Intravascular papillary endothelial hyperplasia (IPEH) is an exuberant intravascular endothelial proliferation that in many respects mimics an angiosarcoma. A 78-year-old woman complained of a several month history of left-side nasal obstruction and frequent epistaxis. Preoperative endoscopic examination demonstrated a dark red mass occupying the left nasal cavity. The nasal cavity mass was completely removed under endonasal endoscopy. During the six-month follow-up, the patient had no evidence of recurrent disease. We present here a rare case of IPEH within the nasal cavity that demonstrated the reactive nature of this affliction.
Aged ; Endoscopy ; Epistaxis ; Female ; Follow-Up Studies ; Hemangiosarcoma ; Hematoma ; Humans ; Hyperplasia ; Nasal Cavity ; Nasal Obstruction

A foreign body sensation or a globus symptom of the throat after uvulopalatopharyngoplasty (UPPP) is caused by an internal scar formation and such symptoms generally disappear in 9 months after surgery. In rare cases, this sensation could be permanent. If this condition persists, possible primary treatment could be multiple stage steroid injection into the affected site for softening of the submucosal fibrous formation. But rotational or advancement mucosal flaps could be effective if the steroid injection does not work. We present a case of scar contracture of oral mucosa after UPPP was corrected with Z-plasty and mucosal tissue graft.
Cicatrix ; Contracture ; Foreign Bodies ; Mouth ; Mouth Mucosa ; Mucous Membrane ; Pharyngeal Muscles ; Pharynx ; Sensation ; Transplants

No abstract available.
Coronary Artery Disease* ; Coronary Vessels*

No abstract available.
Adenosine* ; Diagnosis* ; Radionuclide Imaging*

Amyloidosis is a disease characterized by deposition of extracellular fibrillar proteins in various tissues mainly derived from the mesoderm. We experienced a case of a 59-year old man with a localized bilateral mass at the angle of the mouth, which was surgically removed. It surrounded the facial arteries bilaterally with the same pattern, and was diagnosed as amyloidosis pathologically. Followed by further workup, he was finally diagnosed with the multiple myeloma. Cases such as this where an amyloidosis mass surrounded the main branches of the facial arteries has not yet been reported in the literature. We present a case of localized amyloidosis at the oral commisure surrounding the facial arteries with the review of its clinical patterns, diagnostic tools, pathologic findings and treatment.
Amyloidosis ; Arteries ; Mesoderm ; Mouth ; Multiple Myeloma ; Proteins

It was difficult to determine the clinical situations of Morgagni diaphragmatic hernias of adults on account of its rarity. The aim of this study was to propose diagnostic and therapeutic guidelines for adult Morgagni diaphragmatic hernias. A computerized `Korean study information co.' and `medical research information center' literature search of domestic articles published since 1950 was carried out. These 10 cases in addition to ours were analyzed. The average age at treatment was 68.7 years of age ranging from 51 to 83 years with 90.9% of patients being female. 18.2% of patients had symptoms immediately after trauma. 27.3% of patients were incorrectly diagnosed preoperatively. 90.9% of all treated Morgagni hernias were located on the right side just behind the sternum with hernia sacs. The most common contents of the hernias were the greater omentum and transverse colon. The preferred method of surgery was the trans-abdominal approach. The mortality rate of the hernias was 9.1%. Morgagni diaphragmatic hernias once diagnosed should be referred for surgical repair due to the risk of bowel perforation. The transabdominal approach or laparoscopic surgery is preferred in accurately diagnosed Morgagni diaphragmatic hernias prior to surgery.
Adult ; Colon, Transverse ; Female ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Laparoscopy ; Mortality ; Omentum ; Sternum

