No abstract available.

Since the patient’s airway is shared between an anesthesiologist and a surgeon, airway management during upper airway surgery can be challenging. Beyond the conventional method of general anesthesia, high-flow nasal oxygenation (HFNO) has recently been used as a key technique for tubeless anesthesia. HFNO provides humidified, heated oxygen up to 70 L/min, which promises improved oxygenation and ventilation, allowing for prolonged apneic oxygenation. In previous physiological and clinical studies, HFNO has been demonstrated that tubeless anesthesia safely provide an uninterrupted surgical field during laryngeal surgeries. Although tubeless anesthesia remains uncommon, it can be a good alternative to conventional anesthesia if an anesthesiologist and a surgeon select appropriate patients together with sufficient experience. A safe strategy for tubeless anesthesia, along with appropriate backup plans, including endotracheal intubation and high-frequency jet ventilation, should be considered for upper airway surgery.

Objective: This study investigated the prevalence and comorbidities of attention deficit hyperactivity disorder (ADHD) among adults and children/adolescents in Korea. Methods: This study used data from the Korea Health Insurance Review and Assessment Service collected from 2008 to 2018. Study participants comprised patients with at least one diagnosis of ADHD (International Statistical Classification of Diseases and Related Health Provisions, 10th revision code F90.0). Prevalence rates and psychiatric comorbidities were also analyzed. Results: We identified 878,996 patients diagnosed with ADHD between 2008 and 2018. The overall prevalence rate of diagnosed ADHD increased steeply from 127.1/100,000 in 2008 to 192.9/100,000 in 2018; it increased 1.47 times in children/adolescents (≤ 18 years) and 10.1 times in adults (＞ 18 years) during this period. Among adult and children/adolescent ADHD patients, 61.84% (95% confidence interval [95% CI] 61.74−61.93) and 78.72% (95% CI 78.53− 78.91) had at least one psychiatric comorbidity, respectively. Conclusion Our results showed that the prevalence rate of diagnosed ADHD has increased in Korea; however, it is lower than the global average. Further studies are required to identify and treat vulnerable populations appropriately.

Dermatofibrosarcoma protuberance is a relatively rare malignant soft tissue tumor which is locally invasive and looks like a protruded hardened plaque composed of multiple nodules. It seldom occurs on the scalp and the occurrence rate is less than 5%. Nowadays there is a tendency to choose Mohs surgery as a primary treatment instead of a wide excision, because Mohs surgery can reduce cases of recurrence. We report a case of multiple dermatofibrosarcoma protuberans on the scalp of a 32-year-old man. We planned a delayed operation using tissue expanders. We inserted two skin expanders and successfully expanded scalp tissue more than 150% after 7 months. Mohs surgery was performed with a 4 cm distance from borderline of lesions and then the large scalp skin defect was covered by the expanded skin which had been prepared by tissue expanders. It has been 9 months since the operation was performed and there have been no signs of recurrence.
Adult ; Dermatofibrosarcoma* ; Humans ; Mohs Surgery* ; Recurrence ; Scalp* ; Skin ; Tissue Expansion Devices ; Tissue Expansion*

BACKGROUND: Xanthelasma palpebrarum is the most common type of xanthoma. Due to its delicate location near the eye, treatment of xanthelasma palpebrarum is rather difficult. The treatment includes surgical excision, local treatment with chemicals, and various laser therapies. OBJECTIVE: This study was designed to review the various therapeutic modalities and to evaluate the efficacy and safety of bichloroacetic acid (BCA) for the treatment of xanthelasma palpebrarum. METHODS: Nine patients, with a total of 19 xanthelasma lesions, were treated with BCA. The efficacy and safety were assessed over a follow-up period of 6 to 24 months (average, 16 months). RESULTS: All lesions were grossly removed completely with a single treatment and the treatment was well-tolerated by patients. Erythema and oozing were observed in six patients but improved after two weeks' dressing. Xanthelasma palpebrarum recurred in three patients, but the mean size of the recurred lesions was smaller in comparison to the primary lesion. CONCLUSION: BCA is an effective and safe therapeutic modality for xanthelasma palpebrarum. Advantages include simplicity, cost-effectiveness, speed, safety and efficacy.
Bandages ; Dichloroacetic Acid* ; Erythema ; Follow-Up Studies ; Humans ; Laser Therapy ; Xanthomatosis

Heterotopia refers to the finding of normal tissue in foreign sites, entirely separate from the main organ. Heterotopic gastric mucosa has been observed throughout the alimentary tract, everywhere from the oral cavity to the rectum. However, occurrences in the umbilicus are an extremely rare and peculiar phenomena. We report the case of heterotopic gastric mucosa in the umbilicus.
Gastric Mucosa ; Mouth ; Rectum ; Umbilicus

