No abstract available.
Aspergillosis*

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position

Purpose: We report an atypical case of ischemic oculomotor palsy occurring sequentially in both eyes and then improving, followed by a new abducens palsy in a diabetic patient with poor blood sugar control.Case summary: A 51-year-old woman presented with diplopia, dizziness, and pain in the right eye and was diagnosed with oculomotor palsy in the right eye. Magnetic resonance imaging of her brain was normal but glycated hemoglobin concentration was 13.4%. After 2 months, the third nerve palsy in the right eye had recovered completely but a new third nerve palsy occurred in the left eye. 1 month later, the symptoms had improved, and the patient did not return to our clinic until 18 months later, when she returned with new diplopia. This time, she was diagnosed with a sixth nerve palsy in the left eye and was observed while controlling her blood sugar. She recovered after 4 months. Conclusions Generally, cranial nerve palsies occur unilaterally in situations that can cause ischemia, such as diabetes, high blood pressure, and hyperlipidemia. Rarely, they occur bilaterally, or two or more cranial nerve palsies occur simultaneously. However, it is very rare that cranial nerve palsy occurs sequentially in both eyes under the same systemic blood sugar control. Diabetic patients with poor blood sugar control require long-term monitoring, considering the possibility of symptoms developing in both eyes with a time lag or other forms of ischemic cranial nerve palsy.

Although paraovarian cysts rarely cause symptoms, they may be complicated due to massive size, torsion or internal hemorrhage from rupture. Moreover, benign or malignant neoplasms may occasionally develop in paraovarian cysts. We present a case of a 73-year-old patient who suffered from a twisted large left paraovarian cyst. The patient visited emergency room with a chief complaint of acute abdominal pain. The patient was treated with good result by laparoscopic surgery. The maximum diameter of the mass was 10cm which was twisted 3 1/2 times clockwise. In conclusion, paraovarian cysts, even in elderly patients, can reach large sizes requiring awareness of the possible complications caused by large cyst which could be treated successfully by laparoscopy.
Abdominal Pain ; Aged ; Emergencies ; Hemorrhage ; Humans ; Laparoscopy ; Rupture

We aimed to assess one-year persistence with antihypertensive therapy (AHT) among newly treated uncomplicated hypertensive patients in Korea and to evaluate the effect of initial therapeutic classes on persistence. We retrospectively analyzed a random sample of 20% of newly treated uncomplicated hypertensive patients (n = 45,787) in 2012 from the National Health Insurance claims database. This group was classified into six cohorts based on initial AHT class. We then measured treatment persistence, allowing a prescription gap of 60 days. Adherence to AHT was assessed with the medication possession ratio. Calcium channel blockers (CCB, 43.7%) and angiotensin receptor blockers (ARB, 40.3%) were most commonly prescribed as initial monotherapy. Overall, 62.1% and 42.0% were persistent with any AHT and initial class at one year, respectively, and 64.2% were adherent to antihypertensive treatment. Compared with ARBs, the risk of AHT discontinuation was significantly increased with initial use of thiazide diuretics (hazard ratio [HR], 3.16; 95% confidence interval [CI] 2.96-3.74) and beta blockers (HR, 1.86; CI, 1.77-1.95) and was minimally increased with CCBs (HR, 1.12; CI, 1.08-1.15). In conclusion, persistence and adherence to AHT are suboptimal, but the differences are meaningful in persistence and adherence between initial AHT classes.
Adolescent ; Adrenergic beta-Antagonists/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Antihypertensive Agents/classification/*therapeutic use ; Calcium Channel Blockers/therapeutic use ; Cohort Studies ; Female ; Humans ; Hypertension/*drug therapy ; Male ; Medication Adherence ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Sodium Chloride Symporter Inhibitors/therapeutic use ; Young Adult

