BACKGROUND AND OBJECTIVES: Voice quality may be an important issue for choosing treatment options of early glottic cancer. It has been reported that voice quality is worse after laser cordectomy compared to that of radiation therapy. But, with developed visualization tools, the precise localization of lesions became possible enabling surgeons to decide the appropriate surgical extent to preserve voice after laser cordectomy. The authors assessed the postoperative voice quality of patients who underwent laser cordectomy according to the classification by the European Laryngological Society. SUBJECTS AND METHOD: Thirty patients who were diagnosed with glottic cancer and treated with laser cordectomy between April, 1999 and January, 2006, were evaluated. All the patients were followed-up more than 6 months. Objective evaluations included maximal phonation time, fundamental frequency, jitter, shimmer, noise-to-harmonics ratio and subjective evaluation was performed by the GRBAS scale. RESULTS: The type II laser cordectomy group and some cases of the type III cordectomy showed no significant differences compared with the normal control group in both objective and subjective evaluations. CONCLUSION: This study shows that the group of laser cordectomy type II and some cases of type III had acceptable results compared to that of the normal control group. Thus, laser cordectomy could be considered as an alternative to radiation therapy in selected patients with early glottic cancer, even when preserving the quality of voice is an important issue.
Humans ; Phonation ; Voice ; Voice Quality

BACKGROUND: During coronary anastomosis in off-pump coronary artery bypass surgery (OPCAB), hemodynamic alternations can be induced by impaired diastolic function of the right ventricle. This study was designed to examine the effect of milrinone on right ventricular function and early outcomes in patients undergoing OPCAB. METHODS: Forty patients undergoing OPCAB were randomly assigned in a double-blind manner to receive either milrinone (milrinone group, n = 20) or normal saline (control group, n = 20). Hemodynamic variables were measured after pericardiotomy (T1), 5 min after stabilizer application for anastomosis of the left anterior descending coronary artery (LAD, T2), the obtuse marginalis branch (OM, T3), the right coronary artery (RCA, T4), 5 min after sternal closure (T5), and after ICU arrival. The right ventricular ejection fraction (RVEF) and right ventricular volumetric parameters were also measured using the thermodilution technique. For evaluation of early outcomes, the 30-day operative mortality and morbidity risk models were used. RESULTS: There was no significant difference in hemodynamic variables, including mean arterial pressure, between the 2 groups, except for the cardiac index and RVEF. The cardiac index and RVEF were significantly greater at T3 in the milrinone group than in the control group. CONCLUSIONS: Continuous infusion of milrinone demonstrated a beneficial effect on cardiac output and right ventricular function in patients undergoing OPCAB, especially during anastomosis of the graft to the OM artery, and it had no adverse effect on early outcomes.
Arterial Pressure ; Arteries ; Cardiac Output ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Heart Ventricles ; Hemodynamics ; Humans ; Milrinone ; Pericardiectomy ; Stroke Volume ; Thermodilution ; Transplants ; Ventricular Function, Right

Malaria is a protozoan disease transmitted by Anopheles mosquitoes. Since Plasmodium vivax malaria reemerged in the north west areas of South Korea in 1993, many cases with various manifestations have been reported. Clinicians should be aware of the rare and severe complications as well as the common complications. Splenic complications such as hematoma formation, rupture, torsion, cyst formation, and infarction are unusual manifestations of tertian malaria; therefore, we present two cases of P. vivax malaria with severe splenic complications with review of literature. One had a splenic infarction and the other had a splenic rupture, which was diagnosed by computed tomography. Both patients were successfully treated with a conservative approach.
Anopheles ; Culicidae ; Hematoma ; Humans ; Infarction ; Malaria ; Malaria, Vivax ; Plasmodium vivax ; Republic of Korea ; Rupture ; Splenic Infarction ; Splenic Rupture

Malaria is a protozoan disease transmitted by Anopheles mosquitoes. Since Plasmodium vivax malaria reemerged in the north west areas of South Korea in 1993, many cases with various manifestations have been reported. Clinicians should be aware of the rare and severe complications as well as the common complications. Splenic complications such as hematoma formation, rupture, torsion, cyst formation, and infarction are unusual manifestations of tertian malaria; therefore, we present two cases of P. vivax malaria with severe splenic complications with review of literature. One had a splenic infarction and the other had a splenic rupture, which was diagnosed by computed tomography. Both patients were successfully treated with a conservative approach.
Anopheles ; Culicidae ; Hematoma ; Humans ; Infarction ; Malaria ; Malaria, Vivax ; Plasmodium vivax ; Republic of Korea ; Rupture ; Splenic Infarction ; Splenic Rupture