OBJECTIVE: To help preserve accessory pudendal arteries (APAs) and to ensure optimal postoperative sexual function after a laparoscopic or robot-assisted radical prostatectomy, we have evaluated the incidence of APAs as detected on multidetector-row CT (MDCT) angiography and have provided a detailed anatomical description. MATERIALS AND METHODS: The distribution of APAs was evaluated in 121 consecutive male patients between February 2006 and July 2007 who underwent 64-channel MDCT angiography of the lower extremities. We defined an APA as any artery located within the periprostatic region running parallel to the dorsal vascular complex. We also subclassified APAs into lateral and apical APAs. Two radiologists retrospectively evaluated the origin, course and number of APAs; the final APA subclassification based on MDCT angiography source data was determined by consensus. RESULTS: We identified 44 APAs in 36 of 121 patients (30%). Two distinct varieties of APAs were identified. Thirty-three APAs (75%) coursed near the anterolateral region of the prostatic apex, termed apical APAs. The remaining 11 APAs (25%) coursed along the lateral aspect of the prostate, termed lateral APAs. All APAs originated from the internal obturator artery and iliac artery or a branch of the iliac artery such as the inferior vesical artery. The majority of apical APAs arose from the internal obturator artery (84%). Seven patients (19%) had multiple APAs. CONCLUSION: APAs are more frequently detected by the use of MDCT angiography than as suggested by previous surgical studies. The identification of APAs on MDCT angiography may provide useful information for the surgical preservation of APAs during a laparoscopic or robot-assisted radical prostatectomy.
Aged ; Angiography/*methods ; Arteries/*abnormalities ; Humans ; Incidence ; Laparoscopy ; Male ; Middle Aged ; Prostate/*blood supply ; Prostatectomy/*methods ; Retrospective Studies ; Robotics ; Tomography, X-Ray Computed/*methods

BACKGROUND AND OBJECTIVES: The evaluation of subjective outcomes of hearing aid fitting is of paramount importance along with audiometric improvement. The aim of this study was to develop a Korean adaptation of the International Outcome Inventory for Hearing Aids (IOI-HA) and to determine its reliability and validity. SUBJECTS AND METHOD: The translation of IOI-HA into the Korean version (K-IOI-HA) was completed through a process of forward translation, reconciliation, reverse translation and cognitive debriefing. K-IOI-HA was administered to 101 patients using hearing aids and visiting any the 10 referral hospitals. Reliability was evaluated by Cronbach's alpha coefficient and by test-retest analysis. Validity was assessed by confirmatory factor analysis and criterion validity based on the results of pure tone audiometry. RESULTS: K-IOI-HA showed a good internal consistency (Cronbach's alpha=0.83) and a high test-retest reliability (r=0.943, p<0.01). Validity checked by confirmatory factor analysis also showed good construct validity. CONCLUSION: The Korean version of IOI-HA is a reliable and valid tool for evaluating subjective outcomes of hearing aids.
Hearing ; Hearing Aids ; Humans ; Surveys and Questionnaires ; Referral and Consultation ; Reproducibility of Results

PURPOSE: Insistence that total regression of primary tumor would not represent long-term oncologic outcomes has been raised. Therefore, this study aimed to evaluate the outcomes of these patients after preoperative chemoradiotherapy (PCRT) and radical surgery and to evaluate the associated risk factors. METHODS: We included 189 patients with rectal cancer who showed total regression of the primary tumor after PCRT, followed by radical resection, between 2001 and 2012. Recurrence-free survival (RFS) was calculated using the Kaplan-Meier method, and the results were compared with 77 patients with Tis rectal cancer who received only radical resection. Factors associated with RFS were evaluated using Cox regression analysis. RESULTS: Sphincter-saving resection was performed for 146 patients (77.2%). Adjuvant chemotherapy was administered to 168 patients (88.9%). During the follow-up period, recurrence occurred in 17 patients (9%). The 5-year RFS was 91.3%, which was significantly lower than that of patients with Tis rectal cancer without PCRT (P = 0.005). In univariate analysis, preoperative CEA and histologic differentiation were associated with RFS. However, no factors were found to be associated with RFS. CONCLUSION: RFS was lower in patients with total regression of primary rectal cancer after PCRT than in those with Tis rectal cancer without PCRT, and it would not be considered as the same entity with early rectal cancer or “disappeared tumor” status.
Chemoradiotherapy ; Chemotherapy, Adjuvant ; Follow-Up Studies ; Humans ; Methods ; Rectal Neoplasms ; Recurrence ; Risk Factors

Background and Objectives: Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI).Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. Results: The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.