While intradermal nevi are common benign pigmented skin tumors, their occurrence within the external auditory canal(EAC) is uncommon. We experienced a case of huge intradermal nevus which almost completely obstructed EAC without accompanying conductive hearing loss. It originated in the anterior wall of cartilaginous portion of EAC. It was treated by en bloc excision with split skin graft. The clinical and pathologic features of the intradermal nevus arising within the external auditory canal are presented, and the literatures were reviewed.
Ear Canal* ; Hearing Loss, Conductive ; Nevus, Intradermal* ; Skin ; Transplants

No abstract available.

PURPOSE: PVP using a high-power potassium-titanly-phosphate(KTP) laser offers safe and efficacious surgical therapy for men with symptomatic BPH. To demonstrate its efficacy, safety and durability, we present the results of PVP for treatment of BPH with 12 month follow-up. MATERIALS AND METHODS: 104 consecutive men with symptomatic BPH underwent PVP with an 80 W KTP laser (Laserscope) between July 2003 and August 2004. All underwent preoperative and postoperative evaluation, including assessments of international prostate symptom score(IPSS), quality of life(QOL), peak urinary flow rate(Qmax), post-void residual volume(PVR), prostate specific antigen(PSA), and ultrasound prostate volume(PV). Secondary outcome parameters included surgical time, anesthesia, and length of catheterization. Follow-up assessment occurred at 1, 3, 6, and 12 months. Data were analyzed using the Wilcoxon signed rank test. RESULTS: Preoperative mean PV was 57.2+/-4.2 ml. PV decreased to 38.9, 35.4, 32.8 and 35.8 at 1, 3, 6 and 12 months (p <0.01 versus preoperative value). Mean improvements in IPSS, QOL, Qmax, and PVR at 12 months were 67%, 81%, 138% and 94%, respectively(p <0.001). Mean operative time was 26.3+/-15.0 minutes. Anesthesia included pudendal and prostatic block(n=102) and spinal anesthesia(n=2). Ninety-nine(95%) patients were treated as outpatients( <12 hrs) and the remaining 5 patients were admitted for 1 or 2 hospital days. Mean catheterization times were 9.8+/-3.1 hours(range 0~72), with 28(27%) patients not requiring a catheter post-operatively. Minor complications included mild hematuria lasting 3 weeks(3.8%), transient post-operative retention(2.9%), urge incontinence(1.9%), transient dysuria(25%), frequency(21.2%), urgency(17.3%) and retrograde ejaculation(41%). CONCLUSIONS: These results demonstrate that PVP is safe and efficacious for the treatment of symptomatic BPH. Long follow-up will further validate this new modality as the standard for surgical treatment of BPH.
Anesthesia ; Catheterization ; Catheters ; Follow-Up Studies ; Hematuria ; Humans ; Lasers, Solid-State* ; Male ; Operative Time ; Prostate ; Ultrasonography ; Volatilization*

BACKGROUND AND OBJECTIVES: Depending on the pathologic process the treatment of frontal sinus disease has consisted of obliteration of the sinus, or restoration of drainage into the nose. Endoscopic sinus surgery (ESS) gives advantages for dramatically reducing operative morbidity of surgery for frontal sinus disease by offering a minimally invasive alternative to previous osteoplastic or other radical frontal sinus surgery. We present our experience with 18 frontal sinus diseases in which osteoplastic approach or endoscopic sinus were attempted. MATERIALS AND METHODS: Retrospective review of 18 cases were done. Ten patients were treated by ESS, and 8 cases by osteoplastic frontal sinus surgery (OFSS) with obliteration. RESULTS: During the follow-up period, 10 patients treated by ESS had complete resolution of all symptoms but 3 cases treated by OFSS had at least one episode of headache. No recurrence of ESS patients has been noted to date according to the endoscopic follow-up of up to 16 months, and gradual absorbtion of obliterated fat without recurrence was observed. But there was no absorption of obliterated hydroxyapatite granule after long-term period. The frontal sinus can be visualized with follow-up endoscopy, and the difficult evaluation of the obliterated cavity can be avoided. CONCLUSION: ESS is much better than OFSS, but osteoma, fracture and some limited situations are bound to be treated by OFSS. In case of OFSS, hydroxyapatite obliteration shows long-term stability than fat.
Absorption ; Drainage ; Durapatite ; Endoscopy ; Follow-Up Studies ; Frontal Sinus* ; Headache ; Humans ; Nose ; Osteoma ; Recurrence ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Isolated sphenoid sinusitis is often misdiagnosed because of its rarity and varied clinical presentation. Presenting symptom is often both subtle andsuggestive of other intracranial lesions. The purpose of this study is to present typical clinical manifestations and treatment of pure bacterial isolated sphenoid sinusitis. Materials and Method: Nine cases of isolated sphenoid sinusitis of bacterial origin were reviewed retrospectively. RESULTS: Two cases were acute and seven cases were chronic. The most common symptom was deep seated headache. Most of them were transferred via other department. Radiologic diagnosis using CT and MRI was enough to distinguish. Four cases were improved by medical treatment. Five cases were treated by endoscopic sphenoidotomy. CONCLUSION: Isolated sphenoid sinusitis should be considered as a possible cause in case of deep seated, intractable headache. And in this case, CT or thorough endoscopic examination should be recommended. Endonasal endoscopic sphenoidotomy is good and simple treatment for cases intractable to medical treatment.
Diagnosis ; Headache ; Headache Disorders ; Magnetic Resonance Imaging ; Retrospective Studies ; Sphenoid Sinus* ; Sphenoid Sinusitis*

