BACKGROUND AND OBJECTIVES: Three-dimensional (3D) imaging is gaining popularity and has been partially used in robotic surgery but not in sinonasal surgery owing to technical problems. This is not only the first pilot study to evaluate the usefulness of newly-developed ‘twin lens’ HD-3D endoscope (Machida), but also the first clinical study to compare this instrument with the pre-existing ‘insect eye’ 3D endoscope (Visionsense). MATERIALS AND METHOD: A total of 45 surgeries for cerebrospinal fluid leakage, angiofibroma, or sinonasal malignancy were performed using a 3D endoscope between November 2011 and October 2013 (‘insect eye’ Visionsense VSII 3D: 29 cases, ‘twin lens’ Machida HD-3D: 16 cases). RESULTS: Depth perception and recognition of anatomical structures were all excellent in the two 3D methods. The ‘twin lens’ HD-3D endoscope provided better image resolution and naturalness of color and showed less unfavorable phenomena such as image blurring and blackout than the ‘insect eye’ 3D endoscope. CONCLUSION: If the technical limitations are solved, the 3D endoscope will be used as a substitute and a standard tool in endoscopic sinonasal surgery rather than as supplement to the two-dimensional (2D) endoscope in the near future.
Angiofibroma ; Cerebrospinal Fluid Leak ; Clinical Study ; Depth Perception ; Endoscopes* ; Imaging, Three-Dimensional ; Methods ; Paranasal Sinus Neoplasms ; Pilot Projects ; Sinusitis

Maxillary sinus cancer is anatomically located adjacent to the orbit and the skull base. Local recurrence is by far the most common cause of treatment failure and the long-term survival rates is low. Local recurrence is usually happened within 2 years after initial treatment. Late recurrence is generally defined as a recurrence 5 years after initial treatment. But, late recurrence cases of maxillary sinus cancer is very rare, especially 10 years after treatment. We report a case of late recurrence on the previous skin graft site 16 years after the treatment of maxillary sinus squamous cell carcinoma in a 66-yr-old man. The patient was treated with surgical wide excision and skin graft. No recurrence was developed after one and a half year and we discussed the pathogenesis of this very late recurrent case.
Carcinoma, Squamous Cell ; Humans ; Maxillary Sinus ; Maxillary Sinus Neoplasms ; Orbit ; Recurrence ; Skin ; Skull Base ; Survival Rate ; Transplants ; Treatment Failure

PURPOSE: Mucinous gastric carcinoma (MGC) is a histopathologic subtype of gastric adenocarcinoma with a poor prognosis. It comprises about 3~10% of gastric carcinomas. The purpose of this study was to compare the disease course of MGC with non-MGC (NMGC) and study the clinicopathologic features that influence the prognosis of MGC patients. METHODS: We reviewed the records of 2,383 patients with a confirmed histologic diagnosis of gastric carcinoma who underwent surgery at the Department of Surgery, Chonnam National University Hospital. There were 157 patients with MGC compared to 2,226 with NMGC. Patients were evaluated on the basis of gender, age, tumor size, tumor location, depth of invasion, region and number of lymph nodes with metastasis, hepatic or peritoneal metastasis, stage at presentation, estimate of surgical curability, and TNM stage based on the UICC classification. Multivariate analysis was performed to test the hypothesis that the histologic mucin contents themselves in MGC are an independent prognostic factor. RESULTS: There was no gender or age-at-diagnosis distinction between these two groups. The mean tumor size of MGC was larger than that of NMGC, but the difference was not statistically significant. Most carcinomas of both types were located in the antrum with no statistical difference in location between MGC and NMGC. However, a depth of invasion greater than T3 was more frequently found in MGC than in NMGC, not to a statistically significant degree. The mean number of lymph node with metastases was 2.78 in MGC and 2.28 in NMGC (P<0.001). There were more MGC patients with TNM stages II through IV(UICC classification). The overall survival rate was lower for the MGC group(46.5%) than for the NMGC group (64.0%). Depth of invasion, lymph node metastasis, and stage at diagnosis were significant factors affecting the outcome. Mucinous histologic type itself was not an independent predictive factor in survival. CONCLUSION: The factors that influence the poorer prognosis(lower 5-year survival rate) of MGC are advanced stage at the time of diagnosis, lymph node metastases, and a higher TNM status. The histologic subtype itself was not an independent prognostic factor.
Adenocarcinoma ; Classification ; Diagnosis ; Humans ; Jeollanam-do ; Lymph Nodes ; Mucins* ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis* ; Survival Rate

