We present a series of 97 patients with spinal cord injury. Those patients were treated at Soonchunhyan University Chonan Hospital during six-year-period(January 1986-December 1992), and followed up for at least 3 months. They were divide into four groups ; complete-surgical, complete-conservative, partial-surgical, and partial-conservative. Male to female ratio was 3.6:1, and the peak age was the fifth decade. Passenger's traffic accident(46%) was the most common cause of injury and fall/slip(39%) followed next. Level of spinal injury was cervical in 51%, thoracic in 29%, lumbar in 13%, and others in 7%. Type of injury was fracture-dislocation in 31%, dislocation in 19%, compression fracture in 19%, burst fracture in 18%, cord injury without bony lesion in 7%, and others in 7%. Cord injury was complete in 36 patients(37%) and partial in 61 patients(63%). Surgery was performed in 20 patients with complete cord injury and 34 patients with partial injury. Majority of operations were performed for spinal stability, and posterior instrumentation was the most commonly used operative method. The mean neurotrauma motor index on admission was 44.1 in the complete-surgical group, 39.5 in complete-conservative group, 70.1 in partial-surgical group, and 63.2 in partial-conservative group. It improved to 52.5, 50.3, 90.4, 80.3 at 3 months, and 53.4, 51.7, 91.8, 82.0 at final examination(mean follow-up period was 182.2 days), respectively. The mean values of the final index were higher in the surgically treated groups than the conservatively treated groups, but these differences were not statistically significant(student t-test p>0.1) The mean recovery rate was 14.2% in the complete-surgical group, 17.7% in complete-conservative group, 66.1% in partial-surgical group, and 46.1% in partial-conservative group at 3 months. It improved to 16.6%, 19.3%, 70.0%, and 48.7% at final examination, respectively. The mean recovery rates were higher in the partially injured groups than the completely injured groups(student t-test, p<0.01), regardless the methods of treatment. The final neurotrauma motor index was significantly(regression analysis, p<0.01) related to the initial index except the partial-surgical group. Neurotrauma motor index was a useful method for assessing the injury severity, comparing the recovery rate and predicting prognosis.
Chungcheongnam-do ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Prognosis* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

BACKGROUND AND OBJECTIVES: There is a reported association between the increased levels of specific IgE and Staphylococcus aureus exotoxins (SE) and eosinophilic inflammation in nasal polyp tissue. However, the role of IgE to SE in allergic rhinitis has not been known definitely. We sought to find whether the specific IgE to SE has a correlation with the allergic rhinitis. SUBJECTS AND METHOD: Nasal mucosa and serum were obtained from 30 patients undergoing submucous turbinectomy of inferior turbinates for allergic rhinitis and 20 control patients undergoing septoplasty. Nasal culture was performed for each patient. Specific IgE levels for S. aureus exotoxin A (SEA), S. aureus exotoxin B (SEB), and toxic shock syndrome toxin 1 (TSST-1) were measured using ImmunoCAP method in both nasal mucosa and serum. RESULTS: The culture rate for S. aureus was 13.3% for allergic rhinitis and 10% for the control. The specific IgE for S. aureus in serum was significantly expressed in allergic rhinitis (30%) compared to in the control (10%). In nasal mucosa of allergic rhinitis patients, the specific IgE has shown higher expression rate (20%) than the control (0%). CONCLUSION: Our results demonstrated that there is a correlation between allergic rhinitis and specific IgE to S. aureus exotoxin in both nasal mucosa and serum. These results suggest that S. aureus exotoxin can act as a traditional allergen and induce the development of allergic rhinitis.
Eosinophils ; Exotoxins ; Humans ; Immunoglobulin E ; Inflammation ; Mucus ; Nasal Mucosa ; Nasal Polyps ; Rhinitis ; Rhinitis, Allergic, Perennial ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Statistics as Topic ; Turbinates

BACKGROUND AND OBJECTIVES: Staphylococcus aureus (S. aureus) exotoxins (SE) have been implicated in the pathogenesis of chronic sinusitis with nasal polyposis (CRSwNP). The aim of this study was to identify the contribution of S. aureus exotoxin as allergen in the development of nasal polyp. MATERIALS AND METHOD: Nasal polyp and serum were obtained from 30 patients who underwent endoscopic sinus surgery for CRSwNP and 10 control turbinate mucosae were used. Nasal culture was done for each patients. Specific IgE levels for S. aureus exotoxin A (SEA), S. aureus exotoxin B (SEB), and toxic shock syndrome toxin 1 (TSST-1) were measured using ImmunoCAP method in nasal tissue and serum. The patients were divided into three groups : A, nasal polyp (+)/culture (+) ; B, nasal polyp (+)/culture (-) ; C, nasal polyp (-)/culture (-). RESULTS: The culture for S. aureus was 27% in CRSwNP when compared to 10% in control. The specific IgE for S. aureus in serum was significantly expressed in nasal polyp (30%) compared to control (0%). Also the Group A showed a significant high rate of specific IgE (63%) compared to Group B (18%) and Group C (0%) in serum. In nasal polyp tissue, the specific IgE has showed no specific difference between nasal polyp (7%) and control (10%). However, it was also increased in Group A (25%), compared to Group B (0%) and Group C (11%). CONCLUSION: Our results demonstrated that there was a correlation between nasal polyp and specific IgE levels to S. aureus exotoxin. These results suggest that S. aureus exotoxin can act as a traditional allergen and induce the inflammatory reaction in CRSwNP. Background and Objectives : Staphylococcus aureus (S. aureus) exotoxins (SE) have been implicated in the pathogenesis of chronic sinusitis with nasal polyposis (CRSwNP). The aim of this study was to identify the contribution of S. aureus exotoxin as allergen in the development of nasal polyp.
Exotoxins* ; Humans ; Immunoglobulin E* ; Mucous Membrane ; Mucus* ; Nasal Polyps ; Shock, Septic ; Sinusitis ; Staphylococcus aureus* ; Staphylococcus* ; Statistics as Topic* ; Turbinates

BACKGROUND AND OBJECTIVES: The treatment of deep neck infection is antibiotic therapy followed by surgery when it is indicated. There is no detailed guideline for the treatment according to clinical feature or extension of infection. So the purpose of this study is to find out factors affecting the treatment of deep neck infection in the point of clinical feature, laboratorial study and CT finding. SUBJECTS AND METHOD: We have conducted a retrospective study of 67 patients that had been seen between January 2005 and July 2007. We divided patients into a non-surgical group and a surgical group, analyzed clinical informations and laboratorial tests between the two groups, and studied the relations between lesion size, degree of infection and treatment method. RESULTS: There were significant differences between the non-surgically treated and surgically treated groups. The latter group presented with older age, larger lesion, more numbers of involved spaces, highly elevated WBC counts, more decreased in protein counts and had longer treatment period prior to hospitalization than the former group. Also, the size of the affected lesion was bigger, the incidence of abscess formation higher and required surgical treatment more often. CONCLUSION: Surgical management has an advantage when the lesion size is more than 7 cm, even if it presents an incomplete abscess. If the laboratory study reveals highly sustained WBC counts after proper antibiotic therapy and low protein counts, more aggressive treatment should be considered, especially for old patients.
Abscess ; Hospitalization ; Humans ; Imidazoles ; Incidence ; Neck ; Nitro Compounds ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Asian sand dust (ASD) is known to aggravate the respiratory symptoms in patients with bronchial asthma. However, the effect of ASD in allergic rhinitis is not known. The objective of this study was to investigate whether ASD can activate the allergic inflammation in allergic mouse model. MATERIALS AND METHOD: Forty female BALB/c mice were divided into 4 groups. Group 1 was nebulized with saline and group 2 with ASD. Group 3 was nebulized with ovalbumin (OVA) only and Group 4 with OVA plus ASD after intraperitoneal injection with OVA. The allergic symptom scores were checked. The mouse OVA specific IgE/IgG1, IL-4, IL-5 and IFN-gamma were measured by ELISA. The nasal mucosa was examined for the expression of IL-4 and IL-5 by immunohistochemical stain. RESULTS: The average symptom score was increased in Group 4 compared to Group 3 (p< 0.05). The IgE was significantly increased in Group 4 compared to Group 3 (p< 0.01). The IL-4 level of nasal lavagefluid (NALF) was significantly increased in Group 4 compared to Group 3 (p< 0.05). The IL-5 level showed no significant difference between the Group 3 and Group 4 both in the serum and NALF. The level of IFN-gamma was not changed in NALF. Immunohistochemical staining showed that the positive cells for IL-4 were expressed in epithelial layer and submucous gland and the positive cells were more increased in Group 4 than in Group 3. CONCLUSION: In allergic mouse model, ASD has shown to activate the allergic inflammatory reaction by the stimuli of Th2 cytokineproduction.
Animals ; Asian Continental Ancestry Group ; Asthma ; Cytokines ; Dust ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E ; Inflammation ; Injections, Intraperitoneal ; Interleukin-4 ; Interleukin-5 ; Mice ; Nasal Mucosa ; Ovalbumin ; Ovum ; Rhinitis ; Rhinitis, Allergic, Perennial ; Silicon Dioxide

