Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, low grade neoplasm which usually occurs in subcutaneous soft tissue. Histologically, it features ectatic blood filled vessels surrounded by hyalinized stroma and pleomorphic spindle cells. Clinically and histologically, PHAT could be misdiagnosed as such tumor as neurogenic tumor, malignant fibrous histiocytoma. About 100 cases of PHAT have been reported so far, and it is even rarer in head and neck area. We experienced a case of PHAT in 41-year-old male with several months of history of gradually enlarging neck mass which was surgically removed by wide excision.

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, low grade neoplasm which usually occurs in subcutaneous soft tissue. Histologically, it features ectatic blood filled vessels surrounded by hyalinized stroma and pleomorphic spindle cells. Clinically and histologically, PHAT could be misdiagnosed as such tumor as neurogenic tumor, malignant fibrous histiocytoma. About 100 cases of PHAT have been reported so far, and it is even rarer in head and neck area. We experienced a case of PHAT in 41-year-old male with several months of history of gradually enlarging neck mass which was surgically removed by wide excision.

Invasive fungal sinusitis is common in immunodeficiency patients and can spread into the orbit or intracranial cavity. The Onodi cell, which is one of the anatomical variations of the ethmoid sinus, refers to the space that has been pneumatized superolateral to the sphenoid sinus. We experienced a case of invasive fungal sinusitis that caused vision loss by invading the Onodi cells. Endoscopic sinus surgery and antifungal treatment successfully recovered the patient’s vision and we herein report on the case with a review of the literature.

Epiphora is a symptom in which tears overflow onto the face, with its most common cause being the obstruction of the nasolacrimal system. As a cause of nasolacrimal system obstruction, nasolacrimal duct tumors are very rare. Angioleiomyoma, which is a benign tumor, arises from vascular smooth muscle, occurs in the nasolacrimal duct, and is extremely rare. With the development of endoscopic intranasal approach for the treatment of nasolacrimal duct obstruction, there is increased importance for the consideration of otorhinolaryngological evaluation and treatment as well as dacryocystorhinostomy by conventional external approach. In this article, we introduce a case in which angioleiomyoma in the nasolacrimal duct was detected by nasal endoscopy and was successfully treated with endoscopic surgery.

BACKGROUND: The purpose of this study was to evaluate the effects of propofol-fentanyl anesthesia in comparison with fentanyl alone on the functional recovery of postischemic reperfused myocardium and on the incidence of ischemia-reperfusion arrhythmia in an open-chest canine model. METHODS: Dogs were subjected to 15 minutes of left anterior descending coronary artery (LAD) occlusion followed by 3 hour of reperfusion during fentanyl (n=12) or propofol plus fentanyl (n=11) anesthesia. Regional myocardial contractility was evaluated using systolic shortening (%SS), the preload recruitable stroke work slope (Mw), intramyocardial pressure (IMPs), and regional stroke work area (RSWA). RESULTS: Dogs anesthetized with propofol-fentanyl had a significantly lower regional (%SS, Mw, IMPs, and RSWA) and global myocardial contractility (cardiac index, mean aortic pressure and left ventricular dP/dt) than fentanyl anesthetized dogs during pre-occlusion baseline. LAD occlusion produced a significant reduction in the regional contractile functions (%SS, Mw, IMPs, and RSWA) in both groups. During reperfusion, gradual return of the regional contractile functions (%SS, Mw, IMPs, RSWA) toward their respective baselines were observed without any differences between the groups. However, ventricular fibrillation associated with LAD occlusion was lower in the propofol-fentanyl group than in the fentanyl group (zero vs 33%, p<0.05). CONCLUSIONS: Propofol supplementation over moderate-dose fentanyl reduces reperfusion arrhythmia during coronary occlusion and subsequent reperfusion but does not improve functional recovery of post-ischemic, reperfused myocardium compared with high-dose fentanyl anesthesia in dogs.
Anesthesia* ; Animals ; Arrhythmias, Cardiac ; Arterial Pressure ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Fentanyl* ; Incidence ; Myocardial Stunning* ; Myocardium ; Propofol ; Reperfusion ; Stroke ; Ventricular Fibrillation

