Pulmonary hypertension (PH) is a condition of increased blood pressure in the pulmonary arteries and is diagnosed with an increased a mean pulmonary artery pressure ≥25 mm Hg. This condition may be associated with multiple clinical situations. Based on pathophysiological mechanisms, clinical presentation, hemodynamic profiles, and treatment strategies, the patients were classified into five clinical groups. Although there have been major advances in the management of PH, it is still associated with significant morbidity and mortality. The diagnosis and treatment of PH have been performed mainly by following European guidelines, even in Korea because the country lacks localized PH guidelines. European treatment guidelines do not reflect the actual status of Korea. Therefore, the European diagnosis and treatment of PH have not been tailored well to suit the needs of Korean patients with PH. To address this issue, we developed this guideline to facilitate the diagnosis and treatment of PH appropriately in Korea, a country where the consensus for the diagnosis and treatment of PH remains insufficient. This is the first edition of the guidelines for the diagnosis and treatment of PH in Korea, and it is primarily based on the ‘2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.’ with the acceptance and adaptation of recent publications of PH.

Regdanvimab is the only monoclonal antibody available in Korea that targets severe acute respiratory syndrome coronavirus 2. We retrospectively evaluated the clinical characteristics of 374 adults hospitalized with coronavirus disease 2019 (COVID-19) who were treated with regdanvimab from September through December 2021. In total, 322 (86.1%) patients exhibited risk factors for disease progression. Most patients (91.4%) improved without additional treatment. No patient died or was transferred to intensive care. This study shows that regdanvimab prevented disease progression in high-risk patients with mild to moderate COVID-19 infections during Delta variant predominance.

BACKGROUND: Otomycosis is a fungal infection that comprises 7~10% of outer ear infections. Although the occurrence is higher in humid climates, relatively few studies have investigated otomycosis occurrences in humid environments. While recurrent chronic otitis media discharge in the ear creates a milieu in which otomycosis is likely to occur, investigations of otomycosis co-occurring with chronic otitis media have been rare. OBJECTIVE: To examine the characteristics of patients with otomycosis co-occurring with chronic otitis media and identify causative fungi. METHODS: The study included 60 patients with chronic otitis media who presented typical otomycosis findings in the outer ear canal and the presence of fungi. Patients were treated in the department of otolaryngology, Daegu Catholic University Medical Center, between July 2011 and June 2018. RESULTS: The mean patient age was 57.77 years, and our study included 20 men and 40 women (p=0.010). The lesion was on the right in 39 patients and on the left in 21 (p=0.020). Ear discharge was the most common chief complaint at diagnosis. Of the 54 patients over age 19, 10 had diabetes (18.5%). Aspergillus was causative in 29 patients and Candida in 31. Aspergillus niger was identified in 15 patients, Aspergillus sp. in 14, Candida parapsilosis in 12, Candida sp. in six, and Candida albicans in five. CONCLUSION Otomycosis and chronic otitis media co-occurrences increase with age. The Aspergillus and Candida genera were similar in proportion. A. niger was the most common Aspergillus species, while C. parapsilosis was the most common Candida.

BACKGROUND AND OBJECTIVES: Honey has various biological and pharmacological activities and has been used as treatment against various inflammatory diseases. The aim of this study was to compare the anti-inflammatory characteristics of manuka, kanuka, and black locust honey. MATERIALS AND METHOD: Peripheral blood mononuclear cells (PBMCs) from healthy human volunteers were isolated and then stimulated with lipopolysaccharide (LPS) with or without pre-treatment of various concentrations of honey for 72 hours. The cytotoxic effects of honeys were measured using an aqueous cell proliferation kit, and the supernatants were analyzed for interleukin-5 (IL-5), IL-10, interferon-γ (INF-γ), and tumor necrosis factor-α (TNF-α) using an enzyme-linked immunosorbent assay. RESULTS: Samples of 1% manuka and kanuka honey were found to have cytotoxic effects on PBMCs. Honey itself enhanced the production of IL-10 and TNF-α production. Manuka and kanuka honeys suppressed LPS-induced IL-10 and INF-γ production, while black locust honey only suppressed IL-10 production from PBMCs. CONCLUSION: Honeys had immunomodulatory properties of both immunostimulatory and immunosuppressive effects on PBMCs. Different honeys might have different immune modulatory functions due to their different components.
Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Honey* ; Interleukin-10 ; Interleukin-5 ; Kunzea* ; Methods ; Necrosis ; Robinia*

