• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.49-52
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• 2016

X-linked agammaglobulinemia (XLA) is a hereditary humoral immunodeficiency that results from Bruton's tyrosine kinase (BTK ) gene mutations. These mutations cause defects in B-cell development, resulting in the virtual absence of these lymphocytes from the peripheral circulation. Consequently, this absence leads to a profound deficiency of lg all isotypes, and an increased susceptibility to encapsulated bacterial infections. A 15-month-old Korean boy presented with recurrent sinusitis and otitis media after 6 months of age, and had a family history of 2 maternal uncles with XLA. Laboratory tests revealed a profound deficiency of Ig isotypes, and a decreased count of $CD19^+$ B cells in the peripheral circulation. Based on his family history and our laboratory test results, he was diagnosed with XLA. We performed BTK gene analysis of peripheral blood samples obtained from family members to confirm the diagnosis. Mutational analysis revealed a novel hemizygous frameshift mutation (c.82delC, p.Arg28Alafs*5), in the BTK gene. His mother and maternal grandmother were heterozygous carriers of this mutation and his two maternal uncles were hemizygous at the same position. After XLA diagnosis, intravenous immunoglobulin (400 mg/kg, monthly) treatment was initiated; recurrent sinusitis and otitis media were subsequently brought under control. To our knowledge, this is the first reported case of a Korean pedigree with a novel mutation in the BTK gene.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.8.3-8
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• 1978

In normal auditory systems, the difference between the bone conduction thresholds obtained with the test ear opened and occluded in low frequency signals below 1, 000Hz is about 10~25 dB. But no difference in these thresholds suggests the presence of a lesion in the conductive mechanism. Sullivan added the differences in these thresholds at 250Hz, 500Hz and 1,000Hz and called "Occlusion Index". In oder to study the audiological significance, we have measured the occlusion index in 40 ears of normal persons, 20 ears of chronic otitis media patients and 20 ears of sensori-neural hearing impairment patients. We also measured the static compliance in 40 normal ears and observed the correlation with the occlusion index. The results are as follows: 1. Occlusion index was 33. $10\pm10.63dB$ in normal group, $3.10\pm3.03dB$ in chronic otitis media; group, $28.10\pm15.17dB$ in sensori-neural group. 2. Static compliance in normal group was $0.61\pm0.31cc$ (0.22~1.75cc) 3. Occlusion index showed inverse proportion to static compliance.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.19.2-19
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• 1983

A Clinical and bacteriologcal observation was performed 128 cases of chronic otitis media who had taken middle ear surgery at Dept. of otolaryngology of St. Benedict Hospital during the period of Feb. 1981 to Feb. 1983. The following results were obtained. 1) Among total 128 cases, male were 60 cases (46.9%) and female were 68 cases (53.1 %) and age distribution showed 48 cases (37.5 %) in 3rd decade, 37 cases (28.9 %) in 2nd decade and 27 cases (21.1 %) in 4th decade. 2) Site distribution were 71 cases (55.5%) in right, 57 cases (44.5 %) in left. 3) Degree of preoperative hearing loss were 64 cases (50%) in moderate, 32 cases (25% ) in mild, 27 cases (21.1 %) in severe and 5 cases (3.9%) were normal. 4) Central perforation were observed in 65 cases (50.8 %), total perforation in 44 cases (34.4 %), attic perforation in 12 cases (9.4 %) and marginal perforation in 7 cases (5.4 %). 5) Pathologic changes of middle ear and mastoid antrum showed granulation in 81 cases (63.3 %), cholesteatoma in 47 cases (36.7%). 6) The route of approach were 123 cases (96.1%) in postauricular, 3 cases (2.3%) in transmeatal and 2 cases (1.6 %) in endaural. 7) Type of operation were 53 cases (41.4 %) in intact canal wall tympanoplasty with mastoidectomy, 42 cases (32.8 %) in tympanoplasty without mastoidectomy, 23 cases (18%) in modified radical mastoidectomy and 10 cases (7.8%) in radical mastoidectomy. 8) Type of anesthesia were 95 cases (74.2 %) by local anesthesia, 33 cases (25.8 %) were by general anesthesia. 9) Among 93 specimens of culture, proteus (31.2%), staphylococcus (28.7%), pseudomonas (23.7 %), streptococcus (7.5 %) and etc. (8.7%) in order of frequency.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.87-94
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• 2017