Objectives : Recently, several attempts have been made to use repeated transcranial magnetic stimulation (rTMS) with various stimulation frequencies as a novel treatment for patients with obsessive-compulsive disorder (OCD). However, findings about the efficacy of rTMS in treating OCD have been inconsistent. In the present study, we evaluated the clinical effect and safety of low frequency rTMS on the right dorsolateral prefrontal cortex in the treatment of refractory OCD. METHODS : Twenty-four patients with treatment-refractory OCD received a daily treatment of 20 minutes low frequency rTMS (1 Hz) to the right dorsolateral prefrontal cortex with power of 100% of motor threshold, for 15 days. Clinical status was evaluated using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Anxiety Scale (HAMA), and Clinical Global Impression (CGI) at baseline, at the end of the rTMS treatment (3 weeks), and 4 weeks after finishing the rTMS treatment course. RESULTS : After 3 weeks treatment with low frequency rTMS, Y-BOCS, HAMA and CGI-S scores were significantly decreased. CONCLUSION : The present study found that low-frequency rTMS on the right prefrontal cortex for 3 weeks showed significant therapeutic effects in patients with OCD. Further controlled trials are indicated to assess the efficacy of rTMS in the treatment of OCD.
Anxiety ; Humans ; Obsessive-Compulsive Disorder ; Prefrontal Cortex ; Transcranial Magnetic Stimulation

BACKGROUND: Current blood and blood components are prepared from 320ml or 400ml blood collection. The analytic values and standard values of blood and blood components were evaluated at Seo-Bu Blood Center, The Republic of Korea National Red Cross, Seoul, Korea. METHODS: Blood and blood components were analyzed with weight, specific gravity, content volume, RBC counts, WBC counts, platelets counts, hemoglobin, hematocrit, pH, total protein, albumin, factor VII and bacterial culture. RESLUTS: The volume, hemoglobin, hematocrit and pH of 320ml and 400ml standard unit of whole blood was 328 +/- 31ml and 405 +/- 22ml, 12.7 +/- 1.7g/dl and 14.8 +/- 2.0g/dl, 38.0 +/- 4.0% and 40.8 +/- 4.6%, mean of 7.16 and 7.13, respectively. The volume and hematocrit of packed red cells prepared from 320ml and 400ml standard unit of whole blood was 188 +/- 23ml and 248 +/- 23ml, 73.2 +/- 4.7% and 72.6 +/- 5.4%, respectively. Leukocytes poor red cells from 400ml standard unit of whloe blood showed 225 +/- 12ml of volume, 71 +/- 2.4% of hematocrit, and WBC removal was 87 +/- 5%. The volume, hematocrit and total protein in washed red cells was 224 +/- 11ml, 59 +/- 6.0% and 0.10 +/- 0.05g/unit, respectively. Leukocytes concentrates revealed 50 +/- 4.6ml of volume, 2.0 +/- 0.5x109/unit of WBC count and WBC recovery was 78 +/- 6.0%. Platelet concentrates prepared from 320ml and 400ml standard unit of fresh whole blood showed 38 +/- 3ml and 48 +/- 3ml of volume, 4.68 +/- 1.60x1010 and 5.55 +/- 1.80x1010 of platelet per unit, and 7.05 +/- 0.25 and 6.95 +/- 0.34 of pH, respectively. The fresh frozen plasma from 320ml standard unit of whole blood contained 143 +/- 25ml of volume, and that from 400ml whole blood showed 161 +/- 27ml of volume and 112 +/- 33 IU/unit of factor VII. The cryoprecipitate from 320ml whole blood showed 42 +/- 3ml of volume and 81 +/- 9 IU/unit of factor VII. There were no bacterial growth for all the components inoculated. CONCLUSION: At Seo-Bu Blood Center, we evaluated the characteristics of current blood and blood components, and established the standard values for whole blood (320ml, 400ml) as well as packed red cells, leukocytes poor red cells, washed red cells, leukocyte concentrates, platelet concentrates, fresh fozen plasma and cryoprecipates from 320ml and 400ml whole blood based on the present studies. Compared to the Standards for Blood Banks and Transfusion Services, American Association of Blood Banks, values of evluated items of current blood and blood components showed comparable results, but platelet counts from 320ml collection did not meet to those standards.
Blood Banks ; Blood Platelets ; Factor VII ; Hematocrit ; Hydrogen-Ion Concentration ; Korea ; Leukocytes ; Plasma ; Platelet Count ; Red Cross ; Republic of Korea ; Seoul ; Specific Gravity

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus