Although rare, agranulocytosis is the most serious, potentially fatal side effect of antithyroid drug. We experienced a 13-year-old girl who developed methimazole-induced agranulocytosis at 1 month after the initiation of treatment. Her granulocyte count recovered after discontinuation of methimazole and treatment with broad spectrum-antibiotics, G-CSF, and methylprednisolone. After recovery from agranulocytosis she was treated with radioiodine ablation therapy. Early detection and proper management of antithyroid drug-induced agranulocytosis is very important.
Adolescent ; Agranulocytosis* ; Female ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Methimazole ; Methylprednisolone*

PURPOSE: Adenoid hypertrophy is a physical alteration that may affect speech, and a speech disorder can have other negative effects on a child's life. Airway obstruction leads to constricted oral breathing and causes postural alterations of several oro-facial structures, including the mouth, tongue, and hyoid bone. The postural modifications may affect several aspects of speech production. METHODS: In this study, we compared articulation errors in 19 children with adenoid hypertrophy (subject group) to those of 33 children with functional articulation disorders independent of anatomical problems (control group). RESULTS: The mean age of the subject group was significantly higher (P=0.016). Substitution was more frequent in the subject group (P=0.003; odds ratio [OR], 1.80; 95% confidence interval [CI], 1.23-2.62), while omission was less frequent (P<0.001; OR, 0.43; 95% CI, 0.27-0.67). Articulation errors were significantly less frequent in the palatal affricative in the subject group (P=0.047; OR, 0.25; 95% CI, 0.07-0.92). The number of articulation errors in other consonants was not different between the two groups. Nasalization and aspiration were significantly more frequent in the subject group (P=0.007 and 0.014; OR, 14.77 and 0.014; 95% CI, [1.62-135.04] and NA, respectively). Otherwise, there were no differences between the two groups. CONCLUSION: We identified the characteristics of articulation errors in children with adenoid hypertrophy, but our data did not show the relationship between adenoid hypertrophy and oral motor function that has been observed in previous studies. The association between adenoid hypertrophy and oral motor function remains doubtful.
Adenoids* ; Airway Obstruction ; Articulation Disorders ; Child* ; Humans ; Hyoid Bone ; Hypertrophy* ; Mouth ; Mouth Breathing ; Odds Ratio ; Respiration ; Tongue

PURPOSE: Hand, foot, and mouth disease (HFMD) is a common childhood illness. Enterovirus 71 (EV71) epidemics have recently been associated with HFMD-based neurologic complications in the Asia-Pacific region. This study described HFMD clinical features, and investigated clinical parameters in patients presenting with acute neurologic complications associated with HFMD. METHODS: We retrospectively reviewed medical records from 235 hospitalized patients who developed HFMD with or without neurologic complications (22 and 213 cases, respectively) in Uijengbu, Korea between 2010 and 2013. Clinical manifestations, radiologic findings, cerebrospinal fluid (CSF) analyses, virological analyses, and treatment regimens were summarized. Additionally, routinely collected baseline data from 235 patients were retrospectively analyzed to identify clinical parameters associated with neurologic complications. RESULTS: Brainstem encephalitis was the most frequent neurologic complication (11 cases), followed by aseptic meningitis (seven cases). We also found acute disseminated encephalomyelitis and meningitis retention syndrome. Both have rarely been reported in EV71-associated HFMD. Virological analyses were performed for 15 cases, and 14 demonstrated EV71 infection, while one patient demonstrated Coxsackievirus B3 infection. Multivariate logistic regression analysis indicated patients were more likely to develop neurologic complications if they experienced nausea/vomiting (OR= 13.65, P<0.001) and lethargy (OR=10.68, P=0.003). Males were more likely to develop neurologic complications compared to females (OR=2.12, P=0.005). In addition, neurologic complications were associated with a higher peak heart rate (OR=1.13, P=0.001). CONCLUSION: This study revealed usual and unusual findings of HFMD-associated neurologic complications. Male gender, nausea/vomiting, lethargy, and peak heart rate parameters predicted HFMD-associated neurologic complications. However, laboratory findings did not reliably predict HFMD-associated neurologic complications.
Brain Stem ; Cerebrospinal Fluid ; Encephalitis ; Encephalomyelitis, Acute Disseminated ; Enterovirus ; Female ; Foot* ; Hand* ; Heart Rate ; Humans ; Korea ; Lethargy ; Logistic Models ; Male ; Medical Records ; Meningitis ; Meningitis, Aseptic ; Mouth Diseases* ; Retrospective Studies

