The protection afforded against CO2 and KTP(potassium titanium phosphate) laser-induced combustion by six different types of tracheal tubes was evaluated. Some of them were wrapped with aluminum foil. They were compared before and after the application of human blood to their external surfaces. The difference of protective efficacy against laser between normal saline filled and air filled cuff was evaluated, too. The tracheal tubes tested were laser-resistant tubes such as Bivona Fome-Cuf (Group 1), Xomed Laser-shield 11 (Group 2) and Mallincrodt Laser Flex (Group 3) tubes. Aluminum foil wrapped Rusch red rubber (RR) (Group 4) and Mallincrodt reinforced Polyvinylchloride (PVC) (Group 5) tubes and unwrapped Baxter plain PVC (Group 6) tubes were also tested. CO2 loser set to 38W in continuous mode and KTP laser set to 15W were directed at the shaft of the tracheal tube under study, which had 5L/min. of oxygen flowing through it. The laser was actuated for 90 seconds or until combustion or melting occurred. Bivona tubes (Group 1) resulted in combustion in 5 tubes before and after blood application with CO2 laser, but unaffected before blood and resulted in combustion in 4 of 5 after blood application with KTP laser. Laser-shield 11 tubes (Group 2) offered good protection form both laser before and after application of blood except 1 case. At one case in Group 2, combustion occurred after blood application with CO2 laser. A combustion occured in 1 of 5 prior to application of blood and 5 of 5 after blood in Laser Flex tubes (Group 3) with CO2 laser, but occurred no tube with KTP laser. Wrapped RR (Group 4) and reinforced PVC tubes (Group 5) were unaffected by both laser, but application of blood to the foil wrapped tube shaft resulted in melting in 4 of 5 tubes. Unwrapped PVC tube (Group 6) resulted in immediate combustion in all tubes tested with both laser. Saline inflated cuffs were not perforated only in Group 2 and 3 in KTP laser and perforated immediately in other groups, but there was no combustion with saline in all groups. Air filled cuffs were all perforated in both laser, and combustion occurred. The presence of blood on the surface of metallic foil wrapped or special laser-resistant tracheal tubes may make laser-induced combustion more likely during airway surgery. However, the Laser-shield 11 and aluminum foil wrapped tracheal tube provided good protection from even when covered with blood. In addition, Mallincrodt stainless steel Laser-Flex tube provided good protection from KTP laser only. The saline filling cuffs served as a heat sink that will absorb the lasers energy, thus preventing combustion of cuffs.
Aluminum ; Freezing ; Hot Temperature ; Humans ; Lasers, Gas ; Lasers, Solid-State ; Oxygen ; Rubber ; Stainless Steel ; Titanium

PURPOSE: To overcome the potential disadvantages of the use of foreign materials and autologous fat or collagen, we introduce here an autologous plasma gel for injection laryngoplasty. The purpose of this study was to present a new injection material, a plasma gel, and to discuss its clinical effectiveness. MATERIALS AND METHODS: From 2 mL of blood, the platelet poor serum layer was collected and heated at 100degrees C for 12 min to form a plasma gel. The plasma gel was then injected into a targeted site; the safety and efficacy thereof were evaluated in 30 rats. We also conducted a phase I/II clinical study of plasma gel injection laryngoplasty in 11 unilateral vocal fold paralysis patients. RESULTS: The plasma gel was semi-solid and an easily injectable material. Of note, plasma gel maintains the same consistency for up to 1 year in a sealed bottle. However, exposure to room air causes the plasma gel to disappear within 1 month. In our animal study, the autologous plasma gel remained in situ for 6 months in animals with minimal inflammation. Clinical study showed that vocal cord palsy was well compensated for with the plasma gel in all patients at two months after injection with no significant complications. Jitter, shimmer, maximum, maximum phonation time (MPT) and mean voice handicap index (VHI) also improved significantly after plasma gel injection. However, because the injected plasma gel was gradually absorbed, 6 patients needed another injection, while the gel remained in place in 2 patients. CONCLUSION: Injection laryngoplasty with autologous plasma gel may be a useful and safe treatment option for temporary vocal cord palsy.
Adult ; Aged ; Aged, 80 and over ; Animals ; *Blood Platelets ; Female ; Humans ; Laryngoplasty/*methods ; Male ; Middle Aged ; Plasma/*physiology ; Rats

