Background and Objectives: Some reports propose an increased risk of otitis media and hearing impairment after total laryngectomy. However, the incidence of otitis media following laryngectomy and the mechanism remain unclear. This study aimed to identify the incidence and risk factors of otitis media after total laryngectomy. Subjects and Methods: This retrospective cohort study assessed 77 patients who underwent total laryngectomy from 2010 to 2020 in a tertiary referral center. Serial imaging studies (computed tomography [CT], magnetic resonance imaging, and positron emission tomography-CT) were used to assess otitis media. Results: The study enrolled 58 patients (mean age, 67.0±7.7 years; male, 56 [96.6%]); nine (15.5%) underwent a gastrostomy tube (four preoperatively and five postoperatively). Otitis media was confirmed in seven (12.1%) patients. Gastrostomy tube insertion was the only significant risk factor for otitis media (p=0.012). Of the nine patients who underwent gastrostomy tube insertion, four developed otitis media; all four had the procedure after laryngectomy. Conclusions This study found an increased incidence of otitis media after total laryngectomy. Swallowing difficulties likely contribute to otitis media as it occurred more frequently in patients requiring postoperative gastrostomy tube insertion.

We investigated the effect of alpha-subunit of the stimulatory GTP-binding protein (Galphas) gene mutation on the expression of the thyrotropin-releasing hormone (TRH) receptor (TRH-R) gene in GH3 cells and in growth hormone (GH)-secreting adenomas of acromegalic patients. In the presence of cycloheximide, forskolin and isobutylmethylxanthine, cholera toxin, and GH-releasing hormone (GBRH) decreased rat TRH-R (rTRH-R) gene expression by about 39%, 43.7%, and 46.7%, respectively. Transient expression of a vector expressing mutant-type Galphas decreased the rTRH-R gene expression by about 50% at 24 h of transfection, whereas a wild-type Galphas expression vector did not. The transcript of human TRH-R (hTRH-R) gene was detected in 6 of 8 (75%) tumors. Three of them (50%) showed the paradoxical GH response to TRH and the other three patients did not show the response. The relative expression of hTRH-R mRNA in the tumors from patients with the paradoxical response of GH to TRH did not differ from that in the tumors from patients without the paradoxical response. Direct PCR sequencing of GALPHAs gene disclosed a mutant allele and a normal allele only at codon 201 in 4 of 8 tumors. The paradoxical response to TRH was observed in 2 of 4 patients without the mutation, and 2 of 4 patients with the mutation. The hTRH-R gene expression of pituitary adenomas did not differ between the tumors without the mutation and those with mutation. The present study suggests that the expression of TRH-R gene is not likely to be a main determinant for the paradoxical response of GH to TRH, and that Galphas mutation may suppress the gene expression of TRH-R in GH-secreting adenoma. However, a certain predisposing factor(s) may play an important role in determining the expression of TRH-R.
Acromegaly ; Adenoma ; Alleles ; Animals ; Cholera Toxin ; Codon ; Colforsin ; Cycloheximide ; Gene Expression ; Growth Hormone ; GTP-Binding Proteins ; Humans ; Pituitary Neoplasms ; Polymerase Chain Reaction ; Rats ; Receptors, Thyrotropin-Releasing Hormone* ; RNA, Messenger* ; Thyrotropin-Releasing Hormone ; Transfection

Gossypiboma, an infrequent surgical complication, describes a mass of cotton material inadvertently left in the body cavity after an operation. It is an extremely rare iatrogenic complication of nasal surgery, with only a few cases reported in literature to date. Here we present a case of gossypiboma in the nasal septum of a 35-year-old male patient who previously underwent septorhinoplasty fourteen years prior. He was treated by endoscopic endonasal surgery to remove the lesion. Pathologic findings showed a foreign body (gauze filament) with a giant cell reaction. This report will be helpful for treating patients with similar histories in the future.

Background and Objectives: There is limited study reported on the relationship between horizontal saccades and anti-compensatory saccades (ACS) in the suppression head impulse paradigm (SHIMP). We investigated the relationship between horizontal saccades and ACS in SHIMP in individuals with normal vestibular function and determined the correlation between the associated factors.Subjects and Method Medical records of 79 patients with normal vestibular function and brain magnetic resonance images were retrospectively reviewed. Results: ACS and horizontal saccades results were strongly correlated with velocity (R= 0.345, p<0.001) and latency (R=0.547, p<0.001). The latency of ACS was significantly shorter (p<0.001) than that of horizontal saccades. The velocity of ACS was negatively correlated with the latencies of ACS (R=-0.318, p<0.001) and horizontal saccades (R=-0.322, p<0.001). Bilateral ACS latency (R=0.384 and 0.471 in right and left, p<0.001 in both side) and left side ACS velocity (R=-0.263, p=0.019) were significantly affected by age. Conclusion ACS in the SHIMP was strongly correlated with horizontal saccades. However, the latency of ACS was shorter than that of horizontal saccades. Therefore, patient age and results of the horizontal saccades tests should be considered while interpreting the ACS velocity, which reflects vestibulo-ocular reflex function in patients with vestibulopathy.