PURPOSE: The supply of donor organs does not meet the demand of transplantation. To find a possible way of expanding the donor pool, we have evaluated the risk factors of cadaveric donors that influence the graft survival. METHODS: Between Feb. 1995 and Dec. 1999, we performed 200 cases of cadaveric kidney transplantation. The graft survival rates in 1 yr, 2 yr, & 3 yr are 93.0%, 91.1%, & 89.9%, respectively. We defined the marginal donor as a donor who possesses one of the risk factors of donor age > or = 50, or < or =5 year old (n=18), ICU stay > or =10 days (n=46), history of hypertension (n=30), CPR > or =20 min (n=7), prolonged hypotension (SBP < or =80 mmHg, over 6 hr) (n=40), high dose inotropic support (dopamine > or =20microgram/kg/min, or dobutamine > or =15microgram/kg/min) (n=78), serum creatinine level > or =2.5 mg/dl (n=16), or cold ischemic time > or =12 hr (n=34). We compared graft survival rates between the marginal donor group and the non-marginal donor group, and analyzed risk factors affecting graft survival by univariate and multivariate methods. RESULTS: CPR > or =20 min (71.5%, 71.5%, - vs 93.8%, 91.8%, 90.6%, p=0.027), prolonged hypotension (85.0%, 85.0%, 80.3% vs 95.0%, 92.6%, 92.6%, p=0.028) and serum creatinine > or =2.5 mg/dl (75.0%, 75.0%, 75.0% vs 94.6%, 92.4%, 91.0%, p=0.001) affect graft survival in univariate analysis. There is, However, no risk factor that affects graft survival in multivariate analysis. CONCLUSION: We can increase the supply of donor organs for kidney transplantation by the selective use of high-risk cadaver donor. However, a prospective randomized study including recipient factors is needed to define the acceptable conditions better.
Risk Factors

BACKGROUND: As dental implants receive masticatory stress, the distribution of stress is very important to peri-implant bone homeostasis and implant survival. In this report, we created a saddle-type implant and analyzed its stability and ability to distribute stress to the surrounding bone. METHODS: The implants were designed as a saddle-type implant (SI) that wrapped around the alveolar bone, and the sizes of the saddles were 2.5, 3.5, 4.5, and 5.5 mm. The X and Y displacement were compared to clarify the effects of the saddle structures. The control group consisted of dental implants without the saddle design (CI). Using finite element modeling (FEM), the stress distribution around the dental implants was analyzed. RESULTS: With saddle-type implants, saddles longer than 4.5 mm were more effective for stress distribution than CI. Regarding lateral displacement, a SI of 2.5 mm was effective for stress distribution compared to lateral displacement. ASI that was 5.6 mm in length was more effective for stress distribution than a CI that was 10 mm in length. CONCLUSIONS: The saddle-type implant could have a bone-gaining effect. Because it has stress-distributing effects, it might protect the newly formed bone under the implant.
Dental Implants ; Homeostasis

BACKGROUND: The concern about growth hormone, used for treatment of growth hormone deficiency, wasting diseases, is increasing recently. There is much to be desired about the study for the reference range of insulin-like growth factor-1 (IGF-1) of Korean healthy adults, because there was a lack of studies of IGF-1 level. The authors investigated the concentration of IGF-1 according to age groups, and its correlation factors in healthy adults in Korea. METHODS: The subjects were 10,681 Korean healthy adults (5,263 females, 5,418 males) aged over 20 years, who visited the Department of Family Practice and Community Health in a university hospital from March 1998 to December 2003. We excluded the subjects with DM, liver diseases, renal diseases, thyroid diseases, and cancer. We measured the serum IGF-1, fasting glucose, lipid profile, serum albumin, protein, waist circumference, hip circumference, and body mass index. RESULTS: IGF-1 level showed gender difference (184.6 +/- 86.3 ng/mL for men, 178.6 +/- 91.8 ng/mL for women) and decreased significantly with age. Age was the most reliable correlation factor with IGF-1 (R: -0.325 for men, R: -0.463 for women). After adjusting fot age and weight, IGF-1 showed correlations with total protein, albumin, creatinine, triglycerides, and HDL cholesterol for men and height, waist circumference, body mass index, waist-hip ratio, systolic blood pressure, total protein, albumin, creatinine, triglycerides, and HDL cholesterol for women. CONCLUSION: IGF-1 concentration decreased with age over 20 years old. It showed the highest correlation with age in both gender.
Adult ; Aged ; Blood Pressure ; Body Mass Index ; Cholesterol, HDL ; Creatinine ; Family Practice ; Fasting ; Female ; Glucose ; Growth Hormone ; Hip ; Humans ; Insulin-Like Growth Factor I ; Korea ; Liver Diseases ; Male ; Reference Values ; Serum Albumin ; Thyroid Diseases ; Triglycerides ; Waist Circumference ; Waist-Hip Ratio ; Wasting Syndrome