Purpose: The inappropriate prescription of antibiotics in children with upper respiratory tract infection (URTI) is common. This study evaluated the factors that influence antibiotics use in hospitalized children with viral URTI confirmed by reverse transcriptase-polymerase chain reaction (RTPCR) assay. Methods: The medical records of admitted patients who performed RT-PCR assay for respiratory virus pathogens from January 2013 to November 2014 were examined. The demographic and clinical features were compared between patients who were administered antibiotics at admission and those who were not. We also investigated differences between children who continued antibiotics and those who stopped antibiotics after a viral pathogen was identified. Results: In the total 393 inpatients, the median age was 23 months (interquartile range, 13 to 41.3 months). Antimicrobial agents were prescribed in 79 patients (20.1%) at admission. Patients with acute otitis media (AOM) had higher rates of antibiotics prescription than those without AOM (48.1% vs. 2.2%, P<0.001), with an adjusted odds ratio of 91.1 (95% confidence interval, 30.5 to 271.7). Level of high-sensitivity C-reactive protein and the proportion of acute rhinosinusitis were also significantly associated with antibiotics use (P<0.001). Among the 44 patients with viruses identified using the RT-PCR method during hospitalization, antibiotic use was continued in 28 patients (63.6%). AOM was statistically associated with continued antibiotic use in the patients (P=0.002). Conclusions: Although the respiratory virus responsible for URTI etiology is identified, clinicians might not discontinue antibiotics if AOM is accompanying. Therefore, careful diagnosis and management of AOM could be a strategy to reduce unjustified antibiotic prescriptions for children with URTI.

• Herbal Formula Science
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• v.16 no.1
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• pp.79-94
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• 2008

Although inflammatory mediators such as nitric oxide(NO) and pro-inflammatory cytokines are involved in host defense mechanism, these overproduction contributes to the pathogenesis of several diseases such as otitis media, hearing loss, periodontitis, bacterial sepsis, rheumatoid arthritis, chronic inflammation and autoimmune diseases. We investigate the anti-inflammatory effects of water extract from Ji-Pae-San(JPSWE) fomulated with Angelica dahurica plus Fritillaria Verticillata, Angelica dahurica(ADWE), and Fritillaria Verticillata(FUVE) in vitro and in vivo. Each extract inhibited the production of inflammatory mediators(NO, $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, and prostaglandin $E_2$) and the expression of inducible NO synthase(iNOS) and cyclooxygenase-2(COX-2) in lipopolysaccharide(LPS)-stimulated RAW 264.7 macrophages in a dose-dependent manner. These inhibitory effects were synergistically increased by their combination. JPSWE also inhibited $TNF-{\alpha}$, $IL-1{\beta}$, IL-6. and $PGE_2$ production as well as COX activity in LPS-stimulated mice. Moreover, JPSWE significantly suppressed death by LPS-septic shock in mice(survival rate: 100%). These results suggest that Ji-Pae-San may be useful for therapeutic drugs against inflammatory immune diseases, probably by suppressing the production of inflammatory mediators.

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.103-108
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• 2015

Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.

