Ethmoidal Mucocele Presenting as Oculomotor Nerve Paralysis

A 56-year-old male was admitted with an acute headache and sudden ptosis on the right side. No ophthalmological or neurological etiologies were apparent. A mucocele of the right posterior ethmoid sinus was observed with radiology. After the marsupialization of the mucocele via a transnasal endoscopic approach, the patient's symptoms (oculomotor nerve paralysis and headache) resolved in 4 weeks. Oculomotor paralysis is a rare symptom of an ethmoidal mucocele. In this article, we report this rare case along with a literature review.

Flow cytometric analysis of DNA ploidy in primary non-small cell carcinoma of the lung in Korea

Flow cytometrically determined nuclear DNA content has been measured on 74 formalin-fixed, paraffin embedded specimens of non-small cell carcinoma of the lung. Of the 60 tumors that were successfully analyzed, 32 (53%) were diploid and 28 (47%) were aneuploid. The mean DNA index of aneuploid tumor was 1.5 +/- 0.25, ranging from 1.1 to 2.0. There was no significant correlation between DNA ploidy and the patient's clinical characteristics, histology of tumor, nodal status or tumor stage. Tumor ploidy was not found as a prognostic determinant in non-small cell carcinoma of the lung in this study.

Phase II study of cyclophosphamide, doxorubicin, and vincristine (CAV) and etoposide plus cisplatin (EP) alternating chemotherapy combined with radiotherapy in small cell lung cancer

The development of drug resistance is the major limiting factor influencing the survival of patients with small cell lung cancer (SCLC). We have thus examined the activity of cyclophosphamide, doxorubicin and vincristine (CAV) alternating with etoposide and cisplatin (EP) in 35 patients with SCLC. The treatment courses were alternated every 3 or 4 weeks. After induction chemotherapy, patients with limited disease (LD) received thoracic radiotherapy (5000 cGy), prophylactic cranial irradiation (3000 cGy) and maintenance chemotherapy and patients with extensive disease (ED) received maintenance chemotherapy only. In this group of 35 patients, 13 had limited disease (LD) and 22 had extensive disease (ED). After completion of the therapy, 100% of the patients with LD achieved complete plus partial remission (CR + PR) and 68% of the patients with ED achieved CR + PR. The median survival time was 66 weeks (15.3 months) in patients with LD and 44 weeks (10.2 months) in patients with ED. The over all survival for patients with LD was superior to that for patients with ED (p less than 0.05). Also, median response duration for patients with LD (35 wks) was longer than that for patients with ED (17 weeks) (p less than 0.05). The primary site was the most vulnerable site to relapse (18 patients). Toxicity was mild to moderate and acceptable, and there were no treatment-related deaths. These results suggest that the alternation of CAV and EP is effective treatment strategy in the management of SCLC. A randomized controlled study will be required to discriminate the actual effect of this alternating regimen.

Relationship between the result of preoperative pulmonary function test and postoperative pulmonary complications

Good preoperative screening and evaluation of patients undergoing surgery is necessary because it serves to identify the individual who is at risk of increased intra-operative and postoperative morbidity and mortality. The retrospective study was done in an attempt to determine if abnormalities in preoperative pulmonary function, detected by routine pulmonary function tests, would predict which patients would suffer from pulmonary complications following surgery. Pulmonary complications in the postoperative period included fever, atelectasis and respiratory failure. The overall incidence of pulmonary complications from our 78 patients undergoing surgery was 37 percent based on clinical criteria. This incidence was high in patients with FEV1 less than 1.0 L/sec, MVV less than 40% of predicted value and PCO2 more than 45 mmHg.

The Role of Whole Body Bone Scan in Bronchogenic Carcinoma

One hundred and sixty patients having bronchogenic carcinoma were evaluated for bone metastasis by means of 99mTc-monodiphosphate bone scanning, correlative radiographic bone survey and their clinical findings. In all patients, diagnosis was histologically proved. Bone scan demonstrated the possible evidence of bone metastasis in 75 patients (46.9%) and radiography, in 29 patients (18.1%). False negative was noted in 1 patient-Bone scan correlated with radiography in 37.3%, and with accompanying bone pain in 52% of the patients. But there was no correlation with the level of serum calcium, inorganic phos- phorus and alkaline phosphatase. In connection with their clinical stages before scanning, bone scans were positive in 33.3% of clinical stage I, 10.8% of clinica1 stage II and 54.1% of clinical stage III. Our Study suggests that bone scanning with 99m-monodiphosphate detected early bone metastasis in patients with bronchogenic carcinoma before their lesions became evident clinically or radiographically, and also important to determine operability.

An Experience in Fiberopticbronchoscopy in the Diagnosis of Pulmonary Diseases

We analysed the results of the 521 bronchofiberscopies which was carried out at the Severance Hospital during 1977-1980. The purpose of the bronchofiberscopic procedures were diagnostic in 488 cases (93.8%), therapeutic in 18 cases (3.4%) and follow up observation in 15 cases (2.8%). It's major role is in the diagnosis of lung cancer and the tuberculosis in our hospital. In 190 patients of lung cancer confirmed positive typing was possible in 72.9% by bronchial biopsy, 52.6% by washing cytology. In 48 patient with tuberculosis who was not diagnosed before bronchofiberscopy, tubercle bacilli were found in 20% by AFB smear, 51% by AFB culture and 68.4% by bronchoscopic biopsy. Complications were minimal(1.9%).