Schwannomas are slow-growing, benign neurogenic tumors arising from the sheath of myelinated nerve fibers. They usually occur in the head and neck region. Only 4% of schwannomas found in the head and neck region originate in the sinonasal tract. Schwannoma of the nasal septum is rarer, and only few cases have been previously reported in the literature. We experienced a rare case of the schwannoma of the posterior nasal septum in a 71-year-old woman. She was treated successfully by transnasal endoscopic surgery. No recurrence was detected within 18 months follow-up period.
Aged ; Female ; Follow-Up Studies ; Head ; Humans ; Nasal Septum ; Neck ; Nerve Fibers, Myelinated ; Neurilemmoma ; Nose Neoplasms ; Recurrence

STUDY DESIGN: Determination of human cervical spine disc response under cyclic loading. PURPOSE: To explain the potential mechanisms of intervertebral disc injury caused by cyclic loading. OVERVIEW OF LITERATURE: Certain occupational environments in civilian and military populations may affect the cervical spine of individuals by cyclic loading. Research on this mechanism is scarce. METHODS: Here, we developed a finite element model of the human C4–C5 disc. It comprised endplates, five layers of fibers, a nucleus, and an annulus ground substance. The endplates, ground substance, and annular fibers were modeled with elastic, hyperviscoelastic, and hyper-elastic materials, respectively. We subjected the disc to compressive loading (150 N) for 10,000 cycles at frequencies of 2 Hz (low) and 4 Hz (high). We measured disc displacements over the entire loading period. We obtained maximum and minimum principal stress and strain and von Mises stress distributions at both frequencies for all components. Further, we used contours to infer potential mechanisms of internal load transfer within the disc components. RESULTS: The points of the model disc displacement versus the loading cycles were within the experimental corridors for both frequencies. The principal stresses were higher in the ground matrix, maximum stress was higher in the anterior and posterior annular regions, and minimum stress was higher along the superior and inferior peripheries. The maximum principal strains were radially directed, whereas the minimum principal strains were axially/obliquely directed. The stresses in the fibers were greater and concentrated in the posterolateral regions in the innermost layer. CONCLUSIONS: Disc displacement was lower at high frequency, thus exhibiting strain rate stiffening and explaining stress accumulation at superior and interior peripheries. Greater stresses and strains at the boundaries explain disc injuries, such as delamination. The greater development of stresses in the innermost annular fiber layer (migrating toward the posterolateral regions) explains disc prolapse.
Fatigue ; Finite Element Analysis ; Humans ; Intervertebral Disc ; Military Personnel ; Neck Pain ; Nerve Fibers, Myelinated ; Prolapse ; Spine

Morgellons disease is a rare disease with unknown etiology. Herein, we report the first case of Morgellons disease in Korea. A 30-year-old woman presented with a 2-month history of pruritic erythematous patches and erosions on the arms, hands, and chin. She insisted that she had fiber-like materials under her skin, which she had observed through a magnifying device. We performed skin biopsy, and observed a fiber extruding from the dermal side of the specimen. Histopathological examination showed only mild lymphocytic infiltration, and failed to reveal evidence of any microorganism. The polymerase chain reaction for Borrelia burgdorferi was negative in her serum.
Adult ; Arm ; Asian Continental Ancestry Group ; Biopsy ; Borrelia burgdorferi ; Chin ; Female ; Hand ; Humans ; Korea ; Morgellons Disease* ; Nerve Fibers, Myelinated ; Polymerase Chain Reaction ; Rare Diseases ; Skin

Schwannomas are benign neoplasms arising from the sheath of myelinated nerve fibers and may occur in any part of the body. They mostly occur in the head and neck region, accounting for about 25% to 45% of all cases. The eighth cranial nerve is the most common site of origin. About 4% of all head and neck schwannomas originate in the nasal cavity and paranasal sinuses. The best treatment of schwannomas is surgical excision. Since it is an encapsulated tumor, difficultly is rarely encountered in its complete removal, and recurrence is unlikely. We present a unique and rare case of a 71-year-old man with a recurrent septal mass, finally diagnosed as a schwannoma, with a review of the literature.
Aged ; Head ; Humans ; Nasal Cavity ; Nasal Septum ; Neck ; Nerve Fibers, Myelinated ; Neurilemmoma* ; Paranasal Sinuses ; Recurrence ; Vestibulocochlear Nerve

When anesthesiologists encounter conditions in which intubation is not possible using a conventional direct laryngoscope, they can consider using other available techniques and devices such as fiber optic bronchoscope (FOB)-guided intubation, a laryngeal mask airway (LMA), intubating LMA (ILMA), a light wand, and the Combitube. FOB-guided intubation is frequently utilized in predicted difficult airway cases and is generally performed when the patient is awake to enable easier access to the trachea. An LMA can be introduced to ventilate the patient with relative ease, while an ILMA can be used for definite endotracheal intubation. However, occasionally, an endotracheal tube (ETT) cannot pass through the larynx, despite successful introduction of a FOB into the trachea and placement of an ILMA by the anesthesiologist. Therefore, we initially introduced an ILMA for emergent ventilation, followed by successful insertion of an ETT under FOB guidance. In this report, we describe three cases of difficult intubation using a FOB and ILMA combination approach.
Bronchoscopes* ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopes ; Larynx ; Nerve Fibers, Myelinated* ; Trachea ; Ventilation

