A Case of Severe Pseudomembranous Tracheobronchitis Complicated by Co-infection of Influenza A (H1N1) and Staphylococcus aureus in an Immunocompetent Patient / 결핵및호흡기질환

Although influenza A (H1N1) virus leads to self-limiting illness, co-infection with bacteria may result in cases of severe respiratory failure due to inflammation and necrosis of intra-airway, as pseudomembranous tracheobronchitis. Pseudomembranous tracheobronchitis is usually developed in immunocompromised patients, but it can also occur in immunocompetent patients on a very rare basis. We report a case of pseudomembranous tracheobronchitis complicated by co-infection of inflenaza A and Staphylococcus aureus, causing acute respiratory failure in immunocompetent patients.

The Effect of Sexual Abuse on Posttraumatic Psychiatric Symptoms in Children and Adolescents with Sexual Abuse

OBJECTIVES: The purpose of this study is to examine the effects of the characteristics of victim and sexual abuse on posttraumatic psychiatric symptoms in children and adolescents with a history of sexual abuse. METHODS: A total of 137 children and adolescents were recruited from the Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center, from January 2009 to December 2013. We collected the demographic data of the victims and the Trauma Symptom Checklist for Children (TSCC) from victims. We hypothesized victims' age, sex, and intelligence quotient, and the characteristics of sexual abuse as the affecting factors of posttraumatic psychiatric symptoms. Descriptive analysis and hierarchical regression analysis were performed for analysis of demographic data, TSCC scores, and psychiatric symptoms. RESULTS: The victims' age and the characteristics of sexual abuse were significantly related to the traumatic distress of sexual abuse. R-square was 23% for anxiety, 39% for depression, 21% for posttraumatic stress, and 37% for dissociation on TSCC. CONCLUSION: This study suggests that victims' age, type, frequency and duration of exposure, and disclosure of sexual abuse are significant affecting factors on posttraumatic psychiatric symptoms in children and adolescents. Exploration of psychiatric symptoms other than posttraumatic symptoms, and relations between pretraumatic and posttraumatic psychiatric symptoms is needed through collection of larger samples.

Headache and Facial Pain in Rhinologic Field : A 1 Year Experience

BACKGROUND AND OBJECTIVES: Sinus headaches are frequently mistaken as primary headaches, and thus, emphasizes the necessity of a specific diagnosis of symptoms to treat patients properly. Therefore, the authors investigated the specific clinical symptoms of patients who visited a rhinologist complaining of headaches or facial pain. SUBJECTS AND METHODS: The present study was performed with retrospective clinical analysis of 990 patients who visited rhinologists from August 2010 to August 2011. The presence and characteristics of headaches or facial pain, physical findings, and the results of treatment were investigated. RESULTS: One hundred sixteen out of 990 rhinologic patients complained of headaches or facial pain. Nineteen out of 69 patients with acute rhinosinusitis (27.5%), 28 out of 317 patients with chronic rhinosinusitis (8.8%), 7 out of 11 patients with fungal sinusitis (63.6%), and 10 out of 222 patients with allergic rhinitis (4.5%) had headaches or facial pain. The symptoms of the majority of cases were ameliorated after an appropriate rhinologic treatment. CONCLUSION: The differential diagnosis of diseases causing headache or facial pain in the rhinologic field should be strongly considered in order to cure patients with headaches more accurately, minimizing erroneous prescriptions.

Rat Mastoid Bullae Obliteration with Hydroxyapatite: Histopathologic Results with Various Size of Hydroxyapatite / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mastoid obliteration is the technique developed to reduce cavity problems after canal wall down mastoidectomy. Different materials have been explored for the technique, and of the variety of materials that have been used for mastoid obliteration, hydroxyapatite has gained particular attention. Hydroxyapatite can be made into a specific particle size, which affects the postoperative result. The aim of this study is to evaluate the histopathologic findings of mastoids obliterated with various particle sizes of hydroxyapatite in the temporal bullae of rat. Materials and Method: Rat bullaes were obliterated with hydroxyapatite and diversified into different particle sizes. In group 1, the mastoids were obliterated with Mimix(R) powder and in groups 2, 3, 4 with Bongros(R). The particle sizes were 0.3-0.6 mm, 0.6-1.0 mm and 1.0-3.0 mm each. After 3 months, the mastoids were examined under the microscope. RESULTS: In group 1, a new bone was formed in a consecutive fashion from the mastoid wall toward the center of the mastoid; there was no inflammation, with the new bone formation constituting 15%. In group 2, 3, 4, the proportion of new bone formation was higher than in the group 1, and constituted 40%, 55% and 60%, respectively. Inflammation was more severe when the particle size became larger. CONCLUSION: New bone formation was faster if larger hydroxyapatite particles were used; however, inflammation also increased. The powder form of hydroxyapatite was slow in new bone formation, but there was little inflammation. We therefore think that the hydroxyapatite is a very safe material.

