No abstract available.
Central Nervous System Infections* ; Central Nervous System*

No abstract available.
Histiocytosis*

OBJECTIVES: The objective of this study was to determine the various factors that affect the extrusion rate of ventilation tubes (VTs), including the nature of the middle ear effusion. METHODS: A retrospective chart review of 82 pediatric patients (177 ears) who received VT insertion surgery under general anesthesia was carried out to evaluate the relationship between various factors and the VT extrusion rate. The factors we analyzed included age, gender, the adenoid size, the amount and content of the middle ear effusion after myringotomy, bleeding events, associated adenoidectomy and the findings of the tympanic membrane status, the tympanometry and the audiometry of the air bone gap. RESULTS: The mean extrusion time was 254 days (range, 11 to 809 days). The patients with no history of previous VT insertion had a longer extrusion time (mean, 279 days) than did the patients who had undergone previous VT insertion (mean, 203 days). The patients with serous effusion had the shortest extrusion time (mean, 190 days) as compared to those patients with glue (273 days) and pus (295 days) effusions. Other factors had no statistical significant relationship with the extrusion time. CONCLUSION: The mean VT extrusion time was 254 days. The VT extrusion time was significantly related to the characteristics of the middle ear effusion and a history of previous VT insertion. Thus, the nature of middle ear effusion can provide a clinical clue to predict the VT extrusion time.
Acoustic Impedance Tests ; Adenoidectomy ; Adenoids ; Adhesives ; Anesthesia, General ; Audiometry ; Hemorrhage ; Humans ; Otitis Media with Effusion ; Retrospective Studies ; Suppuration ; Tympanic Membrane ; Ventilation

Inflammatory myofibrolastic tumor (IMT) is a rare borderline neoplasm. It frequently occurs in the lung but occasionally occurs in extrapulmonary sites such as the genitourinary tract, gastrointestinal tract, breast, salivary glands, sinonasal tract, orbit, and the central nervous system. Laryngeal involvement of IMT is very rare.A 61-year-old woman who complained of hoarseness persisting for 3 months visited our hospital. Laryngoscopy showed an elevated lesion in the right true vocal cord. Incisional biopsy was confirmed as larygeal inflammatory myofibrolastic tumor. We performed a transoral excision with CO2 LASER under suspension examination. Regional recurrence or distant metastasis was not observed after 9 months of follow-up. Herein we report a case of larygeal inflammatory myofibrolastic tumor that was treated with surgery alone, with a literature review.
Biopsy ; Breast ; Central Nervous System ; Female ; Follow-Up Studies ; Gastrointestinal Tract ; Hoarseness ; Humans ; Laryngoscopy ; Larynx ; Lasers, Gas ; Lung ; Middle Aged ; Myofibroblasts ; Neoplasm Metastasis ; Orbit ; Recurrence ; Salivary Glands ; Vocal Cords

Among a variety of malignant types for parotid gland tumors, intracapsular carcinoma ex pleomorphic adenoma which is classified as a non-invasive tumor has been reported rarely. We report a case of a 69-years old patient, who presented with a left parotid mass that was detected 30 years ago. Fine needle aspiration biopsy result of the mass was “suggestive of pleomorphic adenoma”. Superficial partial parotidectomy was performed for the mass and the permanent pathologic finding was “intracapsular carcinoma ex pleomorphic adenoma” which was a salivary ductal carcinoma with well-preserved myoepithelial cells surrounding the malignant epithelial cell clusters. Surgical resection is the main treatment modality for the treatment of intracapsular carcinoma ex pleomorphic adenoma. Herein, we present the case with a review of literature.

Objective: Fiberoptic endoscopic evaluation of swallowing (FEES) is a standard diagnostic tool for swallowing disorders. However, it has not been used frequently in Korea because of the long test time, low cost, and the absence of a standard evaluation system. The purpose of this study was to suggest a standard fill-out form for the FEES result. Methods: From February 2019 to June 2020, a total of 98 FEES tests were performed by an otolaryngologist (JYJ) at the Wonkwang University Hospital. After the exclusion of 68 cases, 30 cases were analyzed twice by 4 raters with over 5 years of experience as otolaryngologists working in various hospitals. The results were measured for the rater’s test-retest reliability and inter-rater consistency. Results: Cohen’s kappa values for measuring the intra-rater consistency of the four raters were 0.984, 0.887, 0.848, and 0.930, respectively, meaning very good alignment of 0.8 or more, respectively. The Fleiss Kappa value for measuring inter-rater consistency was 0.276, meaning ‘fair’ for values of 0.2 or more. To examine consistency, an intraclass correlation coefficient (ICC) analysis conducted by assuming the grading score to be a constant continuous variable gave an ICC value of 0.729 (P＜0.001), showing a very reliable tendency. Conclusion In this study, all the items of the fill-out form were rated using a three-step grading scale, so the degree of agreement was high when performed twice by the same rater, but the degree of agreement among raters was relatively low. Therefore, our fill-out form for FEES will be useful in evaluating the improvement of a patient over the course of clinical treatment.

