BACKGROUND AND OBJECTIVES: This study is aimed to investigate the efficacy of dexamethasone and methylprednisolone when used for Intratympanic steroid injection (ITSI) concurrent with systemic steroid as primary therapy. SUBJECTS AND METHOD: We undertook a retrospective study of 106 patients diagnosed with Idiopathic Sudden Sensorineural Hearing Loss at our institution. These patients were divided into the following groups based on their intratympanic steroid medications: Group 1 (which received dexamethasone for ITSI) and Group 2 (which received methylprednisolone for ITSI). The severity of pain after ITSI was also compared using Visual Analogue Scale. RESULTS: The therapeutic results of both groups showed no significant difference. The improvement of pure tone audiometry average threshold were 18.3±19.5 dB for Group 1 and 22.4±25.8 dB for Group 2, with no significant differences (p=0.402). The recovery rate according to Siegel's criteria were 34/70 (48.6%) and 18/36 (50.0%) respectively, with no significant differences (p=0.889). The degree of pain after ITSI were 1.51±1.06 and 3.92±1.63 for Group 1 and 2, respectively, showing significant differences (p<0.001). Again, there were no significant differences even when accompanying symptoms or severity of initial hearing loss were considered. CONCLUSION: There was no significant difference between efficacy of dexamethasone and methylprednisolone when used as primary therapy. Methylprednisolne caused more severe pain after ITSI, suggesting the choice of dexamethasone. Further studies are needed about the concentration of injected steroid.
Audiometry ; Dexamethasone ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Injection, Intratympanic ; Methods ; Methylprednisolone ; Retrospective Studies ; Steroids

Anatomic Variation ; Arteries ; Humans ; Korea ; Maxilla ; Osteotomy ; Sphenoid Bone ; Spine

Spontaneous neonatal esophageal perforation (EP) is a rare condition. However, iatrogenic EP due to a feeding tube is not uncommon, particularly in premature infants. Iatrogenic EP can result in serious complications, such as a pneumothorax, and can be fatal. Usually a pneumothorax develops as a result of EP. However, we experienced an EP in a patient with a pneumothorax. The EP occurred after inserting a feeding tube while the patient was suffering from a pneumothorax. Thus care is needed when inserting the feeding tube in a patient with a pneumothorax.
Complex Mixtures ; Esophageal Perforation ; Humans ; Infant, Newborn ; Infant, Premature ; Pneumothorax ; Stress, Psychological

OBJECTIVES: The purpose of this study was to investigate the pattern of longitudinal changes in cerebral blood perfusion defects using SPECT in patients with dementia of Alzheimer's type . METHOD: Twelve patients with dementia of Alzheimer's type(10 male, 2 female; mean age 73.25+/- 10.62 years), diagnosed by the criteria of the DSM IV and the NINCDS-ADRDA, and ten normal comparison subjects(7 male, 3 female; mean age 75.10+/-5.76 years) were recruited. They were rated by Mini-Mental Status Examination, Mattis dementia Rating Scale, and Hamilton Depression Rating Scale. rCBF(regional cerebral blood flow) was measured using 99mTc-HMPAO SPECT at the initial study in all subjects, but rCBF was remeasured only in the patients after the follow-up period of average 2 years. SPECT scans of dementia patients and comparison subjects were analyzed by three- dimensional volume of interest method. RESULTS: Results were as follows. 1) There were significant perfusion defects in the bilateral frontal and temporoparietal areas in patients with dementia compared with normal comparison subjects at the baseline evaluation. More extensive perfusion defects including left superior frontal and medial temporal areas were observed in the follow-up SPECT scan compared with baseline scan. 2) There was significant negative correlation between rCBF of bilateral temporal lobe at the baseline scan and the rate of decline of scores of MMSE-K and Mattis dementia rating scale. 3) Various areas of the brain showed correlations between rCBF at the baseline scan and the rate of decline of scores of five subscales of Mattis dementia rating scale. CONCLUSIONS: Three-dimensional VOI approach using SPM analysis showed the characteristic perfusion defects and pattern of longitudinal changes in the patients of dementia of Alzheimer's type, which may be overlooked by the conventional region-of-interest technique. This alteration in rCBF may be closely related to the pathophysiological process of dementia of Alzheimer's type.
Brain ; Dementia* ; Depression ; Female ; Follow-Up Studies ; Frontal Lobe ; Humans ; Longitudinal Studies* ; Male ; Perfusion* ; Technetium Tc 99m Exametazime ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