The prevalence of intestinal tuberculosis has been markedly decreased with the development of antituberculous chemotherapy, improved economic conditions, preventive medicine and early detection and treatment of pulmonary tuberculosis. An even more impressive resurgence of pulmonary and extrapulmonary tuberculosis has been seen in recent years among persons infected with the human immunodeficiency virus. The most common site of intestinal tuberculosis is the ileocecal region, and duodenum is a rare site. Symptoms and signs of duodenal tuberculosis are nonspecific. The gross pathologic appearance of the duodenal tuberculous lesions has to its traditional categorization into three forms: 1) ulcerative, 2) hypertrophic, and 3) ulcerohypertrophic (mixed). Hypertrophic lesions of the duodenal tuberculosis should be differentiated from duodenal adenocarcinoma and lymphoma. We herein report a case of duodenal tuberculosis presenting as intraluminal protruding mass in gastroduodenoscopy and multiple intraabdominal lymphadenopathy on abdominal CT. We have confirmed the duodenal tuberculosis by endoscopic biopsy, and review the current literatures.
Adenocarcinoma ; Biopsy ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; HIV ; Humans ; Lymphatic Diseases ; Lymphoma ; Prevalence ; Preventive Medicine ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

BACKGROUND: To evaluate whether Staphylococcus aureus is actually the leading cause of infective endocarditis in Korea, investigation on updated clinical pictures, treatments, and prognosis was performed. This study also aims to describe differences in clinical characteristics of infective endocarditis in patients undergoing maintenance hemodialysis. MATERIALS AND METHODS: Fifty five patients who were diagnosed with infective endocarditis, using modified Duke criteria, at 4 Soon Chun Hyang University Hospitals (located in Seoul, Bucheon, Cheonan, and Gumi) from January of 2000 to June of 2007 were enrolled. Patients were separated into two groups; those on hemodialysis and those who were not on hemodialysis (control group). Medical records and laboratory results of each patient were reviewed retrospectively. RESULTS: The positive rate of blood culture was 72.7%. Staphylococcus aureus was isolated in 38.2% of the patients, making it the most common causative organism of infective endocarditis. It was also the most common organism in both hemodialysis group and non-hemodialysis group. Six patients (10.9%) died while admitted to the hospital and the in-hospital death rate for hemodialysis group was significantly higher. CONCLUSION: In most parts of the world, S. aureus is increasingly becoming the principal causative organism of infective endocarditis. To our knowledge, this is the first study that shows S. aureus to be the most common causative organism of infective endocarditis in Korea, and that Korea is not except from this global epidemiology.
Endocarditis ; Hospitals, University ; Humans ; Korea ; Medical Records ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

BACKGROUND: To evaluate whether Staphylococcus aureus is actually the leading cause of infective endocarditis in Korea, investigation on updated clinical pictures, treatments, and prognosis was performed. This study also aims to describe differences in clinical characteristics of infective endocarditis in patients undergoing maintenance hemodialysis. MATERIALS AND METHODS: Fifty five patients who were diagnosed with infective endocarditis, using modified Duke criteria, at 4 Soon Chun Hyang University Hospitals (located in Seoul, Bucheon, Cheonan, and Gumi) from January of 2000 to June of 2007 were enrolled. Patients were separated into two groups; those on hemodialysis and those who were not on hemodialysis (control group). Medical records and laboratory results of each patient were reviewed retrospectively. RESULTS: The positive rate of blood culture was 72.7%. Staphylococcus aureus was isolated in 38.2% of the patients, making it the most common causative organism of infective endocarditis. It was also the most common organism in both hemodialysis group and non-hemodialysis group. Six patients (10.9%) died while admitted to the hospital and the in-hospital death rate for hemodialysis group was significantly higher. CONCLUSION: In most parts of the world, S. aureus is increasingly becoming the principal causative organism of infective endocarditis. To our knowledge, this is the first study that shows S. aureus to be the most common causative organism of infective endocarditis in Korea, and that Korea is not except from this global epidemiology.
Endocarditis ; Hospitals, University ; Humans ; Korea ; Medical Records ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus