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Sudden sensorineural hearing loss after third molar extraction: Case report and literature review (제 3대구치 발치 후 발생한 돌발성 난청: 증례보고 및 문헌 고찰)

  • Kim, Hyung Ki;Kim, Il-hyung;Ku, Jeong-Kui;Noh, Min-Ho
    • The Journal of the Korean dental association
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    • v.58 no.7
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    • pp.404-411
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    • 2020
  • This study reports the unusual complications of 22-year-old male who presented with sudden hearing loss after the right mandibular third molar extraction under local anesthesia with 3.6 ml of 2 % lidocaine. Total 8.75 mg of oral dexamethasone for 1 week immediately after extraction was prescribed in department of oral and maxillofacial surgery but hearing did not improve after 1 week. As referral to otolaryngology, total 600 mg of oral methylon and hyperbaric oxygen therapies were operated for 2 weeks. The hearing of patient was improved at 6 weeks after extraction but tinnitus was persisted even after 12 months. The reason and treatment were discussed with literature review, searching with the keywords ['hearing loss' AND ('dental' OR 'tooth extraction'OR'teeth extraction')] in PubMed and Google scholar at October 2019. Total five cases were reported after tooth extraction with local anesthesia. The sudden hearing loss could be associated with local anesthesia containing vasoconstrictors. Early steroid (extensive medication and intra-tympanic injection) and hyperbaric oxygen therapies were recommended within 2 weeks. As a proper treatment, hearing could be improved but other additional symptoms, such as tinnitus, dizziness, might be remained.

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A Case of Rifampin-Induced Recurrent Adrenal Insufficiency During the Treatment of Pulmonary Tuberculosis in a Patient with Addison's Disease (애디슨병 환자에게 리팜핀 투여 후 발생한 급성 부신피질기능 저하증 1예)

  • Kang, Jong-Sik;Ko, Gwang-Beom;Lee, Jae-June;Kim, Min-Soo;Jeon, Sung-Jin;Choi, Gwang-Hyeon;Kim, Sun-Mok;Lee, Woo-Je
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.19-23
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    • 2012
  • Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

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A Case of Osmotic Demyelination Syndrome in a Patient with Severe Hyponatremia Complicated by Rhabdomyolysis (횡문근융해증이 합병된 중증 저나트륨혈증 환자에서 발생한 삼투성 탈수초 증후군 1예)

  • Lee, Da Young;Hong, Chang Woo;Lee, In Hee
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.25-30
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    • 2013
  • Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

Pumpless extracorporeal interventional lung assist for bronchiolitis obliterans after allogenic peripheral blood stem cell transplantation for acute lymphocytic leukemia

  • Park, Yeon-Hee;Chung, Chae-Uk;Choi, Jae-Woo;Jung, Sang-Ok;Jung, Sung-Soo;Lee, Jeong-Eun;Kim, Ju-Ock;Moon, Jae-Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.98-101
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    • 2015
  • Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate $CO_2$ effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

Recurrent Brain Abscess In Chronic Sinusitis : A Case Report (만성부비동염을 가진 환자에서 재발된 뇌농양 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.275-279
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    • 2018
  • A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

A STUDY ON THE CYTOTOXICITY OF THE ORTHODONTIC BONDING MATERIALS (교정용 접착제의 세포독성에 관한 실험적 연구)