Malignant insulinomas are very rare endocrine tumours with a variable clinical course. Here, a case of a malignant insulinoma, resected from the tail of the pancreas 10 years previously, which was found to have hepatic metastasis, is reported. A pancreatic mass, without evidence of metastasis, has been found using an abdominal CT scan and intra-operative ultrasonography 10 years previously. Recently, the patient has suffered from dizziness, sweating and an altered mentality. Hyperinsulinemia was diagnosed from the biochemical laboratory finding. An abdominal CT scan and intra-operative abdominal sonography showed multiple hepatic metastasis, without local recurrence in pancreas. Therefore, a partial hepatic segmentectomy was performed. Immunohistochemical staining of the postoperative specimen was strongly positive for insulin. The postoperative biochemical response was normalized, and the patient experienced no further hypoglycemic symptom.
Dizziness ; Humans ; Hyperinsulinism ; Hypoglycemia ; Insulin ; Insulinoma* ; Liver* ; Mastectomy, Segmental ; Neoplasm Metastasis ; Pancreas ; Pancreatectomy* ; Recurrence ; Sweat ; Sweating ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: It has been already known that each trophic hormone in combined pituitary responsiveness according to gender and age brings about variable response, but in Korea, there has been no actual data. In this study, in order to assess the pituitary responsiveness, a combined pituitary stimulation test was performed in Korean subjects with the variation in CRH, GHRH, GnRH, and TRH according to their age and gender. Were these the variables that were changed according to age and gender? Clarify that. Also, it might be good to write out the abbreviations.) METHOD: Fourteen physically and mentally healthy male subjects and fourteen female subjects, also physically and mentally healthy, underwent the combined anterior pituitary stimulation test by CRH, GHRH, LHRH, and TRH. Each gender group was divided further into young(meanSE; male: 231, female: 221) and old (mean; male: 513, female: 522) groups. RESULTS: There were significant differences between the gender and age groups. The Peak GH level and maximal GH increment were significantly increased in young men compared to old men. The Peak ACTH level and maximal ACTH increment were significantly increased in old men as opposed to young men. The Peak PRL level, maximal PRL increment, Peak TSH level, and maximal TSH increment were significantly increased in old women compared to old men. The Peak FSH level was significantly increased in the two old groups compared to the young groups, which showedindependence in gender, and the maximal FSH increment was significantly increased in old men when compared with the young men. CONCLUSION: These results show that in order to for accurate interpretation of the response from the combined pituitary stimulation test, it is necessary to consider age and gender of the subjects. We suggest response values of the combined pituitary stimulation test in terms of age and gender in healthy Korean subjects.
Adrenocorticotropic Hormone ; Corticotropin-Releasing Hormone ; Female ; Gonadotropin-Releasing Hormone* ; Growth Hormone-Releasing Hormone ; Humans* ; Korea ; Male

Astrocytes are reported to have critical functions in ischemic brain injury including protective effects against ischemia-induced neuronal dysfunction. Na-K ATPase maintains ionic gradients in astrocytes and is suggested as an indicator of ischemic injury in glial cells. Here, we examined the role of the Na-K ATPase in the pathologic process of ischemic injury of primary cultured astrocytes. Chemical ischemia was induced by sodium azide and glucose deprivation. Lactate dehydrogenase assays showed that the cytotoxic effect of chemical ischemia on astrocytes began to appear at 2 h of ischemia. The expression of Na-K ATPase alpha1 subunit protein was increased at 2 h of chemical ischemia and was decreased at 6 h of ischemia, whereas the expression of alpha1 subunit mRNA was not changed by chemical ischemia. Na-K ATPase activity was time-dependently decreased at 1, 3, and 6 h of chemical ischemia, whereas the enzyme activity was temporarily recovered to the control value at 2 h of chemical ischemia. Cytotoxicity at 2 h of chemical ischemia was significantly blocked by reoxygenation for 24 h following ischemia. Reoxygenation following chemical ischemia for 1 h significantly increased the activity of the Na-K ATPase, while reoxygenation following ischemia for 2 h slightly decreased the enzyme activity. These results suggest that the critical time for ischemia-induced cytotoxicity of astrocytes might be 2 h after the initiation of ischemic insult and that the increase in the expression and activity of the Na-K ATPase might play a protective role during ischemic injury of astrocytes.
Adenosine Triphosphatases ; Astrocytes ; Brain Injuries ; Glucose ; Ischemia ; L-Lactate Dehydrogenase ; Neuroglia ; Neurons ; RNA, Messenger ; Sodium Azide

No Abstract available.
Abscess* ; Thyroid Gland* ; Thyroiditis, Autoimmune ; Thyroiditis, Suppurative