BACKGROUND: Even though lasers have been used in hemorrhoidectomies, there has been much debate about their effect. PURPOSE: A prospective randomized study was performed comparing the efficacy of a Nd:YAG laser with that of scalpel excision when performing a ligation excision, semi-closed hemorrhoidectomy. METHODS: Sixty patients, who had more than three piles, with 3rd or 4th grade hemorrhoids, were enrolled into this study. Hemorrhoidectomies were performed under low spinal anesthesia. The ligation excision, semi-closed hemorrhoidectomy technique was used. Data evaluated included age, sex, operative time, postoperative pain scores, postoperative analgesic requirement, wound-healing time, and postoperative complications. Of the sixty patients enrolled into this study, 30 received laser excision and the other 30 scalpel excision. RESULTS: There were no significant differences between the two groups, except for operative time (laser, 34.6 8.4 min; scalpel, 24.1 4.8 min). Postoperative complications, such as urinary retention, fecal impaction, skin tags, and postoperative fissure, were more common in the laser group. CONCLUSIONS: A hemorrhoidectomy using a Nd:YAG laser takes longer than a conventional hemorrhoidectomy and neither reduces the postoperative pain nor shortens the wound-healing time. For achieving an effective treatment in hemorrhoids by using lasers, improved laser instruments are required, along with more detailed study of lasers and their effects.
Anesthesia, Spinal ; Fecal Impaction ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Lasers, Solid-State ; Ligation ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Prospective Studies ; Skin ; Urinary Retention

Nowadays, inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, is increasing; however, infectious colitis, such as amebic colitis, is decreasing, so many doctors are not apt to be interested in infectious colitis. In addition, recently amebic colitis has been relatively rare in Korea, and the colonoscopic and the pathologic findings of amebic colitis are very similar to those of other inflammatory bowel diseases. As a consequence, the diagnosis is very difficult if the cyst or the trophozoite of the ameba is not found in the stool examination or in the tissue pathology. The authors experienced three cases in which initial diagnoses of tuberculous colitis, ulcerative colitis, and a simple ulcer were made based on colonoscopic and X-ray findings. However a colonoscopic biopsy revealed a trophozoite form of ameba in the tissue. Hence, a diagnosis of amebic colitis could be made with confidence. Based on these results, we insist that infectious colitis should be included in the differential diagnosis when making a diagnosis of inflammatory bowel disease. In addition, it is extremely important to consider all kinds of infectious colitis, such as amebic colitis.
Amoeba ; Biopsy ; Colitis* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Dysentery, Amebic* ; Inflammatory Bowel Diseases ; Korea ; Pathology ; Trophozoites ; Ulcer

The recent discovery of plasmid derived beta-lactamase production by N. gonorrhoeae has changed the outlook of treatment of gonococcal infections and may well become the single most important factor in gonorrhoea control. Penicillinase is a beta-lactamase that splits the beta-lactam ring of penicillin hetween the C and N atoms to form penicilloic acids. We have been trying to assess the prevalence of PPNG in Korea since May 1980. We report here 7 strains of beta-lactamase producing N. gonorrhoae detected by chrornogenic cephalosporin method from Jan. 1981 to Mar. 1981 at the Joong Ku puhlic health center in Seoul. In January, I strain (l.3%); February, 2 strains (5.0%); and March, 4 strains .(6 4%) have been isolated. All restrains were confirmed by sugar feriventation test. Previously only one strain of PPNG had been reported among Korean laymen. The sudden appearance of PPNG among Korean laymen in 1981 may mean the barruer between U.S. Army enc1aves and Korean public has been broken recently and/or direct irnport of PPNG frorn abroad especially from South East Asia.

Seventeen volunteers with cutaneous dermatophytosis were enrolled in a clinical trial to evaluate the effectiveness of oral ketoconazole. The group included six patients with tinea cruris(6 malcs), four with tinea corporis, including one with tinea faciai, (3 males, 1 female), three with tinea versicolor(3 males) and four with tinea capitis(3 males, 1 female). The oral ketoconazole was taken within 10 minutes after a meal. The patients under the age of 10 received 100mg of ketoconazole per day, whereas those aged over 11 received 200mg of ketoconazole until the skin lesions are cured. Seventeen patients had complete clinical and mycologic cure, one responded clinically. It required one to four weeks to become culturally negative for tinea cruris, four to seven weeks for tinea corporis, three to eight weeks for tinea capitis. For tinea versicolor it required three to five weeks to become negative by scotch tape method. Adverse reactions to ketoconazole were absent and no patients required discontinuation of the drug. The results indicate that ketoconazole is a safe and effective drug for the treatment of dermatophytosis.
Humans ; Ketoconazole* ; Male ; Meals ; Skin ; Tinea Capitis ; Tinea Versicolor ; Tinea* ; Volunteers

