Laryngomalacia is repoted as the most common cause of congenital stridor. The majority of cases have mild symptom and do not require surgical intervention. However, in approximately 10 per cent of these infants the condition is life-threatening. The standard treatment for these patients has been to perform a tracheostomy. Recent reports have shown encouraging results following endoscopic surgery to the supraglottic structures. We report a case of patient in whom a tracheostomy was avoided by performing an CO2 laser microsurgeries on supraglottis.
Humans ; Infant ; Laryngomalacia* ; Lasers, Gas ; Microsurgery ; Respiratory Sounds ; Tracheostomy

Adrenoleukodystrophy is an inborn error of metabolism characterized by adrenal insufficiency and progressive demyelmation of brain white matter and peripheral nerves. Authors experienced three cases of adrenoleukodystrophy in a 7 year old boy, a 17 and a 210 year old males that were diagnosed by increased plasma content of very long chain fatty acid(VLCFA). The clinical symptoms include seizure, visual impairment, and hemiparesis. Two cases showed typical radiological findings and sural nerve biopsy was performed in one.
Adrenal Insufficiency ; Adrenoleukodystrophy* ; Biopsy ; Brain ; Child ; Humans ; Male ; Metabolism ; Paresis ; Peripheral Nerves ; Plasma ; Seizures ; Sural Nerve

No abstract available.
Biopsy, Fine-Needle* ; Thyroid Gland* ; Thyroid Nodule*

BACKGROUND AND OBJECTIVES: Transient evoked otoacoustic emissions (TEOAEs) have been used as a screening test for early detection of hearing loss in newborns and infants, because most of the normal hearing show TEOAEs. But the lack of understanding about the properties of spontaneous otoacoustic emissions (SOAEs) has limited their usefulness on the clinical basis. This study was designed with the purpose to find out the properties of SOAEs and their correlation with TEOAEs. MATERIALS AND METHODS: TEOAE and SOAE tests were performed in 95 neonates (190 ears, male:female=47:48) of well baby clinic in DKUH. RESULTS: 1) The prevalence of SOAEs were 86.8% (165/190 ears):87.2% (82/94 ears) in male and 86.5% (83/96 ears) in female, 91% (86/95 ears) in the right ears and 83% (75/95 ears) in the left ears. 2) The number of peaks in SOAEs was 4.14+/-1.92 overally, 4.38+/-2.01 in right ears, 3.87+/-1.79 in left ears, and 4.34+/-1.95 in males and 3.94+/-1.88 in females. There was a significant difference between the right and the left ears. 3) The level of SOAEs was -18.4 to 22.6 dB SPL. The highest amplitude of SOAEs in each subject was 3.69+/-8.87 dB SPL. 4) The SOAE frequency was mainly between 1000 Hz and 4000 Hz, and most frequently between 3000 Hz and 4000 Hz. The mean frequency of the highest amplitude of SOAE was 2907+/-1092 Hz. 5) The highest amplitude of SOAE was correlated with the overall response amplitude of TEOAE (r=0.619, p<0.01), but not the number of peaks (r=0.086, p=0.272). CONCLUSION: Neonates have robust SOAEs, which correlated with their TEOAEs.
Ear ; Female ; Hearing ; Hearing Loss ; Humans ; Infant ; Infant, Newborn* ; Male ; Mass Screening ; Otoacoustic Emissions, Spontaneous ; Prevalence

BACKGROUND AND OBJECTIVES: The objective of this study is to investigate the incidence and clinical implication of osteitis in patients with chronic paranasal sinusitis. MATERIALS AND METHODS: Forty three patients diagnosed as chronic paranasal sinusitis were examined with 99mTc-MDP bone SPECT preoperatively and underwent endoscopic operation, and 6 volunteers were recruited and examined as a control group. Each SPECT image was semiquantitatively assigned one of three grades of 0, 1, 2 according to intensities of isotope uptake. Quantitative analysis of the uptake of the isotope was performed by computer. The incidence of osteitis was analyzed. The correlation between semiquantitative grades and quantitative uptake indices was evaluated, and degree of isotope uptake and the severity of mucosal pathology on CT was correlated. The degree of isotope uptake between the patients who had recurrence and had not was compared. RESULTS: Quantitative evaluation of uptake indices were significantly higher in the patient group than in the control group. Marked uptakes of isotope on the sinus areas, suggesting the presence of osteitis, were shown in the patient group by 53.5%. The semiquantitative grades and quantitative indices showed positive correlation, and SPECT and CT scan findings also showed significant correlation. The uptake indices of patients who had recurrence were significantly higher than those of patients who showed no recurrence in both ethmoid sinus areas. CONCLUSIONS: The results of this study showed that significant proportion of patients with chronic paranasal sinusitis have osteitis, and patients with more severe osteitis represent poorer postoperative courses.
Ethmoid Sinus ; Evaluation Studies as Topic ; Humans ; Incidence ; Osteitis* ; Pathology ; Recurrence ; Sinusitis* ; Technetium Tc 99m Medronate* ; Tomography, Emission-Computed, Single-Photon* ; Tomography, X-Ray Computed ; Volunteers