PURPOSE: Point-of-care tests (POCTs) have the potential to significantly influence management of neonates. The aim of this study was to assess the clinical usefulness of the POCT chemistry analyzer in a neonatal intensive care unit (NICU). METHODS: Blood samples of neonates admitted to the NICU were tested using a POCT chemistry analyzer (Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) and a central laboratory chemical analyzer (Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan) from March to September, 2010. Correlation of 15 analytes between the POCT and the central laboratory machine was evaluated. For consistency of the POCT, three consecutive samplings were performed. Differences among the three tests were recorded. The causes of performance errors were checked through log files. RESULTS: One hundred of 112 pairs of tests for accuracy performed in 54 neonates showed a high correlation between the two machines. Twelve performance errors occurred during the 112 tests. The most common error was insufficient sample error. Eighteen triplet tests performed in 18 patients for consistency revealed a difference range of 3-10%, which was considered to be acceptable. No error occurred during the 54 tests. CONCLUSION: The POCT is capable of analyzing multiple analytes with a minimal amount of whole blood in a short time. The few performance errors noted presently are likely preventable. This POCT is concluded to be suitable for use as a simple and rapid diagnostic method in the NICU with a minimal amount of blood collected in a less invasive manner.
Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Point-of-Care Systems ; Tokyo ; Triplets

BACKGROUND AND OBJECTIVES: Surgeons operate carefully to prevent nasal deformity during septoplasty, however, rarely unfavorable esthetic outcomes such as saddle nose deformity may occur. This study was designed to investigate patient factors associated with post-septoplasty saddle deformity. SUBJECTS AND METHOD: Of 588 patients who underwent endonasal conservative septoplasty from Jan. 2011 to Dec. 2014, a total of 183 patients were enrolled in this study group after exclusion. Patients were divided into two groups: 12 patients who developed saddle deformity of nasal dorsum after septoplasty belonged to the 'deformity group', and the remaining 171 patients were enrolled in the 'non-deformity group'. We investigated preoperative external nose status, patterns of septal deformity, dorsal septal thickness, the angle of axial and coronal deviation of caudal sepum on CT scan. RESULTS: The postoperative saddle deformity was not found to correlate with the location of the most deviated septum and the thickness of dorsal septum (p>0.05). 50% of patients in the deformity group had saddle nose preoperatively, showing statistical differences between the two groups (p=0.000). 75% of patients in the deformity group had severe deviation at the most deviated site, also showing a significant difference compared with the non-deformity group (p=0.011). The axial and coronal deviation angle of caudal septum in the deformity group were significantly increased compared with the non-deformity group (p<0.01). CONCLUSION: The preoperative saddle nose, severity of deviation, and angle of axial and coronal deviation of caudal septum are all possible risk factors of postoperative saddle deformity. We recommend that the surgeon should check these factors before septoplasty to prevent postoperative saddle nose deformity.
Congenital Abnormalities* ; Humans ; Nose* ; Risk Factors* ; Tomography, X-Ray Computed

