BACKGROUND: Tracheal tubes are different on the flexibility, material and bevel angle according to the manufacturers. These may affect the success rate of blind tracheal intubation through laryngeal mask airway (LMA). In addition, using straight-tip exchanger or curved-tip introducer, we tried to compare the success rate of tracheal tube insertion through LMA. METHODS: After receiving informed consents, 30 patients were enrolled. Blind tracheal intubation was tried with reinforced tracheal tube (M group), or one of two kinds of conventional tracheal tube (P group and B group). Tracheal tube was selected in random order and advanced into the trachea through LMA one by one. If all the three attempts was unsuccessful, we considered the blind tracheal intubation through LMA a failure. We also compared the success rate of blind tracheal insertion through LMA using straight-tip exchanger or curved-tip introducer. The first trial was performed on the neutral head position. The exchanger or introducer was rotated during the second trial. If the second attempt was unsuccessful, the exchanger- or intubator-guided intubation was performed on the sniffing position and, as a last and fourth trial, while mandible was being elevated with hands. RESULTS: Success rate of blind tracheal intubation through LMA was 50% (15/50) in group P and 36.7% (11/30) in group M, 33.3% (10/30) in group B (P=0.05). By using curved-tip introducer, intubation through LMA was successful in 80% (16/20), while it was successful only in 35% (7/20) via straight-tip exchanger. CONCLUSION: Blind tracheal intubation through LMA was dependent on the types of tracheal tube. Also, curved tip introducer may be a more valuable aid in performing blind tracheal intubation through LMA. Its use seems to be better technique than directly inserting tracheal tube through LMA.
Hand ; Head ; Humans ; Intubation* ; Laryngeal Masks* ; Mandible ; Pliability ; Trachea

PURPOSE: To examine the effects on erectile function of concomitant treatment with an alpha-blocker (tamsulosin) and an antimuscarinic agent (solifenacin) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Fifty-seven male patients with LUTS/BPH were assessed for the degree of LUTS and erectile function. In group 1 (tamsulosin) and group 2 (tamsulosin and solifenacin), changes in the International Prostate Symptom Score [IPSS: total scores, storage symptoms (ST), voiding symptoms (VD), and quality of life (QoL)], prostate-specific antigen, trans-rectal ultrasonography, urine flowmetry, residual urine, and a 5-item version of the International Index of Erectile Function (IIEF-5) were assessed after a 3-month treatment period. In both groups, it was determined whether treatment was associated with changes in LUTS and erectile function and whether improvement in the IPSS was correlated with the IIEF-5. Comparative analysis was also done to examine the linear relationship between improved IPSS scores and IIEF-5 scores. RESULTS: A comparison of the degree of improvement in all the parameters indicated that both groups showed significant improvement in total IPSS, IPSS-ST, IPSS-VD, and IPSS-QoL (p<0.05). A comparison of the degree of improved sexual function associated with improved LUTS in each patient showed significant improvement in the IIEF-5 score associated with the degree of improvement in the IPSS-ST domain in group 1, but no significant associations were found in group 2. In cases in which tamsulosin was administered, the IIEF-5 score significantly improved as the IPSS-ST domain score improved. In the group in which tamsulosin and solifenacin were concomitantly administered, improvement of the IPSS-ST domain score had no significant effect on the IIEF-5 score. CONCLUSIONS: In patients with LUTS/BPH, tamsulosin and solifenacin combination therapy was effective for LUTS, but erectile function was not significantly improved. Therefore, although effective for improving LUTS, combination therapy with an alpha-blocker and an antimuscarinic agent was not effective for improving erectile function.
Humans ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Quinuclidines ; Rheology ; Sexual Dysfunction, Physiological ; Sulfonamides ; Tetrahydroisoquinolines ; Urinary Tract ; Solifenacin Succinate

PURPOSE: The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free. MATERIALS AND METHODS: We retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated. RESULTS: Of the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9+/-392.5 mm2. The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%. CONCLUSIONS: RIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones.
Humans ; Kidney Calculi ; Kidney Pelvis ; Lithotripsy ; Multivariate Analysis ; Retrospective Studies ; Ureteroscopy

