Many patients regard tonsillectomy as a minor operation because it is performed frequently. Although tonsillectomy is considered a relatively safe surgical procedure, numerous complications have been described. The common complications are hemorrhage, infection, and following anesthesia, aspiration, cardiac arrhythmia, and laryngeal trauma. Cervicofacial emphysema and pneumomediastinum are rarely observed sequelae of surgical intervention in the upper aerodigestive tract. Although these complications resolve spontaneously in most cases, a few cases result in tension pneumothorax and other life-threatening conditions. Symptoms include chest pain, neck pain, dyspnea and odynophagia. Treatment involves frequent assessment of the airway and extent of the emphysema. The authors of the present study report of a patient who developed pneumomediastinum shortly after an adenotonsillectomy as well as a review of the related literature.
Anesthesia ; Arrhythmias, Cardiac ; Chest Pain ; Dyspnea ; Emphysema ; Hemorrhage ; Humans ; Mediastinal Emphysema ; Neck Pain ; Pneumothorax ; Subcutaneous Emphysema ; Tonsillectomy

PURPOSE: It is known that due to both their imaging and pathologic features, the accurate differentiation ofchondrosarcoma from chordoma is difficult. Through an analysis of MR and CT findings, this study aims to determinethe differential points between these two tumors. MATERIALS AND METHODS: In 21 patients, CT and MR imagingstudies of chordoma(n=12) and chondrosarcoma(n=9) at the base of the skull were retrospectively reviewed.Diagnosis had been established by histologic examination of surgically removed specimens. Eleven of the chordomaswere subclassified as 'conventional' and one as 'chondroid'; eight chondrosarcoma were 'conventional' andone was 'myxoid'. Four chordoma patients underwent CT and MR ; in six, only MR was performed ; and in two, onlyCT. Eight chondrosarcoma patients underwent both CT and MR, while in one, only CT was performed. All scans wereretrospectively evaluated for the location(midline/off-midline), direction of extension, margin and shape, bonydestruction and calcification, MR signal intensity and enhancement patterns of the tumors. Degree of calcificationwas graded from I to III. RESULTS: The epicenter of the mass of ten chordomas (83%) was midline, in twochondrosarcomas(22%), this was off-midline. Foci of calcification were observed in three of eleven chordomas(27%),and heavy calcification (grade III) was observed in one. In contrast to these findings, foci of calcificationswere observed in eight of nine chondrosarcomas (89%) and grade III calcification was observed in five. In bothtumors, calcification was coarse. Between the two kinds of tumor, there were no significant difference in MRsignal intensity and enhancement patterns, margin and shape, or direction of extension. CONCLUSIONS: Although MRand CT findings were similar in both types of tumor, location and degree of calcification may be features whichusefully distinguish chordoma from chondrosarcoma.
Chondrosarcoma* ; Chordoma* ; Humans ; Retrospective Studies ; Skull Base* ; Skull*

PURPOSE: To compare the usefulness of echo-planar imaging (EPI) and fast spin-echo (FSE) in routine brain MR imaging. MATERIALS AND METHODS: Twenty-five patients with various intracranial diseases were prospectively examined with T2-weighted MR imaging on a 1.5T unit using FSE, spin echo singl-shot EPI (SS-EPI) and multi-shot EPI (MS-EPI) techniques. For qualitative assessment, overall image quality, discrimination between cortical gray-white matter and between basal ganglia-white matter, lesion conspicuity, image distortion and artifacts (motion, ghost, flow, and susceptibility) were all evaluated using a subjective scoring system ranging from 1 to 4 (1 for the worst and 4 for the best). For quantitative assessment, contrast and contrast-to-noise ratio (CNR) were calculated for cortical gray-white matter, basal ganglia-white matter, and lesion-white matter. RESULTS: Overall image quality, discrimination between cortical gray-white matter, basal ganglia-white matter, and lesion-white matter, lesion conspicuity, image distortion and susceptibility artifacts showed the highest value in FSE and the lowest in SS-EPI. Motion artifacts were seen only in FSE, while flow and ghost artifacts were most commonly seen in SS-EPI. Contrast and CNR of anatomical and pathologic structures showed the highest value in FSE, especially for cortical gray-white matter and basal ganglia-white matter . CONCLUSION: With regard to overall image quality, image distortion, susceptibility artifacts, contrast and CNR, EPI is far inferior to FSE. In routine brain MR imaging., the usefulness of EPI techniques would therefore be very limited.
Artifacts ; Brain* ; Discrimination (Psychology) ; Echo-Planar Imaging ; Humans ; Magnetic Resonance Imaging* ; Prospective Studies

Gastric carcinoid tumors were previously believed to be rare lesions, representing less than 2% of all carcinoid tumors and less than 1% of all stomach neoplasms. More recent studies have demonstrated that they may constitute as much as l0-30% of carcinoid tumors. We recently experienced a 35-years old businessman with gastric carcinoid tumor who camplained of postprandial epigastric discomfort. Gastrofiberscope showed protruding mass with central depression and erasion which was located on greater curvature of lower body and its size was 1 x 1 cm. Gastroendoscopic biopsy was per formed. It was identified to carcinoid tumor(Argyrophilic tumor). EUS(endoscopic ultrasonography) revealed that the lesion was limited to submucosa without evidence of any metastasis to adjacent lymph node. The carcinoid tumor was successfully removed by endoscopic polypectomy. Gastrofiberscope and EUS 9months after polypectomy showed that the lesion was nearly normal mucosa without submucosal thickening.
Adult ; Biopsy ; Carcinoid Tumor* ; Depression ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Stomach Neoplasms

