Plexiform schwannomas representing a rare subset, comprise 5% of all schwannomas. However, their occurrence in the thyroid gland is exceptionally rare. A 32-year-old male presented with an incidentally discovered, asymptomatic thyroid mass. Imaging revealed an approximately 5 cm heterogeneous solid mass on the right thyroid lobe extending to the upper mediastinum and directly invading the upper trachea. Under the suspicion of thyroid malignancy, the patient underwent right thyroidectomy. Histological examination confirmed a plexiform schwannoma with S100-positive spindle cells. Currently, the patient is undergoing outpatient follow-up, with no reported complications. To our knowledge, this is the first documented case of plexiform schwannoma of the thyroid gland within the English literature. This case highlights the diverse and unpredictable clinical manifestations of thyroid masses, emphasizing the importance of a multidisciplinary approach for diagnosing and managing rare entities, such as thyroid gland schwannomas.
Active and prompt scale-up screening tests are essential to efficiently control the coronavirus disease 2019 (COVID-19) outbreak. The goal of this work was to identify shortcomings in the conventional screening system (CSS) implemented in the beginning of the outbreak. To overcome these shortcomings, we then introduced a novel, independently developed system called the Yeungnam University type drive-through (YU-Thru), and distributed it nationwide in Korea. This system is similar to the drive-throughs utilized by fast food restaurants. YU-Thru system has shortened the time taken to test a single person to 2–4 minutes, by completely eliminating the time required to clean and ventilate the specimen collection room. This time requirement was a major drawback of the CSS. YU-Thru system also reduced the risk of subjects and medical staff infecting one another by using a separate and closed examination system. On average, 50 to 60 tests were conducted per day when using the CSS, while now up to 350 tests per day are conducted with the YU-Thru system. We believe that the YU-Thru system has made an important contribution to the rapid detection of COVID-19 in Daegu, South Korea. Here, we will describe the YU-Thru system in detail so that other countries experiencing COVID-19 outbreaks can take advantage of this system.
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BACKGROUND Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. METHODS: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. RESULTS: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. CONCLUSION: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.
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Osteomas are benign osteoblastic tumors that occur mainly in the fronto-ethmoid areas ofthe head and neck region. When they occasionally occur in the temporal bone, the external auditory canal is the most common site of origin; they rarely occur in the mastoid region. Moreover, mastoid osteoma with mastoiditis is an extremely rare entity in the temporal bone. Recently, the authors experienced a case of mastoid osteoma with mastoiditis in the left temporal bone. The mastoid osteoma was completely resected itself without a mastoidectomy, only for correction of the cosmetic deformity; the mastoiditis was not treated. Hence, the authors report the first case of a mastoid osteoma with mastoiditis in Korea, along with a review of the related literature.
A microdebrider is increasingly used in endoscopic sinus surgery. Although it has many advantages over conventional instruments, it has been associated with severe complications. We treated a case of rupture of the left medial rectus muscle after use of a microdebrider during endoscopic sinus surgery in a 50 year-old female patient who complained of binocular diplopia and exotropia. The patient showed marked limitation on adduction and about 40 prism diopters of left exodeviation. The orbital computed tomography showed a bony defect at the left medial orbital wall, and injury of the medial rectus muscle. The exodeviation was corrected after ophthalmologic surgery. We report a case of the rupture of the medial rectus muscle after use of a microdebrider during endoscopic sinus surgery and review the medical literature.
BACKGROUND Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. RESULTS: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage IV disease and three patients with stage III disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity
BACKGROUND Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. MATERIALS AND METHODS: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. RESULTS: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. CONCLUSION: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.
BACKGROUND Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2 inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous report that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development. MATERIALS AND METHODS: We used 5 human laryngeal carcinoma cell lines whether they have deletions or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity (LOH) of CDKN2. PCR was performed by using microsatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162, D9S166, D9S171, D9S200 and D9SIFNA). For informative cases, allelic loss was scored if the signal of one allele was significantly decreased in tumor DNA when compared to the same allele in normal DNA. RESULTS: The CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases (87.5%). CONCLUSION: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma.