Cochlear Implant Failure due to Cochlear Nerve Deficiency in a Child with Normal Internal Auditory Canal / 대한이비인후과학회지

The cochlear nerve, which propagates electrical signals to the auditory cortex, must function well for successful cochlear implantation. A narrow internal auditory canal (IAC) increases the risk of hypoplasia or aplasia of cochlear nerve, which may result in the failure of cochlear implantation. Therefore, a functioning cochlear nerve must be verified before deciding to do cochlear implantation by means of behavioral audiometry, electrophysiologic tests, or imaging studies in cases with narrow IAC. On the other hand, a candidate with a normal IAC can be overlooked in investigating the presence of functioning cochlear nerve. Because normal IAC does not always guarantee the presence of normal cochlear nerve, the functioning cochlear nerve should be proved prior to cochlear implantation in those cases. We report on a child, who had normal IAC and cochlea but failed auditory stimulation after cochlear implantation, and who was diagnosed as having cochlear nerve deficiency through retrospective review.

Histopathologic Study on the Obliteration of the Temporal Dorsal Bullae in Rat Using Hydroxyapatite Cement and Demineralized Bone Matrix / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mastoid obliteration surgery is a useful technique for otitis media either with or without cholesteatoma. Obliterating materials have to satisfy low antigenecity, less inflammation, little tissue resorption, high regeneration power and good integration into the host tissue. The aim of our study is to evaluate histopathological changes and effectiveness resulting from the different obliterating materials in the temporal dorsal bullae in rats. MATERIALS AND METHOD: We divided the rats into two groups. Group A was untreated, but group B underwent removal of mastoid mucosa with 2% trichloroacetic acid (TCA). Both groups had mastoid obliteration by the implantation of hydroxyapatite cement (Mimix(R)) and demineralized bone matrix (Regenafil(R)). Twelve weeks after the implantation, a histological study was performed to evaluate remaining implanted material, new bone formation and the formation of cysts within the bullae. RESULTS: There was no or minimal inflammation or foreign body reactions in the mastoid obliteration groups with Mimix(R) and Regenafil(R). In the obliterated group that was not treated with 2% TCA, the remaining implanted material with Mimix(R) group was more than in the Regenafil(R) group (p<0.05). The obliterated groups of Mimix(R) and Regenafil(R) were similar with respect to new bone formation. The mucocele formation in the obliterated groups treated with 2% TCA was less than in the obliterated groups not treated with 2% TCA (p<0.05). CONCLUSION: We suggest that Mimix(R) and Regenafil(R) could be valuable resources as graft materials for mastoid obliteration procedures. The research continues for evaluation of long term results of these materials and their potential as graft materials.

A Case of Nasal Septal Abscess Originated from Dentigerous Cyst / 대한이비인후과학회지

Nasal septal abscess can result from various causes such as septal hematoma from septal trauma or hematologic disorder, and infections of surrounding structures like nasal vestibule, upper lip and other oral lesions and hematogenous spread of other infections. Dentigerous cyst is one of the common odontogenic cysts, associated with unerupted teeth, and usually asymptomatic. Symptoms of the dentigerous cyst present mostly oral or maxillomadibular lesions, whereas nasal symptoms of the dentigerous cyst is uncommon. We report an unusual case of dentigerous of a 61 year-old of the dentigerous cyst of mesiodens with nasal septal abscess.

Psychopathology of Sexually Abused Children In Korea / 신경정신의학

OBJECTIVES: This study aimed to identify psychopathologies of sexually abused children and intervening variables of symptom severity. METHODS: Eighty-four school-aged children were identified for sexual abuse from a center for child sexual abuse by psychiatrists, clinical psychologists, and social workers. We analyzed correlations among symptom severity, types of sexual abuse, gender, age, relationship with the abuser, family system, and current and past psychopathologies. RESULTS: The percentage of victims with particular psychiatric disorders (current) were 79.8%. Children without identifiable disorders were 20.2%, but these children had significantly increased scores on self report scales of anxiety (RCMAS), depression (CDI), and withdrawal scores on parental reports of child behavior checklist (K-CBCL). Sixty nine percent of abused children had primary diagnosis related to sexual abuse in DSM-IV diagnositic system. PTSD was 41.7%, depressive disorder was 38.1%, and anxiety disorder was 21.4%. Psychopathologies were more severe if perpetrators were of acquaintance or if victims had previous psychopathologies or parent-child relational problems. Types of primary caregiver and older age were also related to the severity of psychopathologies. CONCLUSION: Present study suggests that most victims of childhood sexual abuse suffer from significant psychological distress. Intervening variables are relationship with the perpetrator, previous mental health status, age of the child, type of the primary care taker, and the quality of parent-child relationship.