We reviewed 67 cases of non-visualizing from September, 1979 to August, 1981. Among these, renal tuberculosis was the most common cause of non-visualizing kidney and renal or ureteral stone was thenext in number.
Kidney* ; Tuberculosis ; Tuberculosis, Renal ; Ureter

BACKGROUND: A new tumor entity of the salivary glands, mammary analogue secretory carcinoma (MASC) with ETV6-NTRK3 translocation, has recently been proposed. MASC was originally diagnosed as adenocarcinoma, not otherwise specified (ANOS), or acinic cell carcinoma (AciCC) by the current World Health Organization classification. We aimed to identify MASC cases by molecular tests, and to characterize their clinical, histological, and immunohistochemical features. METHODS: Thirty cases of MASC candidates were selected after review of 196 salivary gland tumors, and subjected to break-apart ETV6 fluorescence in situ hybridization (FISH), and immunohistochemical study for S100 protein, gross cystic disease fluid protein 15, DOG1, estrogen receptor, and progesterone receptor. RESULTS: Valid FISH results were obtained in 23 cases, and 13 positive cases were retrieved. MASCs were histologically varied, and the most frequent features observed in 10 cases were low-grade papillary/cystic/glandular patterns, intraluminal secretory materials, ovoid/wrinkled nuclei, and relatively abundant granular eosinophilic cytoplasms, corresponding to papillary-cystic or follicular types of AciCC. All cases showed diffuse immunopositivity for S100 protein. Three cases developed recurrences, but all patients remained alive. CONCLUSIONS: MASC could be a molecularly well-defined salivary gland neoplasm, encompassing some portions of AciCC and ANOS, but its histological spectrum and clinical implication require further investigation.
Adenocarcinoma ; Carcinoma, Acinar Cell ; Cytoplasm ; Eosinophils ; Estrogens ; Fluorescence ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Oncogene Proteins, Fusion ; Progesterone ; Recurrence ; Salivary Gland Neoplasms ; Salivary Glands ; World Health Organization

BACKGROUND AND OBJECTIVES: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the respiratory tract. RRP is usually divided into two groups by age of onset. We aimed to investigate the different clinical courses between the childhood-onset and the adult-onset RRP and review the effects of the treatments. MATERIAL AND METHOD: We retrospectively reviewed 44 patients with RRP who had been treated in our hospital over the last 13 years. We compared the clinical courses and intersurgical intervals of childhood-onset RRP with those of adult-type and evaluated the effect of the alpha-interferon (local injection) by comparing preadjuvant average surgical interval with postadjuvant surgical interval with a review of the literature. RESULTS: Childhood-onset RRP was most often diagnosed between 1 and 4 years of age. It was more widespread and it recurred more frequently than adult-onset RRP, often involving the trachea and necessitating the tracheostomy. Therefore, more frequent surgical interventions were needed in childhood-onset RRP (2.81/year) than in the adult-type (1.14/year). Adjuvant therapy (local injection of alpha-interferon) was applied to 10 patients. Seventy-five percent of the 8 patients (2 were excluded due to short duration of F/U period) showed complete response (CR) or partial resopnse (PR) and only two patients did not respond to alpha-interferon at all. CONCLUSION: Childhood-onset RRP is more aggressive and widespread than its adult counterpart and intralesional injection of alpha-interferon seems to have a potential of a safe and effective adjuvant therapy for RRP.
Adult ; Age of Onset ; Child ; Humans ; Injections, Intralesional ; Interferon-alpha ; Papilloma* ; Respiratory System ; Retrospective Studies ; Trachea ; Tracheostomy

BACKGROUND AND OBJECTIVES: A pyriform sinus fistula can cause a recurrent abscess in the neck. Complete excision is recommended but in many cases, surgery is complicated because of recurrent infection. Recurrence may result from failure to recognize, or inadequate excision of the tract. To avoid this, we attempted chemocauterization of the internal opening of the fistula tract with trichloracetic acid (TCA) on suspension laryngoscopy. MATERIALS AND METHOD: This was a 9-year review of 30 patients with pyriform sinus fistula. Medical history, diagnostic methods, operative findings and treatment results were analyzed with a review of the literatures. RESULTS: On suspension laryngoscopy, a fistula opening was found in the pyriform sinus of all patients, mainly on the left side. Except for two patients, 28 patients were managed by TCA chemocauterization. Of the five patients who had recurrent masses, three patients were successfully managed by simple excision and two patients were managed by repeated TCA cauterization with unobliterated internal openings. There was no serious intra- or postoperative complication. CONCLUSION: TCA cauterization is an appropriate first line treatment method for pyriform sinus fistula, especially for patients who have had recurrent neck abscess and undergone open drainage procedure. This method can be used to avoid morbidity of an open surgical procedure.
Abscess ; Cautery ; Drainage ; Fistula* ; Humans ; Laryngoscopy ; Neck ; Postoperative Complications ; Pyriform Sinus* ; Recurrence ; Trichloroacetic Acid

