A 29 year old man without any noticeable past or familial history presented with left ACA and MCA territorial hemorrhagic infarction after consuming an overdose of disulfiram in a drunken state. This hemorrhagic infarction was thought to be caused by cardiac embolism, which developed following cardiac arrhythmia and cardiac injury induced by O form acceptor reductase associated with disulfiram poisoning. (J Korean Neurol Assoc 19(3):294~297, 2001)
Adult ; Arrhythmias, Cardiac ; Cerebral Infarction* ; Disulfiram* ; Embolism ; Humans ; Infarction ; Oxidoreductases ; Poisoning*

BACKGROUND AND OBJECTIVES: Recently, there has been an increase in olfactory disorders due to many etiologies. Many therapeutic methods have been tried with some favorable results. Some of the therapeutic methods are functional endoscopic sinus surgery (FESS), oral and topical steroids, and other pharmacologic therapies (vitamin A, aminophylline, zinc sulfate, etc). In this study, we tried to find out the transition of olfactory recovery in patients with olfactory disturbance. MATERIALS AND METHODS: Sixty-one patients with olfactory disturbance were studied. There were 25 patients who had chronic sinusitis with nasal polyp, 10 patients who had chronic sinusitis without nasal polyp, 12 patients who had upper respiratory infection, 5 patients who had congenital disorder, 4 patients who had head trauma, and 5 patients who had nasal septal deviation. Chronic sinusitis was treated by functional endoscopic sinus surgery, nasal septal deviation was treated by septoplasty and others were treated by drug therapy and topical steroid. The degree of olfactory disturbance and recovery was scored with a KVSS test (Korean Version of Sniffin Sticks test) prior to treatment and also three and six months after the treatment. RESULTS: Twenty-one patients with chronic sinusitis with nasal polyp (84%) showed improvement of olfaction on the third postoperative month, and 6 months later (p<0.01). Seven patients with chronic sinusitis without nasal polyp (70%) also showed improvement of olfaction (p<0.01). But seven patients with upper respiratory tract infection (58%) did not show significant improvement of olfaction, and it would be necessary to follow up these patients longer. Patients with congenital disorder, nasal septal deviaton, and head trauma did not show significant improvement of olfaction. CONCLUSION: The mentioned test can aid in investigating the etiology of olfactory disturbance, and in accurately assessing the degree of the olfactory disturbance.
Aminophylline ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Craniocerebral Trauma ; Drug Therapy ; Follow-Up Studies ; Humans ; Nasal Polyps ; Nasal Surgical Procedures ; Respiratory Tract Infections ; Sinusitis ; Smell ; Steroids ; Zinc Sulfate

BACKGROUND AND OBJECTIVES: Popular myringoplasty techniques include either an underlay or an onlay approach using tissues such as temporalis fascia or perichondrium as grafting materials. The "cartilage butterfly technique" using a tragal cartilage graft that resembled butterfly wings without incising canal skin was described by Eavey in 1998. This study describes the results of using this technique and analyzes the postoperative hearings. MATERIALS AND METHODS: Cartilage butterfly inlay tympanoplasty was carried out in 28 patients to close small-to-medium tympanic membrane perforations from October 1998 to December 2000. We excluded one patient due to accidental removal of graft at another clinic. We evaluated the success rate and postoperative hearing results. RESULTS: The graft take rate was 96.3% (26/27) at the end of the follow-up period (mean follow-up was 6.0 months). All of successful cases had cartilage grafts that were intact and dry at the last visit. One patient failed due to otorrhea and extruding graft. Two patients were not evaluated, because one had profound preoperative hearing loss and the other was a cerebral palsy patient. Mean air-bone gap (A-B gap) was improved from 16.3 dB to 9.8 dB. Ten patients had an A-B gap average between 0 and 10 dB, 14 patients between 11 and 20 dB, and no patient greater than 20 dB. CONCLUSION: The cartilage butterfly technique was effective to close tympanic membrane perforations in selected patients. It could provide advantages in high success rate, ease, speed and patient comfort.
Butterflies* ; Cartilage* ; Cerebral Palsy ; Fascia ; Follow-Up Studies ; Hearing ; Hearing Loss ; Humans ; Inlays ; Myringoplasty* ; Skin ; Transplants ; Tympanic Membrane ; Tympanoplasty

