No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

No abstract available.

Vestibular rehabilitation (VR) is valuable tool to manage balance problem in various kinds of diseases. Over the last decades, numerous studies on the effect of VR have been reported. Recently, systematic analysis integrating the individual studies have been tried and the results suggest that VR is safe and effective management for the acute/chronic and unilateral/bilateral peripheral vestibular dysfunction, and also for the elderly people. VR relieves dizziness and improves gaze stability, postural stability, parameters of gait, and activities of daily living. Currently released "Clinical practice guideline of VR on peripheral vestibular dysfunction" support and assist the use of VR in clinical field. More research is needed to develop uniform evaluation tool to measure the symptomatic and functional status of the patients and individualized efficient rehabilitation programs. It is expected that device for VR incorporating new technologies such as virtual reality will be developed in near future.
Activities of Daily Living ; Aged ; Dizziness ; Gait ; Humans ; Rehabilitation ; Vertigo

Heterotopic pregnancy occurs when an intrauterine pregnancy co-exists with an ectopic pregnancy. It is a potentially fatal condition, rarely occuring in natural conception cycle. But its incidence is increased since the rise in PID, pelvic surgery, IUD, and advent of assisted reproductive technology involving use of superovulatory drugs and/or in vitro-fertilization. We present a case of intrauterine twin pregnancy and right tubal pregnancy following treatment with in vitro-fertilization. The right tubal pregnancy was diagnosed after rupturing at 6th gestational weeks, and resected via laparoscopy. And healthy twin babies were delivered without complication at 38th gestational week. So we report this case with a brief review of the literatures.
Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Pregnancy, Twin ; Reproductive Techniques, Assisted

Tuberculous petrositis is a very rare disease. It is thought to be developed by a spread of tuberculous infection from the middle ear or pneumatized air cells of mastoid. We report a patient with tuberculous petrositis who complained persistent headache after previous tympanomastoid surgery. The classic symptoms of petrositis (Gradenigo's syndrome) were absent, but the diagnosis of petrositis was made with CT, MRI and Ga-67 citrate scan. Revision surgery including infracochlear drainage of the petrous apex was performed, and the pathologic report revealed a tuberculous infection.
Citric Acid ; Diagnosis ; Drainage ; Ear, Middle ; Headache ; Humans ; Magnetic Resonance Imaging ; Mastoid ; Petrositis* ; Petrous Bone ; Rare Diseases ; Tuberculosis

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma with a high rate of metastasis. MCC is rarely suspected during clinical examination, thus requiring biopsy to establish a pathologic diagnosis. In addition, MCC sometimes occurs in double primary cancers. Although there have been reviews on double primary cancers, only a few cases involving MCC have been described. Herein, we report a case of a 54-year-old female patient who presented to our clinic with a diagnosis of earlobe MCC following an excisional biopsy performed by another clinic. Further evaluation, including chest imaging, revealed a mass in the lung. The patient underwent a wide excision of the right earlobe, and video-assisted thoracic surgery on the lung. Pathology confirmed MCC in the right earlobe and adenocarcinoma in the lung. The patient underwent postoperative adjuvant chemotherapy followed by radiotherapy. Up to this point, 3 years after the surgery, there has been no evidence of recurrence.

PURPOSE: The elbow joint is one of the most stable joints. Dislocation and fracture can occur in elbow joint most commonly next to shoulder joint. Various injuries can occur according to generated mechanism, age of patient and impact. Despite proper treatment, various complications can occur. MATERIALS AND METHODS: We describe etiology and treatment of these complications after elbow trauma such as stiffness, instability and heterotopic ossification. RESULTS AND CONCLUSION: Malunion, nonunion and traumatic arthritis are addressed as a possible complication after fracture around elbow joint.
Arthritis ; Dislocations ; Elbow ; Elbow Joint ; Humans ; Joints ; Shoulder Joint

While systemic steroid therapy is most widely considered as a main treatment for idiopathic sudden sensorineural hearing loss (SSHL), the disadvantages of its use are numerous side effects. Intratympanic steroid injection (ITS) delivers steroids through transtympanic route, hence avoids possible side effects with higher perilymph concentration. We conducted a reviewed 47 clinical studies after an online search of the PubMed databases for the following terms "sudden hearing loss, intratympanic steroid". Although the study settings are varied among reviewed articles, most studies in this review consistently showed some benefit of hearing in salvage cases. In addition, it is suggested that intratympanic steroids are equivalent to systemic steroid therapy as initial treatment for SSHL. In patients with contraindications against the use of systemic steroid, ITS may be considered as valuable option for primary therapy. Further studies are necessary to elucidate the optimal protocol of administration.
Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Perilymph ; Steroids

While systemic steroid therapy is most widely considered as a main treatment for idiopathic sudden sensorineural hearing loss (SSHL), the disadvantages of its use are numerous side effects. Intratympanic steroid injection (ITS) delivers steroids through transtympanic route, hence avoids possible side effects with higher perilymph concentration. We conducted a reviewed 47 clinical studies after an online search of the PubMed databases for the following terms "sudden hearing loss, intratympanic steroid". Although the study settings are varied among reviewed articles, most studies in this review consistently showed some benefit of hearing in salvage cases. In addition, it is suggested that intratympanic steroids are equivalent to systemic steroid therapy as initial treatment for SSHL. In patients with contraindications against the use of systemic steroid, ITS may be considered as valuable option for primary therapy. Further studies are necessary to elucidate the optimal protocol of administration.
Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Perilymph ; Steroids

BACKGROUND: The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. METHODS: From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. RESULTS: Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. CONCLUSIONS: The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
Anticoagulants ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Hemostasis, Surgical ; Heparin ; Humans ; International Normalized Ratio ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Retrospective Studies ; Tracheostomy*