No abstract available.
Gallium* ; Neoplasm, Residual* ; Wounds and Injuries*

Background: South Korea has one of the world’s fastest aging populations and is witnessing increased age-related hearing impairment cases as well as an increase in the number of hearing aid users. The aim of this study was to analyze complications caused by hearing aid mold materials. In addition, we hope to raise awareness of the harm and danger that inexperienced hearing aid providers can cause to patients. Methods: We retrospectively reviewed the medical records of 11 patients who were diagnosed with hearing aid mold material as a foreign body in the ear at a tertiary center between 2016 and 2020. The following data were analyzed: symptoms, endoscopic findings, audiometry, temporal bone CT images, treatment methods, and complications after removal. The currently available literature was also reviewed to develop clinical guidelines, to identify the systematic weaknesses in the South Korean hearing aid market, and to identify policies that warrant better quality control. Results: Among the 11 cases, 9 were restricted to the external auditory canal, all of which were successfully removed under endoscopy with minor complications. Two cases with middle ear involvement resulted in infection and thus required surgical removal with mastoidectomy. The average age of these patients was 76.4, and all patients received their molding procedure at private hearing aid shops without an otolaryngologist’s examination. Conclusion Thorough patient history-taking and otologic examination must be performed to identify patients at higher risk of complications. Such patients should be referred to an otolaryngologist. If a patient exhibits alarming symptoms, early referral is critical since prompt surgery can minimize complications. A CT scan is highly recommended to determine an optimal approach for foreign body removal. Systematic and regulatory changes in hearing aid dispensers, such as requiring apprenticeship, raising the required level of education, and legally mandating referrals, can help reduce these complications.

The development of renal glomerular lesions secondary to severe visceral infection (pulmonary, pleural, retroperitoneal or hepatic abscess) is not generally appreciated. Such patients resemble those with infective endocarditis. The suggested pathogenetic mechanisms by which infection can cause glomerular damage are immunologic interaction, direct toxicity of a bacterial products, and some other triggering factors; However, direct correlation between the infectious and immunologic events has not been demonstrated. The histopathologic findings of infectious glomerulonephritis are variable, and these findings, as well as the clinical abnormalities, may resolve with effective antimicrobial therapy or abscess drainage. We experienced a case of glomerulonephritis and acute renal failure due to staphylococcal retroperitoneal abscess. The patient was a 58-year-old man who presented with abdominal and back pain. We performed an abdominal CT scan which showed a retroperitoneal abscess which was proven to be a staphylococcal infection upon percutaneous abscess drainage. Furthermore, we performed a renal biopsy in order to investigate hematuria, RBC casts, and proteinuria. Pathologic findings revealed postinfectious glomerulonephritis. Abscess drainage and sensitive antibiotics were administered, after which his symptoms and urinary abnormalities disappeared, and the retroperitoneal abscess subsided. Here, we report a case of a staphylococcal retroperitoneal abscess which led to postinfectious glomerulonephritis and acute renal failure along with a brief review of the literatures.
Abscess* ; Acute Kidney Injury ; Anti-Bacterial Agents ; Back Pain ; Biopsy ; Drainage ; Endocarditis ; Glomerulonephritis* ; Hematuria ; Humans ; Middle Aged ; Proteinuria ; Staphylococcal Infections ; Tomography, X-Ray Computed

Twin-to-twin transfusion syndrome (TTTS) is one of the complications showing high mortality rate in monochorionic twins with vascular communication in the placenta. Clinical manifestations of TTTS are usually characterized by polyhydramnios, circulatory overload, cardiac failure and fetal hydrops in the recipient twin and symmetrical fetal growth restriction, oligohydramnios, hypovolemia and anemia in the donor twin. TTTS occurres in 10-35% of monochorionic twins. We report three cases of TTTS with fetal hydrops in which amnioreduction was serially attempted and maternal digoxin treatment was tried for the therapeutic purpose.
Anemia ; Digoxin ; Female ; Fetal Development ; Fetal Therapies ; Fetofetal Transfusion* ; Heart Failure ; Humans ; Hydrops Fetalis ; Hypovolemia ; Mortality ; Oligohydramnios ; Placenta ; Polyhydramnios ; Pregnancy ; Tissue Donors