An oval-shaped mass with a smooth surface was found in the ear canal of a 22-month-old male infant. Although the mass appeared to be almost entirely blocking the ear canal, it was successfully removed under a surgical microscope without general anesthesia at the outpatient department. Under an optical microscope with hematoxylin and eosin staining, the specimen was observed to have a cuticle with a serrated surface and a pore canal, as well as parts of the capitulum, salivary glands, muscles, midgut, and the legs. The specimen was identified as a hard tick of the family Ixodidae, based on gross and histological findings. This paper is the first report in Korea on the diagnosis and treatment of a tick bite in the ear canal.
Anesthesia, General ; Diagnosis ; Ear Canal* ; Eosine Yellowish-(YS) ; Female* ; Hematoxylin ; Humans ; Infant* ; Ixodidae* ; Korea ; Leg ; Male ; Muscles ; Outpatients ; Salivary Glands ; Tick Bites ; Ticks

PURPOSE: Chronic rhinosinusitis with nasal polyps is a chronic inflammatory disease with markedly increased eosinophils, Th2-type lymphocytes, fibroblasts, and goblet cells. Fungi are commonly associated with airway inflammatory diseases, and thymic stromal lymphopoietin (TSLP) is important in the development of Th2 inflammatory responses. The aim of this study was to investigate the interaction between airborne fungi and nasal fibroblasts in TSLP mRNA and protein expression. METHODS: Inferior turbinate and nasal polyp fibroblasts were stimulated with Alternaria and Aspergillus, respectively, for 48 hours, and TSLP mRNA and protein expressions were measured. The reverse transcriptase polymerase chain reaction was performed for the Toll-like receptor (TLR) mRNA expression of the nasal fibroblasts. To determine the role of TLR in the induction of TSLP, the fibroblasts were transfected with siRNA against TLR2 and TLR5. RESULTS: Alternaria induced TSLP mRNA and protein expression in both inferior turbinate and nasal polyp fibroblasts. The nasal polyp fibroblasts responded more strongly to the fungi. TLR2 and TLR5 mRNA expressions were significantly increased with fungal stimulation and TSLP production was significantly inhibited by siRNA against TLR2. CONCLUSIONS: The results of this study show that TSLP expression could be induced in nasal fibroblasts by exposure to Alternaria and that TLR2 may be involved in the process. The promotion of TSLP production in nasal fibroblasts by airborne fungi may facilitate the development or exacerbation of Th2-type nasal inflammation, especially in CRS with nasal polyps.
Alternaria* ; Aspergillus ; Eosinophils ; Fibroblasts* ; Fungi ; Goblet Cells ; Inflammation ; Lymphocytes ; Nasal Polyps ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; RNA, Small Interfering ; Toll-Like Receptor 2* ; Toll-Like Receptors* ; Turbinates

PURPOSE: The purpose of this study is to investigate the prognostic value of lymph node (LN) ratio (LNR) in patients with breast cancer after neoadjuvant chemotherapy. MATERIALS AND METHODS: This retrospective analysis is based on the data of 814 patientswith stage II/III breast cancer treated with four cycles of doxorubicin/cyclophosphamide followed by four cycles of docetaxel before surgery. We evaluated the clinical significance of LNR (3 categories: low 0-0.20 vs. intermediate 0.21-0.65 vs. high 0.66-1.00) using a Cox proportional regression model. RESULTS: A total of 799 patients underwent breast surgery. Pathologic complete response (pCR, ypT0/isN0) was achieved in 129 patients (16.1%) (hormone receptor [HR] +/human epidermal growth factor receptor 2 [HER2] –, 34/373 [9.1%]; HER2+, 45/210 [21.4%]; triple negative breast cancer, 50/216 [23.1%]). The mean numbers of involved LN and retrieved LN were 2.70 (range, 0 to 42) and 13.98 (range, 1 to 64), respectively. The mean LNR was 0.17 (low, 574 [71.8%]; intermediate, 170 [21.3%]; high, 55 [6.9%]). In univariate analysis, LNR showed significant association with a worse relapse-free survival (3-year relapse-free survival rate 84.8% in low vs. 66.2% in intermediate vs. 54.3% in high; p < 0.001, log-rank test). In multivariate analysis, LNR did not show significant association with recurrence after adjusting for other clinical factors (age, histologic grade, subtype, ypT stage, ypN stage, lymphatic or vascular invasion, and pCR). In subgroup analysis, the LNR system had good prognostic value in HR+/HER2–subtype. CONCLUSION: LNR is not superior to ypN stage in predicting clinical outcome of breast cancer after neoadjuvant chemotherapy. However, the prognostic value of the LNR system in HR+/HER2–patients is notable and worthy of further investigation.
Breast Neoplasms* ; Breast* ; Cohort Studies* ; Drug Therapy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoadjuvant Therapy ; Prognosis ; Receptor, Epidermal Growth Factor ; Recurrence ; Retrospective Studies* ; Survival Rate ; Triple Negative Breast Neoplasms

Labyrinthine fistula refers to a condition caused by an abnormal connection between the inner ear and surrounding structures. Most cases of that occur as a result of a complication brought about by cholesteatoma. It may also be generated by long repeated infections of a mastoid cavity that has been exposed to the outside after canal wall down mastoidectomy (CWDM). The infection is usually repeated for several years or decades after surgery. Therefore, labyrinthine fistula after CWDM is known as a late complication. In this case, labyrinthine fistula occurred in two months after surgery due to postoperative infection. Although cholesteatoma was removed after CWDM and the horizontal semicircular canal (HSCC) was not damaged during the operation, this labyrinthine fistula was thought to develop very early after surgery. Two months after surgery, the patient complained of dizziness, we identified the opened bony labyrinth and damaged endosteum of the HSCC in the patient.
Cholesteatoma ; Dizziness ; Ear, Inner ; Fistula ; Humans ; Mastoid ; Semicircular Canals

BACKGROUND AND OBJECTIVES: Zinc has antioxidant effect, anti-inflammatory effect and neuromodulative function. The purpose of this study was to investigate whether treatment with zinc can improve the outcome of sudden sensorineural hearing loss (SSNHL). SUBJECTS AND METHOD: The study group consisted of 143 patients diagnosed as SSNHL. Of the patients, 82 were given corticosteroid treatment (group Ct) and 61 were given oral zinc plus corticosteroid treatment (group Zn). In group Zn, serum zinc level was checked before treatment and the patients with normal serum zinc level were included. Hearing was assessed before therapy and at 2 weeks, 1 month and 2 months after the initiation of therapy. RESULTS: A significantly larger hearing gain in pure tone average (group Ct vs. group Zn=26.40 dB HL vs. 34.28 dB HL) and at 2000 Hz (group Ct vs. group Zn=24.93 dB HL vs. 33.60 dB HL) and 8000 Hz (group Ct vs. group Zn=11.64 dB HL vs. 20.66 dB HL) were seen in group Zn compared with the group Ct. CONCLUSION: Oral zinc supplementation may have beneficial effects in the treatment of SSNHL, especially at 2000 and 8000 Hz.
Antioxidants ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Zinc*

Benign paroxysmal positional vertigo is the most common disease of the peripheral vestibular disorder. A 51-year-old man showed geotropic horizontal nystagmus in the head roll test. After head-bending posture, the nystagmus of the patient was changed to apogeotropic horizontal nystagmus in the head roll test. We concluded that transition of canalolithiasis into cupulolithiasis happened during head-bending posture. The cupulolithiasis was returned to canalolithiasis by using side-lying position with the affected ear downward for approximately 45 minutes.
Ear ; Head ; Humans ; Middle Aged ; Nystagmus, Pathologic ; Posture ; Semicircular Canals ; Vertigo