Objective: The aims of the study was to compare the treatment outcomes associated with the steroid administration routes in unilateral sudden sensorineural hearing loss. Methods: From January 1998 to December 2014, three hundred and eighteen patients with unilateral sudden sensorineural hearing loss were assessed. Among them, 34 patients received the intravenous dexamethasone (16 mg/day)while the others 284 patients received 1mg/kg prednisolone daily with a subsequently tapered dose. We performed a propensity score matching analysis using previously known prognostic factors including initial hearing level, presence of vertigo and duration of onset of treatment to compare treatment outcome of IV and oral steroid. The hearing recovery between the IV steroid group and propensity score matched oral steroid group was assessed according to the AAO-HNS guideline and Siegel's criteria. Results: In the comparison between oral and IV steroid group, mean age, the initial hearing level was significantly higher in the oral steroid group than in IV steroid group (p=0.002, p=0.003) After propensity score matching, initial hearing level, age, sex and other clinical parameters were not significantly different between IV steroid and matched oral steroid group. In the treatment outcome, the complete recovery rate in IV steroid and the oral steroid group were 64.7% and 47.1% respectively. Although the recovery rate of the IV steroid group was higher than that of the oral steroid group, statistical significance was not identified. Conclusions: The administration route of systemic steroid did not affect the clinical outcomes of idiopathic sudden sensorineural hearing loss. (J Clinical Otolaryngol 2017;28-:42-48)
서 론 Immunoglobulin G4(IgG4) 연관 경화성 질환(IgG4 related sclerosing disease)은 면역조직화학 검사상 IgG4에 양성을 보이며, 전신에 종물과 유사한 양상의 침범을 보이는 특징을 갖고 있는 질환으로 비교적 최근에 임상병리학적으로 분류 된 질환이다. 1) IgG4 연관 경화성 질환은 자가면역성 췌장염 을 연구하는 과정에서 처음 알려졌으며, 2) 이후 담관에서 경화 성 담관염(sclerosing cholangitis), 3) 간에서 염증성 위종양(inflammatory pseudotumor), 3) 후복막강에서 후복막섬유증식 증(retroperitoneal fibrosis), 4) 폐에서 염증성 위종양(inflammatory pseudotumor) 및 간질폐렴(interstitial pneumonia) 5) 으로 나타나는 증례들이 보고되었다.두경부 영역에서 IgG4 연관 경화성 질환은 악하선(Ku ¨ttner tumor), 눈물샘 및 이하 선(Mikulicz's disease), 뇌하수체(lymphoplasmacytic hypophysitis)에 주로 나타나는 것으로 알려져 있으며, 6-8) 비강 이나 인후두에도 발생할 수 있으나 그 빈도는 매우 드물다. 9)따라서 비인두 부위에 발생한 종물에서 IgG4 연관 경화성 질환을 의심하고 진단하기는 쉽지 않은 일이며, 비인두암이 나 뇌기저부 골수염 등과 혼동되기 쉽다.최근 저자들은 비 인두에 발생하여 비인두암으로 오인되었으나, 결국 IgG4 연 관 경화성 질환으로 진단된 2예를 치험하였기에 문헌고찰과 함께 보고하는 바이다.증 례 증 례 1 78세 남자 환자가 내원 2개월 전부터 발생한 우측 측두부 와 우측 경부의 통증을 주소로 내원하였다.신체진찰에서 비 강,
A poorly differentiated lymphoepithelioma-like carcinoma (LELC) of the cervix is an extremely rare presentation. We herein present an unusual case of LELC of the cervix, which was treated with radical trachelectomy for fertility preservation.A 28-year-old female patient presented with a 1-month-history of post-coital vaginal bleeding, and a 2 cm tumor was found on gynecological sonography and magnetic resonance imaging.The final pathological examination established a conclusive diagnosis of LELC of the cervix. After surgery, the patient was finally diagnosed as The International Federation of Gynecology and Obstetrics (FIGO) stage IB1 with no vaginal wall or parametrium infiltration.Subsequently, a surgery was scheduled, and intraoperatively, we performed resection twice because of a frozen biopsy result that was resection margin-positive initially. As a result, further resection was performed, which was a 5mm thickness for each. Cisplatin adjuvant chemotherapy was administered 3 weeks after the operation to prevent recurrence.The patient has been followed for 1 year postoperatively, with an adjuvant treatment, with no evidence of tumor recurrence or metastasis.Based on this case, we highly recommend that operators should consider a deeper resection margin range than that visible on magnetic resonance imaging. More attention is needed to better understand the treatment method for LELC of the cervix. We also plan to closely monitor the patient's prognosis and fertility, and to conduct additional studies.
