PURPOSE: Facial paralysis is an uncommon but significant complication of chronic otitis media (COM). Surgical eradication of the disease is the most viable way to overcome facial paralysis therefrom. In an effort to guide treatment of this rare complication, we analyzed the prognosis of facial function after surgical treatment. MATERIALS AND METHODS: A total of 3435 patients with COM, who underwent various otologic surgeries throughout a period of 20 years, were analyzed retrospectively. Forty six patients (1.33%) had facial nerve paralysis caused by COM. We analyzed prognostic factors including delay of surgery, the extent of disease, presence or absence of cholesteatoma and the type of surgery affecting surgical outcomes. RESULTS: Surgical intervention had a good effect on the restoration of facial function in cases of shorter duration of onset of facial paralysis to surgery and cases of sudden onset, without cholesteatoma. No previous ear surgery and healthy bony labyrinth indicated a good postoperative prognosis. CONCLUSION: COM causing facial paralysis is most frequently due to cholesteatoma and the presence of cholesteatoma decreased the effectiveness of surgical treatment and indicated a poor prognosis after surgery. In our experience, early surgical intervention can be crucial to recovery of facial function. To prevent recurrent cholesteatoma, which leads to local destruction of the facial nerve, complete eradication of the disease in one procedure cannot be overemphasized for the treatment of patients with COM.
Adult ; Aged ; Chronic Disease ; Facial Nerve/surgery ; Facial Nerve Diseases/*etiology/*surgery ; Facial Paralysis/*etiology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/*complications ; Retrospective Studies ; Young Adult

This is a report of anesthesia for five cases of renal transplantation which was performed between February 1969 and August 1969 at St. Mary's Hospital, Catholic Medical College, Seoul, Korea. General of renal insufficiency of the operated cases were described. Operative technique were unilateral nephrectomy for three cases and bilateral nechprectomy with splenectomy for 2 cases ; Anesthesia was induced with epontol (propanidid) 250mgs i.v. and 4% halothane-oxygen and maintained with 1% halotbane-oxygen which was supplemented by nitrous oxide occasionally. 6% dextrose and lactated-Ringer's solution were infused. For transfusion, whole blood was given to replace the operative blood loss. Dextran was also used to maintain adequate blood volume. Shortly before anastomosis of renal and femoral vessels, patients were haparinized. Fluids and electrolytes balance were studied pre-and post-operatively. Preoperatively, uremia and hyperpotassemia was corrected by several hemodyalysis. Urinary output after surgery showed a marked degree of diuresis up to 1800 ml/hr until second post-operative day. The special concern of anesthesia for kidney transplantation were: 1. Patients were suffering from severe uremia and metabolic disterbances. 2. Acidosis and hyperpotassemia should be corrected before surgery by hemo-or peritoneal dialysis. 3. Immunosuppressive agents made the patient less resistant to infection. 4. Anemia and hydrops was difficult to be corrected before surgery. 5. Muscle relaxants of choice were depolarizing agents, because of impaired renal excretion.
Acidosis ; Anemia ; Anesthesia* ; Blood Volume ; Dextrans ; Diuresis ; Edema ; Electrolytes ; Glucose ; Humans ; Hyperkalemia ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Korea ; Nephrectomy ; Nitrous Oxide ; Peritoneal Dialysis ; Propanidid ; Renal Insufficiency ; Seoul ; Splenectomy ; Uremia

Fibrothecoma are mesenchymal tumors deriving from the ovarian stroma and consisting of theca-like elements and fibrous tissue. The reported incidence is between 0.4 and 8.0% of all ovarian tumors and this side variability can be attributed to the difficulty in differentiation fibrothecoma from ovarian fibroma or hyperplastic stroma nodules. A dermoid cyst is composed of well-differentiated derivatives of the three germ layers; ectoderm, mesoderm, and endoderm. We have experienced a case of ovarian fibrothecoma with mature cystic teratoma of the ipsilateral ovary and ovarian fibroma of the contralateral ovary in a 33-year-old woman. We report a case with brief review of literature.
Adult ; Dermoid Cyst ; Ectoderm ; Endoderm ; Female ; Fibroma* ; Germ Layers ; Humans ; Incidence ; Mesoderm ; Ovary* ; Teratoma*

OBJECTIVE: The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to evaluate the clinical usefulness of meconium-crit method as an objective method for quantitative measurement of meconium content in AF. METHODS: Seventy of AF samples were obtained with amniocentesis from the pregnants of 30 weeks and over. Twenty-four of meconium-stained AF(MSAF)samples among them were separated through the subjective and gross assessment of clinicians. MSAF samples, except for the two samples contaminated by blood, were again divided into two categories: AF with fresh-meconium (11 samples) and AF with old-meconium(11 samples). Absorption spectra and meconium-crit of the samples were measured. RESULTS: Correlation coefficients between meconium-crit and absorption spectra at 425nm were 0.741 for 11 AF with fresh meconium, 0.255 for AF with old meconium and 0.354 for all MSAF samples. Those at 550nm were 0.934 for 11 AF with fresh meconium, 0.669 for 11 AF with old meconium and 0.639 for all MSAF samples. Those at 700nm were 0.916 for 11 AF with fresh meconium, 0.680 for 11 AF with old meconium and 0.706 for all MSAF samples. Analyses of correlation coefficients show very good or excellent relationship between absorption spectra and meconium-crit for AF with fresh meconium while little or moderate relationship for AF with old meconium. CONCLUSIONS: Therefore meconium-crit can be used as the objective and quantitative method that can measure meconium content in AF although variable results are shown in AF with old meconium.
Absorption ; Amniocentesis ; Amniotic Fluid* ; Female ; Meconium*

BACKGROUND AND OBJECTIVES: Preservation of facial nerve function in vestibular schwannoma (VS) surgery is still a significant operative challenge. Several prognostic factors correlate with postoperative facial nerve function. Most partial facial nerve damage can recover completely without functional defect. However, recovery of the facial nerve in some patients is either incomplete or non-existent. To evaluate the cause of incomplete facial function recovery at long term follow-up (> or =1 year), we analyzed the factors that influenced facial function recovery in a consecutive series of patients that had immediate post-operative, partial paralysis after VS surgery with preservation of neural integrity. MATERIALS AND METHODS: We conducted a retrospective review of 143 cases of VS surgery that occurred between January 1994 and December 2008. Twenty-seven patients that had immediate, postoperative partial facial paralysis and normal preoperative facial function with intact nerve after tumor excision were analyzed with regards to age, sex, tumor size, tumor location, internal auditory canal (IAC) widening, duration of surgical procedure, postoperative complication, and facial function after a postoperative follow-up period of > or =1 year by the House-Brackmann (HB) grading system. RESULTS: Of the 143 patients that underwent VS surgery, 27 (18.8%) patients had immediate, postoperative partial facial paralysis. At long-term follow-up, there were 11 (7.6%) patients with incomplete facial recovery. Facial function recovery after facial nerve injury did not show a significant difference in tumor size, surgical approach, or tumor location. However, preoperative IAC widening and the duration of the procedure were related to facial restoration after surgery. CONCLUSIONS: The injured facial nerve during VS surgery showed incomplete recovery in many cases. Chronic compression of the facial nerve, together with IAC widening preoperatively, led to incomplete restoration of injured facial nerves.
Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Follow-Up Studies ; Humans ; Neuroma, Acoustic ; Paralysis ; Postoperative Care ; Recovery of Function ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Preservation of facial nerve function in vestibular schwannoma (VS) surgery is still a significant operative challenge. Several prognostic factors correlate with postoperative facial nerve function. Most partial facial nerve damage can recover completely without functional defect. However, recovery of the facial nerve in some patients is either incomplete or non-existent. To evaluate the cause of incomplete facial function recovery at long term follow-up (> or =1 year), we analyzed the factors that influenced facial function recovery in a consecutive series of patients that had immediate post-operative, partial paralysis after VS surgery with preservation of neural integrity. MATERIALS AND METHODS: We conducted a retrospective review of 143 cases of VS surgery that occurred between January 1994 and December 2008. Twenty-seven patients that had immediate, postoperative partial facial paralysis and normal preoperative facial function with intact nerve after tumor excision were analyzed with regards to age, sex, tumor size, tumor location, internal auditory canal (IAC) widening, duration of surgical procedure, postoperative complication, and facial function after a postoperative follow-up period of > or =1 year by the House-Brackmann (HB) grading system. RESULTS: Of the 143 patients that underwent VS surgery, 27 (18.8%) patients had immediate, postoperative partial facial paralysis. At long-term follow-up, there were 11 (7.6%) patients with incomplete facial recovery. Facial function recovery after facial nerve injury did not show a significant difference in tumor size, surgical approach, or tumor location. However, preoperative IAC widening and the duration of the procedure were related to facial restoration after surgery. CONCLUSIONS: The injured facial nerve during VS surgery showed incomplete recovery in many cases. Chronic compression of the facial nerve, together with IAC widening preoperatively, led to incomplete restoration of injured facial nerves.
Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Follow-Up Studies ; Humans ; Neuroma, Acoustic ; Paralysis ; Postoperative Care ; Recovery of Function ; Retrospective Studies

