No abstract available.
Adie Syndrome ; Paroxysmal Hemicrania

Although spinal arachnoid cysts are relatively common findings observed incidentally in adults, they are much rarely reported in children. They are usually asymptomatic and are mainly located in the middle and lower thoracic regions. However, in rare circumstances, these cysts can cause mass effects that lead to neurologic symptoms. We report the rare case of a spinal extradural arachnoid cyst in a 12-year-old boy who showed signs and symptoms of cauda equina syndrome. Magnetic resonance imaging of the lumbar spine revealed a huge extradural arachnoid cyst extending from L2 to L5. Emergent laminectomy and repair of dural defect was performed after total resection of the extradural arachnoid cyst. There were no postoperative complications. Total recovery was achieved 6 months after surgery. Here, we report this rare case with a review of the literature.

Lung cancer metastatic to the small intestine is uncommon. Despite the widespread nature of metastases that characterize this carcinoma, symptomatic intestinal metastases are extremely rare, but have been reported as a cause of intestinal obstruction, hemorrhage, malabsorption, and perforation. We have recently encountered two cases with squamous cell lung cancer who underwent endoscopic retrograde cholangiopancreatography for obstructive jaundice. Biopsies obtained from concentric ulcerative mass in the duodenum showed metastatic squamous cell carcinoma in the lymphatics. Histologically, the pulmonary and duodenal lesions were identical and this suggests a lymphatic route of dissemination. This is the report of two cases with obstructive jaundice secondary to duodenal metastasis from primary lung cancer. Metastatic squamous cell carcinoma of the lung to the duodenum should be considered in the differential diagnosis of patients harboring such a malignancy who have obstructive jaundice.
Biopsy ; Carcinoma, Squamous Cell ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Duodenum ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intestine, Small ; Jaundice ; Jaundice, Obstructive* ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Ulcer

BACKGROUND AND OBJECTIVES: Nasolabial cysts are relatively rare and are sometimes confused with tumors due to progressive enlargement. Treatment of a nasolabial cyst consists of sublabial excision or endonasal endoscopic marsupialization (EEM). The purpose of this study was to investigate the clinical features of nasolabial cysts in order to provide a basis for correct diagnosis and treatment. MATERIALS AND METHODS: Sixty-four patients with a nasolabial cyst were surgically treated between December, 1989 and January, 2010 at the Department of Otolaryngology, Asan Medical Center. Their clinical features, radiologic and histopathologic findings, and treatment and outcomes were retrospectively analyzed. RESULTS: The patients comprised 51 (80%) women and 13 men (20%), with ages ranging from 16 to 69 years with a mean of 43 years. Swelling of the nasolabial fold was the most frequently experienced symptom. There was no right or left side preponderance. Sublabial excision was applied in 57 cases (89%), while seven cases (11%) were treated via the endonasal approach. There was no case of recurrence. CONCLUSION: Nasolabial cysts should be suspected in patients with swelling of the nasolabial area and nasal obstruction. Enhanced CT may be needed to differentiate from tumors, odontogenic cysts, or other inflammatory lesions. Nasolabial cysts can be successfully treated via sublabial or endonasal approaches. Postoperative complications or recurrence is very rare.
Female ; Humans ; Male ; Nasal Cavity ; Nasal Obstruction ; Nasolabial Fold ; Nose ; Odontogenic Tumors ; Otolaryngology ; Postoperative Complications ; Recurrence ; Retrospective Studies

Peripheral neuroepithelioma (PNE) of soft tissue is a malignant neuroectodermal tumor arising from peripheral (nonautonomic) nerve. It may occur in both children and adults, and are highly aggressive neoplasms that rapidly give rise to metastatic disease and death. We exprienced a case of peripheral neuroepithelioma of soft tissue in the upper arm in a 18-year-old female. Cytologic features revealed small round cells with scanty cytoplasm occurring both singly and in clusters. The clusters frequently tended to form Homer-Wright rosettes. The cells had a round to oval nucleus with fine chromatin and in- conspicuous nucleoli in a hemorrhagic background.
Adolescent ; Adult ; Arm ; Carcinoma, Transitional Cell ; Child* ; Chromatin ; Cytoplasm ; Female ; Humans ; Neuroectodermal Tumors ; Neuroectodermal Tumors, Primitive, Peripheral ; Urinary Bladder