PURPOSE: The neuroendocrine cell(NEC) is one of the constitutional cells found in the prostate gland; these cells secret neurotransmitters. These neuroendocrine products have been associated with prostate cancer progression. We evaluated the significance of neuroendocrine differentiation(NED) in radical prostatectomy specimens. MATERIALS AND METHODS: We studied 45 patients who underwent bilateral pelvic lymphadenectomy and radical prostatectomy. The patients were classified into three groups according to their pathological stage. Group A included cases with organ confined tumors, Group B local advanced tumors and Group C cases had any T stage and lymph node metastasis. The cellular expression of chromogranin A in matched samples from the same patients was evaluated by immunohistochemical staining using commercially available monoclonal antibodies. RESULTS: Sixteen(35.6%) tumors had chromogranin A stained cells. Chromogranin A immunoreactivity was greatest in cases with lymph node involvement(75.0%) compared to those with primary prostate cancer(5.9% in group A and 37.5% in group B). Pathologically advanced tumors or tumors with the highest histological grades were associated with increased NED. The median staining score was 0 in Group A, 0 in Group B and 1 in Group C. The logistic regression analysis the odds ratio for group C cases showed a relative risk of 32.07(95% CI: 2.783-369.416) for NED compared to Group A. An increased prostate-specific antigen(PSA) and Gleason score were also associated with the NED. CONCLUSIONS: The degree of NEC immunohistochemical staining using the chromogranin A monoclonal antibody was marginally useful for predicting the outcome in prostate cancer patients after radical prostatectomy, especially in node positive patients. However, it is important to determine a therapeutic plan for patients with low PSA and internal organ metastasis.
Antibodies, Monoclonal ; Chromogranin A ; Humans ; Logistic Models ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Neuroendocrine Cells ; Neurotransmitter Agents ; Odds Ratio ; Prognosis ; Prostate ; Prostatectomy ; Prostatic Neoplasms

BACKGROUND AND OBJECTIVES: Most secondary hyperparathyroidism is caused by chronic kidney disease. The purpose of this study is to evaluate the effectiveness of subtotal parathyroidectomy in the surgical treatment of renal hyperparathyroidism. SUBJECTS AND METHOD: We studied twelve patients with renal hyperparathyroidism who underwent parathyroidectomy from Dec. 2002 to Mar. 2007. We measured the amount of serum, intact parathyroid hormone, calcium, ionized calcium, inorganic phosphorus, and alkaline phosphatase preoperatively and postoperatively. RESULTS: Subtotal parathyroidectomy was performed in nine patients, and three enlarged parathyroid glands were removed from three patients. Hyperparathyroidism was observed in four patients (33.3%), normal parathyroid function in six patients (50.0%) and hypoparathyroidism in two patients (16.7%) at 5 years after surgery. All of three patients who had removed three enlarged parathyroid glands showed persistent hyperparathyroidism. Serum ionized calcium was normal in 10 patients and two patients showed hypocalcemia after operation. CONCLUSION: Based on the results of this study, we conclude that subtotal parathyroidectomy may be effective in the surgical treatment of renal hyperparathyroidism. However, further studies are necessary to determine the optimal amount of remnant parathyroid tissue in subtotal parathyroidectomy to maintain normal parathyroid function postoperatively.
Alkaline Phosphatase ; Calcium ; Follow-Up Studies ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroidectomy ; Phosphorus ; Renal Insufficiency, Chronic

OBJECTIVE: The purpose of this study was to identify the relationship between metabolic syndrome and stress urinary incontinence. METHODS: Based form 362 case, the risk factors including the parameters of metabolic syndrome for stress urinary incontinence (SUI) were analyzed retrospectively: body mass index (BMI), hypertension, insulin resistance, triglyceride, HDL-cholesterol. RESULTS: The risk for metabolic syndrome were associated positively with SUI. Women with the risks for metabolic syndrome had 2.503 times of the odds for SUI compared without the risks for metabolic syndrome (95% CI 1.28-4.87, p<0.001). The independent risk factors for SUI were BMI (OR 3.574 ; 95% CI 0.09-0.31, p<0.001) and insulin resistance (OR 2.563 ; 95% CI 0.04-0.31, p=0.011) by multivariate analysis. CONCLUSION: Our results suggested that metabolic syndrome was the important factor of the stress urnary incontinence. And we confirmed the need for the treatment of metabolic disturbance and the prevention of metabolic syndrome aimed at correcting hormonal-metabolic disturbance in middle-aged and older women with SUI.
Body Mass Index ; Female ; Humans ; Hypertension ; Insulin Resistance ; Risk Factors ; Urinary Incontinence

OBJECTIVES: The extracapsular spread (ECS) of metastatic lymph nodes is associated with aggressive tumor behavior, and is regarded as a major risk factor for local recurrence in patients with head and neck squamous cell carcinoma. However, the significance of ECS of metastatic lymph nodes has not been well established in well-differentiated thyroid carcinoma. The purpose of this study was to examine this question. METHODS: A retrospective review was performed of 335 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lymph node dissection from April 2001 to December 2009. We analyzed various clinical characteristics, pathologic factors, and the size, number, and ECS of foci in metastatic lymph nodes. RESULTS: On pathologic review, 201 of the patients (56.6%) had lymph node metastasis. This was significantly related to age and tumor size. ECS was noted in 64 of these 201 patients (31.8%), and was significantly related to male gender, tumor size, presence of extrathyroidal extension, metastatic lymph node size, and focus size. Recurrence occurred in 13 patients (3.9%), and the presence of ECS was significantly related to recurrence. CONCLUSION: ECS of metastatic lymph nodes is an important prognostic factor for loco-regional recurrence in papillary thyroid carcinoma.
Carcinoma, Squamous Cell ; Head ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neck ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy