Parathyroid adenoma usually manifests with symptoms related to hypercalcemia, such as urinary stone and bone fracture. It may also present with asymptomatic hypercalcemia. However, spontaneous cervical hematoma may occur very rarely as a result of extracapsular hemorrhage of a cervical parathyroid adenoma causing acute painful cervical swelling, bruising, dyspnea, hoarseness and dysphagia. We report a 44-year-old woman who manifested as a spontaneous cervical hematoma without any clinical evidence of hyperparathyroidism.
Acute Pain ; Adult ; Deglutition Disorders ; Dyspnea ; Female ; Fractures, Bone ; Hematoma ; Hemorrhage ; Hoarseness ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Neck ; Parathyroid Neoplasms ; Urinary Calculi

Diamino-diphenyl-sulfone (Dapsone) is widely used in the treatment of leprosy and a variety of blistering skin diseases. It sometimes has adverse side effects with common usual doses, such as skin, nervous system, gastrointestinal tract, liver, kidney and hematologic toxicity. One of these side effects is a rare but serious hypersensitivity reaction called dapsone syndrome, which occurs several weeks after the initial administration of the drug and results in unpredictable, sometimes fatal outcomes. This report deals with a 13-year-old girl's case with typical features of dapsone syndrome that included fever, exfoliative dermatitis, jaundice, hemolytic anemia and pleural effusion after being treated with dapsone for four weeks.
Adolescent ; Anemia ; Anemia, Hemolytic ; Blister ; Dapsone* ; Dermatitis, Exfoliative ; Fatal Outcome ; Fever ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Jaundice ; Kidney ; Leprosy ; Liver ; Nervous System ; Pleural Effusion ; Skin ; Skin Diseases

Myoepithelial carcinoma is a very rare malignant tumor accounting for less than one percent of the salivary gland neoplasms. This uncommom tumor, showing almost exclusively tumor cells with myoepithelial differentiation, is most commonly diagnosed in the parotid gland and in the minor silivary glands of the palate. We report a 77-year-old woman with myoepithelial carcinoma originating from maxillary sinus, one of the most unusual locations. The patient presented with progressive nasal obstruction and signs of a space-occupying lesion in the left maxillary sinus. A frozen biopsy identified a malignant tumor and a radical maxillectomy was performed. Histology confirmed the presence of a malignant myoepithelial carcinoma. Patient was followed up for one year without any recurrence or distant metastasis.
Accounting ; Aged ; Biopsy ; Female ; Humans ; Maxillary Sinus ; Myoepithelioma ; Nasal Obstruction ; Neoplasm Metastasis ; Palate ; Parotid Gland ; Recurrence ; Salivary Gland Neoplasms

Vascular tinnitus, a sort of pulsatile tinnitus, should be differentiated with other sensorineural tinnitus because it is possible to be cured by correction of underlying systemic disease or surgery. The dehiscent high jugular bulb, a common cause of venous pulsatile tinnitus, can be cured by reconstruction of hypotympanum. We present a case of pulsatile tinnitus with dehiscent high jugular bulb which has been treated by surgery. Preoperative microscopic finding showed dark bluish pulsating mass in posteroinferior portion of tympanic membrane. Temporal bone CT showed high jugular bulb with bone defect of hypotympanum. The hypotympanum was reconstructed and high jugular bulb lowered using the harvested bony fragment from mastoid cortical bone. The pulsatile tinnitus disappeared immediately after surgery.
Mastoid ; Temporal Bone ; Tinnitus ; Tympanic Membrane

OBJECTIVES: The purpose of this study was to explore the influence of high school students' mental health on their academic achievement and school dropout rate by using longitudinal data. METHODS: For this study, 153 high schools were randomly sampled on a nationwide scale. The descriptive data was collected from a school information internet site which is organized by the Korean Ministry of Education. We used the schools' mean scores on the Adolescent Mental Health Problem-Behavior Questionnaire-II (AMPQ-II) scale which was used for estimating students' mental health in the 2013 school-based mental health screening test. The data analysis was conducted by using hierarchical regression analysis. RESULTS: The results of this study showed that the AMPQ-II scale's mean scores have significant effects on the following year's academic achievement and annual dropout rates. Especially, the AMPQ-II scale's mean scores tend to increase the school dropout rate in vocational schools. CONCLUSION: The finding of this study is that Korean high school students' mental health states significantly influence their academic achievement and school dropout rate.
Adolescent ; Education ; Humans ; Internet ; Mass Screening ; Mental Health* ; Statistics as Topic ; Student Dropouts*

PURPOSE: The prehospital ambulance run report function's as a legal and billing document, a unit of database for emergency medical service system quality improvement and community resources allocation. We examined how much ambulance run report is collected, contents are checked and whether there is a hospital-wise difference. METHODS: Prehospital run report of patients who visited the emergency department of Severance hospital, YongDong Severance hospital and Ilsan hospital by ambulance during the month of August in 2003 were collected. The items in run report were grouped according to relevancy in 11categories including 6 essential cetegories. The scores of each item was calculated as follows; 1 point if completed, 0 point if not checked and 0.5 point if incomplete. The categorical score, total score and essential score was consisted of corresponding scores. RESULTS: There was 1,339 (13.5%) 119 ambulance transportation in 9,946 total visit and 783 (58.5%) reports were collected with no statistical difference among hospitals. Overall score completed 100 point scale was in total 54.43 in total score, 70.61 in essential score. In essential categories, transportation category score (78.26) was higher than EMS information (73.04), rand & signature category (72.73) and patient condition & care category (45.20) scores. Among hospitals, YongDong Severance hospital showed significantly higher total and essential score than others. In essential categories, YongDong Severance hospital in EMS information, patient condition & care, rank & signature categories and Ilsan hospital in transportation category had higher score than others with significant differences. CONCLUSION: In this study, the collection rate and completion score of prehospital 119 run report were disappointedly low and differed among hospitals. To improve present status, we prepare urgent need redesign of run report, was of uniform data set and proper education of emergency medical personnel.
Ambulances* ; Dataset ; Education ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Quality Improvement ; Resource Allocation ; Transportation

BACKGROUND AND OBJECTIVES: The timing of surgery is an important consideration point in the management of blowout fracture (BOF) of the orbit. This study aimed to compare the surgical outcome of early and delayed reduction and to suggest the best timing of surgery in the pure medial BOF of the orbit. SUBJECTS AND METHOD: Fifty-two patients who had endoscopic endonasal reduction of medial BOF were studied retrospectively. Patients were divided into an early group (N=42) who had surgery within one month after the trauma and a delayed group (N=10) who had surgery after one month from the trauma. Surgical indications, results of the surgery, and complications were compared between the two groups. RESULTS: The surgical indications in the early group were persistent diplopia, large defect expecting later enophthalmos and limitation of EOM, whereas the delayed group complained mainly of enophthalmos and diplopia. There were no significant differences in surgical outcomes and the rate of complications between the two groups. CONCLUSION: When patients with pure medial BOF have large defects without any persistent diplopia and limitation of EOM, surgery would be safely deferred until significant enophthalmos occurs.
Diplopia ; Endoscopes ; Enophthalmos ; Humans ; Orbit ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Hearing improvement after CWD tympanomastoidectomy is another major goal of surgery after eradication of disease, especially in cases with intact stapes. The objective of this study is to compare the postoperative results of hearing gain and middle ear condition according to the types of ossiculoplasty described above. SUBJECTS AND METHOD: Of patients who received CWD tympanomatoidectomy, 90 who had been followed up for more than 1 year after surgery were selected. We found 30 cases of classical tympanoplasty type III, 38 SC tympanoplasty cases, and 22 PORP tympanoplasty cases. Age and sex distribution, success rate of hearing improvement, mean of postoperative air-bone gap (ABG), rate of middle ear adhesion were analysed according to the type of surgery. RESULTS: At 3 months after surgery, success rates of hearing improvement were 37.0%, 51.4%, 57.1% for classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Means of postoperative ABG in the above listed order were 25.1 dB, 19.4dB, 17.2 dB, respectively. Hearing results were statistically better in PORP tympanoplasty when compared with other groups (ANOVA with Duncan's multiple range test). At 1 year after surgery, success rates of hearing improvement were 21.1%, 35.5%, 64.7% in classical tympanoplasty type III, SC tympanoplasty, PORP tympanoplasty, respectively. Means of postoperative ABG in the above listed order were 29.1 dB, 20.3 dB, 16.7 dB, respectively. Hearing results were statistically better in PORP tympanoplasty compared with other groups (ANOVA with Duncan's multiple range test.). Rates of middle ear adhesion were 23.1%, 54.5% in classical tympanoplasty type III, tympanoplasty using strut, respectively. CONCLUSION: In cases with intact stapes in CWD tympanoplasty, we conclude that tympanoplasty using strut is more useful for hearing improvement and prevention of middle ear adhesion than classical tympanoplasty type III; for the strut material, we found PORP more effective than autologous materials.
Ear, Middle ; Hearing ; Humans ; Ossicular Prosthesis ; Sex Distribution ; Stapes ; Tympanoplasty

Objective: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.

Objective: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.