BACKGROUND AND OBJECTIVES: Middle ear effusion (MEE) is common in children, so the effects of the ventilation tube (VT) should be taken into account in prescribing hearing aids. With the ventilation tube, the external auditory canal communicates with the middle ear space, hence changing the impedance in the middle ear. This change, in turn, will have an effect on the external ear resonance (EER, real ear unaided response (REUR)). The aim of this study is to observe the effects of the tympanic membrane perforations caused by the ventilation tube on EER. MATERIAL AND METHODS:We selected 30 ears with MEE and measured EER before and after the ventilation tube insertion. We compared the EERs of the control group with the MEE group and two types of VT groups. RESULTS: In the subjects who had middle ear effusion, the average gain of the peak resonance was larger than that of the control group. After the VT insertion, the amplitude of the gain decreased to the level of control groups, although negative gain appeared in some cases characteristically around 1000 Hz. This negative gain was observed more frequently in the VT with larger diameter. CONCLUSION: The external ear resonance gain can be changed according to disease status or by VT insertion in patients with MEE. These changes should be considered especially in the low frequencies around 1000 Hz when prescribing the hearing aids for patients.
Child ; Ear ; Ear Canal ; Ear, External* ; Ear, Middle* ; Electric Impedance ; Hearing Aids ; Humans ; Otitis Media with Effusion* ; Tympanic Membrane ; Ventilation*

BACKGROUND AND OBJECTIVES: External ear resonance (EER) can normally increase the sound pressure level at the tympanic membrane by as much as 20 dB at the frequency between 2 and 4 kHz. Perforation of tympanic membrane (TMP) may alter the resonance characteristics. Surgical modifications of the external auditory canal by tympanoplasty may also change the EER features. We aimed to analyze the EER of patients with the TMP before and after surgery. MATERIALS AND MEHTOD: This study comprised of 130 patients (135 ears) with chronic otitis media. We checked EERs before and after the surgery. The preoperative group was divided into two groups according to perforation size. Postoperatively, the EER was checked at 3, 6, 9, 12 months or after 15 months. We compared these data with the control group which comprised of 96 adult ears. RESULTS: In the preoperative group, the peak resonant gain and the frequency were not different from the control's and the peculiar negative peaks appeared around 1500 Hz in half of the cases. No significant differences were found in the first peak gains according to the perforation size. The negative peaks appeared deeper in the larger perforation group. After tympanoplasty, the gain markedly increased. As time passed, the gain tended to decrease, but did not equalize with the control's data. CONCLUSION: Additional gain should be considered in the frequency of around 1 kHz for hearing aid users with the TMP. We could expect alterations of EER after tympanoplasty, suggesting that these changes should be considered at the time of fitting hearing aids.
Adult ; Ear ; Ear Canal ; Ear, External* ; Hearing Aids ; Humans ; Otitis Media* ; Otitis* ; Thymidine Monophosphate ; Tympanic Membrane ; Tympanic Membrane Perforation ; Tympanoplasty