No abstract available.
Hodgkin Disease*

A generalized Shwartzman reaction(gSr) is characterized by vascular injury with microvascular fibrin deposition, leukocyte aggregation and hemorrhagic lesions in various organs and elicited by endotoxin from gram-negative bacteria. Leukocyte adherence to endothelial cells has been regarded as a pivotal event in this type of neutrophil mediated inflammatory response. Recently, it was described that leukocyte adhesion to endothelium is facilitated by the adhesion molecules, such as LFA-1(CDIIa/CD18) or Mac-1 (CDllb/CD18) binding to intercellular adhesion molecule-1(ICAM-1). To investigate the role of cell adhesion molecules in inflammatory vascular injury, the authors examined the expression of cell adhesion molecules, ICAM-1 and CD18, in gSr. Group A(n=5) received two injections of lipopolysaccharide(LPS) from E. coli 055:B5; 200 microgram/kg and 200 microgram/kg 24hours apart. Group B(n=5) received one dose of LPS(200 microgram/kg) after glucocorticoid treatment(methylprednisolone, 25mg/kg/day). Group C(n=5) received single dose of LPS(200 microgram/kg). The control group(n=3) received two injections saline instead of LPS. Animals were sacrificed four hours after the last dose of LPS or saline, The results were as follows: 1) Group A and B showed numerous fibrin micro-thrombi, inflammatory cell infiltration and some he-morrhagic change in kidney and lung, but group C and the control group did not show any lesions. In kidney the degree of fibrin deposition by IF was significantly increased in group A and B when compared to group C(p<0.05). 2) ICAM-1 was expressed by vascular endothelium including glomerular capillaries and some lymphocytes in the control group, This expression was increased in group C. But, group A and B was significantly decreased in ICAM-1 expression, especially in kidney comparing with group C and the control group(p<0.05). 3) Group A and B were significantly increased in CD18 expressing cells in glomerulus when compared with the control group(p<0.05). The number of CD18 expressing cells in glomerulus correlated significantly with a degree of fibrin deposition. In conclusion, these results suggest that the development of gSr requires the adhesion of activated inflammatory cells especially neutrophils to vascular endothelium and these are achieved by the interaction of adhesion molecules like ICAM-1 and CD18. Replacing the LPS with a glucocorticoid also expressing ICAM-1 on endothelium and prepares for leukocyte adhesion to endothelium.
Animals ; Capillaries ; Cell Adhesion Molecules ; Cortisone* ; Endothelial Cells ; Endothelium ; Endothelium, Vascular ; Fibrin ; Gram-Negative Bacteria ; Intercellular Adhesion Molecule-1 ; Kidney ; Leukocytes ; Lung ; Lymphocytes ; Neutrophils ; Shwartzman Phenomenon* ; Vascular System Injuries

PURPOSE: The universal vaccination against hepatitis B during early infancy is the only effective way to control hepatitis B infection in highly endemic areas in Korea. The purpose of this study was to assess the effectiveness of simultaneous hepatitis B vaccination with DPT and oral polio at 2, 4, 6 months of age in babies of HBs antigen negative mothers. METHODS: One hundred and eighty-one infants who were admitted to the Neonatal Intensive Care Unit (NICU), Chonnam University Hospital from August, 1994 to December, 1995 were enrolled in this study. Infants received Hepavax-B 0.5ml (10 microgram) at contralateral thigh intramuscularly, simultaneously with DPT vaccination. Antibody was assessed by MEIA (microparticle enzyme immunoassay) at seven to nine months of age. RESULTS: The seroconversion rate of Hepatitis B after vaccination was 98.3%. There were no significant differences in positive rate of antibody according to gestational age, birth weight and sex. Seroconversion rate to hepatitis B in twins was lower than in singlets. Twenty-two infants among 23 infants, who were able to assess antibody titer, showed effective antibody titer, above 100mIU/ml. CONCLUSION: The results suggest that the simultaneous administration of hepatitis B vaccine with DPT/TOPV is very effective and simplifies schedule. Moreover, this schedule will improve the compliance of vaccination.
Appointments and Schedules ; Birth Weight ; Compliance ; Gestational Age ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Jeollanam-do ; Korea ; Mothers ; Poliomyelitis* ; Thigh ; Twins ; Vaccination