BACKGROUND AND OBJECTIVES: It has been assumed that salivary glands receive secretory fibers both from parasympathetic and sympathetic nerves. In fact, however, the existence of sympathetic secretory fibers in the cervical sympathetic nerve has not been established yet, because the salivary response to the cervical sympathetic stimulation is variable and short-lasting, and it tends to cease in spite of continued stimulation. This study investigated whether or not the cervical sympathetic nerve contains specific secretory fibers. MATERIALS AND METHODS: Salivary and blood flow responses to different frequency stimulation of the cervical sympathetic nerve, and often some autonomic drugs administration were observed from the submandibular gland in chloralose-anesthetized cats. RESULTS: 1) Low frequency stimulation (1-2 Hz) of the sympathetic nerve did not evoke salivary outflow and any change of blood flow, whereas high frequency stimulation of the nerve evoked salivary outflow and decrease of blood flow, in which salivary response tended to cease in spite of continued stimulation. 2) The salivary and blood flow responses to high frequency stimulation (20 Hz) of the nerve were not affected by the intravenous administration of propranolol, but were abolished by regitine. 3) Noradrenalin evoked salivary outflow and decreased blood flow which were not affected by the administration of propranolol but were abolished by regitine. 4) Isoproterenol increased blood flow but did not evoke salivary outflow, and the blood flow response was abolished by propranolol. CONCLUSION: These results suggest that the cervical sympathetic nerve does not contain specific secretory fibers and salivary outflow response to high frequency stimulation of the nerve may be due to either excitation of motor fibers innervating contractile elements of the excretory duct or chemical transmitters released from the vasomotor fibers.
Administration, Intravenous ; Animals ; Autonomic Agents ; Cats* ; Isoproterenol ; Phentolamine ; Propranolol ; Salivary Glands ; Submandibular Gland*

Focal segmental glomerulosclerosis (FSGS) is presented as not only one of the primary glomerular diseases but also as a secondary phenomenon for chronic irreversible renal diseases. The main pathological feature of FSGS is the accumulation of extracellular matrix in the glomeruli, for which overexpression of transforming growth factor-beta (TGF-beta) may be responsible for the accumulation of pathological matrix. A new animal model (FGS/NgaKist mouse) of renal failure by spontaneously generating glomerulosclerosis was developed. To elucidate the role of TGF-beta for FSGS, authors observed glomeruli of FGS/NgaKist mouse periodically. FGS/NgaKist mouse strain showed progression of proteinuria and focal glomerular sclerosis with the aging. The glomeruli showed anti IgG, IgA, IgM and complement complex deposits and extracellular matrix accumulation in the mesangium. TGF-beta mRNA and beta2antibody expressions were increased with the advance of glomerular sclerosis. The results suggest the following; FSGS of FGS/NgaKist strain is immune mediated disease and this stimuli on mesangial or endothelial cells may activate TGF-beta gene in their nuclei. This activation, in turn, can cause sclerosis by increasing TGF-beta mRNA transcription followed by secretion of TGF-beta and its action as cytokine for making collagen fibrils.
Aging ; Animals ; Collagen ; Complement System Proteins ; Endothelial Cells ; Extracellular Matrix ; Glomerulosclerosis, Focal Segmental ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Mice* ; Models, Animal ; Proteinuria ; Renal Insufficiency ; RNA, Messenger ; Sclerosis ; Transforming Growth Factor beta

No abstract available.
Bronchiectasis* ; Bronchography*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

OBJECTIVES AND METHODS: The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. RESULTS: Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinorna: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer..patients was 32.y %(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+GEM>22%) in lung cancer patients was 42.9% (15/35), but none in benign diseases. In (iffy-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. CONCLUSIONS: The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.
Aneuploidy ; Biopsy ; Cell Cycle ; Diagnosis ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Ploidies* ; Surgical Instruments ; Thoracotomy