the parameters of PFT (FEV1, FEV1/FVC and FVC), and the types of surgery were analyzed to evaluate the postoperative pulmonary complication. We used a retrospective analysis of medical records and Fisher exact method to verify the relationships between preoperative risk factors and the pulmonary complications. RESULTS: 8 patients had postoperative pulmonary complication. Age, history of lung diseases and PFT parameters had no statistical significance. Among them, 7 patients and 1 patient had takensupracricoid laryngectomy and supraglottic laryngectomy, respectively. Supracricoid laryngectomy cases had more significant postoperative pulmonary complications than vertical partial laryngectomy cases. CONCLUSION: Age, the history of lung diseases, and parameters of PFT had no predictable value for postoperative lung complications. In the comparison between the surgery types, only supracricoid laryngectomy cases had statistical increase of postoperative pulmonary complications.
Diagnosis ; Humans ; Laryngeal Neoplasms ; Laryngectomy* ; Lung ; Lung Diseases ; Medical Records ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors

Calcifying epithelial odontogenic tumor (CEOT) is a rarely reported benign tumor, accounting for 0.4-3% of all odontogenic tumors. Approximately 150 cases have been reported in the literature between 1958 and 2003. The age range of CEOT varies from 8 to 92 years with mean of 36.9 years, and the occurrence of the lesion in both genders is almost equal. It has 2 clinico-topographic variants: the intraosseous (94%) and the extraosseous (6%) type. The intraosseous type has a predilection for mandible (maxilla : mandible ratio of 1 : 2). The intraosseous CEOT commonly associated with non-erupted teeth accounts for more than half (52%) of the cases and usually appears as painless swelling that causes bony expansion. The location of diffused round-shaped calcifying material is inside the connective tissue stroma and epithelial islands. The tumors tend to be located toward the tooth crown, which usually has a unilocular radiolucent region containing variant radiopaque materials radiologically. In this paper, we report a case of CEOT occurring in the left mandibular first premolar of a 23-year-old female and present a brief review of the literature.
Accounting ; Bicuspid ; Connective Tissue ; Female ; Humans ; Islands ; Mandible ; Odontogenic Tumors ; Skin Neoplasms ; Tooth ; Tooth Crown ; Young Adult