OBJECTIVE: To evaluate the swallowing problems after a primary resection in patients with tongue cancer. METHODS: Thirty-eight patients with primary tongue cancer, who underwent a glossectomy and had undergone a Video Fluoroscopic Swallowing Study (VFSS) prior to surgery in a university hospital between January 2010 and May 2015, were included retrospectively. The clinical and swallowing features, including the VFSS parameters before and after surgery, were analyzed. RESULTS: Among the 38 patients, 33 patients were T1 and T2 stage. Thirty-one, six and one patient underwent a partial glossectomy, hemiglossectomy, and total glossectomy, respectively. More than ninety percent of the patients had a selective neck dissection. All the patients were on a regular diet before surgery and showed no penetration or aspiration on the VFSS. Immediately after surgery, 33 patients (87%) had to change to non-oral feeding. At discharge, 8 patients (21%) maintained non-oral feeding, and 30 patients ate a limited diet. In a telephone survey (mean 19 months after surgery), among the 25 survey participants, 24 patients (96%) reported no problems with their regular diet. CONCLUSION: In tongue cancer patients with low Tumor-Node-Metastasis (TNM), American Joint Committee on Cancer (AJCC) stages, a primary resection of tongue cancer did not cause statistically significant dysphagia after surgery. Although many patients had to change their diet to limited or non-oral feeding immediately after surgery, almost all patients improved and could eat a regular diet after the long term follow up.
Deglutition ; Deglutition Disorders* ; Diet ; Follow-Up Studies ; Glossectomy ; Head and Neck Neoplasms ; Humans ; Joints ; Neck Dissection ; Retrospective Studies ; Telephone ; Tongue Neoplasms* ; Tongue*

BACKGROUND AND OBJECTIVES: Palatine tonsils and adenoids protect the human body from various pathogens entering through the pharyngeal mucosa. Many studies have been performed for the specific immunity, but the innate immunity related to cell-mediated immunity has been rarely studied. Natural killer (NK) cells, CD5+ B lymphocytes, and gamma sigma T lymphocytes are the key mediators of natural immunity. The aim of this study was to investigate the role of lymphocytes related to the innate immunity property in these lymphoid tissues by examinig the frequency and distribution of these cells. MATERIALS AND METHODS: Palatine tonsils and adenoids were obtained from 12 children and 5 adults with idiopathic tonsillar hypertrophy. Immunohistochemisty was performed to examine the distribution of the CD5+ B lymphocytes, gamma sigma T lymphocytes and NK cells, and the flow cytometry was performed for the frequency of these cells compared with that of the patient's blood. RESULTS: On immunohistochemistry, CD5+ B cells were strongly stained mainly on the interfollicular and subepithelial areas of both the palatine tonsil and adenoid. But, gamma sigma T lymphocytes, and CD56+ cells were weakly stained on the interfollicular, epithelial, and subepithelial areas of both lymphoid tissues. Flow cytometry showed no difference in the frequency of CD5+CD19+ B cells and CD3+ gamma sigma T lymphocytes in these tissues compared to that of the blood. The frequency of NK cells of these tissues was much lower than that of the blood. And the frequency of CD3+ gamma sigma T lymphocytes of adults was lower than that of children in both the palatine tonsils and blood. CONCLUSION: In the palatine tonsils and adenoids, there were no active immune cells related to innate immunity, except for the CD5+ B lymphocytes in the non-stimulating state. And the innate immunity of the lymphoid tissues has possibility of association with the changing activity according to age.
Adenoids* ; Adult ; B-Lymphocyte Subsets ; B-Lymphocytes ; Child ; Flow Cytometry ; Human Body ; Humans ; Hypertrophy ; Immunity, Cellular ; Immunity, Innate* ; Immunohistochemistry ; Killer Cells, Natural ; Lymphocytes* ; Lymphoid Tissue ; Mucous Membrane ; Palatine Tonsil* ; T-Lymphocyte Subsets ; T-Lymphocytes