Hypertrophic cardiomyopathy(HCM) is defined as a thickened wall of heart muscles and non-dilated left ventricle, but is not accompanied underlying cardiac or systemic diseases that induce ventricular hypertrophy. HCM is responsible to exercise limitation for all ages and also is known as the most common cause of heart-related sudden death during childhood and adolescents. Epidemiological studies showed that prevalence in young adults is 0.2% and HCM is caused by a mutations in genes that code the proteins of cardiac muscles. HCM with Wolff-Parkinson-White Syndrome is extremely rare and associated with a high risk of tachyarrhythmia and sudden death. We report an infantile HCM with WPW syndrome who died suddenly.
Adolescent ; Cardiomyopathy, Hypertrophic* ; Death, Sudden ; Death, Sudden, Cardiac ; Heart Ventricles ; Humans ; Hydrocephalus ; Hypertrophy ; Myocardium ; Prevalence ; Tachycardia ; Wolff-Parkinson-White Syndrome* ; Young Adult

BACKGROUND AND OBJECTIVES: Noise-induced hearing loss (NIHL) is associated with the damage in outer hair cell (OHC). Otoacoustic emmision (OAE) is sensitive to the detection of damage in OHC. We intended to evaluate the usefulness of transient evoked OAE (TEOAE) and distortion product OAE (DPOAE) on early detection and monitoring of NIHL in guinea pigs. MATERIALS AND METHODS: Ten healthy guinea pigs were exposed to 90+/-3 dBA white noise 8 hours daily for 9 days. Daily measurements of auditory brainstem response (ABR), TEOAE and DPOAE were performed before the noise exposure and daily after the noise exposure. RESULTS: ABR threshold became poorer gradually until the 8th day of post noise exposure, and some recovery on the 9th day. Wave reproducibility on TEOAE demonstrated an abrupt decrement on the 6th post-exposure day, and a tendency of recovery from the 7th day. While the echo amplitudes in f2=2002 Hz and f2=4004 Hz showed similar pattern of change with ABR threshold, the echo amplitude of f2=6348 Hz showed marked decrease on the 5th day compared to two other frequencies (f2=2002 Hz, 4004 Hz). CONCLUSION: The results of this study suggest that wave reproducibility in TEOAE and echo amplitude in high frequency in DPOAE may have applicability for early detection and monitoring of NIHL.
Animals ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs* ; Guinea* ; Hair ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Hearing* ; Noise*

Objective: Biliary decompression through bile drainage is a key treatment for common bile duct obstruction with cholangitis. However, the effectiveness of early interventions has not been studied sufficiently in Korea. This study investigated the effectiveness of fast-track biliary decompression. Methods: A group of patients diagnosed with common bile duct obstruction with cholangitis between January 1, 2014, and December 31, 2019, was reviewed retrospectively. We divided them into two groups: before and after the implementation of fast-track biliary decompression. The following items were analyzed in the two groups: time to intervention, number of hospital days, length of stay in the emergency department, and intensive care unit (ICU) admission. Results: Between January 1, 2014, and December 31, 2019, 418 patients were admitted for common bile duct obstruction, and a total of 369 patients were included in this study. Of these, 168 patients visited the hospital prior to implementation of the treatment, and 201 patients visited after implementation. The time to intervention was 6.1 (4.2-11.0) hours in the fast-track group, which was about 9 hours shorter than the other group (P<0.001). There was no statistical difference in the number of hospital days, emergency department length of stay, and ICU admissions (P=0.535, P=0.034, P=0.322). Conclusion The time to intervention was shortened significantly in the fast-track group. However, we did not observe a significant improvement in patient prognosis. It may be possible that the procedure time may need to be shortened for a better prognosis. This should be investigated in future studies.

Background: Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines. Methods: We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed. Results: A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%). Conclusion Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA.

Background: Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines. Methods: We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed. Results: A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5–25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9–26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), Pneumocystis jerovecii pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%). Conclusion Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA.