Synovial sarcoma is an uncommon, malignant tumor which originates from the synovial lining of the joints, bursae and tendon sheaths. But it rarely occurs from bones. We have experienced a synovial sarcoma of the left ulna. Microscopically cleft spaces lined by epithelioid cells and bundle formation by spindle spaped cells were seen. Above elbow amputation of the left arm was done.
Amputation ; Arm ; Elbow ; Epithelioid Cells ; Joints ; Sarcoma, Synovial ; Tendons ; Ulna

Acute or chronic sinusitis is common disease of ENT. Most cases usually respond to appropriate treatment; however, some cases occasionally progress to the development of serious complication and poor prognosis. The orbital complications are most common complication fallowed by intracranial complications. The incidence of sinogenic intracranial complications is about 3.7-11.0% and these complications are progressively decreasing however the complications occur due to incorrect use of antibiotics, antibiotics resistant pathogens, decreasing host immunity, improper diagnosis and delayed surgical treatment. Therefore the case of epidural abscess in anterior portion of middle cranial fossa secondary to acute sphenoid sinusitis, which was treated with transnasal endoscopic sphenoidotomy and intravenous antibiotics, is being reported.
Anti-Bacterial Agents ; Cranial Fossa, Middle* ; Diagnosis ; Epidural Abscess* ; Incidence ; Orbit ; Prognosis ; Sinusitis ; Sphenoid Sinus* ; Sphenoid Sinusitis*

PURPOSE: To evaluate the effects of wearing rigid gas permeable (RGP) contact lenses on the topographic changes in keratoconus. METHODS: Seventy-seven keratoconic eyes that wore multicurve RGP contact lenses and 30 keratoconic eyes that wore no contact lenses were retrospectively analyzed. The mean follow-ups were 22.6 and 20.5 months in the lens-wearing and control groups, respectively. Visual acuity, comfort, daily wearing time, and corneal staining were evaluated for both groups. The changes in topographic indices were compared between the lens-wearing and control groups. RESULTS: Multicurve RGP lens corrected logarithm of the minimum angle of resolution visual acuity of the lens-wearing group significantly improved from -0.016+/-0.065 to -0.032+/-0.10 at follow-up (p=0.05). In the lens-wearing group with advanced keratoconus, the Sim Kmax, Sim Kmin, apical power, astigmatic index, and anterior elevation significantly decreased from 57.68+/-4.26 diopter (D), 50.50+/-2.32 D, 62.79+/-5.11 D, 7.20+/-0.55 D and 67.36+/-16.30 microm to 55.51+/-4.28 D, 49.62+/-3.26 D, 60.31+/-5.41 D, 5.90+/-0.51 D and 60.61+/-16.09 microm, respectively (paired t-test, p<0.05). The irregularity index of 3 mm did not significantly change. Meanwhile, in the control group, the apical power and irregularity index increased from 55.56+/-7.25 D and 3.06+/-1.68 D to 57.11+/-7.75 D and 3.25+/-1.71 D, respectively (paired t-test, p=0.008, p=0.01). CONCLUSIONS: Properly fitted multicurve RGP contact lenses are not likely to contribute to the progression of keratoconus.
Adult ; Astigmatism/etiology/pathology/therapy ; *Contact Lenses ; Cornea/*pathology ; *Corneal Topography ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Keratoconus/complications/pathology/*therapy ; Male ; Prognosis ; Prosthesis Design ; Retrospective Studies ; Time Factors ; Young Adult

Bilateral vocal cord paralysis generally arises from trauma, tumor compression of the recurrent laryngeal nerves, surgery on neck and neurological diseases. Progressive supranuclear palsy is a rare degenerative disease showing supranuclear ophthalnoplegia, rigidity, bradykinesia, dysarthria and dementia. Bilateral vocal cord paralysis in patients with progressive supranuclear palsy can be found only in a few cases reported in literature. The finding of bilateral vocal cord paralysis is important because it can be life threatening. We managed a patient with the laterofixation of vocal cord for preventing respiratory failure due to glottic airway compromise. We report this case with a review of literature.
Dementia ; Dysarthria ; Humans ; Hypokinesia ; Neck ; Recurrent Laryngeal Nerve ; Respiratory Insufficiency ; Supranuclear Palsy, Progressive ; Vocal Cord Paralysis ; Vocal Cords

Neurilemmoma is a relatively rare benign tumor originating from the Schwann cells of all nerve fibers outside the central nervous system, with the sole exception being the optic and olfactory nerves. About 25-40% of neurilemmoma occurs in the head and neck region and the acoustic nerve is most frequently involved. But the tumor rarely affect the hypopharynx. In this paper, authors report a case of neurilemmoma of the lateral wall of the hypopharynx in a 61-year old female patient. The tumor was successfully removed via endoscopic approach. So, we report the case with literature.
Central Nervous System ; Cochlear Nerve ; Female ; Head ; Humans ; Hypopharynx* ; Middle Aged ; Neck ; Nerve Fibers ; Neurilemmoma* ; Olfactory Nerve ; Schwann Cells