BACKGROUND AND OBJECTIVES: Psychogenic dizziness has not been studied extensively in Korea while it is seen frequently. We investigated the prevalence of psychiatric diagnosis and the results of vestibular function testings in patients with the diagnosis of psychogenic dizziness at a Korean tertiary university hospital. MATERIALS AND METHODS: The study was conducted on 38 patients with the diagnosis of psychogenic dizziness. They all received vestibular function testings (ENG, rotating chair test and posturography). Patients with central or vestibular organic disease were excluded from this study. RESULTS: Somatoform disorder was the most common psychiatric disorder causing psychogenic vertigo(47.4%) in this study. Anxiety disorder(21.1%) and depression(21.1%) were the next common causes. The vestibular function testings were abnormal in 19 patients(50.0%). The electronystagmography in 11, rotating chair test in 6, and posturography in 14 patients were abnormal. CONCLUSIONS: Somatoform disorder was the most common psychiatric disorder and vestibular function tests were abnormal in 50% of psychogenic dizziness patients. It implies that the patients with psychogenic dizziness have functional abnormalities in vestibular system.
Anxiety ; Diagnosis ; Dizziness* ; Electronystagmography ; Humans ; Korea ; Mental Disorders* ; Prevalence ; Somatoform Disorders ; Vestibular Function Tests*

Lipoma is one of the most common benign neoplasm in the subcutaneous tissues, but the lipoma of larynx is rare as fewer than 100 cases have been reported in the world. The symptoms are variable, but it has clinical importance when lipoma does occur, for they can cause unpredictable airway obstruction, particularly during the induction of general anesthesia. In this article, we report a case of lipoma of the epiglottis with a review of the related literature. We successfully treated the tumor with tracheostomy and surgery.
Airway Obstruction ; Anesthesia, General ; Epiglottis ; Larynx ; Lipoma ; Subcutaneous Tissue ; Tracheostomy

No abstract available.
Biopsy, Fine-Needle* ; Thyroid Gland* ; Thyroid Nodule*

BACKGROUND: The morphological characteristics of hepatocytes transplanted into the spleen have been studied. However few attempts has been made to determine the expression of genes in intrasplenically transplanted hepatocytes. The aim of this study was to explore whether the pattern of expression of albumin gene in intrasplenically transplanted hepatocytes is similar to that in adult liver, resulting in the long-term expression of this hepatocyte-specific gene. METHODS: Hepatocytes isolated from liver of syngeneic Fischer 344 rats and transplanted into the spleen of rats from the same strain survived for 12 months in the absence of immunosuppressive drugs. Microscopic examination of intrasplenic hepatocytes and Northern blotting for albumin gene expression of RNA extracted from liver and spleen was performed. RESULTS: Microscopy demonstrated that hepatocytes attached themselves only in the red pulp of the spleen and isolated hepatocytes preserved the fine structures characteristic of normal hepatic parenchymal cells. Throughout the 12 months period, intrasplenically transplanted hepatocytes expressed albumin mRNA. CONCLUSIONS: Intrasplenically transplanted hepatocytes represent a unique in vivo system of extrahepatic maintenance of hepatocytes. This novel transplantation system could be used to investigate hepatocyte engraft, proliferation and gene expression.
Adult ; Animals ; Blotting, Northern ; Gene Expression* ; Hepatocytes* ; Humans ; Liver ; Microscopy ; Rats ; RNA ; RNA, Messenger ; Spleen

Multiple-system atrophy (MSA) is an adult-onset, sporadic, progressive neurodegenerative disease. Clinically, the cardinal features include autonomic failure, parkinsonism, cerebellar ataxia, and pyramidal signs in any combination, of which autonomic failure is an integral component in the diagnosis. Pathologically, MSA is characterized by alpha-synuclein-positive glial cytoplasmic inclusions and neuronal loss, predominantly in the basal ganglia, brainstem, cerebellum, and intermediolateral cell columns of the spinal cord. We report the first case of MSA confirmed by autopsy in Korea.
Atrophy ; Autopsy ; Basal Ganglia ; Brain Stem ; Cerebellar Ataxia ; Cerebellum ; Inclusion Bodies ; Korea ; Multiple System Atrophy ; Neurodegenerative Diseases ; Neurons ; Parkinsonian Disorders ; Spinal Cord

