Schwannomas are benign tumors derived from the Schwann cells of the nerve sheath. These are rare tumors that can be found in any part of the body although fewer than 4% of these tumors involve the nasal cavity and paranasal sinuses. Here, we present three cases of sinonasal schwannoma. The tumor masses were removed by endoscopic excision under general anesthesia. Pathological examination of the excised specimens confirmed schwannoma and the tumor cells were immunoreactive for S-100 protein. The patients are doing well with no evidence of recurrence.
Anesthesia, General ; Humans ; Nasal Cavity ; Neurilemmoma ; Nose ; Paranasal Sinuses ; Recurrence ; S100 Proteins ; Schwann Cells

BACKGROUND: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. METHODS: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age,sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. RESULTS: 1) Group 1 patients had lower glucose level{63.3+/-30.8(mg/dl)} than that of the group 2{98.5+/-34.2(mg/dl), p<0.05}, and higher LDH level{776.3+/-266.0(IU/L)} than the group 2 patients{376.3 +/-123.1(IU/L), p<0.05), and also longer duration of symptom before treatment{2.0+/-1.7(month)} than the group 2{ 1.1 +/-1.2(month), p<0.05)}, respectively. 2) In group 1, FVC changed from preoperative 2.55+/-0.80(L) to postoperative 2.99+/-0.78(L)(p<0.05), and FEV1 changed from preoperative 2.19 +/- 0.70(L/sec) to postoperative 2.50+/-0.69(L/sec) (p<0.05). 3) There was no difference in pleural fluid protein level(5.05+/-1.01(gm/dL) and 5.15+/-0.77 (gm/dl), p>0.05) and WBC differential count between group 1 and group 2. CONCLUSION: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.
Biochemistry ; Cell Count ; Drug Therapy ; Dyspnea ; Glucose ; Humans ; Pleural Effusion* ; Pleurisy ; Prospective Studies ; Tuberculosis, Pleural*

BACKGROUND AND OBJECTIVES: Hyperhomocyt(e)inemia is known to be one of independent risk factors for the ischemic heart diseases recently, but the role of hyperhomocysteinemia in restenosis after coronary intervention is unclear. The relationship between plasma homocysteine level and restenosis after coronary intervention was evaluated in Korean patients. MATERIALS AND METHOD: Eighty three patients underwent successful percutaneous coronary intervention (PCI) and follow-up coronary angiography were divided into two groups according to restenosis, and the level of plasma homocysteine was compared between groups with restenosis (n=5, M:F=7:8, 60.6+/-13.5 years) and without restenosis (n=8, M:F=0:8, 60.3+/-12.8 years). RESULTS: The clinical manifestation, atherosclerosis risk factors except for hypertension, and coronary angiographic findings were not significantly different in patients with or without restenosis(P=S). The value of homocysteine was 9.3+/-3.1 micromol/L in 35 patients with restenosis and 8.4+/-2.5 micromol/L in 48 patients without restenosis(P=S). All of 8 patients whose values of plasma homocysteine were more than 13 micromol/L, had angiographic restenosis. Plasma homocysteine was not an independent risk factor of restenosis by means of logistic regression analysis. CONCLUSION: Plasma homocysteine is not a potential risk factor of restenosis after percutaneous coronary intervention.
Atherosclerosis ; Coronary Angiography ; Follow-Up Studies ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hypertension ; Logistic Models ; Myocardial Ischemia ; Percutaneous Coronary Intervention* ; Plasma ; Risk Factors

Squamous papilloma is a benign epithelial tumor that can develop in any mucosal site of the upper aerodigestive tract. While this tumor is found mainly in the squamocilliary junction, its distribution does not occur randomly. However, in many cases, squamous papilloma is asymptomatic, and only a small number of cases are diagnosed. We experienced a patient presented with the complaint of snoring. This patient was diagnosed as having squamous papilloma of the soft plate on the nasopharyngeal surface. The patient might have been misdiagnosed as having merely a simple snoring problem, as nothing was found upon macroscopic examination. Nevertheless, squamous papilloma was detected through fiberoptic nasopharyngolaryngoscopy. This patient was successfully treated with laser-assisted uvulopalatoplasty, and we report this case, along with the associated literature.
Humans ; Nasopharyngeal Neoplasms ; Palate, Soft ; Papilloma ; Snoring

Unlike the small cell carcinoma of the lung, much remains to be discovered about the natural history and of optimal therapy of primary small cell carcinoma of the pancreas. We experienced a case of a primary small cell carcinoma of pancreas with both adrenal metastasis. The patient was a seventy-year old woman who had complained of right upper quadrant abdominal pain for 1 month. Chest x-ray revealed no abnormality. Abdominal CT scan showed a non-enhancing low density mass in uncinate process of pancreas, retropancreatic lymphadenopathy and well defined masses in both adrenal gland. CT-guided biopsy of pancreas showed small cell carcinoma. Herein, we report a case of primary small cell carcinoma of the pancreas with both adrenal metastasis and review the literature.
Abdominal Pain ; Adrenal Glands ; Biopsy ; Carcinoma, Small Cell* ; Female ; Humans ; Lung ; Lymphatic Diseases ; Natural History ; Neoplasm Metastasis ; Pancreas* ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Carcinoma, Squamous Cell*

