Clinical features of respiratory adenovirus infections in pediatric inpatients in a single medical center

PURPOSE: The purpose of this study is to identify the epidemiologic and clinical characteristics of respiratory adenovirus infections in children, and to investigate the difference in the clinical features between single adenovirus infection and coinfection with adenovirus and other respiratory viruses. METHODS: A retrospective study was performed in 470 children hospitalized with respiratory adenovirus infections in Gwangmyeong Sungae Hospital between January 2013 and December 2013. RESULTS: The mean age of the patients was 46.2 months and the peak incidence was in the 12- to 24-month age group. The mean duration of hospitalization and fever were 4.5+/-1.1 and 4.5+/-9.2 days, respectively. Seasonally it had occurred throughout the year, but showed the highest prevalence in August and high prevalence in July, September, and October. The frequency of viral coinfection with other respiratory viruses was 39.6%. The age was significantly younger in coinfection group than in the single adenovirus infection group (P<0.001). The prevalence rates of bronchiolitis (P<0.001) and pneumonia (P=0.042) were significantly higher in the respiratory syncytial virus coinfection group. The coinfection rate was significantly higher in children aged less than 2 years (P<0.001), and the prevalence rates of bronchiolitis (P<0.001) and pneumonia (P<0.001) were also higher in the group aged less than 2 years than other age groups. CONCLUSION: Adenovirus is an important viral agent in hospitalized children with acute respiratory tract infection. Lower respiratory tract infections, such as bronchiolitis and pneumonia, and coinfection with other respiratory viruses were more frequently occurred in patients under 2 years of age. Further studies are needed to clarify whether coinfection with other respiratory viruses would increase the rate of lower respiratory tract infections in patients with respiratory adenoviral infections.

Hypocalcemia Followed by Total Thyroidectomy with Central Neck Dissection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are many controversies about the extent of thyroidectomy and neck dissection in cases of thyroid cancer. Hypocalcemia is one of serious complications after total thyroidectomy. The on-set of hypocalcemia depends on many factors and different literature cites variable incidence. This study was performed to evaluate the incidence of postoperative hypocalcemia and the safety of total thyroidectomy with central neck dissection in thyroid cancer. MATERIALS AND METHODS: We conducted a retrospective chart review of 17 patients who underwent total thyroidectomy for thyroid malignancies from June 1995 to December 1998. Routine central neck dissection was performed and modified radical neck dissection was done in cases with positive neck node. We analyzed the onset-time of hypocalcemia, serum albumin level, hypocalcemic incidence according to the number of identified and autotransplanted parathyroid glands, lowest calcium level, clinical features and duration of calcium replacement in hypocalcemic patients. RESULTS: The incidence of postoperative hypocalcemia was 76.5% (13/17)and most cases (58.9%)occurred on the first postoperative day. The serum albumin level was lower on the first postoperative day than on the third postoperative day. The average number of identified parathyroid glands was three, and the more parathyroid glands there are, the less hypocalcemia we found. Parathyroid gland autotransplantation were performed in 12 cases. Symptomatic transient hypocalcemia occurred in 6 cases (35.2%). Asymptomatic transient hypocalcemia occurred in 6 cases (35.2%). Permanent hypocalcemia occurred in 1 case (5.9%). CONCLUSION: The incidence of postoperative hypocalcemia was relatively high but half of them were asymptomatic. There are no need for thyroid hormone replacement in asymptomatic transient hypocalcemic patients and that we found total thyroidectomy with central neck dissection is a safe procedure in most of thyroid malignancies.

A Case of Brain Hernia in Mastoid Cavity / 대한이비인후과학회지

Brain tissue herniation into the mastoid cavity is an uncommon phenomenon: nevertheless, it has been described since the earliest years of this century. Serious sequelae and central nervous system infection may result from inadequate management, but it has become relatively rare with improved antibiotic treatment and surgical technique. It might be caused by chronic otitis media, previous ear surgery, trauma and neoplasm, or spontaneously. Spontaneous brain herniation is extremely rare. It gives rise to cerebrospinal fluid otorrhea, progressive hearing loss, meningitis and other neurologic symptoms. Treatment depends on site and size of dura defect. We experienced one case of spontaneous brain herniation into the mastoid cavity, which we treated with surgery.

Two Cases of Ceruminous Adenoma Arising from the External Auditory Canal / 대한이비인후과학회지

The external auditory canal is composed of skin, subcutaneous tissue and gland. The mass originated from external auditory canal can produce otorrhea and some obstructive symptoms. Ceruminoma is a broad term expressing the tumor arising from the ceruminous gland. The ceruminous gland tumors is assigned to one of four categories(adenoma, pleomorphic adenoma, adenocystic carcinoma & adenocarcinoma) by Wetli's protype. The wide local excision is a treatment of choice for all benign ceruminous gland tumors except the malignant tumors needed combined treatment modalities as surgery and radiotherapy. We report our recent experience of two ceruminous adenomas causing ear canal obstruction & otorrhea.

Transillumination of Maxillary Sinuses: A Clinical Re-evaluation / 대한이비인후과학회지

BACKGROUND: Transillumination of maxillary sinuses was an important method before the invention of X-rays. But as the more precise and valuable methods have been developed, its importance has been reduced in clinical practice. OBJECTIVES: To elucidate the vailidity of the transillumination in diagnosing the maxillary sinus diseases, the transillumination method was compared with the conventional PNS series. MATERIALS AND METHOD: We performed transillumination tests in 100 adults(48 males and 52 females). A fiberoptic cable with halogen light sorce was enough for the examination. The light detected in the face of examinee in the dark room was evaluated. We studied the clinical reliability of transillumination in representing the status of the maxillary sinus. RESULTS: For bilateral sinusitis group(N=48), transillumination matched with the conventinal PNS series in 64.6%(31/48) of the cases, unilateral sinusitis group(N=17) in 82.4%(14/17) and normal group(N=35) in 88.6%(30/35). The overall matched-rate was 75%(75/100). CONCLUSIONS: The transillumination is a helpful non-invasive mothod for clinical evaluation of the maxillary sinus conditions.