No abstract available.
Brain* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The organ procurement organization (OPO) and transplant coordinator were established in Chonnam National University Hospital in 1993 to promote organ donation and to manage organ procurement. At the same time, the first protocol and planning transplant was performed simultaneously. We performed this study to know the predicting factors and survival rate of cadaveric kidney transplantation. METHODS: First cadaveric donor kidney transplantation was performed at May 1993 in Chonnam National University Hospital. Thereafter 52 cases of cadaveric kidney transplantation were performed using 28 cadaver donors till December 1999. The most frequent cause of brain death was head injury by traffic accident. Male to female donor ratio was 1.8 : 1. 52 recipients (29 males, 23 females), aged 20 to 65 years (median age 36 years) were the subjects of this study. The immunosuppressive regimens consisted of cyclosporin, mycophenolate mofetil, and prednisone. Acute rejection was treated with three consecutive bolus of 1.0 gram methylprednisolone or 5 mg/day for 10 days of OKT3. Three HLA mismatchs were 7 cases (13.5%) and six mismatches were 6 cases (11.5%). There were 2 cases of multiple renal arteries. RESULTS: There was no primary non functioning graft. In the first 7 post operative days, urine amount less than 4,000 mL per day was noted in 29 patients (55.8%) and serum creatinine over 1.5mg/dL was noted in 13 patients (25%). No significant proteinuria and hematuria was observed. Postoperative medical complications were occured in 12 patients (23.1%) and minor surgical complications in 3 patients (5.8 %). One patient was performed reoperation because of urinary leakage. CMV infections were noted in 15 patients (28.8%). Acute rejection episodes were 17 cases (32.7%). We lost 4 grafts within 1 year. The major cause of graft loss was patient death. Recipient age was significant risk variable for graft and patient survival in multivariate analysis (P=0.012). one and five year graft survival rates were 92.15%. CONCLUSION: To achive better results, continued attention should be paid to the cadaveric donor organ procurement.
Accidents, Traffic ; Brain Death ; Cadaver* ; Craniocerebral Trauma ; Creatinine ; Cyclosporine ; Female ; Graft Survival ; Hematuria ; Humans ; Jeollanam-do ; Kidney Transplantation* ; Kidney* ; Male ; Methylprednisolone ; Multivariate Analysis ; Muromonab-CD3 ; Prednisone ; Proteinuria ; Renal Artery ; Reoperation ; Risk Factors ; Survival Rate ; Tissue and Organ Procurement ; Tissue Donors* ; Transplants

No abstract available.
Pneumonia* ; Squalene*

Most patients with duodenal carcinoids are asymptomatic or suffer from nonspecific symptoms. But the tumors in the periampullary region may be associated with symptoms of obstruction related to the size of the lesion. Two serial internal dranage procedures (cystogastrostomy and cystojejunostomy) were performed in a 46-year-old man because of recurred pancreatic pseudocyst at an interval of five months. Eight months after the first operation, an abdominal CT showed a remained pancreatic pseudocyst. And duodenoscopic findings showed a luminally protrusing mass, with preserved mucosa at the second portion of duodenum. Local resection of the mass was perfomed. Grossly, the mass had a 2 cm-sized, well circumscribed yellowish appearance. Microscopic findings showed well-defined intramucosal mass having almost glandular and nest of tumor cells showing uniform round nuclei, glandular and basophilic cytoplasm. And the nonspecific neuroendocrine markers chromogranin and NSE are positive. We report a case of Periampullary duodenal carcinoid tumor with complicated pancreatic pseudocyst.
Basophils ; Carcinoid Tumor* ; Cytoplasm ; Duodenum ; Humans ; Middle Aged ; Mucous Membrane ; Pancreatic Pseudocyst* ; Tomography, X-Ray Computed

Human hydatid cyst of the liver is rare in Korea, although it is the most frequent cause of liver cysts in the world. It is endemic in Greece, other parts of Eastern Europe, South America, Australia, and South Africa. Until now, a few cases have been reported in the Korean literature. But it is expected to confront this disease because of recent increase in traveling to the endemic area. With this trend, we experienced a case of hydatid cyst of the liver in a 66- year-old male patient who had been worked in the middle east for 4 years. In this clinical case report, we present all the patient course and treatment with brief review of previous literature.
Australia ; Echinococcosis* ; Europe, Eastern ; Greece ; Humans ; Korea ; Liver* ; Male ; Middle East ; South Africa ; South America