PURPOSE: The objective of this study was to evaluate the effect of microthreads on removal torque and bone-to-implant contact (BIC). METHODS: Twelve miniature pigs for each experiment, a total of 24 animals, were used. In the removal torque analysis, each animal received 2 types of implants in each tibia, which were treated with sandblasting and acid etching but with or without microthreads at the marginal portion. The animals were sacrificed after 4, 8, or 12 weeks of healing. Each subgroup consisted of 4 animals, and the tibias were extracted and removal torque was measured. In the BIC analysis, each animal received 3 types of implants. Two types of implants were used for the removal torque test and another type of implant served as the control. The BIC experiment was conducted in the mandible of the animals. The P1-M1 teeth were extracted, and after a 4-month healing period, 3 each of the 2 types of implants were placed, with one type on each side of the mandible, for a total of 6 implants per animal. The animals were sacrificed after a 2-, 4-, or 8-week healing period. Each subgroup consisted of 4 animals. The mandibles were extracted, specimens were processed, and BIC was analyzed. RESULTS: No significant difference in removal torque value or BIC was found between implants with and without microthreads. The removal torque value increased between 4 and 8 weeks of healing for both types of implants, but there was no significant difference between 8 and 12 weeks. The percentage of BIC increased between 2 and 4 weeks for all types of implants, but there was no significant difference between 4 and 8 weeks. CONCLUSIONS: The existence of microthreads was not a significant factor in mechanical and histological stability.
Animals ; Biomechanics ; Dental Implants ; Mandible ; Osseointegration ; Swine ; Tibia ; Tooth ; Torque

Eccrine poroma is described as a benign neoplasm originating from the intraepidermal eccrine duct of sweat glands. This tumor is known to arise in bare skin areas, but more rarely appeared in head and neck region. A 54-year-old female presented with a mass on the retroauricular aspect of the left auricle. There was a soft, protruding, and purple-colored, solitary mass of about 1.0x1.0 cm in size. After authors performed an excisional biopsy, eccrine poroma was confirmed histopathologically. Thus, we report a rare case of eccrine poroma of the ear with the review of literature.
Biopsy ; Ear ; Ear Auricle ; Female ; Head ; Humans ; Middle Aged ; Neck ; Poroma* ; Skin ; Sweat Glands

BACKGROUND: Percutaneous vertebroplasty (PV) is a minimally invasive, image-guided therapy used to relieve pain from osteoporotic vertebral compression fractures. Venography before injection of bone cement has been advocated as a means of identifying sites of potential venous leakage during the procedure. However, venography has been used only in selected situations, and its need is debatable. We aimed to analyze the usefulness of venography with percutaneous vertebroplasties for osteoporotic compression fractures and to report our recent experiences in treating such patients. METHODS: One hundred PVs performed on 93 patients were evaluated. To identify the usefulness of venography, our cases were divided into 2 groups. Group A patients had venographies before the PVs, whereas Group B patients were treated without venography. We analyzed their clinical status, pain status, and complications linked to leakage of bone cement. RESULTS: There were no significant differences in any of the collected data for the two groups. CONCLUSION: Our results indicate that PVs can be performed safely without venography beforehand. However, venography may be beneficial for less experienced physicians or trainees.
Fractures, Compression ; Humans ; Intraoperative Complications ; Phlebography ; Vertebroplasty

BACKGROUND: Percutaneous vertebroplasty (PV) is a minimally invasive, image-guided therapy used to relieve pain from osteoporotic vertebral compression fractures. Venography before injection of bone cement has been advocated as a means of identifying sites of potential venous leakage during the procedure. However, venography has been used only in selected situations, and its need is debatable. We aimed to analyze the usefulness of venography with percutaneous vertebroplasties for osteoporotic compression fractures and to report our recent experiences in treating such patients. METHODS: One hundred PVs performed on 93 patients were evaluated. To identify the usefulness of venography, our cases were divided into 2 groups. Group A patients had venographies before the PVs, whereas Group B patients were treated without venography. We analyzed their clinical status, pain status, and complications linked to leakage of bone cement. RESULTS: There were no significant differences in any of the collected data for the two groups. CONCLUSION: Our results indicate that PVs can be performed safely without venography beforehand. However, venography may be beneficial for less experienced physicians or trainees.
Fractures, Compression ; Humans ; Intraoperative Complications ; Phlebography ; Vertebroplasty

PURPOSE: The thoracodorsal vessels have been the standard recipient vessels for the majority of surgeons performing free abdominal flap breast reconstructions. Recently, the internal mammary vessels have been recommended as the first-choice recipient vessels for microvascular breast reconstruction. To approach the internal mammary vessel, 3rd or 4th rib cartilage excision is needed, but this method has some demerits such as vessel injury, post operative pain and post operative chest hollowness. So, authors propose the approach method to the internal mammary vessel through intercostal space without rib cartilage resection. METHODS: From November, 2008 to May, 2009, 13 patients underwent free abdominal flap breast reconstruction with approach to the internal mammary vessel through intercostal space without rib cartilage resection. RESULTS: The mean patient age was 41.8 years, and the mean height was 159.3 cm. 11 patients underwent immediate breast reconstruction. Free DIEP flap reconstruction was performed in 7 patients, Free TRAM flap was performed in 5 patients, and Free SIEA flap was performed in 1 patient. Except 1 case, approach to the internal mammary vessel was took through 3rd intercostal space, and all width of intercostal space exceeded 1 cm. CONCLUSION: In the authors' experience, use of approach to the internal mammary vessels without rib cartilage resection method is safe and reliable to overcome demerits of rib cartilage resection method.
Breast ; Cartilage ; Diclofenac ; Female ; Glycosaminoglycans ; Humans ; Mammaplasty ; Mammary Arteries ; Ribs ; Thorax

Myxomas are benign mesenchymal tumors that occur rarely in the head and neck. When they occur in the head and neck region, they mainly involve facial bones such as mandible and maxilla. Myxomas arising from subcutaneous soft tissues, including the larynx, are very rare. There are only sporadic cases of laryngeal myxomas reported in English literature. Within the larynx, the vocal folds, aryepiglottic fold, and epiglottis are the reported sites of involvement. The most common clinical presentation is hoarsness and difficulty in breathing. We described two cases of laryngeal myxomas in a 62-year-old male and a 52-year-old male.
Epiglottis ; Facial Bones ; Head ; Humans ; Larynx ; Male ; Mandible ; Maxilla ; Middle Aged ; Myxoma* ; Neck ; Respiration ; Vocal Cords

PURPOSE: We investigated articulation patterns in children with ankyloglossia who developed articulation disorders in order to determine the relationship between ankyloglossia and articulation disorders, and to clinically detect children who have articulation disorders associated with ankyloglossia. METHODS: The participants of this study were 23 children with articulation disorders that accompanied ankyloglossia and 55 controls with functional articulation disorders independent of anatomical problems, who were admitted to our hospital from January 1, 2002 to December 31, 2012. All children underwent speech-language pathologic evaluation using the Picture Consonant Articulation Test (PCAT; Young-Tae Kim, 1994). We retrospectively compared collected data between the subject and control groups using Fisher's exact test and odds ratio tests with a 95% confidential interval for categorical variables and the independent Mann-Whitney U-test for continuous variables. RESULTS: The number of patients with articulation errors in the velar nasal was lower significantly only in the subject group (P=0.038). The total numbers of articulation errors in the bilabial plosive, velar plosive and velar nasal also were lower (P=0.007, P<0.001, and P=0.034, respectively). There were no differences in the numbers of patients with articulation errors according to phonological changes between the two groups. However, the total numbers of fronting and frication were lower in the subject group (both P<0.001), but the total numbers of plosivation and tensing were higher (P=0.002 and P=0.008, respectively). CONCLUSION: This study showed that the relationship between an articulation disorder and ankyloglossia is doubtful, although some results suggest that ankyloglossia may cause articulation errors only in certain individuals. Therefore, clinicians should be careful when determining the relationship between ankyloglossia and articulation disorders and use caution when making a treatment decision.
Articulation Disorders* ; Child* ; Humans ; Odds Ratio ; Retrospective Studies ; Transcutaneous Electric Nerve Stimulation