The declining tendency of signal joint T-cell receptor excision circles (sjTRECs) in peripheral blood is known to be age-dependent, and their quantification in blood or bloodstains has recently been introduced as a tool for age estimation. Lymphoid tissues such as the thymus and spleen represent potential candidates for age estimation because they undergo age-related structural and functional changes. In the present study, the correlation between age and sjTREC levels in human lymphoid tissues, namely the thymus, spleen, and blood, obtained from autopsy cases were investigated, with the goal of establishing a reliable age estimation model. Results showed negative regression curves with coefficient values of r=-0.410, r=-0.611, and r=-0.584 for thymus, spleen, and blood, respectively. In addition, this model was testing using thymus samples from the torsos of dismembered bodies from two real forensic cases, and results showed the predicted ages to be close to the actual ages of the victims. Further study will be required to improve accuracy and reduce estimation error, particularly within the lower age range. Nonetheless, these results suggest that quantification of sjTRECs in not only blood but also in other lymphoid tissues could be a useful tool for age estimation in forensic cases.
Autopsy ; Humans* ; Joints* ; Lymphoid Tissue* ; Receptors, Antigen, T-Cell* ; Spleen ; T-Lymphocytes* ; Thymus Gland ; Torso

Juvenile xanthogranuloma (JXG) is a fibrohistiocytic proliferative disorder predominant in infancy and childhood. It is a benign and transient skin lesion that usually appears in the cephalic area. Recently, the concurrent finding of neurofibromatosis (NF), juvenile chronic myelogenous leukemia (JCML), and JXG has been repeatedly reported. Especially, the family history of NF may represent a risk factor for the development of JCML in patients with NF and in patients with NF and JXG. So, a finding of JXG and NF in infants should alert the physician to a possible development of JCML. We report a case of JXG developed in a neurofibromatosis child with family history.
Child ; Humans ; Infant ; Leukemia, Myelomonocytic, Juvenile ; Neurofibromatoses ; Risk Factors ; Skin ; Xanthogranuloma, Juvenile

Jessner's lymphocytic infiltration of the skin (JLIS) is a well-known but poorly understood disorder. Some doubt still exists about whether it is a distinct disease or a variant of lupus erythematosus or, less commonly, polymorphous light eruption, cutaneous lymphoid hyperplasia. An effective therapy is still unavailable for JLIS. We report a patient with JLIS which was successfully treated with dapsone and intermittent systemic glucocorticoid therapy.
Dapsone ; Humans ; Hyperplasia ; Light ; Skin

BACKGROUND: The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. METHODS: The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. RESULTS: A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. CONCLUSIONS: As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes.
Consensus ; Dentistry ; Education ; Korea ; Medicine, East Asian Traditional

Lichenoid drug eruption can arise as a result of exogenous compound exoposures and closely mimic idiopathic lichen planus. A 45-year-old man who had taken antituberculosis drugs (isoniazid, rifampin, ethambutol, pyrazinamide) for 2 months developed pruritic violaceous papules and plaques with silvery scales on the whole body. On close inspection, he had superficial erosions on the lips and reticulate white papules on the buccal mucosa. Histopathologic findings were hyperkeratosis, parakeratosis, and hypergranulosis in the epidermis and band-like lymphohistiocytic infiltration, numerous eosinophils, and perivascular lymphohistiocytic infiltration in the dermis. The skin lesions improved leaving hyperpigmentation after cessation of the antituberculosis drugs and application of topical corticosteroid.
Dermis ; Drug Eruptions ; Eosinophils ; Epidermis ; Ethambutol ; Humans ; Hydrazines ; Hyperpigmentation ; Lichen Planus ; Lip ; Middle Aged ; Mouth Mucosa ; Parakeratosis ; Rifampin ; Skin ; Weights and Measures

Liposarcomas are one of the most common soft-tissue sarcomas in adults. They usually arise in the deep soft tissues, and patients present with large painless masses. Four major types of liposarcomas are generally recognized and have epidemiologic and prognostic differences: atypical lipomatous neoplasm/well-differentiated; myxoid/round- cell; dedifferentiated; pleomorphic variants. Myxoid liposarcoma is the second most common type of liposarcoma, representing 30~40% of all liposarcomas in the extremities. We report a case of myxoid liposarcoma in a 78-year-old man who presented with an asymptomatic, firm, deep-seated mass in the lateral aspect of his left upper arm.
Adult ; Aged ; Arm ; Extremities ; Humans ; Liposarcoma ; Liposarcoma, Myxoid ; Sarcoma

Primary malignant melanoma of the vagina is an exceedingly rare entity, accounting for about 3% of all primary vagina1 malignant tumors and 0.3% of all melanoma. The overall 5-year survival in patients with primary vaginal melanoma is notoriously poor, estimated to be between 13% and 19%. A case of primary malignant melanoma of the vagina treated with the wide local excision of vagina and rectum was presented with a brief review of literature.
Humans ; Melanoma* ; Rectum* ; Vagina*