The diagnostic value of preoperative hematological changes in endometrial cancer (EC) remains unclear. This study aimed to assess the role of preoperative hematologic parameters in differentiating EC from benign endometrial lesions in postmenopausal women with endometrial masses.Preoperative laboratory variables were retrospectively reviewed in patients with malignant or benign endometrial lesions, and the significance of intergroup differences was assessed. Receiver operating characteristic curves were used to analyze the optimal cut-off values for each variable. Logistic regression analysis was used to identify the variables predicting the presence of endometrial malignancy.Preoperative laboratory variables of 176 patients (84 EC and 92 benign lesions) with endometrial masses were analyzed. Significant differences were observed between malignant and benign lesions in terms of WBC count, ANC, MCV, MPV, PDW, CA125, NLR, PMR, LMR, and SII (P < 0.05). Multivariate analyses showed that a high WBC count, high ANC, low MCV, low MPV, low PDW, high CA125, high NLR, high PMR, high LMR, and high SII independently predicted the presence of endometrial malignancy.The combination markers, MPV+PDW+NLR, had good discriminatory power for the presence of malignancy (AUC 0.797). Our results suggest that hematologic markers could be useful for the differentiation of malignant and benign endometrial lesions.
Objective: MiR-429 has been reported to be involved in regulating various cellular processes.And We found that ROR1 is the target of miR-429 through the target scan 7.2 (https:// www.targetscan.org/vert_72/).Receptor-tyrosine-kinase-like orphan receptor 1 (ROR1) associated with a poor prognosis in various cancers.The purpose of this study is to investigate the role of miR-429 through the regulation of ROR1 in the progression of endometrial cancer.Methods: The expression of ROR1, microRNA-429 (miR-429), and EMT markers was measured using quantitative real-time polymerase chain reaction and western blot.Cell proliferation abilities were detected by Cell Counting Kit-8 (CCK-8) and colony assay.Cell invasion and migration ability was observed through scratch assay or transwell assays.Murine xenograft model was established to investigate the role of miR-429 and ROR1 in vivo. Results:The results of our study indicate that miR-429 and its target genes are associated with cancer-related signaling pathways and that lower miR-429 expression corresponds with a poor prognosis.miR-429 overexpression is inhibited endometrial cancer cell proliferation, migration, and invasion in vitro, as well as hindered tumor growth in vivo.Moreover, ROR1 bound to miR-429 based on bioinformatics prediction and inhibition of miR-429 abolished the effects of ROR1 knockdown on endometrial cancer cell. Conclusion:The results of our study suggest that miR-429 suppresses the proliferation and invasion of endometrial cancer via inhibiting the ROR1 signaling pathway.
Pulmonary cryptococcal infections occur mainly in immunocompromised individuals, such as those with malignancies. Preoperative diagnosis of pulmonary cryptococcosis (PC) can be challenging for both clinicians and radiologists because of nonspecific clinical manifestations and variable radiologic features, as it is easily misdiagnosed as metastatic lung cancer.In case 1, a 76-year-old woman with a history of cervical cancer presented with lung nodules detected on chest computed tomography (CT) 13 months after completing concurrent chemoradiotherapy. In case 2, a 56-year-old woman with a history of ovarian cancer presented with pulmonary nodules on chest CT 19 months after completing chemotherapy. Both patients were clinically asymptomatic, and tumor markers were not elevated.In case 1, chest CT revealed multiple enhanced nodules with lobulated margins in the left lower lobe, and positron emission tomography (PET)-CT showed uptake in the nodule with a standardized uptake value of 3.7. In case 2, chest CT revealed several nodules in the right upper lobe abutting the right major fissure, and PET-CT revealed fluorodeoxyglucose uptake in the nodules. Pathology revealed granulomatous inflammation with cryptococcal infection, and mucicarmine and periodic acid-Schiff staining confirmed cryptococcal infection in both cases.Presumptive diagnoses of lung metastases were made in both cases and thoracoscopic lobectomy was performed. Postoperatively, the patients received antifungal therapy with fluconazole.PC was differentially diagnosed and effectively managed. The patients remained disease-free for both PC and gynecological cancers during subsequent follow-ups.Recognition that PC can mimic lung metastasis is important for managing gynecological cancers. PC should be considered in the differential diagnosis when single or multiple nodules are detected on chest radiography without elevation of tumor markers in patients with gynecological cancer.
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