PURPOSE: Laparoscopic surgery has become the mainstream surgical operation due to its stability and feasibility. Even for liver surgery, the laparoscopic approach has become an integral procedure. According to the recent international consensus meeting on laparoscopic liver surgery, laparoscopic left lateral sectionectomy (LLS) might be a new standard of care for left lateral surgical lesions. This study was designed to compare open LLS to laparoscopic LLS. METHODS: In total, 82 patients who had undergone LLS at Chonnam National University Hwasun Hospital between 2008 and 2015 were enrolled in this study. Among them, 59 patients underwent open LLS and 23 underwent laparoscopic LLS. These two groups were compared according to general characteristics and operative outcomes. RESULTS: The data analysis results showed that laparoscopic liver resection is superior to open liver resection in terms of the amount of bleeding during the operation and the duration of hospital stay. There was no statistical difference between the two groups in terms of operation time (p value=0.747). The amount of bleeding during the operation was 145.5±149.4 ml on average for the laparoscopic group and 320±243.8 ml on average for the open group (p value=0.005). The mean duration of hospital stay was 10.7±5.8 days for the laparoscopic surgery group and 12.2±5.1 days for the open surgery group (p value=0.003). CONCLUSION: This study showed that laparoscopic LLS is safe and feasible, because it involves less blood loss and a shorter hospital stay. For left lateral lesions, laparoscopic LLS might be the first option to be considered.
Consensus ; Hemorrhage ; Humans ; Jeollanam-do ; Laparoscopy ; Length of Stay ; Liver ; Standard of Care ; Statistics as Topic

Lymphangiomas are rare congenital benign tumors arising from the lymphatic system, and are mostly encountered in the neck and axillary regions of pediatric patients (95%). Lymphangioma of the pancreas is extremely rare accounting for less than 1% of these tumors. We report here on a case of pancreatic cystic lymphangioma. A 54-year-old woman presented with intermittent postprandial abdominal discomfort and radiating back pain. Abdominal computed tomography scan revealed 8 x 6.5 cm hypodense cystic mass arising from the tail of the pancreas without septa or solid component. The initial impression was a pancreatic pseudocyst. The patient underwent distal pancreatectomy with splenectomy. The histopathologic and immunohistochemical study helped make the diagnosis of a pancreatic cystic lymphangioma. Herein, we report a case of pancreatic cystic lymphangioma mimicking pancreatic pseudocyst and review the relevant medical literature.
Accounting ; Back Pain ; Female ; Humans ; Lymphangioma ; Lymphangioma, Cystic ; Lymphatic System ; Middle Aged ; Neck ; Pancreas ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Splenectomy

PURPOSE: Tetanus is difficult for emergency physician to diagnosis at an early stage because of its low incidence and atypical initial clinical features. Therefore, we reviewed the clinical features of 54 tetanus cases and attempted to identify factors associated with prognosis in order to improve early diagnosis and treatment. METHODS: We carried out a retrospective chart review of 54 adult tetanus patients who presented to the ED of Chonnam National University Hospital between January 1996 and December 2005. We collected information on demographics, SAPS II score, clinical feature, course of infection and prognosis. We divided the patients to two groups according to the survival and compared their data statistically. RESULTS: Fifty four patients, 33 men and 21 women, were included in the study. The mean age was 50.97+/-15.95. The most common initial diagnosis in ED were electrolyte imbalance (n=15), neck and facial dystonia (n=9). The mean incubation period was 10.27+/-6.47 days. The initial SPAS II score 17.29+/-8.45 and the Wood score was 3.12 +/-1.47. Most commonly symptom was dyspnea and dysarthria. Twenty one patients were supported by mechanical ventilation, and the duration of mechanical ventilation was 5.92+/-4.52 days. On multivariate logistic regression analysis, four variables were found to be associated with the prognosis: incubation period, Wood score, Time interval from initial symptom to mechanical ventilation, initial SAPS II. CONCLUSION: Four variables correlated well with the prognosis: Incubation period, Wood score, Time interval from initial symptom to mechanical ventilation, initial SAPS II score.
Adult ; Demography ; Diagnosis ; Dysarthria ; Dyspnea ; Dystonia ; Early Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Jeollanam-do ; Logistic Models ; Male ; Neck ; Prognosis ; Respiration, Artificial ; Retrospective Studies ; Tetanus* ; Wood