PURPOSE: This study was conducted to investigate the characteristics of drug induced anaphylaxis and anaphylactic shock in patients who were admitted to the emergency department. METHODS: We retrospectively collected the data on patients with drug induced anaphylaxis and who were admitted to the emergency department from January 2001 to June 2009. The study group was divided into the non-shock and shock groups according to whether the systolic blood pressure more than 90 mmHg. The initial demographic data, the causes of drug-induced anaphylaxis, the clinical manifestations, the treatment and the prognosis were reviewed for 72 patients. RESULTS: The mean age of the study subjects was 47.9+/-14.2 years old and there were 40 male patients and 32 female patients. There were 26 patients in the non-shock group and 46 in the shock group. The mean age was older in the shock group than in the non-shock group (51.5+/-15.1 vs 42.5+/-10.6, p-0.002). A history of drug allergy was more common in the shock group, but no difference was found for the comorbid chronic diseases between the two groups. Radio-contrast media was the most common cause, followed non-steroidal anti inflammatory drugs and antibiotics, but there is no difference in the causes between the two groups. The symptoms of cyanosis, syncope, sweating and dizziness were more frequently manifested in the shock group. The administration of intravenous fluid and injection of subcutaneous epinephrine at the emergency department were more frequent in the shock group than in the non-shock group. CONCLUSION: For the patients who were admitted to the emergency department with drug induced anaphylaxis, the mean age was older and the symptoms of cyanosis, syncope, sweating, dizziness were more frequent in the anaphylactic shock patients than in the non-shock group. More treatments were given at the emergency department to the anaphylactic shock patients.
Anaphylaxis ; Anti-Bacterial Agents ; Blood Pressure ; Chronic Disease ; Cyanosis ; Dizziness ; Drug Hypersensitivity ; Emergencies ; Epinephrine ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies ; Shock ; Sweat ; Sweating ; Syncope

Although there has not yet been a clear determination of the structures responsible for nasal tip support, it is generally agreed that for Caucasians the components of nasal tip support include the attachment between the upper and lower lateral cartilage, the attachment between the lateral crus and the pyriform aperture, the attachment between the paired domes of the lower lateral cartilages, and the medial crural attachments of the caudal septum. To our knowledge, there has been no anatomical study of the nasal tip supporting structures for Asian patients. The purpose of this study is to determine these structures and how they differ from those of Caucasian patients. Ten noses of fresh cadavers were investigated. Dissection was performed and the above-mentioned nasal tip supporting structures were observed and excised. Histological examination was done with hematoxylin and eosin stains and Van Gieson elastin stains. Based on our results, we propose that the structures between upper and lower lateral cartilages, between lateral crus and pyriform aperture, between the paired domes of lower lateral cartilages should referred to as an intercartilaginous ligament, sesamoid fibromuscular tissure, and interdomal loose connective tissue, respectively. There is no identified specific tissue between medial crus and caudal septum. We consider that the loose connection between the domes of the middle crura and the lack of a specific structure between the medial crus and caudal septum might be the reasons why the nasal tips of Asian patients tend to be broad and unprojected with a wide base.
Asian Continental Ancestry Group ; Cadaver ; Cartilage ; Coloring Agents ; Connective Tissue ; Elastin ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Ligaments ; Nose

PURPOSE: To analyze the causes of vocal cord fixation in laryngeal cancer and to demonstrate its spiral CT findings. MATERIALS AND METHODS: We retrospectively applied the five pathologic mechanisms of vocal cord fixationto spiral CT findings and evaluated mechanisms of fixed vocal cord in 16 patients with laryngeal cancer of T3 or more on staging. CT findings of another six patients (T2) showing one or more suspicious mechanisms of vocal cord fixation in conventional CT were compared with those of the 16 patients (T3 or more). RESULTS: In 16 patients with laryngeal cancer of T3 or more, the most common finding of vocal cord fixation was the complete replacement of the true vocal cord (including the thyroarytenoid and vocalis muscle) by the tumor and tumor invasion of the paralaryngeal space (n = 16). Other findings were tumor invasion and fixation of the cricoarytenoid joint (n = 9), interference with cord mobility by the bulky mass (n = 6), tumor invasion of the thyroid cartilage, with vocalcord fixation (n = 4) and subglottic tumor spread (n = 3). In another six patients (T2) with suspicious vocal cordfixation, conventional CT showed partial vocal cord invasion and intact or minimal invasion of the paralaryngeal space (n = 3), a bulky mass without vocal cord invasion (n = 1) and subglottic extension but movable vocal cord (n= 2). CONCLUSION: Although the cause of vocal cord fixation from laryngeal cancer may be due to one of five patterns of cancer spread, or to a combination of these, the most common spiral CT finding is complete replacement of true vocal cord by the cancer and tumor invasion of the paralaryngeal space. Accurate evaluation of vocal cord fixation and the extent of the tumor could be evaluated with spiral CT using the breathing technique.
Humans ; Joints ; Laryngeal Neoplasms* ; Respiration ; Retrospective Studies ; Thyroid Cartilage ; Tomography, Spiral Computed* ; Vocal Cords*

BACKGROUND AND METHODS: The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists developed a standardized pathology reporting format for gastric cancer in collaboration with the Korean Gastric Cancer Association. RESULTS: The diagnostic parameters are divided into two part: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by UICC, the WHO classification, and the Korean Gastric Cancer Association classification. Therefore, the standard part is adequate for routine surgical pathology service. We included detailed descriptions on each item. CONCLUSIONS: The authors anticipate that this standardization can improve the diagnostic accuracy and decrease the discrepancies that occur in the pathologic diagnosis of gastric cancer. Furthermore, the standard format can encourage large scale multi-institutional collaborative studies.
Asian Continental Ancestry Group ; Classification ; Cooperative Behavior ; Diagnosis ; Humans ; Neoplasm Staging ; Pathology* ; Pathology, Surgical ; Stomach Neoplasms*