When anesthesiologists encounter conditions in which intubation is not possible using a conventional direct laryngoscope, they can consider using other available techniques and devices such as fiber optic bronchoscope (FOB)-guided intubation, a laryngeal mask airway (LMA), intubating LMA (ILMA), a light wand, and the Combitube. FOB-guided intubation is frequently utilized in predicted difficult airway cases and is generally performed when the patient is awake to enable easier access to the trachea. An LMA can be introduced to ventilate the patient with relative ease, while an ILMA can be used for definite endotracheal intubation. However, occasionally, an endotracheal tube (ETT) cannot pass through the larynx, despite successful introduction of a FOB into the trachea and placement of an ILMA by the anesthesiologist. Therefore, we initially introduced an ILMA for emergent ventilation, followed by successful insertion of an ETT under FOB guidance. In this report, we describe three cases of difficult intubation using a FOB and ILMA combination approach.
Bronchoscopes* ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopes ; Larynx ; Nerve Fibers, Myelinated* ; Trachea ; Ventilation

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.
Adult ; Biopsy ; Cauda Equina ; Charcot-Marie-Tooth Disease* ; Congenital Abnormalities ; Constipation ; Foot Deformities ; Humans ; Immunoglobulin G ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Nerve Fibers, Myelinated ; Neural Conduction ; Polyneuropathies* ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ; Polyradiculopathy* ; Recurrence ; Schwann Cells ; Spinal Nerve Roots ; Spine ; Sural Nerve ; Urinary Incontinence

BACKGROUND: Severe injuries in skeletal muscle result in muscle weakness that delays recovery and contribute to progressive decline in muscle function. Microcurrent therapy (MCT) is a novel treatment method used in soft tissue injury and tissue regeneration therapy. The regenerative capacity of skeletal muscle tissue resides in satellite cells, the quiescent adult stem cells. AIM: The present work aimed at investigating the relation between microcurrent therapy and local stem cells in regeneration of induced skeletal muscle injury in albino rat. MATERIALS AND METHODS: Twenty six adult male albino rats were divided into Sham group, Injury group (I): subjected to soleus muscle injury and subdivided into subgroups I1 & I2 sacrificed 2 and 4 weeks after injury respectively. Microcurrent group (M): subjected to muscle injury and micro-current was applied. The animals were subdivided into subgroups M1 and M2 sacrificed 2 and 4 weeks after injury. Histological, immunohistochemical and morphometric studies were performed. RESULTS: Atypical fibers widely separated by infiltrating cells and strong acidophilic sarcoplasm with focal vacuolations were found in injury group. In M1 subgroup few atypical fibers were found. In M2 subgroup multiple typical fibers were detected. A significant decrease in the mean area of atypical fibers, a significant increase in the mean area% of alpha SMA+ve cells and that of CD34+ve cells were found in microcurrent group compared to injury group. CONCLUSIONS: A definite therapeutic effect of the microcurrent was found on induced skeletal muscle injury. This effect was proved to be related to satellite cell activation.
Adult ; Adult Stem Cells ; Animals ; Humans ; Male ; Muscle Weakness ; Muscle, Skeletal* ; Nerve Fibers, Myelinated ; Rats ; Regeneration ; Soft Tissue Injuries ; Stem Cells*

Schwannoma is a benign tumor arising from the sheath of myelinated nerve fibers and may occur in any part of the body. However, a vidian nerve schwannoma is extremely rare. A 41 year-old man has experienced an occipital area headache and posterior neck stiffness for 2 weeks. Brain computed tomography (CT) angiography, magnetic resonance image revealed lobulated soft tissue density mass in left sphenoid sinus with upward displacement of sphenoid sinus floor and pressure erosion of sphenoid sinus and petrous apex. Ostiomeatal unit CT scan showed a 28x16 mm sized mass filling the left pterygoid canal. The mass was resected using endoscopic sinus surgery. The mass was confirmed as schwannoma. We report a case of vidian nerve schwan-noma that was treated by endoscopic sinus surgery.
Adult ; Brain ; Endoscopy ; Headache ; Humans ; Magnetic Resonance Angiography ; Neck ; Nerve Fibers, Myelinated ; Neurilemmoma* ; Sphenoid Sinus ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to compare the efficacy of two imaging modes in a cone beam computed tomography (CBCT) system in detecting root fracture in endodontically-treated teeth with fiber posts or screw posts by selecting two fields of view. MATERIALS AND METHODS: In this study, 78 endodontically-treated single canal premolars were included. A post space was created in all of them. Then the teeth were randomly set in one of 6 artificial dental arches. In 39 of the 78 teeth set in the 6 dental arches, a root fracture was intentionally created. Next, a fiber post and a screw post were cemented into 26 teeth having equal the root fractures. High resolution (HiRes) and standard zoom images were provided by a CBCT device. Upon considering the reconstructed images, two observers in agreement with each other confirmed the presence or absence of root fracture. A McNemar test was used for comparing the results of the two modes. RESULTS: The frequency of making a correct diagnosis using the HiRes zoom imaging mode was 71.8% and in standard zoom was 59%. The overall sensitivity and specificity in diagnosing root fracture in the HiRes mode were 71.79% and 46.15% and in the standard zoom modes were 58.97% and 33.33%, respectively. CONCLUSION: There were no significant differences between the diagnostic values of the two imaging modes used in the diagnosis of root fracture or in the presence of root canal restorations. In both modes, the most true-positive results were reported in the post space group.
Bicuspid ; Cone-Beam Computed Tomography ; Dental Arch ; Dental Pulp Cavity ; Intention ; Nerve Fibers, Myelinated ; Sensitivity and Specificity ; Tooth ; Tooth Fractures ; Tooth, Nonvital