Kimura's disease is a chronic inflammatory disease which commonly affects the head and neck regions in young oriental men. It is a rare disease and is found as tumor-like painless swelling with or without lymphadenopathy. However, it's treatment method is not clearly defined. The purpose of this article is to report a very unusual case which is often mistaken for a malignant tumor. A 15-year old male was seen with diffuse epiglottic swelling and cervical lymphadenopathy. CT and MRI showed diffusely enlarged epiglottis with homogenous ensity and bilateral multiple lymphadenopathy in internal jugular and spinal accessory chains. Biopsy of epiglottic mass was performed under the impression of malignant lymphoma. The histology revealed marked lymphoid follicular hyperplasia and massive interfollicular eosinophilic cell infiltration, which was compatible with Kimura's disease. The mass was partially excised especially in laryngeal surface area because the mass was not separated from epiglottis itself. After surgical removal, oral prednisolone was taken. The epiglottis was nearly returned to its normal figure after subsequent excision and vaporization with CO2 laser and neck nodes enlargements were spontaneously resolved. The etiology of this disease is still unknown. It is essential to differentiate it with malignant tumor through biopsy. When Kimura's disease is confirmed, combination of surgical excision and oral steroid appear to be effective therapeutic modality.
Adolescent ; Biopsy ; Eosinophils ; Epiglottis* ; Head ; Humans ; Hyperplasia ; Lasers, Gas ; Lymphatic Diseases ; Lymphoma ; Magnetic Resonance Imaging ; Male ; Neck ; Prednisolone ; Rare Diseases ; Volatilization

Exposure to intense noise has been identified as a potential risk in the development of hearing impairment. Social concern about excessive noise is increasing and this also extends to the operating room. A noise level study was performed in the operating room during mastoidectomy with a sound level meter and it was analyzed by a sound-analyzing program. The drilling instruments used included the Stryker, Midas, M.P.S. and Med-Next. The operator was exposed to sound levels from 69 to 83 dBA. The loudest drilling instrument was the Midas and it produced an average sound level of 83 dBA to the operator. The mean exposure time was 41 minutes during mastoidectomy. This is below the occupational noise-level regulations in Korea. However, considering that individual susceptibility to noise varies and that the otologic surgeon is repeatedly exposed to prolonged drilling noise, ear protection is recommended for the operators of high-speed drilling instruments.
Chronic Disease ; Human ; Mastoid/surgery* ; Noise*/adverse effects ; Otitis Media/surgery ; Otolaryngology/instrumentation*

PURPOSE: Fetal echocardiography is used for the prenatal diagnosis of congenital heart disease. Fetal echocardiography allows decisions to be made in advance where the fetal abnormality is not compatible with life after delivery or where early correction is required. Our fetal echocardiographic experience was analysed retrospectively to guide future clinical application. METHODS: 138 mothers had fetal echocardiography from April 1992 to December 1995. Their echo findings were recorded on VHS video tape. We followed up the infant after delivery. Data was collected from obstetric outpatient records and admission records, pediatric admission records and outpaitent records. RESULTS: 1)138 mothers had fetal echocardiography. Serious heart disease was found in 9 cases with a detection rate of 6.4%. Average age of the mother was 28.9+/-4.2 years (range 17-44 years). Average gestational period was 24.0+/-5.1 weeks(range 10-36 weeks). 2)Indications for fetal echocardiography were as follows; maternal factors 77 cases, including 34 cases of alpha fetoprotein abnormality. fetal factor 32 cases including 18 cases of arrhythmia, genetic factors 29 cases, including 26 cases of family history of congenital heart disease. 3)Serious cardiac anomalies were 5 cases. Serious arrhythmia were present in 4 cases(Total 9 cases with detection rate of 6.5%). Mild arrhythmia was detected in 7 cases(5.1 %). 4)The serious cardiac anomalies were mitral hypoplasia, right atrial tumor, AVSD, TOF and VSD. 5)The Serious arrhythmia were complete atrioventricular block 1 case, second degree atrioventricular block 1 case, transient cardiac arrest 1 case and atrial flutter 1 case. 6)The Mild arrhythmia were premature atrial contraction 4 cases and premature ventricular contraction 3 cases. 7)The non-cardiac anomalies were one case of hydrocephalus, cerebral arteriovenous fistula, diaphragmatic hernia, agenesis of right kidney, sacrococcygeal teratoma, fetal ascites and 4p-syndrome. There were 2 cases of spontaneous abortion without definite anomaly. During the study period, there were 8 terminations of pregnancy including 3 cases of spontaneous abortion. 8) 105 infants were followed up after birth. 25 cases were missing. CONCLUSIONS: Most of the congenital heart disease confirmed by fetal echocardiography was predicted by antenatal ultrasound. Most of the fetal echocardiography was performed to confirm the congenital heart diseas when any of the fetal abnoramlities were found. In some of the treatable heart disease, especially like fetal arrhythmia, maternal adminstration of adequate medication make a good treatment results.
Abortion, Spontaneous ; alpha-Fetoproteins ; Arrhythmias, Cardiac ; Arteriovenous Fistula ; Ascites ; Atrial Flutter ; Atrial Premature Complexes ; Atrioventricular Block ; Diagnosis* ; Echocardiography ; Female ; Fetus ; Heart ; Heart Arrest ; Heart Defects, Congenital ; Heart Diseases ; Hernia, Diaphragmatic ; Humans ; Hydrocephalus ; Infant ; Kidney ; Mothers ; Outpatients ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies ; Teratoma ; Ultrasonography ; Ventricular Premature Complexes

Sjogren's syndrome is a chronic autoimmune disorder causing dry eye or dry mouth from the lymphocytic infiltration in the lacrimal gland and the salivary gland. Renal involvement is seen in about 20-40% of patients with primary Sjogren's syndrome. Tubulointerstitial nephritis is the most common renal complication in primary Sjogren's syndrome. However, glomerulonephritis such as membranoproliferative glomerulonephritis, membranous glomerulonephritis rarely may complicate primary Sjogren's syndrome. Sjogren's syndrome associated with glomerulonephritis hasn't been reproted yet in Korea. We report nephrotic syndrome associated with membranous glomerulonephritis in a case with primary Sjogren's syndrome. Nephrotic syndrome resolved after treatment with corticosteroid.
Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous* ; Humans ; Korea ; Lacrimal Apparatus ; Mouth ; Nephritis, Interstitial ; Nephrotic Syndrome ; Salivary Glands ; Sjogren's Syndrome*