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea syndrome is one type of sleep disorder breathing. During sleep, in respiration, nasal obstruction causes negative pressure, which in turn causes the pharyngeal airway to collapse during inspiration. We investigated how nasal surgery affects patients who have undergone OSA surgery but still suffer from the remaining symptoms of snoring and sleep disorder breathing. SUBJECTS AND METHOD: We reviewed 24 patients, who had undergone obstructive sleep apnea (OSA) surgery only to show no enhancement in snoring and qualities of sleep; they showed nasal septal deviation or inferior turbinate hypertrophy. Septal surgery or inferior turbinoplasty was performed by the same otolaryngologist. Over the period between preoperation and 1, 3, 6, 12 months after operation, we evaluated Apnea-Hypopnea Index (AHI) and oxygen saturation by polysomnography, degree of snoring by Visual Analogue Sacle (VAS) score, satisfaction for quality of sleep by Epworth Sleepiness Scale (ESS), minimal cross section area and volume of nasal cavity by acoustic rhinometry, respectively. RESULTS: After nasal surgery, the volume of nasal cavity and MCA increased. There were significant improvements of AHI, oxygen saturation, VAS and ESS score. CONCLUSION: As for OSA surgery, the evaluation of nasal cavity is an indispensible factor for improving the quality of sleep and snoring. When treating OSA patients who have nasal obstruction, nasal surgery including septoplasty and inferior turbinoplasty should be considered.
Humans ; Hypertrophy ; Methods ; Nasal Cavity ; Nasal Obstruction ; Nasal Surgical Procedures* ; Oxygen ; Polysomnography ; Respiration ; Rhinometry, Acoustic ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive* ; Sleep Wake Disorders ; Snoring* ; Turbinates

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.
Anxiety ; Dizziness ; Follow-Up Studies ; Humans ; Incidence ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Semicircular Canals ; Vertigo

Exercise-induced ischemic ST responses were analyzed in 36 patients who presented with chest pain and had exercise test and the results were compared with their coronary angiographic findings. Among 36 exercise test positives, the incidences of one-, two- and three vessel disease, and left main disease were 25%(9 cases), 30%(11 cases), 25%(9 cases) and 9%(3 cases), respectively. The incidence of multivessel disease(i.e., two-to three vessel disease or left main disease) in patients with ST depression > or =2.0mm was 72% and that in those with ST depression of 1.0-1.9mm was 45%. In patients with downsloping ST depression, the incidence of multivessel disease was significantly higher than that of one vessel disease(86% vs 14%, p<0.001). But both incidences of one vessel disease and multivessel disease were similar in patients with flat and slowly upsloping ST depression. More than two thirds of patients with ischemic ST depression appearing in the first 6 minutes of exercise or those lasting past 7 minutes in recovery were associated with multivessel disease. It is concluded that attention to depth, type, appearance time and duration of ST depression during exercise test is particularly helpful in detecting patients with advanced coronary disease.
Chest Pain ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography* ; Exercise Test ; Humans ; Incidence

Hemangiomas are common benign soft tissue tumors in the head and neck, but they occur infrequently in the sinonasal cavity. Most of nasal hemangiomas arise from the nasal septum or vestibule and are of capillary type. Only a few arise from the lateral wall of the nose, and these usually are cavernous. Chief symptoms are recurrent epistaxis and nasal obstruction; if the tumor becomes large, it may cause adjacent bony erosion. Cavernous hemangioma shows essentially little tendency to regress, and in adults, it is more common than capillary hemangioma. Consequently, the majority of cavernous hemangiomas require surgery in contrast to their capillary counterparts. We report a case of cavernous hemangioma of middle turbinate in an adult female, together with a review of the literature.
Adult ; Capillaries ; Epistaxis ; Female ; Head ; Hemangioma ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Humans ; Nasal Obstruction ; Nasal Septum ; Neck ; Nose ; Turbinates*

C1 inhibitor (C1 INH) deficiency is characterized by recurrent attacks of angioedema. The disorder may be inherited or acquired, with both types presenting a similar phenotypic picture. The angioedema most frequently affects the extremities, gastrointestinal, genital, facial and, airway swelling. The laryngeal angioedema can compromise the integrity of the upper airway, so its early diagonsis is crucial. Acquired angioedema by C1 deficiency is a rare disorder characterized by adult onset and lack of inheritance of the disease. We experienced a case of angioedema in a 37-year old man. He had no family history of angioedema and laboratory data showed depressed C1 inhibitor levels. With a review of literature, authors report a case of acquired angioedema by C1 inhibitor deficiency who had a history of the recurrent swelling of tongue, lip and, oral buccal mucosa.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Extremities ; Humans ; Lip ; Mouth Mucosa ; Tongue ; Wills