BACKGROUND: The p73 is a recently identified homologue of the tumor suppressor gene, p53, and it has been found to induce apoptosis and inhibit cell proliferation. However, its role in the development of tumors is unclear. This study examined the expression of p73 in patients with non-small cell lung carcinomas (NSCLCs) to determine its clinical significance and association with the expressions of p53, pRb, and mdm2. METHODS: A total of 183 NSCLCs were analyzed immunohistochemically using a tissue microarray. RESULTS: The p73 protein was expressed in the cell nuclei in 156 (85.2%) out of the 183 cases. There was no correlation between the p73 expression and the clinicopathological variables. However, there was a correlation between the p73 expression and the mdm2 and pRb expressions. Multivariate Cox survival analysis identified tumor size and lymph node metastasis to be independent prognostic factors, but the p73 expression was not found to be associated with the patients' survival. CONCLUSIONS: p73 is commonly expressed in NSCLC and it might, in conjunction with pRb and mdm2, be involved in the development of these tumors.
Apoptosis ; Carcinoma, Non-Small-Cell Lung ; Cell Nucleus ; Cell Proliferation ; Genes, Tumor Suppressor ; Humans ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Although spinal arachnoid cysts are relatively common findings observed incidentally in adults, they are much rarely reported in children. They are usually asymptomatic and are mainly located in the middle and lower thoracic regions. However, in rare circumstances, these cysts can cause mass effects that lead to neurologic symptoms. We report the rare case of a spinal extradural arachnoid cyst in a 12-year-old boy who showed signs and symptoms of cauda equina syndrome. Magnetic resonance imaging of the lumbar spine revealed a huge extradural arachnoid cyst extending from L2 to L5. Emergent laminectomy and repair of dural defect was performed after total resection of the extradural arachnoid cyst. There were no postoperative complications. Total recovery was achieved 6 months after surgery. Here, we report this rare case with a review of the literature.

BACKGROUND: Electrocardiographic variables such as changes in the ST-T segment, and increased QT interval have been found to predict the occurrence of myocardial ischemia. But disadvantages of most of these variables have poor reproducibility and require analysis of all ECG leads. If electrocardiographic T axis properly predicts myocardial ischemia, it can be used as a useful marker for diagnosing myocardial ischemia in primary practice. METHODS: We selected 147 persons, who visited the emergency room or an outpatient clinic because of chest pain, in whom coronary angiography was performod. We reviewed their medical records. Electrocardiographic T axis was classified as normal, borderline and abnormal T axis. We identified the relation between cardiovascular risk factors and electrocardiographic T axis, and also, the relation between ischemic electrocardiographic variables and T axis. We examined the relation between coronary angiographic results and electrocardiographic T axis. RESULTS: The sensitivity and specificity of electrocardiographic T axis was 26.7% and 86.9%, respectively. The positive predictive value and negative predictive value was 81.8% and 35.1%, respectively. The proportion of hypertension was 41.2% in normal T axis group, 65.5% in borderline T axis group, and 34.4% in abnormal T axis group, which was statistically significant (P=0.032). The relation between coronary angiographic results and electrocardiographic T axis was not statistically significant. The subjects with abnormal T axis were associated with ST depression (P=0.016). CONCLUSION: The T axis abnormality was not useful for screening myocardial ischemia, but it was useful to rule out other diseases due to its high specificity.
Ambulatory Care Facilities ; Axis, Cervical Vertebra* ; Chest Pain ; Coronary Angiography ; Depression ; Diagnosis* ; Electrocardiography* ; Emergency Service, Hospital ; Humans ; Hypertension ; Mass Screening ; Medical Records ; Myocardial Ischemia* ; Risk Factors ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Recently, there has been an increase in olfactory disorders due to many etiologies. Many therapeutic methods have been tried with some favorable results. Some of the therapeutic methods are functional endoscopic sinus surgery (FESS), oral and topical steroids, and other pharmacologic therapies (vitamin A, aminophylline, zinc sulfate, etc). In this study, we tried to find out the transition of olfactory recovery in patients with olfactory disturbance. MATERIALS AND METHODS: Sixty-one patients with olfactory disturbance were studied. There were 25 patients who had chronic sinusitis with nasal polyp, 10 patients who had chronic sinusitis without nasal polyp, 12 patients who had upper respiratory infection, 5 patients who had congenital disorder, 4 patients who had head trauma, and 5 patients who had nasal septal deviation. Chronic sinusitis was treated by functional endoscopic sinus surgery, nasal septal deviation was treated by septoplasty and others were treated by drug therapy and topical steroid. The degree of olfactory disturbance and recovery was scored with a KVSS test (Korean Version of Sniffin Sticks test) prior to treatment and also three and six months after the treatment. RESULTS: Twenty-one patients with chronic sinusitis with nasal polyp (84%) showed improvement of olfaction on the third postoperative month, and 6 months later (p<0.01). Seven patients with chronic sinusitis without nasal polyp (70%) also showed improvement of olfaction (p<0.01). But seven patients with upper respiratory tract infection (58%) did not show significant improvement of olfaction, and it would be necessary to follow up these patients longer. Patients with congenital disorder, nasal septal deviaton, and head trauma did not show significant improvement of olfaction. CONCLUSION: The mentioned test can aid in investigating the etiology of olfactory disturbance, and in accurately assessing the degree of the olfactory disturbance.
Aminophylline ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniocerebral Trauma ; Drug Therapy ; Follow-Up Studies ; Humans ; Nasal Polyps ; Nasal Surgical Procedures ; Respiratory Tract Infections ; Sinusitis ; Smell ; Steroids ; Zinc Sulfate

In the assessment of thoracolumbar burst fractures, computed tomography(CT) is superior to other imaging modalities, especially when a more definitive assessment of the posterior elements of the spine or the nueral canal is desired. A few authors have reported the relationship between traumatic spinal canal stenosis and neurologic deficits. Authors analysed 64 patients with thoracolumbar burst fractures about the relationship between traumatic spinal canal stenosis and neurologic deficits using plane x-ray findings and CT scans. The results were as follows; 1. There was no difference of kyphotic angle and anterior vertebral height loss between neurologic deficit group on lateral plane x-ray findings. 2. The incidence of injury of the superior endplate was 100%(64/64); of the inferior endplate 53%(36/64); of the posterior element 45.3%(29/64). 3. Twenty(69.0%) of 29 patients with disruption of posterior element had neurologic deficits, while fourteen(40.0%) of 35 patients without disruption had neurologic deficits. 4. Spinal canal ratio of 35.3% or more at the epiconus level, 56.0% or more at the conus medullaris level, and 65.3% or more at the cauda equine level were significant factors for neurologic deficits in thoracolumbar burst fractures. Spinal canal ratio of 22.0% or less at the epiconus level, 34.5% or less at the conus medullaris level, and 43.1% or less at the cauda equine level were not accompanied with neurologic dieficit in thoracolumbar burst fractures. 5. Fifteen(68%) of 22 patients with neurologic deficit in epiconus and conus medullarsis level had the horsehoe or crescent shape of patient spinal canal, eight (66.7%) of 12 patients with neurologic deficit in cauda equine level had the horsehoe or crescent shape of spinal canal.
Constriction, Pathologic ; Conus Snail ; Humans ; Incidence ; Neurologic Manifestations ; Spinal Canal ; Spinal Cord ; Spine ; Tomography, X-Ray Computed