Benign laryngeal injuries have been usually differentiated by the clinical finding. Traditionally the pathologic findings between the polyps and nodules by hematoxylin and eosin(H and E) staining looks alike. So we have used immunohistochemical technique to differentiate the laryngeal response to injury. We have studied 25 paraffin embedded tissues(20 cases: vocal polyps, 5 cases: vocal nodules) to compare their distribution of fibronectin and type IV collagen in vocal fold lamina propria by using their monoclonal antibodies. We have chosen fibronectin, a critical structural glycoprotein in the lamina propria, because of its deposition as a result of tissue injury and type IV collagen because of its location only in the basement membrane zone. The results were as follows: 1) In vocal polyps there were sparse fibronectin(less than normal) staining in superficial layer of lamina propria and the type IV collagen staining in basement membrane zone shows thin, normal thickness band form. These suggests that the injury often seems to be confined to the lamina propria only without basement membrane zone disruption. 2) In voal nodules there were intense fibronectin staining(more than normal) in the superficial layer of the lamina propria and the type IV collagen band in basement membrane shows thick and often coupled with disruption injury. The above results represent only two structural proteins, but it may be possible to suggest that the pathogenesis and the development origin of these laryngeal injuries are different. The deposition of fibronectin may explain why some nodules do not respond to voice therapy and suggest the following better treatment.
Antibodies, Monoclonal ; Basement Membrane* ; Collagen Type IV* ; Fibronectins* ; Glycoproteins ; Hematoxylin ; Mucous Membrane* ; Paraffin ; Polyps ; Vocal Cords ; Voice

BACKGROUND: We studied clinical and angiographic findings of 16 Korean patients who had isolated laft coronary ostial steonsis and compared them with those of the patients with non-ostial left main stenosis. The aim of this study is to find the characteristics of the patients with isolated left voronary ostial stenosis. METHODS: Medical records and coronary angiograms were reviewed. We divided the patients with left main stenosis into four groups by lesion location and associated lesion. Clinical and angiographic findings of each group were compared. RESULTS: Twenty four patients(0.15%) had left coronary ostial stenosis and among them sixteen patients(0.1) had an isolated lesion. Their mean age was 48 years and 62% were female. Only 6 patients had coronary risk factors. Two patients were diagnosed as having Takayasu's srteritis. At treadmill exercise test, 7 out of 11 patients lhowed positive results at stage I. Eight patients had undergone surgical treatment. Comoared with the patients who had non-ostial left main stenosis, left ostial group showed lower mean age, female preponderance and lower incidence of coronary risk factors. There was no difference in the results of treadmill exercise test and hemodynamic parameters. CONCLUSION: Isolated left coronary ostial stenosis in Korea also predominantly occured in young female patients who had less risk factors as previous reports. But the incidence of this lesion and nonatherosclerotic origin seemed to be higher. And most of the patients with the left coronary ostial stenosis had isolated ostial stenosis.
Constriction, Pathologic* ; Exercise Test ; Female ; Hemodynamics ; Humans ; Incidence ; Korea* ; Medical Records ; Risk Factors

BACKGROUND: We studied clinical and angiographic findings of 16 Korean patients who had isolated laft coronary ostial steonsis and compared them with those of the patients with non-ostial left main stenosis. The aim of this study is to find the characteristics of the patients with isolated left voronary ostial stenosis. METHODS: Medical records and coronary angiograms were reviewed. We divided the patients with left main stenosis into four groups by lesion location and associated lesion. Clinical and angiographic findings of each group were compared. RESULTS: Twenty four patients(0.15%) had left coronary ostial stenosis and among them sixteen patients(0.1) had an isolated lesion. Their mean age was 48 years and 62% were female. Only 6 patients had coronary risk factors. Two patients were diagnosed as having Takayasu's srteritis. At treadmill exercise test, 7 out of 11 patients lhowed positive results at stage I. Eight patients had undergone surgical treatment. Comoared with the patients who had non-ostial left main stenosis, left ostial group showed lower mean age, female preponderance and lower incidence of coronary risk factors. There was no difference in the results of treadmill exercise test and hemodynamic parameters. CONCLUSION: Isolated left coronary ostial stenosis in Korea also predominantly occured in young female patients who had less risk factors as previous reports. But the incidence of this lesion and nonatherosclerotic origin seemed to be higher. And most of the patients with the left coronary ostial stenosis had isolated ostial stenosis.
Constriction, Pathologic* ; Exercise Test ; Female ; Hemodynamics ; Humans ; Incidence ; Korea* ; Medical Records ; Risk Factors

Medial blowout fracture with persistent diplopia and enophthalmos was required surgical treatment. Conventionally, surgery of blowout fracture of the medial wall has been performed by the transorbital approach with external incision. The conventional method had some disadvantages of external scar, increased morbidity, and general anesthesia. We performed endoscopic endonasal surgery without external incision in 2 cases of medial blowout fracture under local anesthesia. The bony fragments were removed after the intranasal ethmoidectomy. And the entrapped medial rectus muscle was released from the bony fragments. Merocel(R) was placed in the ethmoid sinus for the support of the orbital defect for 48 hours. Results of the surgery in all 2 cases were satisfactory and there were no evidences of diplopia and enophthalmos so far.
Anesthesia, General ; Anesthesia, Local ; Cicatrix ; Diplopia ; Enophthalmos ; Ethmoid Sinus ; Orbit

The inverted papilloma is an uncommon benign tumor constituting 0.5% to 4% of all primary nasal tumors. The tumor is characterized by local aggressiveness, high rate of recurrence and association with malignancy. Intracranial extension or encroachment without associated malignancy is very rare. The treatment should be en bloc resection to prevent the recurrence. Recently, the authors have experienced a case of large inverted papilloma of the nasal cavity invading the anterior cranial base without associated malignancy. The tumor was removed en bloc by craniofacial resection combined with medial maxillectomy through lateral rhinotomy approach. The defect of the skull base was repaired with pericranial flap and temporal muscle flap. The patient has been followed for 2 years and has showed no recurrence.
Humans ; Nasal Cavity ; Papilloma, Inverted* ; Recurrence ; Skull Base* ; Skull* ; Temporal Muscle

Background and Objectives: It is important to identify variations of paranasal sinuses during sinus surgery. The Onodi cell (OC), a variant of the paranasal sinuses, is the most posterior ethmoid cell with a close relationship with the optic nerve (ON). The purpose of this study is to evaluate the prevalence of OCs and analyze the relationship of OCs with ON in Koreans.Subjects and Method This retrospective study utilized CT images of 526 slides from 263 Korean adults. The prevalence of the OCs and the degree of indentation of the ON within the OC was determined using binary logistic regression analysis. Results: The OCs were observed in 37.3% of 263 subjects and in 27.6% of 526 slides. The OCs are found more frequently in males than in females (p=0.01), and also more frequently in the right side than in the left side (p=0.001). Binary logistic regression analysis revealed that the ON protrusion in female was 0.339 times lower than in male and 1.052 times higher with the increased age. The ON protrusion within the OC in the postsellar type was 10.214 times higher than that in the presellar. Conclusion The OCs were observed in 37.3% of the Koreans. The protrusion of the ON within the OCs increased in male and in the postsellar type of the sphenoid sinus.

This study was undertaken to evaluate the present status of intestinal helminthic infections in Koreans, from April 1967 through May 1969. The nationwidely collected stool specimens and scotch-tape anal swabs from primary schoolchildren, middle school students, draftees to army recruitment camp, soldiers and inhabitants of various parts of Korea were examined. The methods employed were Kato's cellophane thick smear technique and formalin-ether sedimentation technique in 40,581 for the prevalence rate of various intestinal helminths, scotch-tape anal swab technique in 8,585 for the prevalence rate of Enterobius vermicularis and by Stoll's dilution egg counting technique in 1,174 for the evaluation of the worm burden of some helminths. The results are as follows. Result of stool examination: The positive rate of intesinal helminthes of any kind was 90.5% among 40,581. In rural people, it was 92.3% in average in contrast to 85.0% in Seoul inhabitants. The infection rate of A. lumbricoides in 40,581 was 58.2%. It was higher in rural people 62.9% than in Seoul inhabitants and highest in 5-9 year-old group by age. The infection of Trichocephalus trichiurus showed the highest prevalence rate in Koreans and it was 74.5%. No remarkable difference was observed between Seoul inhabitants(72.2%) and rural people(75.2%). The tendency of higher prevalence rate with the older age group was observed. The infection rates of hookworm and Trichostrongylus orientalis in 40,581 examinations by cellophane thick smear were 5.1% and 5.8% respectively. But in 4,949 examinations for which refined cellophane thick smear technique and formalin-ether sedimentation technique were employed, the infection rates were turned out 17.6% in hookworm and 15.9% in T. orientalis. Although rural people showed higher infection rate of hookworm(18.8%) than Seoul inhabitants(13.8%), the reverse was true in T. orientalis infection rate(14.5% : 20.3%). Both kinds of infections were tend to be higher with the increase of age. The infection rates of Clonorchis sinensis and Metagonimus yokogawai were 4.7% and 0.4% respectively. In both kinds of infections male showed higher infection rates than female and the tendencies of higher infection rate in the older age group were observed. The provinces which showed the higher infection rate of C. sinensis were South and North Kyongsang Do and North Cholla Do, all of which are provinces of southern part of Korea. Some endemic foci of M. yokogawai were noticed in South Kyongsang Do and South Cholla Do. The infection rate of Taenia spp. by applying only the stool examination was 0.7% throughout the survey. No sex difference in infection rate of Taenia spp. was noticed, but in older age group it was increased. Cheju Do, the island of extreme southern part of Korea seemed the most endemic area and South and North Cholla Do were next in ranking of Taenia infection rate. The ova of Hymenolepis nana were observed in 0.2% and all of them were under the age of 20 except only one caes. The infection rate seemed higher in female (0.3%: 0.1%). No geographical difference was noticed except 1.1% of schoolchilderen and students of Cheju Do. Result of Scotch-tape anal swab technique for E. vermicularis infection. The infection rate of E. vermicularis in 8,585 urban and rural schoolchildren and rural inhabitants was 46.6%. Female (57.9%) had definitely higher infection rate than male (41.4%). The infection rate was significantly higher in rural people than Seoul schoolchildren. The exteme example was 79.7% in schoolchildren of South Cholla Do. Result of worm burden examination by Stoll's dilution egg-counting technique: Among 1,174 examinations, countable(E.P.G.> 100) cases of A. lumbricoides were 745(63.5%) and the mean E.P.G. was 9,723. The mean E.P.G. in Seoul inhabitants was 5,835 in contrast to 10,820 in rural people. The age group of 5-9 showed the heaviest mean E.P.G., 11,337. 70.6% of 745 cases were less than 10,000 in E.P.G. which means light infection. Countable cases by Stoll's technique for T. trichiurus ova were 63.5% and mean E.P.G. was 649. No difference between Seoul and rural inhabitants was observed. Grade I and II in which E.P.G. is less than 5,000 involve 99.3% of positive cases. 91 cases (7.9%) in 1,174 were positive for hookworm ova by Stoll's technique and mean E.P.G. was 501. All cases were in Grade I and II which were less than 5,000 in E.P.G. Trichostrongylus orientalis was positive only in 25 cases (2.1%) by Stoll's technique and mean E.P.G. was 340. No cases were found to have more than 5,000 in T. orientalis E.P.G. The mean E.P.G. of Clonorchis sinensis among the referred cases of clonorchiasis to Department of Parasitology, Seoul National University, was 9,416. On the other hand mean E.P.G. of C. sinensis was 21,376 among cases in the hyperendemic area of Kimhae, South Kyongsang Do, and 3,073 in cases from other various localities. Among referred clonorchiasis cases to our Department, 21.6% were turned out to have the E.P.G. more than 10,000. The cases who have the E.P.G. more than 10,000 in hyperendemic area, Kimhae were 40.7% and in other various localities were 9.1%
parasitology-helminth-nematoda-trematoda-cestoda ; epidemiology ; Ascaris lumbricoides ; Trichocephalus trichiurus ; Trichostrongylus orientalis ; Clonorchis sinensis ; Metagonimus yokogawai ; Taenia sp. ; Hymenolepis nana ; Enterobius vermicularis

