Development of a cystic mass on the nasal dorsum is a very rare complication of aesthetic rhinoplasty. Most reported cases are of mucous cyst and entrapment of the nasal mucosa in the subcutaneous space due to traumatic surgical technique has been suggested as a presumptive pathogenesis. Here, we report a case of dorsal nasal cyst that had a different pathogenesis for cyst formation. A 58-yr-old woman developed a large cystic mass on the nasal radix 30 yr after augmentation rhinoplasty with silicone material. The mass was removed via a direct open approach and the pathology findings revealed a foreign body inclusion cyst associated with silicone. Successful nasal reconstruction was performed with autologous cartilages. Discussion and a brief review of the literature will be focused on the pathophysiology of and treatment options for a postrhinoplasty dorsal cyst.
Cysts/diagnosis/pathology/surgery ; Female ; Foreign Bodies/diagnosis/*etiology ; Humans ; Microscopy, Electron, Scanning ; Middle Aged ; *Nose/pathology ; Nose Diseases/diagnosis/etiology/pathology ; Rhinoplasty/*adverse effects ; Tomography, X-Ray Computed

Zenker diverticulum is rare and symptoms of diverticulum are atypical. This is most commonly seen at the Killian's triangle. This is caused by altered motility, which results in abnormal intraluminal pressure and the pushing of the mucosa through weakness of the wall. Treatment is surgical via an endoscopic or external approach. Previous external approaches are associated with high com-plication rates and morbidity. We report a new external surgical approach using the gastrointestinal autostapler (GIA) instrument.
Diverticulum ; Mucous Membrane ; Zenker Diverticulum

Isolated fourth(IV) ventricle in shunted patients has been reported with increasing frequency. Symptomatic isolated IV ventricular hydrocephalus in adults, however, has seldom been described. We report five such cases among total of 420 shunted cases in our institution from January 1992 to December 1995. The causes of initial hydrocephalus were postsurgical meningitis(SAH, teratoma and abscess of posterior fossa), tuberculous meningitis and neurocysticercosis of the IV ventricle. All cases were symptomatic with clinical findings related to posterior fossa lesions. Two patients developd symptoms in 2 months after V-P shunts and the others between 17 and 118 months after V-P shunts. These 5 patients required IV ventricular shunting. All patients improve postoperatively except one patient who developed 6th nerve palsy related to secondary irritation of the brainstem by the IV ventricular catheter. Inflammatory changes in the ependyma of both aqueduct of Sylvius, foramina Luschka and Magendi have been regarded as the most important factors in the development of the isolation of IV ventricle, especially in adults. It is generally recommended to shunt in cases of the adult symptomatic isolated IV ventricle. Alternative surgical techniques and prevention of such complications are discussed.
Abducens Nerve Diseases ; Abscess ; Adult* ; Brain Stem ; Catheters ; Cerebral Aqueduct ; Diagnosis* ; Ependyma ; Humans ; Hydrocephalus* ; Neurocysticercosis ; Teratoma ; Tuberculosis, Meningeal

Bell's palsy is acute idiopathic peripheral facial nerve palsy which is diagnosed after all the possible causes are ruled out. Several symptoms and signs of polyneuropathy, such as hypesthesia of cranial nerve IX or V, vagal motor weakness, retroauricular pain, and hearing impairment were frequently accompanied with Bell's palsy. However, association of vertigo has been rarely reported, and moreover, associated vestibulopathy was not characterized in detail in those cases. We report a 35 year-old male patient with Bell's palsy accompanying acute peripheral vestibular loss, which eventually evolved to benign paroxysmal positional vertigo.
Adult ; Bell Palsy* ; Facial Nerve ; Glossopharyngeal Nerve ; Hearing Loss ; Humans ; Hypesthesia ; Male ; Paralysis ; Polyneuropathies ; Vertigo

A tumor and cortical dysplasia may be the concomitant cause of the causes of intractable epilepsy, but a few studies have examined so far. From among 249 patients who underwent surgery for intractable epilepsy at Dongsan Epilepsy Center, those in whom neoplasia and cortical dysplasia coexisted were selected for this study, and were reviewed the clinical, electrophysiological, neuroimaging and pathological findings. In 17 of 25 lesionrelated epilepsy patients, tumors including dysembryoplastic neuroepithelial tumor(DNT)(n=6), ganglioglioma(n=5), gangliocytoma(n=1), low grade astrocytoma(n=2), oligodendroglioma(n=2), hypothalamic hamartoma(n=1) were verified. Of these 17 cases involving tumors, concomitant cortical dysplasia was observed in 7(DNT; 6, ganglioglioma; 1). All these patients underwent sophisticated presurgical evaluation and intraoperative acute recording(EcoG) for the identification of adjacent or remote epileptogenic areas as well as functional brain mapping by electrical stimulation or SSEP to verify the eloquent areas. In intractable epilepsy, the coexistence of cortical dysplasia and neoplasia is not common, though careful intraoperative evaluation of the tumor and surrounding tissue using electrocorticogram (EcoG) may lead to its pathological identification and excellent surgical results for these rare lesions.
Brain Mapping ; Electric Stimulation ; Epilepsy* ; Ganglioglioma ; Humans ; Malformations of Cortical Development* ; Neuroimaging

Biliary papillomatosis (BP) is a rare disease that is classified as either the mucin-hypersecreting type or nonmucin-secreting type. Typical papillomas of the biliary tree mainly involve intrahepatic bile ducts or both intra- and extrahepatic bile ducts. The isolated involvement of the extrahepatic bile duct is rare, and there is no report of BP confined to the gallbladder in Korea. We report a case of a 50-year-old man who developed obstructive jaundice due to hypersecreted mucin from papillomas of the gallbladder.
Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Carcinoma, Papillary* ; Gallbladder* ; Humans ; Jaundice, Obstructive* ; Korea ; Middle Aged ; Mucins ; Papilloma ; Rare Diseases

We report two patients who suffered from hemolytic transfusion reactions due to anti-Jkb antibody: one showed acute- and the other showed delayed-type hemolysis. The first patient was a 40-year-old man who suffered from epilepsy after the operation for arteriovenous malformation 16 years ago. He received five units of red blood cells (RBC) after right temporal lobectomy. On the fifteenth postoperative day, fever and chill developed during transfusion of one unit of packed RBC, followed by dark urine and oliguria. The polyethylene glycol-Coombs test and enzyme test revealed anti-Jkb antibody which had not been detected on the pretransfusion specimen. The second patient was a 41-year-old man who was admitted for the reoperation of the prosthetic mitral valve. Because hemoglobin was 5.9g/dL at admission, he received five units of packed RBCs. Oliguria and laboratory findings consistent with hemolytic anemia were observed from the third day of transfusion. Anti-Jkb antibody was detected on antiglobulin phase. Both patients developed acute renal failure (ARF) and hemodialysis with conservative management were done. They finally recovered from ARF without any residual complications. Implementation of more sensitive pretransfusion tests should be considered to prevent rare, but serious hemolytic transfusion reactions.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Arteriovenous Malformations ; Blood Group Incompatibility* ; Epilepsy ; Erythrocytes ; Fever ; Hemolysis ; Humans ; Mitral Valve ; Oliguria ; Polyethylene ; Renal Dialysis ; Reoperation

No abstract available.
Factor XII Deficiency* ; Humans