  • Sa, Myung-Hee;Yang, Won Sik
    • The korean journal of orthodontics
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    • v.22 no.1
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    • pp.147-158
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    • 1992
  • This study was aimed to compare the relative cytotoxicity of the five common orthodontic bonding materials (Concise. Mon-lok, Ortho-One, Super C, Transbond) using cell culture technique. DNA synthesis of the fibroblasts was assessed by $^3H$-thymidine uptake to evaluate the effect of the bonding materials on the growth of the cells. The human gingival fibroblasts were explanted from the buccal gingiva of 10 year-old girl and cultured in $\alpha$-MEM/10% FBS/1% antibiotics medium, $37^{\circ}C$, 5% $CO_2$ incuvator. The gingival fibroblasts were tested with the medium into which the bonding materials had been soaked for 1 week. Or the bonding materials were placed on the cells immediately or 2 weeks after polymerization. After 22 hours, $^3H$-thymidine was added into the microtest wells and after 24 hours, the uptake of $^3H$-thymidine was determined by liquid scintilation counter. The results of this study were as follows. 1. DNA synthesis was significantly decreased with Super C and Transbond than Ortho-One, when treated with medium into which the bonding materials had been soaked for 1 week. 2. DNA synthesis was significantly decreased with Concise, Super C and Transbond than control, when treated immediately after polymerization. 3. DNA syntehsis was significantly decreased with Concise, Super C and Transbond than Ortho-One, when immediately after polymerization. 4. There was no significant difference in DNA synthesis between the bonding materials, when treated 2 weeks after polymerization.

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The characteristics and treatment results of squamous cell carcinomas of oral tongue (구강설에 발생한 편평상피세포암의 특성과 치료효과)

  • Kim, Ki-Ho;Choi, Eun-Joo;Kim, Hyung-Jun;Nam, Woong;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.15-20
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    • 2011
  • Introduction: The characteristics of oral tongue squamous cell carcinomas (SCC) and the treatment results were reviewed to determine the appropriate treatment strategies. Materials and Methods: The medical records of 140 patients diagnosed and treated for oral tongue SCC at Yonsei University Health System from January 1995 to December 2004 were reviewed. For statistic analysis, the survival rate was determined using the Kaplan-Meier method with SPSS version 12.0, and the difference in survival rates was evaluated using a log-rank test. Results: The mean age of the patients with oral tongue SCC patients was 55 (19-85 years old). According to the T, N and pathologic stage, the patients were distributed from a higher to a lower incidence of cases, as follows: T2 (46.4%), T1 (37.9%), T4 (8.5%), and T3 (7.1%); N0 (65%), N1 (20.7%), N2 (13.6%), and N3 (0.7%); and stage I (31.4%), stage II(25.7%), stage IV (22.2%), and stage III (20.7%). Local and regional recurrence and distant metastasis was present in 13.6%, 5% and 4.2% of patients, respectively. The five-year survival rate was 72.2%, and the prognostic factors for oral tongue SCC included neck metastasis, pathologic stage of the disease, cell differentiation, treatment modality, neck dissection as part of the treatment plan, and neck node recurrence. Discussion: It is suggested that ipsilateral neck dissection or bilateral neck dissection should be selected as a treatment of tongue SCC patients with advanced stage.

Breakfast skipping and breakfast type are associated with daily nutrient intakes and metabolic syndrome in Korean adults

  • Chung, Sang-Jin;Lee, Yoonna;Lee, Seokhwa;Choi, Kyungran
    • Nutrition Research and Practice
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    • v.9 no.3
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    • pp.288-295
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    • 2015
  • BACKGROUND/OBJECTIVES: Emerging evidence shows that eating breakfast and breakfast types may be associated with health outcomes and dietary intakes in various populations. The aim of this study was to investigate the association between breakfast types in Korean adults with their daily nutrient intakes and health outcomes. SUBJECTS/METHODS: A total of 11,801 20- to 64-year-old adults (age $42.9{\pm}11.8$ yrs [$mean{\pm}standard$ error of the mean]; male 41.1%, female 58.9%) in 2007-2009 Korean National Health and Nutrition Survey data were divided into 5 groups based on breakfast types in a 24-hr dietary recall: rice with 3 or more side dishes (Rice3+, 35.3%), rice with 0-2 side dishes (Rice0-2, 34.73%), noodles (1.56%), bread and cereal (6.56%), and breakfast skipping (21.63%). Daily nutrient intakes and the risk of metabolic syndrome were compared among five groups. RESULTS: Compared with Korean Recommended Nutrient Intake levels, the breakfast-skipping group showed the lowest intake level in most nutrients, whereas the Rice3+ group showed the highest. Fat intake was higher in the bread and noodle groups than in the other groups. When compared with the Rice3+ group, the odds ratios for the risk of obesity and metabolic syndrome were increased in the breakfast skipping, Rice0-2, and noodle groups after controlling for confounding variables. CONCLUSIONS: The rice-based breakfast group showed better nutritional status and health outcomes when eating with 3 or more side dishes. Nutrition education is needed to emphasize both the potential advantage of the rice-based, traditional Korean diet in terms of nutritional content and the importance of food diversity.

