Adenoid is a kind of tonsil located in the posterior wall of nasopharynx. Enlargement of the adenoid can produce obstruction of the nasopharynx and Eustachian tube. Disturbance in discharge of nasal and paranasal secretions can be a cause of chronic rhinitis, sinusitis, and otitis media. Diagnosis of enlarged adenoid simply by inspection is difficult due to its location. Measurement of nasopharyngeal airway and adenoid using lateral radiographs of nasopharynx may be inaccurate for magnification and rotation. It was some limitations in demonstrating the actual state of nasopharyngeal airway and adenoid because it gives only two-dimensional informations. The authors measured the sizes and areas of nasopharyngeal airway and adenoid using MRI with sagittal and oblique coronal pilot views of T1 weighted spin echo. We categorized the patients into 4 groups according to the scoring system by symptoms such as apnea, mouth breathing, and snoring. The results of several measurements and their ratios were evaluated in these 4 categorized patients. The ratios of area of adenoid and nasopharyngeal airway(AA/Na) in each patient group were 6.52, 7.76, 10.53, 15.93, respectively. And the ratios of adenoid and nasopharyngeal airway (A/N) by Fujioka's method were 0.6, 0.65, 0.69, 0.71, respectively. We found that AA/Na might be the most effective index as an objective indicator in the evaluation of nasopharyngeal obstruction by the enlarged adenoid.
Adenoids* ; Apnea ; Diagnosis ; Eustachian Tube ; Humans ; Magnetic Resonance Imaging* ; Methods ; Mouth Breathing ; Nasopharynx ; Otitis Media ; Palatine Tonsil ; Rhinitis ; Sinusitis ; Snoring

Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scarf, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy ai a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.
Abdomen ; Barium ; Biopsy ; Breast ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Signet Ring Cell* ; Cisplatin ; Colon ; Diagnosis ; Drug Therapy, Combination ; Enema ; Etoposide ; Gallbladder ; Humans ; Lung Neoplasms ; Lung* ; Pancreas ; Prostate ; Radiotherapy ; Rectum ; Stomach ; Ureter ; Urinary Bladder

The cesarean section has been considered as one of the most prime and most commonly performed operations in the obstetrics and gynecology field. In fact, all cesarean sections have depended upon the operator`s experience. However, there have been several cases reported on new technique of cesarean section in many developed countries, but not in Korea until we started the recent research. We have developed a new type of cesarean section named FAST(Finger Assisted Stretching Technique) through study on strength/weakness of other operation techniques as well as many other researches we conducted in the past plus our own experiences. To find the differences on the following subjects; operating time, postoperative complication, and recovery period. We compared and analyzed data from using new and traditional techniques. We selected 120 patients(group A using FAST: 45 patients, group B using traditional technique: 75 patients) as samples for this study. Together, they were all conducted cesarean section at Korea University, Guro Hospital between May 1993 and December 1995. Student-t-test and chi-square test were used for statistical analysis. We consider that below 0.05 for P value is statistically significant. The results of comparative study between two groups are; 1. There was no comparative difference on average age: group A: 29.6(range 23~39, S/D 7.1) group B: 31.1(range 24~38, S/D 5.4) 2. There was a significant difference on average operation times: group A: 15.4 min.(range 11~19, S/D 3.6) group B: 41.3 min.(range 23~50, S/D 19) 3. There was a significant difference on average amount of bleeding: group A: 580 ml(range 450~750, S/D 101) group B: 916 ml(range 800~1000, S/D 99) 4. There was a significant difference on the value of hemoglobin before and after operation group A: 0.8 g/dl(range 0.4~1.6, S/D 0.25) group B: 1.9 g/dl(range 0.9~2.6, S/D 0.21) 5. There was a significant difference on average period of hospitalization: group A: 3.7 days(range 3~4, S/D 0.7) group B: 6.4 days(range 5~8, S/D 0.6) 6. No one from group A experienced any infection, but 3 cases of wound infection and 2 cases of voiding difficulty were reported from group B. 7. 11 cases from group A and 16 cases from group B had laparotomy for some other reasons, later. There was no adhesion found in group A, but adhesions found in 2 cases from group B.
Cesarean Section* ; Developed Countries ; Female ; Fingers* ; Gynecology ; Hemorrhage ; Hospitalization ; Humans ; Korea ; Laparotomy ; Obstetrics ; Postoperative Complications ; Pregnancy ; Wound Infection

