Neurilemmomas of the trachea are extremely rare. The most common site of them is the distal third of the trachea and the age of the patients at presentation varied from 6 to 78 years old. They usually have a freqeuntly very long natural history, causing symptoms only after they have attained a considerable size. We experienced a case of near-total obstruction of the trachea by an intraluminal sessile neurilemmoma. The patient was a 66-year-old man with 2-year history of progressive exertional dyspnea and had several episodes of pneumonitis associated with productive cough. Grossly, the tumor was a well-circumscribed mass. Microscopically, typical cellular Antoni A and myxoid Antoni B areas were revealed.
Aged ; Cough ; Dyspnea ; Humans ; Natural History ; Neurilemmoma* ; Pneumonia ; Trachea

BACKGROUND: Fanconi's anemia(FA) is an autosomal recessive disease characterized by aplastic anemia and congenital malformations. As up to 30% of patients have no physical stigmata, the modern diagnosis of FA rests on chromosomal breakage of patient's cells induced by chemical clastogens such as diepoxybutane(DEB) or mitomycin-C(MMC). METHODS: We reviewed the clinical manifestations, laboratory findings, diagnostic methods, treatment and outcome of 6 patients diagnosed to have a FA at the Chonnam University Hospital for the last 6 years. RESULTS: Six cases(16.2 %) were found to have FA among 37 aplastic children who were diagnosed during the same period. The mean age at diagnosis was 6.3 years which was the usual onset of hematologic findings. All patients had features of aplastic anemia, and had one or more anomalies, such as low birth weight, hyperpigmentation, cafeau-lait spots, mental retardation, developmental delay, peculiar face(broad nasal bases, epicanthal folds, micrognathia), polydactyly, microcephaly, short stature, and dislocation of hip. We found increased breaks in cultured cells with DEB and MMC in 5 cases tested. The median duration of follow-up was 30 months. Oxymetholone and prednisolone treatment was partially beneficial in three cases. Immunosuppressive treatment with ALG/ATG was not successful in two cases tried. Four cases are living now, without transfusion in three. Two patients were died of disseminated fungal infection and transplant-related problems, respectively. CONCLUSIONS: Fanconi's anemia should be sought carefully in any patients with aplastic anemia because the prognosis, treatment modality, and the approach to bone marrow transplantation are quite different when the hematologic disorder is inherited rather than acquired.
Anemia, Aplastic ; Bone Marrow Transplantation ; Cells, Cultured ; Child ; Christianity ; Chromosome Breakage ; Diagnosis ; Dislocations ; Fanconi Anemia* ; Follow-Up Studies ; Hip ; Humans ; Hyperpigmentation ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Jeollanam-do ; Microcephaly ; Mitomycin ; Mutagens ; Oxymetholone ; Polydactyly ; Prednisolone ; Prognosis

This study was undertaken to investigate the activities of genioglossus and orbicularis oris muscle between normal occlusion and anterior open bite group. 39 subjects without the experience of orthodontic treatment and T.M.disorder were selected for this study. 20 subjects were normal occlusion, 19 subjects were anterior open bite. The twenty items were measured from the cephalometric headplates, and EMG recording of the genioglossus, orbicularis oris muscle were taken at rest position, water swallowing, jaw opening, isometric tongue protrusion, maximum tongue protrusion. All data were analyzed and processed with the computer statistical method. The following results were obtained: 1. Except at rest position, the muscle activities of genioglossus muscle in anterior open bite were higher than in normal occlusion with significant difference. 2. Except during water swallowing, the muscle activities of orbicularis oris muscle in anterior open bite were higher than in normal occlusion with significant difference. 3. During maximum tongue protrusion, the geniolossus muscle of anterior open bite subjects showed the highest muscle activity. 4. Anterior open bite showed closer interrelationship between facial morphology ad the genioglossus, orbiculars oris muscle activities than that of normal occlusion with significant difference.
Deglutition ; Jaw ; Open Bite* ; Tongue ; Water

Sudden sensorineural hearing loss (SSNHL) is a common disorder; however, sequential, bilateral presentation of the disease is rarer than unilateral presentation. Clinical otologists usually focus on treating the side with impaired hearing when patients first present with unilateral SSNHL, and therefore, may not warn patients of the possibility of subsequent hearing impairment in the contralateral ear. Furthermore, it is professionally discouraging when a patient presents with profound, sequential SSNHL after initial treatment. This may adversely impact the doctor-patient relationship, even if the patient is offered the best possible care from their first visit. Herein, we report the case of a patient with profound, idiopathic, bilateral SSNHL with a time interval of 37 days between involvement of both ears. Even though high-dose steroids were administered intraorally and intratympanically, the patient’s hearing was not restored, and the patient eventually required bilateral cochlear implant surgery. Our report demonstrates that sequential, profound, bilateral SSNHL may manifest without any specific signs.

The periodontal health has been evaluated clinically by various epidemiological indices, and in researches by measurement of gingival crevicular fluid. Laser Doppler flowmetry is a reliable and objective method that allows immediate measurement of erythrocyte flux in approximately one cubic mm of the capillary bed without disturbing the tissues. The purpose of the present study was to determine whether human gingival blood flow was different according to measuring area, measuring time, and sex or not. Forty volunteers with good general and periodontal health, aged early twenties and unmarried, were selected. Laser Doppler flowmetry(floLAB(R), Moor Instruments Ltd., England) was applied to measure the gingival blood flow of marginal gingiva, interdental papilla, attached gingiva and alveolar mucosa. The blood flow of interdental papilla was measured at 9-10 AM, 1-2 PM, and 5-6 PM. The difference of blood flow according to measuring area and measuring time was statistically analyzed by one way ANOVA and Dunkan test, and the difference of blood flow between men and women was statistically analyzed by t-test. (1) Mean blood flow was significantly higher in alveolar mucosa than in the gingiva(p<0.05), and there was no significant difference in blood flow between marginal gingiva and interdental papilla(p>0.1). (2) Mean blood flow was significantly higher at 5-6 PM than at 9-10 AM and 1-2 PM(p<0.05). But there was no significant difference in gingival blood flow between 9-10 AM and 1-2 PM(p>0.1). (3) There was no significant difference in gingival blood flow between men and women(p>0.1). The above results suggest that the measurment of gingival blood flow using laser Doppler flowmetry may be clinically applicable to early determination of gingival inflammation and evaluation of healing status, but further studies are necessary to standardize and simplify the measuring procedure.
Capillaries ; Erythrocytes ; Female ; Gingiva ; Gingival Crevicular Fluid ; Humans ; Inflammation ; Laser-Doppler Flowmetry* ; Male ; Mucous Membrane ; Single Person ; Volunteers

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

Vocal cord paralysis is a comlex disorder which may result from numerous causes. It is often associated with trauma, disease in adjacent tissue, or a generalized neuroligical disorder. Laryngeal EMG is a useful technique for vocal cord paralysis. However it has not been used due to the uncertainties of normal human vocal cord physiology and the technical difficulties in performing these studies. We investigated the pathophysiology of vocal cord paralysis with laryngeal electromyography(LEMG). We studied 20 patients with idiopathic vocal cord paralysis. 6 patients were denervated in the cricothyroid(CT) and 6 patients in the thyroarytenoid(TA), and 3 patients in both CT and TA muscles. These indicated superior laryngeal neuropathy, recurrent laryngeal neuropathy, and proximal laryngeal or vagus neuropathy, respectively. LEMG proved to be a safe and effective procedure in the diagnosis of laryngeal neuropathy, and make it possible to use electromyography as a routine procedure in diagnosis laryngeal paralysis.
Diagnosis ; Electromyography* ; Humans ; Muscles ; Physiology ; Vagus Nerve Diseases ; Vocal Cord Paralysis* ; Vocal Cords*

PURPOSE: Nevus sebaceus is a congenital hamartomatous lesion, typically involving head and neck. Various benign and malignant neoplasms can develop in association with nevus sebaceus. We report a case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma in nevus sebaceus. METHODS: A 73-year-old man presented with erythematous to black verrucous nodules on the right subauricular area. The upper part was accompanied with inflammation and ulceration, and no specific findings suspicious for malignant degeneration were found in the lower part preoperatively. The mass was totally excised and the defect was directly closed. Lymph nodes were not involved on concomitant neck dissection. RESULTS: Histopathologic examination confirmed the presence of squamous cell carcinoma in the upper part and basal cell carcinoma in the lower part of a nevus sebaceus. Negative margins were achieved on resection. No clinical problems were found during the 3-month follow-up period. CONCLUSION: We experienced a rare case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma within the same nevus sebaceus. Because patients with nevus sebaceus have risk of malignant changes, surgical excision and work-up for recurrence and metastasis should be considered in suspicious cases. And even in a totally asymptomatic case, the possibility of occult secondary cancer should be informed before surgery in aged patients.
Aged ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Follow-Up Studies ; Head ; Humans ; Inflammation ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Nevus ; Recurrence ; Ulcer

Atlato-axial instability is a serious condition that often requires operation. Atlanto-axial subluxation may cause severe symptoms; and threaten the intergrity of the spinal cord, leading to quadriplegia or sudden death. A techique of combining C1-C2 posterior screw fixation with a supplemental bone wire fusion has been advocated for the management of atlantoaxial instability. It was used in 9 patients with this disorder. Patients ages ranged from 20 years to 52 years; follow-up period ranged from 3 to 16 months with a mean of 9.8 months. All nine patients gained immediate rigid fixation of C1,2 with this technique. Of these 9 patients, instability occurred due to trauma in seven, os odotoideum in one and os odontoideum with trauma in another one. One patient was presented with nonunion and C1,2 instability after a Halovest applications a result of type II odontoid fracture. All 9 patients were placed in a philedelphia collar for 12weeks and all achieved solid fusion. Posterior atlantoaxial facet screw fixation provides immediate multidirectional rigid fixation of C1,2 and is mechanically superior to siring or clamp fixation. This technique maximizes success without the need for a supplemental rigid external orthosis.
Bone Wires ; Death, Sudden ; Follow-Up Studies ; Humans ; Orthotic Devices ; Quadriplegia ; Spinal Cord ; Spinal Fusion ; Transplants*

Phenylpropanolamine is a sympathomimetic amine used widely as a decongestant or appetite suppressant. Reports of the myocardial injury from the use of phenylpropanolamine are rare and the mechanism of the myocardial injury is not known clearly. We experienced a case of myocardial injury after ingestion of phenyl-propanolamine. A 46-year-old woman was admitted because of chest pain and dyspnea after ingestion of 5 tablets of anorectic pill containing phenylpropanolamine 75 mg per tablet. The serum creatine kinase MB isoenzyme levels were elevated and electrocardiographic abnormalities suggesting myocardial infarction were seen in the precordial lead. In echocardiograpy, left ventricular anteroseptal wall motion was nearly akinetic but coronary angiography showed normal coronary arteries except sluggish blood flow in left anterior descending artery.
Appetite ; Arteries ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Creatine Kinase ; Dyspnea ; Eating* ; Electrocardiography ; Female ; Humans ; Middle Aged ; Myocardial Infarction ; Phenylpropanolamine* ; Tablets