Acute or chronic sinusitis is common disease of ENT. Most cases usually respond to appropriate treatment; however, some cases occasionally progress to the development of serious complication and poor prognosis. The orbital complications are most common complication fallowed by intracranial complications. The incidence of sinogenic intracranial complications is about 3.7-11.0% and these complications are progressively decreasing however the complications occur due to incorrect use of antibiotics, antibiotics resistant pathogens, decreasing host immunity, improper diagnosis and delayed surgical treatment. Therefore the case of epidural abscess in anterior portion of middle cranial fossa secondary to acute sphenoid sinusitis, which was treated with transnasal endoscopic sphenoidotomy and intravenous antibiotics, is being reported.
Anti-Bacterial Agents ; Cranial Fossa, Middle* ; Diagnosis ; Epidural Abscess* ; Incidence ; Orbit ; Prognosis ; Sinusitis ; Sphenoid Sinus* ; Sphenoid Sinusitis*

BACKGROUND AND OBJECTIVES: Fine needle aspiration cytology (FNAC) is a safe and economical biospy technique which is widely applicable to palpable masses as a first-line procedure. Successful FNAC, however, demands high specimen quality and experience on the part of both the aspirator and the pathologist. We compared cytological diagnosis with histopathological diagnosis in the head and neck region, in order to increase accuracy and solve any discrepancy in the two types of diagnoses. MATERIALS AND METHODS: From July 1996 through to July 1998, FNAC were carried out in 830 cases in palpable mass of the head and neck region in the Department of Pathology, Chonnam University Hospital. The major target sites were lymph nodes (61.4%), soft tissues (22.2%), and salivary glands (16.4%). Histopathological diagnoses were performed in 267 cases by surgical methods. Cytological reports were classified into the following diagnostic categories: non-tumor, tumor (benign, malignant: primary or metastatic). RESULTS: In a series of 267 cases, there were 70 non-tumor lesions (26.2%), 197 tumor lesions (73.8%), (benign: 77, malignant: 120). Lymph nodes were the most common anatomic sites for FNAC. The overall diagnostic accuracy, sensitivity and specificity of FNAC were 95.5%, 98.8%, and 94.2% allowed an correct diagnosis between FNAC and histopathology. CONCLUSION: FNAC of the head and neck region is a sensitive and specific diagnostic tool, especially when diagnosing metastatic carcinomas. Four major causes of error were identified: material adequacy criteria, sampling technique, cytological interpretation and limitations in the procedure. In particular, attention must be paid to subtle morphological changes when making detailed clinical pathological observations; this may help avoid discrepancies and achieve the right diagnosis.
Biopsy* ; Biopsy, Fine-Needle* ; Cytological Techniques ; Diagnosis* ; Head* ; Jeollanam-do ; Lymph Nodes ; Neck* ; Pathology ; Salivary Glands ; Sensitivity and Specificity

C1 inhibitor (C1 INH) deficiency is characterized by recurrent attacks of angioedema. The disorder may be inherited or acquired, with both types presenting a similar phenotypic picture. The angioedema most frequently affects the extremities, gastrointestinal, genital, facial and, airway swelling. The laryngeal angioedema can compromise the integrity of the upper airway, so its early diagonsis is crucial. Acquired angioedema by C1 deficiency is a rare disorder characterized by adult onset and lack of inheritance of the disease. We experienced a case of angioedema in a 37-year old man. He had no family history of angioedema and laboratory data showed depressed C1 inhibitor levels. With a review of literature, authors report a case of acquired angioedema by C1 inhibitor deficiency who had a history of the recurrent swelling of tongue, lip and, oral buccal mucosa.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Extremities ; Humans ; Lip ; Mouth Mucosa ; Tongue ; Wills

Cryptotia is a congenital auricular anomaly found more commonly in orientals than whites. It is characterizaed by the invagination of the upper part of the auricle under the temporal skin and deformity of the auricular cartilage. Surgeries to correct cryptotia principally involves addition of skin to the deficient retroauricular sulcus and cartilage plasty. We have developed a surgical method using modified retroauricular flap and have obtained good result without complication. We hereby report a surgical case with discussion and review of literatures.
Cartilage ; Congenital Abnormalities ; Ear Cartilage ; Skin