Carcinoma showing thymus-like element (CASTLE) is a very rare malignant neoplasm in the lower portion of the thyroid gland or soft tissue of the neck. Recurrent laryngeal nerve (RLN) is the most frequent site of CASTLE. Non-RLN is also a rare anomaly. Both CASTLE and non-RLN are risk factors for vocal cord paralysis. In this report, the authors describe a 73-year-old patients diagnosed with CASTLE and non-RLN. During total thyroidectomy, one RLN was sacrificed inevitably because of tumor invasion, while the other non-RLN was successfully saved, which was expected based on preoperative computed tomography (CT). If the diagnosis is uncertain, CT should be checked to prevent unexpected risks.
Aged ; Diagnosis ; Humans ; Laryngeal Nerves* ; Neck ; Recurrent Laryngeal Nerve ; Risk Factors ; Thymus Gland ; Thyroid Gland ; Thyroidectomy ; Vocal Cord Paralysis

PURPOSE: Since pathophysiologic evidence has been raised to suggest that obesity could facilitate an allergic reaction, obesity has been known as an independent risk factor for allergic disease such as asthma. However, the relationship between sedentary behavior and lifestyle which could lead to obesity, and those allergic diseases remains unclear. MATERIALS AND METHODS: We analyzed the relations between physical activity, including sitting time for study, sitting time for leisure and sleep time, and obesity, asthma, allergic rhinitis, and atopic dermatitis using the Korea Youth Risk Behavior Web-based Survey, which was conducted in 2013. Total 53769 adolescent participants (12 through 18 years old) were analyzed using simple and multiple logistic regression analyses with complex sampling. RESULTS: Longer sitting time for study and short sitting time for leisure were associated with allergic rhinitis. High physical activity and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis. Underweight was negatively associated with atopic dermatitis, whereas overweight was positively correlated with allergic rhinitis and atopic dermatitis. CONCLUSION: High physical activity, and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis.
Adolescent* ; Asthma* ; Dermatitis, Atopic* ; Humans ; Hypersensitivity ; Korea ; Leisure Activities ; Life Style ; Logistic Models ; Motor Activity* ; Obesity* ; Overweight ; Rhinitis, Allergic* ; Risk Factors ; Risk-Taking ; Sedentary Lifestyle ; Thinness

PURPOSE: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. METHODS: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal(UGI) endoscopy to evaluate location and severity of caustic injury. RESULTS: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12months to 9.8 years). Twenty-seven(87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia(54.8%), vomiting(48.3%), chemical burn on lips and skin(45.2%), excessive salivation(45.2%), coughing and respiratory grunting(32.3%) and aspiration pneumonia(9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children : grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children(19.4%) and gastric outlet stricture in 1(3.2%). All of them showed grade II or III caustic injury on endoscopic examination. CONCLUSION: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.
Acetic Acid ; Burns, Chemical ; Child* ; Constriction, Pathologic ; Cough ; Diagnosis ; Eating ; Emergency Service, Hospital ; Endoscopy ; Esophageal Stenosis ; Esophagitis* ; Esophagus ; Female ; Humans ; Jeollanam-do ; Lip ; Male ; Medical Records ; Retrospective Studies ; Stomach