The Effect of Therapeutic Massage and Mckenzie Exercise on Pain and Range of Motion in Chronic Neck Pain Patient: a Case Study (치료적 마사지와 맥켄지 운동이 만성 경부통 환자의 통증과 관절가동범위에 미치는 영향: 단일사례연구)

  • Lee, Seong-Jin;Oh, Hwan-Hee;Chae, Ji-Su;Kwon, Nam-Il;Park, Do-Yeon;Kwon, Hyo-Joo;Chung, Eun-Jung
    • Journal of Korean Physical Therapy Science
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    • v.24 no.2
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    • pp.61-70
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    • 2017
  • Purpose : The purpose of this study was to examine the effect of therapeutic massage and Mckenzie exercise on pain and range of motion in chronic neck pain patient: a case study. Method : A Twenty-year old female subject with chronic neck pain was selected, she received therapeutic massage and Mckenzie exercise for 30 minutes a day, three days a week for five weeks. Pain was measured visual analog scale(VAS), neck disability index(NDI) and the Copenhagen neck functional disability scale (CNFDS). Range of motion was measured using a goniometer(shoulder joint) and the CROM Deluxe(cervical range of motion instrument). Result : VAS, NDI and CNFDS were decreased 3 score, 4 score and 6 score(respectively) than before the training. The range of motion was increased in shoulder joint and neck movement than before the training. Conclusion : The massage and Mckenzie exercise increased range of motion in shoulder joint and neck movement, and decreased neck pain in chronic neck pain patient. Additional research on therapeutic massage and Mckenzie exercise for improving pain and range of motion is need.

Graves disease following rabbit antithymocyte globulin treatment of severe aplastic anemia in a Korean child

  • Choi, In Su;Kim, Han Kyul;Han, Dong Kyun;Baek, Hee Jo;Jang, Hae In;Kim, Chan Jong;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.58 no.7
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    • pp.267-269
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    • 2015
  • Antithymocyte globulin (ATG) is used as an immunosuppressive treatment (IST) to deplete clonal suppressor T cells in patients with severe aplastic anemia (SAA). The depletion of suppressor T cells by ATG may affect the activation of B cells, which results in an increased risk for autoimmune conditions. A 12-year-old boy was diagnosed with idiopathic SAA. As he did not have an human leukocyte antigen-matched sibling, he was treated with rabbit ATG (3.5 mg/kg/day for 5 days) and cyclosporine. Five months later, he became transfusion independent. However, 23 months after IST, he complained of mild hand tremors, sweating, weight loss, palpitations, and goiter. Results of thyroid function tests revealed hyperthyroidism (free thyroxine, 3.42 ng/dL; thyroid stimulating hormone [TSH], <0.01 nIU/mL; triiodothyronine, 3.99 ng/mL). Results of tests for autoantibodies were positive for the antimicrosome antibody and TSH-binding inhibitory immunoglobulin, but negative for the antithyroglobulin antibody and antinuclear antibody. He was treated with methimazole, and his symptoms improved. The patient has been disease free for 39 months after IST and 9 months after methimazole treatment. This case report suggests that although rare, rabbit ATG may have implications in the pathogenesis of autoimmune hyperthyroidism. Our findings suggest that thyroid function tests should be incorporated in the routine follow-up of SAA patients treated with ATG.