PURPOSE: Robotic surgery is expected to have advantages over laparoscopic surgery; however, there are limited data regarding the feasibility of robotic surgery for rectal cancer after preoperative chemoradiotherapy (CRT). Therefore, we evaluated the short-term outcomes of robotic surgery for rectal cancer. MATERIALS AND METHODS: Thirty-three patients with cT3N0-2 rectal cancer after preoperative CRT who underwent robotic low anterior resection (R-LAR) between March 2010 and January 2012 were matched with 66 patients undergoing laparoscopic low anterior resection (L-LAR). Perioperative clinical outcomes and pathological data were compared between the two groups. RESULTS: Patient characteristics did not differ significantly different between groups. The mean operation time was 441 minutes (R-LAR) versus 277 minutes (L-LAR, p < 0.001). The open conversion rate was 6.1% in the R-LAR group and 0% in the L-LAR group (p=0.11). There were no significant differences in the time to flatus passage, length of hospital stay, and postoperative morbidity. In pathological review, the mean number of harvested lymph nodes was 22.3 in R-LAR and 21.6 in L-LAR (p=0.82). Involvement of circumferential resection margin was positive in 16.1% and 6.7%, respectively (p=0.42). Total mesorectal excision (TME) quality was complete in 97.0% in R-LAR and 91.0% in L-LAR (p=0.41). CONCLUSION: In our study, short-term outcomes of robotic surgery for rectal cancer after CRT were similar to those of laparoscopic surgery in respect to bowel function recovery, morbidity, and TME quality. Well-designed clinical trials are needed to evaluate the functional results and long-term outcomes of robotic surgery for rectal cancer.
Chemoradiotherapy* ; Flatulence ; Humans ; Laparoscopy* ; Length of Stay ; Lymph Nodes ; Recovery of Function ; Rectal Neoplasms*

BACKGROUND AND OBJECTIVES: As a society develops, olfactory disturbance increases with the increased industrial disaster, traffic accidents, upper respiratory tract infection, chronic sinusitis and allergic rhinitis from air pollution, Parkinson's disease and Alzheimer's disease from aging process. Nevertheless, there is no practical clinical test of olfactory function in Korea. Authors decided to develop the "Korean olfactory test" using the odorants which are familiar to Koreans. MATERIALS AND METHODS: KVSS Test (Korean Version of Sniffin' Sticks Test) is composed of KVSS Test I (screening test) and KVSS Test II (comprehensive test). KVSS Test I was performed on 120 controls with normosmia, 39 patients with hyposmia, and 24 patients with anosmia. KVSS Test II was performed on 117 controls with normosmia, 29 patients with hyposmia, and 22 patients with anosmia. The subjects ranged in ages from 20 to 69 years. RESULTS: In KVSS Test I, the range of scores (smell test) was 5.36-7.34 in normosmia, 3.41-6.73 in hyposmia, and 1.14-3.16 in anosmia. In KVSS Test II, the range of T.D.I. score (the sum of olfactory threshold score, odor discrimination score, and odor identification score) was 25.98-35.48 in normosmia, 17.01-30.63 in hyposmia, and 7.32-14.06 in anosmia (p<0.001). CONCLUSION: It is concluded that KVSS Test I and II are suitable for the routine clinical assessment of olfactory performance in Koreans.
Accidents, Traffic ; Aging ; Air Pollution ; Alzheimer Disease ; Disasters ; Discrimination (Psychology) ; Humans ; Korea ; Odors ; Olfaction Disorders ; Parkinson Disease ; Respiratory Tract Infections ; Rhinitis ; Sinusitis

Purpose: We aimed to collect opinions on the diagnostic experiences and quality of life profiles for men with prostate cancer in Korea as part of the “Blue Ribbon Campaign” of the Korean Urological Oncology Society. Materials and Methods: Korean Urological Oncology Society conducted an online survey of 212 prostate cancer patients belonging to the Prostate Cancer Patient Association. A survey on diagnostic experience and quality of life based on Expanded Prostate Cancer Index Composite 26 Short Form were conducted. Results: About half of all respondents (50.5%) answered, “I experienced symptoms of urine leakage more than once a week,” during the last four weeks, 85% of the respondents said their sexual function level was “weak,” and 64.2% said, “very weak.” When asked about the level of erectile dysfunction, 58 percent of the respondents answered, “I never had an erection when I wanted one.” Of the respondents, 47.1% of men said that clinical stage at initial presentation was prostate cancer stage 3–4 and 99.1% of the respondents hoped that the prostate-specific antigen (PSA) test would be included in the national cancer screening. Conclusions Through this survey of patients, we were able to confirm the difficulties of the low quality of life currently experienced by prostate cancer patients and what they want to do with prostate cancer treatment. All patients are eager to include a PSA test in the national cancer screening so that prostate cancer can be detected early and patients can receive proper treatment at an appropriate time.