Nonparasitic true splenic cyst is a rare disease and the epidermoid cyst accounts for the majority of the cases. And the epidermoid cyst producing CA19-9 is extremely rare. We present a case of true splenic cyst with high cystic fluid CA19-9 level. A 26-year-old woman complained left upper quadrant abdominal pain. Abdominal ultrasonography and CT depicted a 17 x 13 cm sized cystic lesion in the left upper abdomen. The aspirated cystic fluid showed high concentration of CA19-9, but serum CA19-9 level was normal. Spleen with huge unilocular cyst was removed surgically. The cyst was lined with single layered cuboidal epithelial cells and negative for immunohistochemical staining with anti-CA19-9 antibody.
Abdomen ; Abdominal Pain ; Adult ; Epidermal Cyst ; Epithelial Cells ; Female ; Humans ; Rare Diseases ; Spleen* ; Splenic Diseases ; Ultrasonography

BACKGROUND AND OBJECTIVES: Since chronic E-tube dysfunction is believed to play an important role in the development of otitis media, it is necessary to evaluate the function of the E-tube clinically. Recently, the endoscopic techniques have been used more frequently to directly inspect the E-tube orifice. In this study, I evaluated the morphologic and dynamic motion of the E-tube orifice with 4 mm 30 degrees videoendoscope and compared with the other existing tests of the E-tube function. SUBJECTS AND METHOD: 101 E-tubes with chronic otitis media were selected. I performed the transnasal 4 mm 30 degrees videoendoscopic examination of the pharyngeal E-tube orifice when patients were swallowing, and classified morphologic and dynamic findings of the E-tube orifice into three categories as follows: Type A, the E-tube is opened widely on swallowing with normal mucosa (normal); Type B, the E-tube is not opened with normal mucosa (functional blockage) and Type C, the E-tube is not opened with pathologic mucosa (mechanical blockage). Throughout the study, the control group was 60 E-tubes that were free of ear pathologies. RESULTS: There were more type As in the control group than in the otitis media group according to videoendoscopic findings of the E-tube orifice. The videoendoscopic analysis of the E-tube orifice had a close correlations with the results of inflation deflation test and with the classification of otitis media, but had no significant relationship with the degree of mastoid pneumatization. CONCLUSION: The morphologic and dynamic examination of the E-tube orifice with videoendoscopic techniques may be an important and useful method to examine the tubal function as well as its dysfunction.
Classification ; Deglutition ; Ear ; Endoscopy ; Eustachian Tube* ; Humans ; Inflation, Economic ; Mastoid ; Mucous Membrane ; Otitis Media ; Pathology

BACKGROUND AND OBJECTIVES: This study investigated the surgical methods and their results according to the subtypes of zygomatic fractures. SUBJECTS AND METHOD: Medical records of 99 zygomatic fractures treated between March 1997 and December 2006 were reviewed regarding fracture type, surgical method and time of operation from the initial trauma. RESULTS: Overall, operations were performed in 70 out of 99 cases. For zygomatic arch fractures, facial asymmetry and trismus in all 14 of 20 cases after surgery by Gillies incision were improved, and one revision procedure was performed. For tetrapod and multifragment fractures, one revision procedure was performed because of displacement of repaired bone fragment following surgery in 60 cases. Considering location and replacement of fractures, surgery was performed through one of incisions below: Gillies, lateral canthal, gingivobuccal, and subcilliary incision. All preoperative symptoms were improved. CONCLUSION: For zygomatic arch fractures, Gillies approach would be an optimal method, while for displaced tetrapod and multifragment fractures, two or more point fixation points would achieve satisfactory results.
Displacement (Psychology) ; Facial Asymmetry ; Medical Records ; Trismus ; Zygoma ; Zygomatic Fractures

Lymphatic malformation is a congenital abnormality of the lymphatic system, which manifests frequently at birth or before 2 years of age. Lymphatic malformations are classified as macrocystic or microcystic. Microcystic lesions typically occur above the level of mylohyoid muscle and need conservative treatment rather than surgical resection because of the high rate of incomplete excision and recurrence. We report our experience with two cases of radiofrequency ablation of lymphatic malformation in the oral cavity recently seen in our practice.
Congenital Abnormalities ; Lymphatic System ; Mouth ; Muscles ; Parturition ; Recurrence

To achieve safe airway management, it is essential first to predict whether there will be difficulties in intubating or ventilating the patient's airway. An enlarged thyroid mass can produce a tracheal obstruction by compression or intraluminal invasion or both. We report two patients with thyroid cancer that obstructed the trachea by compression or invasion. There was no difficulty in endotracheal intubation of the patients with marked thyroid enlargement or in securing passage of the endotracheal tube through the compressed or narrowed portion of the trachea.
Airway Management ; Humans ; Intubation, Intratracheal ; Thyroid Gland ; Thyroid Neoplasms ; Trachea