Owing to its unique physicochemical properties such as high surface area, notable biocompatibility, robust mechanical strength, high thermal conductivity, and ease of functionalization, 2D-layered graphene has received tremendous attention as a futuristic nanomaterial and its-associated research has been rapidly evolving in a variety of fields.With the remarkable advances of graphene especially in the biomedical realm, in vivo evaluation techniques to examine in vivo behavior of graphene are largely demanded under the hope of clinical translation. Many different types of drugs such as the antisense oligomer and chemotherapeutics require optimal delivery conveyor and graphene is now recognized as a suitable candidate due to its simple and high drug loading property. Termed as ‘ radio-graphene’, radioisotope-labeled graphene approach was recently harnessed in the realm of biomedicine including cancer diagnosis and therapy, contributing to the acquisition of in vivo information for targeted drug delivery. In this review, we highlight current examples for bioapplication of radiolabeled graphene with brief perspectives on future strategies in its extensive bio- or clinical applications.
Diagnosis ; Graphite ; Hope ; Nanostructures ; Theranostic Nanomedicine ; Thermal Conductivity

Guillain-Barre syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weakness, areflexia, and ascending paralysis. Guillain-Barre syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods. We report a Cesarean delivery in the case of a 32-year old woman who was diagnosed with Guillain-Barre syndrome 18 weeks into gestation. Tracheostomy was performed due to progressive respiratory muscle weakness and respiratory failure, and ventilator support was required in the intensive care unit. The respiratory difficulty was exacerbated by the growth of the fetus, necessitating emergency Cesarean delivery. The delivery was successfully performed under general anesthesia, and the patient recovered without neurological sequelae.
Anesthesia, General ; Cesarean Section ; Emergencies ; Female ; Fetus ; Guillain-Barre Syndrome ; Humans ; Intensive Care Units ; Paralysis ; Polyradiculopathy ; Pregnancy ; Respiratory Insufficiency ; Respiratory Muscles ; Tracheostomy ; Ventilators, Mechanical

Bronchoconstrictions can occur by stimuli to the airway during anesthesia. Inhalational agents prevent or attenuate brochoconstriction and successfully inhibit reflexes of airway in asthmatic patients, and their mechanisms are well established. However, the effects of inhalational agents on the normal respiratory system is controversial. Therefore we studied the changes of compliance and resistance of the total respiratory system before and after administration of one of halothane, enflurane and isoflurane to unstimulated patients. We selected thirty adult patients without respiratory problems and excluded patients of receiving thoracic and abdomenal surgery because airway pressure might be changed by surgical manipulation. The patients without any premedication were ventilated with 50% oxygen by closed circuit ventilator(Physio-Flex(R)) after slow intravenous injection of thiopental sodium, fentanyl and vecuronium. We randomly allocated patients to one of three inhalational anesthetics( halothane, enflurane, isoflurane group). Then we intubated with I.D. 8 mm sized endotracheal tube for men and with I.D. 7 mm for women. Tidal volume and respiratory rates were maintained constantly during controlled ventilation and we increased concentration of inhalational agent by 0.5 MAC from zero to 1.5 MAC stepwise. At 10 minutes aft/er change of concentration of agent, we checked peak airway pressure, plateau airway pressure, mean airway pressure and end-tidal CO2 and then calculated compliance and resistance of the total respiratory system. We found that neither compliance nor resistance was changed by administration of or increasing concentration of halpthane, enflurane or isoflurane. The unstimulated normal airway in anesthetized patients was may be fully dilated, so that there was no more bronchodilatation after administration of inhalational agents.
Abdomen ; Adult ; Anesthesia ; Bronchoconstriction ; Compliance* ; Enflurane* ; Female ; Fentanyl ; Halothane* ; Humans ; Injections, Intravenous ; Isoflurane* ; Lung ; Male ; Oxygen ; Premedication ; Reflex ; Respiratory Rate ; Respiratory System* ; Thiopental ; Tidal Volume ; Vecuronium Bromide ; Ventilation

BACKGROUND: The purpose of this study was to measure and compare the optimum depth of the internal jugular venous catheterization between the right and left side. METHODS: Forty-four patients were enrolled for this study and divided into two groups (22 patients each). The optimum depth of the catheterization was calculated using the sum of two component (A and B); the advanced length of the catheter from the level of the cricoid cartilage (A) and the distance from the catheter tip to the junction of the superier vena cava and right atrium (B). RESULT: The optimum depths of the internal jugular venous catheterization were 16.0 1.0 cm (right) and 18.4 1.5 cm (left) respectively. Left side was significantly longer than right side (p<0.05). In this study, we experienced some complications; arterial punctures (5 cases) and migration of the catheter to the opposite subclavian vein (1 case). Five complications were associated with left internal jugular venous cannulation and one was associated with the right side cannulation. CONCLUSION: We concluded that the optimum depth of the internal jugular venous catheterization was longer in the left side than in the right side.
Catheterization* ; Catheters* ; Cricoid Cartilage ; Heart Atria ; Humans ; Punctures ; Subclavian Vein

OBJECTIVE: The purpose of this study is to examine the effects of oral exercise on oral function and denture satisfaction of the elderly using dentures. METHODS: The study was conducted with targets of the elderly in the 13 senior community centers in Cheongsong-gun, Gyeongsangbuk-do from September 2013 to April 2014. The study subjects were divided into two groups, the intervention group provided with 8 week oral exercise program and the control group without exercise. The data on oral function, denture satisfaction and oral health related quality of life (OHIP-14) were analyzed among the 79 subjects from the intervention group and the 71 subjects from the control group. RESULTS: For oral function, salivary flow rate, mouth opening, pronunciation and salty taste were significantly improved in the intervention group (p<0.01). There were significant differences in salivary flow rate, mouth opening, pronunciation and salty taste between the two groups (p<0.01). For denture satisfaction, there were significant differences in masticatory function, fixing function, general treatment satisfaction and total denture satisfaction between the two groups (p<0.05). There were significant differences between the two groups in the total points of oral health related quality of life. CONCLUSION: Oral exercise was effective in improving oral function and denture satisfaction of the elderly using dentures. To improve oral health related quality of life of the elderly further researches and programs will be necessary.
Aged* ; Dentures* ; Gyeongsangbuk-do ; Humans ; Mouth ; Oral Health ; Quality of Life

BACKGROUND: Lipids in the stratum corneum which acts as a barrier prevents transepidermal water loss and percutaneous absorption of a substance differs at different anatomic sites of skin. No study has yet been done on the recovery rate of the skin barrier after its destruction in relation to anatomic sites. OBJECTIVES: The purpose of this study was to measure the recovery rate of the skin barrier after its disruption in relation to anatomic sites and also to examine the lipid composition of skin surface lipids at different anatomic sites of skin. METHODS: The study population consisted of 20 healthy male subjects. We used 3M Scotch tapes to remove the stratum corneum and examined the recovery rate by measuring the TEWL using an evaporimeter after 2.5, 6, 10, 24, 48 and 72 hours at eight different anatomic sites consisting of the post-auricular area, chest, abdomen, back, forearm, thigh and calf. The skin surface lipids were extracted using 99% ethanol at ten different anatomic sites including the face, chest, abdomen, back, upper arm, forearm, palm, thigh, shin and sole. The composition of skin surface lipids was determined by thin layer chromatography. RESULTS: 1. The transepidermal water loss was highest in the post-auricular area and ahdomen, back, thigh, forearm, upper arm, thieh and chest in a decreasing order, although there was no statistical significance(p>0.05). 2. The recovery rate was highest in the post-auricular area after 2.5 hours with a statistical significance compared to other sites except for the abdomen(p<0.05). 3. The recovery rate was also highest in the post-auricular area after 6, 10, 24, 48 and 72hrs compared with other sites with a statistical significance (p<0.01). 4. Lipid analysis of ten anatomic sites demonstrated that the concentration of cholesterol sulfate was highest on the face, that of cholesterol was highest on the back and that of sphingolipid was highest on the abdomen but there was no statistical significance. CONCLUSION: The post-auricular area showed the fastest recovery rate after its barrier disruption which can be applied in the percutaneous absorption of substances. Also the composition of human skin surface lipids, especially epidermal lipids at different anatomic sites was not statistically different.
Abdomen ; Arm ; Cholesterol ; Chromatography, Thin Layer ; Ethanol ; Forearm ; Humans* ; Male ; Skin Absorption ; Skin* ; Thigh ; Thorax