Clinical characteristics of heat stroke in bath facilities, and analysis of predictive factors of multiple major complications

OBJECTIVE: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. METHODS: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. RESULTS: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2–29.9), Glasgow Coma Scale (GCS)≤8 (OR, 8.2; 95% CI, 1.3–49.4), and mean arterial pressure (MAP), body temperature above 40.5℃ (OR, 8.1; 95% CI, 1.1–58.8) < 60 mmHg (OR, 14.8; 95% CI, 1.8–122.9). CONCLUSION: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ≤8, and MAP < 60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

The Effects of Sperm Motility Stimulants on the Hyperactivation, Acrosomal Reaction of Sperm and their in vitro Fertilization / 대한산부인과학회잡지

OBJECTIVES: To evaluate the effects of sperm motility stimulants on the hyperactivation (HA), acrosomal reaction (AR) and sperm penetration assay (SPA) in fresh and frozen-thawed spermatozoa from fertile men. METHODS: We treated the semen samples obtained from 20 normospermic men (fresh semens from 10 and cryopreserved ones from 10) with pentoxiphylline (PF) and 2-deoxyadenosine (2-DXA) to evaluate the change of the patterns of motility using the computerized motility analyzer. The semen samples treated with motility stimulants were incubated in the medium with calcium ionophore A23187 for the examination of the proportion of acrosome lost spermatozoa. Finally we performed SPA in both groups for the evaluation of fertilizing capacity after stimulant treatments. RESULTS: In both fresh and cryopreserved semen samples, the addition of PF and 2-DXA significantly altered the patterns of motility (ALH, VCL, HA) known to have association with sperm quality without increasing the number of sperms with progressive motility and velocity. A23187 induced AR was also augmented by the treatment with PF and 2-DZA. Although the treatment with PF did not increase the mean rates of egg penetration significantly, in selected cases in the cryopreserved semen group, the improvement of the motility pattern was impressive. CONCLUSION: PF and 2-DXA can improve the quality of sperm function in both fresh and frozen-thawed semen from normal fertile men and may increase the sperm penetration rate of zona-free hamster eggs in selected samples of the frozen-thawed semen. The results suggest that PF and 2-DXA pretreatment can be used in the clinical practice for intrauterine insemination (IUI) program with frozen-thawed sperms as well as with samples from men with abnormal semen parameters. In addition, it may be a cost- effective therapy to try IUI combined with such a pretreatment for the couples planned to enter into the ART program.

A Clinical Study of Medullary Thyroid Carcinoma: 12 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Medullary thyroid carcinoma (MTC) accounts for about 5-10% of all thyroid cancers worldwide, but only for 2-4% in Korea. Its prognosis is relatively poorer than well-differentiated thyroid carcinoma (WDTC). We performed this study to find the adequate treatment methods through the analysis of clinical features and treatment process of 12 MTC cases. MATERIALS AND METHODS: We conducted retrospective chart review about 12 cases of pathologically proven MTC treated from 1991 to 1996 at the department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital. We analyzed their clinical features, treatment modalities and treatment outcomes. RESULTS: Male/female ratio was 1:1 (6:6) with the mean age of 46.2 (19-73) years. Mean follow-up periods were 26.8 (3-48) months and MTC accounted for 2.7% of all thyroid cancers during the period of 1991 to 1996. We performed surgical procedures in all cases. In 5 cases of disease-free status, complete surgical removal of tumor was performed in the first operation, and no recurrence occurred during the follow-up period. In the other 5 cases, incomplete surgical removal was inevitable due to carotid artery invasion or mediastinal extension, etc. These patients received many additional surgery and radiotherapy, but their condtion did not improve. In one case, we performed complete excision but he expired with double primary cancer: one other case who was confirmed as MEN type 2b had been suspicious of recurrence, but she was lost during the follow-up period. CONCLUSION: We confirmed that MTC has relatively poorer prognosis than WDTC, and completeness of surgical excision is important. Persistent tumor is a major cause of mortality, and the tumor is unable to remove through the other methods. So early diagnosis and treatment is the most important prognostic factor. We recommend that aggressive and meticulous surgical removal is important in MTC management.

A Case of Malignant Lymphoma of the Thyroid Gland / 대한이비인후과학회지

Malignant lymphoma of the thyroid gland is extremely rare and its relatedness to Hashimoto's thyroiditis is well documented. Thyroid lymphoma frequently compromises the upper aerodigestive tract and should be differenciated from the anaplastic thyroid carcinoma. Also, thyroid lymphoma is known to often recur in the gastrointestinal tract. Recently we have experienced a case of B cell immunoblastic type, non-Hodgkin's malignant lymphoma of the thyroid gland in a 61 year-old male patient. The case presented a rapidly growing mass with dyspnea at the anterior neck, and an open biopsy with tracheostomy was carried out. The patient received a combination chemotherapy and a partial remission was observed.

