Schwannomas are neurogenic tumors that arise from Schwann cells of the neural sheath. They are most often benign and solitary. Ancient schwannoma is a rare variant of schwannoma with a typical characteristics of a slow growing benign tumor. A case of ancient schwannoma which originated from the lingual nerve has not been reported in the literature yet. The clinical and histological aspects of this tumor are discussed and the literature regarding this rare entity is reviewed.
Lingual Nerve* ; Neurilemmoma* ; Schwann Cells

The purpose of this study was to evaluate the abrasion-resistance of root surface after NaF iontophoresis, Nd:YAG laser irradiation and combined treatment 50 anterior teeth with flat interproximal root surface that had been extracted due to periodontal destruction were selected. All teeth were treated by the same procedure as conventional periodontal root treatment, such as scaling and root planing, root conditioning with tetracycline HCl(100mg/ml, 5min). The pre-treatment weight of each tooth was measured by a dial scale(SHIMADEU Co., LIBROR EB-220HU, capacity 220.000 g, Japan). All teeth were divided into 5 groups as follows; Nd:YAG laser irradiation(group 1, 1 W, 100 mJ, 10Hz, fiberoptic-root surface distance=5mm, 10 sec.x6times, EL.EN.EN060, Italy); NaF iontophoresis(group 2, 150micronA, 4 min.); Nd:YAG laser irradiation following NaF iontophoresis(group 3); NaF iontophoresis following Nd:YAG laser irradiation(group 4); No treatment(control group). Electric toothbrushing (Oral-B, Brown Co., Germany) was conducted during 1 hour(10 min.x6 times). Subsequently post-treatment weight was remeasured by the same method as pre-treatment weight measurement. The difference of abrasion rate among all groups was statistically analyzed by ANOVA(SAS program). Following results were obtained; 1. The abrasion rate was significantly lower in Nd:YAG laser irradiation group than NaF iontophoresis group(p < 0.001). 2. The abrasion rate was significantly lower in combined groups of Nd:YAG laser irradiation and NaF iontophoresis than either Nd:YAG laser irradiation group or NaF iontophoresis group(p < 0.001). 3. There was no significant difference in abrasion rate according to application order in the combined groups(p > 0.05). 4. The abrasion rate was significantly lower in all experimental groups than control group(p < 0.001). The results suggest that combined treatment of Nd:YAG laser irradiation and NaF iontophoresis on exposed root surface after periodontal therapy can enhance the abrasion-resistance of root surface and may inhibit the root caries development.
Iontophoresis* ; Root Caries ; Root Planing ; Tetracycline ; Tooth ; Toothbrushing

Periodontal disease and/or loss of teeth brings pathologic tooth migration that can result in esthetic and occlusal problems. Diastema and general spacing of the teeth, particularly in the anterior segments of the dentition are frequently developed in individuals with advanced periodontal disease. Thus, the overall treatment plan for a patient with advanced periodontal disease often involves periodontal orthodontic combined therapy. Orthodontic treatment in adults with periodontal disease is restricted to tooth alignment with special caution. Indirect bonding can achieve accurate bracket placement. A 38 year old woman with adult periodontitis was treated by periodontal therapy. Subsequently, her diastema was orthodontically corrected by indirect bonding technique. It must be an appropriate case report of periodontal-orthodontic combined therapy.
Adult ; Chronic Periodontitis ; Dentition ; Diastema ; Female ; Humans ; Periodontal Diseases ; Periodontitis* ; Tooth ; Tooth Migration

Meningiomas account for approximately 13 to 18 per cent of all primary intracranial neoplasms. The majority of meningioma cases develops in the supratentorial compartment with only 8 to 9 per cent occurring in the posterior fossa. Twenty per cent of intracranial meningiomas eventually develop an extracranial extension. Intracranial tumors that extend to the middle ear and external auditory canal are uncommon. The most common pathway in the temporal bone is through the jugular foramen and foramen lacerum into the parapharyngeal space. When a meningioma gains access to the temporal bone, neurological symptoms usually develop. By the time symptoms become apparent, however, the tumor is usually quite large. The presentation was unusual in that there were no demonstrable neurological signs clinically, despite the large size of the intracranial tumor and mass effect. We experienced a case of extracranial meningioma in the external auditory canal that was extended from intracranial meningioma, and which was diagnosed with biopsy and radiographic examination. In this paper, we report this case with review of literature.
Biopsy ; Brain Neoplasms ; Ear Canal* ; Ear, Middle ; Meningioma* ; Temporal Bone