• Korean Journal of Clinical Laboratory Science
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• v.40 no.2
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• pp.135-141
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• 2008

Benign paroxysmal positional vertigo (BPPV) is one of the most common clinical entities encountered in a dizziness clinic. Treatment of this disease, canalith repositioning procedures, have been reported to be successful in 44-90%. Treatment requires only one treatment visit in most patients. However, there are significant numbers of patients who require multiple treatment visits for relief. The goal of this study is to identify variables that may be associated with these difficult to treat cases. Retrospective review was performed for the patients diagnosed as BPPV at St. Carollo dizziness center. Variables for statistical analysis included age, sex, involved canal, presence of bilateral disease, presence of recent head trauma, presence of chronic otitis media, history of middle ear surgery, history of otologic surgery, unilateral vestibular loss, underlying disease such as hypertension or diabetes, change of involved canal during treatment course and number of treatment visits. Two hundred patients with BPPV who received treatment were identified from JAN. 2006 to JUN. 2007. 87% required one treatment visit, 5% required second treatment visit, and 95% were successfully treated after three treatment visits. Variables such as bilateral disease, post-traumatic BPPV, duration of symptom before treatment and change of involved canal during treatment were significantly related with number of treatments. Patient's with bilateral BPPV or with recent head trauma or longer duration of symptom are more likely to require multiple visits for canalith repositioning.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.156-158
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• 2014

Malassezia spp. was isolated from the skin lesion of a South American Sea Lion (Otaria byronia) in South Korea. Colonies were cream to yellowish with smooth margin on Sabouraud dextrose agar without lipid supplements. Yeast cells were ovoid to cylindrical in shape and budding daughter cells from broad base. We conducted 26s rRNA sequencing to specify the strain of the yeast and found out this isolate highly matched with Malassezia pachydermatis isolated from canine otitis. The pulse therapy of oral itraconazole was very effective in this case. M. pachydermatis has a wide range of host animals but this is the first report in a sea lion in South Korea.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.176-181
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• 2008

Fluid accumulation within the tympanic bulla is an important diagnostic indicator of canine otitis media although its identification can be a challenge using currently available imaging techniques. The purpose of this study was to compare radiography, computed tomography (CT) and magnetic resonance imaging (MRI) in the identification of fluid accumulation within canine tympanic bulla. Unilateral tympanic bulla in 10 beagles were experimentally filled with blood or saline. Quantitative analysis of CT images were obtained by using Hounsfield unit (HU). MR signal intensity was obtained by using region of interesting (ROI) and compared with those of gray matter. On the CT image, the presence of blood or saline produced a fluid opacity occupying the tympanic bulla. On the MR image, the appearance of blood in the tympanic bulla was isointense in T1-weighted images and hyperintense in T2-weighted images. However, the appearance of saline in the tympanic bulla was hypointense in T1-weighted images and hyperintense in T2-weighted images. This study suggest that CT and MR imaging are useful methods for detection and differentiation of fluid in canine tympanic bulla.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1050-1054
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• 2000

Objective : The incidence of head injury has been increasing in the rural area. The author investigated the clinical features and difficulties in care of the acute head-injured patients in this area. Method and Material : The authors performed a retrospective review of radiological data and clinical records in patients with mild to moderate head injury. Cause, type of craniocerebral injury, delayed intracranial lesions, complications, its relation to alcohol abuse, and outcome were analyzed. Results : In total of 68 cases, 20(29.4%) victims were associated with acute alcohol intoxication. Motor vehicle accident was the leading cause of head injury and the most common craniocerebral lesion was basilar skull fracture. Eight(11.8%) patients showed delayed radiological and clinical deterioration and 40(58.8%) were followed-up regularly after discharge. The subdural hygroma was commonly noted in the elderly and alcoholics. Causes of thirty events that resulted in an atypical and difficult neurosurgical practice were as follows : delayed admission, premature discharge against doctor's request, refusal of radiological studies and admission, misunderstanding of disease entity, and unreasonable desire of transfer to tertiary hospitals. Inaccurate initial diagnoses were made by emergency doctors in twenty patients. During the course of treatment, there were a few complications such as alcohol withdrawal, acute otitis media, cerebrospinal fistula, facial weakness, and posttraumatic seizure. Outcome was good in 60(88.2%) patients. Conclusion : Most of minor head trauma patients in this series have shown good results, but we have to consider some possible complications and delayed intracranial lesions in these patients that should be managed with special cautions with various kinds of treatment difficulties.