Although some cases of benign positional vertigo are associated with a chronic ipsilateral sensorineural hearing loss, an association with simultaneous ipsilateral sudden deafness is rare. We report a 53-year old woman with sudden deaf-ness with simultaneous positional vertigo in the same ear characterized by benign paroxysmal positional vertigo of pos-terior semicircular canal type. After a modified Epley particle-repositioning maneuver, the patient's vertigo was resolved. Clinical and neuro-otologic evaluations suggested that the lesion responsible for this patient was probably located within inner ear rather than within the vestibulocochlear nerve. (J Korean Neurol Assoc 19(4):410~412, 2001)
Ear ; Ear, Inner ; Female ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Middle Aged ; Semicircular Canals ; Vertigo* ; Vestibulocochlear Nerve

Cartilage extension and nasal envelop expansion play a main role incorrecting short or contracted nose. Despite numerous studies for cartilage expansion, there has been no reports of nasal skin elongation methods. We hereby preport a new method for expansion of nasal envelop with a comprehensive understanding of anatomical structures. From April 2009 to September 2010, 6 patients underwent operations to correct short or contracted nose. Two separating procedures were included for nasal envelop elongation; division of muscle(Procerus, Transverse nasali, Levator labii superior alaque nasi: PTL muscles) confluence located at nasal hinge and release of transverse nasalis sling. To estimate the degree of nasal envelop extension, forced skin traction test was performed. Comprehensive research with fresh cadaver was held to study the relationship between nasal SMAS and surrounding structures. Average 3.8mm elongation was documented by forced skin traction testafter the procedure. In the fresh cadaver study, transverse nasalis sling and PTL muscle confluence were firmly attached to the supportive framework. From our clinical experience and cadaver study, we discovered that release of transverse nasalis sling and division of PTL muscle confluence are the main factors for nasal envelop expansion in short or contracted nose.
Cadaver ; Cartilage ; Congenital Abnormalities ; Contracts ; Humans ; Muscles ; Nose ; Nose Deformities, Acquired ; Rhinoplasty ; Skin ; Traction

Nasal osteotomy for aesthetic results is required in patients who have broad nasal bone. Since the procedure is difficult, many operators hesitate the surgery. From January 2007 to July 2009, we performed 77 cases of nasal osteotomy, consisting of paramedian oblique medial osteotomy or median oblique-medial osteotomy and percutaneous lateral osteotomy. Most of the patients had satisfying results, however three patients had asymmetric shape and inappropriate inward movement of nasal bone which required revision with percutaneous lateral osteotomy. Osteotomy procedure varies, depending on surgeon's preference and experience, however, each surgeon should be aware of good and weak points of those procedures and use the most suitable method. In order to achieve maximal satisfying results, preoperative analysis of patients and minimal invasive handling should be done. Based on these efforts, this method could broadly be used in the aesthetic field.
Handling (Psychology) ; Humans ; Nasal Bone ; Nose ; Osteotomy ; Rhinoplasty

Purpose: The preemptive use of renin-angiotensin system (RAS) inhibitors may reduce doxorubicin (DOX)-related cardiotoxicity. Using the national insurance claims data of Korea, this study compared cardiovascular (CV) outcomes following the use of four major antihypertensive drug classes in patients with hypertension and breast cancer who underwent DOX-containing chemotherapy. Methods: A total of 4,722 patients with hypertension and breast cancer who underwent DOXcontaining chemotherapy were included. The outcomes were compared between patients who used RAS inhibitors, calcium channel blockers (CCBs), beta-blockers (BBs), and thiazide and thiazide-like diuretics (TDs). The primary outcome was a composite of incident heart failure and serious ventricular arrhythmias, including ventricular tachycardia and fibrillation, ischemic heart disease, and stroke. Results: In the propensity score-matched population, there were no significant differences in the primary outcome between RAS inhibitor and CCB users; however, patients with diabetes who used CCBs had a worse primary outcome than those who used RAS inhibitors (adjusted hazard ratio [aHR], 1.93; 95% confidence interval [CI], 1.06–3.51). BB and TD users had a worse primary outcome compared with RAS inhibitor (aHR, 1.88; 95% CI, 1.30–2.71 in BB users and aHR, 2.55; 95% CI, 1.37–4.75 in TD users) or CCB (aHR, 1.54; 95% CI, 1.09–2.16 in BB users and aHR, 2.08; 95% CI, 1.13–3.82 in TD users) users. Conclusion RAS inhibitors are preferred for the treating hypertension and improving CV outcomes in patients with hypertension and breast cancer undergoing DOX-containing chemotherapy, particularly in patients with comorbid diabetes. However, CCBs are equivalent to RAS inhibitors and are more favorable than BBs and TDs in terms of improving CV outcomes.

Congenital laryngeal cleft is a rare anomaly, which can cause serious problems of airway and repeated aspiration pneumonia. It is due m failure of fusion of the posterior cricoid cartilage lamina. Dysphagia with aspiration of food is commonly seen w1h resultant bouts of pneumonia. Detection of an unsuspected minor cleft may be difficult, but the pediatrician should suspect the possibility of deft from the clinical features. This paper includes. a detailed case report of one patient with congenital laryngeal cleft and the review of literatures.
Cricoid Cartilage ; Deglutition Disorders ; Humans ; Pneumonia ; Pneumonia, Aspiration

Acute changes of the bilateral basal ganglia shown in the brain MRI a diabetic uremic patient have been rarely reported. We report a 52-year-old diabetic uremic patient who had neurological disturbances. At admission, axial diffusion-weighted images and T2-weighted images showed high signal intensities in the bilateral basal ganglia, and axial T1-weighted images visualized low signal intensities in same area. The underlying mechanism may be associated with metabolic as well as vascular factors.
Basal Ganglia* ; Brain ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Uremia

BACKGROUND: Recently, obesity has become an important health problem in Korea. In 2000, the WHO Western Pacific Region recommended an obesity diagnostic criteria for Asian population. But among Asians, each ethnic group had their own anthrometric characteristics and so it was difficult to apply the same criteria to different ethnic groups. Thus, the aim of this study was to study the appropriate cut-off value of visceral fat area (VFA) and waist circumference (WC) which increases the risk of obesity-related disorders and to validate the diagnostic criteria of abdominal obesity and metabolic syndrome in Korean adult population. METHODS: A total of 278 of subjects (101 men and 177 women) were included for this study. The subjects were selected among Korean adults who visited the Department of Family Medicine, St. Mary's Hospital from January 1999 to August 2005. Three obesity-related disorders were defined to hypertension, hyperglycemia, and dyslipidemia. RESULTS: The cut-off value of visceral fat area which increased the risk of obesity-related disorders by ROC curve was 114.3 cm2 (sensitivity 76.3%, specificity 65.9%, P<0.005), and the waist circumference corresponding to a VFA of 114.3 cm2 by simple regression analysis was 74.2 cm in men and 87.37 cm in women (P<0.05). CONCLUSION: Based on the results of this study, the visceral fat area which increased the risk of obesity-related disorders was 114.3 cm2 and the WC corresponding to this VFA was 74.2 cm in men and 87.37 cm in women. For appropriate diagnostic criteria of abdominal obesity and metabolic syndrome in Korean adult population, further studies are required.
Adult* ; Asian Continental Ancestry Group ; Dyslipidemias ; Ethnic Groups ; Female ; Humans ; Hyperglycemia ; Hypertension ; Intra-Abdominal Fat* ; Korea ; Male ; Obesity ; Obesity, Abdominal ; ROC Curve ; Sensitivity and Specificity ; Waist Circumference

BACKGROUND AND OBJECTIVES: Off-thyroxine serum thyroglobulin (Tg) level is important to predict metastatic disease (MD) in papillary thyroid cancer (PTC); however, it is unclear whether a single off-thyroxine Tg level is sufficient for predicting MD. In this study, we determined whether serial measurement of off-thyroxine serum Tg level can predict metastasis in PTC patients after total thyroidectomy. MATERIALS AND METHODS: We enrolled 140 PTC patients in whom serum thyroid-stimulating hormone (TSH) and Tg levels were measured 7 days before radio-iodine (RAI) treatment (TSHA and TgA) and on the day of RAI treatment (TSHB and TgB) with withholding L-thyroxine for 4 weeks before RAI treatment. The values of TSHinc (TSHB-TSHA) and Tginc (TgB-TgA), Tgratio (TgB/TgA), Tginc/TSHinc and Tgratio/TSHinc were calculated. Tginc/TSHinc and Tgratio/TSHinc were tested if those parameters can predict MD in patients with TSHA>30 microIU/mL and TgA<10 ng/mL. RESULTS: Forty-four patients had MD and 96 had no evidence of MD (non-MD). MD group showed higher levels of TgA, TgB, Tginc, Tginc/TSHinc and Tgratio/TSHinc compared with non-MD group. A significant correlation was found between TSHinc and Tgratio (r=0.669) in MD group. In 43 patients with TSHA>30 microIU/mL and TgA<10 ng/mL (MD, 9; non-MD, 34), both Tginc/TSHinc (100%) and Tgratio/TSHinc (89%) had higher sensitivities for predicting MD than TgB (78%). CONCLUSION: With the increment in serum Tg corrected for the increment in serum TSH, serial measurements of off-thyroxine serum TSH and Tg levels can help predict PTC metastasis.
Factor IX ; Humans ; Neoplasm Metastasis ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Thyroxine

Small bowel variceal bleeding is a rare cause of gastrointestinal hemorrhage, with clinical manifestations ranging from asymptomatic incidental findings to life-threatening conditions. The diagnosis and management of small bowel bleeding are challenging because of the localization of the lesion and the difficulty of the procedure. Trans-arterial embolization (TAE) is a secure and straightforward method for treating ectopic varices. On the other hand, there have been limited local studies on the outcomes of TAE for patients with small bowel variceal hemorrhage. This paper reports patients diagnosed with small bowel variceal bleeding and treated with TAE.

We experienced 3 cases of food-borne botulism within a family. They presented with progressive ptosis, dysphonia, dysarthria and limb weakness, which had started about 12 hours after ingestion of vacuum-packed sausage. Two cases progressed to respiratory failure. Botulinum toxin A was detected from the stool sample of one case. Conservative treatment with mechanical ventilation was done and they recovered from respiratory failure over a 30-70 days period. This is the first case report of food-borne botulism in Korea.
Botulinum Toxins ; Botulism* ; Dysarthria ; Dysphonia ; Eating ; Extremities ; Humans ; Korea ; Respiration, Artificial ; Respiratory Insufficiency