BACKGROUND Nasopharyngeal cancer is a rare disease with a relatively poor prognosis because it tends to be diagnosed at an advanced stage. The aim of this study was to establish the clinical characteristics of nasopharyngeal cancer. MATERIALS AND METHODS: The medical records of 54 patients with nasopharyngeal cancer from January 1993 to December 2002 were reviewed retrospectively. Forty one cases were male (75.9%) and thirteen were female (24.1%). The average age was of 46.9 (range 16 to 78 years) years. The majority of patients (79.6%) were diagnosed in the advanced stage. The most common complaints were a neck mass (55.5%) and the WHO type III (53.7%) was the most frequent histological type. RESULTS: The cumulative survival rate for a 5-year period was 46.5% and the T stage, N stage, pathologic type, and clinical stage were not significantly related to the survival rate. Sixteen of 54 (31.5%) cases presented with a distant metastasis of the bone, lung, brain, spine, and liver, and six cases (11.1%) presented with a locoregional recurrence. CONCLUSION: TNM staging is not appropriate for predicting survival rate of nasopharyngeal carcinoma patients. Therefore, a newer staging system, which includes new factors, is needed to predict the prognosis.
BACKGROUND Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. MATERIALS AND METHODS: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. RESULTS: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. CONCLUSIONS: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.
BACKGROUND Septoplasty with turbinate surgery is common surgical treatment in patients with septal deviation and chronic hypertrophic rhinitis. The aim of this study was to evaluation objective outcomes of septoplasty with turbinate surgery by analysis of subjective symptom score with objective acoustic rhinometric test before and after surgery, prospectively. MATERIALS AND METHODS: We reviewed 45 adult patients which were done septoplasty with bilateral turbinectomy or turbinoplasty and followed up at least 3 months by one rhinologist from November 1999 to April 2000, prospectively. We analyzed subjective symptom score, minimal cross-sectional area (MCA), C-notch cross-sectional area, and total volume of both nasal cavity before and after surgery. Correlation test was studied between symptom improvement and acoustic rhinometric results. RESULTS: Twenty nine cases were male and sixteen cases female. The average age was 26.9 year-old (range: 17 to 57 years). There was significantly improvement of symptom score in postoperative 3 months (p<0.05). There was significantly increased C-notch cross-sectional area and total volume in postoperative 3 months. Symptoms improvement were associated with acoustic rhinometric profiles, but, there was not significantly correlation. CONCLUSION: Septoplasty with turbinate surgery is considered to be effective for nasal obstruction in patients with septal deviation and turbinate hypertrophy. Acoustic rhinometric test is favorable objective test for evaluation of symptom improvement after septal surgery.
Different techniques for culturing respiratory epithelial cells have been developed to overcome the limitations of studies on in vivo and on bioptic material. Traditionally, culture systems are divided into organ cultures, explant cultures and dissociated cell cultures. The first two contain both epithelial and non-epithelial cells. However, in monolayer cultures of dissociated cells only epithelial cells are present, the effects observed are caused by a pure epithelial responses. The purpose of this study is to establish primary culture method of human nasal epithelium (HNEC) by monolayer culture of dissociated cells to evaluate the role of the epithelial cells in the allergic and non-allergic nasal inflammatory reactions. HNEC was prepared by primary culture method of monolayer culture of dissociated cells from human inferior nasal turbinate mucosa of septal deviation patients. Primary cultured cells were characterized by indirect immunofluorescence assay and transmission electron microscopy. The immunoreactivities of cytokeratin-pan and cytokeratin No. 8 were observed in cultured HNEC. However, the immnoreactivities of vimentin and von Willebrand factor were not observed in cultured HNEC. The tonofilaments and desmosome were observed in cultured HNEC. The cultured epithelial cells were identified to be pure nasal epithelial cells. The monolayer culture of dissociated cells could successfully be employed for further study to investigate the role of the epithelial cells in allergic or non-allergic nasal inflammatory diseases.