Neurofibromatosis affects primarily cell growth of neural tissues and can cause tumors to grow on nerves at any time and any location. it is a heritable disease that is transmitted as an autosomal-dominant trait. Neurofibromatosis type II is characterized by bilateral acoustic neuromas with high incidence of other tumors. Hearing loss is the most common symptom in patients with neurofibromatosis type II. The other symptoms may be tinnitus, facial weakness, and dizziness. Audiometric test and MRI are essential to diagnose neurofibromatosis type II. Most cases of neurofibromatosis type II may need for surgical procedures. We experienced a case of neurofibromatosis type II having cervical spinal cord neuroma, multiple intracranial meningiomas, and bilateral acoustic neuromas. There was positive family history. Her two brothers also had neurofibromatosis type II, confined by MRI. Her acoustic neuroma on left side was removed successfully via translabyrinthine approach and cervical spinal cord neuroma by cervical laminectomy was removed.
Dizziness ; Hearing Loss ; Humans ; Incidence ; Laminectomy ; Magnetic Resonance Imaging ; Meningioma ; Neurofibromatoses* ; Neurofibromatosis 2* ; Neuroma ; Neuroma, Acoustic ; Siblings ; Spinal Cord ; Tinnitus

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) production in the respiratory epithelium and the demonstration of inducible nitric oxide synthase in ciliated epithelium of the upper airway have recently been reported. The aim of this study was to investigate the expression of inducible nitric oxide synthase in the nasal epithelium after capsaicin treatment, which stimulates the substance P innervation. MATERIALS AND METHODS: In vivo treatment -Capsaicin (112 nM) was applied to the nasal cavities of the rat and guinea pig, and 30 nl of normal saline was applied for the control groups. After 2 hours, animals were sacrificed with cardiac perfusion of 4% paraformaldehyde and septal mucosa were removed. The 8 nm serial frozen tissue sections were made, and the expression of inducible nitric oxide synthase was determined using nicotinamide adenine diphosphate-diaphorase histochemistry. In vitro treatment- The nasal septum of the rats and the trachea of the guinea pigs were incubated in DMEM culture media with or without 112 nM capsaicin for experimental or control groups. After 0, 30 or 120 minutes of incubation, the tissues were fixed and processed for nicotinamide adenine diphosphate-diaphorase histochemistry. RESULTS: Both in vivo and in vitro studies demonstrated that the strong positive histochemical reactivity were observed in the respiratory epithelium of the rats and guinea pigs after capsaicin treatment compared to control groups. CONCLUSION: These data imply that capsaicin induces the expression of inducible nitric oxide synthase and that the substance P innervation of the nasal mucosa may have a protective role in the airway defense mechanism through nitric oxide production.
Adenine ; Animals ; Capsaicin* ; Culture Media ; Epithelium* ; Guinea Pigs ; Guinea* ; Mucous Membrane ; Nasal Cavity ; Nasal Mucosa ; Nasal Septum ; Niacinamide ; Nitric Oxide ; Nitric Oxide Synthase Type II* ; Perfusion ; Rats* ; Respiratory Mucosa ; Substance P ; Trachea

INTRODUCTION: The utility of the C-terminal cross-linking telopeptide test (CTX) as a method for staging Bisphosphonate-related osteonecrosis of the jaws (BRONJ) and its healing process was examined. MATERIALS AND METHODS: A total 19 patients who were diagnosed with BRONJ underwent a fasted morning CTX test, were enrolled in this study. The serum CTX values ranged from 50 to 630 pg/mL (mean 60). The risk assessment was rated according to the CTX values of the individual patient (minimal risk, > or =150 pg/mL, moderate, 100 to 150 pg/mL, high, < or =100 pg/mL). The BRONJ scores were then calculated according to the number of BRONJ lesions and their stage. The operation was done as soon as possible, regardless of BORNJ stage. RESULTS: The mean duration of bisphosphonate therapy was 4.1 years. Of the 19 patients, 15, 2 ans 2 received alendronate, risedronate and zoledronate, respecively. Of the 19 patients who underwent a sequestrectomy, saucerization and smoothing, 15 healed after the initial surgery, 1 patient healed after one more surgical procedure, 3 patients did not heal completely but showed improvement in symptoms. Therefore, 17 out of the 19 patients healed completely with complete mucosal coverage and the elimination of pain. The risk assessment using the CTX value and disease severity were not correlated (r=-0.264, P=0.275). In addition, the risk assessment using CTX value and healing after surgery were not correlated (r=-0.147, P=0.547). CONCLUSION: The serum CTX should be considered carefully by clinicians as part of overall management. Early surgical intervention is of benefit in the treatment of stage II BRONJ.
Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Collagen Type I ; Diphosphonates ; Etidronic Acid ; Humans ; Imidazoles ; Jaw ; Jaw Diseases ; Osteonecrosis ; Peptides ; Risk Assessment ; Risedronate Sodium

