Nasotracheal intubation is an anesthetic technique widely used for maxillofacial surgery. It has the advantage of easier access to the surgical site to surgeon. However, when the nasothracheal intubation is performed a few complications may occur, such as nasal mucosa damage, epistaxis, sinusitis by sinus drainage occlusion and transient bacteremia. In addition, concha bullosa is a common anatomic variant of the middle turbinate, which is pneumatized, and very susceptible to trauma. We report a case of accidental middle turbinectomy by nasotracheal intubation, in the patient who had bilateral concha bullosa.
Bacteremia ; Drainage ; Epistaxis ; Humans ; Intubation* ; Nasal Mucosa ; Sinusitis ; Surgery, Oral ; Turbinates

We report the case of a patient with gastric adenocarcinoma with multiple liver metastases. This patient showed complete remission for more than 68 months after S-1/cisplatin combination chemotherapy and radical total gastrectomy. The patient, a 63-year-old man, presented with dyspepsia and difficulty in swallowing. Endoscopic findings showed a huge ulcero-infiltrative mass at the lesser curvature of the mid-body, extending to the distal esophagus. Biopsy revealed a poorly differentiated tubular adenocarcinoma. An abdominal computed tomography scan demonstrated multiple hepatic metastases. S-1/cisplatin combination chemotherapy was initiated, and following completion of six cycles of chemotherapy, the gastric masses and hepatic metastatic lesions had disappeared on abdominal computed tomography. Radical total gastrectomy and D2 lymphadenectomy combined with splenectomy were performed. The patient underwent three cycles of S-1/cisplatin combination chemotherapy followed by tegafur-uracil therapy for 1 year. He remained in complete remission for more than 68 months after surgery.
Adenocarcinoma* ; Biopsy ; Cisplatin ; Deglutition ; Drug Therapy ; Drug Therapy, Combination ; Dyspepsia ; Esophagus ; Gastrectomy ; Humans ; Liver* ; Lymph Node Excision ; Middle Aged ; Neoplasm Metastasis* ; Splenectomy ; Stomach Neoplasms

BACKGROUND AND OBJECTIVES: Candesartan cilexetil (Atacand ), a selective type I angiotensin II receptor blocker, has recently been introduced as a new antihypertensive agent. We evaluated its anti-hypertensive effect and safety in mild to moderate hypertensive patients. MATERIALS AND METHODS: Candesartan cilexetil, 8 mg or 16 mg, was administered once a day over 8 weeks period in the patients with mild to moderate hypertension (25 male, 26 female, mean age: 53.5+/-1.2 years). For safety evaluation, laboratory tests were performed before and after treatment with candesartan cilexetil. Changes in blood pressure, heart rate and electrocardiogram were also observed. RESULTS: 1) The mean blood pressures in the sitting position were systolic 164.1+/-2.1 mmHg and diastolic 106.3+/-0.8 mmHg before treatment, which were lowered to 135.4+/-2.0 mmHg and 89.1+/-1.1 mmHg, repectively after 8 weeks of treatment (p<0.05). 2) Candesartan cilexetil had a significant dose-dependent antihypertensive effect for diastolic pressure in 35 patients (8 mg: 97.8+/-0.9 mmHg, 16 mg: 91.3+/-1.1 mmHg, p<0.05). 3) Heart rate was not significantly changed before and after treatment during the treatment with candesartan cilexetil (72.2+/-1.2/min vs. 72.0+/-1.3/min: p>0.05). 4) Laboratory tests revealed no significant abnormality by the treatment with candesartan cilexetil. 5) Left ventricular hypertrophy by ECG criteria detected in 3 cases disappeared after treatment with candesartan cilexetil. 6) No significant side effects were observed during the treatment period. CONCLUSION: Candesartan cilexetil, 8 mg or 16 mg, once a day is an effective and well tolerated antihypertensive treatment. It has a significant dose-dependent antihypertensive effect.
Blood Pressure ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Receptors, Angiotensin