Purpose: The declining recruitment rate of pediatric residents in Korea has led to a decrease in the number of emergency departments (EDs) offering a 24/7 pediatric emergency care (PEC). This study evaluated the impact of reduced PEC hours on the utilization patterns of a single ED. Methods: We reviewed medical records of pediatric patients who were defined as individuals aged 14 years or younger undergoing pediatricians’ practices in a tertiary hospital ED in Korea. Given the reduction of PEC hours from full-time to 08:00-24:00 on September 27, 2022, the patients were grouped as those who visited during March 27, 2022-September 26, 2022 (“control”), and those who visited during September 27, 2022-March 26, 2023 (“reduction”). The following variables were analyzed between the 2 periods: the number of patients, age, sex, visits via ambulances, severity by the Korean Triage and Acuity Scale with high acuity (a level 1-2 of the scale), disease-related visits, time of visit, ED length of stay (EDLOS), disposition, chief complaints, and diagnoses. Results: Among 3,577 pediatric patients, 1,315 visited the ED during the reduction period, down by 41.9% in numbers from the control period. From the control to reduction periods, we observed an increase in the median age (from 3.0 years [interquartile range, 1.0-7.0] to 4.0 years [1.0-8.0]; P = 0.005) and decreases in the median EDLOS (from 140.0 minutes [80.0-217.0] to 104.0 minutes [54.0-169.8]; P < 0.001) and proportion of hospitalization (from 22.1% to 12.6%; P < 0.001). No change was observed in the proportions of highacuity cases or chief complaints. We noted decreases in infection-related diagnoses during the reduction. Conclusion Reducing PEC hours was associated with shorter EDLOS, fewer hospitalizations, and older age, with no difference in the severity. Even with reduced PEC hours, relevant resources should be redistributed to ensure the accessibility to PEC.

A liposarcoma is the most common soft tissue sarcoma in adults with an incidence of about 20% of all soft tissue sarcomas. Although incidence differs from a region of origination, a case arisen from mesentery has rarely been reported. We experienced a case of liposarcoma arising from the mesentery of a 51-year-old male patient. He was treated by wide excision. Histologically, the tumor was composed of a mixed well-differentiated liposarcoma with myxoid and spindle cell type.
Diagnosis, Differential ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Liposarcoma/*diagnosis/pathology/surgery ; Magnetic Resonance Imaging ; Male ; Mesentery/*pathology ; Middle Aged ; Tomography, X-Ray Computed

Operative laparoscopy has begun to replace laparotomy for women with various pelvic diseases. The advantages of laparoscopy include less pain, reduced postoperative complications, small scars, shorter hospital stay, reduced recovery time and low cost. However, the study about operative laparoscopy during pregnancy are still rare in Korea. We experienced two cases of laparoscopy during early pregnancy. Two pregnant women with an adnexal mass underwent laparoscopic operations under general anesthesia. One patient underwent laparoscopic salpingo-oophorectomy due to ovarian cyst at 14weeks of gestation, and the other patient did laparoscopic cystectomy at 12weeks of gestation. There was no specific anesthetic problem during operation, patients had uneventful pregnancy.
Anesthesia, General* ; Cicatrix ; Cystectomy* ; Female ; Humans ; Korea ; Laparoscopy ; Laparotomy ; Length of Stay ; Ovarian Cysts ; Postoperative Complications ; Pregnancy* ; Pregnant Women

Perinatal transmission and infection of hepatitis B virus (HBV) in early childhood were observed in the offsprings of hepatitis B surface antigen (HBsAg)-positive mothers who had been vaccinated against HBV immediately after giving birth. This prophylaxis failure of perinatal HBV infection is likely due to the interplay of the virus and host immune response. To investigate whether the HLA polymorphism affected the outcome of the perinatal prophylaxis, HLA class I (HLA-A, B and Cw) and class II (HLA-DRB1, DQA1, DQB1 and DPB1) were typed using serology, PCR-SSOP (polymerase chain reaction-sequence specific oligonucleotide probe), and PCR-ARMS (amplification refractory modification system) methods in 22 HBeAg-positive mothers and their 10 prophylaxis-succeeded and 12 prophylaxis- failed children. The HLA types of the mothers and their children were compared with 198 HBsAg-negative healthy controls in a Korean population. HLA-B35 (relative risk=4.2, p<0.01), B51 (relative risk=3.2, p<0.02), DRB1*07 (relative risk=3.8, p<0.03), and DQA1*02 (relative risk=3.8, p<0.03) alleles were more frequent in HBeAg-positive mothers than in the controls. Also, HLA-DRB1*13 (relative risk=0.1, p<0.02) and DPB1*0401 (relative risk=0.1, p<0.02) alleles were less frequent in HBeAg-positive mothers. However, HLA alleles did not affect the outcome of the perinatal prophylaxis against HBV. These results suggest that the reported influences of some HLA alleles on the natural chronic HBV infections may not operate in the HBV infections in children received perinatal prophylaxis.
Alleles* ; Child ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; HLA-B35 Antigen ; Humans ; Mothers ; Parturition

