Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

Perforating injury of the thoracic esophagus leads to an almost Immediate exposure of the mediastinum to both oral secretions and refluxed gastric contents. And necrotizing inflammatory response developed inevitably. So, without proper managements, mediastinitis results in severe dehydration or septic conditions, and consequently the life of the patient can be threaten. We experienced recently 4 cases of esophageal perforation. Three cases were Boerhaave's syndromes and the other one was instrumental perforation in patient with corrosive esophageal stricture. Curative surgical procedures were done in 3 cases and the drainage procedure was only possible in the other one due to hepatic failure. And the patient with the drainage management was dead.

Background： Infectious mononucleosis is a disease precipitated by Epstein-Barr virus(EBV) in mostly children, some seronegative adolescents and young adults comprising clinical symptoms such as fever, lymphadenopathy, and pharyngitis as well as laboratory findings such as hetero-phil antibodies and atypical lymphocytosis. It is confirmed by serologic test for EBV. Materials and Methods： A retrospective evaluation of 26 patients who diagnosed with infectious mononucleosis was peformed through the analysis of typical symptom, sign and laboratory findings. Results : Infectious mononucleosis occurs mostly at 3 to 10 years (74.9%), common symptoms and signs are fever, cervical lymphadenopathy, tonsillar enlargement and exudate. Positive ratio of atypical Lymphocyte(>10%) and hetrophil antibodies are 61.5%, 35.2% respectively, it is less diagnostic. EBV-viral capsid antigen(VCA) IgM are positive in all cases, so it is most diagnostic findings. Conclusion： Infectious mononucleosis should be considered as a cause of cervical lymphadenopathy and pharyngotonsillitis in children and young adults, the assessment of EBV-VCA IgM is necessary for the diagnosis.

Between 1994 to 1998, 7 patients had taken emergency operations by iatrogenic esophageal perforation. To evaluate patterns of injury, clinical presentation, and treatment options for patients, we reviewed all the 7 patients who had gotten transmural injury to the esophagus during dilatations or stenting procedures at our hospital. The primary diagnosis of the patients were as followings , two were achalagia and remaining five were corrosive esophageal strictures. Chest pain, fever, tachycardia were the early signs after esophageal perforation. The sites of perforation were thoracic esophagus in all cases and all of them underwent operation within 8 hours of initial injury. There were no postoperative mortality. Complications were developed three cases： stricture of anastomotic site, mediastinitis due to graft failure of colon and pleural empyema.

Postoperative pain, poor oral intake and various complaints of adenotonsillectomized patients are the main problems for the otolaryngologist. Steroids have been advocated to reduce morbidity after adenotonsillectomy, but the results are conflicting. This study is to determine the effect of preoperative and postoperative oral steroid. Material and Methods : A prospective, randomized study was performed on 40 patients from 4 to 13 years of age. 20 patients undergoing adenotonsillectomy received steroid(experimental group), others undergoing adenotonsillectomy did not receive steroid(control group). An oral prednisolone was administered preoperatively for 3 days and postoperatively 7 days. A dosage was determined by patient's weight. Postoperatively each patients was examined for weight loss as well as for subjective signs of pain, oral intake, activity, mouth odor and analgesic usage. Results： experimental group showed decreased morbidity in view of postoperative pain, oral intake with statistical significance (p<0.05). The usage of analgesics was decreased in steroid group. but, activity, mouth odor and body weight showed no statistical difference. Conclusion： The results showed that preoperative and postoperative oral steroid affect the postoperative morbidity in adenotonsillectomy.

