Subglottic stenosis (SGS) and tracheal stenosis (TS) are rare conditions that can cause significant breathing difficulties and, if not properly managed, may lead to life-threatening complications. Despite their clinical importance, debate continues regarding the optimal management of adult SGS and TS, and no comprehensive guidelines have been established to date. The Korean Bronchoesophagological Society appointed a task force to develop clinical practice guidelines with the goal of providing evidence-based recommendations for managing SGS and TS in adults. The task force conducted a systematic review of the relevant literature by searching PubMed, Embase, and the Cochrane Library using predefined search terms aligned with key clinical questions. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, which also informed the formulation and reporting of the recommendations. The strength of each recommendation reflects the guideline panel’s confidence that the benefits of an intervention outweigh its risks for eligible patients. After drafting the guidelines, feedback was obtained through Delphi questionnaires completed by members of the Korean Bronchoesophagological Society. Ultimately, the committee developed 17 evidence-based recommendations across four categories: initial evaluation, medical management, surgical treatment, and postoperative management and rehabilitation. These guidelines aim to support clinicians in delivering optimal care to adult patients with SGS and TS.

PURPOSE: Encephalitis is an inflammation affecting brain parenchyma. At the time of presentation, it may be difficult to differentiate between viral encephalitis and altered mental status or seizures during febrile illness. The aim of the present study is to identify the predictive factors and to determine the prognostic factors of viral encephalitis in children presenting as seizure with fever. METHODS: From the retrospective review of the medical records, children with seizures or altered mental status during febrile illness who presented to Samsung Medical Center between January 2008 and May 2013 were included in the study. RESULTS: 81 patients were enrolled in this study (female:male=32:49). The mean age at admission was 4.9±4.3 years (range 0–14 years old). The patients were categorized into two groups according to the clinical diagnosis: (1) Viral encephalitis (VIRAL ENC, n=66), (2) Complex febrile seizures imitating viral encephalitis(C-FS, n=15). The predictive factors of viral encephalitis were focal and/or lateralized abnormalities in electroencephalography (EEG) (P<0.001). CONCLUSION: EEG can be helpful to predict the viral encephalitis, in pediatric patient who shows delayed restoration of consciousness after seizure during febrile illness.
Brain ; Child ; Consciousness ; Diagnosis ; Electroencephalography ; Encephalitis ; Encephalitis, Viral* ; Fever ; Humans ; Inflammation ; Medical Records ; Retrospective Studies ; Seizures ; Seizures, Febrile

Endothelial cells are a vital constituent of most mammalian organs and are required to maintain the integrity of these tissues. These cells also play a major role in angiogenesis, inflammatory reactions, and in the regulation of thrombosis. Angiogenesis facilitates pulp formation and produces the vessels which are essential for the maintenance of tooth homeostasis. These vessels can also be used in bone and tissue regeneration, and in surgical procedures to place implants or to remove cancerous tissue. Furthermore, endothelial cell regeneration is the most critical component of the tooth generation process. The aim of the present study was to stimulate endothelial regeneration at a site of acute cyclophosphamide (CP)-induced endothelial injury by treatment with human umbilical cord-derived endothelial/mesenchymal stem cells (hEPCs). We randomly assigned 16 to 20-week-old female NOD/SCID mice into three separate groups, a hEPC (1 x 10(5) cells) transplanted, 300mg/kg CP treated and saline (control) group. The mice were sacrificed on days 5 and 10 and blood was collected via the abdominal aorta for analysis. The alanine transaminase (ALT), aspartate aminotransferase (AST), serum alkaline phosphatase (s-ALP), and albumin (ALB) levels were then evaluated. Tissue sections from the livers and kidneys were stained with hematoxylin and eosin (HE) for microscopic analysis and were subjected to immunohistochemistry to evaluate any changes in the endothelial layer. CP treatment caused a weight reduction after one day. The kidney/body weight ratio increased in the hEPC treated animals compared with the CP only group at 10 days. Moreover, hEPC treatment resulted in reduced s-ALP, AST, ALT levels compared with the CP only group at 10 days. The CP only animals further showed endothelial injuries at five days which were recovered by hEPC treatment at 10 days. The number of CD31-positive cells was increased by hEPC treatment at both 5 and 10 days. In conclusion, the CP-induced disruption of endothelial cells is recovered by hEPC treatment, indicating that hEPC transplantation has potential benefits in the treatment of endothelial damage.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aorta, Abdominal ; Aspartate Aminotransferases ; Blood Vessels ; Cyclophosphamide ; Endothelial Cells ; Eosine Yellowish-(YS) ; Female ; Glycosaminoglycans ; Hematoxylin ; Homeostasis ; Humans ; Hypogonadism ; Immunohistochemistry ; Kidney ; Liver ; Mice ; Mitochondrial Diseases ; Ophthalmoplegia ; Regeneration ; Stem Cell Transplantation ; Stem Cells ; Thrombosis ; Tooth ; Transplants ; Weight Loss

Citrobacter freundii is frequently isolated in antimicrobial-resistant nosocomial infections. Many strains of Citrobacter freundii are capable of producing an inducible broad-spectrum beta-lactamase. We report a case of an abdominal aortic aneurysm infected with Citrobacter freundii. A 55-year-old woman presented with acute lower back pain. Contrast enhanced computed tomography revealed a saccular aneurysm of the infrarenal abdominal aorta, with impending rupture. She underwent emergency surgery, during which a segment of aneurysmal aorta and infected tissue were completely removed and an in situ graft was placed for vascular reconstruction. The anastomotic site and inserted graft were wrapped with greater omentum. Citrobacter freundii was isolated by tissue culture from the resected aneurysmal wall.
Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; beta-Lactamases ; Citrobacter ; Citrobacter freundii ; Cross Infection ; Emergencies ; Female ; Humans ; Low Back Pain ; Middle Aged ; Omentum ; Rupture ; Transplants