Tracheal Shaving in the Thyroid Papillary Carcinoma with Airway Invasion / 대한이비인후과학회지

OBJECTIVES: We analyzed the outcome of trachea shaving in 20 patients with locally invasive thyroid papillary carcinoma. MATERIALS AND METHODS: From Jan. 1992 to Jun. 1994, we treated surgically 205 patients with papillary thyroid carcinoma, of whom 41 revealed upper airway invasion and 20 were treated with the shaving method. The others were treated with window resection, circumferential resection, and total laryngopharyngectomy with free jejunal graft. Twenty patients who underwent the shaving procedure were followed up for 28 to 59 months (mean of 49.5 months) and were examined for the incidence of recurrence by way of physical examinations, elevated serum thyroglobulin, despite of the TSH suppression therapy, iodine whole body scan, and the endoscopic examination. RESULTS: The rate of recurrence was 5% (one patient), and it was detected by the iodine whole body scan. The site of recurrence was the pyriform sinus and paraglottic space, so we performed partial laryngopharyngectomy. CONCLUSION: In thyroid papillary carcinoma invading the upper airway, the extent of resection should be determined individually according to the extent of tumor invasion. If the adventitia of the trachea is only the invasion site, and a grossly complete resection is performed, the 'shaving' method may be sufficient. However, the window resection or the circumferential resection should be performed in more invasive cases. Our data suggest that the surgical method of resection may be determined individually, and surgeons who have flexible attitudes may have good results.

The Study of Prognostic Factor of the Parotid Tumor / 대한이비인후과학회지

BACKGROUND: Tumors developing in the parotid gland tend to be of a large variety of histopathologic types. The relative rarity of parotid gland tumors makes epidemiologic study more difficult. To develop a rational therapeutic plan for tumors of the parotid gland, the surgeon must be fully cognizant of the factors that may affect survival. MATERIALS AND METHOD: The authors retrospectively studied 110 patients with histologically confirmed salivary gland tumor in the parotid glands at Korea Cancer Center between 1986 and 1995. We analyzed the histopatologic type and 5-year survival rate according to the some prognostic factors. RESULTS: Among the 110 patients, 39 had malignant parotid tumors. There were no recurtence in those who had parotid tumors. The overall 5-year survival rate was 62.4%. We observed statistically significant differences for patients of different clinical stages and histological grade. CONCLUSION: In summary, the clinical stage and histological grade are the significant prognostic factors, and these factors need to be considered in the treatment of parotid gland tumors.

A Clinical Analysis in Minor Salivary Gland Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. Generally, it is reported that the prognosis of malignant tumors of minor salivary glands are worse than that of such lesions of major salivary glands. We performed this study to find out the clinical features and determine the prognostic factors of minor salivary gland tumors. MATERIALS AND METHODS: We analyzed retrospectively, 83 cases of minor salivary gland tumor and the 10 year survival rates using the Kaplan-Meier method. RESULTS: We found 16 benign tumors and 67 malignant tumors. Among the patients, 43 were males and 40 were females. The most common age group was the sixties, with the mean age of 50. The most common site of benign tumor was the palate, whereas malignant tumors were most commonly found in the maxillary sinus, palate, and floor of mouth, etc. Histopathologically, 14 patients with benign tumor had pleomorphic adenoma, and 39 patients with malignant tumor had adenoid cystic carcinoma. According to the criteria set by the AJCC on staging, the most common stage found for the subjects were the stage IV. Overall, the 5 year and 10 year survival rates were 56.1% and 46.9%, respectively. Histopathologic type had no effect on 10 year survival rates. The clinical stage had a significant impact on survival. CONCLUSION: In minor salivary gland tumor, the most significant prognostic factor was its clinical stage. Considering the frequent local recurrence and distant metastasis, long term follow ups will be needed.

A Clinical Analysis of Neck Masses / 대한이비인후과학회지

OBJECTIVE: We studied the clinical manifestations and charicteristics of the neck masses for taking the correct diagnosis. MATERIALS AND METHODS: In 1995, 403 patients were admitted and treated with neck masses at department of otolaryngology-head and neck surgery, Korea Cancer Center Hospital and analyzed retrospectively. The diagnosis was confirmed by radiological(CT, MRI, Ultrasonograph, etc) and histopathological(fine-needle aspiration cytology, incisional or excisional biopsies, and surgical procedures) studies. RESULTS: Ten cases(2.5%) were below 15 year-old age group and there were 4 cases of congenital masses, 3 cases of inflammatory masses, 2 cases of benign neoplasia, and 1 cases of malignant neoplasm. One hundred thirty-one cases(32.5%) were between 16 and 40 year-old age group and there were 7 cases of congenital masses, 33 cases of inflammatory masses, 31 cases of benign neoplasia, and 60 cases of malignant neoplasia. Two hundred sixty-two cases(65.0%) were above 41 year-old age group and there were 6 cases of congenital masses, 16 cases of inflammatory masses, 31 cases of benign neoplasia, and 20 cases of malignant neoplasia. Above 41 year-old age group, the malignant neoplasia were frequent. In all cases, the malignant neoplasia were frequent(67.0%) and among these primary malignant neoplasia were 118 cases and metastatic malignant neoplasia were 152 cases. In 17 cases of congenital masses, thyroglossal duct cyst was 7 cases and branchial cleft cyst was followed. In 52 cases of inflammatory masses, tuberculous lymphadenitis was the most(27cases) and reactive lymphadenitis was followed. In benign neoplasia, adenomatous goiter was the most(47cases) among 64 cases. CONCLUSION: Malignant neoplasia was 67.0%(270/403) of the neck masses and among these metastatic tumors was 56.3%(152/270). In women congenital masses was the most and then inflammatory masses and benign tumors were followed but in men malignant tumors were the most. After 5th decade, malignant neoplasia were frequent(79.8%) and neck masses in old age-patients were suspicious for the malignancies.

A case of simultaneous presentation of uterine endometrial adenocarcinoma with right ovarian endometrioid carcinoma and left ovarian serous adenocarcinoma / 대한산부인과학회잡지

No abstract available.

Three cases of acardia monster / 대한산부인과학회잡지

No abstract available.