Recent Increase of Human Granulocytic Anaplasmosis and Co-Infection with Scrub Typhus or Korean Hemorrhagic Fever with Renal Syndrome in Korea

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.

A Case of Parotid Gland Salivary Fistula Treated by Tympanic Neurectomy / 대한이비인후과학회지

The parotid gland salivary fistula is one of the complications following parotidectomy and can result in patient discomfort and wound infection. Various methods have been used for resolution of salivary gland fistula including non surgical and surgical management. Non-surgical managements such as pressure dressing, radiation therapy and pharmacotherapy are simple and safe but mostly require a relatively long period for healing. Surgical managements are recommended if conservative therapy and pharmacological intervention fail. Surgical options for parotid gland salivary fistula include total parotidectomy, salivary duct ligation, delayed primary repair of duct, and tympanic neurectomy. However, there is no uniform consensus regarding the surgical option of choice for parotid gland salivary fistula. Recently, we experienced a patient with a persistent parotid gland salivary fistula after parotidectomy, which was successfully treated by tympanic neurectomy. We found that the effect of tympanic neurectomy was not strong enough to be recommended as a method of choice for the clinical inactivation of persistent parotid gland salivary fistula. Therefore, we report this case for the first time in our country with the review of literatures.

A Case of Chronic Invasive Fungal Sinusitis Invading Pterygopalatine Fossa / 대한이비인후과학회지

Chronic invasive fungal sinusitis is a slowly destructive process that most commonly affects the ethmoid and sphenoid sinus, but may involve any paranasal sinus. The disease typically has a time course over 12 weeks. Pathologically, it is characterized as a dense accumulation of hyphae, occasional vascular invasion and sparse inflammatory reaction with involvement of local structures. Aspergillus fumigates is the most common pathogen. In this report, we present a patient with chronic invasive fungal sinusitis invading pterygopalatine fossa, which was presented as only mild thickening of posterior wall of maxillary sinus at initial CT scan.

Conditioned Medium from Dying Smooth Muscle Cell Induced Apoptotic Death

In this study, the authors investigated whether death of vascular smooth muscle cell (VSMC) had a pathological pertinence. Conditioned media obtained from rat aorta smooth muscle cell (SMC) that were induced death by expressing FADD in the absence of tetracycline (FADD-SMC) triggered death of normal SMC. DNA fragmentation and caspase-3 activation were observed in dying SMC by conditioned media. FADD-SMC showed transcriptional activation of tumor necrosis factor (TNF)-alpha. Conditioned medium contained TNF-alpha, indicating secretion of the cytokine from dying FADD-SMC. It was investigated if secreted TNF-alpha was functional. Conditioned medium activated ERK and p38 MAPK pathways and induced MMP-9 expression, whereas depletion of the cytokine with its soluble receptor (sTNFR) remarkably inhibited induction of MMP-9 by conditioned medium. These findings suggest that TNF-alpha in conditioned medium seems to be active. Then, contribution of TNF-alpha on death-inducing activity of conditioned medium was examined. Depletion of TNF-alpha with soluble TNF-alpha receptor decreased the death activity of conditioned medium by 35%, suggesting that TNF-alpha play a partial role in the death activity. Boiling of medium almost completely abolished the death-inducing activity, suggesting that other heat labile death inducing proteins existed in conditioned medium. Taken together, these results indicate that SMC undergoing death could contribute to inflammation by expressing inflammatory cytokines and pathological complications by inducing death of neighboring cells.

Clinical Studies on Congenital Heart Diseases

The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.

Two cases of doxorubicin-induced dilated cardiomyopathy

No abstract available.