BACKGROUND AND OBJECTIVES: Biofilm is an encased colony of bacteria and the bacteria with-in the biofilm have resistance to antibiotics and the humoral immune system. Biofilm is currently thought to play an important role and to be very refractory to conventional therapeutics. The aim of this study is to analyze the relationship between the biofilm of the tonsil and recurrent tonsillitis with a case-control study. SUBJECTS AND METHOD: This is a case-control study. The case group included 31 patients who had histories of tonsillitis and the control group included 29 volunteers who had no history of tonsillitis. Confocal laser scanning microscopy was performed to identify biofilms. We compared the prevalence rates of biofilm between the 2 groups. Fluorescent in situ hybridization (FISH) was performed to identify bacteria, using probes for S. aureus, S. pyogenes, H. influenzae, S. pneumoniae, and K. pneumonia. RESULTS: In case group, biofilms were found in 22 (71.0%) of 31 and in control group, biofilms were found in 12 (41.4%) of 29. The prevalence rates of biofilm were significantly higher in case group (p=0.036). Twenty nine cases were enrolled in FISH and 12 cases of them were positive for FISH. S. aureus was most commonly identified. CONCLUSION: This study suggests that the biofilms could play a causative role in recurrent tonsillitis, further studies are needed to confirm pathogenic relation between biofilm and recurrent tonsillitis.
Anti-Bacterial Agents ; Bacteria ; Biofilms ; Case-Control Studies ; Humans ; Immune System ; In Situ Hybridization, Fluorescence ; Influenza, Human ; Microscopy, Confocal ; Palatine Tonsil ; Pneumonia ; Prevalence ; Tonsillitis

BACKGROUND AND OBJECTIVES: Obliterative otitis media is a condition in which the entire middle ear cavity is filled up with fibrous tissue and with intact tympanic membrane. The aim of this study was to define the clinical features and analyze the treatment outcomes of this disease. SUBJECTS AND METHOD: Between January 2000 and August 2011, 16 patients consistent with the criteria of obliterative otitis media were analyzed retrospectively. RESULTS: All patients had intact but thickened eardrum, with mixed hearing loss of mild to moderate degree. The video pneumatic otoscopic examination revealed very limited mobility of eardrum. Myringotomy did not reveal any air-filled spaces or fluid in the tympanic cavity. There was no significant improvement of hearing after myringotomy or ventilation tube insertion. CONCLUSION: Obliterative otitis media is a discrete clinical entity and should not be confused with otitis media with effusion or adhesive otitis media.
Adhesives ; Ear, Middle ; Eustachian Tube ; Hearing ; Hearing Loss ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Otitis ; Otitis Media ; Otitis Media with Effusion ; Tympanic Membrane ; Ventilation

BACKGROUND/AIMS: The recent introduction of computerized surveillance systems has promoted the monitoring of adverse drug reactions (ADRs), a feature that facilitates voluntary reports and enables prompt feedback. To investigate the causative agents and severity of ADRs that occurred in a single hospital, we analyzed the features of 980 ADRs that occurred over 14 months after developing a computerized ADR reporting system in Hallym Sacred Heart Hospital. METHODS: ADR data collected prospectively from September 2007 to October 2008 by a computerized reporting system were analyzed. The World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria were used to determinate causality for each ADR. RESULTS: The number of ADR cases reported voluntarily increased rapidly since the introduction of the computerized ADR reporting system. Of the 980 cases, antibiotics (34.5%) were the most common causative drugs, followed by analgesics such as tramadol and its compound (15.2%), radiocontrast media (7.0%), narcotics (5.9%), and nonsteroidal anti-inflammatory drugs (NSAIDs) (5.5%). Fifty-nine (6.0%) and 206 (21.0%) cases were classified as severe and moderate reactions, respectively. The mean age was older in patients with severe ADRs than in patients with non-severe ADRs. The most common clinical features were skin manifestations, such as pruritus, skin eruptions, and urticaria. Gastrointestinal symptoms including nausea, vomiting, and diarrhea were the second most frequently reported ADRs. Among antibiotics, first-generation cephalosporins were the most frequently reported causative drugs, followed by second-generation cephalosporins, penicillin/beta-lactamase inhibitors, and third-generation cephalosporins. While 11.6% of ADRs related to penicillin/beta-lactamase inhibitors were classified as severe, there was only one severe ADR (1.1%) for first-generation cephalosporins. Most ADRs were reported equally in men and women, although female cases constituted about two thirds of ADRs associated with tramadol and NSAIDs. CONCLUSIONS: We believe that a computerized reporting and replying system promoted the monitoring of ADRs. Antibiotics were reported most frequently as the causative agent of ADRs. Elderly patients seemed to be more susceptible to severe ADRs. With the voluntary reporting system, skin manifestations and gastrointestinal symptoms were detected successfully, while laboratory abnormalities without prominent symptoms seemed to be overlooked. Further efforts to screen for automated ADR signals are required.
Aged ; Analgesics ; Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Cephalosporins ; Contrast Media ; Diarrhea ; Drug Toxicity ; Electronics ; Electrons ; Female ; Heart ; Humans ; Male ; Narcotics ; Nausea ; Prospective Studies ; Pruritus ; Skin ; Skin Manifestations ; Tramadol ; Urticaria ; Vomiting ; World Health ; World Health Organization