This study was designed to investigate the associations of the percent body fat dietary intake, plasma lipoprotein profile, lipoprotein(a), and plasminogen activator inhibitor-1(PAI-1) concentrations of 1982 Korean subjects(men : 1000 and women : 982) between the ages of 40 and 59 years. The dietary assessment consisted of twenty-four hour dietary records and food frequency questionnaires. The subjects were identified into one of the five rating groups of % body fat : lean, underweight, normal, overweight and obese groups. The biochemical assessment included measurements of plasma total cholesterol(TC), HDL-cholesterol(HDL-C), LDL-cholesterol(LDL-C), triglyceride(TG), lipoprotin(a)(Lp(a)), and PAI-1. With respect to the ratio of percent energy intake of carbohydrate : protein : fat of the normal group of the women was 62% : 17% : 20%, respectively. Women apparently had a higher intake of carbohydrates than men(52% : 17 : 20%) did. There was a linear relationship between energy intake and % body fat in both mean and women(with the exception of the underweight group of women). The relationship of % body fat of men to the protein and fat intake was higher than that of the carbohydrate intake. Of the men in the study, intakes of energy, protein and alcohol were positively correlated to % body fat. In women, energy, carbohydrate and protein intake were positively correlated to % body fat, however, the fat, cholesterol and alcohol intake did not show any correlation to the % body fat in women. This study showed that % body fat was positively correlated with plasma TC, LDL-C, PAI-1 levels, and TG, but the % body fat was negatively correlated with plasma HDL-C level in both men and women. These results indicated that the high energy intake of obese or overweight subjects might contribute to several of the biochemical indices fo coronary heart disease(CHD) risk. In conclusion, increased energy intake is associated with overweight or obesity in middle aged Korean people. There was no relationship between % energy intake of fat and % body fat in the study, in middle-aged Korean men and women. The plasma lipid profile and PAI-1 level thought to be the risk factors of CHD were positively associated with percent body fat in middle aged Korean people.
Adipose Tissue* ; Adult* ; Carbohydrates ; Cholesterol ; Diet Records ; Energy Intake ; Female ; Heart ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Male ; Middle Aged* ; Obesity ; Overweight ; Plasma* ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Surveys and Questionnaires ; Risk Factors ; Thinness

PURPOSE: The purpose of this study was to evaluate the fit of zirconia core using MAD/MAM system comparing to that of conventional metal-ceramic and CAD/CAM system. MATERIALS AND METHODS: Duplicating the prepared resin tooth, 50 improved stone dies were fabricated. These dies are classified as a group of 5 to create the core. The groups were composed of metal-ceramic, Cercon(R), Ceramill(R), Rainbow(TM), and Zirkonzhan(R). Each core was cemented to stone die, and then, absolute marginal discrepancy was measured with microscope at a magnification of x50. Statistical analysis was done with one-way ANOVA test and Tukey's HSD test. RESULTS: The mean absolute marginal discrepancy for metal-ceramic was 51.97 +/- 23.38 micrometer, for Cercon(R) was 62.16 +/- 25.88 micrometer, for Ceramill(R) was 67.64 +/- 40.38 micrometer, for Rainbow(TM) was 125.07 +/- 42.19 micrometer, and for Zirkonzhan(R) was 105 +/- 44.61 micrometer. CONCLUSION: 1. Fit of margin was identified as in the order of metal-ceramic, Cercon(R), Ceramill(R), Zirkonzhan(R), and Rainbow(TM). 2. Absolute marginal discrepancy of the zirconia core that designed by MAD/MAM system had significant differences in order of Ceramill(R), Zirkonzhan(R), and Rainbow(TM). 3. The mean absolute marginal discrepancy between Cercon(R) and Ceramill(R) did not show significant differences.
Tooth ; Zirconium

PURPOSE: We created an 'AAPM TG18 Evaluation Tool' and we determined its usefulness for the quality control of a diagnostic monitor. MATERIALS AND METHODS: We created an evaluation tool (the AAPM TG18) for conducting quality control of a diagnostic monitor, and we evaluated the measurement items of the AAPM TG18 evaluation tool. The measurement items were geometric distortion, fixed quantity assessment and visual assessment of the veiling glare, and we carried out adjustment for the luminance meter 0% calibration, which was used to revise the diagnostic monitor DICOM LUT. RESULTS: With the AAPM TG18 Evaluation Tool, we measured the 2-dimensional length when evaluating the quantitative geometric distortions in the TG18-QC test pattern, and we measured the veiling-glare ring response function, which provided information regarding the spatial extent of the luminance spread, and this measurement of the can be performed using the TG18-GV pattern. Additionally, the AAPM TG18 Evaluation Tool can be used for sensor calibration to standardize the basic rate of 0% luminance when performing periodic calibration. CONCLUSION: The evaluation tool is a very useful for easily evaluating many of the examination items of the AAPM TG18 for performing quality control of a diagnostic monitor.
Calibration ; Computer Terminals ; Glare ; Organothiophosphorus Compounds ; Quality Control ; Radiology Information Systems ; Total Quality Management

Immune checkpoint inhibitor is associated with variety of immune-related adverse events. We present a case of polyneuropathy induced by immune checkpoint inhibitor, which was refractory to steroid and immunoglobulin. While high-dose steroid and immunoglobulin were not effective, we tried rituximab which is effective in other immune-mediated polyneuropathy. After rituximab treatment, patient's clinical symptom and nerve conduction study finding was markedly improved. We suggest rituximab might be effective in polyneuropathy induced by immune checkpoint inhibitor.
Autoimmune Diseases ; Immunoglobulins ; Neural Conduction ; Polyneuropathies ; Rituximab

PURPOSE: To evaluate subjective satisfaction of patients and clinical results after arthroscopic ACL reconstruction using freeze-dried allograft. Materials & Methods : From May 1994 to January 1997, arthroscopic ACL reconstruction with freeze-dried allograft were performed in 33 patients in ACL deficient knee. Minimum follow-up period is 3 years, and average follow-up is 4.6 years. We analyzed clinical results according to the Lysholm scores, physical examination and KT-2000 knee ligament arthrometer. RESULTS: The average preoperative Lysholm score was 60 11, and the average postoperative score was 89 6. Anterior drawer tests and Lachmann tests were positive in 24 cases preoperatively and in 11 cases postoperatively. Postoperative instrumented laxity tests with KT-2000 knee ligament arthrometer (MEDMetric, San Diego, CA) were also performed postoperatively, and its average results was 3.7mm 1.3mm on 30lbs. There was no restriction or complaint in regular daily activities. But the postoperative ligament laxity was more prominent than that of using fresh-frozen allograft or autograft CONCLUSION: Despite the relatively good outcome of the patient's satisfaction, the use of freeze-dried allograft using the standard technique in arthroscopic ACL reconstruction can cause more laxity than that of fresh-frozen allograft.
Allografts* ; Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans* ; Knee ; Ligaments ; Physical Examination

Among the congenital coronary artery fistulae, multiple coronary artery microfistulae arising from the left and right coronary artery and emptying into the left ventricle are very rare and little is known of their anatomic and clinical features, especially in apical hypertrophic cardiomyopathy. A 67-year- old woman was referred for the evaluation of chest pain at exertion, and shortness of breath. Electrocardiographic and echocardiographic findings were typical of apical hypertrophic cardiomyopathy. Coronary arteriography showed normal epicardial coronary arteries, but multiple coronary artery-left ventricular microfistulae arising from the left and right coronary arteries. Transthoracic color Doppler echocardiography, using a high frequency transducer with a low Nyquist limit, demonstrated multiple coronary artery-left ventricular microfistulae just beneath the apical impulse window.
Aged ; Cardiomyopathy, Hypertrophic/*complications/diagnosis ; Coronary Angiography ; Coronary Vessel Anomalies/*complications/diagnosis/*ultrasonography ; Echocardiography ; Electrocardiography ; Female ; Heart Defects, Congenital/*complications/diagnosis/*ultrasonography ; Heart Ventricles ; Human ; Hypertrophy, Left Ventricular/complications/diagnosis

PURPOSE: To determine the associations of visual field index (VFI) with advanced glaucoma intervention study (AGIS) score, mean deviation (MD), pattern standard deviation (PSD), and average retinal nerve fiber layer (RNFL) thickness as measured by optical coherence tomography (OCT) and to evaluate the diagnostic abilities of these parameters. METHODS: One hundred fifteen glaucomatous eyes and 78 healthy eyes were enrolled in this cross-sectional study. Each participant had a Humphrey visual field analyzer test and OCT done. The diagnostic abilities of these parameters were analyzed using the receiver operating characteristic (ROC) curve, and we sought to determine the association of these parameters with VFI by Pearson correlation analysis. RESULTS: The associations between analyzed parameters and VFI were statistically significant (all, p<0.001). The area under the ROC curve (AUROC) value of VFI was greater than that of the MD and AGIS score (all, p<0.001) but was not different from the PSD and RNFL average thickness measured by OCT (p=0.756, p=0.638). CONCLUSIONS: The VFI showed significant associations with AGIS score, MD, PSD, and average RNFL thickness as measured by OCT and revealed similar diagnostic abilities as these parameters.
Cross-Sectional Studies ; Eye ; Glaucoma ; Clinical Trial ; Nerve Fibers ; Retinaldehyde ; ROC Curve ; Tomography, Optical Coherence ; Visual Fields