BACKGROUND AND OBJECTIVES: The aims of this study were to evaluate the anatomical features of patients with obstructive sleep apnea syndrome (OSAS) using upper airway computed tomography (CT) in the awake state, and to analyze the correlation between anatomical features and severity of polysomnography (PSG) findings. MATERIALS AND METHODS: Sixty-eight patients presenting with snoring and sleep apnea were included, and upper airway CT in the awake state and PSG were performed in all patients. The average apnea-hypopnea index (AHI) and minimal arterial oxygen saturation (minSaO2) values were calculated. The axial and sagittal images from the level of the nasopharynx to that of the hypopharynx were obtained and measured. The correlations of the anatomical parameters with AHI and minSaO2 were statistically analyzed. RESULTS: The significant parameters correlated with AHI were nasopharynx anterior-posterior (A-P) diameter and transverse diameter, soft palate transverse diameter, uvula length, tongue length, lingual transverse diameter, and hypopharynx A-P diameter & transverse di-ameter. The parameters correlated with minSaO2 were nasopharynx transverse diameter and lingual transverse diameter. Conclusions: Upper airway analysis using CT in awake OSAS patients provides anatomical parameters which correlate with the severity of OSAS. Therefore, upper airway CT in the awake state may be helpful in diagnosing OSAS.
Airway Obstruction ; Humans ; Hypopharynx ; Nasopharynx ; Oxygen ; Palate, Soft ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring ; Tongue ; Uvula ; Wakefulness

OBJECTIVE: This study is aimed to see ultrastructural changes of pineal gland in rats exposed to microwaves. METHODS: We conducted an experiment by exposing rats at the electromagnetic wave frequency of 2.45GHz, using with an EMR(electromagnetic radiation) emitting apparatus to study the effect of electromagnetic wave on the pineal gland. Paying especial attention to measure damages to pineal gland cells in the brain, we set the levels of EMR according to the duration of electromagnetic wave exposure at 1.2 joules(20min exposure), 2.4 joules(40min exposure), 3.6 joules(60 min exposure), and 4.8 joules(80min exposure) per 1cm2. RESULTS: Compared with normal cells, main histologic changes were observed with an electron microscope included swelling of the pineal gland cells, a decrease in the electron density of interstitial tissue, an increase in the distances between pineal gland cells, an increase in number of lipid-droplets, and swelling of mitochondria. Especially in those pineal cells exposed to EMR for 80 min, severe swelling of mitochondria and a slight increase in lysosome were observed. CONCLUSION: The authors could identify the harmful effect of microwave by observing abnormal ultrastructural changes of pineal cell in rat according to the increasement of electromagnetic radiation.
Animals ; Brain ; Electromagnetic Radiation ; Lysosomes ; Microwaves* ; Mitochondria ; Pineal Gland* ; Rats*

Orbital apex syndrome (OAS) has been described previously as a syndrome involving damage to the oculomotor nerve, trochlear nerve, abducens nerve, and ophthalmic branch of the trigeminal nerve in association with optic nerve dysfunction. The conditions and symptoms of OAS are characterized by blindness, fixed dilated pupils, proptosis, ptosis of the eye and ophthalmoplegia. Infectious diseases involving the central nervous system, paranasal sinuses, and periorbital structures may lead to an OAS. We recently experienced a rare case of sphenoidal aspergillosis, which damaged the adjacent cavernous sinus structures and led to the definite symptom of OAS in a 75 year-old female. We present this rare case with a brief review of these disease's entities.
Abducens Nerve ; Aspergillosis ; Blindness ; Cavernous Sinus ; Central Nervous System ; Communicable Diseases ; Exophthalmos ; Eye ; Female ; Humans ; Oculomotor Nerve ; Ophthalmoplegia ; Optic Nerve ; Orbit ; Paranasal Sinuses ; Pupil ; Sinusitis ; Sphenoid Sinusitis ; Trigeminal Nerve ; Trochlear Nerve

Sebaceous trichofolliculoma is a rare benign tumor and represents a variant of trichofolliculoma. Up to now, only 5 cases of sebaceous trichofolliculoma were reported in Korea. It generally presents as a centrally depressed solitary tumor and occurs in areas rich in sebaceous lobules. Microscopically, it shows cystic cavities with or without keratin-filled portion and sebaceous lobules. The lobules are connected to the cystic wall. We report a case of infected sebaceous trichofolliculoma on the right cheek accompanied by a unilateral microtia in a 16-year-old man. The patient was treated with oral antibiotics and surgical excision. By summariz-ing 12 past cases, 6 Korean and 7 international, we have put together clinical features of Se-baceous trichofolliculoma.
Adolescent ; Anti-Bacterial Agents ; Cheek ; Congenital Abnormalities ; Ear ; Follicular Cyst ; Humans ; Korea ; Neoplasms, Basal Cell ; Skin Neoplasms

