Nasopharynx as a Microbiologic Reservoir in Chronic Suppurative Otitis Media: Preliminary Study

ObjectivesThe present study was designed to identify the correlations of bacterial strains of the middle ear and the nasopharynx in chronic suppurative otitis media (CSOM) patients who were scheduled for operations.MethodsSixty-three patients with CSOM were enrolled in the study. Culture specimens were collected from the middle ear and nasopharynx of patients who were admitted for operation. Samples collections were performed 3 times; from the middle ear and nasophaynx at the admission day, from the middle ear during the operation, and from the external auditory canal post-operatively. Bacteria were identified by gram staining and biochemical tests. The correspondence rate of organisms which simultaneously exist in the middle ear and the nasopharynx was measured.ResultsSixty-eight organisms were isolated from the middle ear and 57 organisms from the nasopharynx among 63 patients. Of 68 bacteria identified in middle ear, 26.52% (18 bacteria) corresponded with those of nasopharynx. MRSA had the high correspondence rate, and of 18 methicillin-resistant Staphylococcus aureus (MRSA) isolated from middle ear, 33.3% (6 bacteria) corresponded with nasophaynx. Meanwhile, 3 organisms of MRSA were detected from the external auditory canal post-operatively, although they were only found in nasopharynx pre-operatively.ConclusionThe current trend of middle ear swab alone for bacterial detection would be insufficient to identify the potent MRSA and impede early antibiotic intervention for the effective middle ear surgery. Therefore, it is necessary to perform nasopharynx cultures together with conventional middle ear culture to control potent risk for infection pre-operatively

Does the Kyphotic Change Decrease the Risk of Fall?

ObjectivesFalls are a major problem in the elderly. Age-related degeneration of the human balance system increases the risk of falls. Kyphosis is a common condition of curvature of the upper spine in the elderly and its development occurs through degenerative change. However, relatively little is known about the effect of kyphotic changes on balance in the elderly. The aim of this study is to investigate the influence of kyphosis on the balance strategy through use of the motor control test (MCT) in computerized dynamic posturography.MethodsFifty healthy subjects who were not affected by other medical disorders that could affect gait or balance were enrolled in the study. By simulation of kyphotic condition through change of the angles of the line connecting the shoulder to the hip and the ankle axis by approximately 30°, the latency and amplitude of the MCT were measured in upright and kyphotic condition.ResultsIn the kyphotic condition, latency was shortened in backward movement. In forward movement, latency was shortened only in large stimulation. The amplitude in forward movement was decreased in kyphotic condition. However, the change of amplitude was not significant in large intensity backward movement in the same condition.ConclusionKyphotic condition decreases the latency of MCT, especially in backward movement. These findings imply that kyphotic condition may serve as a protective factor against falls

Mediastinal Lymphangioma and Chylothorax: Thoracic Involvement of Gorham's Disease

We report a case of mediastinal lymphangioma associated with Gorham's disease in a 38-year-old man who had suffered recurrent clavicular fractures during a seven-year period. Mediastinal widening associated with osteolysis of the clavicles and the sternal manubrium was revealed by chest radiography, while computed tomography demonstrated a cystic anterior mediastinal mass infiltrating mediastinal fat and associated with osseous destruction of the clavicles and manubrium. Chylothorax recurred during the course of the disease

Concurrent Pneumopericardium and Pneumothorax Complicating Lung Cancer: A Case Report

The coexistence of pneumothorax and pneumopericardium in patients with primary lung cancer is a very rare phenomenon. We report one such case, in which squamous cell carcinoma of the lung was complicated by pneumopericardium and pneumothorax. Several explanations of the mechanisms involved will be discussed

Analysis of Inner Ear Anomalies in Unilateral Congenital Aural Atresia Combined With Microtia

Objectives The aim of this study was to analyze the incidence of inner ear anomalies in patients with unilateral congenital aural atresia (CAA) combined with microtia. Methods We retrospectively reviewed 61 patients with unilateral CAA combined with microtia who underwent high-resolution temporal bone computed tomography (TBCT) and hearing examination. Inner ear anomalies were analyzed using TBCT and evaluated according to the Jahrsdoerfer grading system, Marx classification, and extent of inferior displacement of the mastoid tegmen. Results Inner ear anomalies were observed in 14 patients (23.0%). Lateral semicircular canal (LSCC) dysplasia was the most common inner ear anomaly, with an incidence of 16.4%. The incidence was significantly higher on the pathologic side than on the unaffected side (P=0.002). All vascular anomalies were observed in the high-riding jugular bulb, with an incidence of 24.6%. The incidence was significantly higher on the pathologic side than on the unaffected side (P<0.001). LSCC dysplasia was significantly more common in patients with a lower Jahrsdoerfer score (odds ratio, 0.66; P=0.004). Conclusion The incidence of inner ear anomalies was relatively high in patients with unilateral CAA combined with microtia; LSCC dysplasia was the most common anomaly and the probability of coexistence was higher in patients with a lower Jahrsdoerfer score

Angiolipoma of the Posterior Mediastinum with Extension into the Spinal Canal: A Case Report

Angiolipoma is a rare benign soft tissue tumor, an unusual variant of lipoma, consisting of fatty and vascular components and located in the subcutis, usually in the trunk and extremities. We report a case of posterior mediastinal angiolipoma extending into the spinal canal and showing both fat and angiomatous features on CT scan

Computed Tomography in Pulmonary Tuberculosis

CT scans in patients with primary tuberculosis commonly show findings of Iympho-hematogeneous spread of the disease, while those of reactivation tuberculosis commonly show findings of bronchogenic spread. Typical CT findings of primary tuberculosis are airspace consolidation of the middle and lower lobes with mediastinal and hilar lymphadenopathy showing central lower attenuation and peripheral rim en- . hancement. Typical CT findings of reactivation tuberculosis are nodular and linear pulmonary lesions at the apex without lymphadenopathy. High-resolution CT is extremely helpful in understanding the patho-morphologic changes, mode of spread of the disease, sequential morphologic change after antituberculous chemotherapy, and possibly in diagnosing activity of the disease. Centrilobular small nodule or branching linear lesions are the most common findings of fresh active pulmonary tuberculosis, which represent intra- and peri-bronchiolar caseation necrosis. CT is also useful in the evaluation of longstanding destructive pulmonary lesions and tracheobronchial tuberculosis. The importance of the role of CT scan in patients with pulmonary tuberculosis is increasing