PURPOSE: X-ray film over responds to low-energy photons in relative photon beam dosimetry because its sensor is based on silver bromide crystals, which are high-Z molecules. This over-response becomes a significant problem in clinical photon beam dosimetry particularly in regions outside the penumbra. In intensity modulated radiation therapy (IMRT), the radiation field is characterized by multiple small fields and their outside-penumbra regions. Therefore, in order to use film dosimetry for IMRT, the nature the source of the over-response in its radiation field need to be known. This study is aimed to verify and possibly improve film dosimetry for IMRT. MATERIALS AND METHODS: Modulated beams were constructed by a combination of five or seven different static radiation fields using 6 MeV X-rays. In order to verify film dosimetry, we used X-ray film and an ion chamber were used to measure the dose profiles at various depths in a phantom. In addition, in order to reduce the over-response, 0.01 inch thick lead filters were placed on both sides of the film. RESULTS: The measured dose profiles showed a film over-response at the outside-penumbra and low dose regions. The error increased with depths and approached 15% at a maximum for the field size of 15X15 cm(2) at 10 cm depth. The use of filters reduced the error to 3%, but caused an under-response of the dose in a perpendicular set-up. CONCLUSIONS: This study demonstrated that film dosimetry for IMRT involves sources of error due to its over-response to low-energy photons. The use of filers can enhance the accuracy in film dosimetry for IMRT. In this regard, the use of optimal filter conditions is recommended.
Film Dosimetry* ; Photons ; Silver ; X-Ray Film

PURPOSE: The European Organization for Research and Treatment of Cancer quality-of-life questionnaire-OG25 was developed to evaluate the quality of life in patients with stomach and esophageal cancer. The following are included in the OG25 but not in the STO22: odynophagia, choked when swallowing, weight loss, trouble eating with others, trouble swallowing saliva, trouble talking, and trouble with coughing. In this study, we evaluated the quality of life of gastrectomized patients using both, the OG25 and the STO22. MATERIALS AND METHODS: A total of 138 patients with partial gastrectomy (PG) (distal gastrectomy=91; pylorus-preserving gastrectomy= 47) and 44 patients with total gastrectomy (TG) were prospectively evaluated. Body weight and scores from the OG25 and STO22 were evaluated preoperatively and at 3 weeks, 3 months, and 6 months after surgery. RESULTS: Patients with TG had significant weight loss compared to patients with PG. At 3 months, TG was associated with worse scores for dysphagia, eating, odynophagia, trouble eating with others, trouble with taste, and weight loss on the OG25. TG was also associated with dysphagia, eating restrictions, and anxiety on the STO22. The OG25 helped differentiate between the groups with respect to weight loss, odynophagia, choked when swallowing, and trouble eating with others. The OG25 scores changed over time and were significantly different. CONCLUSIONS: The OG25 is a more sensitive and useful scale than the STO22 for evaluating the quality of life of gastrectomized patients, especially those with total gastrectomy.
Anxiety ; Body Weight ; Cough ; Deglutition ; Deglutition Disorders ; Eating ; Esophageal Neoplasms ; Gastrectomy* ; Humans ; Prospective Studies ; Quality of Life* ; Saliva ; Stomach ; Stomach Neoplasms ; Weight Loss