Submental endotracheal intubation is a method introduced by Hernandez Altemir in 1986 for maintaining the airway. In the treatment of multiple facial fractures, the appropriate airway maintenance is a challenge for both anesthesiologists and surgeons. Oral endotracheal intubation precludes achieving adequate access to the fracture and maxillomandibular fixation for proper occlusion. Nasotracheal intubation is contraindicated in cases accompanying fractures of skull base or nasal bones. Tracheostomy is the standard method for airway management in these traumas. It does not interfere with surgical access and occlusion, and can be used for prolonging ventilation treatment. However, it has a significant risk of iatrogenic complications. On the other hand, submental endotracheal intubation is an alternative method of airway maintenance in facial traumas. It does not compromise the surgical fields but enables maxillomandibular fixation and can avoid complications of tracheostomy. In this case report, we present our experience of submental endotracheal intubation in two cases with multiple facial traumas.
Airway Management ; Hand ; Humans ; Intubation ; Intubation, Intratracheal ; Jaw Fixation Techniques ; Maxillofacial Injuries ; Nasal Bone ; Skull Base ; Tracheostomy ; Ventilation

We studied three patients in whom otorrhea occurred without bacterial infection following ventilation tube (VT) insertion. These patients took oral steroids since the conventional therapy was not effective; however, the oral steroids produced temporal effect since sticky otorrhea occurred when the oral steroids were stopped. We collected ear discharge from each patient and consulted the pathologist about histopathologic findings of it. We identified the predominant eosinophilic infiltration at specimen. We tried to relate this type of otitis media with eosinophilic otitis media (EOM) and treated the patients with intratympanic steroid injection.
Bacterial Infections ; Dexamethasone ; Ear ; Eosinophils ; Humans ; Middle Ear Ventilation ; Otitis ; Otitis Media ; Polymethacrylic Acids ; Steroids ; Ventilation

Lymphatic malformations in cases with macrocystic lesions can be treated with surgical excision or sclerotherapy using alcohol, bleomycin, doxycycline, or OK-432. We report a case of a 24-year-old woman who underwent percutaneous drainage and povidone-iodine sclerotherapy as primary treatment for cervical lymphatic malformation. The patient underwent povidone-iodine sclerotherapy for 3 consecutive days. After 8 months, ultrasonography of the lesion in the neck revealed complete resolution of the cervical lymphatic malformation without any complication. Povidone-iodine sclerotherapy can be a safe and cost-effective treatment option for cervical lymphatic malformation.
Bleomycin ; Doxycycline ; Drainage* ; Female ; Humans ; Neck ; Picibanil ; Povidone-Iodine* ; Sclerotherapy* ; Ultrasonography ; Young Adult

The prevalence of people presenting with fish bone foreign body (FFB) is high in Asian countries, including Korea, and coastal areas around the world. Pointed linear-shaped FFBs are common in the oral cavity and upper esophageal sphincter, whereas large flat bones are more common FFBs in the esophagus. If the FFB is not found on endoscopy, residual foreign body sensation or embedded FFB is possible. In such cases, CT is helpful. However, in the case of totally embedded FFB, not only preoperative diagnosis but also localization during operation or surgery is important. If these are not performed, the initial incision site or operation method would be difficult to determine. For this purpose, no standard guideline has been established yet. We report a case of upper esophageal sphincter-embedded FFB diagnosed using CT rather than endoscopy. The bone was successfully localized using conventional ultrasonography during the operation and then removed surgically.
Asian Continental Ancestry Group ; Diagnosis ; Endoscopy ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies ; Humans ; Korea ; Methods ; Mouth ; Pharynx ; Prevalence ; Sensation ; Ultrasonography

BACKGROUND AND OBJECTIVES: The Voice Handicap Index (VHI) was developed to assess patients' perception on the severity of their voice disorders. The purpose of this study was to determine the severity of handicap expressed by patients with various voice disorders, and to help clinicians in making future treatment plan. VHI may also be used as a guideline in making diagnosis according to different factors of voice quality. SUBJECTS AND METHOD: The people who had visited the Asan Medical Center with hoarseness from August 2000 to August 2001 were studied. They filled out the questionnaire composed of 30 questions about their voice disorders. The subjects were consisted of 6 groups; 50 patients with vocal cord nodule, 43 patients with laryngitis, 42 patients with vocal cord polyp, 25 patients with glottic cancer and 14 patients with unilateral vocal cord paralysis. Descriptive statistics were used to analyze the data and mean value of VHI scores. RESULTS: The mean score of VHI was found to be statistically higher in the subjects with the history of voice abuse (p<0.002). Overall, the group with unilateral vocal cord paralysis showed the highest VHI score that was statistically significant (p<0.001). When the functional factor is considered, groups with unilateral vocal cord paralysis and glottic cancer had shown higher scores compared to the other groups. When the physical factor is considered, groups with unilateral vocal cord paralysis and vocal cord polyp had shown higher scores. When the emotional factor is considered, groups with unilateral vocal cord paralysis had shown higher scores. CONCLUSION: Measurement of VHI in patients with voice disorders provides a measure of self-perception on the severity of the problems that cannot be assessed through visual perception or objective acoustic and aerodynamic measures. In addition, the measurement of VHI score was easy to perform, non-invasive, and inexpensive. In using this method, we expect to reveal the efficacy of the treatment for voice disorders.
Acoustics ; Chungcheongnam-do ; Diagnosis ; Fibrinogen ; Hoarseness* ; Humans ; Laryngitis ; Polyps ; Surveys and Questionnaires ; Self Concept ; Visual Perception ; Vocal Cord Paralysis ; Vocal Cords ; Voice Disorders ; Voice Quality ; Voice*

BACKGROUND AND OBJECTIVES: Anaplastic carcinoma of thyroid gland is a lethal entity: few patients live more than 12 months following the diagnosis. We retrospectively reviewed the experience with this entity at our institute with respect to prognostic factors influencing survival. MATERIALS AND METHODS: Thirteen cases of anaplastic carcinoma of thyroid gland diagonsed from 1995 to 2000 were analyzed retrospectively. The median age at presentation was 66.2 years; the male/female ratio was 1.17:1: and the most common symptom was a rapidly enlarging neck mass. RESULTS: All but one patient died within one year of diagnosis. Tumor size of less than 7 cm and complete resection of tumor were significant prognostic factors. Patients who had operation with or without radiotherapy and/or chemotherapy survived significantly longer than other patients. Median survival duration was 74 days. CONCLUSION: This study showed that complete resection and multimodal treatment for tumor of size less than 7 cm resulted in prolonged survival for a subgroup of patients with anaplastic thyroid carcinoma.
Carcinoma* ; Combined Modality Therapy ; Diagnosis ; Drug Therapy ; Humans ; Neck ; Radiotherapy ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms

BACKGROUND AND OBJECTIVES: The study was designed to measure the change of serum aldosterone concentration after noise exposure in BALB/c mice. MATERIALS AND METHODS: BALB/c hybrid mice with < or =25 dB nHL in auditory brainstem responses (ABR) were used. Six mice were exposed to 120 dB SPL broad white band noise for 3 hours per day for 3 consecutive days. ABRs in all mice were examined after noise exposure. Serum aldosterone concentration was checked by radioimmunoassay in three mice without noise exposure, in three mice immediately after noise exposure (0 day after noise group), and in three mice 3 days after noise exposure (3 days after noise group). RESULTS: Permanent noise exposure-related threshold shift was induced in mice of 0 day after noise group and 3 days after noise group (83.3+/-2.9 and 88.3+/-2.9 dB nHL, respectively). The serum aldosterone concentration of the mice after noise exposure was significantly lower than control mice (p=0.046). The changes of aldosterone concentration were 879+/-137.5 pg/mL without noise exposure, 623+/-75.9 pg/mL immediately after noise exposure, and 683+/-49.2 pg/mL 3 days after noise exposure. CONCLUSIONS: In BALB/c mice, serum aldosterone concentration is decreased significantly after noise exposure.
Aldosterone ; Animals ; Chimera ; European Continental Ancestry Group ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Humans ; Mice ; Noise ; Radioimmunoassay

