BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the outcomes and prognosis of traumatic facial paralysis in patients treated with facial nerve decompression via transmastoid approach. SUBJECTS AND METHOD: The authors retrospectively reviewed 20 patients who suffered from temporal bone fractures resulting in facial paralysis and received surgical facial nerve decompression treatment via transmastoid approach from 2004 to 2012. RESULTS: In 14 patients, the House-Brackmann grade improved to 1, 2, or 3. The preoperative average House-Brackmann grade of 4.95 improved from 4.95 to the postoperative average House-Brackmann grade of 3.15. Statistically significant improvements were found in all groups whether the operation was performed within two weeks, or from two weeks to four weeks, or after four weeks. CONCLUSION: Postoperative results of facial nerve decompression in traumatic temporal bone fracture can be excellent. Surgeons can expect better outcomes with early diagnosis and lesser nerve damage.
Decompression ; Early Diagnosis ; Facial Nerve ; Facial Paralysis ; Humans ; Prognosis ; Retrospective Studies ; Temporal Bone

Failure of pulmonary ventilation capacity results in carbon dioxide (CO2) retention. When this produces loss of consciousness, it is called CO2 narcosis. Chronic obstructive pulmonary disease is a common cause of CO2 retention. Bilateral vocal cord paralysis is a typical disorder resulting in upper airway obstruction. However, bilateral vocal cord paralysis has been rarely documented in the chronic course of obstructive diseases related to the ear/nose/throat because its symptoms are relatively obvious. A 49-year-old man who complained of hoarseness and dyspnea for several years was diagnosed with bilateral vocal cord paralysis. CO2 narcosis occurred after tracheostomy and laser posterior cordotomy had been applied to relieve dyspnea. Details of the case are provided along with a review of the relevant literature.
Airway Obstruction ; Carbon ; Carbon Dioxide ; Cordotomy ; Dyspnea ; Hoarseness ; Humans ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Ventilation ; Retention (Psychology) ; Stupor ; Tracheostomy ; Tracheotomy ; Unconsciousness ; Vocal Cord Paralysis ; Vocal Cords

Excessive microglial activation and subsequent neuroinflammation lead to synaptic loss and dysfunction as well as neuronal cell death, which are involved in the pathogenesis and progression of several neurodegenerative diseases. Thus, the regulation of microglial activation has been evaluated as effective therapeutic strategies. Although dieckol (DEK), one of the phlorotannins isolated from marine brown alga Ecklonia cava, has been previously reported to inhibit microglial activation, the molecular mechanism is still unclear. Therefore, we investigated here molecular mechanism of DEK via extracellular signal-regulated kinase (ERK), Akt and nicotinamide adenine dinuclelotide phosphate (NADPH) oxidase-mediated pathways. In addition, the neuroprotective mechanism of DEK was investigated in microglia-mediated neurotoxicity models such as neuron-microglia co-culture and microglial conditioned media system. Our results demonstrated that treatment of anti-oxidant DEK potently suppressed phosphorylation of ERK in lipopolysaccharide (LPS, 1 microg/ml)-stimulated BV-2 microglia. In addition, DEK markedly attenuated Akt phosphorylation and increased expression of gp91(phox), which is the catalytic component of NADPH oxidase complex responsible for microglial reactive oxygen species (ROS) generation. Finally, DEK significantly attenuated neuronal cell death that is induced by treatment of microglial conditioned media containing neurotoxic secretary molecules. These neuroprotective effects of DEK were also confirmed in a neuron-microglia co-culture system using enhanced green fluorescent protein (EGFP)-transfected B35 neuroblastoma cell line. Taken together, these results suggest that DEK suppresses excessive microglial activation and microglia-mediated neuronal cell death via downregulation of ERK, Akt and NADPH oxidase-mediated pathways.
Adenine ; Cell Death* ; Cell Line ; Coculture Techniques ; Culture Media, Conditioned ; Down-Regulation ; Microglia ; NADP* ; NADPH Oxidase ; Neuroblastoma ; Neurodegenerative Diseases ; Neurons* ; Neuroprotective Agents ; Niacinamide ; Phosphorylation ; Phosphotransferases ; Reactive Oxygen Species

PURPOSE: The diagnostic criteria of gastric intraepithelial neoplasia (IEN) are controversial across the world. We investigated how many discrepancies occur in the pathologic diagnosis of IEN and early gastric carcinoma in endoscopic submucosal dissection (ESD) specimens, and evaluated the reasons of the discordance. MATERIALS AND METHODS: We retrospectively reviewed 1,202 ESD specimens that were originally diagnosed as gastric IEN and early carcinoma at 12 institutions. RESULTS: The final consensus diagnosis of carcinoma were 756 cases, which were originally 692 carcinomas (91.5%), 43 high-grade dysplasias (5.7%), 20 low-grade dysplasias (2.6%), and 1 others (0.1%), respectively. High- and low-grade dysplasia were finally made in 63 and 342 cases, respectively. The diagnostic concordance with the consensus diagnosis was the highest for carcinoma (91.5%), followed by low-grade dysplasia (86.3%), others (63.4%) and high-grade dysplasia (50.8%). The general kappa value was 0.83, indicating excellent concordance. The kappa values of individual institutions ranged from 0.74 to 1 and correlated with the proportion of carcinoma cases. The cases revised to a final diagnosis of carcinoma exhibited both architectural abnormalities and cytologic atypia. The main differential points between low- and high-grade dysplasias were the glandular distribution and glandular shape. Additional features such as the glandular axis, surface maturation, nuclear stratification and nuclear polarity were also important. CONCLUSION: The overall concordance of the diagnosis of gastric IEN and early carcinoma in ESD specimens was excellent. It correlated with the proportion of carcinoma cases, demonstrating that the diagnostic criteria for carcinoma are more reproducible than those for dysplasia.
Consensus ; Diagnosis ; Retrospective Studies ; Stomach Neoplasms