Primary malignant melanoma of the vagina is an exceedingly rare entity, accounting for about 3% of all primary vagina1 malignant tumors and 0.3% of all melanoma. The overall 5-year survival in patients with primary vaginal melanoma is notoriously poor, estimated to be between 13% and 19%. A case of primary malignant melanoma of the vagina treated with the wide local excision of vagina and rectum was presented with a brief review of literature.
Humans ; Melanoma* ; Rectum* ; Vagina*

Depigmented halos surrounding cutaneous lesions have been the common description of many diseases, including benign melanocytic nevus, acquired blue nevi, malignant melanoma and neurofibromatosis. To the best of our knowledge, a halo around seborrheic keratosis has not been reported in the Korean dermatologic literature, and only two cases have been described abroad. Though vitiligo is known to be frequently associated with this halo phenomenon, the exact etiopathogenesis of vitiligo and the halo phenomenon is still unknown. Herein, we report on a case of halo seborrheic keratosis in a patient with vitiligo.
Humans ; Keratosis, Seborrheic ; Melanoma ; Neurofibromatoses ; Nevus, Blue ; Nevus, Pigmented ; Vitiligo

Pneumosinus dilatans is a rare disease in which 1 or more paranasal sinuses are dilated without functional alteration. The frontal sinus is the most commonly affected site, with involvement of the maxillary sinus being rare. A 25-year-old man had complained of facial pain and headache of frontal area. These symptoms were aggravated after nose blowing. A computed tomographic scan showed a hyperaeration of both maxillary sinus and frontal sinus. We treated the condition by endoscopic sinus surgery (middle meatal antrostomy, both). Just after operation, facial pain and headache of frontal sinus have subsided. No recurrence was detected. In this article, the authors present surgical options for the treatment of pneumosinus dilatans of the maxillary sinus, including a review of the literature.
Facial Pain ; Frontal Sinus ; Headache ; Maxillary Sinus ; Nose ; Paranasal Sinuses ; Rare Diseases ; Recurrence

Penetrating traumatic laryngeal injuries are relatively rare and traumatic injuries to the epiglottis are extremely rare. The present case is 58-year old man with suicidal history, chronic alcoholism, and schizophrenia who complained of neck laceration and unconsciousness after stab injury. Examination revealed a large transverse laceration of 7 cm in size, penetrating deep to the level of thyroid cartilage from the lateral border of the sternocleidomastoid muscle, exposing the thyroid cartilage. There was about a 3 cm-sized deep wound under the thyroid gland level but no major vessel injury. The stump of transected epiglottis accompanied by rupture of thyroid membrane was shown but the esophagus was intact. We sewed the amputated epiglottis with the rest of the epiglottis by using two Lambert sutures with vicryl 4-zero on each side under general anesthesia. There was no necrosis of the severed epiglottis, swallowing difficulty, and aspiration on eating food. We report here on the penetrating laceration with subtotal transection of epiglottis that was successfully repaired.
Alcoholism ; Amputation ; Anesthesia, General ; Deglutition ; Eating ; Epiglottis ; Esophagus ; Glycosaminoglycans ; Lacerations ; Membranes ; Muscles ; Neck ; Necrosis ; Polyglactin 910 ; Rupture ; Schizophrenia ; Sutures ; Thyroid Cartilage ; Thyroid Gland ; Unconsciousness

BACKGROUND: Although the number of medical institutions running a smoking cessation clinic is on the rise, there remains a paucity of research on the long- and short-term success rates of smoking cessation programs, as well as on smoking relapse rates, before and after project implementation. This study assessed the general characteristics of patients visiting the smoking cessation clinic, success rate of smoking cessation in the short term, and risks of relapse. METHODS: Medical records from March 2015 to April 2017 were analyzed and telephone surveys were conducted with 151 smokers who visited a hospital smoking cessation clinic from March 2015 to April 2017. RESULTS: Of the 139 smokers who were eligible for follow-up, 22 (15.8%) failed to quit smoking initially. The clinic's 6-month success rate of smoking cessation was 64.83%. Those with higher medication compliance had a lower risk of primary failure (odds ratio, 0.056; 95% confidence interval, 0.005–0.609), whereas those with higher age (hazard ratio [HR], 0.128; P=0.0252) and a greater number of visits to the clinic (HR, 0.274; P=0.0124) had a lower risk of relapsing. CONCLUSION: The risk of primary failure to quit was higher with low medication compliance, and that of relapsing was higher with lower age and fewer number of clinic visits. Various evaluation and analysis methods can be carried out in the future based on the accumulated data for maintenance of smoking cessation and relapse prevention.
Ambulatory Care ; Follow-Up Studies ; Humans ; Medical Records ; Medication Adherence ; Recurrence ; Running ; Secondary Prevention ; Smoke ; Smoking Cessation ; Smoking ; Telephone ; Varenicline

Occurence of lactic acidosis with adequate tissue oxygenation(type B lactic acidosis) has been described in association with leukemia, lymphoma, small cell carcinoma and breast cancer. However, no such case has been reported in Korea. Therefore, we report a case of type B lactic acidosis in a man with rapidly progressing acute lymphoblastic leukemia which had been transformed from lymphoma.
Acidosis, Lactic* ; Breast Neoplasms ; Korea ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*