Temporal bone trauma can cause hearing loss and in case of prolonged conductive hearing loss, traumatic ossicular injury should be considered. Separation of the incudostapedial joint is the most common lesion, and stapediovestibular dislocation is relatively rare but can easily cause perilymphatic fistula. Here, we report a very rare case of external stapediovestibular dislocation after trauma, ending up with successful surgical outcome. A 27-year-old man with non-progressive hearing loss on the right side since childhood visited the clinic. Audiogram showed a conductive hearing loss with air-bone gap of 55 dB on the right side. Temporal bone CT revealed the disruption of ossicular chain. An exploratory tympanotomy identified multiple ossicular disruptions including external stapediovestibular dislocation with shiny fibrous membrane sealing the oval window. Ossicular chain reconstruction was performed using the total ossicular replacement prosthesis of titanium. A postoperative audiogram showed a recovery of air-bone gap less than 10 dB. To the best of our knowledge, this is the first case of external long-standing stapediovestibular dislocation, with oval window completely sealed with fibrous membrane, ending up with successful hearing recovery by surgery. This case would help dealing with such condition which can be encountered in the clinic.

Langerhans cell sarcoma is a rare, proliferative tumor of Langerhans cells, which shows cytologic characteristics and clinical features of malignant tumor. Langerhans cell sarcoma primarily occurs in lymph nodes, skin, lung, liver, and spleen. However, very few cases have been reported in the head and neck region. Because of its rarity, an optimal treatment approach is unknown; however, Langerhans cell sarcoma grows aggressively and shows a poor prognosis, such that a more aggressive and multi-modality treatment approach is necessary. Here, we report the case of a 36-year-old male with Langerhans cell sarcoma, who presented with a mass in the submandibular gland area and was treated with wide excision and postoperative radiotherapy.
Adult ; Head ; Humans ; Langerhans Cell Sarcoma ; Langerhans Cells ; Liver ; Lung ; Lymph Nodes ; Male ; Neck ; Prognosis ; Radiotherapy ; Sarcoma ; Skin ; Spleen ; Submandibular Gland

Osseous choristoma is a rare, benign proliferative osseous lesion, which is defined as the growth of normal tissue in an abnormal location. The etiopathogenesis for its formation is unknown, but various hypotheses have been proposed. Treatment of choice is en-bloc resection, and no recurrence has been reported. Here, we report the two cases of osseous choristoma, presented with a mass on the base of the tongue with/without globus symptom and were treated with surgical excision.
Choristoma ; Osteoma ; Recurrence ; Tongue

Background: There is little information about the airborne hazardous agents released during the heat treatment when manufacturing a welding material. This study aimed to evaluate the airborne hazardous agents generated at welding material manufacturing sites through area sampling. Methods: concentration of airborne particles was measured using a scanning mobility particle sizer and optical particle sizer. Total suspended particles (TSP) and respirable dust samples were collected on polyvinyl chloride filters and weighed to measure the mass concentrations. Volatile organic compounds and heavy metals were analyzed using a gas chromatography mass spectrometer and inductively coupled plasma mass spectrometer, respectively. Results: The average mass concentration of TSP was 683.1 ± 677.4 μg/m3, with respirable dust accounting for 38.6% of the TSP. The average concentration of the airborne particles less than 10 μm in diameter was 11.2–22.8 × 104 particles/cm3, and the average number of the particles with a diameter of 10–100 nm was approximately 78–86% of the total measured particles (<10 μm). In the case of volatile organic compounds, the heat treatment process concentration was significantly higher (p < 0.05) during combustion than during cooling. The airborne heavy metal concentrations differed depending on the materials used for heat treatment. The content of heavy metals in the airborne particles was approximately 32.6%. Conclusions Nanoparticle exposure increased as the number of particles in the air around the heat treatment process increases, and the ratio of heavy metals in dust generated after the heat treatment process is high, which may adversely affect workers' health.

Langerhans cell sarcoma is a rare, proliferative tumor of Langerhans cells, which shows cytologic characteristics and clinical features of malignant tumor. Langerhans cell sarcoma primarily occurs in lymph nodes, skin, lung, liver, and spleen. However, very few cases have been reported in the head and neck region. Because of its rarity, an optimal treatment approach is unknown; however, Langerhans cell sarcoma grows aggressively and shows a poor prognosis, such that a more aggressive and multi-modality treatment approach is necessary. Here, we report the case of a 36-year-old male with Langerhans cell sarcoma, who presented with a mass in the submandibular gland area and was treated with wide excision and postoperative radiotherapy.

Background and Objectives: Sinonasal inverted papilloma (IP) is a benign tumor with a locally aggressive nature and a propensity to recur. Many risk factors for recurrence have been reported, but they are still controversial. The aim of this study was to comprehensively assess the demographic data, clinical features, and potential risk factors for recurrence of IP.Subjects and Method: This work is a retrospective review of 382 patients diagnosed with and treated for sinonasal inverted papilloma between 1986 and 2017 at a single tertiary medical center. Demographic data, presence of associated malignancy, information about previous surgeries, tumor location, Krouse stage, surgical approach, follow-up duration, and data on recurrence were obtained. Results: In our study, 31 of 382 cases (8.1%) were associated with malignancy. Mean age was significantly higher in patients with associated malignancy compared to the benign IP group. Of the 351 benign cases, 263 (74.9%) were primary, and 88 (25.1%) were revision cases (residual or recurrent disease). Although the proportion of patients with high Krouse stage or multifocal involvement was high in the revision cases, there was no significant difference in recurrence rate. The 226 patients with a minimum follow-up of 1 year were included for recurrence analysis. Recurrence rate was significantly higher in the conventional surgery group (17.4%) compared to that of the endoscopic and combined surgery groups (8.1% and 3.6%, respectively). Also, the recurrence group showed significantly larger proportion of patients with high Krouse stage and multifocal involvement. Conclusion Risk factors for recurrence of IP found in this study are comparable to those previously published. Generally, the factors associated with recurrence of IP were prior surgery, clinical stage, involved site, and surgical approach. Therefore, surgeons should always consider these risk factors to reduce the chance of recurrence.

OBJECTIVE: This multicenter clinical trial was carried out to investigate the efficacy and the safety of olanzapine for the treatment of Korean patients. METHOD: 105 patients with schizophrenia and schizophreniform disorder, visited at 10 mental or university hospitals, had received an open and non-comparative treatment with olanzapine for 8 weeks. Patients had psychotic or depressive symptoms with the severity above moderate degree or intolerable side effects to previous antipsychotics. After a wash-out period of 2-7 days, 10mg olanzapine was prescribed initially to all the patients, and then the dosage could be adjusted within the range of 5-20mg/day of olanzapine by 3-7 days. RESULTS: 90(85.7%) of 105 patients completed the 8-weeks trial and the mean modal dose of olanzapine was 16.1(+/-4.7)mg/day. At the end of the trial, 73 patients(69.5%) were classified as responder, which was defined as 40% or more improvement in BPRS(Brief Psychiatric Rating Scale) score comparing to baseline. There was a significant reduction in the scores of PANSS(Positive and Negative Syndrome Scale) and subscales including negative symptom scores and CGI. Also weekly analysis showed that the reductions in scores were kept on for the whole period of the trial. 43.8% of all the patients had depressive symptoms at the baseline and total scores of MADRS(Montgomery-sberg Depression Rating Scale) and HAM-A(Hamilton Rating Scale for Anxiety) were also reduced after the trials. Vital signs revealed no clinically significant changes but continuous weight gain was observed during the treatment with olanzapine. The scores of SAS(Simpson-Angus Scale) and AIMS(Abnormal Involuntary Movement Scale) for assessing the EPS(extrapyramidal symptoms) and tardive dyskinesia respectively were significantly decreased and only a few patients reported EPS as adverse events. Although mild and clinically non-significant elevation of ALT/SGPT was observed, most laboratory parameters including plasma prolactin level showed no significant changes during the trial. CONCLUSIONS: Although this trial had many limitations because it was a non-comparative and open study, olanzapine showed high efficacy on the positive, negative and depressive symptoms in schizophrenia and schizophreniform disorder. In addition to that, olanzapine showed a substantially favorable safety profile, such as low incidence of EPS and hyperprolactinemia.
Antipsychotic Agents ; Depression ; Dyskinesias ; Hospitals, University ; Humans ; Hyperprolactinemia ; Incidence ; Movement Disorders ; Plasma ; Prolactin ; Psychotic Disorders* ; Schizophrenia* ; Vital Signs ; Weight Gain

Although the role of alpha-synuclein aggregation on Parkinson's disease is relatively well known, the physiological role and the regulatory mechanism governing the expression of alpha-synuclein are unclear yet. We recently reported that alpha-synuclein is expressed and secreted from cultured astrocytes. In this study, we investigated the effect of valproic acid (VPA), which has been suggested to provide neuroprotection by increasing alpha-synuclein in neuron, on alpha-synuclein expression in rat primary astrocytes. VPA concentration-dependently increased the protein expression level of alpha-synuclein in cultured rat primary astrocytes with concomitant increase in mRNA expression level. Likewise, the level of secreted alpha-synuclein was also increased by VPA. VPA increased the phosphorylation of Erk1/2 and JNK and pretreatment of a JNK inhibitor SP600125 prevented the VPA-induced increase in alpha-synuclein. Whether the increased alpha-synuclein in astrocytes is involved in the reported neuroprotective effects of VPA awaits further investigation.
Acetylation ; alpha-Synuclein* ; Animals ; Astrocytes* ; MAP Kinase Signaling System* ; Neurons ; Neuroprotective Agents ; Parkinson Disease ; Phosphorylation ; Rats* ; RNA, Messenger ; Valproic Acid*