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

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*

No abstract available.

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*

No abstract available.
Bronchiectasis* ; Bronchography*

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.
Female ; Pregnancy ; Pregnancy, Ectopic*

Almost all advanced glomerular diseases have glomerular sclerotic changes to varying degrees whatever causes their primary glomerular disease are. Pathogenesis of these sclerosis has been thought of as the hyperfiltration in the primary glomerulosclerosis due to development of glomerular hypertension in each insulted glomeruli. This background gave the theoretical bases for antihypertensive therapies for supporting chronic renal insufficient patients. Angiotensin converting enzyme (ACE) inhibitor, one of the antihypertensive drugs, has received attention recently for its effectiveness. The aims of this study determined the effects and mechanism of the ACE inhibitor, enalapril, on the glomerulosclerosis in FGS/NgaKist mice, which was an animal model of chronic renal failure by generating spontaneously heavy proteinuria and progressive glomerulosclerosis. Five-week-old FGS/NgaKist mice (n=38) were assigned to four groups. Group 1a (n=6) and group 2a (n=8) fed with a vehicle, were sacrificed at the end of 10 weeks and 15 weeks, respectively. Group 1b (n=12) and 2b (n=12) received enalapril (100 mg/L) in drinking water for 5 weeks and 10 weeks from 6th week of age respectively, and were sacrified on the same day as the control groups. Doses of enanapril were maintained to 2 mg/kg/day by measuring the amount of water consumption. In enalapril groups 1b and 2b, systemic blood pressure (74.7 14.0 mm Hg, 74.3 15.9 mmHg) were significantly lower than control group 2a (116.1 4.6 mmHg, P<0.001). Similarly, degree of proteinuria lowered in enalapril group 2b versus control group 2a (0% and 50.0%, P<0.001). Glomerulosclerosis percentage significantly decreased (P<0.001) (group 1b and 2b; 1.9 6.5, 5.6 7.0 vs control 1a and 2a; 32.8 15.5, 31.4 13.8). Glomerulosclerosis score also decreased (P<0.001) (group 1b and 2b; 0.02 0.08 vs control 1a and 2a; 0.48 0.12, 0.30 0.14). The immunofluorescent staining of enalapril groups showed negative for mesangial deposition of IgG, IgA, IgM, and C3 which were positive in control groups. Immunohistochemical staining with TGF-beta1 was negative in enalapril groups and sclerotic glomeruli both enalapril groups and control groups. These results support that the ACE inhibitor has a renoprotective effect on glomerulosclerosis not only by decreasing the blood pressure but also by suppressing the immune deposits on glomeruli.
Angiotensins* ; Animals ; Antihypertensive Agents ; Blood Pressure ; Drinking ; Drinking Water ; Enalapril ; Humans ; Hypertension ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Kidney Failure, Chronic ; Mice ; Models, Animal ; Peptidyl-Dipeptidase A* ; Proteinuria ; Sclerosis* ; Transforming Growth Factor beta1