BACKGROUND: Induction of coagulation necrosis by using thermal energy sources such as radio-frequency (RF), microwaves and lasers has recently been as a new, minimally invasive technique for percutaneous tumor ablation. RF ablation is considerd effective and safe for the local control of small HCCs. The aim of this study is to evaluate the therapeutic efficacy and complications according to the diameter and location of the HCC. METHODS: Between May 1999 and December 2000, one hundred fifty patients underwent RF thermal ablation in Dong-A university hospital. Among them, forty nine patients were enrolled in this study who have no history of prior other treatment including hepatic resection, TAE, PEI, and chemotherapy, also who have follow-up CT performed at least six months after ablation. The patients devided into two groups, who have small HCC (3 cm in diameter), the mean follow-up duration was 10.8 months and local recurrence rate was 51.0%+/-12.4. In small HCC group ( Carcinoma, Hepatocellular* ; Drug Therapy ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Microwaves ; Necrosis ; Pleural Effusion ; Pneumothorax ; Recurrence ; Tomography, Spiral Computed

BACKGROUND/AIMS: The association between depression and chronic hepatitis C virus (HCV) infection or pegylated interferon α and ribavirin therapy (PR therapy) has not been extensively studied in Korea. We aimed to clarify the prevalence of depression and its incidence during PR therapy in chronic hepatitis C (CHC) patients. METHODS: In this prospective, multicenter study, 114 CHC patients were screened for depression using two self-reported scales, the Beck Depression Inventory-I (BDI-I) and the Hospital Anxiety and Depression scale (HADS). The incidence of depression during PR therapy was evaluated in 62 patients who underwent PR therapy during the study period. RESULTS: The prevalence of baseline depression was 17.5% according to the BDI-I score ≥10 criterion and 4.4% according to the HADS-D score ≥8 criterion in the 114 CHC patients, and it was significantly associated with an unmarried state. During PR therapy, depression developed in 34.6% according to the BDI-I scale and 29.5% according to the HADS-D, which negatively affected sustained virologic response (SVR). CONCLUSIONS: The prevalence of depression in Korean CHC patients appears to be low compared to that in Western patients; however, its incidence during PR therapy (approximately 30%) was similar to that of other populations, which led to a lower SVR rate. Active screening and multidisciplinary management of depression during PR therapy is warranted.
Anxiety ; Depression* ; Hepacivirus ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence* ; Interferons ; Korea ; Mass Screening ; Prevalence* ; Prospective Studies ; Republic of Korea* ; Ribavirin ; Single Person ; Weights and Measures

Bone and Bones ; Carbocyanines ; Cell Culture Techniques ; Coculture Techniques ; Collagen ; Collagenases ; Drug Combinations ; Durapatite ; Endothelial Cells ; Laminin ; Lipoproteins ; Magnetics ; Magnets ; Mandible ; Mesenchymal Stromal Cells ; Molar, Third ; Nylons ; Osteoblasts ; Osteogenesis ; Perchloric Acid ; Periosteum ; Proteoglycans

Sudden death during or after percutaneous coronary intervention (PCI) could be led to potential medicolegal disputes. This study aimed to investigate the clinical and postmortem findings in PCI-related deaths-focusing on the current statusto inform preventive strategies against these fatalities. Forty-three cases were retrieved from the National Forensic Service's postmortem records between 2015 and 2021, and the corresponding postmortem findings and clinical information were analyzed. The analyses revealed a relatively consistent annual incidence of PCI-related deaths. Immediate deaths during or shortly after PCI occurred in 17 cases (39.5%), and delayed PCI-related deaths after discharge from the hospital occurred in 26 cases (60.5%). The causes of PCI-related deaths in the postmortem cases were categorized into four groups: PCI complications (11 cases, 26%), acute myocardial infarction (23 cases, 53%), ischemic heart disease (8 cases, 19%), and others (1 case, 2%). Postmortem examinations played a critical role in determining the cause of death and obtaining medical evidence, including pathological findings of the heart as well as those of coronary artery and stent insertion. Our findings suggest that a detailed examination of the heart, coronary arteries, stent status, and atherosclerosis in PCI-related deaths could help provide more accurate information as medical evidence and prevent/resolve potential medicolegal issues. Further, this could advance our understanding of PCI-related deaths and inform future preventive strategies.