BACKGROUND AND OBJECTIVES: Tympanostomy tube insertion is one of the most common surgical procedures in children. Despite aseptic procedures with prophylactic antibiotic treatment, postoperative otorrhea may be encountered in some patients. The purpose of this study is to identify the relation between the types of immune cells in otitis media with effusion (OME) and tympanostomy tube otorrhea (TTO) in children. SUBJECTS AND METHOD: Fifty-six patients underwent tympanostomy tube insertion with OME were analyzed retrospectively. Fluid from OME was harvested by suction via syringe connector after myringotomy. Light microscopic examination of middle ear effusion was performed by a pathologist after hematoxylin and eosin staining. We analyzed the relation between the types of immune cells from middle ear effusion and TTO. RESULTS: Of 56 children, 36 were male and 22 were female. The mean age for tympanostomy tube insertion was 3.56 (±2.63) years, with the average follow-up period of 12.56 (±9.96) months. Neutrophils were detected in 19, eosinophils in 14, lymphocytes in 22, mast cells in 2, plasma cells in 7, and histiocytes in 9. TTO occurred in 15 patients. In patients with early TTO, eosinophils were detected more frequently than in patients without TTO (p=0.006). Plasma cells were detected more frequently in patient with late TTO than without TTO (p=0.011). CONCLUSION: According to the analysis of different types of immune cells, eosinophils in the middle ear effusion related with the occurrence of TTO.
Child* ; Ear, Middle* ; Eosine Yellowish-(YS) ; Eosinophils ; Female ; Follow-Up Studies ; Hematoxylin ; Histiocytes ; Humans ; Lymphocytes ; Male ; Mast Cells ; Methods ; Middle Ear Ventilation* ; Neutrophils ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Plasma Cells ; Retrospective Studies ; Suction ; Syringes

BACKGROUND AND OBJECTIVES: When noise-induced hearing loss occurs, destruction of the hair cells is accompanied by mechanical injury, chemical injury, and hypoxia. Proteomics is a powerful tool for protein analysis, as it provides valuable information regarding the biochemical processes involved in diseases, monitors cellular processes, and characterizes protein expression levels. We attempted to identify the proteins associated with the pathophysiology of noise-induced hearing loss, as well as the mechanisms of this disease, using a proteomics approach. MATERIALS AND METHODS: We used BALB/C male mice. The control mice were placed in a booth without noise, while the experimental mice were exposed to noise for three hours daily for three consecutive days. Cochleae from each group were obtained for total protein extraction. The proteins were separated into numerous spots using two-dimensional electrophoresis. Seven protein spots that were strongly detected only in the noise-exposed cochleae were selected and subsequently analyzed using matrix-assisted laser desorption/ionization time of flight mass spectrometry. RESULTS: Approximately 286 protein spots were detected in the noise group. Seven selected spots were analyzed and various proteins identified, including tyrosine protein kinase MEG2, angiopoietin-like 1, heat shock 70 kDa protein, sodium dicarboxylate cotransporter 1, myeloid Elf-1-like factor, disintegrin, metalloproteinase domain 7, and activated leukocyte-cell adhesion molecule. CONCLUSIONS: We identified several proteins expressed in noise-induced hearing loss using a proteomics approach. These proteins may help us to understand the pathogenic mechanisms of noise-induced hearing loss.
Animals ; Anoxia ; Biochemical Processes ; Cochlea ; Electrophoresis ; Hair ; Hearing Loss, Noise-Induced ; HSP70 Heat-Shock Proteins ; Humans ; Male ; Mice ; Noise ; Protein-Tyrosine Kinases ; Proteins ; Proteomics ; Sodium

Human toxocariasis is a zoonotic parasitic disease caused by Toxocara canis or Toxocara cati larvae. Human infection is usually an outcome of accidental ingestion of the embryonated eggs, and the involvement of central nervous system is rare. We report a case of cerebral infarction which was caused by toxocariasis in adult, who had headache, abdominal pain and right side weakness. He had only a history of ingestion of raw liver of deer.
Abdominal Pain ; Adult ; Central Nervous System ; Cerebral Infarction* ; Deer ; Eating ; Eggs ; Headache ; Humans ; Larva ; Liver ; Ovum ; Parasitic Diseases ; Toxocara ; Toxocara canis ; Toxocariasis*