Penetrating neck injuries constitute 5-10% of all trauma cases. These injuries may cause life-threatening suppurative or vascular complications, but the severity and extent of damage depends upon the inflicting object and the involved structures. If significant complications are not expected, then it is best to leave the foreign body embedded and avoid surgical risks. We present a rare case of a foreign body embedded in the neck causing tinnitus and foreign body sensation.
Foreign Bodies* ; Neck Injuries ; Neck* ; Sensation* ; Tinnitus*

There are little information on prevalence of obstructive sleep apnea syndrome (OSAS) and clinical features in the young military population. The purpose of this study was to estimate the prevalence of snoring and high risk of OSAS in young male soldiers in Korea and to identify the risk factors of OSAS. A total of 665 participants (aged 20-23 yr) who visited the Armed Forces Ildong Hospital for regular physical examination were enrolled. All participants completed the Berlin Questionnaire and underwent a physical examination. The participants with high risk for OSAS completed portable sleep monitoring. The prevalence of snoring and high risk of OSAS in young male soldiers in Korea was 13.5% and 8.1%, respectively. The prevalence of high arched palate, tongue indentation, long uvula, large tonsil and retrognathia was significantly higher in the high risk OSAS group. High arched palate, long uvula or low lying soft palate, tonsil size III or IV, Epworth Sleepiness Scale score > 10 and obesity (BMI > 27 kg/m2) were found to independently predict OSAS. For early identification and treatment of young soldiers with OSAS in a military environment, a precise screening by questionnaire and physical examination is needed.
Asian Continental Ancestry Group ; Body Mass Index ; Humans ; Logistic Models ; Male ; *Military Personnel ; Odds Ratio ; Palate/anatomy & histology ; Palatine Tonsil/anatomy & histology ; Polysomnography ; Prevalence ; Questionnaires ; Republic of Korea ; Retrognathia/physiopathology ; Risk Factors ; Sleep Apnea, Obstructive/*epidemiology ; Snoring/epidemiology ; Uvula/anatomy & histology ; Young Adult

Porcine pancreatic extracts (PPE), which are widely used as a digestive drug in Korea, are composed of alpha-amylase and lipase. Such enzymes are commonly described as occupational allergens. This is the first report of occupational rhinitis caused by PPE developing into occupational asthma in a hospital nurse. She showed strong positive response in the skin prick test (SPT) (5+, wheal ratio of allergen to histamine) and had a high serum-specific IgE level to PPE, but showed a negative response in the methacholine bronchial challenge test (MBT). She had been exposed to PPE intermittently with intermittent medications for rhinitis. Two years later, she presented with rhinitis and additional asthmatic symptoms. In contrast to her first visit, she showed a positive response in the MBT, and developed bronchoconstriction in the PPE-bronchial provocation test (BPT). These findings suggest that inhalation of PPE powder can induce IgE-mediated occupational rhinitis in a hospital setting, which will develop into occupational asthma if avoidance is not complete.
Adult ; Animals ; Asthma/*diagnosis/etiology ; Bronchial Provocation Tests ; Female ; Gastrointestinal Agents/adverse effects ; Humans ; Immunoglobulin E/metabolism ; Methacholine Chloride/pharmacology ; Occupational Diseases/*diagnosis/etiology ; Pancreatic Extracts/*adverse effects ; Powders ; Rhinitis/*diagnosis/etiology ; Skin Tests ; Swine

The orbital apex syndrome is a very rare complication of fungal sinusitis, as well as of other conditions, and is characterized by blindness, diplopia, proptosis of the eye and ophthalmoplegia. We present a case of diplopia caused by a fungal ball in the Onodi cell. A 62-year-old woman, diagnosed with orbital apex syndrome and suffering from ophthalmalgia and diplopia in the right eye, was presented to our outpatient clinic. Computed tomography showed a soft tissue lesion occupying the right Onodi cell with chronic inflammation. Patients who have an Onodi cell carry a high risk for optic nerve injury, so endoscopic sinus surgery using navigation was performed. Histopathology examination confirmed the diagnosis of a fungal ball. We experienced a rare case of a fungal ball in the Onodi cell, which caused damage to the adjacent cavernous sinus structure and led to diplopia and orbital pain. We present this case with a brief review of these disease entities.
Ambulatory Care Facilities ; Blindness ; Cavernous Sinus ; Diagnosis ; Diplopia* ; Exophthalmos ; Female ; Humans ; Inflammation ; Middle Aged ; Ophthalmoplegia ; Optic Nerve Injuries ; Orbit ; Sinusitis

BACKGROUND AND OBJECTIVES: Overnight polysomnography (PSG) in a sleep laboratory is the standard method of confirming the diagnosis of obstructive sleep apnea (OSA). However, PSG is expensive, time-consuming, uneasily accessible and labor-intensive, so many patients need a more convenient tool that is ambulatory. The aim of this study was to investigate the usefulness of Embletta by comparing the respiratory parameters derived from Embletta with those of PSG. SUBJECTS AND METHOD: PSG and Embletta sleep study were performed for 42 patients prospectively. Respiratory parameters, such as apnea index (AI), hypopnea index (HI), apnea-hypopnea index (AHI), and oxygen parameters, such as lowest oxygen saturation (LSAT), mean oxygen saturation (MSAT), and oxygen desaturation index (ODI) were measured automatically from Embletta and by hand from PSG. All parameters of Embletta were compared with those of PSG. In addition, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for Embletta were calculated for the diagnosis of OSA. RESULTS: Most of the respiratory parameters and the oxygen parameters were well correlated between PSG and Embletta and the correlation coefficients were well correlated and statistically significant as well. The sensitivity, specificity, PPV, and NPV were 90%, 75%, 0.9, and 0.75, respectively, for Embletta for the diagnosis of OSA. CONCLUSION: Embletta might be clinically useful as a screening device of OSA patients based on its high correlation to PSG and positive predictive value.
Apnea ; Hand ; Humans ; Mass Screening ; Oxygen ; Polysomnography ; Prospective Studies ; Sensitivity and Specificity ; Sleep Apnea, Obstructive

BACKGROUND AND OBJECTIVES: The progress of arterial embolization made it possible to control intractable nasal bleeding and to reduce the blood supply of nasopharyngeal angiofibroma. MATERIALS AND METHODS: We reviewed 19 cases of patients who received arterial embolization from Jan. 1993 to Dec. 1999. We analyzed the cases according to the age, sex, hypertension, purpose, result and complications of arterial embolization. RESULTS: Thirteen patients received arterial embolization due to uncontrolled epistaxis by conservative management. Except one patient who had bleeding from the anterior ethmoidal artery, 12 patients stopped bleeding after successful embolization. Three patients received the arterial embolization for continuous bleeding after endoscopic sinus surgery, and other three patients received it for reducing the blood supply of the nasopharyngeal angiofibroma preoperatively. The complications were seizure like movements, fever and facial pain: but these complications were limited to few cases, and were minimal and temporary. CONCLUSION: Arterial embolization is a safe and effective method that should be considered in the treatment of refractory nasal bleeding and for reducing the intraoperative bleeding in angiofibroma.
Angiofibroma ; Arteries ; Epistaxis ; Facial Pain ; Fever ; Hemorrhage ; Humans ; Hypertension ; Seizures

BACKGROUND AND OBJECTIVES: Although obstructive sleep apnea is common, it has often gone undiagnosed in primary care encounters until now, with no validated screening tool of obstructive sleep apnea (OSA) for Korean patients. The aim of this study was to investigate the usefulness of Berlin questionnaire (Berlin Q) and STOP questionnaire (STOP Q) as a screening test for sleep apnea for the Korean patients. SUBJECTS AND METHOD: We administered Berlin Q and STOP Q to 106 patients who received a full night polysomnography. We investigated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each questionnaire according to patients' severity by apnea hypopnea index (AHI). RESULTS: Results were categorized according to AHI severity using cut-off points of AHI greater than 5, 15, and 30. The sensitivity and specificity of the Berlin Q were 69, 72, 78% and 41, 43, 39%, respectively. NPV and PPV of Berlin Q were 0.20, 0.43, 0.74 and 0.86, 0.72, 0.43, respectively. The sensitivity and specificity of the STOP Q was 97, 97, 98% and 35, 20, 12%, respectively. NPV and PPV for STOP Q were 0.67, 0.78, 0.89 and were 0.89, 0.71, 0.40, respectively. CONCLUSION: Our results indicate that STOP Q shows higher sensitivity than Berlin Q with similar specificity. Therefore, STOP Q is a more convenient and better means than Berlin Q to screen patients for obstructive sleep apnea.
Apnea ; Berlin ; Humans ; Korea ; Mass Screening ; Polysomnography ; Primary Health Care ; Surveys and Questionnaires ; Sensitivity and Specificity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Retrobulbar hematoma is a rare complication following septal surgery under general anesthesia. Symptoms and physical findings include temporary blindness, ophthalmoplegia, mydriasis, ptosis, proptosis and eyelid ecchymosis. Recently, we experienced a rare case of the right retrobulbar hematoma after septal surgery. At present, there is no literature about the occurrence of retrobulbar hematoma following septal surgery. We hereby present this case with an emphasis on the importance of prevention, identification and management of retrobulbar hematoma.
Anesthesia, General* ; Blindness ; Ecchymosis ; Exophthalmos ; Eyelids ; Hematoma* ; Mydriasis ; Ophthalmoplegia

BACKGROUND AND OBJECTIVES: Postoperative taste changes after uvulopalatopharyngoplasty (UPPP) is regarded as an unusual and minor complication. This study aims to evaluate the objective changes of taste threshold according to time course and subjective symptoms change. MATERIALS AND METHOD: With 45 patients who underwent UPPP and 35 patients who underwent nasal surgery as control group, we have prospectively studied postoperative taste changes using a questionnaire, and an electrogustometer (EGM) with regard to symptoms at 7th, 28th days after the surgery. EGM was measured at 5 areas. Also, we have checked pre-operatively about the serum level of zinc. RESULTS: With EGM, the threshold of taste was increased at 7th days after the surgery (p<0.05), but recovered 28th days after the surgery at the posterior part of the tongue in the UPPP group. There were no significant changes in subjective taste dysfunction, smell dysfunction, tongue sensory abnormality, and dysgeusia. CONCLUSION: Taste changes after UPPP was transient and they disappeared within the 1st postoperative month. There were no patients who complained of subjective taste dysfunction, dysgeusia, tongue sensory abnormality after UPPP.
Dysgeusia ; Humans ; Nasal Surgical Procedures ; Prospective Studies ; Surveys and Questionnaires ; Sleep Apnea, Obstructive ; Smell ; Taste Threshold ; Tongue

According to recent studies, the immunogenetic factors are thought to be account for a part of the etiopathogenesis of autoimmune thyroid disease. In Korea, there was one report on the relationship between HLA DR5, DR8, B13 and autoimmune thyroid disease. There were also several reports on a familial hereditary transmission of autoimmune thyroid disease in other countries but not in Korea. We describe the occurrence of autoimmune thyroid disease that affected three members of a family through three generations. This is the first report on familial hereditary transmission of autoimmune thyroid disease in Korea. We report on an 80-year-old woman who presented with Hashimoto's thyroiditis, her 53-year-old daughter who had Graves' disease, and her 29-year-old grand-daughter who had Graves' disease. In order to identify the immunogenetic influence in these cases, HLA haplotypes & thyroid autoantibody were studied. HLA DRB3*02 was obseved in each of the patents. HLA DQB1*0301, DR11, DQB1*05031 and DR14 were observed in the two cases. However, HLA B13, DR5 and DR8 were not observed. The patients are currently undergoing follow-up using PTU, methimazole and synthyroid medication.
Adult ; Aged, 80 and over ; Family Characteristics ; Female ; Follow-Up Studies ; Graves Disease ; Haplotypes ; HLA-B13 Antigen ; Humans ; Immunogenetics ; Korea ; Methimazole ; Middle Aged ; Nuclear Family ; Thyroid Diseases* ; Thyroid Gland* ; Thyroiditis