Sodium hydroxide or caustic soda is a corrosive agent that can cause extensive damage to the oral mucosa, lips, and tongue when ingested either accidentally or intentionally. These injuries include microstomia, shallow vestibule, ankyloglossia, speech impairment, loss of teeth and impairment in facial expression. In the present article, we report a unique case of tongue adhesion to the mouth floor and its surgical management in a 66-year-old female patient, who had a history of caustic soda ingestion.

No abstract available.
Humans ; Male ; Sjogren-Larsson Syndrome

Myxoma is a benign mesenchymal neoplasm found in the heart, bone, and other soft tissues. However, myxoma of the external auditory canal is extremely rare. Since myxoma of the external auditory canal can be manifested as a part of the Carney complex, an autosomal dominant multiple familial neoplastic disorder, correct diagnosis and thorough investigation is important. We report a case of a 59-year-old man who presented to hospital with a complaint of growing mass within the right external auditory canal during one month. The surgical excision was done, and the histopathological examination revealed myxoma. In this article, we report the magnetic resonance imaging and computed tomography findings of the myxoma of the external auditory canal and correlate with the histopathological finding.

Focal epithelial hyperplasia (FEH) is a human papillomavirus (HPV)-induced alteration of the oral mucosa that presents with a clinically distinct appearance. While other HPV-infected lesions such as squamous papilloma, verruca vulgaris, and condyloma acuminatum involve the skin, oral mucosa, and genital mucosa, FEH occurs only in the oral mucosa. The affected oral mucosa exhibits multiple papules and nodules with each papule/nodule being flat-topped or sessile. The affected region resembles the normal color of oral mucosa rather than appearing as a white color since the epithelial surface is not hyperkeratinized. Almost all cases present with multiple sites of occurrence. This rare, benign epithelial proliferation is related to low-risk HPV, especially HPV-13 and -32, and is not transformed into carcinoma. We report a case of FEH that arose on the attached gingiva of an East Asian male adult related to prosthesis without detection of any HPV subtype in HPV DNA chip and sequencing.
Adult ; Asian Continental Ancestry Group ; Dental Prosthesis* ; Focal Epithelial Hyperplasia* ; Gingiva ; Humans ; Male ; Mouth Mucosa ; Mucous Membrane ; Oligonucleotide Array Sequence Analysis ; Papilloma ; Prostheses and Implants ; Skin ; Warts

BACKGROUND/AIMS: Endoscopic ultrasound elastography (EUS-EG) has been widely used for the evaluation of pancreatic cancer in the Western world. To date, there is very little experience with EUS-EG in Korea. We described the results of comparison between normal pancreas and pancreatic cancer in Korea. METHODS: The present study was performed at a tertiary hospital on 35 subjects comprising 20 with normal pancreas (control group) and 15 with pancreatic cancer (disease group). We compared the EUS-EG performance of the two groups. RESULTS: The pancreas in the control group showed a mean elasticity value of 0.53% (95% confidence interval [CI], 0.45 to 0.61). The elasticity value was higher than that previously reported from Western country (0.47%; 95% CI, 0.38 to 0.57). In the disease group, the mean elasticity value of pancreatic lesions was 0.02% (95% CI, 0.01 to 0.02). The mean elasticity value of the disease group was significantly lower than that of the control group (p<0.0001). CONCLUSIONS: EUS-EG could be a highly sensitive diagnostic modality for pancreatic cancer in Korea with little EUS-EG experience. We also provided the reference range of elasticity value of normal pancreas, which might be valuable in the interpretation of pancreatic elasticity data for Korean adults.
Adult ; Elasticity ; Elasticity Imaging Techniques ; Endosonography ; Humans ; Korea ; Pancreas ; Pancreatic Neoplasms ; Reference Values ; Tertiary Care Centers ; Western World

BACKGROUND/AIMS: While gastric variceal bleeding (GVB) is not as prevalent as esophageal variceal bleeding, it is reportedly more serious, with high failure rates of the initial hemostasis (>30%), and has a worse prognosis than esophageal variceal bleeding. However, there is limited information regarding hemostasis and the prognosis for GVB. The aim of this study was to determine retrospectively the clinical outcomes of GVB in a multicenter study in Korea. METHODS: The data of 1,308 episodes of GVB (males:females=1062:246, age=55.0+/-11.0 years, mean+/-SD) were collected from 24 referral hospital centers in South Korea between March 2003 and December 2008. The rates of initial hemostasis failure, rebleeding, and mortality within 5 days and 6 weeks of the index bleed were evaluated. RESULTS: The initial hemostasis failed in 6.1% of the patients, and this was associated with the Child-Pugh score [odds ratio (OR)=1.619; P<0.001] and the treatment modality: endoscopic variceal ligation, endoscopic variceal obturation, and balloon-occluded retrograde transvenous obliteration vs. endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and balloon tamponade (OR=0.221, P<0.001). Rebleeding developed in 11.5% of the patients, and was significantly associated with Child-Pugh score (OR=1.159, P<0.001) and treatment modality (OR=0.619, P=0.026). The GVB-associated mortality was 10.3%; mortality in these cases was associated with Child-Pugh score (OR=1.795, P<0.001) and the treatment modality for the initial hemostasis (OR=0.467, P=0.001). CONCLUSIONS: The clinical outcome for GVB was better for the present cohort than in previous reports. Initial hemostasis failure, rebleeding, and mortality due to GVB were universally associated with the severity of liver cirrhosis.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Endoscopy ; Esophageal and Gastric Varices/*diagnosis/mortality/therapy ; Female ; *Gastrointestinal Hemorrhage ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Prognosis ; Republic of Korea ; Retrospective Studies ; Sclerotherapy ; Severity of Illness Index ; Treatment Outcome ; Young Adult

Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Cystadenocarcinoma ; Humans ; Incidence ; Leiomyosarcoma ; Mouth ; Mouth Neoplasms ; Oligonucleotide Array Sequence Analysis ; Papillomavirus Infections ; Prevalence ; Tongue ; Uterine Cervical Neoplasms

BACKGROUND/AIMS: Primary biliary cirrhosis (PBC) is a slowly progressing autoimmune disease of the liver that is characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Serum total bilirubin is one of the various prognostic factors that have been proposed. A recent study found that PBC with accompanying autoimmune hepatitis (AIH) carries a negative prognosis. This study examined the clinical characteristics of PBC and analyzed the factors that affect its prognosis. METHODS: Patients diagnosed with PBC between January 1998 and December 2010 based on clinical and histopathological findings were compiled and analyzed retrospectively. RESULTS: Among 27 patients, 24 (1 male and 23 females, ages 50.0+/-9.3 years) were followed up. The follow-up period was 8.6+/-0.9 years. Of the 24 patients, 9 patients progressed to liver cirrhosis (LC). Comparison between patients who did and did not progress to LC revealed statistically significant differences in the patients' serum total bilirubin (2.7+/-1.8 vs. 0.8+/-0.4, P=0.012), the Mayo risk score (5.1+/-0.7 vs. 3.9+/-0.6, P=0.001), the revised IAHG (International Autoimmune Hepatitis Group) score (9.2+/-2.3 vs. 5.4+/-3.0, P=0.004) and frequency of AIH overlap (5/9 [55.6%] vs. 0/15 [0%], P=0.001) at the time of diagnosis. CONCLUSIONS: We propose that serum total bilirubin, the Mayo risk score, and the revised IAHG score at the time of diagnosis are helpful for predicting PBC prognosis. In particular, since all of the patients with accompanying AIH progressed to LC, the presence of overlap syndrome at the time of diagnosis is helpful for predicting PBC prognosis and providing an adequate treatment.
Adult ; Aged ; Bilirubin/blood ; Female ; Follow-Up Studies ; Humans ; Liver Cirrhosis, Biliary/*diagnosis/pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; *Severity of Illness Index

PURPOSE: The purpose of this study was to categorize macrocalcifications into several subtypes by the US findings and to determine which type of macrocalcification in a thyroid nodule is associated with thyroid malignancy. MATERIALS AND METHODS: We retrospectively analyzed the macrocalcification patterns of thyroid nodules in 396 patients that underwent ultrasonography (US)-guided thyroid FNA or surgery in our institution between August 2009 and August 2011. Two radiologists evaluated US findings and categorized macrocalcifications into 5 subtyes : (A) solitary macrocalcification no association with thyroid nodule; (B) nodular macrocalcification(s) within indeterminate thyroid nodule; (C) dense macrocalcification without ability to interpret internal content by its posterior acoustic shadowing; (D) irregular-shaped macrocalcification(s); (E) macrocalcification with other suspicious malignant US finding(s). A chi-squared test and a Fisher exact test were used for comparison of categoric variables. The diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) were obtained. RESULTS: Among total of 417 nodules, 114 (27.3%) were suspicious malignancy or malignancy on histopathological result. Macrocalcification with other malignant US feature had the highest incidence of malignancy (77.5%), followed by irregular-shaped macrocalcification(s) (43.9%), and dense macrocalcification without ability to interpret internal content by its posterior acoustic shadowing (38.5%), solitary macrocalcification no association with thyroid nodule (8.3%) respectively, and nodular macrocalcification(s) with indeterminate thyroid nodule had the lowest incidence (7.5%). A nodule with macrocalcification with other malignant US finding(s) has the highest odds ratio (42.52), followed by a nodule with irregular-shaped macrocalcification(s) (9.65) and dense macrocalcification (7.72). Leaving macrocalcification with compositive malignant findings aside, irregular-shaped macrocalcification is more likely to be associated with increased risk for malignancy compared with other patterns of macrocalcification. CONCLUSIONS: Irregular-shaped macrocalcification is a fine indicator for differentiation between benign and malignant thyroid nodules on ultrasonography.
Acoustics ; Humans ; Incidence ; Odds Ratio ; Retrospective Studies ; Sensitivity and Specificity ; Shadowing (Histology) ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

We report two cases of adrenal abscesses that occurred following a Histoacryl(R) (N-butyl-2-cyanocrylate) injection for variceal bleeding. Patients had been diagnosed with alcoholic liver cirrhosis and gastric varices bleeding and received a Histoacryl(R) injection for the variceal bleeding. Patients had fever and abdominal tenderness and were diagnosed with an adrenal abscess at 2 months following the Histoacryl(R) injection. One patient received open drainage and the other underwent percutaneous drainage. When a patient has previously been injected with Histoacryl(R) for the treatment of variceal bleeding and presents with fever, an evaluation for an unusual complication such as adrenal abscess is recommended.
Abscess ; Drainage ; Enbucrilate ; Esophageal and Gastric Varices ; Fever ; Hemorrhage ; Humans ; Liver Cirrhosis, Alcoholic