PURPOSE: To evaluate the usefulness of pulmonary function test for the prediction of successful weaning and extubation from the ventilator in very low birth weight(VLBW) infants with chronic lung disease. METHODS: This study included 15 VLBW infants(<1,500 g) with chronic lung disease who were admitted to Neonatal Intensive Care Unit of Samsung Medical Center from July, 1995 to June, 1996. They had extubation failure more than one time. This study was performed by reviewing of patients records retrospectively. The extubation criteria were based on clinical status, ABGA profiles and ventilatory parameters. At the time of last extubation failure and final success, we analyzed the distribution of age and weight of infants, ventilator profiles, ABGA profiles, dynamic and static pulmonary function test profiles measured by Bicore CP-100R from the infant with ventilator assistance daily in line monitoring. The paired T-test and linear logistic regression analysis were used to compare the variables between the evets of extubation failure and success. RESULTS: At the time of successful extubation, expiratory airway resistance was significantly lower and minute volume was significantly higher in dynamic pulmonary function test and respiratory system resistance was significantly lower in static pulmonary function test(P<0.05). In ventilator parameter, Fi02 and respiratory rate were lower at successful extubation(P<0.05). No statistically significant differences in ABGA profiles were seen between unsuccessful and successful extubation. CONCLUSION: The pulmonary function test is a useful predictor for successful weaning and extubation in VLBW infants with chronic lung disease. Among various parameters of pulmonary function test, expiratory airway resistance, minute ventilation and respiratory system resistance are suggested as successful weaning parameters.
Airway Resistance ; Bronchopulmonary Dysplasia ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Logistic Models ; Lung Diseases* ; Lung* ; Parturition ; Respiratory Function Tests* ; Respiratory Rate ; Respiratory System ; Retrospective Studies ; Ventilation ; Ventilators, Mechanical ; Weaning*

The middle ear adenoma is a rare neoplasm originating from the lining epithelium of the middle ear mucosa. The first report of a middle ear glandular tumor was published in 1898 by Treitel and since then over 100 cases have been reported. At least 14 different descriptions have been given to these lesions, reflecting the controversies relating to their presumed histogenesis and differentiation. The middle ear adenoma has been often classified into mixed and papillary type by cellular morphology, growing pattern, prognosis, and clinical manifestations. The most common initial symptom was decreased hearing, followed by ear-fullness, otalgia, headache, and otorrhea. Radiologically, the most common finding is a soft tissue mass in the middle ear. In this study, we present a case of the middle ear adenoma of the patient complaining hearing difficulty and otorrhea, which was diagnosed by histopathologic finding, and then discuss the current approach to this tumor with a review of literature.
Adenoma* ; Ear, Middle* ; Earache ; Epithelium ; Headache ; Hearing ; Humans ; Mucous Membrane ; Prognosis

Lingual osseous lesion can be classified as one of three types: osteoma, chondroma and osteochondroma. Osteoma is a benign neoplasms consisting of mature normal osseous tissue. Osseous growths within the oral cavity, but it is especially rare to find it in the tongue. The majority of the lesions occur in the posterior third of the tongue at or in close proximity to the foramen cecum and the circumvallate papillae. Clinically, tongue osteomas are benign, slow- growing tumors made up of densely sclerotic, well-formed bone. Symptoms include foreign body sensation, dysphagia, nausea, and choking. However, most patients tend to be asymptomatic, and histologic studies can confirm the diagnosis. Treatment of the oral osteoma is by surgical excision, preferably by a transoral approach. This should give complete resolution and there were rare recurrences with good prognosis. Recently, we experienced a 25 year old woman with asymptomatic hard mass on the base of the tongue. A surgical resection was performed and pathologic analysis confirmed tongue osteoma for the patient. Now we report this case with a review of literature.
Adult ; Airway Obstruction ; Cecum ; Chondroma ; Deglutition Disorders ; Diagnosis ; Female ; Foreign Bodies ; Humans ; Mouth ; Nausea ; Osteochondroma ; Osteoma* ; Prognosis ; Recurrence ; Sensation ; Tongue*

Tinnitus is one of the most common complaints in the otolaryngology. It can be classified as either as subjective or objective; the former refering to that sensation heard only by the patient and the latter to that sensation heard also by the examiner. Arteriovenous fistula is the most common cause of objective tinnitus due to the trauma. Recently, the authors experienced one case of the pulsatile tinnitus caused by post-traurnatic arteriovenous fistula involving the superficial temporal artery. This was confirmed by selectcd angiography and was treated by percutaneous transarterial embolization which resulted in the disappearance of tinnitus.
Angiography ; Arteriovenous Fistula* ; Humans ; Otolaryngology ; Sensation ; Temporal Arteries* ; Tinnitus*