PURPOSE: The purpose of this study is to investigate peculiar patterns of facial asymmetry following incomplete recovery from facial paralysis that require optimal physical therapy for effective facial rehabilitation, and to decrease the incidence of avoidable facial sequelae. MATERIALS AND METHODS: This study involved 41 patients who had facial sequelae following the treatment of various facial nerve diseases from March 2000 to March 2007. All patients with a follow-up of at least 1 year after the onset of facial paralysis or hyperactive function of the facial nerve were evaluated with the global and regional House-Brackmann (HB) grading systems. The mean global HB scores and regional HB scores with standard deviations were calculated. Other factors were also analyzed. RESULTS: Four patterns of facial asymmetry can be observed in patients with incomplete facial recovery. The most frequently deteriorated facial movement is frontal wrinkling, followed by an open mouth, smile, or lip pucker in patients with sequelae following facial nerve injury. The most common type of synkinesis was unintended eye closure with an effort to smile. CONCLUSION: We described common configurations of facial asymmetry seen in incomplete recovery following facial nerve injury in an attempt to develop an optimal strategy for physical therapy for complete and effective facial recovery, and to decrease the incidence of avoidable sequelae.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Face/physiopathology ; Facial Asymmetry/*physiopathology ; Facial Nerve/pathology ; Facial Nerve Injuries/physiopathology/therapy ; Facial Paralysis/physiopathology/*therapy ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Treatment Outcome

PURPOSE: The goal of this study was to develop a technique for creating a computerized composite maxillofacial-dental model, based on point-based surface best fit algorithm and to test its accuracy. The computerized composite maxillofacial-dental model was made by the three dimensional combination of a 3-dimensional (3D) computed tomography (CT) bone model with digital dental model. MATERIALS AND METHODS: This integration procedure mainly consists of following steps : 1) a reconstruction of a virtual skull and digital dental model from CT and laser scanned dental model ; 2) an incorporation of dental model into virtual maxillofacial-dental model by point-based surface best fit algorithm; 3) an assessment of the accuracy of incorporation. To test this system, CTs and dental models from 3 volunteers with cranio-maxillofacial deformities were obtained. And the registration accuracy was determined by the root mean squared distance between the corresponding reference points in a set of 2 images. RESULTS AND CONCLUSIONS: Fusion error for the maxillofacial 3D CT model with the digital dental model ranged between 0.1 and 0.3 mm with mean of 0.2 mm. The range of errors were similar to those reported elsewhere with the fiducial markers. So this study confirmed the feasibility and accuracy of combining digital dental model and 3D CT maxillofacial model. And this technique seemed to be easier for us that its clinical applicability can good in the field of digital cranio-maxillofacial surgery.
Congenital Abnormalities ; Dental Models ; Fiducial Markers ; Skull

No abstract available.
Calcinosis* ; Humans ; Infant*

OBJECTIVES: To find the main cause of facial nerve dysfunction in vestibular schwannoma (VS) surgery and review the prognosis of facial function in relation to tumor size, preoperative facial function and surgical approach. METHODS: We reviewed the surgical outcome of 134 patients with VS treated in our department between 1994 and 2008. All patients included in the study had postoperative facial paralysis after surgical management of their VS. There were 14 women and 7 men. The mean age was 48.5 years, with a mean follow-up period of 57 months. RESULTS: Twenty-one patients (sustained facial palsy, 4; newly developed facial palsy, 17) had facial nerve paralysis after surgery: ten patients in large VS and eleven patients in small VS. In large VS group, 4 patients had facial nerve function of HB grade II, 3 patients had HB grade III, and 3 patients had HB grade IV. In small VS group, 9 patients had HB grade II and 2 patients had HB grade IV. Middle cranial fossa approach rather than translabyrinthine approach for the preservation of hearing, led to facial nerve deterioration and the patients who had facial nerve paralysis perioperatively, had resulted in permanent facial paralysis. CONCLUSION: The tumor size in VS is certainly one of the most important prognostic factors. However, VS tumor size alone should not be considered a unique prognostic indicator. The surgical approach used, which may be related to tumor size, based on the surgeon's experience, can be a deciding factor, and the status of the facial nerve injured by the tumor can influence postoperative facial nerve function.
Cranial Fossa, Middle ; Facial Nerve ; Facial Paralysis ; Female ; Follow-Up Studies ; Hearing ; Humans ; Male ; Neuroma, Acoustic ; Paralysis ; Prognosis