Insular carcinoma of the thyroid is a rare thyroid malignancy, and this was named in 1984 by Carcangiu when he described its characteristic histology. Histologically, insular carcinoma is characterized by uniform cells arranged in distinct nests or an insular pattern that contain variable numbers of small follicles. Clinically and morphologically, it is considered to be in an intermediate position between well-differentiated carcinoma of the thyroid (papillary or follicular) and undifferentiated or anaplastic carcinoma of the thyroid. This thyroid malignancy is distinctive, aggressive and often lethal. However, most authors believe it to be an independent entity. The prognosis of this tumor is worse than that of classic differentiated thyroid carcinoma, and most authors advise aggressive therapy, which can achieve pro-longed survival in some cases. We describe here a patient (a 42 years-old woman) who was managed with completion thyroidectomy after unilateral lobectomy of the thyroid with confirmation of the permanent pathology as insular carcinoma. I-131 ablation (175 mCi) was performed on the remnant thyroid tissues after follow-up of I~131 whole-body scanning.
Carcinoma ; Follow-Up Studies ; Humans ; Pathology ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: Anomalies in the thyroglossal duct are the most common midline, or paramedian cervical lesions of congenital origin. Presenting as a thyroglossal duct cyst (TGDC) or a thyroglossal duct sinus (TGDS), they are found in all age groups. This clinical study was intended to elucidate the clinical characteristics, and the outcomes, of surgical treatment of these anomalies. METHODS: Between January 1992 and May 2002, 91 patients underwent surgery for a TGDC or a TGDS at 4 hospitals affiliated to Hallym University. The demographics of the patients, the clinical characteristics of the lesions, and the outcomes of the treatments were retrospectively evaluated. These characteristics were evaluated according to age groups; younger than 15 (38 patients) and older than 15 (53 patients) years. RESULTS: The male to female ratio was 1.67: 1 (It is better to give the actual figures.), with the first decade showing the highest incidence in the age distribution (33%). Painless masses (83.6%) were the most common presenting symptom, with most symptoms having been manifest for less than 1 year (67%). TGDCs were 90% and TGDSs were 10%. There were 62 cases of infrahyoid and 18 of suprahyoid lesions, with 80 cases on the midline and 11 on the paramedian within 2 cm from the midline. Of the paramedian lesions, 2 cases were in the younger group and 9 were in the older group. This tendency of laterality in the location by age group showed no statistical significance (p=0.172). All the patients underwent a Sistrunk operation, and one experienced a recurrence. CONCLUSION: This study justified the Sistrunk operation as the treatment of choice for anomalies of the thyroglossal duct. The lateral lesions occurred in the old age groups more frequently. A careful approach is needed with paramedian cervial lesions in adults to avoid the loss of the proper treatment of possible hidden congenital lesions.
Adult ; Age Distribution ; Demography ; Female ; Humans ; Incidence ; Male ; Recurrence ; Retrospective Studies ; Thyroglossal Cyst*

PURPOSE: Severe burn patients are easily exposed to infection due to immune compromise and loss of skin barrier. But in spite of advances in burn treatment, complication due to infection has significant influence in mortality and morbidity. Broad spectrum antibiotics are used empirically to reduce bacterial infection in severe burn patients but results in suppression of normal flora and mucosal damage in intestine which facilitates fungal growth. We investigated the incidence, frequent onset time, characteristics of patients with candidemia and found appropriate time for use of antifungal agents and treatment of infection. METHODS: We reviewed the medical records of patients who were admitted to Hangang sacred heart hospital burn ICU between January 2007 and December 2008. RESULTS: In 2007 395 patients were admitted to BICU and 66 patients (16.7%) had fungal infection. In 2008 331 patients were admitted to BICU and 77 patients (23.3%) had fungal infection. Fungus was isolated in blood culture in 22 patients (5.6%) and 7 patients (2.1%) in 2007 and 2008 respectively. 20 patients out of 28 patients with candidemia received ventilator care (p=0.037), mean stay in ICU was 52.2 days in patients with positive blood culture compared with 36.5 days in patients with negative blood culture (p=0.049). Mortality in candidemia patients was 42.9% (p=0.022) which was high. CONCLUSION: Candidemia frequently occurs in patients receiving ventilator care, and as stay in ICU lengthens financial burden increases and results in higher mortality and morbidity. Lowering morbidity through strict infection control and monitoring is needed.
Anti-Bacterial Agents ; Antifungal Agents ; Bacterial Infections ; Burns ; Candida ; Candidemia ; Fungi ; Heart ; Humans ; Incidence ; Infection Control ; Intestines ; Medical Records ; Skin ; Ventilators, Mechanical