Neurofibroma arising solitarily in the larynx is uncommon. With the branch of the superior laryngeal nerve involved, the aryepiglottic fold is the most common site in endolaryngeal neurofibromas. The recurrence rate for the disease is high unless en bloc excision, the treatment of choice, is taken. We present a case of neurofibroma in a 58-year-old female who complained of throat discomfort and dysphagia. The mass was removed by transoral laser surgery and no recurrence was found after 18 months.
Deglutition Disorders ; Female ; Humans ; Laryngeal Nerves ; Larynx ; Laser Therapy ; Neurofibroma ; Pharynx ; Recurrence

BACKGROUND AND OBJECTIVES: Because of the wide application of the endoscopic diagnostic system and increased amount of attention for early stage congenital cholesteatoma (CC) recently, the detection of CC in stages I and II has increased. In this study, we investigated the effectiveness of minimally invasive transcanal myringotomy (MITM), and compared its results with those of postauricular approach (PAA) in early stage CC consisting of stage I and II of Potsic's classification. SUBJECTS AND METHOD: We retrospectively studied 70 patients who were diagnosed with CC after surgery performed by an otologist from June 2006 to June 2013. Thirty-two patients were in early stage CC consisting stage I and II. Of the 32 patients, MITM was performed on 20 and PAA was performed on 12. We analyzed the characteristics of disease, operation time, hospitalization period, recurrence and complications according to the stage and each operation. RESULTS: There were no significant differences between the stages and types of the disease between the MITM and the PAA group (p>0.05). The operation time and hospitalization period for the MITM group were significantly shorter than for the PAA group (p<0.001). There was no recurrence in the two groups during the average follow-up period of 33 months follow-up. Tympanic membrane perforation occurred in one patient in the MITM group. One patient presenting an external aural epidermal cyst in the PAA group was treated with surgical removal. CONCLUSION: The MITM is an efficacious and feasible method to remove early stage CC.
Cholesteatoma* ; Classification ; Epidermal Cyst ; Follow-Up Studies ; Hospitalization ; Humans ; Recurrence ; Retrospective Studies ; Tympanic Membrane Perforation

BACKGROUND: We purposed to systemically review studies investigating the prophylactic effect of both pharmacological and non-pharmacological modalities against rocuronium induced withdrawal movement (RIWM) in the Korean population. METHODS: Literature search was performed using MEDLINE, EMBASE, CENTRAL, Koreamed, KMBASE, KISS and RISS up to March 2014. Randomized controlled trials (RCTs) comparing pharmacological and non-pharmacological interventions with placebo aimed for the Korean population were included. Outcome measures were the incidence and severity of RIWM. We conducted subgroup analyses according to each intervention method. RESULTS: Data were analyzed from 41 RCTs totaling 4,742 subjects. The overall incidence of RIWM was about 80% (range 56-100%). Incidence and severity of RIWM were significantly reduced with lidocaine (risk ratio [RR] 0.60, 95% CI 0.49-0.74; standardized mean difference [SMD] -0.74, 95% CI -1.05 to -0.44), opioids (RR 0.28, 95% CI 0.18-0.44; SMD -1.71, 95% CI -2.09 to -1.34) and hypnotics (RR 0.36, 95% CI 0.25-0.52; SMD -2.20, 95% CI -2.62 to -1.79). Regardless of tourniquet use, lidocaine showed a prophylactic effect against incidence and severity of RIWM: tourniquet (RR 0.36, 95% CI 0.21-0.62; SMD -1.51, 95% CI -2.15 to -0.86); non-tourniquet (RR 0.58, 95% CI 0.47-0.71; SMD -0.74, 95% CI -1.05 to -0.44). Dilution and slow injection of rocuronium decreased incidence and severity of RIWM: dilution (RR 0.47, 95% CI 0.39-0.56; SMD -1.64, 95% CI -2.47 to -0.81); slow injection (RR 0.34, 95% CI 0.17-0.70; SMD -2.13, 95% CI -2.74 to -1.51). CONCLUSIONS: The greater part of pharmacological and non-pharmacological interventions showed prophylactic effect against the incidence and severity of RIWM in the Korean population.
Analgesics, Opioid ; Anesthesia ; Hypnotics and Sedatives ; Incidence ; Lidocaine ; Outcome Assessment (Health Care) ; Tourniquets

Teratoma is a tumor derived from totipotential cells and composed of tissues originating from all 3 germinal layers. The tumor can be malignant based on histologic differentiation, size and location and is commonly found in the sacrococcygeal region, but uncommonly occurs in the head and neck region. A mature teratoma rarely occurs in the Eustachian tube. The authors of the current study present a case of a mature teratoma originating from the Eustachian tube of a 23-year-old woman who complained of left otorrhea. In addition, a review of the literature is presented.
Eustachian Tube ; Female ; Head ; Humans ; Neck ; Sacrococcygeal Region ; Teratoma ; Young Adult

Osteoma is a slow-growing benign tumor that consists of mature or cancellous bone. It most commonly occurs in the frontoethmoidal area of the paranasal sinus and is usually asymptomatic. Surgical excision is necessary for osteoma, which causes symptoms such as headache, nasal obstruction, facial asymmetry, and visual disturbance. Surgical approaches should also be considered depending on the size and location of the osteoma, in order to reduce intracranial and orbital complications. We recently treated a huge frontoethmoid osteoma involving the skull base and orbit, which was removed via endoscopic sinus surgery and a combined extracranial approach. Herein, we report this case with a review of the relevant literature.
Facial Asymmetry ; Headache ; Nasal Obstruction ; Orbit* ; Osteoma* ; Skull Base*

Adenoic cystic carcinoma (ACC) is a malignant tumor, occuring in the major and minor salivary glands. Laryngeal ACC is a rare malignancy that constitutes less than 1% of all laryngeal malignancies. ACC is characterized by slow growth, multiple recurrences and late distant metastasis. The treatment of the ACC is by wide excision or by combining wide excision with postoperative radiotherapy. A 33-year-old woman, who had been diagnosed with epiglottic cyst in 2007, complained of throat discomfort that had been aggravating for the past two weeks. The tumor was treated with transoral laser excision. The pathologic report revealed an adnoid cystic carcinoma on the epiglottis; it was composed of cribriform patterned nests and columns of tumor cells. No recurrence was detected until post-operative 16 months by endoscopic examination. Transoral laser excision was suggested for successful treatment for the adenoid cystic carcinoma.
Adult ; Carcinoma, Adenoid Cystic ; Female ; Humans ; Neoplasm Metastasis ; Pharynx ; Recurrence ; Salivary Glands, Minor

BACKGROUND: About 80 percent of the Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteoarthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis. METHODS: Twenty patients who had visited the department of family medicine, Korea University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed. RESULTS: Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i.e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05). CONCLUSIONS: Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.
Diagnosis ; Hand ; Humans ; Joints* ; Knee ; Knee Joint ; Korea ; Middle Aged ; Osteoarthritis* ; Osteoarthritis, Knee* ; Physical Examination ; Public Health ; Sensitivity and Specificity ; Thermography*

A twenty-year-old male visited our clinic with wrist and long finger metacarpophalangeal (MP) joint pain. Dynamic ultrasonography revealed sagittal band (SB) ulnar subluxation and extensor carpi ulnaris (ECU) volar subluxation. Magnetic resonance imaging showed longitudinal splitting and dislocation of the volar half slip of the ECU tendon. The redundant radial SB was augmented and ECU sheath was advanced to the periosteum using suture anchors. He was able to perform his previous activities at the last follow-up. We encountered a case of "simulateous" ECU dislocation with extensor tendon subluxation of the long finger at the MP joint. Therefore, we report this case with a review of the relevant literature.
Finger Injuries/*diagnosis/*surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Tendon Injuries/*diagnosis/*surgery ; Ultrasonography ; Young Adult

PURPOSE: Dispatcher-assisted telephone instruction during cardiopulmonary resuscitation (CPR) improves the quality of CPR performed by laypersons. However, in Korea, CPR instruction guidelines for bystanders have not made. We therefore studied the effects of verbal instruction on the quality of chest compression. METHODS: Data from two randomized, double-blinded, controlled trials using identical methodology were combined to obtain 175 records for analysis. Subjects were randomized into either a "push as hard as you can and fast" (n=87) or "push down 5~6 cm, 100~120 rate/min" (n=88), verbal instructions in the 2011 Korea Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). Data were recorded via a Resusci(R) Anne SkillReporter(TM), Laerdal Medical mannequin. Primary outcome measures included chest compression depth and chest compression rate per minute. RESULTS: The average compression depth and speed of chest compressions did not significantly differ between the two verbal instructions. CONCLUSION: The verbal istructions provided by telephone based on the 2011 Korean Guidelines for CPR and ECC are not effective. The instructions for high quality CPR of layperson should therefore be studied.
Cardiopulmonary Resuscitation* ; Emergencies ; Heart Massage ; Korea ; Manikins ; Methods ; Outcome Assessment (Health Care) ; Telephone* ; Thorax ; Verbal Learning

PURPOSE: This report presents our experience of the renal transplatation of a long term dysfunctional contracted bladder and its outcome. METHODS: Between March 1996 and May 2006, 425 cases of renal transplantation were performed in our medical center. We found 14 chronic renal failure patients having dysfunctional contracted bladder (DFCB) that was diagnosed through the preoperative voiding cystourethrogram. DFCB was defined as the maximal urinary bladder volume less than 100 mL. No surgical or medical preparation was done before and after renal transplantation. In 8 out of 14 cases, extravesical ureteroneocytostomy (EVUC) was conducted and the Lich's EVUC was done for the other 6 cases. Double J ureteral stent was not employed in any cases. RESULTS: The mean age of the recipients was 41.4 years. The mean capacity of these bladder was 72.1 mL (range 20 to 100 mL). Of the 14 cases, thirteen had living donor related transplantation and one received cadaveric kidney. Postoperative complication was occurred in one case, which was bleeding. There was no evidance of urinary tract complication. All patient excluding of one patient who had the episodesof chronic rejection were stable throughout the entire follow up period. CONCLUSION: DFCB in renal translpantation had no adverse effect on successful outcome in transplant operation deposite no preoperative preparation, especially cadaveric donor transplatation, it may, however, need a delicate surgical skills to perform EVUC.
Cadaver ; Follow-Up Studies ; Hemorrhage ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation* ; Living Donors ; Postoperative Complications ; Stents ; Tissue Donors ; Ureter ; Urinary Bladder* ; Urinary Tract