Hemangiomas are common benign soft tissue tumors in the head and neck, but they occur infrequently in the sinonasal cavity. Most of nasal hemangiomas arise from the nasal septum or vestibule and are of capillary type. Only a few arise from the lateral wall of the nose, and these usually are cavernous. Chief symptoms are recurrent epistaxis and nasal obstruction; if the tumor becomes large, it may cause adjacent bony erosion. Cavernous hemangioma shows essentially little tendency to regress, and in adults, it is more common than capillary hemangioma. Consequently, the majority of cavernous hemangiomas require surgery in contrast to their capillary counterparts. We report a case of cavernous hemangioma of middle turbinate in an adult female, together with a review of the literature.
Adult ; Capillaries ; Epistaxis ; Female ; Head ; Hemangioma ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Humans ; Nasal Obstruction ; Nasal Septum ; Neck ; Nose ; Turbinates*

BACKGROUND: Spinal nerve ligation (SNL) injury in rats produces a pain syndrome that includes mechanical and thermal allodynia. Previous studies have indicated that proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) play an important role in peripheral mediation of neuropathic pain, and that altered dorsal root ganglion (DRG) function and degree of DRG neuronal apoptosis are associated with spinal nerve injury. The present study was conducted to evaluate the expression of TNF-alpha and the extent of apoptosis in the dorsal root ganglion after SNL in rats. METHODS: Sprague-Dawley rats were subjected to SNL of the left L5 and L6 spinal nerves distal to the DRG and proximal to the formation of the sciatic nerve. At postoperative day 8, TNF-alpha protein levels in the L5-6 DRG were compared between SNL and naive groups using ELISA. In addition, we compared the percentage of neurons injured in the DRG using immunostaining for apoptosis and localization of activated caspase-3. RESULTS: SNL injury produced significant mechanical and cold allodynia throughout the 7-day experimental period. TNF-alpha protein levels were increased in the DRG in rats that had undergone SNL (12.7 +/- 3.2 pg/100 microg, P < 0.001) when compared with naive rats (4.1 +/- 1.4 pg/100 microg). The percentage of neurons or satellite cells co-localized with activated caspase-3 were also significantly higher in rats with SNL than in naive rats (P < 0.001, P < 0.05, respectively). CONCLUSIONS: SNL injury produces mechanical and cold allodynia, as well as TNF-alpha elevation and apoptosis in the DRG.
Animals ; Apoptosis ; Caspase 3 ; Cold Temperature ; Cytokines ; Diagnosis-Related Groups ; Enzyme-Linked Immunosorbent Assay ; Ganglia, Spinal ; Hyperalgesia ; Ligation ; Negotiating ; Neuralgia ; Neurons ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; Spinal Nerves ; Tumor Necrosis Factor-alpha

Leukocyte immunoglobulin-like receptors (LILRs), also called CD85s, ILTs, or LIRs, are important mediators of immune activation and tolerance that contain tandem immunoglobulin (Ig)-like folds. There are 11 (in addition to two pseudogenes) LILRs in total, two with two Ig-like domains (D1D2) and the remaining nine with four Ig-like domains (D1D2D3D4). Thus far, the structural features of the D1D2 domains of LILR proteins are well defined, but no structures for the D3D4 domains have been reported. This is a very important field to be studied as it relates to the unknown functions of the D3D4 domains, as well as their relative orientation to the D1D2 domains on the cell surface. Here, we report the crystal structures of the D3D4 domains of both LILRB1 and LILRB2. The two Ig-like domains of both LILRB1-D3D4 and LILRB2-D3D4 are arranged at an acute angle (∼60°) to form a bent structure, resembling the structures of natural killer inhibitory receptors. Based on these two D3D4 domain structures and previously reported D1D2/HLA I complex structures, two alternative models of full-length (four Ig-like domains) LILR molecules bound to HLA I are proposed.
Amino Acid Sequence ; Antigens, CD ; chemistry ; Crystallography, X-Ray ; Histocompatibility Antigens Class I ; chemistry ; Humans ; Immunoglobulins ; chemistry ; Leukocyte Immunoglobulin-like Receptor B1 ; Membrane Glycoproteins ; chemistry ; Models, Molecular ; Peptides ; chemistry ; metabolism ; Protein Binding ; Protein Structure, Tertiary ; Receptors, Immunologic ; chemistry ; Signal Transduction