BACKGROUND/AIMS: Spontaneous HBeAg seroconversion occurs frequently in the immune reactive phase in HBeAg-positive chronic hepatitis B (CHB). Therefore, observation for 3-6 months before commencing antiviral therapy is recommended in patients with alanine aminotransferase (ALT) levels that exceed twice the upper limit of normal (ULN). However, HBeAg seroconversion occurs infrequently in patients infected with hepatitis B virus (HBV) genotype C. The aim of the present study was to determine whether the waiting policy is necessary in endemic areas of HBV genotype C infection. METHODS: Ninety patients with HBeAg-positive CHB were followed prospectively without administering antiviral therapy for 6 months. Antiviral therapy was initiated promptly at any time if there was any evidence of biochemical (i.e., acute exacerbation of HBV infection or aggravation of jaundice) or symptomatic deterioration. After 6 months of observation, antiviral therapy was initiated according to the patient's ALT and HBV DNA levels. RESULTS: Only one patient (1.1%) achieved spontaneous HBeAg seroconversion. Biochemical and symptomatic deterioration occurred before 6 months in 17 patients (18.9%) and 5 patients, respectively. High ALT and HBV DNA levels were both independent risk factors for biochemical deterioration. Of 15 patients with HBV DNA > or =5.1x107 IU/mL and ALT > or =5xULN, biochemical deterioration occurred in 7 (46.7%), including 1 patient receiving liver transplantation due to liver failure. CONCLUSIONS: Spontaneous HBeAg seroconversion in patients with HBeAg-positive CHB is rare within 6 months. Biochemical deterioration was common and may lead to liver failure. Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas of genotype C infection.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Follow-Up Studies ; Genotype ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/*blood ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors

Peutz-Jeghers syndrome (PJS), is a rare autosomal dominant hereditary disorder. Intestinal hamartomatous polyps in association with melanocytic pigmentation of the skin and mucous membranes characterize PJS. Patients with PJS often have complications associated with the polyps, such as intestinal obstruction, intussusception, acute or chronic gastrointestinal bleeding, and the development of various types of cancer. Enteroclysis, small bowel follow-through, and push enteroscopy are generally used to identify the presence and location of small bowel polyps. Wireless capsule endoscopy (CE) has been confirmed as a feasible, safe, and sensitive test for the surveillance of small bowel polyps in patients with PJS and could replace radiographic small bowel surveillance. Here, a case of PJS newly diagnosed by CE is reported. The patient, a 30-year-old man who had developed rectal polyps associated with anal extrusion 7 years previously, had six episodes of hematochezia.
Adult ; Capsule Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Mucous Membrane ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Skin

A 20-year-old Cambodian male living in Korea for 2 years as a foreign worker visited our gastroenterology outpatient clinic. He had a small farm in Cambodia. He complained of postprandial upper abdominal pain with nausea and vomiting for 2 years. Gastroduodenoscopy showed hyperemic mucosa near the major papilla in the duodenum and two small and slender reddish worms. These were removed with endoscopic biopsy forceps. Under microscopy, these were identified as Ancylostoma duodenale by the characteristic morphology of 2 pairs of cutting teeth in the buccal cavity and 3 lobes in the copulatory bursa. After removal of two worms, his symptom improved. Soil-transmitted helminths (STH) present a global health problem. In the Republic of Korea, STH, including hookworms, were highly prevalent until the 1970s. With mass fecal examination followed by selective mass chemotherapy with anthelmintics from 1969 to 1995, the prevalence of STH has rapidly decreased since the 1980s. Since 2004, no hookworms have been found in nationwide surveys on the prevalence of intestinal parasitic infection. Therefore, we report a case of in vivo endoscopic removal of A. duodenale in a patient with abdominal pain.
Abdominal Pain ; Agriculture ; Ambulatory Care Facilities ; Ancylostoma ; Ancylostomatoidea ; Anthelmintics ; Asian Continental Ancestry Group ; Biopsy ; Cambodia ; Drug Therapy ; Duodenum ; Endoscopy ; Gastroenterology ; Global Health ; Helminths ; Humans ; Korea ; Male ; Microscopy ; Mucous Membrane ; Nausea ; Parasitic Diseases ; Prevalence ; Republic of Korea ; Surgical Instruments ; Tooth ; Vomiting ; Young Adult