Interferon has been tried as a drug of choice in patients with chronic active hepatitis by hepatitis B virus infection since Greenberg has reported the effectiveness of interferon in 1976. The effects of interferon therapy have been reported variably and various complications such as fever, myalgia, arthralgia, flu-like symptoms, temporary leukopenia and thrombocytopenia, alopecia, cardiovascular symptoms and autoimmune diseases have been reported. But rhabdomyolysis has been rarely reported in the interferon therapy of chronic hepatitis B. There were some cases of rhabdomyolysis with acute renal failure in the interferon therapy which was designed for chemotherapy of malignant melanoma and for chronic active hepatitis C virus infection. We reported a case of rhabdomyolysis with acute renal failure developed during the interferon therapy in a patient with chronic active hepatitis B.
Acute Kidney Injury* ; Alopecia ; Arthralgia ; Autoimmune Diseases ; Drug Therapy ; Fever ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic* ; Humans ; Interferons* ; Leukopenia ; Melanoma ; Myalgia ; Rhabdomyolysis* ; Thrombocytopenia

Boerhaave's syndrome, spontaneous esophageal rupture, is very rare but fatal disease and commonly associated with alcohol induced vomiting. Polyethylene glycol solution is useful for colonic bowel preparation necessary for colonic examination or surgery. There was no report on polyethylene glycol solution associated Boerhaave's syndrome. We report a case of Boerhaave's syndrome, a patient who present chest pain, fever, and dyspnea after several violent vomitings during colonic bowel preparation with polyethylene glycol solution, and review the relevant literature.
Chest Pain ; Colon ; Dyspnea ; Esophagus ; Fever ; Humans ; Polyethylene Glycols ; Rupture ; Vomiting

Phlegmonous gastritis is a rare disorder caused by suppurative bacterial infection of the gastric wall. The mortality rate remains extremely high and the gastrectomy has been thought to be an effective form of treatment. We report a case of acute phlegmonous gastritis developed in a patient with advanced alcoholic liver cirrhosis, and recovered with early endoscopic diagnosis and antibiotics alone.
Anti-Bacterial Agents* ; Bacterial Infections ; Cellulitis* ; Diagnosis ; Gastrectomy ; Gastritis* ; Humans ; Liver Cirrhosis, Alcoholic ; Mortality

PURPOSE: This study was aimed to investigate the relationship between indoor air pollutant levels and residential environment in children with atopic dermatitis (AD) living in Seoul. METHODS: A total of 150 children with AD were included. Residential environment was assessed by questionnaires which were completed by their parents. To evaluate the level of exposure to the indoor air pollutants, concentrations of the indoor air pollutants including particulate matter with diameter less than 10 microm (PM10), formaldehyde, carbon dioxide (CO2), carbon monoxide (CO), nitrogen dioxide (NO2), Total Volatile Organic Compound (TVOC), benzene, toluene, ethyl-benzene, xylene, styrene, bacterial aerosols, and airborne fungi were measured. RESULTS: A significant difference was exhibited in the levels of PM10 in case of visible fungus on the walls (P=0.047). There was relationship between the construction year of the house, moving to a newly constructed building within 1 year and formaldehyde level. With the use of artificial air freshener, the differences were found in the concentrations of TVOC (P=0.003), benzene (P=0.015), toluene (P=0.012) and ethyl-benzene (P=0.027). The concentration of xylene was significantly high when oil was used as heating fuel (P=0.015). Styrene exhibited differences depending on building type and its concentrations were significantly high in a residential and commercial complex building (P=0.005). The indoor concentration of bacterial aerosols was significantly low with the use of air cleaner (P=0.045). High NO2, benzene concentrations were present in case of almost no ventilation (P=0.028 and P=0.028, respectively). CONCLUSIONS: Individual residential environments are closely related with the levels of the indoor air pollutants. To alleviate AD symptoms, simple questions about residential environments such as visible fungus on the walls and the use of artificial air freshener are helpful to assess the possibility of increased indoor air pollutant levels when direct measurement is not available.
Aerosols ; Air Pollutants ; Air Pollution ; Benzene ; Carbon Dioxide ; Carbon Monoxide ; Child* ; Dermatitis, Atopic* ; Formaldehyde ; Fungi ; Heating ; Hot Temperature ; Humans ; Nitrogen Dioxide ; Parents ; Particulate Matter ; Seoul ; Styrene ; Toluene ; Ventilation ; Xylenes ; Surveys and Questionnaires

Gastrointestinal lipomas are benign adipose tumors that are usually submucosal, and most commonly found in the colon. However, they have also been discovered in the small bowel, stomach and very rarely in the esophagus. Although most of gastrointestinal lipomas are asymptomatic and are found incidentally at time of endoscopy, surgery or autopsy, large lipomas can cause acute abdominal pain, bowel habit changes, gastrointestinal bleeding, intussusception or bowel obstruction. Lipomas can be diagnosed by colonoscopy, abdominal CT, barium series and endoscopic ultrasonography (EUS). Large lipomas need to be treated using various techniques. However, the best treatment modality for large lipomas has not yet been established. A surgical resection of lipomas should be considered for a giant lipoma >2 cm in diameter due to the risk of perforation or hemorrhage. Currently, endoscopic snare polypectomy or endo-loop ligation is used to treat symptomatic lipomas, which may reduce the risk of complications associated with endoscopic treatment. We report a case of giant colonic lipoma that was diagnosed successfully with EUS and treated safely using an endoscopic unroofing technique, endoloop ligation and snare polypectomy in phases.
Abdominal Pain ; Autopsy ; Barium ; Colon ; Colonoscopy ; Endoscopy ; Endosonography ; Esophagus ; Hemorrhage ; Intussusception ; Ligation ; Lipoma ; SNARE Proteins ; Stomach