BACKGROUND AND OBJECTIVES: Venous malformations are one of the most common vascular anomalies, and are more frequently found in head and neck region. Various treatment options are available, and intralesional injection of sclerosant is the commonest primary treatment modality. We reviewed 20 cases of venous malformation treated with sclerotherapy at Seoul National University Hospital. MATERIALS AND METHODS: Twenty cases of venous malformation in head and neck were reviewed retrospectively, which had been managed with sclerotherapy from January 1991 to July 2001. The patients were treated at the department of otolaryngology-Head and Neck Surgery or plastic surgery of Seoul National University Hospital. Emulsion of Ethamolin and Lipiodol was used as a sclerosing agent. Some patients received surgical treatment after sclerotherapy. All of the patients received direct-puncture venography(Digital subtraction angiography) before sclerotherapy. Treatment results were evaluated by using MRI, angiography, or CT. If the reduction of volume of mass was more than 50 percent after sclerotherapy, we regarded the result as effective, if less than 50 percents, non-effective. Statistical analysis was done using SPSS10.0 for windows. RESULTS: Among twenty patients, there were eight males(40%), and twelve females(60%). Ages at the beginning of treatment ranged from six to thirty-eight years(mean age:20.6 years). The most common site of lesions was cheek(in 12 cases). Mass sizes(largest diameter) ranged from 2 cm to 20 cm. Nine cases were managed with both sclerotherapy and surgical excision, and eleven cases, only with sclerotherapy. Thirteen cases(65%) responded well to sclerotherapy(volume reduction>or=50%). There was no major complication. Tenderness, induration, swelling, and pain were reported as post-sclerotherapy complaints. Mild dyspnea occurred in one case, and the patient was managed at ICU shortly without fatal event. CONCLUSION: Sclerotherapy with or without surgical excision was an effective treatment modality for venous malformation, with minimal risk of major complications. There were no significant differences in the treatment results according to the initial size of the lesions.
Angiography ; Dyspnea ; Ethiodized Oil ; Head ; Humans ; Injections, Intralesional ; Magnetic Resonance Imaging ; Neck ; Retrospective Studies ; Sclerotherapy* ; Seoul ; Surgery, Plastic

BACKGROUND: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. METHODS: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. RESULTS: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. CONCLUSIONS: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.
Biopsy, Fine-Needle* ; Biopsy, Large-Core Needle* ; Diagnosis ; Humans ; Parotid Gland ; Salivary Gland Neoplasms ; Salivary Glands* ; Submandibular Gland

BACKGROUND AND OBJECTIVES: Traumatic perforation in hypopharynx and cervical esophagus may be fatal, causing mediastinitis or sepsis. We present six cases of clinical experiences to outline diagnosis and management. MATERIALS AND METHOD: We retrospectively reviewed six patients with hypopharyngeal-cervical esophageal injury, over the period of recent two years. We summarized the method of diagnosis, treatment and clinical course with review of the literature. RESULTS: There were two cases of external blunt trauma, two cases of iatrogenic causes, and two cases of intraluminal injuries. The common clinical signs were painful neck swelling and fever. The five of six in routine X-ray showed air shadow in the neck or chest. The neck CT showed air or abscess in all six cases. The surgical drainage was performed in four cases. CONCLUSION: The diagnostic methods of hypopharyngeal-cervical esophageal injuries include chest X-ray, neck X-ray, Gastrografin(r) esophagography and CT after thorough history-taking and physical examination. CT was highly sensitive and important for decision of surgical management. Surgery is recommended if there is large perforation, abscess, mediastinal contamination or sepsis. In selective cases, non-surgical management is possible.
Abscess ; Diagnosis ; Drainage ; Esophagus ; Fever ; Humans ; Hypopharynx ; Mediastinitis ; Neck ; Physical Examination ; Retrospective Studies ; Sepsis ; Thorax

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Advisory Committees ; Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Counseling ; Expert Testimony ; Humans ; Mouth Neoplasms ; Neck ; Republic of Korea