BACKGROUND: Alcohol is known to affect two epigenetic phenomena, DNA methylation and DNA hydroxymethylation, and iron is a cofactor of ten-eleven translocation (TET) enzymes that catalyze the conversion from methylcytosine to hydroxymethylcytosine. In the present study we aimed to determine the effects of alcohol on DNA hydroxymethylation and further effects of iron on alcohol associated epigenetic changes. METHODS: Twenty-four male Sprague-Dawley rats were fed either Lieber-DeCarli alcohol diet (36% calories from ethanol) or Lieber-DeCarli control diet along with or without iron supplementation (0.6% carbonyl iron) for 8 weeks. Hepatic non-heme iron concentrations were measured by colorimetric assays. Protein levels of hepatic ferritin and transferrin receptor were determined by Western blotting. Methylcytosine, hydroxymethylcytosine and unmodified cytosine in DNA were simultaneously measured by liquid chromatography/mass spectrometry method. RESULTS: Iron supplementation significantly increased hepatic non-heme iron contents (P < 0.05) but alcohol alone did not. However, both alcohol and iron significantly increased hepatic ferritin levels and decreased hepatic transferrin receptor levels (P < 0.05). Alcohol reduced hepatic DNA hydroxymethylation (0.21% ± 0.04% vs. 0.33% ± 0.04%, P = 0.01) compared to control, while iron supplementation to alcohol diet did not change DNA hydroxymethylation. There was no significant difference in methylcytosine levels, while unmodified cytosine levels were significantly increased in alcohol-fed groups compared to control (95.61% ± 0.08% vs. 95.26% ± 0.12%, P = 0.03), suggesting that alcohol further increases the conversion from hydroxymethylcytosine to unmodified cytosine. CONCLUSIONS: Chronic alcohol consumption alters global DNA hydroxymethylation in the liver but iron supplementation reverses the epigenetic effect of alcohol.
Alcohol Drinking* ; Alcohols ; Animals ; Blotting, Western ; Cytosine ; Diet ; DNA Methylation ; DNA* ; Epigenomics ; Ferritins ; Humans ; Iron* ; Liver ; Male ; Methods ; Rats* ; Rats, Sprague-Dawley ; Receptors, Transferrin ; Spectrum Analysis

Benign endobronchial tumors are rare diseases with an incidenced of between 1 and 5% of all lung tumors. An endobronchial fibroepithelial polyp is an extremely rare form of benign bronchial tumor. Clinically, an endobronchial fibroepithelial polyp causes an airway obstruction and obstructive pneumonitis as does other endobronchial tumors. Therefore, it is important to differentiate an endobronchial fibroepithelial polyp pathologically from other benign endobronchial tumors and bronchogenic carcinomas. Here, we report a case of an endobronchial fibroepithelial polyp, in a 25-year-old man who had suffered from chest discomfort upon deep breathing with a brief review of the relevant literature.
Adult ; Airway Obstruction ; Carcinoma, Bronchogenic ; Humans ; Lung ; Pneumonia ; Polyps* ; Rare Diseases ; Respiration ; Thorax

Background/Aims: Periampuilary diverticulum has been known to be associated with various bilio-pancreatic diseases such as choledocholithiasis and disturbs performing selective cannuiation of ERCP and EST. This present study aims to investigate anatomical morphology of periampullary diverticulum and to determine whether periampullary diverticulurn influences difficulty and complication performing of ERCP and to analyse the relationship between periampullary diverticulum and choledocholithiasis. Methods: We reviewed records of chart and diverticular pictures in 1389 cases of underwent ERCP and evaluated the incidence, size, direction, location of periampullary diverticulum and its influence against performing of ERCP and investigated its relationship with bilio-pancreatic diseases such as choledocholithiasis.(continue..)
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Diverticulum* ; Incidence