Background/Aims: The aim of this study was to evaluate the trend of incidence and prevalence of systemic lupus erythematosus (SLE) in South Korea from 2005 to 2015. Methods: From 2005 to 2015, individuals with SLE were identified from the National Health Insurance database, which records information on almost all Koreans. SLE was defined according to the International Classification of Diseases, 10th revision (ICD-10), code M32. The incidence was calculated per 100,000 person-years. The prevalence was calculated per 100,000 people and stratified by year, age group, sex, region, and income. Results: The annual prevalence of SLE increased slightly from 21.25/100,000 people in 2005 to 35.45/100,000 people in 2015. In contrast, the annual incidence of SLE decreased slightly from 5.42/100,000 person-years in 2005 to 3.6/100,000 person-years in 2015. The prevalence and incidence of SLE were 10- and 6-fold higher in women than in men, respectively. The peak age of prevalence and incidence was 30 to 39 years in 2005; in 2015, the peak age of prevalence was 30 to 49 years and of incidence was 20 to 49 years. Regional variation was observed in both incidence and prevalence of SLE. Jeju province showed the highest prevalence of SLE (44.54/100,000 person-years), and Gwangju province showed the highest incidence of SLE (6.98/100,000 person-years) in 2015. The income status did not affect the prevalence or incidence of SLE except in patients without income who received medical aid. Conclusions The incidence of SLE has declined, but the prevalence has increased in Korea in recent years. Peak age of SLE trend to right shift in Korea.

Adult onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by high spiking fever, leukocytosis, high serum ferritin, salmon-colored rash, arthritis, lymphadenopathy, and hepatosplenomegaly. The etiology of AOSD is obscure. AOSD is diagnosed after exclusion of infection, malignancy and other connective tissue diseases. A 53-year-old female patient with membranous nephropathy was admitted with high fever and leukocytosis. She was taking immunosuppressive agents with low dose steroid and cyclosporine to control of proteinuria caused by membranous nephropathy. She was initially treated with antibiotics, antiviral agent and antifungal agent to control of hidden infection. High spiking fever was sustained for 2 weeks and controlled after hydrocortisone treatment. AOSD was diagnosed according to the criteria of Yamaguchi. It should be considered that AOSD is a cause of high fever in patients treated with immunosuppressive agents.
Adult ; Anti-Bacterial Agents ; Arthritis ; Connective Tissue Diseases ; Cyclosporine ; Exanthema ; Female ; Ferritins ; Fever ; Glomerulonephritis, Membranous ; Humans ; Hydrocortisone ; Immunosuppressive Agents ; Leukocytosis ; Lymphatic Diseases ; Middle Aged ; Proteinuria ; Still's Disease, Adult-Onset

PURPOSE: The preoperative prediction of malignant potential in patients with gastric submucosal tumors (SMTs) plays an important role in decisions regarding their surgical management. METHODS: We evaluated the predictors of malignant gastric SMTs in 314 patients with gastric SMTs who underwent surgery in Chonnam National University Hospital. RESULTS: The malignant SMTs were significantly associated with age (odds ratio [OR], 1.067; 95% confidence interval [CI], 1.042 to 1.091; P < 0.0001), presence of central ulceration (OR, 2.690; 95% CI, 1.224 to 5.909; P = 0.014), and tumor size (OR, 1.791; 95% CI, 1.483 to 2.164; P < 0.0001). Receiver operating characteristic curve analysis showed that tumor size was a good predictor of malignant potential. The most relevant predictor of malignant gastric SMT was tumor size with cut-offs of 4.05 and 6.40 cm. CONCLUSION: Our findings indicated that age, central ulceration, and tumor size were significant preoperative predictors of malignant SMTs. We suggest that 4 cm be selected as a threshold value for malignant gastric SMTs. In patients with a gastric SMT larger than 4 cm with ulceration, wide resection of the full thickness of the gastric wall or gastrectomy with adequate margins should be performed because of its malignant potential.
Gastrectomy ; Humans ; ROC Curve ; Stomach Neoplasms ; Ulcer