OBJECTIVES: Infection and replication of the hepatitis B virus are closely related to the host immunity. Anticancer chemotherapy decreases the immune response of the host, Especially, glucocorticoid can activate the replication of hepatitis B virus directly. It is well known that hepatitis B virus infection and hepatic complications are more common in patients with hematologic malignancies like malignant lymphoma. We studied the incidence of hepatitis B virus infection and hepatic complications following anti-cancer chemotherapy in patients with malignant lymphoma. METHODS: Among 224 cases diagnosed as malignant lymphoma from January 1989 to December 1993 at Yonsei University Medical Center, 77 cases tested for hepatitis B virus serology was studied. RESULTS: 1) Eighteen cases (23%) was HBsAg positive. 2) The results of hepatitis C virus serology in six cases were all negative. 3) Eight (57%) of 14 follow-up cases had hepatic complications, Two patients had fulminant hepatitis, two nonicteric hepatitis and four icteric hepatitis. 4) Interferon-alpha was administered in three cases among the patients with hepatic complications. Loss of HBeAg was observed in one case and loss of HBsAg in another case. CONCLUSION: Serious hepatic complications can be occurred following anticancer chemotherapy in HBsAg-positive patients with malignant lymphoma. Therefore, we recommend that patients being considered as candidates for anticancer chemotherapy should routinely undergo serologic test for Hepatitis B virus. In addition HBsAg-positive patients with anticancer chemotherapy should be regularly monitored for hepatic injury. And with the careful use of steroid and interferon, prolongation of survival might be searched for these patients.
Academic Medical Centers ; Drug Therapy* ; Follow-Up Studies ; Hematologic Neoplasms ; Hepacivirus ; Hepatitis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Humans ; Incidence ; Interferon-alpha ; Interferons ; Lymphoma* ; Serologic Tests

Background/Aims: We evaluated changes in the ascending aorta dimension post-transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve (BiAV) and tricuspid aortic valve (TAV) patients. Methods: Patients with severe aortic stenosis undergoing TAVR at Seoul National University Hospital were consecutively recruited. Patients with less than 12 months’ follow-up and/or with an ascending aorta size larger than 50 mm were excluded. The ascending aorta size was measured on a parasternal long axis view using transthoracic echocardiography. Results: Among the 67 patients who were included (age: 76.5 ± 6.5 years; male: 52.2%; AV area: 0.67 ± 0.15 cm2), 19 (28.4%) had BiAV; 48 (71.6%) had TAV. The median (interquartile ranges) follow-up duration was 398 days (361 to 451). BiAV patients were younger (73.2 ± 7.2 vs. 77.8 ± 5.8, p = 0.008), and had lower incidences of chronic renal disease (5.3% vs. 35.4%, p = 0.014) and history of coronary intervention (15.8% vs. 50.0%, p = 0.013), than TAV patients. On pre-procedural echocardiography, the ascending aorta dimensions in BiAV patients were larger than those in TAV patients (40.5 ± 3.8 mm vs. 35.9 ± 4.2 mm, p < 0.005). The ascending aorta dimension changed minimally during follow-up; post-TAVR, the ascending aorta’s growth rate was –0.11 ± 1.9 and 0.26 ± 1.8 mm/yr in patients with BiAV and TAV, respectively (p = 0.50). Progression of the ascending aorta’s dimension postTAVR was not clinically significant in BiAV patients. Conclusions The concern about the progression of aortopathy in BiAV patients post-TAVR may not be a clinical issue. This should be confirmed in studies with a larger population and with a longer follow-up duration.

Background and Objectives: Peritonsillar abscess (PTA) is an accumulation of pus between the palatine tonsil and pharyngeal constrictor muscle. It is a common cause of emergency on-call consultations among ENT doctors and occurs due to the possibility of sepsis, airway obstruction, and progression to deep neck infection. This study aims to compare the effectiveness of needle aspiration (NA) to incision & drainage (I&D) for the treatment of PTA.Subjects and Method From September 2018 to March 2020, 58 patients with PTA were admitted to our ENT Department. After a comprehensive diagnostic procedure, 38 patients were enrolled in the study and they underwent either I&D (20 patients) or NA (18 patients) treatment. Patients were discharged when edema decreased on the endoscopic findings and their symptoms improved, with a visual analogue scale (VAS) score <3 points. For each patient, we evaluated the abscess volume, age, body mass index, hypertension, diabetes mellitus, smoking and drinking history, abscess size, and duration of hospitalization. White blood cell (WBC) count, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were estimated on the 1st, 3rd, and 5th days of hospitalization. Results: The mean age of participants was 42.8±15.5 years and 40.3±14.7 years in the I&D and NA groups, respectively. Except for ESR, the mean hospitalization duration, initial volume of abscess size, VAS pain score, WBC count and the CRP level were not different between the groups. Conclusion Our study revealed no significant differences in hospital stay duration, VAS score, WBC counts or in the CRP level among patients admitted for PTA, whether they underwent I&D or NA.