Background： This study was undertaken to detect the patterns of ciliogenesis in newborn rats trachea. Materials and Methods： The experimental animals(Sprague-Dawley strain) were divided five groups, one day, two day, three day, five day and seven day newborns as experimental groups. To obtain differential distribution of $\alpha$-tubulins in the ciliated cells and patterns of ciliogenesis, we used immunohistochemical stain method with mouse anti $\alpha$-tubulin monoclonal antibody as the primary antibody and gold particles conjugated goat anti mouse IgG as the secondary antibody. And we observed the specimens by electron microscope (Hitach-600 Model). Results : 1) The distribution of the $\alpha$ -tubulin reactions in apical zone was slightly decreased from three day after birth. 2) From 5th day after birth, the decreasing number of gold particles in intermediate zone was remarkable. 3) On the comparison with the other zones, the number of gold particles in the Golgi zone for seven days showed no statistical difference. Conclusion : The ciliogenesis of the tracheal ciliated cells in early newborn rat were made via centriolar and acentriolar pathways, in late groups, from five day after birth, the major ciliogenesis pattern might be centriolar pathway.

The etiology of inverted papilloma(IP) remains unknown, but several studies have reported that Human Papillomavirus(HPV) may play a role in the pathogensis of sinonasal inverted papilloma(IP). And recent reports demonstrate the possible etiologic role of Epstein-Barr virus (EBV) in sinonasal IP. The aim of this study is to detect HPV and EBV in sinonasal IP, to examine the relationship between HPV subtype and sinonasal IP, to investigate the relation between HPV and EBV. We reviewed 30 cases of sinonasal IP(simple IP 19 cases, IP with dysplasia 8 cases, IP with squamous cell carcinoma 3 cases). Paraffin embedded archival tissue was used in this study. Detection of HPV, EBV were examined by in situ hybridization(ISH) using HPV type 6/11, 16/18, 31/33/35 DNA probe and EBER probe. The HPV was detected in 6(20%) out of 30 cases. The HPV 6/11 was dectected in 4 out of 19 cases of simple IP, HPV 16/18 in 1, HPV 31/33/35 in 1 out of 8 cases of IP with dysplasia respectively. The EBV was not detected in 30 cases. HPV may play a role in the pathogensis of sinonasal inverted papilloma. But EBV is not a etiopathologic factor to be considered in the development of sinonasal IP.

The authors recently experienced a case of ectopic thyroid. A 15-year-old female patient visited to ENT department with the complaint of the submental neck mass. On physical examination, the mass was relatively firm, non tender and 3$\times$2cm in size. Oral cavity examination revealed 0.5$\times$0.5cm sized pink colored mass near the foramen cecum area. Suspecting ectopic thyroid, thyroid function test, thyroid scan, neck computed tomogram scan were performed. Thyroid scan revealed a functioning thyroid on the lingual and submental area without normal uptake in the anterior neck area. Thyroid (unction test was normal. Pre-contrast computed tomogram scan revealed an ectopic thyroid in the lingual and submental area. A review of literature concerning ectopic thyroid was discussed.

Sternal recurrence has been defined as a diffuse infiltrate of neoplastic tissue at the junction of the amputated trachea and the skin. The overall prognosis is poor, resulting from progressive tracheostomal obstruction or massive hemorrhage due to erosion of major vessels. Neither radiation therapy nor chemotherapy has demonstrated any efficacy in controlling these sternal recurrence. Surgery, especially mediastinal dissection, may benefit only an occasional patient. Recently authors experienced one case of mediastinal dissection for sternal recurrence after total laryngectomy for laryngeal cancer. We report our case with a brief review of literature.

Odontogenic keratocyst is a central destructive lesion of the jaws characterized by a thin, fragile layer of orthokeratinizing or parakeratinizing stratified squamous epithelium. Correlation between the histologic type and the recurrence ratio remains a subject of controversy, and multiple cysts are known to be associated with the nevoid basal cell syndrome. We experienced a case of multiple odontogenic keratocyst in a 25 year-old male patient involving bilateral mandible and maxilla. The cystic mass of the right maxilla was removed by Caldwell-Luc's approach and the right mandibular mass was removed by intraoral approach but the teeth that were impacted in the mandibular bone were remained in order to prevent an iatrogenic fracture.

The risk of foreign body by small button-disc battery in children has been increasing because the batteries are widely used in electronic device and plaything and easily contact with children. Foreign body of mercury type button-disc battery, when lodged in the esophagus, leak a caustic solution which causes a rapid necrosis of esophageal mucosa. So it should be removed immediately when the radiologic diagnosis is made. We experienced a case of esophageal foreign body by mercuric disc battery in a 14-month-old male. This case will be discussed with literature review.

Broncholithiasis is defined as a condition in which calcified material is present within the bronchial lumen. It is a rare but troublesome disease that can cause life-threatening complications such as massive fatal hemoptysis. Therefore, pulmonary resection is frequently required to remove the broncholiths and irreversibly damaged parenchyma. We experienced 3 cases of broncholithiasis. In one case, a 36 year old female patient suffered from coughing, massive hemoptysis with lithoptysis caused by intrinsic obstructive broncholiths in the right middle and lower lobe. In the 2nd case, a 41 year old male patient complained of long-standing blood tinged sputum and frequent pneumonic symptoms for 10 months because of extrinsic broncholithiasis where the calcified peribronchial lymph node eroded into the bronchial lumen of the right lower lobe. The remaining case involved a 30 year old female patient who complained of intermittent blood-tinged sputum induced by intrabronchial broncholith in the orifice of the right middle lobe bronchus. Two patients underwent bilobectomy(right middle and lower lobe) for removal of the broncholiths, damaged bronchi and parenchyma. The other patient was treated with right middle lobectomy and stone removal by bronchotomy of bronchus intermedius. In all patients, the post-operative course was uneventful.

Neurilemmoma is a benign, well-encapsulated neurogenic tumor that arises in cranial, peripheral, or autonomic nerves that have nerve sheaths containing schwann cells. From 16 to 45% of all neurilemmoma cases occur in the head and neck region and only about 4% of those cases are found in the nose and paranasal sinuses, but very rarely found in the nasal septum. Recently, we experienced a case of isolated neurilemmoma which arose from the nasal septum of a 30-year-old female patient who complained of nasal obstruction and postnasal drip. The mass was broadly based on the right anterior portion of the nasal septum and confined to the nasal cavity, displacing the lateral wall of the nasal cavity and middle turbinate, laterally and posteriorly, respectively. The tumor mass was completely excised through transnasal endoscopic surgery under general anesthesia. The final pathological diagnosis viewed under a microscope after H&E and anti S-100 protein stain was a benign neurilemmoma in which Antoni A type and B type both existed. This report presents a case of neurilemmoma which arose from the nasal septum with reviews of the clinicopathologic features.

Dermoids are rare disease which arise during embryogenesis. They are the most common variety of teratomas occurring in the head and neck region and most arsies in the nasopharynx or oropharynx. They are invariably benign and derived from only two germinal layers, ectoderm and mesoderm. They usually present as repiratory distress and swallowing difficulty at or soon after birth. Treatment consists of surgical resection. We recently experienced a case of a neonatal nasopharyngeal dermoid which led to severe airway obstruction and feeding difficulty and necessitated the endotracheal intubation.

For many years it has been reported that seemingly benign neck cysts may contain carcinoma. Cystic metastases have often mistaken for either branchial cleft cysts or benign mass. Authors experienced two cases which presents cystic cervical metastatic cancer One was a tonsillar carcinoma and the other was a tongue carcinoma. Patients with a cystic squamous carcinoma in the neck likely have a primary in upper aero-digestive system and It is known that the tonsil is most common site. Radiologic examination and fine needle aspiration biopsy of the cyst proved to be non-diagnostic. The development of cervical lymph node metastases before clinical signs of carcinoma of the tonsil is also well recognized. So, in old patients, thorough head If neck examination, panendoscopy and ipsilateral tonsillectomy is mandatory to identify a primary carcinoma prior to cyst excision.