BACKGROUND: Aspiration pneumonia remains a serious result associated with general anesthesia. Therefore, we studied the effectiveness of preanesthetic ranitidine in increasing gastric pH to prevent aspiration pneumonia. METHODS: Eighty patients scheduled for elective surgery were randomly divided into four groups with twenty patients in each group. Patients in control group were not given preanesthetic ranitidine; patients in group I received 300 mg of ranitidine orally at night before surgery, patients in group II received 150 mg of ranitidine orally both the night before surgery and one hour before surgery respecvtively and patients in group III recieved 150mg of ranitidine orally one hour before surgery. RESULTS: Compared with control group, the mean gastric pH of preanesthesia and 1 hour after anesthetic induction increased significantly in the group I, II, III (P<0.0001). There was significant increased gastric pH in the group II compared with group I and III. CONCLUSIONS: These results demonstrate that ranitidine markedly increase the gastric pH. So, we recommend that patients receiving general anesthesia would be taken Hz-antagonist such as ranitidine preoperatively.
Anesthesia, General ; Humans ; Hydrogen-Ion Concentration* ; Pneumonia, Aspiration ; Premedication ; Ranitidine*

A thirty nine year-old male patient was scheduled for emergent craniotomy and epidural hematoma evacuation under general anesthesia. All data of the preoperative check lists for emergent operation were within normal limits and vital signs of the patient were stable. During the induction of anesthesia an armored tube was inserted into the trachea for this operation. Approximately 110 minutes after the induction of anesthesia, signs of complete airway obstruction developed abruptly. At that time we deflated the cuff balloon to exchange the tube. Then, the signs of airway obstruction disappeared completely. Therefore the deflation of cuff balloon is recommended in order to exclude the obstruction by the displaced cuff.
Airway Obstruction* ; Anesthesia ; Anesthesia, General ; Craniotomy ; Hematoma ; Humans ; Intubation ; Male ; Trachea ; Vital Signs

PURPOSE: To evaluate the correlation among hypertropia, inferior oblique overaction (IOOA), and extorsion. METHODS: Thirty-one patients with congenital unilateral superior oblique palsy were evaluated. Visual acuity tests, refraction tests, ocular movement tests, prism cover tests, and fundus photography were performed. The correlations of vertical deviation, IOOA, and extorsion were analyzed. The operation method involved weakening the inferior oblique muscle, and then a comparison was made between measurements 1 month preoperative and 1 month postoperative for vertical deviation, inferior oblique overaction, and extorsion. RESULTS: On average, preoperative hypertropia was 8.84+/-6.88 prism diopters (PD), IOOA was 2.20+/-0.69, and extorsion was 18.06+/-5.83 degrees. The Pearson's correlation of IOOA and extorsion, hypertropia and IOOA, and extorsion and hypertropia were r=0.620, r=0.327, and r=0.126, respectively. Postoperative hypertropia, IOOA, and extorsion were reduced to 1.42+/-3.11PD, 0.42+/-1.11, and 8.63+/-5.09, respectively. CONCLUSIONS: Both extorsion and hypertropia showed significant positive correlations with IOOA, whereas hypertropia and extorsion revealed somewhat weaker positive correlations in congenital monocular superior oblique palsy. In addition, the amount of hypertropia was reduced, and extorsion and IOOA improved after recession of the inferior oblique muscle.
Humans ; Paralysis* ; Photography ; Strabismus* ; Visual Acuity

Mucin-hypersecreting bile duct tumors, which closely resemble intraductal papillary mucinous neoplasms of the pancreas, are rare, and both the clinical features and management thereof are poorly understood. As the biliary tract and the pancreas share a common origin, the two diseases may exhibit homologous histopathological features. Certain intraductal papillary tumors of the bile duct are associated with production of large amounts of mucin that disturb bile flow and cause severe biliary dilatation, obstructive jaundice, and cholangitis. Herein, we report on a patient with an extensive intraductal papillary mucinous neoplasm of the bile duct, involving both the right and left intrahepatic ducts. The ducts were subjected to photodynamic therapy, followed by left hepatectomy. The surgical specimen revealed an adenocarcinoma with a negative resection margin. Photodynamic therapy of the intrahepatic ducts was well-tolerated in the present case, and may serve as a useful therapeutic option for selected patients with intraductal papillary mucinous neoplasms of the bile duct.
Adenocarcinoma ; Bile ; Bile Duct Neoplasms ; Bile Ducts* ; Biliary Tract ; Cholangitis ; Dilatation ; Hepatectomy* ; Humans ; Jaundice, Obstructive ; Mucins* ; Pancreas ; Photochemotherapy*

A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Abdominal Wall ; Actinomycosis ; Biopsy ; Diabetes Mellitus ; Gastrectomy ; Humans ; Hydrazines ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; Penicillin G ; Recurrence

A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Abdominal Wall ; Actinomycosis ; Biopsy ; Diabetes Mellitus ; Gastrectomy ; Humans ; Hydrazines ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; Penicillin G ; Recurrence

Background/Aims: Controversy regarding the effectiveness of neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma (PDAC) still exists. Here, we aimed to identify the potential benefits of neoadjuvant therapy followed by surgery for resectable PDAC. Methods: We reviewed radiologically resectable PDAC patients who received resection with curative intent at a tertiary hospital in South Korea between January 2012 and August 2019. A total of 202 patients underwent curative resection for resectable PDAC: 167 underwent surgical resection first during this period, and 35 received neoadjuvant chemotherapy/chemoradiation therapy followed by surgery. Resectable PDAC patients were subdivided, and 1:3 propensity score matching (PSM) was performed to reduce selection bias. Results: Compared with the group that received surgery first, the group that received neoadjuvant treatment followed by surgery had significantly smaller tumors (22.0 mm vs 27.0 mm, p=0.004), a smaller proportion of patients with postoperative pathologic T stage (p=0.026), a smaller proportion of patients with lymphovascular invasion (20.0% vs 40.7%, p=0.022), and a larger proportion of patients with negative resection margins (74.3% vs 51.5%, p=0.049). After PSM, the group that received neoadjuvant therapy had a significantly longer progression-free survival than those in the group that underwent surgery first (29.6 months vs 15.1 months, p=0.002). Overall survival was not significantly different between the two groups after PSM analysis. Conclusions We observed significantly better surgical outcomes and progression-free survival with the addition of neoadjuvant therapy to the management of resectable PDAC. However, despite PSM, there was still selection bias due to the use of different regimens between the groups receiving surgery first and neoadjuvant therapy. Large homogeneous samples are needed in the future prospective studies.

Since the establishment of the academic society in 1972, Korean allergists have made continuous efforts to elucidate pathogenic mechanisms and therapeutic advances for allergic diseases. The present study aimed to summarize recent progress and explore future prospects of research performance by Korean allergists. We performed a comprehensive bibliometric analysis for research papers published in the Science Citation Index (SCI) or SCI-expanded journals by Korean allergists between 2009 and 2013. Research performance was quantitatively analyzed for the numbers of papers by publication year, research type, and main topic. In addition, the performance was also examined for qualitative indices, such as impact factor and citation number. A total of 1,091 papers were identified. The number of publication increased continuously, with an annual increase rate of 12.3%. Clinical and basic studies were the most frequent types of research, and recently the number of epidemiological studies has increased. By research topic, asthma was the most commonly studied, accounting for 20.9% of the total number of publications. Notably, the amount of rhinitis/rhinosinusitis research has risen steeply in 2013. Qualitative analyses also indicated continuous progress; the median impact factor of published journals increased from 1.918 in 2009 to 2.746 in 2013, yielding an annual increase rate of 7.4%. In conclusion, the present analyses identified a continuous increase in the research performance of Korean allergists over a recent 5 year period (2009-2013), both quantitatively and qualitatively. A more significant contribution is expected in the forthcoming era.
Asthma ; Bibliometrics* ; Epidemiologic Studies ; Hypersensitivity ; Korea ; Publications

Twelve strains of V. vulnificus isolated from clinical specimens in 2002~2004 in Jeollado province were determined for their biologic groups, serotypes, presence of vvhA (hemolysin/cytolysin) gene, DNA sequence, and PFGE patterns of NotI-restricted genomic DNA. The following results were obtained. All 12 isolates were biogroup 1, and API 20E profiles were: 5146105 for 5 (41.7%) isolates, and 5148125 for 2 isolates with sucrose fermentation. Ten (83.3%) of the 12 isolates was V. vulnificus serotype O4A, and two sucrose-fermenting isolates belonged to serotype O2. Alleles of cytolysin-hemolysin gene were detected in all 12 isolates. The nucleotide sequences of vvhA genes from strains WKHC 212 and WKHC 221 showed 94~97% similarity compared with those from previously reported 7 strains, YJ016, CMCP6, L-180, CDC B3547, IF Vv10, CIP 75.4T and CNRVC 970121. PFGE of NotI-restricted genomic DNA from the 12 isolates showed approximately 48.5 to 873-kb fragments and they were clustered to five (A to E) patterns. Two sucrose-fermenting isolates belonged to pattern D with 95% similarity with each other. Two strains isolated from two different patients had two identical patterns C and D. It is concluded that sucrose-fermenting strains also exist among clinical isolates of V. vulnificus in Korea, and they can be identified by using API 20E system, and by detecting vvhA gene. DNA sequences and PFGE pattern of NotI-restricted genomic DNA suggested that the two sucrose-fermenting isolates belonged to an identical clone, and two strains each isolated from two different patients belonged to two identical clones.
Alleles ; Base Sequence ; Centers for Disease Control and Prevention (U.S.) ; Clone Cells ; DNA ; Fermentation ; Humans ; Korea ; Sucrose ; Vibrio vulnificus* ; Vibrio*

In preparation for the surge of coronavirus disease 2019 (COVID-19), it is crucial to allocate medical resources efficiently for distinguishing people who remain asymptomatic until the end of the disease. Between January 27, 2020, and April 21, 2020, 517 COVID-19 cases from 13 healthcare facilities in Gyeonggi province, Korea, were identified out of which the epidemiologic and clinical information of 66 asymptomatic patients at the time of diagnosis were analyzed retrospectively. An exposure-diagnosis interval within 7 days and abnormal aspartate aminotransferase levels were identified as characteristic symptom development in asymptomatic COVID-19 patients. If asymptomatic patients without these characteristics at the time of diagnosis could be differentiated early, more medical resources could be secured for mild or moderate cases in this COVID-19 surge.