Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

BACKGROUNDs: A retrospective study was performed to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic study. METHODS: Parameters of soft-tissue structures(epiglottis width, third vertebral body width, ratio of epiglottic width to third vertebral body width) in 30 adult patients compared with those of age and sex-matched controls with foreign body in throat whose radiographic reading was normal. RESULTS: Epiglottis width of more than 11mm, ratio of epiglottis width(EW) to the third vertebral body width(C3W) of more than 0.5 were, respectively, found to be 100% sensitive and specific in differentiating between patients with and without epiglottitis. CONCLUSION: These preliminary results suggest that EW/C3W ratio of more than 0.5, EW of more than 11mm, respectively, may be useful in the diagnosis of epiglottitis in adult patients.
Adult* ; Diagnosis* ; Epiglottis ; Epiglottitis* ; Foreign Bodies ; Humans ; Neck ; Pharynx ; Retrospective Studies

We studied the usefulness of prostate specific antigen (PSA) as well as prostatic acid phosphatase (PAP) as marker of prostatic cancer in twelve cases of advanced prostatic cancer including 4 or stage C and 8 of stage D, 50 cases of benign prostatic hyperplasia (BPH) and 50 cases of nonprostatic diseases as normal control. The positive rates of PSA were 100% for prostatic cancer, 20% for BPH and O% for nonprostatic diseases, and those of PAP were 75% for prostate cancer, 8% for BPH and 2% for nonprostatic diseases. These results indicated hat PSA is more sensitive than PAP but less specific than PAP in diagnosis of prostatic cancer. Serum PSP level was correlated with the weight of prostate in BPH patients. Serum PSA level determined during the follow-up after endocrine therapy for prostatic cancer reflected the clinical course of the patients. Because of its relatively low specificity, PSA alone may not be useful for early diagnosis of prostatic cancer. If in combination with other diagnostic modalities, it may be useful in early diagnosis and therapeutic monitoring of prostatic cancer within restricted limits.
Acid Phosphatase ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Sensitivity and Specificity

PURPOSE: The diagnosis of Budd-Chiari syndrome on CT is difficult if CT do not demonstrate obstruction of the IVC or hepatic vein and other parameter is needed for the correct diagnosis. The purpose of our study was to determine the usefulness of measuring the diameter of azygos-hemiazygos vein on CT to differentiate Budd-Chiari syndrome from advanced liver cirrhosis. MATERIALS AND METHODS: Fourteen patients who were proven as Budd-Chiari syndrome on vena cavography were studied for analysis. All patients showed evidence of liver cirrhosis on CT. As a control group fifteen cases of advanced liver cirrhosis who underwent endoscopic sclerotheraphy due to esophageal variceal bleeding were also included for comparison. The largest short axis diameter of azygos-hemiazygos vein was measured in all patients at the level of diaphragm on axial CT and the results were compared in both groups. RESULTS: In patients with Budd-Chiari syndrome the largest short axial diameter of azygos-hemiazygos vein ranged from 0.5cm to 2.5cm(mean ;1.5cm). Only one patient who showed hepatic venous obstruction demonstrated a diameter of less than 1 cm(0. Scm). In contrast, the diameter in patients with advanced liver cirrhosis without obstruction of IVC or hepatic vein was less than 1 cm with a range from 0.2cm to 1 cm(mean ;0.6cm). CONCLUSION: The short axis diameter of azygos-hemiazygos vein was an indicator of IVC obstruction (Budd-Chiari syndrome).
Axis, Cervical Vertebra ; Budd-Chiari Syndrome* ; Diagnosis* ; Diaphragm ; Esophageal and Gastric Varices ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Veins*

Laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms begin to appear after weeks of age, become worse at 4-8 months, improve between 8-12 months, and usually heal naturally at 12-18 months. Despite these common natural processes, the symptoms of the disease can be very diverse and, in severe cases, require surgical treatment. The diagnosis can be made by suspicion of clinical symptoms and direct observation of the larynx with the spontaneous breathing of the child. Typical laryngeal features include omega-shaped epiglottis, retroflexed epiglottis, short aryepiglottic fold, poor visualization of the vocal folds, and edema of the posterior glottis, including inspiratory supra-arytenoid tissue prolapse. In this review, we discuss the classification and treatment based on symptoms and laryngoscopic findings in patients with laryngomalacia.
Airway Obstruction ; Child ; Classification* ; Comorbidity ; Diagnosis ; Edema ; Epiglottis ; Glottis ; Humans ; Infant, Newborn ; Laryngomalacia* ; Larynx ; Prolapse ; Respiration ; Respiratory Sounds ; Vocal Cords

The case of a patient with acute onset of flank pain is presented. Initial therapy was directed toward relief of pain believed to be caused by renal calculi. The flank pain did not responded to analgesics. An abdominal ultrasonogram showed that multiple hyperechogenic masses were in the parenchyma of both kidney, and an abdominal CT showed that multiple high-density masses, presumed to be angiomyolipomas, were located in both kidneys and in the perirenal hematoma around the left kidney. Vital signs were stable, and there was no evidence of anemia. On the seventh hospital day, angiographic tumor embolization was performed. Cases such as this should remind emergency physicians to carefully consider alternate diagnoses to renal calculi in patients with flank pain who have atypical clinical features or an atypical course.
Analgesics ; Anemia ; Angiomyolipoma* ; Diagnosis ; Emergencies ; Flank Pain ; Hematoma ; Humans ; Kidney ; Kidney Calculi ; Rupture, Spontaneous* ; Tomography, X-Ray Computed ; Ultrasonography ; Vital Signs

No abstract available.
Agaricales ; Dermatitis

No abstract available.
Ameloblasts* ; Fibroma*

No abstract available.
Ameloblasts* ; Fibroma*

Characteristics of voice problems occurring with professional voice users are not too different from those with general public. However, they react sensitively to relatively subtle changes of voice and have strong demands for their treatments as well. Consequently, treatments for the professional voice users should be implemented in the form of team approach consisting of not only otolaryngologists with plenty of treatment experience and sufficient knowledge but also speech-language pathologist, vocal coach. While treating professional voice users is burdensome and a challenging problem even to otolaryngologists rich in experience, knowledge and experience obtained through treating them will be much help for voice treatments of other general public. In this article, the authors have reviewed approaches and treatment directions for voice problems occurring with professional voice users.
Dysphonia ; Voice