Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

In order to analyze the potential role of basic fibroblast growth factor (bFGF)on retinal wound after laser photocoagulation, we studied the expression of GFAP and the morphologic changes in the retina of pigmented rats. A multiline krypton laser was used to produce laser lesions. After irradiation, eyes were intravitreally injected with 1 microliter vehicle or 1 microgram of bFGF in l microliter of vehicle. And we examined the expression of GFAP at 1 day, 3 days, 7 days and 14 days after treatment.We also measured the size of defect in outer nuclear layer at 7 days after laser. The results were as follows : 1. GFAP immunoreactivity of M ü ller cell begins to appear within 24 hours in whole retina area.It sharply increases until 7 days and then decreases slowly. 2. bFGF stimulates the expression of GFAP and it is statistically significant(p<0.05) 3. BFGF prevents cell death of photoreceptor in the laser lesions(p<0.05 ) From these results, we concluded that bFGF stimulates Müller cell reactivity after laser phtocoagulation and prevents photoreceptor loss. These results may be important to understand the healing mechanism of laser phtocoagulation and to minimize the complications of laser phtocoagulation.
Animals ; Cell Death ; Fibroblast Growth Factor 2* ; Krypton ; Light Coagulation ; Rats ; Retina ; Retinaldehyde ; Wounds and Injuries*

Background: The exact definition of sensitive skin is not established yet. Since its high prevalence and significant influence on quality of life, it has become an important topic of research. Among various ingredients, conditioned media from umbilical cord blood-derived mesenchymal stem cells (UCB-MSC-CM) can be a promising source for the treatment of sensitive skin. Objective: We evaluated the efficacy and safety of UCB-MSC-CM on patients with sensitive skin. Methods: We designed a randomized, single blinded, prospective, split-face comparison study and enrolled thirty patients. All patients underwent nonablative fractional laser over the entire face before UCB-MSC-CM or normal saline was applied. Each facial area was randomly assigned to undergo treatment with either UCB-MSC-CM or normal saline. We performed three sessions at two-week intervals, and final results were assessed on six weeks after the last session. As an outcome measure, we evaluated a five-point global assessment scale, transepidermal water loss (TEWL), erythema index (EI) and Sensitive Scale-10. Twenty seven subjects were included in final analysis. Results: The treated side exhibited greater improvement compared to the untreated side based on a five-point global assessment scale. TEWL, EI of the treated side were significantly lower than those of the untreated side throughout study period. Sensitive Scale-10 was significantly improved after treatment. Conclusion The application of UCB-MSC-CM resulted in improved skin barrier function and reduced inflammatory responsiveness, which could provide beneficial effect on sensitive skin.

BACKGROUND: we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. METHOD: In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. RESULTS: The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia(PaCO2> 45mmHg) have more increased postoperative complications. The preoperative FEVl less than 1 liter, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. CONCLUSION: Age 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia (> or=45mmHg) on preoperative arterial blood gas analysis were predictivd of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.
Aged* ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Humans ; Lung Diseases ; Postoperative Complications ; Smoke ; Smoking ; Spirometry

Bilateral abducens nerve palsy is mediated mainly by increased intracranial pressure, accompaniment to subarachnoid hemorrhage and others, relatively direct involvement of abducens nerve nucleus or its intracranial pathway is unusual case. A 45-year-old male patient complaining of double vision showed isolated bilateral abducens palsy. Cerebral angiography revealed a dissecting aneurysm of the basilar artery. Bilateral abduction deficit has resolved after stent assisted coil embolization. We suggest that basilar artery dissecting aneurysm should be included as a cause of bilateral abducens nerve palsy.
Abducens Nerve ; Abducens Nerve Diseases ; Aneurysm, Dissecting ; Basilar Artery ; Cerebral Angiography ; Diplopia ; Humans ; Intracranial Pressure ; Male ; Middle Aged ; Paralysis ; Stents ; Subarachnoid Hemorrhage

The intrauterine device (IUD) is a widely used contraceptive method. One of the most serious and rare complications of using an IUD is colon perforation. We report a case of colonoscopic removal of an IUD that had perforated into the rectosigmoid colon in a 42-year-old woman who presented with no symptoms. Colonoscopy showed that the IUD had penetrated into rectosigmoid colon wall and that an arm of the IUD was embedded in the colon wall. We were able to remove the IUD easily by using colonoscopy. The endoscopic approach may be considered the first choice therapy for selected patients.
Adult ; Arm ; Colon* ; Colonoscopy ; Contraception ; Female ; Humans ; Intrauterine Devices*

PURPOSE: This study was designed to investigate the validity of a single immunochemical fecal occult blood test (FOBT) for detection of colorectal neoplasia. MATERIALS AND METHODS: A total of 3, 794 average-risk screenees and 304 colorectal cancer patients admitted to the National Cancer Center, Korea, between May 2001 and November 2002, were studied prospectively. All screenees and admitted patients underwent FOBT and total colonoscopic examinations. Stools were self-collected, and examined using an immunochemical fecal occult blood test (OC-hemodia(R), Eiken Chemical Co. Tokyo, Japan) and an OC-sensor analyzer(R) (Eiken Chemical Co. Tokyo, Japan). RESULTS: Of the 3, 794 asymptomatic screenees, the colonoscopy identified colorectal adenomas and cancers in 613 (16.2%) and 12 (0.3%) subjects, respectively. The sensitivities of a single immunochemical FOBT for detecting colorectal cancers and adenomas in screenees were 25.0 and 2.4%, respectively. The false positive rate of FOBT for colorectal cancer in screenees was 1.19%. For the total 316 colorectal cancer cases (including 12 cases from screenees), the FOBT sensitivities according to the T-stage were 38.5, 75.0%, 78.9 and 79.2% for T1, 2, 3 and 4 cancers, respectively. The sensitivities according to the Dukes stages A, B and C were 63.4, 79.3 and 78.6%, respectively. CONCLUSION: The sensitivities of a single immunochemical FOBT for detecting colorectal cancers and adenomas in screenees were 25.0 and 2.4%, respectively. The sensitivities of FOBT were about 80% for Dukes B or C colorectal cancers and 63.4% for Dukes A.
Adenoma ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Korea ; Mass Screening ; Occult Blood* ; Prospective Studies

Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. Results: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). Conclusion Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

BACKGROUND/AIMS: The aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. METHODS: 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. RESULTS: The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. CONCLUSIONS: Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.
Abdominal Pain ; Cisapride* ; Diarrhea ; Dizziness ; Dyspepsia* ; Eructation ; Humans ; Korea* ; Retrospective Studies