BACKGROUND AND OBJECTIVES: Human rhinovirus (HRV) infection is the primary cause of the common cold. It was often reported that the frequency of viral rhinitis is higher among patients with chronic rhinosinusitis with nasal polyposis (CRS/ NP) than normal subjects. And, patients with nasal polyps often complain that they suffer from a relatively severe degree of URI. The purpose of this article was to evaluate whether the HRV infection rate and virus-induced cytokine secretion is different between the organ culture model of the nasal polyp mucosae and the sinus mcuosae. MATERIALS AND METHODS: Organ cultures of nasal polyps from sixteen CRS/NP patients and normal sphenoid sinus mucosae from nineteen patients who underwent the trans-sphenoidal pituitary surgery were tested. The successful viral infection by HRV-16 was determined by seminested reverse transcription-PCR. Immunoreactive IL-6 and IL-8 were quantitated using the ELISA. RESULTS: A PCR product indicating the successful RV infection was detected in nine of sixteen (56.3%) polyp samples and eleven of nineteen (57.9%) normal sphenoid sinus samples were tested positive for HRV-16. Rhinovirus infection increased the IL-6 and IL-8 secretion to 236% and 173% in polyp samples and to 231% and 145% in sphenoid mucosa samples respectively. However, there was no significant difference in rhinovirus infection rate and in the rhinovirus-induced IL-6 and IL-8 secretion between the groups. CONCLUSION: The results of this study may suggest that the nasal polyp mucosae, when compared with normal sinus mucosae, did not show more vulnerability to HRV infection nor more intense cytokine response by HRV infection.
Common Cold ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6 ; Interleukin-8 ; Mucous Membrane* ; Nasal Polyps* ; Organ Culture Techniques* ; Polymerase Chain Reaction ; Polyps ; Rhinitis ; Rhinovirus* ; Sphenoid Sinus*

BACKGROUND AND OBJECTIVES: Continuous Positive Airway Pressure (CPAP) is generally effective in correcting sleep-related respiratory disturbance in Obstructive Sleep Apnea Syndrome (OSAS). But the failure to comply with this treatment poses a serious limitation to its use. The aim of this study is to investigate the state of compliance and the cause of noncompliance of auto-adjusting positive airway pressure (autoPAP) treatment in Korean OSAS patients. MATERIALS AND METHODS: This study performed a survey of 45 patients who had selected the autoPAP treatment between August 2000 and May 2003. RESULTS: Twelve of the 45 patients (26.7%) refused the autoPAP treatment immediately after the first trial due to claustrophobia. Also, twenty patients (44.4%) stopped using it within 1 month. Only 13 patients (28.9%) continued to use it for more than 1 month. Twenty seven of the 33 patients (81.8%) who had used the autoPAP complained of claustrophobia after the first trial. The major factors of low compliance were claustrophobia, restricted body position while asleep, nasal symptoms, high cost, and inadequate education of patients. CONCLUSION: This study shows that claustrophobia is a major cause for the noncompliance of autoPAP. It also shows that the patients are encouraged by the effectiveness of the autoPAP to use it for a longer period. Therefore, we should focus on explaining the effects and drawbacks of autoPAP, desensitization and behavioral modification.
Compliance* ; Continuous Positive Airway Pressure ; Humans ; Patient Education as Topic ; Phobic Disorders ; Sleep Apnea, Obstructive*

Graves disease is the most common clinical feature of hyperthyroidism in childhood. Clinical manifestations include emotional lability, hyperactivity, tremor, excessive sweating, exophthalmos and weight loss. In Graves disease, osteoporosis could occur because of a disturbance of mineral homeostasis which rarely develops from reduced calcium absorption of the gastrointestinal tract and increased urinary calcium excretion related to an increased bone resorption. We report a case of Graves disease with spinal deformity caused by osteoporosis in a 12-year-old female who was presented with back pain, anterior neck mass and kyphosis. Laboratory findings revealed hyperthyroidsm, hypercalciuria in 24-hour urine and normal serum parathyroid hormone. On radiologic examination, multiple osteoporosis and a spinal compression fracture were observed. The bone mineral density was decreased at the hip and lumbar spine on the bone densitometry. After initiating antithyroid drug, calcitonin and vitamin D, she returned to a euthyroid state and her back pain was improved. Bone density was also increased one year later.
Absorption ; Back Pain ; Bone Density ; Bone Resorption ; Calcitonin ; Calcium ; Child ; Congenital Abnormalities ; Densitometry ; Exophthalmos ; Female ; Fractures, Compression ; Gastrointestinal Tract ; Graves Disease* ; Hip ; Homeostasis ; Humans ; Hypercalciuria ; Hyperthyroidism ; Kyphosis* ; Neck ; Osteoporosis* ; Parathyroid Hormone ; Spine ; Sweat ; Sweating ; Tremor ; Vitamin D ; Weight Loss

BACKGROUND: Head and neck anatomy affects the laryngeal mask airway (LMA) cuff volume. The purpose of this study was to identify physical parameters that can be standardized to predict LMA cuff volume and measure the optimal and minimal LMA cuff volume in adults. METHODS: The predictors of volume or pressure of the LMA cuff were investigated in 167 patients. Manufacturers recommend a maximal cuff pressure (MCP) (i.e., 40 ml for size 5, 30 ml for size 4), an optimal cuff volume (OCV) at a cuff pressure of 60 cmH2O, and a minimal cuff volume (MCV) just before audible air leakage. The physical parameters measured included height, weight, body mass index, modified Mallampati classification (MMP), neck circumference, neck length, and thyro-mental distance. Data were analyzed by stepwise multilinear analysis. RESULTS: The regression equations (REs) were as follows: OCV (1.2 + [0.1 × height] + [0.5 × neck length]); MCV for men (−35.7 + [0.25 × height] + [0.7 × neck length] − [4.1 × MMP]); and MCV for women (−42.5 + [0.27 × height] + [0.75 × neck length] − [2.5 × MMP]). The mean values were as follows: MCP > 200 cmH2O, minimal cuff pressure < 20 cmH2O, OCV of 24.7 ml for men and 15.9 ml for women, and MCV of 12.1 ml for men and 7.1 ml for women. CONCLUSIONS: LMA cuff volume is estimated from the patient's height, neck length, and MMP. The RE for calculating the MCV shows a high correlation with height, neck length, and MMP.
Adult ; Airway Management ; Body Weight ; Classification ; Female ; Head ; Humans ; Laryngeal Masks* ; Male ; Neck ; Physical Examination*

BACKGROUND: Head and neck anatomy affects the laryngeal mask airway (LMA) cuff volume. The purpose of this study was to identify physical parameters that can be standardized to predict LMA cuff volume and measure the optimal and minimal LMA cuff volume in adults. METHODS: The predictors of volume or pressure of the LMA cuff were investigated in 167 patients. Manufacturers recommend a maximal cuff pressure (MCP) (i.e., 40 ml for size 5, 30 ml for size 4), an optimal cuff volume (OCV) at a cuff pressure of 60 cmH2O, and a minimal cuff volume (MCV) just before audible air leakage. The physical parameters measured included height, weight, body mass index, modified Mallampati classification (MMP), neck circumference, neck length, and thyro-mental distance. Data were analyzed by stepwise multilinear analysis. RESULTS: The regression equations (REs) were as follows: OCV (1.2 + [0.1 × height] + [0.5 × neck length]); MCV for men (−35.7 + [0.25 × height] + [0.7 × neck length] − [4.1 × MMP]); and MCV for women (−42.5 + [0.27 × height] + [0.75 × neck length] − [2.5 × MMP]). The mean values were as follows: MCP > 200 cmH2O, minimal cuff pressure < 20 cmH2O, OCV of 24.7 ml for men and 15.9 ml for women, and MCV of 12.1 ml for men and 7.1 ml for women. CONCLUSIONS: LMA cuff volume is estimated from the patient's height, neck length, and MMP. The RE for calculating the MCV shows a high correlation with height, neck length, and MMP.
Adult ; Airway Management ; Body Weight ; Classification ; Female ; Head ; Humans ; Laryngeal Masks* ; Male ; Neck ; Physical Examination*