BACKGROUND AND OBJECTIVES: Laser-assisted uvulopalatoplasty (LAUP) is well established in the treatment of snoring and obstructive sleep apnea syndrome (OSAS), although most reports are based on short-term follow-up results. This study was performed to determine the long-term effects on symptoms and polysomnographic measures in patients with OSAS after 5yrs of LAUP. MATERIALS AND METHOD: Fifty patients with OSAS underwent LAUP, and of these patients, 20 have completed postoperative polysomnographic studies. Questionnaires ranking snoring and apneic symptoms were completed by the patient and bed partner before LAUP. The parameters of measurement were apnea index (AI), respiratory disturbance index (RDI), SaO2, and sleep stages. The statistical analysis was performed using Wilcoxon signed rank test. RESULTS: Subjective questionnaires showed statistically significant improvements in snoring, falling asleep while day work, headache upon wakening. The symptomatic improvement persisted long time. The AI decreased from 15.9 to 10.5, RDI decreased from 23.2 to 14.9, and the mean, lowest O2 saturation increased from 85, 93 to 92, 97 (p<0.05). The RDI was reduced to 10 or less in 40% of patients. CONCLUSION: LAUP is an effective method for the management of mild OSAS. Authors have demonstrated long-term improvement in subjective and polysomnographic measures.
Apnea ; Follow-Up Studies ; Headache ; Humans ; Polysomnography ; Surveys and Questionnaires ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep Stages ; Snoring

BACKGROUND AND OBJECTIVES: Some patients who have undergone tonsillectomy complain of voice change, but few studies for the mechanism of voice change were found. To solve this problem, study of voice change after tonsillectomy and adenotonsillectomy was done. MATERIALS AND METHODS: We analyzed voice change of 22 patients who underwent tonsillectomy and 15 patients who underwent adenotonsillectomy at CSL (computerized speech laboratory), St. Benedict Hospital. With the measured cross sectional area of vocal tract and its length from the glottis on MR images, we presented the change of cross sectional area schematically after tonsillectomy. RESULTS: Acoustically, the frequencies of the second formant of /e/ and /i/ increased and that of the first formant of /u/ decreased significantly after tonsillectomy and the frequency of the second formant of /o/ and those of the second and third formants of /i/ and /u/ increased significantly after adenotonsillectomy. It was also showed acoustically that the formant bandwidths of /a/ and /hana/ after tonsillectomy and those of /e/ and /hana/ after adenotonsillectomy increased due to nasalization. Anatomically, it was showed that the cross sectional area of oropharyngeal cavity increased and coupling effect of vocal tract happened after tonsillectomy. CONCLUSION: This study showed that acoustic characteristics and vocal tract shapes of the patients did change following tonsillectomy and adenotonsillectomy. It is imperative that we explain to patients about the postoperative voice change. Research should also be done to find ways to induce better voice changes following the operations.
Acoustics* ; Glottis ; Humans ; Magnetic Resonance Imaging ; Tonsillectomy* ; Voice*

Background: Tuberculosis (TB) survivors have an increased risk of developing chronic obstructive pulmonary disease (COPD). This study assessed the risk of COPD development and COPD-related hospitalization in TB survivors compared to controls. Methods: We conducted a population-based cohort study of TB survivors and 1:1 age- and sex-matched controls using data from the Korean National Health Insurance Service database collected from 2010 to 2017. We compared the risk of COPD development and COPD-related hospitalization between TB survivors and controls. Results: Of the subjects, 9.6% developed COPD, and 2.8% experienced COPD-related hospitalization. TB survivors had significantly higher COPD incidence rates (36.7/1,000 vs. 18.8/1,000 person-years, P < 0.001) and COPD-related hospitalization (10.7/1,000 vs.4.3/1,000 person-years, P < 0.001) than controls. Multivariable Cox regression analyses revealed higher risks of COPD development (adjusted hazard ratio [aHR], 1.63; 95% confidence interval [CI], 1.54–1.73) and COPD-related hospitalization (aHR, 2.03; 95% CI, 1.81–2.27) in TB survivors. Among those who developed COPD, the hospitalization rate was higher in individuals with post-TB COPD compared to those with non-TB COPD (10.7/1,000 vs. 4.9/1,000 person-years, P < 0.001), showing an increased risk of COPD-related hospitalization (aHR, 1.84; 95% CI, 1.17–2.92). Conclusion TB survivors had higher risks of incident COPD and COPD-related hospitalization compared to controls. These results suggest that previous TB is an important COPD etiology associated with COPD-related hospitalization.

BACKGROUND AND METHODS: For standardizing the pathology report and diagnosis of colorectal cancers, the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has developed a pathology reporting format for colorectal cancer in collaboration with the Korean Society of Coloproctology. RESULTS: The diagnostic parameters are divided into two parts: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by AJCC, and the WHO classification. We included detailed descriptions on each item. CONCLUSIONS: The standardized pathology report for colorectal cancers is adequate for its application to routine surgical pathology reports, and it is also helpful to decrease the discrepancies that occur during the pathologic diagnosis of colorectal cancer. Furthermore, this reporting format could encourage nationwide multi-center collaborative studies.
Asian Continental Ancestry Group ; Classification ; Colorectal Neoplasms* ; Cooperative Behavior ; Diagnosis ; Humans ; Neoplasm Staging ; Pathology* ; Pathology, Surgical

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